Emergency medical services in the United Kingdom
Emergency medical services in the United Kingdom provide emergency care to people with acute illness or injury and are predominantly provided free at the point of use by the four National Health Services of England, Scotland and Northern Ireland. Emergency care including ambulance and emergency department treatment is free to everyone, regardless of immigration or visitor status; the NHS commissions most emergency medical services through the 14 NHS organisations with ambulance responsibility across the UK. As with other emergency services, the public access emergency medical services through one of the valid emergency telephone numbers. In addition to ambulance services provided by NHS organisations, there are some private and volunteer emergency medical services arrangements in place in the UK, the use of private or volunteer ambulances at public events or large private sites, as part of community provision of services such as community first responders. Air ambulance services in the UK are not part of the NHS and are funded through charitable donations.
Paramedics are seconded from a local NHS ambulance service, with the exception of Great North Air Ambulance Service who employ their own paramedics. Doctors are provided by their home hospital and spend no more than 40% of their time with an air ambulance service. Public ambulance services across the UK are required by law to respond to four types of requests for care, which are: Emergency calls Doctor's urgent admission requests High dependency and urgent inter-hospital transfers Major incidentsAmbulance trusts and services may undertake non-urgent patient transport services on a commercial arrangement with their local hospital trusts or health boards, or in some cases on directly funded government contracts, although these contracts are fulfilled by private and voluntary providers; the National Health Service Act 1946 gave county and borough councils a statutory responsibility to provide an emergency ambulance service, although they could contract a voluntary ambulance service to provide this, with many contracting the British Red Cross, St John Ambulance or another local provider.
The last St John Division, to be so contracted is reputed to have been at Whittlesey in Cambridgeshire, where the two-bay ambulance garage can still be seen at the branch headquarters. The Regional Ambulance Officers’ Committee reported in 1979 that “There was considerable local variation in the quality of the service provided in relation to vehicles and equipment. Most Services were administered by Local Authorities through their Medical Officer of Health and his Ambulance Officer, a few were under the aegis of the Fire Service, whilst others relied upon agency methods for the provision of part or all of their services.” The 142 existing ambulance services were transferred by the National Health Service Reorganisation Act 1973 from local authority to central government control in 1974, consolidated into 53 services under regional or area health authorities. This led to the formation of predominantly county based ambulance services, which merged up and changed responsibilities until 2006, when there were 31 NHS ambulance trusts in England.
The June 2005 report "Taking healthcare to the Patient", authored by Peter Bradley, Chief Executive of the London Ambulance Service, for the Department of Health led to the merging of the 31 trusts into 13 organisations in England, plus one organisation each in Wales and Northern Ireland. Following further changes as part of the NHS foundation trust pathway, this has further reduced to 10 ambulance service trusts in England, plus the Isle of Wight which has its own provision. Following the passage of the Health and Social Care Act 2012, commissioning of the ambulance services in each area passed from central government control into the hands of regional clinical commissioning groups; the commissioners in each region are responsible for contracting with a suitable organisation to provide ambulance services within their geographical territory. The primary provider for each area is held by a public NHS body, of which there are 11 in England, 1 each in the other three countries. In England there are now ten NHS ambulance trusts, as well as an ambulance service on the Isle of Wight, run directly by Isle of Wight NHS Trust, with boundaries following those of the former regional government offices.
The ten trusts are: East Midlands Ambulance Service NHS Trust East of England Ambulance Service NHS Trust London Ambulance Service NHS Trust North East Ambulance Service NHS Foundation Trust North West Ambulance Service NHS Trust South Central Ambulance Service NHS Foundation Trust South East Coast Ambulance Service NHS Foundation Trust South Western Ambulance Service NHS Foundation Trust West Midlands Ambulance Service University NHS Foundation Trust Yorkshire Ambulance Service NHS TrustThe English ambulance trusts are represented by the Association of Ambulance Chief Executives, with the Scottish and Northern Irish providers all associate members. On the 14 November 2018 West Midlands Ambulance Service became the UK's first university-ambulance trust; the service was operated before reorganisation in 1974 by the St Andrews’ Ambulance Association under contract to the Secretary of State for Scotland. The Scottish Ambulance Service is a Special Health Board that provides ambulance services throughout whole of Scotland, on behalf of the Health and Social Care Directorates of the Scottish Government.
