EXECUTIVE SUMMARY

Good quality care homes are significant for the successful execution of Putting people

first. Care homes are esteemed part of the overall band of care and maintain services

within local communities, providing a range of services to meet individual needs. It

makes person sure that they are assets of residential care home and they will be

provided required care and support. The people who live in care homes and their

families who act as customers are strong witness and their opinions are valued and

acted upon. Due to people’s opinion person becomes able to view the experience of

improved services offered by the care homes.

The staff needs to pay attention, to understand each person’s life history and fondness.

It is a challenging job for some large care homes. Care homes have many examples of

good practices due to effective leadership, balance shift of power and relationship –

centered care. Some standards and instructions are laid down for hygiene, fire,

building safety, and the level of care required, which intends to make sure that

residents in these homes are entertained with services of acceptable standards that are

of gain to them physically, emotionally and socially.

Old people have been an important proportion of our society. The developed world is

experiencing a rise in the proportion of the older population. It is notable in the case of people

who are aged over 85, and have experienced of residential and nursing homes. The old people

are neediest section of the society and deserve to be care and support. The important role is

being played by the Residential and nursing homes. There was a time when residential and
nursing homes were considered workhouse but proper focus on this industry has taken them

out from this label.

Residential facilities are offered for persons who are disable due to social, health or

other reasons, may not live alone or with their families. Residents’ level of care and

support may be divided into different categorized. It is not necessary that only old

people may be admitted into residential care home. A 15 years old child who is

normally weak in health and suffering from a functional (physical and/ or mental)

disability may be admitted into residential care homes. It is possible that he needs

intensive personal care, attention and assistance in the course of daily living activities

such as dressing, toileting and meals but does not require a substantial or high degree

of professional medical or nursing care. Some residents are admitted due to semi-

independent living ability. The objectives were aimed at finding the importance of

effective management in the residential care industry and in that process of research

the data found helped in evaluating the best practices associated with the

implementation of the operational functions.

 Table of Contents

EXECUTIVE SUMMARY..............................................................................................................1
Chapter 1: INTRODUCTION.......................................................................................................4
Research Aim and Objectives................................................................................................9
Research Questions..............................................................................................................9
Chapter 2: LITERATURE REVIEW.............................................................................................10
Types of Registration..........................................................................................................19
Social Factors..................................................................................................................21
Data Collection in UK..........................................................................................................22
Scotland..........................................................................................................................23
Ireland.............................................................................................................................23
Local Authority Homes....................................................................................................24
Resources........................................................................................................................27
Staff Responsibilities.......................................................................................................28
Staff and Culture.............................................................................................................28
Wages of employees.......................................................................................................30
Supply and Demand........................................................................................................31
Increasing Cost................................................................................................................31
Continuous Improvement...................................................................................................32
Chapter 3: RESEARCH METHODOLOGY...................................................................................33
Research Design..................................................................................................................33
Research Sample and Data Collection Sources try and personalize it.................................34
Chapter 4: Data Analysis.........................................................................................................39
Conclusion..........................................................................................................................49
Recommendations..............................................................................................................52
REFLECTION............................................................................................................................54
REFERENCES...........................................................................................................................57
Appendix.................................................................................................................................59
Interview 1..........................................................................................................................59
Interview 2..........................................................................................................................64
 CHAPTER 1: INTRODUCTION

Complex needs of people have raised another problem, so the specialization of

residential care services is very necessary. But the people involved in this business

know a very little about shortcomings like building and other facilities. Decision

making needs consistency. Individual needs can be met by suitability and the ability

of services. The growth of a single assessment procedure has assisted to reveal that an

informed and professional process is attainable. To exercise positive choice for

residential care services needs suitable information that has to be provided at the

right time with any necessary direction and support. The importance of information

can be highlighted by the consecutive reports; as a necessary requirement for

informed choice. Information should be accessible, accurate and available when

people need it. Inspection reports are another form of information.

This project is about the Residential Care Homes in general and in particular in

perspective of UK. This industry is growing rapidly but Still needed to be focused.

The purpose of this research work is to highlight the sensitive issues related to this

industry, factors hinder in the right selection, environmental and behavioral issues,

staffing problems , management problems faced by the people and finally to

discuss how to eradicate the weaknesses. The concept of international services

management needs to be understood as it plays a significant role in organizations

as it relates to providing services as core business, and where services are ancillary

to production.
Residential Provision

The evaluation of the Residential provision has to be done in the context of the total

lives of people. Mostly staff has been criticized for failing to remedy long-standing

problems. To take account of the person’s history and home environment is of great

significance. When young people enter into residential homes, they face pervasive

that are difficult to deal with.

Young people should be admitted in a place where they can best have their needs met.

It is not imperative that they find it at their home or in residential homes. It is consid-

ered as a national issue. According to Quality Programme it is called ‘lack of place-

ment choice’. “In order to help Local Authorities to address the issues the Quality

Protects Programme initially set up a ‘Placement Choice’ working group, this has

now become the ‘Choice Protects’ group (further information on this and other initia-

tives, can be found on the Quality Protects website”: ( www.doh.gov.uk/qualitypro-

tects)

Moving and leaving home

However, old people shift into care homes because this type of living they want to have in

their own homes but cannot get over there. It is a fact that to leave one’s own house and to go

to care home is not an easy job rather it creates depression for the older people as well as their

families. It s probable that old person gets recently discharged from hospital and get

admitted into care home, he will be missing all those comforts he was privileged with in

hospital. He may have suffered a loss which can be in form of physical or mental ability or

the loss of a partner or relative who used to take care of him. Sudden decision of moving

adds fuel to the fire and increases intensity of depression not only for aged person but for his

family who may not arrange care for him on short note. Old people are bit rigid, when they
settle in a care home, they can hardly move into new home. It is imperative that old people

should be given chance f decision making while entering into care home so that they can

make effective plan for their upcoming life. Effective knowledge about the rights of old

people, commitment of the Authority, fair and clear contract terms, and the ability to deal

with the complaint related to their problems and the protection of this group of older people.

Old people find sense of freedom and enjoy their independence at residential care

service. They can not only live independent life but also find no issues related to

privacy, as they do not find it at their homes.

Loneliness and emotional support is the sign of old age. When children grow up, they

remain busy in their own careers and raising families, and they have no time to think

about their parents. Even such cases are witnessed where children could not attend the

funeral of their parents. This practice of ignoring one's old aged parents had raised the

concept of the merciless culture of developing old age homes, which were unknown

some years ago. Other kinds of facilities and services are provided to them. The

services rendered to old people depend on their personal choices and preferences..

Staff helps and their training does work.

Residential childcare workers (RCWs) are accountable for a broad Range of child-

care practices and professional duties and must reveal personal capability in promot-

ing a caring, healthy, stimulating, safe and secure environment for the children and

young people in their care. The social, emotional, intellectual, cultural and physical

needs of children and young people in residential cares are assessed by RCWs. It also

plans, implements and review programmes that convene those needs. They play key

role for one or more children and communicate between the child’s family, field so-

cial worker and school. The residential care task serves to fulfill complex care, health,
social and educational needs of this contrasting group of children. Children daily care

include carrying out, together with children, the daily routines of preparing meals,

helping with personal laundry, shopping and some domestic cleaning and tidying rou-

tines. It means to prepare the children for adult life and independence.

According to The Local Government Association’s Children’s Workforce Survey

2006 there are 6,570 local authority residential care staff, including RSWs and care

assistants. 34 per cent of registered children’s homes are belong to Local authorities

with 59 per cent is associated with the private sector and remaining belong to volun-

tary sector or NHS. Facts can be little more or less. The size of homes varies like two

thirds have places for less than six children. According to 2004 34% were provided

34 per cent by local authorities, 59 per cent by the private sector and 7 per cent by the

voluntary, NHS or other sectors1.

2
Many older people and their families don’t have clear idea about the fee of care homes and

their services, terms and condition of living there. They want to collect this information be -

fore taking the final step so that they can get maximum out in the form of living. Contracts re-

lated to the fee related terms are unclear and vague and allow home care service to introduce

high arbitrary fee. They are made complex deliberately so that old people and their represen -

tatives may get complex and cannot understand them deeply. Older people and their families

face particular difficulties in making complaints.

Weaknesses in the management

1?
http://www.csci.org.uk/default.aspx?page=1341&key

2
Some other problems are related to the environment like décor, cleanliness, bed

rooms, and lack of privacy in toilet and bathroom, poor accessibility to toilet, no

silence in rooms, mixed sex accommodation, shabby accommodation. It should be

management’s duty to create rules and regulation before they face crucial

circumstance from old people not having the proper facilities. What are the

reasons that old people have to face above mentioned inconvenience? It includes

lack of funding, uncaring staff, assessment related to budget not to needs, staff not

being treated with dignity by their employer in return they don’t treat old people

with dignity, person is not as cared as home is cared, poor leadership, less number

of staff and they remain busy, staff having insufficient time, complaints are

ignored, old people are dealt with different members at different times, staff cannot

communicate due to poor communication skills.

Behavior plays significance role in getting the services, so is the case with this

industry. Old people hesitate to get admitted into home care because of stories of

misbehave of staff like forget dignity and respect, not follow the culture of

organization, not having empathy, mock at disability, useless gossip about

residents. They expect Independence and freedom of Choice, privacy, their words

should be heard, safety, they should not be discussed with others, discrimination

should be eradicated and not making them feel as useless segment of society. A

well organized home care provides vital service not only old people but also their

families. Old people who are weak and deserved to be cared are provided safer

place and support to live. It enables them to lead their lives without being

dependent on the shoulder of their families or friends. Aim of the British

Government is that desired outcomes should be achieved from the service to make
the old people contented with the service. That’s why its priority is to make public

sector service more modernized.

Regulating authorities

The Government is emphasizing on the coordination and integration of services.

‘Joined-up government’ means increasing the range of services that should be

provided to different people to cater their different needs by Polishing services the

management of, and making it certain that frontline services are combined. Many

factors are involved in making the system better. Continuous improvement is

subject to different institutions. Weakness should be removed by dialogues.

Effective Communication among users, service commissioners, contracts

managers, care managers and front-line staff can settle down the issues.

