“Residential No Care”

Around 30 years ago I spoke at Birmingham City Hall at a conference about the future of care homes for older people.  I controversially suggested that all residential homes should be shut down within 10 years.  I was assailed by the Lady Chairman of the Residential Care Homes Association and received only half hearted support from the then Director of Social Services.  Needless to say, nothing came of my radical proposition.

Now my old friend Mr Paul Burstow, former Care Minister until 2012, has suggested in a Demos Report that care homes should be “re-branded as housing with care”, to overcome their poor reputation.

While I am sorry Mr Burstow, changing the name won’t change the nature.

Boredom and loneliness still typify many residential homes, so does poor care and unqualified staff.  Neglect and abuse lie just below the surface – there were 7,654 cases of reported abuse in 2013.  How many more examples never get reported for fear of recrimination?

This is nothing new and it is a pity it took a Government Minister responsible for the sector, so long to learn it.  It is even more of a shame that he did not feel able to say it until after he stood down as Care Minister.

There are 450,000 older people currently living in residential care homes in this country.  Estimates in this Demos Report suggest there will need to be another 239,000 places in full time residential care by 2030.

Yet most elderly people view the prospect of moving into a care home as a last resort.  A place to die, not a place to live.

Yes Mr Burstow, the image needs to change, but this will only happen when the reality changes and that requires much more than re-branding.

The system of funding residential care is the fundamental issue, which successive Governments have failed to address.  Nor have they been honest with the electorate in saying there is not enough public money to pay for all the residential care.  The original Dilnot Report proposals attempted to stimulate new insurance products to cover long-term care costs but the coalition Government, of which Mr Burstow was a member, watered down the proposals and nothing new has come forward.

So, 30 years on from when I suggested abolishing residential care homes, very little has changed, except that we now have many more:-

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2 Responses to “Residential No Care”

  1. This subject is a difficult discussion to have! It may take realisation of the general populus, that all is not free! in this world of ours, and that social help in the manner of time and monies are required to help solve the problem.
    To thier credit some of the care home/residential home providers do provide the support and give attention to the elderly and their problems: However this is at a cost!!!!
    When one needs/requires support and care does one then apply for a place in a care home/residential home??? Why not ask the question does not a residential/care home offer support and an environment in which one may enjoy the company of others, and stimulation to assist others and oneself in a more fullfilling way of life as a total social community.
    It would cost and government support would be needed, However the revised outlook and philosphy of care and support for the elderly may benifit all parties Political as well as individuals, and with the current deadlock of the private/shared ownership housing market, give some incentive to be more realistic in its approach to financial expectations, and freeing up much need homes to the younger population of UK plc. It may be a pipe dream, and all sweetness and honey for today, but it does require commitment from some of our political and philanthrapist classes.
    A Care Home/residential home may be a place where one spends their last days and dies: However one should be able to enjoy the intervening time and maybe reflect as one meets st. Peter repeating That was a great place, I have had a fullfilling and a great time of my life.

