Catholic trends for care homes

T he Catholic Church’s involvement in education, child care and
hospices could fill chapters in any history of social policy but
its extensive provision of residential and nursing care for older
people hardly merits a footnote. And as far as politicians and the
public are concerned it is all but invisible.

Residential care for older people provided by religious-based
bodies – including the Catholic Church, the Church of Scotland,
Jewish Care and Methodist Homes for the Aged – is significant.
About 50 of the 238 religious orders in England provide such care,
and those, as well as some of the remaining 188 orders, also offer
residential care for their retired members. But research, media
coverage and political concern about residential care focuses on
the local authority or private sector and, to a lesser extent, the
secular voluntary sector.

Catholic homes have been buffeted by the same harsh weather as the
rest of the sector. Fees have not kept up with costs and there have
been concerns about meeting the new standards brought in under the
Care Standards Act 2000, despite the government’s recent relaxation
of some of the most stringent. Home closures or withdrawal from
providing residential care for older people are now common in
Catholic care, and new research shows that when considering either
of these, religious orders said that standards were the decisive
factor.¹

The Church, as elsewhere in the sector, has opened homes, although
unlike elsewhere, the rate of growth is unknown. But while 42 per
cent of orders have not closed or withdrawn from the sector and
were not planning to do so, nearly a quarter of these said that
they were “just surviving”. It says much about the state of the
market generally that when those which faced closure and withdrawal
sought alternatives, such as trying to find potential purchasers,
mergers, handing over to lay management or redeveloping part of the
site, none could be found.

The fall in vocations to religious life and to members of orders
brings particular problems and has exacerbated the plight of
Catholic homes. Lay staff cost more and work fewer hours. As
elsewhere, they are also in short supply.

Another special factor is that while fee levels are critical,
Catholic homes are not a business: they take people with little or
no support. One congregation had four residents paying £120
per week, even though the nursing home place cost £459. In
financially healthier times, congregations would not have blinked
at such a subsidy.

When closure or withdrawal took place, members of orders often saw
it as an opportunity to seek other types of work, for example
teaching or working with terminally ill people, and most did so.
These events caused distress, and even trauma, to religious staff,
lay staff and residents alike. The latter had expected to end their
days in the home they were living in, whereas they were now faced
with moving into the unknown. Residents, in particular, were said
to feel “let down”, “distraught” and “very vulnerable”. And while
90 per cent of residents found alternative accommodation, 10 per
cent died during the closure and transfer process.

It is true that the staff and residents in secular homes – public,
private or voluntary – would have many of the same reactions to
closure or withdrawal. However, what is unique about Catholic care
– and the loss which was very often most regretted – is the
sacramental life and spiritual ethos in which residents can live
out their last years. These homes also enable older people to
maintain their links with their parishes, as well as allowing them
to live with others who share the same values, experiences and
outlook on life.

This kind of care, too, is severely hampered by the lack of any
organisation that can offer support and advice, as well as the
absence of a national lobbying group. The Care and Housing of
Elderly Religious Project was set up by the Catholic Church in 1990
to help find residential care for order members who were retired,
sick or mentally or physically infirm. Were it to widen its remit
it could offer that much needed advice and support.

As for a national voice, last year the bishops of England and Wales
set up Caritas-Social Action, an umbrella social care
representative body. The Catholic children’s societies, among
others, are members and this proves no bar to their participation
in national secular lobbying bodies, which is something else that
the religious orders urgently need to consider doing.

Independence, comfort and dignity can be found in the best kind of
home, whoever provides it. That Catholic residential care meets a
unique need is shown by the research – it is seen not only to serve
the spiritual needs of older Catholics but also to represent the
Church’s values to the wider world.

But the needs of older people change, whatever their religious
beliefs. Catholic homes will survive, even if diminished in
numbers. But it may be, therefore, that new forms of care will be
desirable and the Catholic community may have to consider what else
it can offer. What one interviewee called a “third way” in
provision could be sheltered housing, which in the private sector
has expanded in the past 20 years. The focus groups and the bishops
both thought such provision was one pointer to the future.

To embark on this kind of care, the Church will need partners. The
most successful orders were ones that had found partners and 50 per
cent of all orders saw partnership with other orders or secular
bodies as a way forward. Child care agencies, with their
partnerships with local authorities, show what can be done without
the loss of Catholic distinctiveness. Like those agencies, too,
orders will need to recognise a greater role for lay staff and
management, not only to compensate for falling vocations but also
to make use of professional expertise.

There is also an irony about the present lot of Catholic homes,
which is that the government stresses an even greater role for the
voluntary sector in social care. In education it looks to more
faith-based provision. And yet when it comes to religious-based
care for older people, the mechanism of the market is what
counts.

Research 

The research was conducted in the summer of 2002. There were
in-depth telephone interviews with 238 members of the Conference of
Religious and others. Interviews were conducted with 200 religious
superiors. Twenty lay people took part in two focus groups in two
dioceses and three bishops were interviewed.   

Terry Philpot is a social policy writer.

References   

¹ T Philpot, On the Homes Front: The
Catholic Church and Residential Care for Older People,
Caritas-Social Action/Conference of Religious, 2003