This thesis draws together a series of publications that were based on research studies conducted between 1981 and 2011, covering care homes and alternative forms of housing with care. The majority of the studies were funded by the Department of Health or its predecessors, and were aimed at responding to policy issues, particularly for local authority grant funding. However, the funding provided the opportunity to collect information for broader purposes, and a central feature linking the studies was the collection, as far as possible, of consistent information about the characteristics of residents over time. The thesis includes 12 pieces of work, based on information collected in ten studies, and illustrates the changes in care home provision from 1981 onwards, and the potential role of alternative forms of housing with care. The aim of the thesis is to explore the following themes: the changing role of care homes and the development of the independent sector, particularly the private sector; factors associated with care home costs; changes in the relative role of residential and nursing homes, including changes in the characteristics of residents over time; changes in the quality of provision; the impact of care home closures; provision for self-funders and the expectations of residents; and the development of alternative forms of housing with care, and the degree to which specialised housing can provide an alternative to residential care. Care homes in the UK provide around 470,000 places and account for over half the expenditure on social care for older people in England. However, information about care facilities and residents is very limited. The papers presented here aimed to fill some of the gaps in understanding residential care and possible alternatives by making use of data collected in a unique series of related research studies conducted over a period of 30 years.

M.Ed. / The way in which an adolescent experiences authority is an important element of the educational process. Without authority, it can be said, there is no education. But adolescents’ experience of authority is something that is developed outside the classroom, primarily during their interactions with parents. This study explores how South African adolescents experience authority, but focused on the effect of living in institutions, and not at home with their parents. A 47-item questionnaire was constructed on the basis of current international and South African research on the adolescents’ experience of the authority of parents/caregivers and educators. Twelve independent variables were included in the questionnaire. These independent variables included questions on age, gender, language, religion and the academic qualifications of their parents. The questionnaire was completed by 247 adolescents in grades 10 and 11, living in the Johannesburg area of South Africa. Of this total, 183 adolescents lived with their parents and 36 lived in institutions where they were being cared for by foster parents. A factor analysis of the questionnaire revealed two statistically significant constructs and they were termed Experience of parental authority (Cronbach alpha of 0.8333) and Experience of educator’s authority (Cronbach alpha of 0.8434). When various independent variables were used to statistically compare the participants with respect to these two factors, the following was found: • Learners who lived at home and learners who were being taken care of by their parents were found to score significantly higher than learners from institutions or those who were being taken care of by others on both factors, Experience of parental authority as well as Experience of educators’ authority. This difference, though statistically significant, was not substantial with respect to Factor One. With respect to Factor Two, Experience of parental authority, the difference was both statistically significant and substantial. The significant finding, then, is that, learners who live at home and those who are being taken care of by their parents appear to have a more positive experience of their parents’ authority than learners who live in an institution or those who are being cared for by persons other than their parents. • Although learners who were older scored significantly higher than younger learners on both factors, the difference was not substantial. • No significant differences could be found on the two factors for a learner’s gender, the learner’s level of education (this also held true when girls and boys were tested separately), the level of education of the learner’s parents or when the learner was orphaned through losing one or both parents. • No significant differences could be found in their experience of adult authority between the scores of learners speaking Afrikaans, English, Nguni or any other language. The impact of this research would indicate that adolescents who live in institutions or those who are being cared for by persons other than their parents, display a significantly more negative experience of parental authority than those who live at home and who are being cared for by their parents. / Prof. C.P.H. Myburgh

M.A. (Social Work) / Please refer to full text to view abstract

This thesis is primarily a review of specific aspects of a residential treatment centre for emotionally disturbed children recently established by the Winnipeg Children's Home. The review covers only the first three years of operation of this centre and is not intended as a technical evaluation of the service offered by this new social agency. Rather, an attempt has been made to compare the facilities of the Winnipeg Children's Home with those of similar residential treatment centres in the United States. The specific aspects chosen for closer scrutiny are: (1) The Age and Sex Groups served, (2) Housing, (3) Personnel, (4) Diagnostic Study and Intake Procedure and (5) Treatment Programme. As a basis of comparison a descriptive study of twelve residential treatment centres in the United States has been used. Five of these have been selected for closer study because they more closely resemble the agency being reviewed. Case studies, annual reports and other pertinent material from the files of the Winnipeg Children's Home has been used, coupled with the writer's first-hand experience as a member of the staff of this agency. Because residential treatment centres for emotionally disturbed children are a new tool in child welfare, an historical background of foster care for children has been included. The question of qualified personnel to serve in a residential treatment centre has been of paramount importance in each centre studied. This pertains not only to social workers, psychologists and psychiatrists but also to house-parents who are key people in each project. To date, insufficient attention has been given to the training of house-parents; that is a matter which might well come within the scope of schools of social work. Further, in relation to the question of personnel, this thesis attempts to highlight the fact that in all communities, the best qualified social workers should be used in the area of family and child welfare. The study of twelve centres used as criteria in this thesis makes evident the shortage of psychiatric time so necessary to the successful operation of a residential treatment centre. This is true of the Winnipeg community. The administration of the Winnipeg Children's Home demonstrated early in the life of this new project that financial costs of this service are, of necessity, high. This fact was confirmed by the study of twelve centres used as criteria. If a project such as that undertaken by the Winnipeg Children's Home is to be successful, the need has to be accepted by and made the responsibility of the total community. Finally, but of considerable importance to all communities is the tendency to invest funds in lavish buildings which can be useless without adequate staff. / Arts, Faculty of / Social Work, School of / Graduate

