An investigation into private sector nursing and residential home care for the elderly in north Wales.

In January 1984 two questionnaires were sent to private homes for the elderly in an area of north Wales with a high concentration of private beds. The first questionnaire was completed by eight nursing homes and 13 residential homes for the elderly and the second questionnaire for each of 321 residents - 154 in the former and 167 in the latter.The two types of homes were compared for staffing levels, facilities available and the degree of dependency of residents. As expected the degree of dependency of the residents in nursing homes was higher than in residential homes but even so the degree of dependency in residential homes was found to be high. The isolation of many residents was evident. Twenty three per cent of residents had come directly to the homes on moving into the area. The problems arising for general practitioners visiting a number of different homes and for homes having many different doctors visiting are highlighted.The need for adequate consultation and assessment prior to admission and periodic reassessment is demonstrated in the light of the recent changes to the supplementary benefit regulations. It was found that at least 20% of the residents had their fees supplemented by the Department of Health and Social Security. The need for greater collaboration between the two different registration authorities under the new legislation (Registration of Homes Act 1984) and with the general practitioners providing general medical services is demonstrated.