Research Aim and Objectives

The aim of the research is to find the relation of management of international

residential care services with the implementation of standards associated with the

maintaining quality of the care provided. The objectives of the study will revolve

around in finding whether the necessary standards are being achieved or not?

Research Questions

 Does the effective management have an important role in maintaining the

standards in the industry?

 What are the factors associated with the best practices implementation in

residential care services?

 What is the growing trend regarding the mission care homes?

CHAPTER 2: LITERATURE REVIEW

Every institution has some history, which tells us how they have developed their

present day culture. This chapter enables us to understand about the position of

current residential homes or in other words a place that can be a home of people

where they spend lives and die.

The term of ‘out-of-home care’ and ‘residential care’ by Australian Institute of

Health and Welfare, is used for the purpose of review. Out-of-home care means to

take care of children age0-17 especially over night care. For this state offers financial

help and residential care is means a building having sufficient place for people to re-

side in and where there are paid staff’(AIHW, 2004, pp. 7- 8). Both sources are used

in shape of empirical studies and principles developed from practice. The literature is

taken from the discipline of psychology, education and social work. Some journals

are popular in residential care , for example Child and Youth Care Forums, from

Canada, and Residential Treatment for Children and Youth, from United States of

America Where possible, there view describes about evaluative studies. The literature

has been taken from the United Kingdom, United States of America, Canada, Europe

and Australia. While search was done by using keywords ‘residential care’, ‘residen-

tial treatment’ , ‘residential care and education’, some literature has been taken from

other areas of relevance to young people’s wellbeing.

The controversial part of this review is that how the finding or one literature can be

used for local community. A of studies reviewed from Holland shows good practices

in residential care treatment, but there is no clue that this has occurred in mandated

context (Scholte & van der Ploeg, 2000). According to Cameron (2004) the approach
from one case can be applied on other case. Various studies related to social sciences

have shown that to control all variables are nearly impossible. (Scholte and van der

Ploeg) recognize that certain factors have attributed success in the residential care en-

vironment (firm but not harsh control, consistent but not obtrusive emotional support,

cognitive behavioral training intensive monitoring of treatment, and including the

family).

Thirdly, definition of positive outcome varies from study to study, and its time and

way affect its measurement. Outcome may not be constant due to the changing politi-

cal condition as well as funding. While analyzing the studies it is vital to get know of

the uninformed points at which funding cause the assessment (Parker, 1998). Both in

Australia and the United Kingdom, young people in residential care face have more

multifaceted troubles than those are cared at home. (Bath, 1998b; Department of

Health, 1998).

Many young people in residential care have seen negligence, varying types of abuse,

shakiness of caring relationships and face difficulties regarding their community (J.

Ward, 2004). When Young people in UK leave out-of-home care have experience

bad physical and mental health, homelessness and education (Richardson & Lelliott,

2003).In the United Kingdom research has signified that young people face psychi-

atric disorder in residential care (J. Ward, 2004). In NSW, Robin Clark found that the

young people over 13 years had schooling problems in residential care, over 30% had

a diagnosed disability or conduct disorder, a third had some relationship with the ju-

venile justice system, and most were boys (Clark,1997, cited in Bath, 1998b, p. 3).
assessment of wants, development and stipulation of individualized services is com-

pulsory (Barth, 2005). In the United Kingdom this has been enshrine in the National

Service Framework, in UK, takes care for all young people. common assessment

framework is utilized in Child Matters strategy to ensure that children’s needs are rec-

ognized and met (UK Chief Secretary to the Treasury, 2003). Each young person will

differ in developmental stages each young person will differ and needs will be differ-

ent to support their development and well being in those areas (Department of Health,

1998; Wise, 1999).

Peter Townsend (in 1960) did the seminal study – THE LAST REFUGE, on the resi-

dential care homes and his study showed that England and Wales had 3335 residential

homes accommodating 110767 people who were on the pension. This study helps us

to understand the conditions faced by the older people at the end of their lives. Survey

focused on the flowing admission and discharge of residents. It was the place where

death was kept hidden, where no one had gone to attend funeral, few homes were

there where residents were kept informed; used to go to say goodbye or went to attend

funeral. As the Thatcher conservative Government came into regime, changed the

concept of residential care homes. Now it had become market commodity. According

to new rules people who were entering into residential homes, would have financial

support through boards and lodging payment. Thus those poorer old people, who

qualified the income support system, got privileged to use public funds. Public fund-

ing was spent on mentally disabled people. By 1845, ‘asylums’ were publically

funded in two-thirds of English and Welsh counties, often large and dreary. Those pa-

tients who could afford it were charged, others were funded by Poor Law authorities.

The difference between health care and social care was not clear and older and dis-
abled people could not take advantage of it. Local authorities found it increasingly

difficult to provide affordable care with the funding available to them. The number of

private sector residential homes grew from 18,800 in1975 to 119,900 in 1990. 17 Un-

til 1980 voluntary sector homes received public funding from Local authorities, In ad-

dition to means-tested payments by the residents themselves. From 1980,

means-tested board and lodging supplementary benefit allowances became available

for residents of all independent sector homes, which encouraged the expansion of the

private sector. By the late 1980s services were increasingly targeted on the most dis-

abled, to cut costs, and by 1990 it was becoming difficult for older and disabled peo-

ple to access help with tasks such as cleaning and shopping if they did not have inten-

sive care needs and could afford private services. Services were still highly variable

across authorities.

The National Assistance Act 1948 was amended in1962. It supported local authorities

to give meals, recreational workshops and day centers for older and disabled people.

Advances in the more medical knowledge and care improved the more life expectancy

of older people would increase. Community care was more economical regarding

cost. According to the Health Services and Public Health Act 1968the power of local

authority was increased so that they could provide care services, including visiting,

laundry, social work and wardens. Older and disabled people should be informed

about services and adaptations needed to be made in their homes. If they acquire

domestic help, it will be charged. The help provided to them could be directly or

Independent providers. The Act came into practice in 1971, when older and disabled

people, who needed constant attention, were introduced Attendance Allowance .Of

all those aged 65 years or above, approx 4 % prefer to live in residential care homes.

This ratio increases along with the age. The dues of more than 50% are paid by local
authorities while 30% are self funders. Future development in this sector requires

funds provided by the central government to local authorities. The internal

environment of residential care homes has been changed with the passage of time.

According to the publications from the daily telegraph, which was published on

Saturday 18th of June 2011, approximately more than 10,000 elderly and disabled

people reside in care homes. Unfortunately they remain deprive of basic minimum

standards of quality or safety. There are various adult care homes in England but they

even cannot meet the basic requirements of the standards set by the law

The care quality commission (CQC).

The care quality commissions has stated that total homes are 18,000, out of which

4,000 homes did not meet the minimum requirements of the standards and it was

estimated because of the complaints. Nearly 100,000 residents are living in each CQC

and a new system named “watch dogs new online care directory” has been utilized

to guide the public. However, it could not produce fruitful result because of technical

problems. After realizing the failure rate of these homes, urgent actions were needed

to be taken to improve the poor quality.

A new inspection rule me was established in last October, according to which homes

should fulfill the basic minimum standards in 16 sections, which include:

 protection from abuse,

 cleanliness,

 safe management of medicine

 Respect and dignity.

CQC proved correct measure when it checked one nursing home in Bristol that was

not meeting 11 out of 16 standards. The residents of these homes were facing pain and

injury.

There are some other care homes that are lacking in meeting the standards and even

not identified by CQC, because its website could not be updated. A CQC spokesman

confessed about the weakness.

It was the telegraph by Richard Alleyne, that was published on the 20-06-2011. He

told that caretakers were having no idea how to wash and feed elder people. Even

some people are left unnoticed for 17 hours and rest are given poor diet. Apart from

this, they visit for a short time that they cannot pay basic attention.

If they are observed properly then it can estimate how much time they give to each

time and skip any important task for some other work lie skip meal in time for

washing. The lack of care was a basic factor that ignored even basic human rights.

Due to this, pensioners were forced to go towards hospitals or care homes. Due to all

these uncertainties, the turnover ratio is very high in this industry. According to a

career, she had changed 32 different carers over two weeks.

The commission also found out that residents were in wearing dirt clothes for hours

and they were not given food in time. The source of these findings was interviews that

was conducted on 500 people including residents and their families.

Residential Care for aged people

Long-term care for older people in the UK was started over 300 years ago and was

fostered through Poor Laws in the Victorian workhouses. At the start of the twentieth

century that ‘old and infirm’ people began to receive institutional ‘care ‘intended to

fulfill their needs. Elemental in the development of long-term services has been the

peculiarity between health care (originally defined within the National Health Service

Act1946) and social care (the National Assistance Act 1948). According to the

National assistance Act 1948 section 21 the local authorities were asked to provide

the shelter in the form of residential accommodation to those persons who, due to any

reason, are homeless irrespective (age, sickness or infirmity). The war had caused

destruction so building material was in short supply. That’s why many public sector

industrial homes were used for the old people. Local authorities played major roles in

providing residential care home to the few growing old people.

The difference can be found between ‘the sick or infirm’ (people with health needs

who should receive care from the NHS) and ‘the frail and old’ (people with social

needs). During the 1980s and 1990s, source of funding has been changed by Depart-

ment of Social Security which has opened a door to new providers. Now independent

sector (private, i.e. for-profit, and voluntary, i.e. not for profit) has taken the

charge of the bulk of older people’s long-term care provision. Consequently, Regis-

tered Homes Act1984 brought development of regulation with a small percentage of

homes dually registered to offer both residential and nursing places. Either local au-

thority or independent sector own care homes. Public raise funds for Local authority

homes and manage largely in the residential care sector. In the independent sector

care homes can be owned by charities or other voluntary organizations or can be pri-
vately owned by anyone from large for-profit companies down to small, one-person

businesses. Number of care homes were started Since the mid-1990s. They were

‘dual-registered’ (Bajekal 2002).

the Healthcare Market Review explains (Laing and Buisson 2004a) that there are

about486,000 places in care homes across the UK, which comprise: ( private nursing

care 164,300 places ,private residential care 182,000 places, voluntary nursing care

15,000 places, voluntary residential care 49,700 places public provision (including

NHS and LA) 74,600 places.)

