Skip to main content

Shelter-with-Care and the Community Care Reforms — Notes on the Evolution of Essential Species

  • Chapter
Residential versus Community Care
  • 30 Accesses

Abstract

The potential role of various forms of residential care — ‘shelter-withcare’ — for elderly people and people with disabilities is the subject of this chapter. The blurring of the boundaries between residential and community-based services in the most innovatory forms of community care is described and the inhibiting effect on such developments of the narrow dualistic conception of residential care within communities acknowledged. Professor Davies’ chapter forges a link between the critique of dualistic conceptions of how communities care, made in earlier chapters, and the accounts which follow of the diversity of roles that good-quality residential facilities can play in promoting community care. The conclusion is that reform of community care in the UK, far from sounding the death knell of residential institutions, provides opportunities for their more complete integration into caring communities.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Ansello, E.F. and Eustis, N.N. (1992) A common stake?: investigating the emerging ‘intersection’ of aging and disabilities. Generations, 16:49–52.

    Google Scholar 

  • Atkinson, A. and Stiglitz, J. (1980) Lectures in Public Economics. London, McGraw-Hill.

    Google Scholar 

  • Audit Commission (1992) Exhibit 6 Community Care: Managing the Cascade of Change. London, Audit Commission.

    Google Scholar 

  • Audit Commission (1996) Balancing the Care Equation: Progress with Community Care. London, Audit Commission.

    Google Scholar 

  • Batavia, A.I., DeJong, G., McKnew, L.B. and Bouscaren, L. (1991) Toward a national personal assistance program: the independent living model of long-term care for persons with disabilities. Journal of Health Policy and the Law, 16:523–42.

    Article  Google Scholar 

  • Baumol, WJ., Panzar, J.C. and Willig, R.D. (1982) Contestable Markets and the Theory of Industrial Structure. New York, Harcourt Brace Jovanovich.

    Google Scholar 

  • Bayley, M.J. (1973) Mental Handicap and Community Care. London, Routledge & Kegan Paul.

    Google Scholar 

  • Caldock, K. (1994) The new assessment: moving towards holism or new roads to fragmentation, in Challis, D., Davies, B. and Traske, K. (eds) Community Care: New Agendas and Challenges from the UK and Overseas. Aldershot, Arena, pp. 133–48.

    Google Scholar 

  • Caldock, K. and Nolan, M. (1994) Assessment and community care: are the reforms working? Generations Review, 4(4): 2–4.

    Google Scholar 

  • Challis, L. and Bartlett, H. (1987) Old and Ill: Private Nursing Homes for Elderly People, Research Paper 1. Mitcham, Surrey, Age Concern England.

    Google Scholar 

  • Cohen, C., Gold, D., Shulman, K. et al. (1993) Factors determining the decision to institutionalise dementing individuals: a prospective study. Gerontologist, 33(6):714–20.

    Article  Google Scholar 

  • Colerick, E.J. and George, L.K. (1986) Predictors of institutionalization among caregivers of patients with Alzheimer’s Disease. Gerontologist, 34: 493–8.

    Google Scholar 

  • Darton, R., Jefferson, S., Sutcliffe, E. and Wright, K. (1987) The PSSRU/CHE Survey of Residential and Nursing Homes: The Costs and Charges of the Surveyed Homes, PSSRU Discussion Paper 563/3. Canterbury, University of Kent at Canterbury.

    Google Scholar 

  • Davies, B.P. (1968) Social Needs and Resources in Local Services. London, Joseph.

    Google Scholar 

  • Davies, B.P. (1987) Equity and efficiency in community care: supply and financing in an age of fiscal austerity. Ageing and Society, 7(2):161–74.

    Article  Google Scholar 

  • Davies, B.P. (1989) Why must we fight the eighth deadly sin: parochialism. Journal of Ageing and Social Policy, 1:217–36.

