The Rules in Institutional Care: An Ethnographic Style Study Introduction Angela Kydd*, Deidre Wild and Ann Fleming

A part of a doctoral study, this paper focuses upon what life was like in long-term care for frail older people waiting to be discharged from a hospital setting to a nursing home Towards the end of the study, the long stay hospital was due to close, making the staff very anxious. All of the patients in this study had been transferred to a ‘long stay’ hospital from an acute hospital, where they had originally been admitted following an acute illness or injury. The status of such patients is formally known in the UK as ‘delayed discharge’, also referred to as ‘ These patients, usually frail older people, are no longer in need of a hospital bed but are not fit enough to go back home and are waiting to be placed in an available communitybased care home facility. Long stay wards within the National Health Service (NHS) in the UK have been mostly discontinued, with a few facilities awaiting closure in Scotland, the research project’s UK country of origin. However, the tenets of this work apply to any institution in which frail older people are cared for and include those who have had to leave their own homes for long-term care. Given that times have moved on since Goffman’s seminal work on asylums [4], and that a personcentered approach is now purported to be implemented as best practice, the findings from the study show that institutional rules and task-orientated work still pervade in some areas. The effect staff stress had on these practices is implicit in the experiences reported by the participants in this study.