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Blog: The future of residential care

31 January 2014

Dr Chai Patel writing exclusively for The Commissioning Review, explores the importance of residential care for improving the care of not just older people, but those with living with disability 

Dr Chai Patel writing exclusively for The Commissioning Review, explores the importance of residential care for improving the care of not just older people, but those with living with disability 
At a time when care issues dominate national headlines, generally for all the wrong reasons, when we have an ageing population; when dementia has come to be recognised as one of the most significant health challenges we face; when local authorities are under immense pressure to make savings and clinical commissioning groups (CCGs) must deliver best value with finite budgets; and within a context of massive change in health policy and systems, our task has never been more important.
Will today's care homes morph into tomorrow's community hospitals, preventing acute hospital admissions, providing much-needed post-acute care and rehabilitation, and a safer way to return older people back to where they want to be – at home? The newly created CCGs and health and wellbeing boards can be a fundamental catalyst for such change.
By decentralising the commissioning process to GPs, both CCGs and health and wellbeing boards are in a strong position to remedy the often medically acute needs of residential care patients. It also means that CCGs are more able to identify potential partnerships between care providers and GP practices.
An example of this working well is in Darlington, where the CCG has launched a scheme to bring together residential care homes with GPs and their practice teams in a bid to improve patient access to medical services. A team of GPs and practice staff undertake weekly ward-round visits and work with staff at the care homes to improve medicines management. This type of initiative will provide proactive patient management and improve end of life care for residents.
Still, there is clearly room for us to improve on how we provide residential care in this country. The Global AgeWatch Index has indicated Britain lags behind Sweden, Norway and Germany at the top of the table for quality of life of the elderly, of which residential care plays a very important part.
Although many providers provide consistently excellent care for residents, the residential care system within Britain still has some way to go to improve standards across the board and ensure that no-one is let down. There are a myriad of reasons as to why failings occur. These can include financial pressures, individual mistakes and policy upheavals that make for a continually adapting and disrupted sector. Trust in the sector is also perilously low, following a series of high profile scandals and revelations. However, I believe that there is also a huge amount of fantastic care available, along with a wealth of ideas and drive to improve standards. It is these that will help us to create a system of social care that will be globally renowned. I believe that now is the time to make this happen.
Last year Demos, a cross-party think tank, launched a new Commission to look into the future of residential care.  The Commission on Residential Care (CORC), which is chaired by former Care Services Minister Paul Burstow, has no small task. Our remit – to develop a vision of residential care, whether it is for older people or those living with learning or physical disabilities, that is fit for the 21st century. Can we radically change the way we think about living environments for people who need care?
To this end, the Commission is gathering evidence from residents, providers, charities, care staff, and the general public to assess not only future demand for "accommodation with care" but also what the ideal response to this demand would look like. We are also looking at care practices overseas to gauge what works and what doesn’t when delivering residential care.
We are currently in our call for evidence, which will conclude on 31st May, and already the submissions the Commission has received have thrown up some very interesting information.
With a career spanning over 30 years in health and social care, and having led and run some of the UK’s largest providers, I am acutely aware of the unique situation we find ourselves in. I can sense a real desire for change and a confluence of adversity, necessity, technology and vision can help us create a radically different future. One which differentiates, provides choice and is rooted in the aspirations of an increasingly demanding older generation.

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