Over the last  five decades, there has been an enormous increase in the numbers of private  residential care homes.  This has primarily been due to  the closures of  social service run 'homes'  as well as  a sharp reduction in the numbers of hospital beds in all areas of service.< >

To be fair , most of these 'private residential facilities'  have delivered a good service of high standard  and  all in all  these places  have been broadly accepted as a suitable alternative to other forms of  statutory care facilities eg  hospitals - both acute and longer stay.   It must be realised that there are hardly any 'longer term care'  beds in our hospitals today  and  this not a bad thing.  The  persistent recommendations have been to keep long term sick  individuals  at their own homes  for  as long as possible  supported within the community.  <>

All that said , with the best will in the world and with the  most intense support , not everyone  could be  maintained in their own homes  ; a level of  residential  care would be needed.  And  as mentioned already , most of those private  homes  have done a good job . <>

Unfortunately  we now know that not ALL the  care homes  AS WELL AS  some hospitals  are delivering optimal  care especially to older people with dementia. The Care Quality Commission informs us that  approximately  40 % of  hospitals and  private  care homes  are failing to meet with the  nationally  accepted  standards of care for these  individuals.  Lack of  proper facilities , lack of  appropriately  trained  personnel and care staff ,  lack of privacy  even   lack of  simple courtesy and personal behaviour   are some of their 'findings' !!!   It is  unfortuante despite  similar  revelations  many times in the past with fairly wide publicity, not enough has yet been done to 'rectify' these  shortcomings completely.  Whilst it is  fully accepted that care staff in these areas do a very difficult job under a lot of pressure, negligence and  improper behaviour and attitude  can never be justified  under any circumstances.  The  managers of  these private  facilities  AS WELL AS those  running our hospitals  MUST remain accountable  and , if  fail  persistently,  should be  removed from their positions.  This  is what happens  in industry and in business/commerce sector ;  why should such stern action not be  taken in  care sectors !!