Due to the remote nature of many areas of Scotland compared to the other Home Nations, the Scottish Ambulance Service has Britain's only publi
Chesterfield is a large market town and borough in Derbyshire, England. It lies 24 miles north of Derby and 11 miles south of Sheffield at the confluence of the rivers Rother and Hipper. Including Whittington and Staveley it had a population of about 103,800 in 2011, making it the second largest town in the ceremonial county after Derby. Archaeologists trace it soon abandoned. An Anglo-Saxon village developed; the name feld. It has a street market of some 250 stalls three days a week; the town sits on a coalfield, economically important until the 1980s. Little visual evidence of mining remains; the best-known landmark is the Church of St Mary and All Saints with its crooked spire built in the 14th century. Chesterfield was in the Hundred of Scarsdale; the town received its market charter in 1204 from King John. The charter constituted the town as a free borough, granting the burgesses of Chesterfield the same privileges as those of Nottingham and Derby. In 1266, it was the site of the Battle of Chesterfield, in which a band of rebel barons were defeated by a royalist army.
Elizabeth I granted a charter of incorporation in 1594, creating a corporation consisting of a mayor, six aldermen, six brethren, twelve capital burgesses. This remained the governing charter until the borough was reformed under the Municipal Corporations Act 1835; the borough consisted only of the township of Chesterfield, but it was extended in 1892 to parts of some surrounding townships. There was a major extension when the borough absorbed New Whittington and Newbold urban district in 1920. Chesterfield's current boundaries date from 1 April 1974, when under the Local Government Act 1972, the Borough of Chesterfield was formed by an amalgamation of the municipal borough with the urban district of Staveley and with the parish of Brimington from Chesterfield Rural District. Chesterfield benefited from the building of the Chesterfield Line – part of the Derby to Leeds railway, begun in 1837 by George Stephenson. During the work, a sizeable seam of coal was discovered during the construction of the Clay Cross Tunnel.
This and the local ironstone were promptly exploited by Stephenson, who set up a company in Clay Cross to trade in the minerals. During his time in Chesterfield, Stephenson lived at Tapton House, remained there until his death in 1848, he is interred in Trinity Church. A statue of him was erected outside Chesterfield railway station in 2006. Chesterfield is located on the confluence and valleys of the River Rother and River Hipper at the Nottinghamshire and Yorkshire Coalfield; the town lies in the eastern foothills of the Pennines, is known as a gateway to the Peak District National Park or "The Gateway to the Peak" lying to the west of the town. The area has surrounding portions of the South and West Yorkshire Green Belt in place to stop urban sprawl into the countryside. Other local greenfield frameworks in place include "strategic gaps" maintaining the openness and landscape qualities of large open areas, "green wedges" penetrating urban areas to provide recreational facilities. Local government in Chesterfield is organised in a two-tier structure.
At the upper tier, services such as consumer protection, main roads and social services are provided by Derbyshire County Council. At the lower tier, services such as housing, refuse collection and burial grounds are provided by Chesterfield Borough Council; the borough is unparished with the exception of Brimington and Staveley: Brimington Parish Council and Staveley Town Council exercise limited functions in those areas. Derbyshire County Council has 64 elected county councillors, each representing a single-member electoral division; the entire council is elected every four years. At the elections in June 2009, the Conservative Party took control from the Labour Party after 28 years. Derbyshire County Council returned to Labour control at the 2013 local elections, but reverted to Conservative control after the 2017 county council elections, when the number of Conservative seats rose from 18 to 37, giving them a ten-seat majority. Chesterfield Borough Council consists of 48 councillors. Elections of the whole council take place every four years, the last elections having occurred in 2015.