    Article  Google Scholar 

  • Davies, B.P. (1990) The ‘trade and industry policy’ metaphor and its relevance to the Griffiths Report, in Bytheway, B. and Johnson, J. (eds) Welfare and the Ageing Experience: A Multidisciplinary Analysis. Aldershot, Avebury, pp. 14–27.

    Google Scholar 

  • Davies, B.P. and Challis, D.J. (1986) Matching Resources to Needs in Community Care. Aldershot, Gower.

    Google Scholar 

  • Davies, B.P. and Chesterman, J. Budget-Devolved Care Management in Two Routine Programmes: Outcomes of Two Experimental Evaluations. Aldershot, Arena, in press.

    Google Scholar 

  • Davies, B.P. and Knapp, M. (1981) Old Peoples Homes and the Production of Welfare. London, Routledge.

    Google Scholar 

  • Davies, B.P. and Knapp, M. (1988) Costs and residential social care, in Sinclair, I. (ed.) Residential Care: The Research Reviewed. London, HMSO.

    Google Scholar 

  • Davies, B.P., Barton, A. and McMillan, I. (1973) The silting-up of unadjustable resources and the planning of the personal social services. Policy and Politics, 1(4):341–55.

    Article  Google Scholar 

  • Davies, B., Bebbington, A. and Charnley, H. (1990) Resources Needs and Outcomes in Community-based Care. Aldershot, Gower.

    Google Scholar 

  • Davies, B.P., Warburton, R.W. and Fernandez, J. (1995) Do different case management approaches affect who gets what? Preliminary results from a comparative British study. Care Plan, December: 26–7.

    Google Scholar 

  • Davies, B.P., Warburton, R.W. and Fernandez, J. with Goldstone, G., Luckham, S. and Milne, A. (1996) Who Gets What: Service Allocations in Post-reform Community Care of Elderly People, PSSRU Discussion Paper number 1214. Canterbury, University of Kent at Canterbury.

    Google Scholar 

  • Department of the Environment (1995b) Projections of Households in England to2016. London, HMSO.

    Google Scholar 

  • Department of Health (1990) Community Care in the Next Decade and Beyond: Policy Guidance. London, HMSO.

    Google Scholar 

  • Department of Health (1994) Statistics of the Health and Personal Social Services in England. London, HMSO.

    Google Scholar 

  • Department of Health (1995a) Local Authority Personal Social Services Statistics: Community Care: Detailed Statistics on Local Authority Personal Social Services England 1994: HMD/94. London, HMSO.

    Google Scholar 

  • Department of Health (1995b) Statistics of the Health and Personal Social Services 1995, edn. London, HMSO.

    Google Scholar 

  • Department of Health (1995c) Community Care Statistics 1995: Statistical Bulletin. London, HMSO.

    Google Scholar 

  • Department of Health (1996) Care Management and Assessment Guide. London, HMSO.

    Google Scholar 

  • Departments of Health and the Environment (1995a) Building Partnerships for Success: Communitu Care Development Programmes. London, HMSO.

    Google Scholar 

  • Department of Health/Social Services Inspectorate (1991) Care Management and Assessment: Managers’ Guide. London, HMSO.

    Google Scholar 

  • Department of Health/Social Services Inspectorate (1993) Inspection of Assessment and Care Management Arrangements in Social Services Departments: Preliminary Overview Report. London, HMSO.

    Google Scholar 

  • Department of Health/Social Services Inspectorate (1994a) Inspection of Assessment and Care Management Arrangements in Social Services Departments: Second Overview Report. London, HMSO.

    Google Scholar 

  • Department of Health/Social Services Inspectorate (1994b) Community Care Packages for Older People. London, HMSO.

    Google Scholar 

  • Department of Health/Social Services Inspectorate (1995) What Next for Carers: Findings from an SSI Project. London, HMSO.

    Google Scholar 

  • Dixit, A. (1980) The role of investment in entry deterrence. Economic Journal, 90: 95–106.

