‘Residential Care – A Positive Future’ Edited by Terry Philpott

1958 – 1988

When the National Assistance Act 1948 and the Children Act 1948 were passed into law, they created frameworks for residential care which lasted for more than three decades. As Minister of Health, Aneurin Bevan wanted to see old people be able to retire into residential care homes where they would be able to enjoy hotel standards – as against the workhouses then in use, with their reputation for harsh conditions and associations of humiliation for the residents. At the same time, local authorities were given wider powers to provide services for children.

Residential Care – a Positive Future has been published to celebrate the twentieth anniversary of the publication of the Wagner Report, A Positive Choice. By the time the Wagner Working Party met, – forty years after Aneurin Bevan’s legislation – his aims had been more or less fulfilled, and the orphanages and workhouses had gone. Residential services were, however, low in public esteem and those who were concerned that residential care should be of high quality and be properly valued for its contribution were greatly concerned. Hence the Wagner Report.

Since 1988

The book makes the point that a lot has happened in the last twenty years. There have been masses of legislation. Quangos have come and gone, overtaken by further developments. Regulatory systems have been set up; quality assurance has become important; training patterns have changed. Indeed the pattern of the services themselves and their providers are dramatically different from those at the time of the Wagner Working Party. However, the Report was forward-looking, and although its recommendations did not receive immediate Government backing, its influence over the last two decades has been considerable. Among the developments have been the implementation of three quarters of the Report’s recommendations, the remainder having been overtaken by events.

75% is a remarkably high hit rate, and spells out real success. Aspects of the service which are now accepted and appear to be established parts of the residential scene today were new ideas at the time of the Wagner Report. There was wide consultation with residents and their families in the preparation of the report, for example. Now, consultation and choice are rightly expected by residents, but the Wagner Report helped to create the movement which has changed expectations.

A Positive Future will be useful to anyone who wants an analysis of the way that residential services have developed over the last few years, and any manager or politician who is planning developments would do well to learn about the roots of the current situation before looking to change it.


Following introductory chapters by Dame Gillian Wagner, Dick Clough and the Editor to set the scene, the book has chapters on key themes from the last two decades by authors who clearly know their subjects well.

Professor Roger Bullock gives a masterly description of the way that residential child care services have developed. Stephen Burke writes about personalisation in residential care. Maria Parsons gives an excellent description of services for older people with dementia – a major sector of today’s residential population. Vic Citarella describes the way that the workforce has been developed, with new training programmes and monitoring systems of much greater sophistication than twenty years ago. Des Kelly analyses the standards required for residential care in some detail. David Walden and John Fraser describe the development of the regulatory system. Janet Crampton discusses issues concerned with commissioning of services, such as the public image of residential care (though a basic description of commissioning would also have been helpful). Finally, Roger Clough looks at what can be done about the abuse of residents.

All these are key themes, and between them they give a really good picture of the way residential services have developed and improved over the last twenty years.

Questions for the Future

The book’s drawbacks? I found the descriptions very sound, but often unquestioning. What are the weaknesses in the current systems which will need to be rectified in the future? Will personalised budgets work? Will the blend of commissioning, packages, block deals and so on actually enable the planning and delivery of a balanced range of provision? What will prove to be the pitfalls which the new regulatory system will need to avoid? Can the public image ever be radically changed, if residential care is associated with social problems and failing health? Is the current blend of private, voluntary and statutory provision going to deliver the right services?

The biggest disappointment is that the book does not deliver what is on the cover. The theme is really “two positive decades” – which is worth writing about – but there is virtually nothing about the future of residential care, even in the closing chapter, which is entitled Learning from the past, creating a better future.

Reading the runes, it is quite possible that the developments described in this book have created solid foundations for an era in which residential care will be of high quality, will be appreciated and valued, and will leave behind its negative historical image. In residential child care at present, for example, there is real excitement about the introduction of restorative practice and social pedagogy and the consequent promise of effective professional services, of a sort not witnessed in the last three or more decades, but the possible impact of such developments is not addressed.

In looking to the future, it is a pity that there is not at least one chapter among all the other excellent descriptive contributions which is a morale-boosting rallying call for those providing and working in residential services. They deserve accolades, and they need to be told that they do indeed have a positive future.

Philpott, T. Ed. (2008) Residential Care – a Positive Future

The Residential Forum, London

ISBN 978-1-900909-06-8

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