The borough is divided with either two or three councillors elected for each ward. The wards are named New Whittington; as of 2018, the Labour Party controlled the borough council with 37 councillors, while the Liberal Democrats had 9 and UKIP with 1. The council chooses one of its members annually to be mayor of Chesterfield, with the 378th mayor elected in May 2018; the borough council uses armorial bearings granted by letters patent dated 10 November 1955. The blazon of the arms is as follows: Gules a Device representing a Pomegranate Tree as depicted on the ancient Common Seal of the Borough the tree leaved and eradicated proper flowered and fructed Or and for the Crest on a Wreath of the Colours Issuant from a Mural Crown Gules Masoned Or a Mount Vert thereon a Derby Ram passant guardant proper. Supporters: On the dexter side a Cock and on the sinister side a Pynot or Magpie proper each Ducally gorged Or The shield is based on the borough's ancient common seal, believed to date from the first half of the 16th century.
Sheffield is a city and metropolitan borough in South Yorkshire, England. Part of the West Riding of Yorkshire, its name derives from the River Sheaf, which runs through the city. With some of its southern suburbs annexed from Derbyshire, the city has grown from its industrial roots to encompass a wider economic base; the population of the City of Sheffield is 577,800 and it is one of the eight largest regional English cities that make up the Core Cities Group. Sheffield is the third-largest English district by population; the metropolitan population of Sheffield is 1,569,000. The city is in the eastern foothills of the Pennines, the valleys of the River Don and its four tributaries, the Loxley, the Porter Brook, the Rivelin and the Sheaf. Sixty-one per cent of Sheffield's entire area is green space, a third of the city lies within the Peak District national park. There are more than 250 parks and gardens in the city, estimated to contain around 4.5 million trees. Sheffield played a crucial role in the Industrial Revolution, with many significant inventions and technologies developed in the city.
In the 19th century, the city saw a huge expansion of its traditional cutlery trade, when stainless steel and crucible steel were developed locally, fuelling an tenfold increase in the population. Sheffield received its municipal charter in 1843, becoming the City of Sheffield in 1893. International competition in iron and steel caused a decline in these industries in the 1970s and 1980s, coinciding with the collapse of coal mining in the area; the 21st century has seen extensive redevelopment in Sheffield, along with other British cities. Sheffield's gross value added has increased by 60% since 1997, standing at £9.2 billion in 2007. The economy has experienced steady growth averaging around 5% annually, greater than that of the broader region of Yorkshire and the Humber; the city has a long sporting heritage, is home to the world's oldest football club, Sheffield F. C. Games between the two professional clubs, Sheffield United and Sheffield Wednesday, are known as the Steel City derby; the city is home to the World Snooker Championship and the Sheffield Steelers, the UK's first professional ice hockey team.
The area now occupied by the City of Sheffield is believed to have been inhabited since at least the late Upper Paleolithic, about 12,800 years ago. The earliest evidence of human occupation in the Sheffield area was found at Creswell Crags to the east of the city. In the Iron Age the area became the southernmost territory of the Pennine tribe called the Brigantes, it is this tribe who are thought to have constructed several hill forts around Sheffield. Following the departure of the Romans, the Sheffield area may have been the southern part of the Brittonic kingdom of Elmet, with the rivers Sheaf and Don forming part of the boundary between this kingdom and the kingdom of Mercia. Anglian settlers pushed west from the kingdom of Deira. A Britonnic presence within the Sheffield area is evidenced by two settlements called Wales and Waleswood close to Sheffield; the settlements that grew and merged to form Sheffield, date from the second half of the first millennium, are of Anglo-Saxon and Danish origin.
In Anglo-Saxon times, the Sheffield area straddled the border between the kingdoms of Mercia and Northumbria. The Anglo-Saxon Chronicle reports that Eanred of Northumbria submitted to Egbert of Wessex at the hamlet of Dore in 829, a key event in the unification of the kingdom of England under the House of Wessex. After the Norman conquest of England, Sheffield Castle was built to protect the local settlements, a small town developed, the nucleus of the modern city. By 1296, a market had been established at what is now known as Castle Square, Sheffield subsequently grew into a small market town. In the 14th century, Sheffield was noted for the production of knives, as mentioned in Geoffrey Chaucer's The Canterbury Tales, by the early 1600s it had become the main centre of cutlery manufacture in England outside London, overseen by the Company of Cutlers in Hallamshire. From 1570 to 1584, Queen of Scots, was imprisoned in Sheffield Castle and Sheffield Manor. During the 1740s, a form of the crucible steel process was discovered that allowed the manufacture of a better quality of steel than had been possible.
