Residential Care Transformed Revisiting 'The Last Refuge'

by Johnson, Julia; Rolph, Sheena; Smith, Randall

• ISBN13: 9780230202429
• ISBN10: 023020242X
• Format: Hardcover
• Copyright: 2010-06-15
• Publisher: Palgrave Macmillan

Summary

This book revisits Peter Townsend's classic study of residential care for older people in Britain conducted in the late 1950s. It provides not only a fascinating account of residential care for older people over the last 50 years but is also an important contribution to the literature on research methods.

Author Biography

JULIA JOHNSON is Senior Lecturer in the Faculty of Health and Social Care at The Open University, UK. She has published widely on the topics related to ageing and later life and is review editor of the journal Ageing & Society. Her most recent book is Understanding Health and Social Care (edited with Corinne DeSouza). 
  
SHEENA ROLPH is Visiting Senior Research Fellow at The Open University, UK. She has published widely in the social history of learning disability and the history of residential care for older people. Her background is in art history and her research interests include the history of visual images relating to her specialist fields. 
  
RANDALL SMITH is Professor of Social Gerontology in the School for Policy Studies, University of Bristol, UK. He has co-authored books on community care and the development of policies for older people. Between 2003 and 2009, he was a member of the Executive Committee of the British Society of Gerontology and is a Trustee of Age Concern Bristol.

Table of Contents

List of Figures and Photographs	p. x
List of Tables	p. xi
In Memoriam	p. xii
Acknowledgements	p. xiii
List of Abbreviations	p. xv
The Context
Why Revisit The Last Refuge?	p. 3
A work of lasting importance	p. 3
The impact of Townsend's research	p. 9
Revisiting The Last Refuge	p. 11
The plan of the book	p. 14
Changing Contexts of Care	p. 17
An ageing population	p. 17
Changes in residential care provision	p. 21
The welfare state: The early years	p. 23
Privatization	p. 27
Modernization	p. 29
Paying for care	p. 32
Personalization and residential care	p. 34
Changing research agendas	p. 35
The Study Design and Methods	p. 40
Survivors or non-survivors?	p. 41
The tracing study	p. 44
The follow-up study	p. 49
The context of change	p. 51
Research instruments and methods	p. 53
Access, participation and consent	p. 56
Methodological issues	p. 58
Revisiting The Last Refuge
Survivors and Non-Survivors	p. 63
The ex-PAIs	p. 64
Other local authority homes	p. 66
The voluntary homes	p. 68
The private homes	p. 71
Accounting for survival	p. 74
Conclusion	p. 83
Residents and Staff	p. 85
Residents: Gender, age and ethnicity	p. 86
Residents: Family and social circumstances	p. 88
Residents: Personal assistance and capacity for self-care	p. 90
Residents: Reasons for admission	p. 94
Staff: Numbers and roles	p. 97
Staff: Training and qualifications	p. 103
Managerial responsibilities	p. 105
Conclusion	p. 107
The Living Environment	p. 109
Location and scale	p. 110
Internal spaces	p. 112
External spaces	p. 119
Creating a 'homely' environment	p. 123
Rules, regulations and routines	p. 126
Managerial styles and staff attitudes	p. 133
Conclusion	p. 135
Daily Lives	p. 138
From domestic work to daily living activities	p. 139
Caring and supporting	p. 144
Organized group activities	p. 146
Hobbies and pastimes	p. 150
Friends, cliques and internal communities	p. 153
Getting out and about	p. 155
The role of family and friends	p. 159
Conclusion	p. 162
The Quality of Care	p. 165
Townsend's quality measure	p. 166
The CSCI quality ratings	p. 174
The worst homes	p. 177
The best homes	p. 180
Conclusion	p. 186
Conclusions
Revisiting and Reuse	p. 189
Working with 'volunteer' researchers	p. 190
Reusing data	p. 197
Conclusion	p. 205
Continuity and Change in Residential Care for Older People	p. 207
Stability and change	p. 207
Social care in the twenty-first century	p. 210
De-stigmatizing residential care	p. 216
Appendixes	p. 219
Notes	p. 254
References	p. 261
Index	p. 277
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