Darton et al (2003)has done survey of care homes in 21 local authorities and found

that buildings of local authority homes and the voluntary homes were in purpose-

built premises. On the other hand buildings for private residential homes, dual-regis-

tered homes and nursing homes were converted .occupancy rate is 92% n care homes.

Occupancy rate, according to Laing and Buisson’s (2004b) survey of care homes was

in 2003 to be 91.8 per cent for all for-profit homes as compared with the average of

90.4 per cent in 2002), 92.3 percent for private residential homes and 87.7 percent for

dual-registered homes. The Social Policy on Ageing Information Network (SPAIN)

(2005) explains that this is above the optimal level . People who have high level of

dependency move into nursing homes where as those who have less dependency

move go into residential care (Bebbington et al 2001). Much struggle has been done

over the past 20years to advance standards in care homes. Greater power has been

given to both local and health authorities in the regulation of care homes by The Reg-

istered Homes Act (DH 1984) . However, according to Nazarko(2000), as the legisla-
tion was unclear in words and open to analysis, it resulted in health and local authori-

ties all applying different standards.

Southern Care Named and Shamed

Southern Cross is renowned provider of residential care for older people. There are

750 homes in which 30,000 residents are lived. An 81-year-old woman feisty woman

Kathleen Stenson was abused in one of the nursing home of Southern Cross in

England. She was restricted to see visitors of her choice; her phone calls were never

transferred to her and did not provide food properly. Her son William has been doing

a long struggle against Social Services and The Court Nursing Home who were not

allowing him to meet with his mother. These two institutions had accused him and

supervised him during the meeting hours with his mother. Their conversation was

tapped and even private mails of Mrs. Stenson, were checked.

If nursing home or care houses are providing this type of protection then what type of

image people will have on their minds about their protection when they will grow

old? Will they perceive that they can have peace and contemplation?

Only other people can raise voice for this tyranny and injustice with Mrs Stenson and

her son , otherwise this practice will be lingered on.

The UKHCA helps to support the best possible standard of home care provision to

older people. Home care agencies (holding membership of organization) are

promoted by UKHCA. Through it they attain certain standards of home care

provision. Via the UKHCA one may be able to get a ‘price list’ from individual home

care agencies for the services they offer to older people in their own home.

Residential care service is becoming popular because it accommodates those people

who cannot live their lives freely at their own homes. They are proves better living

option for those older people who return after a long period in hospital. People are

given extra care and other housing based solutions which prove for them much better

and safer environment than home. Mostly when old people move into residential care

for temporarily find it so good that they prefer to stay for long.

Types of Registration

The (HASSASSA Act in 1983) brought development of dual registration. One type of

registration was for those who needed nursing care and second type of registration

was for those who just needed residential care without nursing care. Those homes

which were providing both type of care should be registered with District Health

Authorities for nursing and with Local Social Services Authorities as residential care

homes. The main objective of resident care house was to provide quality life to the old

people so that they should feel comfortable not only in the house but in the room

without any anxiety that they will be moved unnecessarily. Much attention was given

on the staff training that how they should deal if death occurs and how to inform

others about the demise. For this staff had to learn the local and cultural customs of

the deceased person and his family. Health care services were disorganized because

staff was not fully aware about the services. According to international standards,

Residential Care homes in the UK are small by (average size around 20 residents).

They don’t provide the facility of health care service but only provide nursing facility.

Homes were managed into self-contained units, each with its own lounge and dining-
room and kitchenette. Fully-furnished bedrooms were given to residents where they

could save their ornaments even, TV and radio and small item of furniture.

The positive image of residential care service is so much strong that even some

negative sides of it can easily be overlooked. But these negative images become

chronic and create bias which overrule positive impact of it .prejudices serves the role

of negativity among the other pillars of the system and finally all the services of this

become devalued. Whatever the case may be, it is like blessing for the old people.

With the passage of time the service standards of residential care service have got

better but even then the negative standards are so stiff that cannot be changed by the

time and changing conditions. The residential care service is facing many difficulties

in the case of old people due to the presence of traditional thinking pattern. If one has

to understand and acknowledge its contribution to the spectrum of community care

services; it is imperative to clarify the purpose of residential care service. The role of

residential care service is also promotion independence. It also needs specialists to

achieve the target positively and strongly but it needs innovation and practice in the

best way. Residential care service can be redefined to spur positive impact in it by

focusing on demonstrating user focus, challenging ageism, and be at the cutting edge

of innovative services and best practice.

Outcomes

The people giving and receiving the services gave much more importance to

outcomes but it requires particular changes especially in case of older people. It

requires continuous improvement by assessment and throughout monitoring the whole

process. An outcome is considered as a means of evaluating the quality and

effectiveness of care services. Particular changes are required for residential care

services. It has been proved by different forums of residential care service for the
older people that this goal can be achieved definitely by the taking positive changes

only by monitoring and evaluation process.

It is our daily life experience that meaningful involvement and positive activities

plays a vital role to form our good decision making. The same case can be applied on

the older people of residential care services. The older people should be given

opportunities to meet their friends, family members and many other people they like.

By such practice we can raise the standards of residential care service. Social contacts

and companionship play an important role in the lives of older people especially who

stay at residential care service Well-being and quality of life for most people is

enhanced through meaningful involvement and activity. The same aspects are true for

older people in residential care settings.

Social Factors

Wider contribution can be attained by social contact for both within care settings and

outside. It is of great significance for social identity and fulfillment. Such a

contribution should not be underestimated. The role of Residential care is increasingly

and now it is operating as a specialist facility that offers End of Life Care. Quality

service in residential care can be ensured by Leadership capability and front line

management skills which are the main components. Future with modernized services

can be anticipated by the development in the management of change. Standardized

assessment performs like tool across residential care services for older people. If there

is no measurement and assessing tolls will not be any benchmark against which to

make judgments about services and trends.

 Data Collection in UK

Data collection is a tough activity and the homecare sector face the difficulty in

routine data collection in all four administrations of the UK. Sometimes people cannot

be counted properly who pay for their care privately, as local authority does not count

them. Analysis has been done on Wales, Scotland and Northern Ireland than for

England. It will help to understand that how many people benefit from homecare, who

provides the care, and how it is paid for. England has a large number of populations

who take advantage of residential care service, and it is the reason that extensive data

is available on it. According to 2010 survey the estimated size of workforce of RCS

was 351,470, including; 267,180 in independent sector, 48,130 in the voluntary sector

and 36,160 in local authorities. In workforce mostly female workers were dominant.

Approx pay of a worker according to a survey of 2008-2009 was–£6.80. This figure

can be changed according to a geographical region.

Wales

On the name of RCS, approx 22 local authorities are working in Wales, which are

providing care to the old people, who are helped according to certain eligibility

criteria. Most councils give contract to the independent sector for the provision of

funded homecare. There is constant emphasize of helping people who are in need.

Policy makers have to set their direction to achieve the goals but so far they have not

followed Scotland’s lead. The elimination of large variations in the social care

charges induced by the local authorities for the measure of social care services. This

includes that the local authorities will be responsible to charge of maximum £50 per

week for non-residential social care .it was found that total tally of 18,117 older ones

got funded homecare during one sample week in September 2009. Providers in Wales

work under the provision of Care and Social Services Inspectorate Wales. In session
2008-2009 the homecare services witnessed improved quality in the services like

(care planning, quality assurance and medication) performed by the provider in a

number of areas. In 2001, independent sector contained 6000 homecare workers.

Meager information is available on the independent sector homecare workforce in

Wales.

Scotland

The people aged 65 and above got privileged for free personal care in Scotland in July

2002. But they were charged by the local authorities, for their domestic services. It

has transformed from residential care to homecare. Still the consistency of the policy

in the long term is unanswerable and due to the shortage of funding, the policy makers

are yet to provide reasonable services. As in England and Wales, the local authorities

have been unable to meet the requirements and couldn’t catch up the fast growing

inflation and other issues of the employers. Local authorities had either provided or

purchased homecare service which was received approximately 66,224 people till the end of

March 2010.A gradual decrease was seen in the previous year. Combined care at home can be

estimated by the Scottish Social Services Council 33And figure of 67,120 housing support

workforce was estimated at independent sector.

Ireland

A consensus was taken in which it was observed that the public administration of

Northern Ireland had established five Health and Social Care Trusts that operate both

health and social care services. There are symptoms that in UK campaigners such as

Age Concern cut back services. The independent sector has observed that the services

offered by the trusts have never been up to the standards and lacking behind in other

sectors of society and causing problems for the employers. Regulation and Quality
Improvement Authority has inspected RCS and regulated them in Northern Ireland in

2008.

In short, the major concern is on delivering social care services to their users. Major

practical challenges are emerged in the planning, commissioning, and delivery of

services and changes in the activities of managers and practitioners. The outputs of

focused services that have been provided include the achievement of desired goals,

aspirations and the major priorities of every single service user. The services should

set the benchmark to improve the quality; sometime the goal set by the service does

not meet the criteria standardized service. Accountability of the authorities is done as

they are answerable for providing the residents the best possible services and the

security by monitoring them closely.

Local Authority Homes

According to Team managers the advantage of local authority home over the private

homes was that it is like change to residential that allows a the elderly person to

change their mind. Service should be more flexible. Short term care is difficult to

manage because in short terms staff gets hardly know the person, his mood and

nature. It takes time to get familiarized with him and later on he/she may be converted

into future candidate of RCS. A person not only needs the care of RCS but also his

relatives are great source of care for him.

India

In India, Grandparents look after their grand children in absence of he parents. How-

ever, this trend is diminishing as they live far due to their jobs, location or their own

interest to be perused. Careful parents get worry about the physical and mental train-

ing of their children given to them by that their grandparents. Domestic help is not ex-
pensive but availability is rare. Quality child care are present but they need to be im-

proved. There is no statutory framework to make sure the quality provision of center-

based care. Now government has concern regarding it infrastructure and meaningful

quality standards. It includes trained staff, educational program, environmental related

facilities.

Street children are an especially defenseless group in India. Their lack of parental sup-

port means they are all orphans. They become habitual of drugs and alcohol and are

vulnerable to sexual abuse and recruitment as criminals. They cannot reach to public

health programs.