    Article  Google Scholar 

  • Doty, P., Kasper, J. and Litvak, S. (1995) Consumer-directed Models of Personal Care: Lessons from Medicaid, ASPE. Washington, DC, Department of Health and Human Services.

    Google Scholar 

  • Eggert, G. (1994) Consumer-orientated Integration of Rural Health Care: A Research Proposal. Rochester, NY, Monroe County Long Term Care Program.

    Google Scholar 

  • Ellis, K. (1993) Squaring the Circle: User and Carer Participation in Needs Assessment. York, Joseph Rowntree Foundation.

    Google Scholar 

  • Forder, J., Knapp, M. and Wistow, G (1996) Competition in the mixed economy of care. Journal of Social Policy, 25(2):201–21.

    Article  Google Scholar 

  • General Accounting Office (1994) Medicaid Long-term Care: Successful Efforts to Expand Home Services While Limiting Costs, GAO/HEHS-94–167. Washington, DC, General Accounting Office.

    Google Scholar 

  • Golant, S.M. (1991) Matching congregate housing settings with a diverse elderly population: research and theoretical considerations. Congregate Housing for the Elderly, 21–38.

    Google Scholar 

  • Golant, S. (1996) Shelter and care for the elderly population: reasons for cynicism. Gerontologist, 36:410–13.

    Article  Google Scholar 

  • Gostick, C., Davies, B.E, Lawson, R. and Walden, C. From Vision to Reality in Community Care: Changing Direction at a Local Level 1990–1993. Canterbury, PSSRU, University of Kent at Canterbury, in press.

    Google Scholar 

  • Granovetter, M. (1985) Economic action and social structure: the problem of embeddedness. American Journal of Sociology, 91:481–510.

    Article  Google Scholar 

  • Griffiths, R. (1988) Community Care: Agenda for Action, a Report to the Secretary of State for Social Services. London, HMSO.

    Google Scholar 

  • Hansard (1948) House of Commons Debate, Session 1947/8, Volume 444.

    Google Scholar 

  • Hawes, C., Wildfire, J.B. and Lux, L.J. (1993) Regulation of Board and Care Homes: Results of a Survey in Fifty States and the District of Columbia. Washington DC, American Association of Retired Persons.

    Google Scholar 

  • House of Commons (1978) Eighth Report from the Expenditure Committee, Annex v. Trends in Unit Costs for Residential Accommodation for the Elderly and the Younger Physically Handicapped1975–76, House of Commons Paper 600v, Session 1978. London, HMSO.

    Google Scholar 

  • Howe, A. (1996) Community care at the margins of the acute care system, Paper presented at British Congress of Gerontology, Manchester, 3–5 July, 1996.

    Google Scholar 

  • Hudson, H. (1986) Case management, the EPIC model: a case of not grasping the nettle, in Challis, D., Davies, B. and Traske, K. (eds) Community Care: New Agendas and Challenges from the UK and Overseas. Aldershot, Arena, pp. 149–59.

    Google Scholar 

  • Hunt, M. and Merrill, J.L. (1994a) Naturally Occurring Retirement Communities. The Invisible Housing Alternative. Wisconsin, University of Wisconsin at Madison, Institute of Aging.

    Google Scholar 

  • Hunt, M.E. and Merrill, J.L. (1994b) Rural NORC Study. A Typology of Rural Naturally Occurring Retirement Communities. Wisconsin, University of Wisconsin at Madison.

    Google Scholar 

  • Hunter, D., McKeganey, N. and MacPherson, I. (1988) Care of the Elderly: Policy and Practice. Aberdeen, Aberdeen University Press.

    Google Scholar 

  • Kane, A. (1995) Expanding the home care concept: blurring distinctions among home care, institutional care, and other long-term care services. The Milbank Quarterly, 73:161–86.

    Article  Google Scholar 

  • Kane, R.A. and Wilson, K.B. (1993) Assisted Living in the United States: A New Paradigm for Residential Care of the Frail Elderly. Washington, DC, American Association for Retired People.

