A community care scheme was designed to provide an alternative to resi
dential care by the flexible use of informal paid carers to supplement
or replace formal care. We report details of client problems and depe
ndency, outcomes and use of hospital inpatient beds for the first 92 c
lients, The mean age was 83 years (28 men, 64 women). In all, 88/92 su
ffered from dementia. The CAFE survey dependency of the clients was A
2%, B 8%, C 23%, D 40%, E 27%, The 1-year outcome was 50% at home, 25%
died, 10% part III, 15% long-term care; at 3 years: 24% at home, 64%
died, 7% part III, 6% long-term care. In the year before admission to
the scheme, 58% were admitted to hospital, totalling 139 patient month
s in hospital, and in the first year of the scheme 55% were admitted,
spending 82 patient months in hospital, Frail elderly people supported
at home have a significant mortality and morbidity rate, and continue
to need a high use of NHS inpatient resources.