India also has the phenomena of de facto orphans. Due to parents bad health children

have to leave school to take the responsibilities Of household Children. They have to

do jobs. The children in orphanage home don’t indicate the death of their parents but

also due to abuse of alcohol and drugs, mother’s sex work, mental illness, or divorce.

Blue Haven Children’s Home and School is a project to set up and run a fully self-

sufficient home for 200 orphan and poor children and an international-quality school

for 500 students. In 2005 Blue Haven Children Home (with 32 orphaned, semi-orphan

and destitute children) was started. it is located in the Gangetic Plain of North India,

midway between Delhi and Calcutta. In the state of Uttar Pradesh in area of North In-

dia, there are an estimated 35 million destitute children. They are half-starved, have

no opportunity to get an education, and are utilized in child labor.

This massive problem is addressed by very few institutions or programs. Those insti-

tutes are not independent and take help of funds from west. A high quality children’s

home and school must be acquired that will make able poor children to get high qual-
ity of education. These institutes will make children fluent in English and develop

their skills necessary for modern world.

As the facilities are less so a large house has been taken on rent in the city of Luc -

know. Alok Srivastava, director of this work along with his wife looks after children

in this area. A husband and wife from Nepal are caretakers. They themselves were

very poor and due to this poverty, their own sons were deprived of food and educa-

tion. However, they became happy because they, not only taking care of other chil-

dren but their own sons are getting good food and education. Many would have grown

up as beggars on the streets or as temple prostitutes. These hopeless children now got

bright future and a loving family. They study in excellent English-medium Christian

school and most are now fluent in English.

The Indian government declared the National Policy of the Older Persons in January

1999, the International Year of the Older Persons. The policy focus on the rising el-

derly population and an urgent need to understand and deal with the medical, psycho-

logical and socio-economic problems faced by the elderly. Along with the govern-

ment , non governmental organizations should help the government to form a society

where the needs and the priorities of old people should be fulfilled.

A voluntary society was develop whose main objective was to work on the cause and

care of the older people of India namely Help Age India. A political society works

for the welfare of people without their personal interests. The Act, 1960, was

introduced in1978. The HelpAge India was oriented in 1978 with the assistance of

Mr. Cecil Jackson Cole, who is an active member of helping the aged people.

Physical environment is of primary focus.

The Scope of Age Ventures India

It is vital to build such places for the old people where they can lead a safe, secure,

hassle free and enriching life. These houses not only will provide residential care,

health and wellness services but also provide a place of same age people who can talk

to each other on their common interests. Buildings are embellished in a user-friendly

way like the one totally, wheel chair enabled, have anti skid tiles, grab bars etc.

A survey was conducted and responses of different people were taken. For them the

choice of location was main issue because due to age factor old people feel loneliness

and wish to live near their families. Now the choices are increased and people feel

easy to live anywhere wherever they want. Visitors feel pleasure to visit small

villages. They feel easy to travel their nearest place which will be located in the other

locality.

Resources

Another problem faced by the management was the space, head of the home felt that

the resources were less to upgrade the building. It will require a lot of money. They

want to enhance the area but they are restricted by money. Still people have found

great difference between private home and RCS. They like to go to private homes due

to staff behaviors. As it was a great issue. They are short-staffed. They have 30-40-50

residents per home. They don’t have niceties serviettes, cups and saucers, tablecloths,

foot-stools. They get fewer funds and less staff. On the other hand no one can deny

their advantages like of accountability, security, staff training and standards. Private

sector lay great emphasize on size, physical environment, atmosphere and choice. The

disadvantages of local authority house are more visible to the people. Though private

homes were small in size, with a more homely atmosphere where residents feel as if

they are living in their own house. few number of respondents give extra marks of this
privacy contained in residential care --having a single room -- whereas shared rooms

and multiple occupancy rooms was taken as a disadvantage of local authority homes.

It does not mean that private homes are free from flaws; they have also disadvantages

like issues of security related to financial and health care, lack of accountability, the

perceived lack of staff training and cost. Strong emotions were articulated by those

who were in the public sector that elderly people could be very defenseless in private

homes, especially if they have no money in their pocket or they badly need nursing

care. Lack of security creates fear for old people that they will be out of the home at

any time and this threat mingled the profit and care. It is general notion that any

business can be done on concept of profit, where this concept hovers the needs of

elderly person is forgotten.

Staff Responsibilities

Residential care staff performs a significant role in the day-to-day lives of residents.

They face a lot of problems in many forms like a lack of information to encourage the

well being of residents (Smith, 1998). RCS has also hierarchy where the roles are

performed according to the designation; they provide personal care assistants having a

significant role in resident care. As they are poorly equipped so cannot provide quality

care (Atchison, 1998). Their less education hinders in their learning. Due to limited

knowledge they adopt bad practices from their co-staff and finally it becomes their

habit.

Staff and Culture

Action research is a collaborative activity among colleagues searching for solutions to ev-

eryday, real problems. The action research is used in real scenario, rather than in artifi-

cial set up. Its primary focus is on solving real problems. This activity gives Power to

the staff to recognize the problem and modify c practice to make better resident care.
It assists to identify the knowledge gap and enable the staff to fulfill the deficiency.

This report emphasizes on an action research module of a project and the purpose is to

enhance the social and physical health and comfort of residents of aged. Along with

this much focus is given on nutrition and physical activity. Staff were playing the

leading role the in the project. The usage of action research approach was adopted be-

cause it encourages making staff powerful, the way they plan and allow staff to recog-

nize the problems and bring changes to achieve best practice. Undertaking action re-

search will be affected by the culture of the organization in an aged care. Organiza-

tional culture means the social structure and distinctiveness of an organization. Cul-

ture of the organization is understood by members so that they distinguish the organi-

zation from other organizations’ (Robbins, 1986). Changes occur with the passage o

time in every structure but for this management has to be active so that it can promote

the new culture, to support and encourage staffs who take up changes. Staff should be

involved in the process to build up consensus and trust (Robbins, 1986). Facilities

draw a positive impact of organizational culture. Newness will bring more practices

and try new approaches (Smith et al., 2000). Practice standards set by the facility

management but it does not mean that they meet the standards and the reason can be

of staffing or organizational issues. For example, fresh fruit was considered an impor-

tant element in menu –‘cut up and ready for eating’ – but this practice was hardly fol-

lowed. The flaws occur always due to some reasons behind it and same thing hap-

pened here .there was lack of staff time, a poor selection of fruit made by the kitchen

staff etc or staff might be not aware about the residents choice what would they

like ,lack of awareness about the health related issues of the old people. This issue

should be highlighted and also rectified. All the issue should be dealt with before the

food item could be served on job training is a constant learning for the staff and it can
be imparted to them by adopting some traditional and modern methodology. Staff at

RCS was also ignorant regarding the nutrition and physical activity due to gap of

knowledge and skill. Some times to provide the information and resources alone were

often not sufficient to bring change into practice. Workforce at RCS consists of

mainly nurses and personal care workers. So the learning knowledge and skills de-

pends on their availability.

Wages of employees

Wage difference creates frustration for the workforce so difference between aged care

and acute nurses should be diminished. Current funding for aged is so less that it does

not allow to apply this practice. The government should develop a strategy which is

comprehensive and should meet all type of necessities of national aged care

workforce.

In the coming decade the number of residents in the care service industry will be

doubled approximately, which is obvious due to the increasing population in the area

and the improvement in the health care and medicine industry as well. The long term

trend of aged residential care has been in the demand for over past decade but the

services required by the people are changing. There has been a decline in rest home

utilization and steadily increasing utilization of hospital and dementia facilities. Over

the last decade much of the growth in demand for aged care services has been

absorbed by increasing utilization of home support services. The increasing demand

of dependency levels of rest home residents indicate that the recent decline in rest

home utilization will slow. Also, the increasing levels of elderly dependency mean

that remaining people at home will become a less feasible option as weakness levels

increase.
Supply and Demand

The supply and demand factor is vital as to keep up the standards provided. The

points that need to be focused on are to the bed numbers which will be increasing and

the need will be to maintain the supply. This will also mean to increase the facilities

and services up to the demand. The overall supply and renewal of facilities in the past

years have not been effective and has slowed and needs to increase significantly to

cope with projected demand. The changes can focus on the mix toward hospital and

dementia care as the number of aged people increases.

Increasing Cost

the increasing costs has made it difficult to generate profits and provide the necessary

services needed as the rate with which the people are shifting towards residential care

services in comparison with the investment is much higher. A comprehensive industry

survey was carried out on costing as part of the costing component of the Review

(Grant Thornton, 2010). This survey had the highest provider participation rate of any

comparable international study. Pricing was not included, although all income sources

were surveyed and included within the results (Grant Thornton, 2010). Key findings

from the costing component include:

 Limited investment in new aged residential care building stock

 Target of recent investment in modern aged care facilities

 Cost of rest home and dementia services resulted in the lowest financial

returns

 Low number of beds in most of the facility.

 Old building stock with almost depreciated value which deliver the lowest

financial returns

 37% of facilities were co-located with retirement villages

  Half of all the facilities charge extra fees for additional services which has

doubled since 2006

 Average bed occupancy is 91% for rest home, 93% for hospital and 96% for

dementia beds.

 Variations in the operating cost according to the different services provided

 Earnings are not compensating the return on investment and are inadequate to

cover expanses

The workforce employed in the residential care sector has doubled in the last two

decades, which is likely to increase due to high demand of residential care services.

Workforce supply is likely to adjust the demand as the new workforce is entering in

the industry and the increased salaries but the main focus should be on retaining the

existing nursing workforce as they know all the work and do not need training. New

support workers are needed, with the effective and efficient management of the senior

workers, the costs can be reduced regarding the training costs.

Continuous Improvement

Continuous improvement is always needed for the system to work efficiently and

effectively. For that purpose, the focus should be on using the best practices which

will help in yielding profits and gaining more operational efficiency. In the

residential care industry the points that can be emphasized on can be improvement in

the current approach, an enhancement of professional services in the community, an

individualized funding approach and providing joint housing options for older people

between their own home and residential care. The authorities in the specific area need

to make sure that the standards are met according to the defined points. For example,

the health information and quality authority in Ireland has developed the national

quality standards for residential care settings for older people which are based on
legislation, standards in other jurisdictions, research findings and best practices. There

are 32 standards which are made up of standard statements and criteria. The standard

statements set out what is expected in terms of the service provided to the resident.

