Guidelines for the closure of care homes for older people: prevalence and content of local government protocols

The rise in the number of care home closures in recent years has raised concerns about the way in which residents and their relatives and carers are being affected by such relocation and the way in which it is managed. Currently there is no statutory guidance in England aimed specifically at the way in which care homes close. This paper presents a review of local government guidelines and protocols for the closure of care homes for older people. The objectives of the study were to identify the prevalence of written guidelines and the nature of existing principles and recommendations for good practice. Thirty-three documents were analysed to identify their purpose and scope, the ways in which roles and responsibilities were defined and allocated, and suggestions and recommendations for good practice

The Rate, Causes and Consequences of Home Closures

One of the attributes of a mixed economy of care is that inevitably some homes will go out of business, with consequent costs for the individuals involved and the regulating authorities. However, the rise in home closures during recent years has given rise to concerns about the capacity of the care home sector and the effects on current residents. This report describes the results of the first phase of a study on the causes, processes and consequences of home closure. A survey of registration and inspection (R&I) units was conducted to identify rates of closure, the proportion of closures that were due to business reasons, changes in registration, the consequences for supply and the views of unit managers. A follow up telephone interview was conducted with those units that covered areas included in a 1996 survey of homes. This interview was used to collect more detailed information about the two most recent closures

The closure of care homes for older people: relatives’ and residents’ experiences and views of the closure process

This paper describes relatives’, informal carers’ and residents’ views about their experience of care home closure and their recommendations for how the process might be better managed. The research was part of a larger study that investigated the way in which independent care homes for older people are closed from the perspective of those involved. A case study approach was used. Interviews were conducted with people connected to eight care home closures. The homes were in five local authorities, ranged in size, were mainly residential but included a nursing and a dual registered home and closed for business related reasons in 2002. Ten residents and 28 relatives and informal carers linked to the case study home closures were interviewed. To capture a wide range of experiences relatives and informal carers with recent experience of a home closure were also invited to take part via national and local carer associations and groups, and a local care home and day centre. The further seven relatives recruited in this way told us about more extreme closure situations, which it would have difficult to find out about via case studies. Overall we gathered information about or from 43 residents of homes in seven authorities

Care home closures: the provider perspective

As part of a wider investigation into supply of care homes a study was conducted investigating the factors andcircumstances that lead to homes closing from the perspective of independent providers. Following five in-depthexploratory interviews structured interviews were designed and conducted with 20 owners, managers or owner/managersof homes that had closed within the previous two years or (in one case) were at the point of closure. The interviewsfocused on the background and motivation of providers, the characteristics and history of the home, the combinations offactors and circumstances that led to closure, and the closure process and consequences for staff and residents. Theprocess and consequences of closure will be reported in a separate paper

Social care regulation: resource use. Final report

This paper reports on the findings of a study investigating the resource use of the NCSC. Our aim was to identify the resource requirements of the NCSC given current workloads and practice. The timing of the study means that the results need to be treated with some caution (see Appendix A). We start by briefly describing the method and response rates and then set the context in terms of the overall levels of regulatory responsibilities and activity during the first year of the NCSC. In section 4 we describe the work undertaken by inspectors and managers in terms of their caseloads and overall time use. We then turn to the individual regulatory activities in order to identify the resource use in terms of time input to the regulatory process, compare with the results of the previous studies and explore factors associated with variations in time taken. We end by identifying the unit cost of staff time and the estimated costs of each of the measured regulatory activities

Analysis to Support the Development of the Relative Needs Formula for Older People: Final Report

