Warehouse care homes
Stanley,
Having childhood memories of a relative ending up spending the last 20 yeasr of her in one of the massive Victorian institutions you mention, they were in many ways awful, although they were an improvement on what went before. But one of the pressures resulting in their overall size was the same - reducing overhead costs. One attempt to reconcile the demands for concentrating services to keep costs down together with the need for smaller, more personalised care and more flexible units was the bulding of smaller blocks on one site - there are/were examples of these different approaches wihtin a few miles of each other in Hertfordshire at one stage. I wonder if that kind of campus approach might be revived, or if any TPers have examples of such approaches in UK or abroad?
It is going to be increasingly difficult for smaller care homes in older buildings to meet the ongoing aand increasing requirements for safety, disabled access etc, and I'd expect new builds to become more common, espcially if the process of selling off homes on valuable land continues. Some homes also probably deserve the "warehouse" epithet with all its negative connotations, but I suspect staff atitudes and management leadership have a lot more to do with how user-friendly a home is. Small isn't necessarily always better, although I acknowledge it often can be.
However, there appears to be over-capacity in the care home industry at the moment. This and the increasing patchiness of availability combined with difficulties in some areas in recruiting and retaining staff seem to me to be real areas for concern. It's pretty evident thqt large amounts of money aren't going to be directed that way any time soon. Most government pronouncements on dementia are couched in the rhetoric of care, but on analysis the subtext is often about finding methods (whether through research and drugs or management) of minimising the demand that chronic illnesses (including the dementias) make on public funds by slowing progress of the disease. While we'd all wish to see that, the care side of the equation doesn't seem to carry anything like the same weight.
W