In about the same period, a technique was developed for fusing a thin sheet of silver onto a copper ingot to produce silver plating, which became known as Sheffield plate. These innovations spurred Sheffield's growth as an industrial town, but the loss of some important export markets led to a recession in the late 18th and early 19th century; the resulting poor conditions culminated in a cholera epidemic that killed 402 people in 1832. The population of the town grew throughout the 19th century; the Sheffield and Rotherham railway was constructed in 1838. The town was incorporated as a borough in 1842, was granted a city charter in 1893; the influx of people led to demand for better water supplies, a number of new reservoirs were constructed on the outskirts of the town. The collapse of the dam wall of one of these reservoirs in 1864 resulted in the Great Sheffield Flood, which killed 270 people and devastated large parts of the town; the growing population led to the construction of many back-to-back dwellings that, along with severe pollution from the factories, inspired George Orwell in 1937 to write: "Sheffield, I suppose, could justly claim to be called the ugliest town in the Old World".
The Great Depression hit the city in the 1930s, but as international tensions increased and the Second
The United Kingdom the United Kingdom of Great Britain and Northern Ireland, sometimes referred to as Britain, is a sovereign country located off the north-western coast of the European mainland. The United Kingdom includes the island of Great Britain, the north-eastern part of the island of Ireland, many smaller islands. Northern Ireland is the only part of the United Kingdom that shares a land border with another sovereign state, the Republic of Ireland. Apart from this land border, the United Kingdom is surrounded by the Atlantic Ocean, with the North Sea to the east, the English Channel to the south and the Celtic Sea to the south-west, giving it the 12th-longest coastline in the world; the Irish Sea lies between Great Ireland. With an area of 242,500 square kilometres, the United Kingdom is the 78th-largest sovereign state in the world, it is the 22nd-most populous country, with an estimated 66.0 million inhabitants in 2017. The UK is constitutional monarchy; the current monarch is Queen Elizabeth II, who has reigned since 1952, making her the longest-serving current head of state.
The United Kingdom's capital and largest city is London, a global city and financial centre with an urban area population of 10.3 million. Other major urban areas in the UK include Greater Manchester, the West Midlands and West Yorkshire conurbations, Greater Glasgow and the Liverpool Built-up Area; the United Kingdom consists of four constituent countries: England, Scotland and Northern Ireland. Their capitals are London, Edinburgh and Belfast, respectively. Apart from England, the countries have their own devolved governments, each with varying powers, but such power is delegated by the Parliament of the United Kingdom, which may enact laws unilaterally altering or abolishing devolution; the nearby Isle of Man, Bailiwick of Guernsey and Bailiwick of Jersey are not part of the UK, being Crown dependencies with the British Government responsible for defence and international representation. The medieval conquest and subsequent annexation of Wales by the Kingdom of England, followed by the union between England and Scotland in 1707 to form the Kingdom of Great Britain, the union in 1801 of Great Britain with the Kingdom of Ireland created the United Kingdom of Great Britain and Ireland.
Five-sixths of Ireland seceded from the UK in 1922, leaving the present formulation of the United Kingdom of Great Britain and Northern Ireland. There are fourteen British Overseas Territories, the remnants of the British Empire which, at its height in the 1920s, encompassed a quarter of the world's land mass and was the largest empire in history. British influence can be observed in the language and political systems of many of its former colonies; the United Kingdom is a developed country and has the world's fifth-largest economy by nominal GDP and ninth-largest economy by purchasing power parity. It has a high-income economy and has a high Human Development Index rating, ranking 14th in the world, it was the world's first industrialised country and the world's foremost power during the 19th and early 20th centuries. The UK remains a great power, with considerable economic, military and political influence internationally, it is sixth in military expenditure in the world. It has been a permanent member of the United Nations Security Council since its first session in 1946.
