SSRG Newsletter - July 2005

The Business of Caring: King's Fund Inquiry into Care Services for Older People in London

The results of this year-long Inquiry into the state of care services for older people in London were published by the Kings Fund on 27th June. What follows has been abridged from the Kings Fund website. All papers can be located at: www.kingsfund.org.uk/careservicesinquiry/index.html

The report, written by Janice Robinson and Penny banks, is based on an extensive collection of evidence from older people and their carers, care staff and managers, regulators, and local authority and NHS commissioners, plus special research studies. The Inquiry's key finding is that there are major shortcomings in current arrangements for the support of older Londoners and their carers.

The Inquiry looked at these problems and made 30 recommendations relating not only to London but also nationwide. The recommendations propose specific action for the improvement to care services in the immediate future and in the longer term. The recommendations relate to:

• reforming policy so as to ensure equality of opportunity for older people and a culture that focuses on their rights as well as their needs
• investing in market development to strengthen older people's consumer power, support growth and diversity in care services, and createincentives to provide high-quality services
• improving poor services for specific groups, tackling in particular shortages in services for older people with mental health problems and shortfalls in services to older people from black and minority ethnic communities
• mobilising more public and private resources for the care and support of older people.

In addition to the main report, the Kings Fund has published four working papers:

Looking Forward to Care in Old Age: Expectations of the next generation Levenson R, Jeyasingham M, and Joule N

What do today's middleaged people expect of care services in the future? Based on discussions with seven focus groups of people in their 50s, living in different communities in London, this paper reports on what kind and quality of care they want, and the type of housing, residential and community care options they expect. It also probes how roles and people's expectations of children to care for their parents are changing.

Understanding Public Services and Care Markets Netten A, Darton R, Davey V, Kendall J, Knapp M, Williams J, Fernández J L and Forder J

Most formal care services for older people are funded by the public sector, but they are largely supplied by independent providers. This paper looks at what factors influence the 'mixed economy' of the care market - including what funding is available and from where, and how commissioning works - and the role played by service users. It also examines how markets for home care, care homes and extra care housing work; how the market performs as a whole; and how policy and practice should be developed.

Commissioning Care Services for Older People: Achievements and challenges in London Penny Banks

What services are available to older people is determined to a large extent by how care is commissioned locally. This paper examines how care is being commissioned in six London boroughs, and how local authorities are working with their primary care trust partners, to transform the mix of services on offer. It shows how service users are involved, and assesses the extent which commissioners understand and manage the market and respond to need. It also highlights factors that are helping or hindering commissioning practice across the capital.

Trends in the London Care Market 1994- 2024 William Laing

The demand for care and support in old age is growing nationally, but London faces some particular challenges. For example, although there are fewer older people in inner London, many are likely to need social care as a result of poor health, poverty, poor housing and lack of social support. This paper shows how London differs from the rest of England, examining past, present and future trends in its population profile, and in the resources and services available for older people. It casts light on some controversial issues such as levels of expenditure on residential and home care services, and finding care home places for older people outside the London area.