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Before the war, most of the accommodation in the local nursing
homes was for those suffering from acute medical and acute surgical
conditions and maternity cases; relatively few beds were for the aged.
Most of those that there were, were the small numbers of beds in the houses
of some retired nurses. The charges at these homes were substantially
below those of the other homes and they met a very real need. These
homes have all gone. At the same time, most of the accommodation of
the homes still remaining is occupied by the elderly. Many of these
people are not permanently bedridden and could be accepted at old people's
homes. Some might with advantage be transferred to such homes
because in many nursing homes there is a lack of sitting room and dining
room accommodation with the result that relatively able-bodied people
have to be confined, if not to their beds, at least to their bedrooms, because
there is nowhere else for them.
The responsibility of a local authority in regard to nursing homes
is not well defined. It is easy enough to specify the number of beds the
room of known dimensions should have; it is easy too to decide on the
number of staff for a home of a specified number of beds. The lavatories
and the kitchens can be inspected. What is difficult though is supervision
of the management of the home. In general, inspections can be carried
out as a routine only about twice a year in the ordinary homes, though
those where there are maternity patients are inspected four times a year.
These infrequent visits, although made without previous warning, do not
really give an indication of whether the patients are really getting the
service they need. If there are shortcomings, the remedy lies mostly in
the hands of the patients' doctors who perhaps cannot do much for those
patients who are in, but their knowledge of such shortcomings must
influence their decision about which homes to recommend.
ESTABLISHMENTS FOR MASSAGE AND
SPECIAL TREATMENT
Section 355 of the Middlesex County Council Act, 1944, prohibits
any person carrying on in this district an establishment for massage and
special treatment without a licence from the District Council authorising
him to do so. There is a saving clause for registered members of the
chartered Society of Physiotherapists and for members of the medical
Profession.