It has been a leading member state of the European Union and its predecessor, the European Economic Community, since 1973. The United Kingdom is a member of the Commonwealth of Nations, the Council of Europe, the G7, the G20, NATO, the Organisation for Economic Co-operation and Development and the World Trade Organization; the 1707 Acts of Union declared that the kingdoms of England and Scotland were "United into One Kingdom by the Name of Great Britain". The term "United Kingdom" has been used as a description for the former kingdom of Great Britain, although its official name from 1707 to 1800 was "Great Britain"; the Acts of Union 1800 united the kingdom of Great Britain and the kingdom of Ireland in 1801, forming the United Kingdom of Great Britain and Ireland. Following the partition of Ireland and the independence of the Irish Free State in 1922, which left Northern Ireland as the only part of the island of Ireland within the United Kingdom, the name was changed to the "United Kingdom of Great Britain and Northern Ireland".
Although the United Kingdom is a sovereign country, Scotland and Northern Ireland are widely referred to as countries. The UK Prime Minister's website has used the phrase "countries within a country" to describe the United Kingdom; some statistical summaries, such as those for the twelve NUTS 1 regions of the United Kingdom refer to Scotland and Northern Ireland as "regions". Northern Ireland is referred to as a "province". With regard to Northern Ireland, the descriptive name used "can be controversial, with the choice revealing one's political preferences"; the term "Great Britain" conventionally refers to the island of Great Britain, or politically to England and Wales in combination. However, it is sometimes used as a loose synonym for the United Kingdom as a whole; the term "Britain" is used both as a synonym for Great Britain, as a synonym for the United Kingdom. Usage is mixed, with the BBC preferring to use Britain as shorthand only for Great Britain and the UK Government, while accepting that both terms refer to the United K
The East Midlands is one of nine official regions of England at the first level of NUTS for statistical purposes. It consists of Derbyshire, Lincolnshire, Northamptonshire and Rutland; the region has an area of 15,627 km2, with a population over 4.5 million in 2011. There are five main urban centres, Leicester, Lincoln and Nottingham. Others include Boston, Chesterfield, Grantham, Kettering, Mansfield, Newark-on-Trent and Wellingborough. Relative proximity to London and its position on the national motorway and trunk road networks help the East Midlands to thrive as an economic hub. Nottingham and Leicester are each classified as a sufficiency-level world city by the Globalization and World Cities Research Network; the region is served by East Midlands Airport, which lies between Derby and Nottingham. The high point at 636 m is Kinder Scout, in the Peak District of the southern Pennines in northwest Derbyshire near Glossop. Other upland, hilly areas of 95 to 280 m in altitude, together with lakes and reservoirs, rise in and around the Charnwood Forest north of Leicester, in the Lincolnshire Wolds.
The region's major rivers, the Nene, the Soar, the Trent and the Welland, flow in a northeasterly direction towards the Humber and the Wash. The Derwent, rises in the High Peak before flowing south to join the Trent some 2 miles before its conflux with the Soar; the centre of the East Midlands area lies between Bingham and Bottesford, Leicestershire. The geographical centre of England lies in Higham on the Hill in west Leicestershire, close to the boundary between the Leicestershire and Warwickshire; some 88 per cent of the land is rural in character, although agriculture accounts for less than three per cent of the region's jobs. Lincolnshire is the only maritime county of the six, with a true North Sea coastline of about 30 miles due to the protection afforded by Spurn Head and the North Norfolk foreshore. Church Flatts Farm in Coton in the Elms, South Derbyshire, is the furthest place from the sea in the UK. In April 1936 the first Ordnance Survey trig point was sited at Cold Ashby in Northamptonshire.
The Royal Society of Wildlife Trusts and The Wildlife Trusts are based next to the River Trent and Newark Castle railway station. The National Centre for Earth Observation is at the University of Leicester; the region is home to large quantities of limestone, the East Midlands Oil Province. Charnwood Forest is noted for its abundant levels of volcanic rock, estimated to be 600 million years old. A quarter of the UK's cement is manufactured in the region, at three sites in Hope and Tunstead in Derbyshire, Ketton Cement Works in Rutland. Of the aggregates produced in the region, 25 per cent are from Derbyshire and four per cent from Leicestershire. Lincolnshire and Nottinghamshire each produce around 30 per cent of the region's sand and gravel output. Barwell in Leicestershire was the site of Britain's largest meteorite on 24 December 1965; the 2008 Lincolnshire earthquake was 5.2 in magnitude. Areas of the East Midlands designated by the East Midlands Biodiversity Partnership as Biodiversity Conservation Areas include: Charnwood Forest Coversand Heaths Derbyshire Peak Fringe and Lower Derwent Humberhead Levels Leighland Forest The Lincolnshire Limewoods and Heaths The Lincolnshire coast The Peak District Rockingham Forest Sherwood Forest Rutland, SW Lincolnshire and N Northamptonshire The Wash Areas of the East Midlands designated by the East Midlands Biodiversity Partnership as Biodiversity Enhancement Areas include: The Coalfields The Daventry Grasslands The Fens The Lincolnshire Coastal Grazing Marshes The Lincolnshire Wolds The National Forest The Yardley-Whittlewood RidgeTwo of the nationally designated Areas of Outstanding Natural Beauty are: The Peak District The Lincolnshire Wolds Several towns in the southern part of the region, including Market Harborough, Rothwell, Kettering, Thrapston and Stamford, lie within the boundaries of what was once Rockingham Forest – designated a royal forest by William the Conqueror and was long hunted by English kings and queens.
