Connolly, M. (2013). Exploring the privatisation of geriatric nursing and residential care: An action research project. MMU Psychology Journal (Dissertations), 4, 1-24. (original) (raw)
Related papers
Privatisation of Aged Care for dementia clients -Role for Social Workers
The complex environment of ageing, in particular individuals with dementia, as a social worker understanding their social needs, a greater understanding their culture, their diversity and social environments situations is required (Adams, Dominelli & Payne, 2009). The aged care sector in Australia has been more increasingly dominated with neoliberal market base principles which have placed a prioritisation in cost reductions and profitable efficiencies, which have placed less demands in one sense in the private sector to employ social workers (Kendall & Reid, 2017). Australians are living longer including more years without debilitating disabilities, this lengthening of our life expectancy is imposing implications on the ageing, disability and health sectors (AIHW,2014). This significant rise of persons with dementia together with the demand for more aged care facilities has seen a surge in aged care provisions such as residential aged care or in-home care becoming privatised, and an increased demand for other allied health services including social work. Challenges also faced include the justification of the Australian Federal Government privatising parts of the sector, which include aged care assessment teams, which fundamentally the social workers have worked well in (Broe, 2020). The challenges faced by the social worker in ageing and aged care are surmountable, in particular where capitalism weaves it way through aged care in terms of privatisation and cost benefit models. The social worker in the aged sector, in particular providing person-centred care for people with dementia will need to engage and respect agency, clients structures and their physical and psychosocial environments (Cole, 2019).
Regulating nursing homes: Caring for older people in the private sector in England
BMJ, 2001
Over half of all beds allocated for health care in the United Kingdom are in independent nursing homes for older people; this is a result of policies initially introduced to change the basis of social security payments 1 and now directed towards privatising long term care. Official statistics from the Department of Health indicate that between 1979 and 2000 the total number of beds in the NHS in England decreased from 480 000 to 189 000, while the number of beds in the independent sector, which is run mainly for profit, increased from 23 000 in 1983 2 to 193 000 in 2000. Experiences in the United States and Australia have shown the lack of political will to promote the interests of residents against the interests of the industry and its shareholders. 3 4 In Australia the industry successfully lobbied to replace legally enforceable regulations with less effective accreditation schemes; this has had disastrous consequences. In the United States the industry successfully opposed the introduction of robust standards for minimum numbers of staff, and the result is continuously declining health outcomes for residents. The risks to residents of nursing homes in the United Kingdom are considerable as subsidiaries of large US multinationals enter the United Kingdom 5 ; some of these companies have come under scrutiny in the United States for fraud and embezzlement of government funds and for abusing patients. 3 This paper considers whether the new regulatory framework for nursing homes in the United Kingdom offers adequate protection for patients.
The Journal of Adult Protection, 2020
Purpose Strategic socio-political views are notably scarce among contemporary discourses on the causes of abuse of vulnerable older people in care and nursing homes. This paper aims to catalyse higher order consideration and discussion of one socio-political characteristic that has relevance to the issue of abuse, that is, the market-like environment in which care and nursing homes in England operate. In doing so, the paper argues that the now firmly established but imbalanced “quasi-market” of care that has developed over many years fosters conditions under which both poor care and abuse are more likely to occur. The evidence presented in the paper focusses primarily on the rise to dominance of for-profit care home provision and the contraction of public sector provision. The paper does not examine in detail the characteristics and market presence of the not-for-profit sector because it has not held a numerically significant market share either historically or contemporarily. Desig...
The abuse of older people in private sector care homes: Why does it occur? Why does it endure?
2016
Government policy has existed to protect adults who may be at risk of abuse since 1993 and was significantly revised in 2000 by ‘No Secrets: Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse’. However, a catalogue of abuse of older people in care homes subsequent to 2000 confirms that abusive acts continue. This thesis examined the extent of abuse in English care homes and has sought answers to the question of why it endures. The research employed a mixed methods approach. An anonymously completed questionnaire was used to quantify and explore any previous experiences of abuse from newly appointed care staff in five newly opened care homes. Concurrently, thirty-six semi-structured interviews were conducted with care home staff working in a sample of established homes in five local authority areas to explore their perceptions and experiences of abuse. A clear conclusion from the findings is that action is required at ...