The criteria are the supporting statements that set out how a service can be judged as

to whether the standard is being met or not. The Standards are grouped into seven

sections to reflect the dimensions of a quality service.

CHAPTER 3: RESEARCH METHODOLOGY

Research Design

The main purpose of any research is to gain knowledge and achieve answers of the

research questions in a systematic way. It involves collecting information, analyzing it

and then explaining. The work “Methodology” and “Methods” are different in nature.

The methods was used as a tool to search or gather the data while the methodology

used to describe the research objectives and relate the research questions with the help

of previous academic framework and find the best methods to answer the research

questions. In this report the focus was on the residential care service industry in UK

and India. This made gathering primary source of information difficult but, we will

try to address that situation by using the interview methodology. Secondary source of

knowledge comprises existing knowledge available in the form of publications for

example, books, journals, encyclopedias, and government documents, audio or video

sources. To have an access to the secondary source for data collection is not difficult

because the main advantage of selecting the secondary source is the easy availability

of the data at the less cost. But selecting the secondary source we need to be careful
about the authenticity of the source. The quality of the information was totally

dependent on the selection of the source from where we collect the data. Therefore,

we have collected information from reputed journals and of authors who are well

versed and are currently up to date with the current trends in the market and have

knowledge of the ups and downs of the industry.

Both qualitative and quantitative analysis could be done. We used qualitative method

in which the research was done through

1) Case Studies of mission care

2) In-depth Interviews were conducted including residents in mission care and

employees in mission care in UK and India.

Research Sample and Data Collection Sources try and personalize it

Primary data are collected from respondents, it is pre-requisite for researcher to pin

point the people from whom data can be collected. “Research sample” is the group

selected individuals who might be affected by the research subject and they are

representative of the population on which the research was carried out. Research

sample is vital for primary research. For this research we will conduct interviews. To

analyze the research problem it was necessary to select a sample from the whole

population to do the research in minimum cost and time. It was decided to select a

sample through non probability sampling because of the time and cost consideration.

Research is a process of enquiry and investigation. It was systematic and methodical

study and investigation, especially to discuss new facts is the definition of the

research. The word especially is important in this contact as within academia the

meaning of research has been finally directed. In my research I will use methodology.

These are good interrogative to bear in mind during any enquiring process.
Methodology called “exploratory “exploratory research mean goes beyond this and is

concerned with WHY AND HOW.

Both primary and secondary data was collected. Secondary data collection methods

will include books, journals, articles, and company reports that specific to UK and

Indian market. Primary data collection method is interviews and observation which

will be collected from people related to UK markets. The basic dissimilarity here was

that, in qualitative studies, the information is typically being gathered directly,

whereas in quantitative studies, the data is gathered indirectly, through an instrument,

such as a survey. In field studies and usability studies, for example, the researcher

directly observes how people behave to meet their needs. This gives them the ability

to ask questions. By contrast, insights in quantitative methods are typically derived

from mathematical analysis, since the instrument of data collection (e.g., survey tool)

captures such large amounts of data that are coded numerically. Due to the nature of

their differences, qualitative methods are much better suited for answering question

about why or how to fix a problem, whereas quantitative methods do a much better

job answering how many and how much type of questions. Qualitative research will

be conducted through case study and in-depth interviews while quantitative research

will be done through the analysis of questionnaires.

When a study is designed primarily to describe what is going on or what exists we use

descriptive questions. Public opinion polls that seek only to describe the proportion of

people who hold various opinions are primarily descriptive in nature. Our research

will contain descriptive questions mainly in case study and in-depth interviews. When

a study is designed to look at the relationships between two or more variables we use

questions that are relational in nature. It is basically a public opinion poll that

compares. In this study we will use questions that are relational in nature in all our
methods i.e. in-depth interviews and also in case study. Also when a study is designed

to determine whether one or more variables are forming a basis for another variable

we use causal questions and these will also be used in all our methods i.e. in-depth

interviews and also in case study.

The sampling technique used for this purpose was Convenience Sampling. The reason

behind selecting this technique was that the sampling frame cannot be fully

determined and it would have been time consuming to select a random sample so it

was easier and more feasible to select respondents which were conveniently available.

All the people who were involved in residential care service industry which were

employed and the people who were a living there make up the population. The

samples were selected without any preference regarding gender, age etc. as these are

not of great importance in this particular research. The interview methodology was

mostly used in the research work to answer the ‘how’ and ‘why’ questions. And on

the same strategy for our research work I selected the case study as a research method

to explore my study and find the relevant data from the primary sources. The main

advantage of using this research method is that it provides the complete proof like a

manuscript, artifacts, interviews and interpretations. The whole project will be

completed in time frame which is about 2-3 months. Initially however, there is a high

possibility that there may be experience of some delays in data collection or during

primary survey.

The interview conducted will be structured but, as it an in-depth interview this will be

more of a semi structured interview as answers may lead to new questions. Order of

the questions may also change depending on the direction in which the interview is

going. There may also be some ethical concerns as information regarding the

companies may be seen as surreptitious and disclosing some of this information may
not be fitting. But, it would be requested that such information is provide which is

objective and which may not be harmful to anyone or any company.

The response to my research will remain confidential because privacy is one of the

ethical issues in undertaking such a research. The use of this data would be protected

and individual right to anonymity will be observed .I would respect the individual

rights of the people and companies involved. This will be done through concentration

on all these rights and various other points during my research.

1. Not to participate

2. Not to be harasses or be offered inducement to participate.

3. Not to contact the people at unreasonable time.

4. Try to target right person.

5. Except the researcher to abide by the extent of the consent given and no find

research without first seeking and obtaining permission.

6. Not to be subject to any attempts to prolong the duration of the interview or

observation.

7. Not to answer any question.

8. Not to be subject to question that creates stress or discomfort.

The interview focus will be to find the management issues and the questions that

were asked comprised of:

1) What is residential care?

2) How is residential care different from the care, which is being given to them

by their own loved ones at home?

3) What should a good residential care facility provide?

4) What does your organization provide?

5) How your organization is different from others and what practices do you

implement?

6) How can the loved ones help in making their stay better?

7) What are your views on the current government regulations regarding

residential care facilities?

8) How do you see the future of this industry and how does your institute deal

with the problems faced?

9) Can you put some light on the procedure of selecting a facility and why did

you not go for a personalized home care worker?

10) What are your views on regarding the practices used by the industry?

11) Do you see the future of this industry and what obstacles do you think they

face?
 CHAPTER 4: DATA ANALYSIS

Objectives that have been covered in the study revolve around the issues related with

the management in the residential care service industry in UK and India and how the

management can improve on the issues. The main sources of the data that were

collected in this regard were through case studies and the interviews conducted of

employees and residents of the residential care service industry.

The research that was conducted showed that residential care or assisted living is a

residential option for seniors who want or need help with some of the activities of

daily living. These could include things like cooking meals, getting to the bathroom in

the middle of the night, keeping house, and traveling to various appointments etc.

Sometimes it can be very hard for people to provide their parents with the necessary

care that they require due to their age or preceding illnesses.

Life now a days is getting faster and it is getting harder to keep track of everything

around and in such a situation it gets very hard to take complete care of some one

particularly if he/she is not completely fit (physically and mentally). With this in

mind, residential care is very important as they provide the necessary care and

attention and we cannot give our loved ones no matter how hard we try.

Therefore, it is a good idea to opt for such services for senior who need more personal

care services than what anyone can get at home or an independent living retirement

community.

To get a more comprehensive view of how the residential care system works and how

it is affecting the people that become part of this phenomenon. We conducted a

couple of interviews which included one which conducted of an employee of a

residential care organization. The purpose of this interview was not only to get a

complete idea of how things work but, also to judge how things would evolve in the

future and the obstacles and opportunities that the industry faces.

Residential care can also be defines as assisted living and it is an option that is present

for people who need specific necessities that they themselves or their relatives and

loved ones cannot provide. These would include elderly people, children who need

special attention and also, people who are suffering from some specific ailment which

makes it hard for their loved ones to care for thoroughly. Such services are

recommended for people who require personal care services and need round-the-clock

supervision or medical.

Through this interview we have come to know that there are people who are hesitant

from sending their loved ones to home care institutes and that if they feel they can

take care of their loved ones who require additional support themselves, they should

not opt for such services but, usually the requirements of time and energy tends to

take the most out of them and they are forced to send their loved ones to such

institutions so that they could be better cared for.

We have also, come to know that there are private care providers that can help around

the house and provide support in arranging for all the necessities for the person in

need for special attention. But, usually trust and reputation are big factors in deciding

whether you require someone to come to your house or to send your loved ones to an

institute. It has been observed that people don’t usually trust a specific person

particularly in their homes whereas, they tend to put their faith on institutes

particularly ones that have good reputation or have been around for some time.
Peace of mind is the most important factor when it comes to deciding a particular

institute for your loved ones. An institute that gives you the satisfaction that your

loved ones are being given the best possible care and are using modern and

scientifically proven methods to help your loved ones in their time of need is the one

that people tend to choose.

The employee that we interviewed informed us about the facilities that his institute

provided to people who needed special care and told us about why the institute is

seeing more enrollments of people of all age groups ranging from small kids to

elderly people.

The services that they provide include food supply (three meals a day), assistance in

daily routine, medical aid (particularly in administrating regular medical procedures

and medicine), room cleaning services, round the clock security, and laundry services

etc. These services give the resident the basic needs for living a properly healthy life.

Along with such services the institute also provides basis for human interaction. It

conducts individual and group sessions to help the residents in collaborating

effectively with fellow residents. It also, gives the residents a feel of fitting in to the

institute and develops a strong and healthy relationship among each other which is

returns helps them feel mentally strong.

There are recreational activities that also take place. These also include individual as

well as collective activities which also help in the resident living a happy life style.

It was also observed that the basic problems that are faced by the residents in most

institutes are fairly common and can be understood by the figure that has been given

on the next page.

