Private residential care for older persons: Local impacts of care in the community reforms in England and Wales

The 1990 National Health Service and Care in the Community Act, implemented In 1993, had as a prime objective the creation of social care markets. Pri or to these reforms, private residential homes had enjoyed almost guarantee d state financial support for the care of residents, but since then, reside ntial homes have had to compete amongst each other for a finite number of c lients funded by limited local budgets. The withdrawal of guaranteed state support and the introduction of a marketplace have had negative impacts on many residential home businesses. Indeed, many homes are facing financial d ifficulties. This paper considers the actions and altitudes of proprietors under the new, conditions, based on a three-stage survey in Devon. nle priv ate residential sector illustrates that local social care markets have the potential to produce negative outcomes that are far from ideal and, to some extent, the paper highlights a market failure. Bs a care study this resear ch also demonstrates the value of undertaking locality-based detailed studi es over time to investigate the impacts of policy change.