    • Following on from the above comments, and the slogan ‘No Care Homes’, I must bring a little realisation of what may be if one had the energy, enthusiasm and finance with political will, then maybe one can realise what a retirement care, and support elderly community can become.
      This is my personal vision based on an original concept by John Graham and his board of directors of the ‘Extracare Charitable Trust’ of Coventry.
      The basic concept is a living community for elderly people, of mixed social standing, and all with an independent mind of what they may wish as individuals: with the appreciation of how they can help support a social and cohesive community.
      The retirement village concept of some 250-300 apartments is a reasonable one. The mix being with two bedroom and one bedroom apartments ( for lease/shared and social occupation) for with easy access for all wheelchair bound persons within the village areas and in each apartment- through each doorway, fixed pull cords/telephone connections/smoke and fire alarms in all rooms including the wet room, as appropriate.
      Each room of the apartment must allow free movement of a well chair- this is important in the living room and bedrooms when furnished.
      As for the retirement care support aspect of living one has to consider life style and the age groups envisaged, and the estate management and support.
      In modern parlance ‘Care in the home’ is the objective’ for those seeking support: There has to be consideration of how a modern retirement village ages gently with its residents.
      Originally the age for initial consideration is/was 65 years of age, with the aging society and health well being then this initial age may now have crept up to 65+ but before 70 years of age As all residents are mainly retiree’s then consideration has to be given to their individual outlook on life, and how active they wish to remain in a retirement village society. With this objective in mind volunteering (Non Payment Time) is essential in assisting the management of the retirement village, in keeping interest in the village life and actively helping one’s self as one helps one neighbour, and become socially integrated in retirement village life.
      To bring this all to life one needs behind the scenes a gentle management organisation that is receptive to ideas from its resident (Via an active resident groups, such as residents association, entertainment groups, activity and craft groups, which organise free time activities). Then there is the village mobility and age profile and well being policy where the health and welfare of each resident is actively considered, and constantly monitored so that replacement/new incoming residents with their foibles do not over shadow the general mobility and support required or the ability to promote a sound volunteering policy.( hear one does not need or wish to consider an unbalanced social society on total care and immobility, or on the other hand young and fit elderly who do not appreciate and fully understand the need or requirement for wellbeing and health support.
      In consideration of a retirement village viable for all activities and financial returns the management may have to consider, and should consider the following- All areas of the village and is passageways to all apartments should permit the safe passage of two mobility scooter or wheel chairs at any point in the alleyway/passage, and have charging points and alcoves outside each apartment to recharge all mobility scooters and electric wheelchairs.
      With respect to the public areas, and for the benefit of all residents, there should be consideration given to providing the following:
      Large reception area and reception desk (Manned and assisted by volunteers)
      A corner shop supported by volunteers (Finance by franchise)
      A library free to use with books/tapes and CD’s
      A Craft room sufficient for 30 persons at a session, with ample storage space for goods and chattels of the various craft and activity groups
      A cafe come licensed/bar (Aided and assisted by volunteers) area with a large snooker games table and sufficient room for easy chairs and tables to host entertainment evenings
      A village IT suite with access to the Internet (with volunteer helpers), and the village information internal TC circuit
      A beauty and hairdressing saloon (Unisex)
      A fully functional gymnasium with machines and appliance and a staff member to hep and advise in the well being of residents as they cope with the ailments of old age.
      A private consultancy room for a well being nurse, in advising on health problems as suffered by age and the elderly and that reassurance when medical back up is required.
      A Hobbies wood work room with woodworking machinery and benches-manned entirely by volunteers and residents
      A Village Hall for those large gatherings and activities such as dance or shows or indoor bowls require a lot of space.
      A professional staffed restaurant and kitchen to provide sustenance and support for the cafe/bar, for use by the residents and families and friends. This is manned by staff, and helped with volunteers according to their skills Front and rear of house.
      It is important that some form of greenhouse facility is provided to enable residents to develop skills in plant husbandry and assist as volunteers with the upkeep of their individual gardens and the general well being of the site in general.
      IT IS IMPORTANT THAT the village hall and restaurant can become on large space for general celebrations for the whole of the village residents (300 persons) to meet and enjoy a summer barbecue or jubilee or state occasion.
      Then included should be a further two meeting rooms for 14 to 25 persons, (For formal staff training and residents family occasions (Celebrations and wakes)
      A Further space that is considered essential is a meeting/activity room for some 45-50 persons, with a communal kitchen for activities such as the meeting of well fare groups (religious/alzhimiers) and when not occupied for social card evenings, staff training/family occasions, and that forgotten gathering such as a cheese and wine party where the village hall is too large
      A further aspect is a family room for overnight family guests to reside in while visiting relatives. (This is paid for by the individual guests)
      The concept behind the village maybe heavily based on the social engineering required: however the basic building and its surrounds must give consideration to its grounds/gardens (Where one can quietly contemplate and have a few quiet thoughts. Such things as gardens/ outdoor all weather single bowling green. An indoor short bowls matt, within the resident’s area.
      Last of all the complex must feel secure with CCTV in all public areas and at all points of exit egress, with ample lift provision if the complex is multi-storey. The building and individual spaces should have the facility to be heated independently and to a temperature at an adequate temperature. Sound proofing is a must to isolate all unwanted noise levels both internal (To be heard by a resident) and external noises by adequate levels of sound proofing. All electrical plugs and control devices set at a reasonable height to be wheelchair friendly.
      Do not forget the village management need to provide permanent staff, for administration, maintenance, support (Care in the home) and housekeeping, they must have a sufficient office suite to provide for the safe running of the village with offices and rest room space and store rooms, including overnight staff accommodation for senior staff on call.
      It all costs, however if carefully thought out the concept can reach a wide audience in this aging UKplc.
      This life is not for everyone, and that is accepted but if you are of a mind then the web site ‘The Extracare charitable trust org.uk, or a visit to one of their retirement villages in your own location maybe well worth a visit.

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