Assessing the mental health needs of older people

Care standards



Services for older people, particularly long-term care, are increasingly focused on offering support to some of the oldest, frailest and most dependent people in UK society. In April 2003 there were 460,000 older people living in a total of 23,000 care homes in the UK. Several studies show that over 50 per cent per cent of care home residents have dementia; up to 40 per cent per cent may have depression.

Although it is not known how many older people with mental health problems use domiciliary health and social care services such as home care or community nursing, it is very likely that a significant number are at risk of developing dementia or depression, particularly if they are aged over 80 years. Care standards have a role in ensuring that care homes: promote the mental health of residents, provide appropriate care and treatment for residents with mental health problems, and access primary and secondary care health services regularly.

Care standards legislation

In the UK the quality of care for vulnerable adults, particularly in care homes, has been a key area of policy concern for some years.

The government has put a great deal of emphasis on improving standards, focusing particularly on:

The Care Standards Act 2000 came into effect in April 2002, replacing the Residential Homes Act 1984 and the Residential Homes Amendment Act 1991. The Act set up a new system of national minimum standards for services such as private and voluntary sector residential and nursing homes and, for the first time, extended the registration requirement to local authority care homes (commonly known as 'Part III accommodation'). The Act also covers regulation of personal domiciliary services, e.g. helping someone wash or dress, and includes nursing agencies.

To achieve its aims, the Act set up the Commission for Social Care Inspection whose primary aim is to promote improvements in care via its triple functions of inspection, regulation and review of all social care services. It provides a comprehensive overview of social care in England and works at a local level, at a national level, and across all sectors.

The Commission for Social Care Inspection publishes regular reviews of social care provision structured around types of care and user groups. Of particular interest are inspection reports and publications reviewing national developments (see Further information).

The Act also established the General Social Care Council (GSCC) to regulate the quality and standards of staff working in social care. The General Social Care Council (GSCC) is the regulatory body for the social care workforce in England.

Although the General Social Care Council regulates independent sector hospital and clinics, it does not cover NHS provision. This is the responsibility of the Healthcare Commission, set up under the Health and Social Care (Community Health and Standards) Act 2003. The commission's aim is to improve the quality of health and healthcare.

Further information

The Commission for Social Care Inspection publishes reports reviewing national developments.

The General Social Care Council website includes information about care standards and training.

The Department of Health website provides PDF documents of National Minimum Standards for care homes and National Minimum Standards for domiciliary care.

Useful background information is provided by the Royal Commission's report on long-term care, With respect to old age. (60)

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