The National Forest is an environmental project in central England run by The National Forest Company. Areas of north Leicestershire, south Derbyshire and south-east Staffordshire covering around 200 square miles are being planted in an attempt to blend ancient woodland with new plantings, it stretches from the western outskirts of Leicester in the east to Burton upon Trent in the west, is planned to link the ancient forests of Needwood and Charnwood. Sherwood Forest in Nottinghamshire attracts many visitors, is best known for its ties with the legend of Robin Hood. Regional financial funding decisions for the East Midlands are taken by East Midlands Councils, based in Melton Mowbray. East Midlands Councils is an unelected body made up of representatives of local government in the region; the defunct East Midlands Development Agency was headquartered next to the BBC's East Midlands office in Nottingham and made financial decisions regarding economic development in the region. Since the Conservative-Lib Dem coalition government launched its austerity programme after the 2010 general election, regional bodies such as those have been devolved to smaller groups now on a county level.
As a region today, there is no overriding body with significant financial or planning powers for the East Midlands. The East Midlands' largest settlements are Leicester, Derby, Chesterfield, Mansfield and Kettering. Leicester is the largest
Derbyshire Fire and Rescue Service
Derbyshire Fire and Rescue Service is the statutory fire and rescue service for the county of Derbyshire, England. The Fire Services Act 1947 created two brigades for Derbyshire - the County Borough of Derby Fire Brigade and the Derbyshire Fire Service. In 1974, local government reorganisation led to the creation of a single organisation for the county - Derbyshire Fire Service; the word'rescue' was added to the title in the early 1990s to reflect the changing responsibilities of the service. There are 31 fire stations in operation with the service, consisting of: Buxton, Wholetime/Retained Chesterfield, Wholetime/Retained Staveley, Wholetime/Retained Alfreton, Wholetime/Retained Ilkeston, Wholetime/Retained Kingsway, Wholetime Nottingham Road, Wholetime Ascot Drive, Wholetime Long Eaton, Wholetime/Retained Glossop, Day Crewed Matlock, Day Crewed/Retained Swadlincote, Day Crew +/Retained New Mills, Retained Whaley Bridge, Retained Chapel En Le Frith, Retained Bradwell, Retained Hathersage, Retained Dronfield, Retained Clowne, Retained Bakewell, Retained Bolsover, Retained Shirebrook, Retained Clay Cross, Retained Ashbourne, Retained Wirksworth, Retained Crich, Retained Ripley, Retained Belper, Retained Heanor, Retained Duffield, Retained Melbourne, Retained There are a total of 58 front-line fire engines used by the Service, located at all of the stations.