    Google Scholar 

  • Kane, R.A., Kane, R.L., Illston, L.H. et al. (1993) Adult foster care for the elderly in Oregon: a mainstream alternative to nursing homes? American Journal of Public Health, 81:1113–20.

    Article  Google Scholar 

  • Kane, R.A., Freeman, I.C., Caplan, A.L. et al. (1990) Everyday autonomy in nursing homes. Generations, 14(suppl.):69–71.

    Google Scholar 

  • Kane, R.I., Kane, R.A., Miller, N.A. et al. (1992) Qualitative analysis of the Programme of All-inclusive Care of the Elderly (PACE) Gerontologist, 32:771–80.

    Article  Google Scholar 

  • Klein, R. (1995) Self-inventing institutions: institutional design and the UK welfare state, in Goodin, R.E. (ed.) The Theory of Institutional Design. Cambridge, Cambridge University Press, pp. 240–54.

    Google Scholar 

  • Laming, H. (1996) Social Services Contribution to the Rehabilitation of Older People. Letter from the Chief Inspector to directors of social services in England, CI(96)10. London, Department of Health.

    Google Scholar 

  • Litvak, A., Zukas, H. and Heumann, J.E. (1987) Attending to America: Personal Assistance for Independent Living. Berkeley, CA, World Institute of Disability.

    Google Scholar 

  • London Research Centre (1996) Community Care Trends: The Impact of Funding on Local Authorities, January–September 1995. London, Local Government Management Board.

    Google Scholar 

  • Mollica, R.L., Ladd, R.C., Dietsche, S. et al. (1992) Building Assisted Living for the Elderly into Public Long-term Care Policy: A Guide for the States. Portland, ME, National Academy for State Policy, Center for Vulnerable Populations.

    Google Scholar 

  • Morgan, L.A., Eckert, J.K. and Lyon, S.M. (1995) Small Board-and-Care Homes: Residential Care Homes in Transition. Baltimore, John Hopkins Press.

    Google Scholar 

  • Morris, R.G., Morris, L.W. and Britton, P.G. (1988) Factors affecting the emotional wellbeing of the caregivers of dementia sufferers. British Journal of Psychiatry, 15:147–56.

    Article  Google Scholar 

  • Morycz, R.K. (1985) Caregiving strain and the desire to institutionalize family members with Alzheimer’s disease. Research on Aging, 7:329–61.

    Article  Google Scholar 

  • Murphy, M.M. and Wang, D. A dynamic multi-state projection model for making marital status population projections in England and Wales, in Dale, A. (ed.) Using Census and Survey Data for the Analysis of Marriage and Employment Histories. in press.

    Google Scholar 

  • National Health Service Executive South and West and South and West Regional Health Authority (1995) Evidence-based Purchasing: Rehabilitation of Older People. Bristol, National Health Service Executive South and West and South and West Regional Health Authority.

    Google Scholar 

  • Nelson, R. and Winter, S. (1982) An Economic Theory of Evolutionary Change Cambridge, MA, Harvard University Press.

    Google Scholar 

  • Petch, A. (1996) New concepts, old responses: assessment and care management pilot projects in Scotland, in Phillips, J. and Penhale, B. (eds) Reviewing Care Management for Older People, 14–27.

    Google Scholar 

  • Pous, J., Grand, A., Cayla, F. and Bocquet, H. (1992) L’hébergement collectif en milieu urbain, in Mire and Plan urbain Vieillir dans la ville. Paris, L’Harmatan, pp. 8 7–104.

    Google Scholar 

  • Pruchno, R.A., Michael, E., and Potashnik, S.L. (1990) Predictors of institutionalization among victims of Alzheimer’s disease victims with caregiving spouses. Journal of Gerontology: Social Sciences, 45:S259–66.