From the interview we came to know about how people make their decision regarding

which institute to choose. There are people who go for institutes that are economical

and neglect if the proper care would be given to the residents. This usually happens

when they don’t care much about the resident and want them as far away from their

lives at the most economical fees possible.

But, on the other hand there are people who care a lot about their loved ones and go

the distance in providing them with the best services possible as they want them to

live life to the fullest despite their setbacks.

The interviewee was adamant that their organization provided the best possible

facilities that even though they were marginally more expensive they still provide

more value for money than others. He was of the opinion that the loved ones can

make a big difference by visiting often and through making sure that the residents still

feel they are part of the family and don’t feel secluded in any way.

There was a lot of talk about the government regulations and how they are not enough

to provide the industry with the means necessary to deliver the best possible results.

We discussed the current reports that indicate that the standards of such institutes

were declining drastically and it had become a source of grave concern.

We discussed that how all procedures need to be standardized and that there must be

a quality assurance procedure which monitors the implementation of the standards.

We researched further and came across a few facts that were of importance with

respect to the government’s involvement in residential care and the whole health care

scenario.

The figure listed on the next page, shows the percentage of GDP (Gross Domestic

Production) being used by various countries around the world use in for their health

care. These countries including UK are investing in the health care but, a lot more

needs to be done. It is also evident that UK is using 8.3 percent of GDP which

compared to other countries is not much.

There have been growing concerns regarding the behavior of the employees at such

institutes and we were made aware of their policies regarding the recruitment of

employees and how they make sure that they do a thorough analysis of all candidates

which could be potential employees and how they make sure to pick those that they

feel comfortable with. The fact that, no negative incident had taken place at the

institute in its twenty year history, speaks for itself as to how thorough they are in

their research regarding employees and the residents. This is a standard that needs to

be maintained by the entire industry. We also, discussed the future of the industry and
agreed that negative instances had increased and that the government needs to take

steps to eradicate such events and to make sure that these do not happen in the future.

We also, discussed the global scenario and who the global industry had started to

flourish and that more and more governments were interacting with the institutions

and making them more suitable for residents of all age, gender and ethnicity.

There were two aspects in the care industry that people look certain aspects in two

dimensions. One is related to the care services regarding the children and the other

one is related to the elderly. So the selection criteria for a specific organization

changes depending upon the type of people and care service needed. People are very

conscious when it comes to the care of their loved ones and even minor discrepancies

sometimes can jeopardize the organization’s credibility regarding the reputation and

services they are providing.

To get another vies so, that we can see both sides of the picture an interview of a

person whose loved one was admitted to the institute was conducted. This was

conducted so that we could gather an insight into how people think about these

institutions and what goes through their minds when they are making the tough

decisions on whether to place their loved ones in the care of such institutes and how

they choose a particular institute where they would admit their loved one.

This interview was conducted not only to get a layman’s view on the scenario but, to

actually see how an important stakeholder viewed the complete situation, what were

his views on the institute and the entire residential care industry.
Through this interview we were reminded of the global scenario that we face every

day, that, life has become very fast and proper time utilization has become extremely

important if one needs to survive in these hard times. In such a tough situation it

becomes very hard to balance your office life with your life at home and give proper

attention to your loved ones. This becomes even harder if that loved one needs special

attention and requires monitoring.

It doesn’t matter if that loved one is a small child or an elderly, it is imperative that

they get the necessary attention and support they require to live a complete life and

for this reason the interviewee had admitted his father who was a dementia patient to

the institute as even though he had tried his best to take care of his father and had

even made time from his busy schedule, but till, he couldn’t provide the attention

necessary.

He also, informed that his first priority was to employ a private personalized care

worker but, there were a lot of issues regarding trusting someone with the care of his

father. There were also concerns about the legitimacy and expertise of the care worker

and even though, he persisted with using various private personalized care employees,

he still wasn’t completely satisfied and thus, had to opt for a residential care institute.

He also, stated that he found trusting an organization that had been providing the

necessary support and comfort to people in need for years as a more viable and sane

choice. But, he was very thorough in selecting a care giving residential institution and

he wanted what was best for his father. So, he researched all the viable institutes so

that, he could choose one which was the most suitable for him and his father.

There have been a few studies regarding dementia patients and it has been observed

that more dementia patients are present at residential care homes or nursing homes
rather than assisted living provided at their own residence. The graph below gives a

better description.

The interviewee stated that his research regarding finding the best nursing home for

his father included, their policies regarding admission, financial aspects, house rules,

rules regarding discharge, and additional services provided. He also, examined their

licenses and certifications, the facilities that they provided which included a separate

room, bathroom, various safety features concerned with the usage of this facilities, the

extent and expertise of the conducting of medical aids, and also, the quality of food

that was provided.

He also explored the various packages given by the various institutes and had a deeper

look at the costs and benefits of each and estimated the value for money provided by

each institute and came to the conclusion and even though this institute was fairly

expensive must it provided a lot of benefits and at the end of the day gave more value
for money as well as mental satisfaction than any other institute that he had examined

during his research. Along with all this there was detailed analysis of the history of

the institution, interactions with the people associated with the institute and he even

talked to the kids and elderly people that were residents there. He was adamant that

during his visits to the facility he witnessed that the residents appeared to be happy

and satisfied with the facility. This was very evident in the children that he saw and he

was of the opinion that happy children were one of the factors he wanted his father to

become a resident there, as, they were indicative of the healthy and playful

environment that the staff wanted to implement at the institute. We had a general

discussion on what his views were on the entire industry and how he saw the industry

progressing in the future. He was of the opinion that the number of people enrolling in

such institutes was on a rise but, also stated that due to this increase in demand and

the limited amount of residential care facilities available the standards of such

institutions was going down. He also, pointed to the lack of synchronization in

various instates and the absence of uniformity.

We agreed that there needs to be government actions that would ensure that such

institutes could provide the best possible service without costing much. Currently, the

good institutes that were providing good service were fairly expensive (as was the

case in the facility in question), therefore, people tend to overlook them to save

money. We also talked about the increasing number of unfortunate incidences that

have taken place globally and has tarnished the reputation of such institutes. These

incidents have not been bound by location, or the age or gender of the resident and

have become fairly common which is an alarming development and we discussed the

dire need for the government to step in and make sure that the standards are being

kept and no such incidents take place.

We discussed that there is a need to tighten the selection criteria for the employees

who work at the institute as it is imperative that the people who are in contact with

our loved ones don’t harm them in any way. Also, we talked about the lack of

infrastructure and how, most of the institutes lack the basic structures and facilities

needed to spend a decent lifestyle. He also stated that there was a chance that in the

future he himself would one day be admitted to such a facility and though is a little

freighting but, he still maintains hope that the standards of all the institutes would be

improved so, that people who need special attention get the attention they require, live

their lives in a decent manner, and help the society as a whole.

There are certain conditions that people look before opting for these services and for

that purpose the organization need to be perfect in its operations. For this purpose, a

good residential care facility should first of all provide with the mental satisfaction

that the elderly loved one is being taken care of by professionals and that he/she

would be provided with the best facilities. And in this aspect the basic services found

were the safety and security of 24-hour support and access to care and day or night;

help is only a phone call away. The main problems that were associated with this

industry are that the increasing number of elderly people and how the society

perceives about the residential care industry. Because it has been observed that there

are generally two groups of people that admit their elderly to such a facility. One that

feel they can’t really take care of their elderly loved ones as well as a caring facility

and the other group is one who don’t really care about their elderly and admit them to

any facility they think is cheap and far away from them so that they won’t have to see

them again. So they need to make sure that the services are being provided constantly

with no room for discrepancies otherwise the people will not consider taking the

services of that specific organization. They make sure that the organization implement
the best practices regarding residential care services and in a manner that their

unfortunate past would not affect them in their future. Currently there is very little

uniformity among the institutes that are providing these services and the practices

vary from institute to institute which is very unfortunate. There is a need to

standardize these practices and to do so; the government has been working to crack

down on facilities that are not providing the best facilities. The media shows almost

on a regular basis now days that how patients have been mistreated and people know

that there are plenty of rules that exist to minimize this but they were not properly

implemented. Proper implementation is very important and one of the major reasons

for choosing this facility is turning out to be the proper implementation of these rules.

The problems are mainly associated with the rules and regulations imposed by the

government and in the recent financial crisis have changed the industry to a much

higher level which needed an improvement strategy for the industry. The strategies

that were made focused on saving up the costs through effective implementations of

the operations with reducing the training costs of the employees and regularizing the

bed usage up to ideal level. Regarding the research conducted by Clough, Bullock and

Ward, the increase in the residential care services for the children is evident and what

we have analyzed from this finding that managing would have been a challenge if this

increase in demand was not anticipated.

(Source: “What Works in Residential Child Care”, A review of research evidence and

the practical considerations by Roger Clough,Roger Bullock and Adrian Ward)

(Source: “What Works in Residential Child Care”, A review of research evidence and

the practical considerations by Roger Clough,Roger Bullock and Adrian Ward)

The government has been doing a good job in trying to standardize such facilities so,

that there are no instances where patients have been mistreated or abused. There are

however, no such mechanisms to detect such instances easily, particularly among

patients that are mentally challenged, for instance they could dementia and may not be

able to remember a mistreatment. Such cases are increasing and are causing tension

among people; this has increased further with reports in the media. For this issue the

industry has taken steps to ensure that patients are well treated and this starts from the

hiring of employees, in which they go through an intensive regime to get to the stage

where they can interact with patients making sure that they are provided with the best

facilities and are always in touch with the patients and their loved ones to better

understand the whole scenario. There are a lot of problems like the constant need for

facility up gradation, the supply and demand problems, the increasing costs, the

growing demand of professional workers, improvement in current practices etc. all

these are big problems but in the constant process of providing the best services

available, the customer satisfaction will increase the benefits in the long run.

Conclusion

After carefully reviewing, the data gathered and information that has been used and

the information that has helped us in developing this thesis there are quite a few

variables that we have identified regarding the topic in question. Through our research

we extensively gauged the importance of the residential care industry. We have come

to conclude that the number of people enrolling in such institutes is increasing. But,

due to this increased inflow the demand for maintaining proper living standards for

the residents has arisen. This has become a demand as the standards continue to drop
due to the amplification of influx into the institution which has exposed the lack of

infrastructure that this industry has. The residents of these institutes are not bound by

age, and there are children who are also provided with the special services that they

require. These may include children abandoned by parents or whose parents are

unable to take care of them due to illness or are deceased. These children may also be

ones that have specific illnesses or disabilities that have forced them to become

residents of such an institute.

