Residential care as an alternative to long‐stay hospital: A cost‐effectiveness evaluation of two pilot projects

Abstract

SUMMARYTwo projects were established to help elderly people with mental health problems move from continuing care hospital wards to local authority residential care homes. The projects were part of a larger programme established in the 1980s to test new policy and practice options. Each hospital resident was interviewed and assessed prior to commencing any programme of activities designed to prepare them for resettlement in the community. Data came from hospital patients themselves, from staff and from interviewer observations. Most of the people who moved from hospital were reinterviewed and reassessed approximately 9 months after discharge. The evaluation revealed that quality of life in residential homes was certainly not inferior to hospital but was less expensive. The residential homes offered more lively and psychologically pleasing environments than hospital. Residents' levels of participation were higher according to staff, and residents had more social contacts. The quality of social contacts also appeared to improve. The two projects thus provided a cost-effective alternative to hospital for elderly people with mental health problems.

The Development and Properties of the Support Needs Questionnaire

“…The least support need was for Community Presence, the mean rating being "a bit of help". This is congruent with hospital closure studies that found physical integration was more successful than social integration (Knapp et al, 1992;Leff, 1995). It was likely that this population was deeply excluded.…”

“…Within the context of necessary methodological limitations this study has demonstrated that the SNQ can differentiate between service users' relatively low support needs to achieve community presence and high levels for community participation (Knapp et al, 1992;Leff, 1995). The SNQ has good reliability and validity in most domains, especially those derived from SRV.…”

A qualitative study of the views of residents with dementia, their relatives and staff about work practice in long-term care settings

“…There should be longer stay places for those with the most needs with regular re-assessment to see whether the resident may be able to move. This movement from long-stay placement in hospital has been associated with improved residents' quality of life (Knapp et al 1994). Thirdly, and linked to this, we would recommend that homes should cater for those with different levels of need, and be staffed appropriately, so that increasing needs does not necessarily mean residents moving.…”

Peer support in mental health: a narrative Review of its relevance to social work

“…Research into these projects (Renshaw et al, 1988;Knapp, 1992) sought to identify methods of social support for service users. Projects took different approaches, but initial support included provision for multidisciplinary individualised care planning and subsequently for services to be channelled to individual service users through a key care worker (Renshaw et al, 1988: 67-8).…”