“from a Service Users Perspective Critically Evaluate an Aspect of Adult Community Care Services”

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In this essay I want to carefully examine a broad range of issues concerning elderly people in contemporary British society today. In particular I will want to focus on Residential homes and Older People in Community Care services. I will define residential homes and explain how they have become established from the Poor Law workhouses until present day. I will also discuss relevant government legislation with the viewpoints of older people’s pressure groups and the service users who use residential homes. I will try and suggest changes that could be made in social policy that could help advantage retired and elderly people in this the twenty-first century.

There are two types of homes for older people in contemporary society, residential homes and nursing homes. Residential care is highly an important source of accommodation for old people, who even with domiciliary support cannot manage to live in their own homes, but who still do need intensive nursing care. Grundy and Arie (in Tinker 1992:161) have suggested that residential care is needed for those who need round-the-clock support and live alone. Current provisions which stem from the 1948 National Assistance Act require local authorities to provide: ‘residential accommodation for persons who by reason of age, infirmity or any other circumstances are in need of care which is not otherwise available to them’ (CPA, 1996). Residential care: consist of respite care, short stay and full time residential care. A residential home is expected to provide both personal care and accommodation. A residential home is a means of providing extra support to people who are not able to cope with their illness or disabilities, even after the support from home care services (O’Kell, 1995). An estimated three million people live in homes, a figure that is likely to rise by more than 180 per cent in the next 50 years as the average age of the population rises.

Local authority, private and the voluntary sector provide homes; however there has been a dramatic shift towards private provision, but the proportion of elderly people in residential care has remained constant. In the last fifty years the development of the major voluntary agencies: Centre for Policy on Aging (1997), Age Concern (1997), Helped the Aged (1962), The National Corporation of the Care of Old People (1947) have made significant contributions to elderly care service (Tossell and Webb 1994).

On the other hand, nursing homes provide the latter along with registered nurses for older people who need care for medical purposes. Even though homes provide support and care for older people, they are often criticised as being institutions that are a form of social exclusion and social control. However, provisions for older people have moved on dramatically from the days of the workhouse where older people who could who could not support themselves were placed. (Peace et al, 1997).

Under the 1834 Poor Law Amendment Act, workhouses were established. This was to ensure that people who experienced extreme poverty, for example, the disabled, sick people, children and old people had indoor relief and were required to work in order to be accommodated. Even though the workhouse provided people with shelter, they were stigmatised as harsh, strict and degrading places that incurred individuals to be segregated from the rest of the society. This policy was arguably a form of social control and social exclusion as the rest of society did not want to see these people on the streets due to the Victorian snobbery of the era. In response, the government decided it was best to isolate the poor from the rest of the society by placing them in workhouses. (Peace et al, 1997).

The birth rate is the number of live births born in England per 1000 per year. The number of live births in 2002 was 669 thousand. It has decreased in the last 100 years because 100 years ago, parents had many children, family sizes of 8 and 9. This was important...
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