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Developing the use of 'MDS-RAI' reports for UK care homes
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2008
- Pagination:
- 4p.
- Place of publication:
- York
The MDS-RAI (the Minimum Data Set Resident Assessment Instrument) is a standardised assessment system developed by interRAI used internationally to raise standards of care in long-term care homes. Implementation in the UK has been sparse and currently there are no well-established demonstration sites for use in long-term care (although Cheshire has adopted and successfully implemented the MDS-HC (the Minimum Data Set Home Care) for community care). Successful implementation of the MDS-RAI requires a methodical approach and commitment: it is a way of developing best practice that goes far beyond just gathering information about care needs. This project aimed to develop an implementation process model for MDS-RAI use in three UK care homes through an iterative and collaborative process.
Planning for continuing care retirement communities: issues and good practice
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2006
- Pagination:
- 4p.
- Place of publication:
- York
Few continuing care retirement communities (CCRCs) have been developed in the UK, although they are expected to become increasingly common. As a relatively new concept, there is a general lack of understanding of the characteristics and role of CCRCs and the issues they raise. This analysis of current and emerging policy and practice is intended to provide practical assistance to those involved in the planning and development process, especially local authority planning officers.
Options for financing private long-term care
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2005
- Pagination:
- 4p.
- Place of publication:
- York
Long-term care provision in the United Kingdom has been the subject of much debate and analysis over the past decade, yet the issue of how to fund the cost of that care for future generations remains unresolved. Much of the debate has revolved around how the State should address the problem. As a consequence, the general public are unsure as to where their responsibilities and liabilities lie. There is a perceived unfairness around the current system which leaves significant financial responsibility resting with the individual above basic income and asset levels. Insurance plans designed to cater for the cost of care in later life have not been popular. As a result, most insurers have now withdrawn from this market.Investment-based plans have failed to maintain protection levels and have now also been withdrawn from the market. Annuities specially designed to fund care fees and which recognise reduced life expectancy do provide a solution for some, but access to advice at a time of crisis may be difficult. Equity release or lifetime mortgages are popular but are not being used as a way to fund care. The current pensions ‘crisis’ bears many of the same hallmarks as those relating to long-term care planning. As with the Pensions Commission Report, there does not appear to be one single solution to the problems surrounding long-term care. A combination of measures may be more likely to succeed.
Care and support - a community responsibility?
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2008
- Pagination:
- 12p.
- Place of publication:
- York
In this Viewpoint the author asserts that demographic and societal changes mean there will be a growing shortfall of family carers. It is argued that the wider community must therefore expect to play a growing role. This will also provide an opportunity to end social care's marginalisation.
Paying for long-term care: moving forward
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2006
- Place of publication:
- York
The UK lacks an adequate system for paying for long-term care. It falls short in three main ways: In overall funding levels, there are already signs that needs are going unmet. Without change, private individuals will have to foot a growing share of rising costs, and many will find this hard to afford. In coherence, multiple funding streams create confusing and sometimes irrational, overlapping ways of paying for care. In fairness, in terms of the way costs and responsibilities are shared, family carers often feel unsupported. Means-testing causes widespread resentment by taking away most of people's assets and income before they can get state help.
Lessons from the funding of long-term care in Scotland
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2006
- Pagination:
- 4p.
- Place of publication:
- York
The introduction of free personal care has not reduced the level of informal caring. Free personal care at home supports informal carers and helps them provide other forms of care. Differences between Scotland and the rest of the UK in the public costs of personal and nursing care are smaller than popularly assumed. In Scotland, residential clients no longer receive Attendance Allowance (£61 per week at the higher rate; in the rest of the UK, care home residents continue to receive Attendance Allowance and more generous provision for nursing care. Payments for nursing care in Scotland are fixed at £65 per week; the highest rate currently payable in England is £129. Although the costs of free personal care have been higher than initially predicted, their current value amounts to only 0.2 per cent of Scottish GDP or 0.6 per cent of Scottish Executive spending. Demographic change and real cost rises of 2 per cent per annum would cause these costs to triple by 2053, although they will still be a relatively small share of GDP.
Living in the community after leaving long-stay hospital: findings
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 1994
- Pagination:
- 4p.
- Place of publication:
- York
Long-term hospital and institutional care for people with learning difficulties are rapidly being phased out in favour of living in the community. A study of people with learning difficulties who had left long-stay hospital residence five years earlier found that significantly better outcomes and opportunities had been achieved in the community at the expense of a modest increase in costs.
Future costs of long-term care for older people
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2004
- Pagination:
- 4p.
- Place of publication:
- York
Long-term care spending in the UK would need to rise by around 315 per cent in real terms between 2000 and 2051, to meet demographic pressures and allow for real rises in care costs, if dependency rates, patterns of care and funding arrangements remain unchanged. On this basis, spending on long-term care would need to increase from about 1.4 per cent of GDP in 2000 to around 1.8 per cent of GDP in 2051, assuming a real increase of 2.25 per cent a year in GDP. This projection of 1.8 per cent of GDP in 2051 using the 2002-based official population projections updates an earlier projection of 1.6 per cent of GDP in 2051 using the 2000-based population projections. These projections are sensitive to assumptions about trends in life expectancy, dependency rates and real unit costs of care, as well as changes in patterns of care and funding systems.Public expenditure on long-term care is projected to reach around 1.2 per cent of GDP in 2051 under current funding arrangements and around 1.5 per cent of GDP in 2051 under a policy of free personal care with an assumed 25 per cent increase in demand for domiciliary services. The share of total long-term care costs met publicly is projected to be almost 80 per cent in 2051 under a policy of free personal care, as against around 66 per cent under current funding arrangements.
Residents' views of a continuing care retirement community
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2003
- Pagination:
- 4p.
- Place of publication:
- York
Hartrigg Oaks in New Earswick, York, is the first example in the UK of a Continuing Care Retirement Community (CCRC). This non-profit-making community, developed without government subsidy and run by the Joseph Rowntree Housing Trust, has a financing system unique in the UK. Capital payments and annual fees from each resident are pooled to fund care and support services for all the residents. This allows Hartrigg Oaks to charge a flat rate, inflation-linked fee, that will not rise even if a resident needs permanent residential care. (Residents can opt to pay for care as needed.) The objective is to achieve a balance between those residents who need care and support and those who do not make many demands on its care services. Hartrigg Oaks must therefore try to ensure that it has the right 'balance' of residents and appeals to the 'young-old' who anticipate living independently for some years to come. All potential residents undergo a health check.
Private welfare insurance and social security: findings
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 1997
- Pagination:
- 4p.
- Place of publication:
- York
Where the boundaries are drawn between collectively financed social security and individually financed private provision affects the lives of everyone and the allocation of a large fraction of the national income. The authors used three case studies - insurance against care costs in old age, income replacement during long-term sickness or disability, and cover for mortgage payments if earnings are interrupted - to examine the potential effects of shifts from public to private provision.