Life got better when Birmingham closed "outdated" care homes, says study

Life got better for nearly half of the residents when Birmingham City Council closed 14 of its care homes, according to a new study.

The closures attracted a lot of opposition when it was announced in 2004, that the council wanted to close 29 “outdated” care homes. Yet a study carried out by the University of Birmingham’s Health Services Management Centre (HSMC), found that for the majority of older people affected, the process did not have a negative impact on their lives.

The study examined the closure of the first 14 homes and linked day centres which housed around 237 older people.

The residents were rehoused in new special care centres and other forms of residential care, including extra care housing to support more independent living.

Researchers found 42 per cent from the care homes said life had got better following the resettlement programme and a further 35 per cent said life had stayed the same.

Fifty-nine per cent of those in care homes said they had seen an improvement in their health with 31 per cent reporting a decline in their health.

Of the 19 per cent who said life had got worse following the changes, around half said this was due to deterioration in their actual health rather than due to the services at their current care home.

Professor Jon Glasby who led the study said: “With the recent collapse of Southern Cross the issue of managing resettlement of older people has come into sharp focus. This was one of the largest closures of local authority care homes in Europe, so many of the lessons from Birmingham apply elsewhere.”

He added: “Whilst the closure of homes in Birmingham was distressing at times for staff and service users, our results suggest that you can minimise potential negative impacts by planning resettlement well and carrying it out sensitively.

"Where outcomes were less than optimal to start off with, you might even be able to improve things for some people. Given that the older people in our study were all one year older and frailer at the end of the research, the fact that most things hadn’t got any worse and that some had improved seems a major achievement.”

The key findings were collected just over a year after the residents were rehoused.

For local authorities carrying out similar closures, the researchers recommend having the following procedures in place:

Preparation and strategy: Having a clear strategy and policy that could be easily articulated to stakeholder groups was seen as important. This was particularly apparent with the policy around day centre closure, which was less clear and for many it felt like an ‘add on’ to residential home closures.

Engagement and involvement: Involving key stakeholders upfront in initial decisions about services is important to success. Anxiety and stress is often increased when service users are facing a perceived loss or change to services, and it is important that people feel able to influence what happens to them during resettlement, even if they cannot influence the original decision to close a service.

Implementation and operational capacity: Giving service users adequate assessment is crucial to making sure new services are effective. A key strength of the Birmingham process was a dedicated group of assessors with time and space to carry out detailed assessments, get to know people well, work closely with care staff and provide information and reassurance.

Professor Glasby concluded: “Closing homes is never something to be embarked upon lightly – but this study suggests that the risks of a major decline in quality of life can be reduced and that some positive outcomes can be achieved if the process is conducted well. This needs high levels of respect, communication and empathy, as well as plenty of time and space to follow good practice.”