Abstract

The promotion of choice and control for older people is a policy priority for health and social care services in the UK and is at the heart of recent drives to personalise services (Department of Health, 2010). Increasingly, we are seeing a move away from institutionalised care (e.g. in care homes) towards ‘prevention’, with more services being delivered in community-based settings (WHO, 2002; Windle et al., 2009; Department of Health, 2010). Housing with care, such as extra care housing, has been promoted as a purpose-built, community-based alternative to residential care for older people and is seen as a positive option for older people in current social care policy.

However, whilst accounts of users’ experiences in particular service types are plentiful, the use of different instrumentation and measures makes comparison between settings difficult. The authors combined data from three studies:
(1) a survey of older home care recipients;
(2) a study measuring outcomes of care home residents and
(3) an evaluation of social well-being in extra care housing. All of these studies asked participants to rate their control over daily life, using the Adult Social Care Outcomes Toolkit (ASCOT).

This paper presents the results of an ordinal logistic regression analysis showing that, after controlling for differences in age, ability to perform activities of daily living, and self-rated health, extra care housing residents were the most likely to feel in control and home care recipients the least. Implications for policy and practice are discussed.

Slides