At a recent event at City University London, Lord Hunt said the point that really struck him in the Demos Commission on Residential Care’s report was that care homes should be seen as a positive option, rather than the end of the line.
For me, it is this comment that strikes at the heart of the issue and it has stayed with me since because it is a crucial point that is so often overlooked. Care homes are needed, but not wanted; partly as a result of their negative portrayal in the media.
The population in the UK is rapidly ageing and older people are going into care homes later, sicker and more frail. At this vulnerable stage of life, fear is not appropriate.
One way to make care positive is to change the way we look at the sector and the Commission’s report calls for a move away from ‘residential care’ to ‘housing with care’. This is not a shallow and cynical rebrand, this is about creating a continuum of care with mixed provision – such as combining a care home with apartments.
By changing the name of ‘residential care’ to ‘housing with care’ we can not only avoid the negative image of care homes, but also separate ‘what’ care and support people need from ‘where’ this care is delivered, giving people a freer choice of the housing they want.
At present, when you are frail and no longer able to be nursed at home, the only option appears to be care homes. ‘Housing with care’ would better describe the sector as a housing option first and foremost, with a care package attached. Crucially, this would also address some of the disparities in commissioning, regulating and inspecting.
Champion good care
We also need to shift perceptions of the sector by championing the many cases of excellent care within it, and highlighting the faults in the system that get in the way of not being able to drive forward improvements.
As part of this, health and social care needs to be better integrated with housing and we urgently need more health-related expertise in care homes to meet the changing needs of residents. Tackling how we think about ‘housing with care’ will not achieve enough on its own.
We also need to build on what we have, create a flourishing market of supply, and decide how to fund care.
A sense of belonging, connectedness and independence is so important to us as human beings and it is this thread that has been so important in informing our work. We now need the government to establish a shared vision of what role ‘housing with care’ plays and what it ought to achieve for those it serves.
Take action
Norman Lamb, minister for care and support, spoke passionately at the City University event about how we must make a shift from what is currently a horribly fragmented system to promoting care that is joined up around the needs of the individual.
I think we can all agree with this, but while many governments have long talked about this, we need to turn this rhetoric into action. We need to stop thinking and working in silos and pull together to find a better solution. The Commission’s recommendations hold the key to the future of ‘housing with care’, which cannot just survive, but needs to flourish and grow to help people fulfil their potential and live the lives they choose at the end of life.
Julienne Meyer CBE is Professor of Nursing: Care for Older Adult and Executive Director of My Home Life at City University London
Calling residential homes “housing with care” before they have changed to resemble housing with care risks creating even more confusion amongst the public about the features of the different accommodation and care options available. It also risks tarring extra care housing (commonly called housing with care) with the negative stigma of care homes, rather than transferring the positive image of housing with care onto care homes. This also has regulatory implications – at present we have a distinction between “personal care” which applies in housing settings, and “accommodation together with nursing and/or personal care” which applies to care homes.