The bottom line : an ethnography of for-profit elderly residential care
2011
In the last 20 years the UK’s elderly residential care system has become progressively more privatised with an increase in the number of for-profit organisations delivering these services. This study is a participant observation of care work in one privatised elderly residential care home (‘Meadowvale’), owned and operated by a large provider of such services (‘Moonlight Care’). It provides a rich ethnographic depiction of life at Meadowvale both from the point of view of the workers and the residents. The thesis frames these ethnographic findings against pro-privatisation discourses which argue that serious raises in standards of service delivery are to be made from instilling profit motives within social care systems. I argue that there were a series of contradictions which prevented Moonlight Care from both achieving convincing levels of profitability whilst simultaneously improving the nature of elderly residential care. The fact that the revenue received was largely determined ...
Journal of Health Services Research & Policy, 2013
To examine how organizational factors affect good care and mistreatment of older people in care homes. Methods: Eight residential care homes for older people (including private sector, local authority and NHS providers) took part in a participatory observation-based study of organizational factors affecting care quality. Results Grouping organisational factors into infrastructure, management and procedures, staffing, resident population characteristics and culture we show the context sensitive nature of interactions between these factors. These interactions could enhance care quality where factors combined positively. Conversely, they could amplify difficulties where one factor came to undermine another, thereby limiting care quality. Conclusions This analysis provides empirical insights into how and why similar sector-wide changes to care provision have differential effects at the care home level. It indicates the situated and unpredictable ways in which organizational factors interact, implying the need for locally contextualised quality assessment and improvement actions.
Public Policy and Administration, 2004
This article will present interim research findings from a Department of Health-funded three year-project on the regulation of adult social care in England. Regulation is a very significant form of managing public services in Britain, as central government increasingly relies upon regulatory agencies and mechanisms to measure and improve the performance of agencies delivering public services. The present Labour Government's modernisation strategy has strengthened the key role of state-sponsored regulation of public services, including social care. A key plank to its modernisation agenda facing public services, and underpinned by Third Way thinking, is a move towards partnerships and collaborative governance embracing public, private and voluntary sector bodies in the delivery of public services. In the case of adult social care, this push furthers moves towards a mixed economy of welfare, where ideological 'state-versus-market' arguments take backstage to managerialist discussions about 'what works'. Public service regulation represents a 'third way' between state and market provision of public services. Our preliminary research findings support the view that regulation of adult social care, though not new nor without its tensions, has been and is being transformed as New Labour's modernisation programme of reforming public services increasingly takes hold, and that the transformed adult social care regulatory regime is consistent and informed by Third Way thinking. This article will present interim research findings from a Department of Health-funded three year-project on the regulation of adult social care in England, which started late 2003. This project forms part of the wider research programme, `Modernising Adult Social Care', launched by the Department of Health. Our research project addresses the following two questions: • what are the processes of the regulation of adult social care as perceived by different stakeholders? • what impact does regulation have upon adult social care as perceived by different stakeholders? Key stakeholders within the regulatory regime surrounding adult social care include central government sponsors of regulatory agencies (eg Department of Health, HM Treasury), regulatory agencies (eg Commission for Social Care Inspection (CSCI), General Social Care Council (GSCC)), regulated agencies (eg local authority social services departments (SSDs), private and voluntary providers of adult social care), and users of adult social care services (and their informal, unpaid carers). The four principal vulnerable adult groups investigated are the frail elderly and those adults with learning difficulties, mental health issues and physical handicap.
Building capacity for aged care policy reform: Aspirations and issues
Journal of Care Services Management, 2010
AbstractReform motivated by idealism runs the risk of acting on unrealistic assumptions about the need for and preferences around service types, the effects of competition, technical and organisational obstacles to implementation, and threats to other stakeholder groups which may actively resist the proposed change. For England to successfully introduce a system of long-term care that is primarily home-based, there must be careful consideration and open debate about the intended and unintended consequences of policy. For instance, families would need to be motivated and supported to care for their relatives with dementia and increasing disability; as carer responsibilities increase, employees would need support from employers and possibly review of industrial frameworks to protect their positions while undertaking the dual roles of carer and worker; quality home-based nursing care would need to be enhanced and fully supported so that services are delivered and maintained at an acceptable standard of quali...
2018
Rather than expose and indict shortcomings of the existing system, the author was recently involved in a study that sought to build a vision of what high quality residential care for the elderly could look like. Preliminary findings suggest that care is best fostered in contexts where care is understood as a relationship and where both residents and care workers are treated with dignity and respect. Drawing on qualitative data collected in six countries (Canada, US, UK, Sweden, Germany and Norway), this paper will explore forms of work organisation that fostered care relationships between staff and residents, and inspired quality care. The paper also argues that the conditions of work are the conditions of care and suggests promising practices to support both.