Book contents
- Frontmatter
- Contents
- List of tables and figures
- Advisory Group members
- Acknowledgements
- one Setting the scene
- two Community care and the modernisation of welfare
- three Targeting, rationing and charging for home care services
- four The changing role of local authority residential care
- five The shifting boundaries between health and social care
- six Towards a mixed economy of social care for older people?
- seven Towards quasi-markets in community care
- eight Developing community care for the future: lessons and issues from the past
- References
- Index
four - The changing role of local authority residential care
Published online by Cambridge University Press: 20 January 2022
- Frontmatter
- Contents
- List of tables and figures
- Advisory Group members
- Acknowledgements
- one Setting the scene
- two Community care and the modernisation of welfare
- three Targeting, rationing and charging for home care services
- four The changing role of local authority residential care
- five The shifting boundaries between health and social care
- six Towards a mixed economy of social care for older people?
- seven Towards quasi-markets in community care
- eight Developing community care for the future: lessons and issues from the past
- References
- Index
Summary
Introduction
The focus of this chapter is on the changing nature of local authority residential care from 1971 to 1993 in terms of such issues as capital investment, the level of dependency of residents, the impact of market competition and the growing emphasis on consumer rights.
Our previous research explored the role of such care in the earlier period from the outbreak of the Second World War through to the creation of social services departments in April 1971 (Means and Smith, 1998a). The study focused on how the 1948 National Assistance Act attempted to replace the old public assistance institution with a new form of nonstigmatising residential home to be run by local authorities:
The old institutions are to go altogether. In their place will be attractive hostels or hotels, each accommodating 25 to 30 old people, who will live there as guests not inmates. Each guest will pay for his accommodation – those with private income out of that, those without private income out of the payments they get from the National Assistance Board – and nobody need know whether they have private means or not. Thus, the stigma of ‘relief ’ – very real too, and acutely felt by many old people – will vanish at last. (Public Assistance Officer, quoted in Means and Smith, 1998a, p 155)
Yet the expected new homes were not built in the 1950s because of general restrictions on capital investment programmes during the post-war period of austerity and because older people were seen as a low priority for whatever capital was available.
Local authorities coped with this situation in two main ways. First, they continued to make extensive use of former public assistance institutions. A Ministry of Health (1959) report suggested many of these buildings had been updated (large dormitories partitioned, ceilings lowered, new heating systems installed, floors carpeted, and so on) but that “nevertheless there are still former institutions which have shown little change since 1948” (p 239). Second, large existing homes were bought, often “in splendid grounds, offloaded onto the market by the erstwhile wealthy, left servantless and impoverished by the war” (Kemp, 1973, p 496). Such homes were often in luxurious surroundings, but tended to be in very isolated positions and with very limited access for disabled people.
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- From Community Care to Market Care?The Development of Welfare Services for Older People, pp. 49 - 72Publisher: Bristol University PressPrint publication year: 2002