This study is part of a survey of the wards of the Children's Aid Society of Vancouver, B. C. who were not in foster homes on October 31, 1954. Fourteen wards, ranging in age from fourteen to nineteen years, were resident in commercial boarding homes. Agency policy recommends the limiting of the use of commercial boarding homes to the occasional placement of a boy or girl over the age of eighteen years who is self-supporting and sufficiently mature to meet the responsibilities of such a setting. Accordingly, the purpose of this study is to determine why the commercial boarding homes were being used for these particular wards and to what extent the needs of these wards were being met. Information gathered from the records of the children and their parents was summarized and tabulated for the purpose of study and description. This material was examined to determine whether there was any correlation between the children's pre-admission care and their subsequent adjustment in foster and group homes and their later placement in commercial boarding homes. Case illustrations of three of the wards were used In order to elaborate on their developmental experiences and adjustment in various settings. These cases were typical in illustrating the unsettled early lives experienced by most of this group and the effect of these experiences in preventing them from adjusting to the demands of a foster home and, in some cases, of group homes. Further emphasis was given to the harmful effect of continued foster home replacement. In summary, the study of this group of wards pointed out the great need for a receiving home for all children on admission to care for the purposes of familiarization, diagnosis and planning. In order to avoid the use of commercial boarding homes arid to meet the needs of those children who are unable to adjust in foster homes, a variety of group-living residences should be developed. A treatment home is an urgent necessity to assist disturbed children while they are still young enough to be helped. In general, greater resources are required for preventive work with children while still in their own homes as well as for the improvement of the services to the children after their admission into care. / Arts, Faculty of / Social Work, School of / Graduate

The purpose of this study is to identify how elderly subjects perceive their transition from home to institutional living. The study was conducted with a convenience sample of five subjects, 6-13 months following their admission to a unit which provides care for dependent elderly clients. The methodology introduced by Glaser and Strauss (1967), for the discovery of grounded theory, was used. A conceptualization of the transition to institutional living as five sequential and inter-related phases is introduced. These phases are: anticipation, reaction, interpretation, negotiation and integration. In the first two phases subjects' responses to challenges to development, introduced by the transition, tend to predominate. The third and fourth phases are characterized by subjects' working through these challenges to achieve mastery within the new situation. The final phase is manifest in each individual's attributing personal meaning to the transition within the context of his or her total life. Mastery within the new situation is achieved through problem solving approaches to increasing dependency, acceptance of personal responsibility for adjustment, and the perception of institutionalization as but one incident in each individual's life history. This transition was found to differ from those described amongst younger populations. It is proposed that this difference occurs as a function of developmental stage, frailty, and the environmental situation. The findings of this study a) emphasize the holistic nature and complexity of nursing practice with frail elderly clients, b) support the use of concepts from developmental theory as a basis for nursing practice with elderly clients, and c) suggest ways in which nursing education and research may contribute to the development of nursing care for elderly clients. / Applied Science, Faculty of / Nursing, School of / Graduate

M.A. (Clinical Psychology) / Please refer to full text to view abstract

No / The community care reforms enabled some older people with severe disabilities to remain at home with domiciliary care services, as an alternative to institutional admission. This paper explores the extent to which the reforms actually enabled older people receiving domiciliary care to have greater choice and control in their daily lives than older people living in institutions. Findings are reported from a comparative study carried out in Greater Belfast, Northern Ireland, that determined the extent to which the subjective quality of life of older people--particularly autonomy--varied according to the type of setting. The older people were interviewed using a structured interview schedule and subjective autonomy was assessed using a measure of perceived choice. The measure consisted of 33 activities relating to aspects of everyday life such as what time to get up, when to see visitors or friends, and how much privacy was available. Qualitative data were also recorded which informed on the older people's perspectives on their own lives, particularly the extent to which they exercised choice on a daily basis. Two-hundred and fourteen residents in 45 residential and nursing homes were interviewed, as were 44 older people receiving domiciliary care in private households. The study found that older people living in institutions perceived themselves to have greater decisional autonomy in their everyday lives than did older people receiving domiciliary care. Indeed, it was clear that living at home did not ensure that one's decisional autonomy would be supported. However, living alone may facilitate exercising a relatively higher degree of autonomy when living at home. Whilst the community care reforms have provided some older people who have severe disabilities with the option of receiving care at home, this has not necessarily enabled them to have greater choice and control in their everyday lives than older people admitted to institutions.

published_or_final_version / Sociology / Doctoral / Doctor of Philosophy

published_or_final_version / Social Work / Master / Master of Social Sciences