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Uncovering history: private sector care homes for older people in England
- Authors:
- JOHNSON Julia, ROLPH Sheena, SMITH Randall
- Journal article citation:
- Journal of Social Policy, 39(2), April 2010, pp.235-253.
- Publisher:
- Cambridge University Press
- Place of publication:
- Cambridge
During research for The Last Refuge (1962), Peter Townsend visited 173 public, voluntary and private residential care homes for older people in England and Wales. This article, drawing on this old data now archived at the University of Essex, traces the subsequent history of these homes, revisiting a small sample that were still operating as care homes in 2006. The authors, focusing on the 42 private homes he previously visited, some of which remain open and were revisited by during the current research in 2005/6, note that the pre-1980 history of private sector residential care provision for older people is an elusive and poorly charted subject. Drawing on the two data sets for then and now, this article aims to contribute new insights into this area of UK policy and practice history, by drawing comparison in terms of the physical environment of the residential care home, the resident’s and staff’s opinions, and, using the Commission for Social Care Inspection reports, a measure of quality.
Death and dying in residential care: a matter of concern
- Author:
- SMITH Randall
- Journal article citation:
- Quality in Ageing and Older Adults, 14(3), 2013, pp.205-217.
- Publisher:
- Emerald
Purpose – The purpose of this paper is to trace the history of official policy on the regulation of care homes in respect of end of life care and to contrast this with the results of research on this important theme, not least in terms of what is required to support care home staff in relation to dying residents and their relatives. A central concern is to argue for the open recognition that care homes now cater primarily for frail people towards the end of their lives. Good end of life care and a good death could become a positive “selling point”. The author concludes that the system of regulation has broadly failed to address a good death or good end of life care in a residential home. Death talk should no longer need to be avoided in care homes. The research suggests that appropriate support for care home staff in relation to dying residents needs careful identification and investment. A cultural shift is required. Design/methodology/approach – Following a review of policy documents on regulation and standards of care in residential homes and a subsequent review of the research literature on death and dying in care homes, the paper illuminates the contrast between the ambitious aims in policy documents with very varied practice in everyday care of frail residents. Findings – The recent systems of regulation have broadly failed to address a good death or good end of life care in residential homes. Open acknowledgement of death and dying should not be avoided in care homes. Appropriate support for care home staff in relation to dying residents needs careful identification and investment. Originality/value – The focus of this paper is to contrast official policy with everyday practice. Whilst policy documents suggest recognition of the importance of dignity and respect from dying residents, the research literature indicates great variation in the practice of everyday care. (Publisher abstract)