Sheena Rolph

The Quality of Care

Thus far, we have considered some of the features of continuity and change in the surviving homes and in the everyday lives of those living and working in them. A question that is frequently asked, however, is whether the homes today are better than they were in the past. In this chapter, therefore, we present our findings about the quality of care in the surviving homes then and now. The quality of care in the homes together with policy and practice regarding the registration and inspection of homes was one of Townsend’s key concerns. In the late 1950s, homes owned by the local authority were not subject to registration and inspection procedures. Voluntary and private homes, however, were required to be registered with, and inspected by, the local authority. However, Townsend found that for a variety of reasons some of the voluntary and private homes he visited were exempt; others had not been inspected for at least a year and some for more than five years. The quality of inspection was also mixed. Given some of the conditions found by Townsend, this situation was of considerable concern to him.

Using photography to understand change and continuity in the history of residential care for older people

The Last Refuge by Peter Townsend is a seminal study of residential care for older people. The fieldwork was carried out in the late 1950s and the data are now deposited in the National Social Policy and Social Change Archive at the University of Essex. We have undertaken research, funded by the ESRC, which has revisited Townsends work and some of the homes he studied in order to conduct an overtime comparison. In this paper we focus on Townsends use of photography and our subsequent use of photography in our revisiting study. We argue that although Townsend did not analyse his photographs, they were significant data for use in his arguments critiquing residential care. They were, however, the product of a different socio‐historical context to our own and as such posed considerable practical and ethical challenges for us when attempting to use this aspect of his methodology for an overtime comparison. We argue that despite the resulting constraints, photography was an important part of our methodology, enabling comparisons and illuminating historical patterns in residential care for older people.

The development of community care for people with learning difficulties 1913 to 1946

This article explores from an historical perspective the emerging debates on the similarities and differences between community care and institutional care. While institutional care has been widely condemned, community care has been welcomed as offering greater opportunities for adults who have long term care needs. We argue, however, that it is more helpful to regard institutional and community care as a continuum, and draw on our ongoing research into the history of community care for people with learning difficulties to show that community care has a longer history than has been widely assumed, and that some forms of community care were as much motivated by a desire to control as they were by a wish to provide care. The article ends with some consideration of the relevance of such historical studies for modern understandings of community care.

Uncovering History: Private Sector Care Homes for Older People in England

In conducting his research for The Last Refuge (1962), Peter Townsend visited 173 public, voluntary and private residential care homes for older people in England and Wales. Drawing on his data, now archived at the University of Essex, we traced the subsequent history of these homes and revisited a sample that were still functioning as care homes in 2006. In this article, we focus on the 42 private homes he visited, some of which remain open and were revisited by us in 2005–06. The pre-1980 history of private sector residential care provision for older people is an elusive and poorly charted topic. Drawing on the two data sets for then and now, this article contributes new insights into this area of UK policy and practice.

The Living Environment

In this chapter we address the question of what kind of living environments the 20 homes provided in the early 2000s and how they compare with the past. Forty years ago, Pincus adopted the term the ‘institutional environment’ which he defined as the psycho-social milieu in which the residents live as expressed through and/or generated by (a) physical aspects of the setting, including design, location, furnishing and equipment; (b) rules, regulations and program which govern daily life; and (c) staff behavior with residents.

People, pets and care homes: a story of ambivalence

Purpose – The purpose of this paper is to examine the history of pet ownership and its relationship to wellbeing in later life. In particular, the paper addresses the issue of pet ownership in communal residential settings for older people both now and in the past, comparing attitudes, policies, and practices in regard to pets in the late 1950s with the early years of the twenty‐first century.Design/methodology/approach – Following a review of the research literature on older people and companion animals, the paper draws on new data derived from recent research conducted by the authors. It compares archived material on the residential homes for older people that Peter Townsend visited in the late 1950s as part of his classic study, The Last Refuge (1962), with findings from revisiting a sample of these homes 50 years later. The authors employed the same methods as Townsend (observation together with interviews with managers and residents).Findings – The historical dimension of the research reveals ambival...

Continuity and Change in Residential Care for Older People

We begin this chapter by summarizing our findings regarding residential care for older people over the last 50 years. Has nothing changed, as is often alleged? Or has residential care been transformed? We go on to consider Townsend’s policy recommendations and how these tie in with the policy context at the time of writing this book in 2009. In so doing we consider briefly what our research contributes to current debates relating to the theorization of old age.

Survivors and Non-Survivors

It was through the tracing study that we were able to identify surviving and non-surviving homes. The reports completed by the volunteers on the homes that had closed and by us on those that had survived, provide information on the history of each home since 1959. Drawing on these data we address, in this chapter, the key issues of what type of homes closed between 1958–9 and 2005–6, when they closed and why. The data reveal a pattern of attrition that can be related to changes in social and public policy. They also indicate what kinds of usage surviving buildings have been put to and what changes in ownership have occurred. For example, some have been demolished and replaced by new buildings containing new services for older people such as age-restricted housing. Other buildings have been converted for different uses such as the two that are now museums. One is a doctor’s surgery and another a veterinary practice. Some are now day centres, others hotels, and some are once again private residences. We also look at the 39 homes that survived as care homes and consider some of the factors that might account for their survival.

Residents and Staff

In this chapter we begin to compare the surviving homes as they were in 1958–9 and as they were nearly 50 years later in 2005–6. Our focus here is on who lived and worked in the homes, the residents and the staff, in the two time periods.

Revisiting and Reuse

In Part II of this book, we have described our findings both from the tracing study and the follow-up study. Our particular design is unusual and as such has both strengths and limitations regarding what we can conclude about policy and practice in relation to residential care for older people. As pointed out in Chapter 1, ours was not a ‘restudy’ such as that conducted by Stacey et al. (1975), Phillipson et al. (2001) and Charles et al. (2008). Rather it was a ‘revisiting’ study: one that has revisited not only how Townsend conducted his research, published and archived his findings but also a very specific set of surviving homes. Through access to his archived data, we have been able to visit these homes and compare his findings with ours.