We have come to the conclusion that the instances of negative happening within these

organizations is on the rise and a major factor for this is the defective system of

recruiting the employees that would be responsible for the care of the kids and elderly

present at the institution.

These negative instances have increased all over the globe and it has been noticed that

residents from all age groups, ethnicity and gender have been targeted. Through this

study we have concluded that most of these instances occur due to the increase in

demand, in-effective recruitment system, the cutting down on cost factors, and

compromising on quality. It has been also observed that the institutes tend to have a

beleaguered atmosphere and people are seen to be genuinely unhappy.

Children have also, been known to be deeply affected by these factors and there is the

likelihood of them not getting the family environment that they require to foster. This

is further depleted by the besieged environment that is common in such institutes.

Also, there have been various reports of harassment and even abuse which has further

complicated things and has shed a new light on the morality and effectiveness of such

institutes and how their defined parameters are not being acted upon with proper
spirit. It also, begs us to note the in-efficiencies of the internal workings of such

institutes and how the administration is powerless to stop such actions.

But, despite all the negative aspects that have been discussed there are institutes that

make quality of lifestyle and the preferences of the residents their first priority. They

make sure that an environment is created that is suited to nurturing the kids and

helping the elderly to feel comfortable in their old days. Having said that, the study

found that these institutes are very few, and are fairly expensive, as, compared to the

others discussed before.

We also conclude that governments around the globe are not doing enough to

standardize these institutions so that a proper lifestyle can be provided to these

individuals. The tragedy is that in many countries these institutes don’t even provide

the basic necessities of life to the residents of the institutes. Another factor that has

augmented the problems all over the globe is the fact that this is a very tough job, and

the employees are not given proper credit neither in financial terms nor the

recognition that these should get. This makes them de-motivated and de-motivated

employees cause the residents to feel sad and this augments their existing feeling of

loneliness as, they are distant from their loved ones.

Even with all these problems the future of this industry seems very bright as more and

more people around the globe regardless of age, gender and race now require

specialized care and even though in most cases this care is being provided by their

families but, the fact remains that in a fast moving world there is limited time that can

be given to these individuals, and these individuals require specific needs that need

great expertise that only such institutions can properly provide. Thus, this industry has

grown at such a rapid pace.

 Recommendations

More and more people have started to realize the importance of such institutes and the

demand is increasing very rapidly. There is a shortage of supply and required

infrastructure. Therefore, this industry needs to evolve. It needs to realize its potential

while keeping in mind that continuation of negative instances; such that are being

reported on a regular basis can have a very negative impact on the growth of this

industry. One can understand the increasing demand of workforce yet, the concern is

with the selection criteria for these potential employees. The institutes are not

focusing on a great deal regarding personal characteristics while hiring and this could

negatively impact the patients that are admitted. Another concern is the ever

increasing costs of these places. People admitted to such places have to bear a very

high price to get them to a stage where they would be properly looked after. The

institutions are in fact overpriced but, that probably comes with its repute and the

facilities it provides. But, the fact remains that soon there will be a stage where the

poor would not be able to get the necessary health services that they require in their

tender age.

Another aspect that needs to be taken into account is the lack of infrastructure. There

is a shortage of rooms, beds, staff etc. that has hampered such facilities and there is a

dire need to address this and the government should provide assistance to such

facilities in making sure that the best services are being provided to the seniors

residing here. It is not our intention to put any blame on management or staff in the

residential care service settings, as we are well acquainted that most residential care

staff try their best to solve the issue of strict time constraints and increased workloads.

Our research survey tells us that there are great chances of improvement in services

which are provided to the old people now a day. Residential care service needs to be
changed into such type of center where the traditional values should be considered

deeply and the old people feel more comfortable to themselves center. They should

get the same comfort which they receive at their homes residential. The staff of

residential care service should be knowledgeable so that they can care of older people

and understand the needs attached with old age and/or cognitive malevolence. The

full concession should be provided to the all old people who are eligible regardless of

when they entered residential aged care.

The future is fairly bright as, more and more people are realizing that the services

provided by such care organizations are improving and are at a standard where their

loved ones would be happy. But, obviously there are a lot of negative news spreading

around due to lack of facilities and unprofessional employees in various organizations

and this is also, affecting organizations such as the organization that was researched

which is very professional but still are facing the problems discussed. At such an old

age all you could ask for is some mental satisfaction and there is a need for

government intervention to assist such facilities and to standardize operations. There

still is a long way to go for the industry to achieve the improvement plans and it

would be of vital importance for the organizations to work on those plans if they want

to prosper in the future.

 REFLECTION

Critiquing proves to be helpful in increasing knowledge and skills and doing that

through dissertation is most effective way. This methodology has proved to be a great

help in learning the research practices. When I started this research, I was thinking a

difficult task, not impossible but challenging. I spent a lot of my time in

understanding this procedure. My dissertation supervisor guided me in right direction

and I started in doing it, spending my time in reading books, articles, journals and

news then I started writing about them. When I chose the research topic about

residential care service industry, it was a new domain for me to work on which

needed sound knowledge and concentration. It looked like a societal topic relating to

the society but as I tried to understand the concept it turns out to be lot more than only

that. It took a lot of time in reviewing many articles which were really essential to go

through for making a basis. And to understand its implication on the financial sector

of that region needed an extensive review of literature.

Selecting a suitable topic was a problem for me, I wished to do some work which

would be challenging and interesting too. I was consulting my friends, former

students & module leaders for the selection of suitable topic and research

methodology and from the information that was inferred, I started working for the

relevant topic and management issues regarding the residential care service industry

seemed quite interesting which become the basis of my research.

I started writing dissertation at the later stages of the semester by consulting through

books and internet to understand the basis of the research topic. Through reading I did

understand some concepts. The 13000 words dissertation was required to be prepared

on the basis of the literature review which I was reading from the academic journals
& books. I used internet, consulted articles for the understanding of the different

methodologies used in different markets. It had developed new creative thinking and

that I could assess matters with logics and proper references. The basic understanding

that came up was that the old people find sense of freedom and enjoy their

independence at residential care service. Not only they can live independent life but

also find no issues related to privacy as they don’t find it at their homes. Other kinds

of facilities and services are provided to them. The services rendered to old people

depend on their personal choices and preferences. Sometimes the importance of

residential care house increases more than a house. It not only affects physical

condition but also mental condition also. They feel good about environment and get

recover soon if they have recently returned from hospital. And regarding the

management issues which were found by the research survey shows that there are

great chances of improvement in services which are provided to the old people now a

day. This industry needs to be changed into such type of center where the traditional

values should be considered deeply and the old people feel more comfortable to

themselves centers. They should get the same comfort which they receive at their

homes residential. I kept on writing and writing for one paragraph I needed to check

so many books so many articles, so many authors wrote the same thing in so many

different style, so many combinations of words on some same thing but each had

different context, in each scenario the combination of words made some different

sound which I could understand.

I used qualitative analysis which was the obvious and most effective way for this type

of research. When I did interpret the data, I easily traced the findings of the research

question, which helped me to draw a valid conclusion. Some search work on the

current position of company was done through reading current journals and case
studies which helped me a lot to know about the current situation of the industry.

After finishing my conclusion and recommendations for further research, I started

writing abstract and introduction. And then I started referencing and indexing. As this

research is based on qualitative research approach, some other researchers used

quantitative research tools and gather the data through questionnaires etc and make a

valid conclusion on the basis of primary research. This research is not covering the

whole aspect of industry because it is a vast field regarding the geographic nature of

the industry but my intentions are to support the ongoing research regarding the new

techniques used for the continuous improvement purposes. This research project has

helped me in getting a closer look to the practical life. What this project has done is

that it has provided me with a vision of handling the hurdles that I may face in the

future life. With the right insight of doing the things according to a plan and managing

it up to required level.
 REFERENCES

AIHW. (2004). Children in out-of -home care Australia: data collection standards,

tables and counting rules, 2003-2004. Retrieved 20 September, 2005, fromhttp://

www.aihw.gov.au/childyouth/childprotection/ohc03-04.pdf

Bajekal M (2002) Health Survey for England 2000.Care homes and their residents.

The Stationery Office. London

Bath, H. (1998b). Missing the mark: Contemporary out of home care services for

young People with intensive support needs.

Barth, R. (2005). Residential care: from here to eternity. International Journal of

Social Welfare, 14, 158-162.

Bebbington A, Darton R and Netten A (2001) CareHomes for Older People. Volume

2.Admissions, needs and outcomes. PSSRU. Canterbury

Cameron, C. (2004). Social pedagogy and care: Danish and German practice in young

People’s residential care. Journal of Social Work, 4(2), 133-151.

Charles, K., & Nelson, J. (2000). Permanency planning: Creating life long

connections. Tulsa: The University of Oklahoma

Darton R, Netten A and Forder J (2003) The cost implications of the changing

population and characteristics of care homes. International Journal of Geriatric

Psychiatry. 18: 236 43

Department of Health. (1998). Caring for children away from home: Messages from

research. Chichester: John Wiley and Sons

Laing and Buisson (2004a) Laing’s Healthcare Market Review 2004–2005,

incorporating the Fitzhugh directory of independent healthcare financial information.

17th end. Laing and Buisson. London

Laing and Buisson (2004b) Long term care. Available from

<http://www.laingbuisson.co.uk/longtermcare.htm>

Maneeta Sawhney (2007) The Non Governmental Organization’s Commitment To

The Elderly In India, Institute of Economic Growth University Enclave. Delhi

Nazarko L (2000). A New Broom. The Care Standards Act. Nursing Management 7

(8): 6–9.

Parker, R. (1998). Reflections on the assessment of outcomes in child care. Children

and Society, 12, 192-201.

Richardson, J., & Lelliott, P. (2003). Mental health of looked after children.

AdvancesinPsychiatric Treatment, 9, 249-251. treatment of youngsters with serious

behavioral difficulties. Childhood, 7(2), 129-153.

