The recently published Government White Paper (Department of Health and Social Care (DHSC), 2021), People at the Heart of Care, sets out a person-centred vision of care, building upon the 2014 Care Act. While being far from perfect, it is perhaps the beginnings of a journey to develop and deliver support and care for those who need it as they age. The three stated objectives of the publication are as follows:
- People have choice, control and support to live independent lives
- People can access outstanding quality and tailored care and support
- People find adult social care fair and accessible.
These goals are welcome, and set a high threshold against which any future delivery of support and care can be assessed. Notably, this White Paper acknowledges the importance of the context of people's lives—namely, their home and their community.
The publication of the Social Care Institute for Excellence's (SCIE) report A Place We Can Call Home (King et al, 2021), which investigates the housing needs of those over 65 years of age, is timely. It draws upon the deliberations of the Commission on the Role of Housing in the Future of Care and Support, a group of experts established in October 2020. While people should be supported as far as possible to live in their own homes, the Commission recognised that, for some, this is neither possible nor desirable; nonetheless, people should feel that their place of living is a home, with all its connotations. The Commission recommended that the development of a strategy to increase the availability of quality housing with different care and support options that draws from the experience of older people and those needing support and/or care and other stakeholders, with improved partnership working across the public, voluntary and private sectors, including those developing and building housing and those providing services.
The pandemic has made social and other inequalities more apparent, including those relating to the accessibility of adequate housing. It has also generated fear, enforced isolation, increased inactivity, and the disruption of family life and relationships. The finding that established relationships between grandmothers and their grandchildren have benefits for both parties (Rilling et al, 2021) further highlights the urgent need to progress effective plans for good housing for older people, in order for them to fulfil the familial and social roles that bring meaning and quality to life. In the past, hospital wards and care homes were accused of warehousing older people with limited, if any, attempts at life enrichment, with the result that many older people simply existed rather than experiencing enjoyable lives. As a result, the Care Quality Commission and other regulators require providers to demonstrate that they ‘nurture’ those they care for and support, as well as providing effective and safe physical care.
‘The post-pandemic challenge is to repair and rebuild the disrupted relationships and social lives of older people as a way of providing meaning and fulfilment and establishing healthy, intergenerational communities.’
Therefore, the post-pandemic challenge is to repair and rebuild the disrupted relationships and social lives of older people as a way of providing meaning and fulfilment and establishing healthy, intergenerational communities. An ageing population means that society cannot delay addressing the needs of older people. Offering a full range of housing options is a good start and will enable the delivery of high-quality community nursing care.