Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-12-03T19:26:38.240Z Has data issue: false hasContentIssue false
  • English
  • Français

Choice in Residential Care: Myths and Realities*

Published online by Cambridge University Press:  20 January 2009

John A. Vincent ,
Alan D. Tibbenham  and
David R. Phillips
Get access Rights & Permissions [Opens in a new window]

Abstract

This paper examines the proposition that the welfare policies enacted and legitimised in the name of ‘choice’ have the effect of increasing the effective choice of service by consumers of welfare. The example of residential care of the elderly is used to illustrate the ways in which privatisation has influenced choices of care for elderly people in Devon. The paper reviews empirical material from two surveys of private homes in Devon in order to throw light on the ‘myths’ and realities of choice in residential accommodation and in other welfare provision available to the elderly in Devon. The paper identifies as the key debate the question of priorities: whether resources should be concentrated on providing suitable residential places for the increasing number of the very disabled elderly or used to increase the alternatives for the larger, more able groups. The latter option can perhaps be reasonably achieved through market mechanisms, whilst the former is more likely to require the specialised skills of social workers and other caring professionals. Although it is possible to argue that the growth in numbers of private old people's homes represents an increase in choice for the elderly, on closer examination this appears too simple an assertion. The expansion of the private sector has not necessarily expanded the range of alternative forms of care. In particular, there seems a major flaw in current policies by which the operation of the DHSS subsidy increases the availability of residential rather than domiciliary care.

Type
Articles
Information
Journal of Social Policy , Volume 16 , Issue 4 , October 1987 , pp. 435 - 460
Copyright
Copyright © Cambridge University Press 1987

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Association of Directors of Social Services (1985), Who Goes Where?, ADSS, 09 1985.Google Scholar
Audit Commission (1986), Making a Reality of Community Care, HMSO, London.Google Scholar
Boldy, D. (1983), ‘When the doors close on the dependent’, Health and Social Services Journal, 26.5.83, pp. 626–7.Google Scholar
Boldy, D., Twynam, C. and Kuh, K. (1982), Longitudinal Study of Resident Dependency and Staffing in Registered Private Homes in Devon, Institute of Biometry, University of Exeter.Google Scholar
Ross, R. Brooke (1985), ‘Regulation of residential homes for the elderly in England and Wales’, Journal of Social Welfare Law, 03 1985, pp. 85–94.Google Scholar
Carson, D. (1985a), ‘Registering homes: another fine mess?’, Journal of Social Welfare Law, 03, pp. 67–84.Google Scholar
Carson, D. (1985b), ‘At home with the law’. Health and Social Services Journal. 21.3.85, pp.356–357.Google Scholar
Centre for Policy on Ageing (1984), Home Life: A Code of Practice for Residential Care, CPA, London.Google Scholar
Challis, L. (1982), Private and Voluntary Residential Provision for the Elderly: Report of an Exploratory Study of Residential and Nursing Homes in the City of Bath, Centre for the Analysis of Social Policy, University of Bath.Google Scholar
Challis, L. (1983), Regulation in Welfare: Purposive Control and Non-Purposive Influences on Private and Voluntary Homes for the Elderly, Centre for the Analysis of Social Policy, University of Bath.Google Scholar
Challis, L., Day, P. and Klein, R. (1984), ‘Residential care on demand’, New Society, 5.4.84, p.32.Google Scholar
Challis, L. (1986), ‘Robbing Peter to pay Paul—handsomely’, Social Services Insight, 16.8.86, pp. 12–14.Google Scholar
Charlesworth, A. and Wilkin, D. (1982), Dependency Among Old People in Geriatric Wards, Psychogeriatric Wards and Residential Homes 1977–1981, Research Report No. 6, Psychogeriatric Unit, University Hospital of South Manchester.Google Scholar
CIPFA, Personal Social Services Statistics Actuals, 1980/1 and 1984/5.Google Scholar
Devon County Council (1985), Services for Elderly People: Progress Report to the Joint Consultative Committee (Health), 18.10.85.Google Scholar
Dowson, S. (1985), ‘Residential and nursing home care for the elderly: a review of recent research’, University of York: Social Policy Research Unit. DHSS 238 2.85 SD.Google Scholar
Herington, S. (1985), ‘Private care at public cost: the need for action’, Critical Social Policy. 12, pp.79–82.Google Scholar
Johnson, M. (1983a), ‘A sharper eye on private homes’, Health and Social Services Journal, 4.8.83, pp.930–932.Google Scholar
Johnson, M. (1983b), ‘Controlling the cottage industry’, Community Care, 25.8.83, pp.16–18.Google Scholar
Kellaher, L.S., Peace, S., Weaver, T. and Willcocks, D. (1986), Researching the Private Residential Sector, Centre for Environmental and Social Studies in Ageing, Polytechnic of North London.Google Scholar
Law, C.M. and Warnes, A.M. (1976), ‘The changing geography of the elderly in England and Wales’, Transactions of the Institute of British Geographers, NS 1, pp.453–471.CrossRefGoogle ScholarPubMed
Leaper, R. (1986), At Home in Devon, University of Exeter.Google Scholar
Grand, J. Le and Robinson, R. (1984), Privatisation and the Welfare State, George Allen and Unwin, London.Google Scholar
McCoy, P. (1983), ‘Private Lives’, Community Care, 22.9.83, pp.18–19.Google Scholar
Miller, C. and Sinclair, I. (1987), ‘Half a reality is better than none’, Social Services Insight, 6.2.87, pp.23–25.Google Scholar
Phillips, D. and Vincent, J. (1985), ‘Private residential care for the elderly in Devon: Working Paper I’, Faculty of Social Studies, University of Exeter.Google Scholar
Phillips, D. and Vincent, J. (1986a), ‘Private residential accommodation for the elderly: geographical aspects of developments in Devon’, Transactions of the Institute of British Geographers, NS 11, pp. 155–173.Google Scholar
Phillips, D. and Vincent, J. (1986b), ‘Petit bourgeois care: private residential care for the elderly’, Policy and Politics, 14:2, pp.189–208.Google Scholar
Shaw, W. (1986), ‘Inappropriately placed’, Social Services Insight, 16.8.86, pp.19–21.Google Scholar
Tibbenham, A. (1985), Private and Local Authority Care of the Elderly in Devon, Devon County Council Social Services Department, Research Section, Exeter.Google Scholar
Tinker, A. (1987), ‘Variety and planning for the growing old’. Town and Country Planning, 56:3, 03, pp. 74–5.Google Scholar
Warnes, A.M. and Law, C.M. (1984), ‘The elderly population of Great Britain: locational trends and policy implications’, Transactions of the Institute of British Geographers, NS 9, pp.37–59.Google Scholar
Weaver, T., Willcocks, D. and Kellaher, L. (1985a), ‘The pursuit of profit and care: patterns and processes in private residential homes for old people’, Centre for Environmental and Social Studies in Ageing, The Polytechnic of North London.Google Scholar
Weaver, T., Willcocks, D. and Kellaher, L. (1985b), ‘The business of care: a study of private residential homes for old people’, Centre for Environmental and Social Studies in Ageing, The Polytechnic of North London.Google Scholar
Wenger, C. (1984), The Supportive Network, George Allen & Unwin, London.Google Scholar
Wenger, C. (1985), ‘Care in the community’, Ageing and Society, 5, pp.143–159.Google Scholar
Wynne-Harley, D. (1986), ‘Ensuring elderly people are in the right place at the right time’, Social Services Insight, 16.8.86, pp.2–3.Google Scholar