A game of two halves? Understanding the process and outcomes of English care home closures

Jon Glasby, Kerry Allen, Suzanne Robinson
Social Policy and Administration, vol 53, no 1, January 2019

With care services increasingly delivered via a market, there is always a
risk that care homes could fail financially or struggle in terms of
quality, ultimately having to close. When this happens, the received
wisdom is that subsequent  relocation can be detrimental to the health
and well-being of older residents (possibly even culminating in
increased mortality). However, there is very little formal evidence in
the United Kingdom (UK) or beyond to guide policymakers and  local
leaders when undertaking such sensitive work. Against this background,
this article reports findings from an independent evaluation of what is
believed to be the largest care home closure programme in the UK (and
possibly beyond).  This consisted of qualitative interviews with older
people, families, care staff and social work assessors during the
closure process in one case study care home and one linked day centre,
as well as self-reported health and quality of  life data for older
people from 13 homes and/or linked day centres at initial assessment, 28
days after moving and at 12-month follow up. The study is significant
in presenting public data about such a contested topic from such a  
large-scale closure process, in its focus on both process and outcomes,
in its mixed-methods approach, and in its engagement with older people,
families and care staff, alongside the use of more formal outcome
measures. Despite  significant distress part-way through the process,
the article suggests that outcomes either stayed the same or improved
for most of the sample up to a year after moving to new services. Care
homes closures may thus be a “tale of two  halves”, with inevitable
distress during the closure but, if done well, with scope for improved
outcomes for some people in the longer term. These findings are crucial
for current policy and practice, given that the risk of major closures  
seems to be growing, and given that there is virtually no previous
research on which to base local or national closure processes. While
some of this research is specific to England, the underlying issue of
care home closures and lessons  learned around good practice will also
apply to other countries.

Full text https://onlinelibrary.wiley.com/doi/pdf/10.1111/spol.12412

Published by Residential Forum

The Residential Forum is to promote the achievement of high standards of care and support for children and adults living in residential care and nursing homes, supported housing, residential schools and colleges, hospices and hostels. It contributes to improving the quality of service to the public. Members of the Forum are people of standing and experience drawn from the public, private and voluntary sectors, as well as some who can speak for service users and carers.

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