The specialist appliance fleet consists of: 3 Aerial Ladder Platforms 3 Water Rescue Units 2 Major Rescue Units 1 Emergency Tender 2 Water/Foam Carriers 1 Water Carrier 2 Forward Control Units 1 Unimog multi-terrain vehicle 1 Command Unit 2 Incident Response Units 1 High-Volume Pump 1 Environmental Unit 1 Fire Investigation Dog Unit 1 Rope Rescue Unit Fire service in the United Kingdom FiReControl Fire apparatus Firefighter Fire engine Fire List of British firefighters killed in the line of duty Derbyshire Fire & Rescue Service. "The History of Derbyshire Fire & Rescue Service", Internal Publication
Nursing home care
Nursing homes known as old people's homes, care homes, rest homes, convalescent homes, provide residential care for elderly or disabled people that includes around-the-clock nursing care. These terms have different meanings in the same or different English-speaking countries to indicate that the institutions are public or private or provide assisted living or more or less nursing care and emergency medical care. A nursing home is a place for people who don't need to be in a hospital but can't be cared for at home. Most nursing homes have skilled nurses on hand 24 hours a day; some nursing homes provide short-term rehabilitative stays following surgery, illness, or injury. Services may include occupational therapy, or speech-language therapy. Nursing homes offer other services, such as planned activities and daily housekeeping. Nursing homes may be referred to as convalescent care, skilled nursing or a long-term facility. Nursing homes may offer memory care services. Starting in the 17th century, the concept of poorhouses were brought to America by English settlers.
All orphans, mentally ill and the poor elderly were placed into these living commons. In the twenty-first century, nursing homes have become a standard form of care for the most aged and incapacitated persons. Nearly 6 percent of older adults are sheltered in residential facilities that provide a wide range of care, yet such institutions have not always existed. Before the nineteenth century, no age-restricted institutions existed for long-term care. Rather, elderly individuals who needed shelter because of incapacity, impoverishment, or family isolation ended their days in an almshouse. Placed alongside the insane, the inebriated, or the homeless, they were categorized as part of the community's most needy recipients; these poorhouses gave a place where they could be given daily meals. Poorhouses continued to exist into the early 20th century despite the criticism. Much of the criticism stemmed from the conditions of the poorhouses; the Great Depression overwhelmed the poorhouses as there were a lot of people that needed help and care but not enough space and funding in the poorhouses.
Due to Muck Raking in the 1930s the less than favorable living conditions of the poorhouses were exposed to the public. Poorhouses were replaced with a different type of residential living for the elderly; these new residential living homes were called board-and-care homes or known as convalescent homes. These board-and-care homes would provide basic levels of care and meals in a private setting for a specific fee. Board-and-care homes proved to be a success and by World War 2, the new way of nursing homes began to take shape; as the times continued to change, the government identified the issue of people spending extensive amounts of time in hospitals. To combat these long stays in short-term settings, board-and-care homes began to convert into something more public and permanent, state and federally funded. From this, by 1965 nursing homes were a solid fixture. Nursing homes were a permanent residence where the elderly and disabled could receive any necessary medical care and receive daily meals.
Though nursing homes in the beginning were not perfect, they were a huge step above almshouses and poorhouses in regards to following laws and maintaining cleanliness. From the 1950s through the 1970s the dynamics of nursing homes began changing significantly. Medicare and Medicaid began to make up much of the money that would filter through the homes and the 1965 amendment laws enforced nursing homes to comply with safety codes and required registered nurses to be on hand at all times. Additionally, nursing homes may sue children for the costs of caring for their parents in jurisdictions which have filial responsibility laws. In 1987, the Nursing Reform Act was introduced to begin defining the different types of nursing home services and added the Residents' Bill of Rights. Today nursing homes are different across the board; some nursing homes still resemble a hospital. Nursing home residents can pay for their care out of pocket, others may receive medicare for a short time and some may use long-term insurance plans.
Across the spectrum, most nursing homes will accept medicaid as a source of payment. In most jurisdictions, nursing homes are required to provide enough staff to adequately care for residents. In the U. S. for instance, nursing homes must have at least one registered nurse available for at least 8 straight hours a day throughout the week, at least one licensed practical nurse on duty 24 hours a day. Direct care nursing home employees include registered nurses, licensed practical nurses, certified nursing assistants, physical therapists, amongst others. Nursing homes require that a registered nurse monitor residents; the RN's job duties include implementing care plans, administering medications and maintaining accurate reports for each resident and recording medical changes and providing direction to the nursing assistants and licensed practical nurses. The LPN monitors residents’ well-being and administers treatments and medications, such as dressing wounds and dispensing prescribed drugs. A nursing assistant provides basic care to patients while working directly under a LPN or RN.
These basic care activities referred to as activities of daily living, can include assisting with bathing and dressing residents, helping residents with meals, eit