Policies and perspectives on closing independent care homes for older people

The thesis presents research that investigated the process of closure of care homes for older people by independent sector providers. The care home closure process has received little policy attention and is under-researched. The study aimed to identify and review existing national and local policies and guidelines for voluntary independent closures, to better understand the process and consequences of such closures and to identify recommendations for good practice. The research comprised a survey of council guidelines and a qualitative study of closures. This focused on the activities, experiences and views of older people, their relatives and friends, care home staff and social services care managers. It is the first in-depth study to explore what happens from the perspective of those directly involved.

Little process regulation or specific national guidance was found. However, around one-third of councils responded to enquiries and of these, two-thirds reported having guidelines. This suggests that a significant proportion of councils have none. The content of guidelines varied across councils and inconsistencies and differences were found in recommendations, including approaches towards providing community care needs assessments and views about councils’ ability to prolong closure periods by sending in council staff.

Nine care home closures in five local authority areas were investigated. The research found variation with regard to the length and form of notice, provision of support, and needs assessment and financial support from councils. Falling standards of care during closures were reported and are highlighted as a particular concern, and self-funded residents without relatives identified as a particularly vulnerable group. A range of outcomes and consequences are identified along with structural and individual level influences. Good practice recommendations are presented and issues to consider in guidance and practice development discussed. The findings highlight a need for greater clarification of the responsibilities of councils and the regulator during voluntary closures. They also highlight room for improvement in areas of wider policy relevance, including the nature of state and councils’ involvement in the provision of good quality care homes, access to support, and complaints and protection.