Ricky, Srivastava. (2010). Blue Haven Children’s Home And School Project

Proposal, Tell ASIA Ministries pp,3-6.

UK Chief Secretary to the Treasury. (2003). Every child matters. London:

HerMajesty'sParliament.

Ward, J. (2004). Towards a theory of the everyday: the ordinary and the special in

daily living in residential care. Child and Youth Care Forum, 33(3), 209-225.
 APPENDIX

Interview 1

Employee of homecare

Name: ______________ Date: _________________

Venue: _____________ Job Title: _____________

1) What is residential care?

Answer: Residential care or assisted living is a residential option for seniors who want

or need help with some of the activities of daily living. These could include things

like cooking meals, getting to the bathroom in the middle of the night, keeping house,

and traveling to various appointments etc.

Sometimes it can be very hard for people to provide their parents with the necessary

care that they require due to their age or preceding illnesses. Therefore, it is a good

idea to opt for such services for senior who need more personal care services than you

can get at home or an independent living retirement community, but you don’t need

the round-the-clock medical care and supervision of a nursing home.

2) How is residential care different from the care, which is being given to them by

their own loved ones at home?

Answer: This is something the clients need to think about. If they can take complete

care of their elderly in the best possible manner then they should not opt for such

services but, if their elderly require 24-hour care services then, it would become very

hard for them to balance their work and social needs with the needs of their elderly
loved one. In such a scenario it is very beneficial for them to admit such a senior into

a residential care facility so, that they could be well taken care of by professionals.

3) What should a good residential care facility provide?

Answer: a good residential care facility should first of all provide you with the mental

satisfaction that your elderly loved one is being taken care of by professionals and that

he/she would be provided with the best facilities.

4) What does your organization provide?

Our organization offers the safety and security of 24-hour support and access to care.

Day or night, help is only a phone call away. We develop a personalized plan that

meets their needs and accommodates their disabilities, while giving them the freedom

to do what they can for themselves. We provide them with personal rooms; we have a

group dining area and common areas for social and recreational activities.

The services that we provide include:

 Three meals a day served in a common dining area

 Assistance with eating, bathing, dressing, going to the bathroom, and walking

 Housekeeping services

 Transportation

 Access to health and medical services

 Round the clock security

 Emergency call systems in each resident’s living space

 Exercise and wellness programs

 Medication management
  Laundry services

 Social and recreational activities

 Staff available to help with scheduled needs, as well as unexpected issues

5) How your organization is different from others and what practices do you imple-

ment and do you distinguish between kids and the elderly?

Answer: it has been observed that there are generally two groups of people that admit

their elderly to such a facility. One that feel they can’t really take care of their elderly

loved ones as well as a caring facility and the other group is one who don’t really

care about their elderly and admit them to any facility they think is cheap and far

away from them so that they won’t have to see them again. It is very unfortunate but,

this is the reality of life.

We make sure that we implement the best practices regarding residential care services

through which we make sure that we treat all patients accordingly and make sure that

they are handled properly and in a manner that their unfortunate past would affect

them negatively in their future. It is a very hard thing to do but, we specialize in

helping these people overcome any past grievances and let them lead their lives with

honor, respect and peace of mind.

What you might have noticed while walking around this facility would be the fact that

the people here seem happy, they are interacting with each other and with the staff in

a very hospitable manner and I’m sure after talking to a few of them you would have

realized that they enjoy the group sessions, the social interactions and are very keen

on their hobbies.

As for the children we make sure that proper care is being given to them and they

treated with kindness and respect. We have also, designed play-groups for them that
help them getting accustomed to the institute and helps build a strong bond with other

kids. So, all in all we implement methods that make certain that they are enjoying

their time here.

6) How can the loved ones help in making their stay better?

Answer: the fact is that it doesn’t matter how good a facility we might provide. A

personal home, company and constant interaction with your loved ones would always

be the best solution for anyone. Therefore, it is recommended that loved ones should

always try to visit as often as possible.

7) What are your views on the current government regulations regarding residential

care facilities?

Answer: the government has been doing a good job in trying to standardize such

facilities so, that there are no instances where patients have been mistreated or abused.

There are however, no such mechanisms to detect such instances easily, particularly

among patients that are mentally challenged, for instance they could dementia and

may not be able to remember a mistreatment. Such cases are increasing and are

causing tension among people; this has increased further with reports in the media.

I can assure that we here take the best possible steps to ensure that our patients are

well treated and this starts from the hiring of our employees and they go through an

intensive regime to get to the stage where they can interact with patients and we make

sure we provide the best facilities available and are always in touch with the patients

and their loved ones to better understand the whole scenario.

8) How do you see the future of this industry and how does your institute deal with

the problems faced?

Answer: well, the future is fairly bright as, more and more people are realizing that

the services provided by such care organizations are improving and are at a standard

where their loved ones would be happy. But, obviously there are a lot of negative

news spreading around due to lack of facilities and unprofessional employees in

various organizations and this is also, affecting organizations such as ours which is

very professional and are yet have any negative instance in our 20 year history and we

are very keen to keep it that way.

There are a lot of problems like the constant need for facility up gradation, the supply

and demand problems, the increasing costs, the growing demand of professional

workers, improvement in current practices etc. all these are big problems but, we

think that where there is a will there is a way. We want to provide the best services

available and in doing so, we may cost a little more but, we are very confident that the

services we provide are top notch and patient satisfaction is guaranteed.

At such an old age all you could ask for is some mental satisfaction and we try our

best to provide it. As, I have stated before, the future is bright but, there is a need for

government intervention to assist such facilities and to standardize operations. We

still have a long way to go as an industry and it would be of vital importance that we

have a firm standing so, that we can prosper in the future.

 Interview 2

Elderly admitted the facility

Name:______________ Date:_________________

Venue:_____________ Organization:_________

1) What are your views on residential care and why did you admit your loved one

here?

Answer: life now a days is getting faster and it is getting harder to keep track of

everything around you and in such a situation it gets very hard to take complete care

of some one particularly if he/she is not completely fit (physically and mentally).

With this in mind I think residential care is very important as they provide the

necessary care and attention and we cannot give our loved ones no matter how hard

we try.

In my case, my father has dementia and I have taken care of him for the past two

years, but, even though I have on a personal level take all the necessary precautions

but, still there have been instances where these precautions were rendered useless and

my father got hurt somehow. Therefore, after careful deliberation I came to the

conclusion that this was the best thing to do.

2) Can you put some light on the procedure of selecting a facility and why did you

not go for a personalized home care worker?

Answer: actually I started with a personalized home care worker but, there are many

hassles regarding keeping a residential care worker and trusting one person is harder
that trusting an entire organization that has been around for years and excel in this

department.

As for the first part of the question, I conducted a thorough research before selecting a

facility. I looked at their policies regarding admission, financial aspects, house rules,

rules regarding discharge, additional services provided etc.

Then I had a look at their licenses and certifications. I had a further look at their

facilities the space available, the rooms (shared or separate) and the floor plan and if it

suits my dad, the space for personal belonging and had a detailed look at the bathroom

and changing areas.

I examined their bathroom safety features (safety bars, toilet seats etc.), their call

services, their system regarding walkers and people on wheel chairs and how the

hallways and doorways accommodate them. I personally visited the facility a few

times to see for myself and I interacted with the patients to discuss how they felt about

the facility, their meals, their social interactions, medical assistance provided etc.

I also, looked at the history of the institute and examined a detailed history of the

facility and views of the people associated with the facility and of those that have

interacted with the employees of the facility. I even talked to a few kids and they were

really enjoying themselves and playing around. So, it was a very detailed analysis and

I’m very happy that I decided to admit my father here.

3) You mentioned children, how did their presence influence you? and are you over-

all satisfied with the facilities this institute provides?

Answer: yeah, I mentioned children as I know if the institute can develop an

environment where people can enjoy themselves it would be a good place for anyone
to spend time and it would not feel like a prison as many such institutes feel like. So,

yes, I’m more or less satisfied. I know there is still room for a lot of improvement but,

I’m happy that this facility is constantly evolving according to the latest research

regarding care for the elderly.

4) What are your views on regarding the practices used by the industry?

Answer: currently there is very little uniformity among the institutes that are

providing these services and the practices vary from institute to institute which is very

unfortunate. There is a need to standardize these practices and to do so, the

government need to crack down on facilities that are not providing the best facilities.

We see news almost on a regular basis now a days on how patients have been

mistreated and I know that there are plenty of rules that exist to minimize this but,

alas, they are not properly implemented. Proper implementation is very important and

one of the major reasons for choosing this facility was the proper implementation of

these rules.

5) How do you see the future of this industry and what obstacles do you think they

face?

Answer: more and more people have started to realize the importance of such

institutes and the demand is increasing very rapidly. There is a shortage of supply and

required infrastructure. Therefore, this industry needs to evolve. It needs to realize its

potential while keeping in mind that continuation of negative instances; such that are

being reported on a regular basis can have a very negative impact on the growth of

this industry.
I understand the increasing demand of workforce yet, I am concerned with the

selection criteria for these potential employees. I fear that institutes would not focus a

great deal on personal characteristics while hiring and this could negatively impact the

patients that are admitted here. I am fairly happy with this institute’s selection process

but, I do fear for the industry.

Another concern is the ever increasing costs of these places. People admitted to such

places have to bear a very high price to get them to a stage where they would be

properly looked after. This institute is no different in fact, it is fairly overpriced but,

that probably comes with its repute and the facilities it provides. But, the fact remains

that soon we may get to a stage where the poor would not be able to get the necessary

health services that they require in their tender age. Or, they would not be able to send

their kids that need special attentions to institutes like these.

Another aspect that needs to be taken into account is the lack of infrastructure. There

is a shortage of rooms, beds, staff etc. that has hampered such facilities and there is a

dire need to address this and the government should provide assistance to such

facilities in making sure that the best services are being provided to the seniors

residing here.

It is highly probable that in the future I might be one of the patients here just as my

dad is today and would hope that I am treated with respect, and I am given my

privacy. There may even be a chance that my kids may need some special attention,

so, it is my wish that and I hope that the rules and regulation that would be in place

then are properly implemented so that I could have a decent living here.