© 2010

Residential Care Transformed

Revisiting ‘The Last Refuge’


Table of contents

  1. Front Matter
    Pages i-xvi
  2. The Context

    1. Front Matter
      Pages 1-1
    2. Julia Johnson, Sheena Rolph, Randall Smith
      Pages 3-16
    3. Julia Johnson, Sheena Rolph, Randall Smith
      Pages 17-39
    4. Julia Johnson, Sheena Rolph, Randall Smith
      Pages 40-59
  3. Revisiting The Last Refuge

    1. Front Matter
      Pages 61-61
    2. Julia Johnson, Sheena Rolph, Randall Smith
      Pages 63-84
    3. Julia Johnson, Sheena Rolph, Randall Smith
      Pages 85-108
    4. Julia Johnson, Sheena Rolph, Randall Smith
      Pages 109-137
    5. Julia Johnson, Sheena Rolph, Randall Smith
      Pages 138-164
    6. Julia Johnson, Sheena Rolph, Randall Smith
      Pages 165-186
  4. Conclusions

    1. Front Matter
      Pages 187-187
    2. Julia Johnson, Sheena Rolph, Randall Smith
      Pages 189-206
    3. Julia Johnson, Sheena Rolph, Randall Smith
      Pages 207-218
  5. Back Matter
    Pages 219-285

About this book


This book, now in paperback, revisits Peter Townsend's classic study of residential care for older people in Britain conducted in the late 1950s. It provides not only a fascinating account of residential care for older people over the last 50 years but is also an important contribution to the literature on research methods.


care Design environment methods

Authors and affiliations

  1. 1.The Open UniversityUK
  2. 2.University of BristolUK

About the authors

JULIA JOHNSON is a Visiting Senior Research Fellowat the Faculty of Health and Social Care at The Open University, UK. She has published widely on the topics related to ageing and later life andwas review editor of the journal Ageing& Society. Her most recent book is Understanding Health and Social Care (edited with Corinne DeSouza).
SHEENA ROLPH is Visiting Senior Research Fellow at The Open University, UK. She has published widely in the social history of learning disability and the history of residential care for older people. Her background is in art history and her research interests include the history of visual images relating to her specialist fields.
RANDALL SMITH is Professor of Social Gerontology in the School for Policy Studies, University of Bristol, UK. He has co-authored books on community care and the development of policies for older people. Between 2003 and 2009, he was a member of the Executive Committee of the British Society of Gerontology and is a Trustee of Age Concern Bristol.

Bibliographic information



'This study gives us a unique insight into the changing nature of institutional care over half a century. It is methodologically innovative, using older volunteers to help in the research, but it is reflective and self-critical about the limits of its approach - a model for students in the subject. It is beautifully written with moving accounts of the quality of the last years of individuals' lives. It could not be more relevant to policy in an ageing society.' - The British Academy juding panel for the inaugural Peter Townsend Policy Press Prize

'Elegantly written it is a pleasure to read...highly recommended.' - Journal of Social Policy

'This is an important book. It addresses key issues about the quality of residential care for the elderly, about 'institutional' life more broadly, and especially about methodologies and ethics in social science research.' - Canadian Journal of Sociology

'This book enhances our understanding of key issues, such as the balance between regulations and human dignity in care provision, and the stigmatization of residential care as opposed to other types of care provision, which are central to the current policy debate about the quality of care for older people and the future design of care provision.' - Social Policy and Administration

'Starting with Peter Townsend's landmark study of residential care, The Last Refuge, and re-tracing his footsteps the authors have produced a remarkable volume that successfully combines a record of the sea-change in residential care over the past 50 years, a compelling analysis of current care environments and quality, a novel example of participative research and a forceful critique of fashionable simplistic portrayals of institutions. The book is a fully worthy companion to Townsend's classic study and will become an indispensable text for anyone interested in how society treats some of its most vulnerable citizens.' - Alan Walker, Professor of Social Policy and Social Gerontology, University of Sheffield, UK

'For those working within social care [this book] provides some welcome answers around the history and development of residential care institutions, in particular providing an overview of practical issues of ownership, staff and residents, the living environment and daily activities. For an academic audience of historians and sociologists the text pays tribute to classic studies whilst celebrating contemporary developments in methodology.' - Kerry Allen, Health Services Management Centre, University of Birmingham, UK

'This is an important book that raises fascinating questions about the place of residential care in society and the similarities and differences in the way in which researchers undertook their tasks in 1960 and 2010...In this book, Julia Johnson, Sheena Rolph and Randall Smith highlights the questions that underlie the debates about residential living. Read it.'

-Roger Clough, Professor Emeritus, Lancaster University, UK

'Fascinating...there is much to reflect on in this book.' -

'In identifying the differences and continuities between residential care in the 1950s and now, the authors succeed in emphasising the broad historical developments in the conceptualisation of welfare states and care while avoiding oversimplification. This book is important for any social scientist, empirical researcher and student of any social science discipline, and the fact that the data are recorded and stored promises a new revisiting study and studies which can, on the basis of historical developments, analyse the ideological persistence of the stigma of institutional care.' - Berhard Weicht, International Journal of Ageing and Later Life

'Fascinating...this book deserves a place on all library shelves and should be required reading for anyone interested in the welfare of some of the most vulnerable members of society.' - Ageing & Society