    Article  Google Scholar 

  • Pynoos, J and Liebig, P. (eds) (1995) Housing Frail Elders: International Policies, Perspectives and Prospects. Baltimore, John Hopkins Press.

    Google Scholar 

  • Regnier, V., Hamilton, J. and Yatabe, S. (1992) Best Practices in Assisted Living: Innovations in Design, Management and Financing National Eldercare. University of Southern California, LA, Institute on Housing and Supportive Services.

    Google Scholar 

  • Ridley, N. (1988) The Local Right: Enabling not Providing. London, Centre for Policy Studies.

    Google Scholar 

  • Rose, R and Peters, B.G. (1978) Can Government Go Bankrupt? New York, Basic Books.

    Book  Google Scholar 

  • Sabatino, C.P. and Litvak, S. (1992) Consumer-directed home care: what makes it possible. Generations, 16:53–8.

    Google Scholar 

  • Scala, M.A., Mayberry, P.S. and Kunkel, S.R. (1995) Consumer-Directed Home Care: Client Profiles and Service Challenges. Oxford, OH, Miami University, Scripps Gerontology Centre.

    Google Scholar 

  • Scanlon, W., Difederico, E. and Stassen, M. (1979) Long-Term Care: Current Experience and a Framework for Analysis. Washington, DC, Urban Institute.

    Google Scholar 

  • Schulz, R. and Brenner, G. (1977) Relocation of the aged: a review and theoretical analysis. Journal of Gerontology, 32:322–33.

    Article  Google Scholar 

  • Seebohm Report (1968) Report of the Committee on Local Authority and Allied Personal Social Services, Cmnd 3703. London, HMSO.

    Google Scholar 

  • Tirole, J. (1988) The Theory of Industrial Structure. Cambridge, MA, MIT Press.

    Google Scholar 

  • Townsend, P. (1962) The Last Refuge. London, Routledge & Kegan Paul.

    Google Scholar 

  • Waterson, M.W. (1988) Regulation of the Firm and Natural Monopoly. Cambridge, MA, MIT Press.

    Google Scholar 

  • White Paper (1989) Caring for People: Community Care in the Next Decade and Beyond, Cmnd. 849. London, HMSO.

    Google Scholar 

  • Wiener, J., Illston, L. and Hanley, R. (1994) Sharing the Burden: Strategies for Public and Private Long-term Care Insurance. Washington, DC, Brookings Institution.

    Google Scholar 

  • Willcocks, D., Pearce, S. and Kellaher, L. (1987) Private Lives in Public Places: A Research-based Critique of Residential Life in Local Authority Old Peoples Homes. London, Tavistock.

    Google Scholar 

  • Wilson, K.B. (1994) Assisted living: a residential model of long-term care, in Maddox, G.L., Atchley, R.C., Evans, J.G. et al. (eds) The Encyclopedia of Aging. New York, Springer, pp. 83–6.

    Google Scholar 

  • Wilson, K.B. (1995) Assisted Living: Reconceptualising Regulations to Meet Consumers’ Needs and Preferences. Washington, DC, American Association of Retired Persons.

    Google Scholar 

  • Wistow, G., Knapp, M., Hardy, B. and Allen, C. (1994) Social Care in a Mixed Economy. Buckingham, Open University Press.

    Google Scholar 

  • Wistow, G., Knapp, M., Hardy, B. et al. (1996) Social Care Markets. Buckingham, Open University Press.

    Google Scholar 

  • Yawney, B.A. and Slover, D.L. (1973) Relocation of the elderly. Social Work, 18:86–95.

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Copyright information

© 1998 Bleddyn Davies

About this chapter

Cite this chapter

Davies, B. (1998). Shelter-with-Care and the Community Care Reforms — Notes on the Evolution of Essential Species. In: Jack, R. (eds) Residential versus Community Care. Palgrave, London. https://doi.org/10.1007/978-1-349-14135-7_5

Download citation

Publish with us

Policies and ethics