On the determination of the manpower requirements of old people's homes

THE determination of the optimal level of staffing of residential homes has received much attention in the thirty years since the National Assistance Act. However, each recommendation for a staff-resident ratio has been based on only a partial study of the many determinants. This paper sets out those determinants of manpower requirements suggested by an economic model of residential care. Using data collected in the Census of Residential Accommodation, the impact of home design, resident dependency, and service delivery determinants is examined empirically with the help of a series of multiple regression analyses. These determinants are found to explain much of the observed variation in the number of supervisory, care, domestic, and night staff and in the corresponding staff-resident ratios. The results would appear to imply that local authorities should be careful in designing new old people's homes in order to promote resident independence; that the increasing dependency of successive cohorts of new entrants to these institutions will push up manpower requirements, particularly for care and night staff; and that the integration of residential and day care services likewise has important implications for staffing policies.