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The History Of Nursing Homes

Nursing and care homes are big business these days, with people living longer than ever before and the number of elderly people requiring care increasing year on year, but the modern idea of care within an institution bears very little resemblance to the humble beginnings of nursing homes.

lady drinking tea

Early Welfare

In the 1800s, if you needed care from something like a nursing home history shows that you were unlikely to get any help. However, in 1834, the government brought in a new Act of Parliament that completely overhauled the existing law governing the poverty relief system. The idea was far removed from anything that would be considered acceptable in this day and age, with the provision of workhouses for those who could not support themselves due to age, infirmity or simply lack of work. With no real welfare state, the workhouse was a last resort, designed to be a place that no one would choose to go to unless desperate. By 1905, a Royal Commission recognised that workhouses were unsuitable for the widely differing residents’ needs, but it wasn’t until 1930 that the system was officially abolished. By 1948, most of the remaining workhouses had been converted into “old folks’ homes” that were run by local authorities.

Private Nursing Care

In the first quarter of the 1900s, the wealthy tended to have their elderly relatives cared for within the family home, with private nurses taking on care duties. Things began to change in the 1920s, with an increasing number of people being looked after in convalescent and nursing homes. Despite this increase in numbers (from around 26,000 patients in 1921 to around 55,000 a decade later), the care received was usually low-quality and quite basic. In the decades following, the standard of care improved steadily, with services such as central heating, single-occupancy bedrooms and en-suite toilet facilities becoming mandatory.

During the 1980s, another shift in care took place, with a steady increase in private nursing homes that took over the provision of care for the elderly from the public sector. The change in the provision of care from public to private sector looks set to continue, with around 85% of care being private by the end of the 20th century as compared to just 18% in the 80s.

Modern Nursing Home Care

Care homes in England today, whether public or private, are regulated by the Care Quality Commission, which ensures that care homes are inspected at least every three years. Scotland, Northern Ireland and Wales also have their own commissions that are responsible for the oversight of care. These regulatory bodies help to ensure that a minimum standard of care is met and that complaints about care within nursing homes can be investigated and dealt with if necessary. Funding in most cases comes from a combination of personal contribution and council payments to ‘top up’ the amount to cover the private fees where there is not enough available from the estate of the person requiring the care. From very humble beginnings, the industry is now huge and very efficient, with every effort made to ensure the well-being and dignity of those vulnerable members of society who are in need of care.

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