QUALITY OF SERVICES FOR OLDER PEOPLE: AN ENGLISH PERSPECTIVE Chris Payne

CONTEXT England – population about 50 million, the largest of the 4 countries comprising the UK An ageing population – as many retired people as there are under 21 Income, Health, Housing, Personal Care are all linked issues affecting quality of life Demand for services is from older people with disabilities and health care problems e.g. dementia

SERVICES About 20k care homes the majority owned by independent providers 4k domiciliary care agencies Numerous voluntary organisations Supported housing Local Authorities more commissioners than providers Development of a regulated market approach

REGULATION State Regulation using legislation, standards, inspection, legal enforcement Quality assurance requirements built into standards Separate standards for each set of services with common underpinning values and principles Introduction of quality ratings from 2007

COMMENTS Do top down approaches drive up standards? In some ways yes in other ways no Strengths – better protection, focus on needs of people receiving the services, greater transparency and awareness of what is needed Weaknesses – approach is over controlled and too bureaucratic, too sensitive to political and media influences