This report presents the findings of a study of social services for older people in England. The study was one of three studies commissioned in 2004 by the Department of Health to produce options for improved and updated formulae for allocating central government funding to councils with social service responsibilities (CSSRs) under the Formula Spending Shares (FSS) system. The FSS system for the allocation of resources for local authority services was replaced in 2006-07 by the system of Relative Needs Formulae (RNFs), and this report refers to the RNF system. There are three personal social services RNFs, covering children, younger adults and older people, and separate studies were commissioned for each of these client groups. A guide to the formula grant distribution system has been published by the Office of the Deputy Prime Minister (2006a), and full details of the distribution of grant are given in the Local Government Finance Report (Office of the Deputy Prime Minister, 2006b). The RNF formula for older people covers provision for people aged 65 and over in care homes, day care, home care and home help services, and meals, together with the associated social work and administration costs. The formula contains four components: a need component, a low income adjustment, a sparsity adjustment, and an area cost adjustment. The study described in this report was commissioned to examine the needs component

Analysis to Support the Development of FSS Formulae for Older People: Interim Report

This paper reports the interim findings of a study of social services for older people in England. The aim of the study is to produce options for an improved and updated formula for the formula spending share (FSS) which is used to allocate central government funding to councils with social service responsibilities (CSSRs), concentrating on the needs component. We do not present here principles or details of the approaches used, which will be provided in the final report, but focus on the calculation of the formulae. The approach to determining the needs component for the FSS formula involves the prediction of demand for social services on the basis of an estimate of the number of people living in a CSSR area who might be expected to need services under a standard level of service. The development of services in recent years indicated that up-to-date information was needed, and since sources of secondary data such as the General Household Survey (GHS) are incomplete, new data collections were required. Two approaches were adopted. First, individual level analyses required information about older people in receipt and not in receipt of services. Second, small area analyses required information about service receipt by individuals in specific areas (usually wards) with known characteristics

Annex K: Consumer behaviour and care homes: A literature assessment

The OFT study into the care homes market for older people found that people need easier access to information when choosing a care home and more support once in a home. Care homes also need to ensure that fee related terms used in their contracts are fair and transparent. The report makes a series of recommendations to improve the way in which the care homes market is working for older people and their representatives. A key recommendation is that the government should establish a central information point or 'one stop shop' where people can get clear information about care for older people. As part of this study the OFT commissioned the PSSRU to conduct a literature assessment to inform the strand of the market study looking at consumer behaviour. The review is divided into five main parts. It starts by summarising the characteristics of older people living in care homes. The legal and policy context is outlined in terms of relevant policy aims and objectives, including those related to advocacy and complaints mechanisms, and the responsibilities and duties of councils, the National Health Service (NHS) and care home providers. This is followed by a description of key issues and concerns. The fourth section of the review describes the literature on consumer behaviour and care homes. It reviews the evidence about the meaning and significance of moving to a care home for older people and their relatives, the frequency of moves between homes, and the process of moving. The process of moving is considered in terms of the following stages: the timing and reasons for moves; the choice of moving to a care home; the choice of individual home. Evidence about the effectiveness of redress mechanisms and the impact of consumer behaviour on the market is also assessed. Finally some comments are offered about the strengths and limitation of the evidence base

English local authority powers, responsibilities and guidelines for managing the care home closure process

In England, the majority of older people living in care homes are publicly funded and the majority of publicly funded places are purchased from the independent sector. While the sector is subject to regulation, there is currently no statutory guidance aimed specifically at how care home closures are managed. This article reviews the powers and responsibilities of councils and the rights of residents during care home closures, before describing the prevalence and content of existing council guidelines. Just over a third of councils in England responded to inquiries and, of these, two-thirds reported having guidelines. This suggests that a considerable proportion of councils have no guidelines in place. Existing guidelines also varied. Differences included approaches to allocating responsibilities and providing help, and assessment to self-funding residents. The large number of arrangements and activities described suggest that some sort of plan or guidance is warranted to support the task of front line care managers. At the national level, the variation found in the guidelines combined with the lack of national guidance specific to closures suggests that clarification of councils’ legal responsibilities and powers during a care home closure is needed. Clarification of the role and responsibilities of the national regulatory body would also be useful