Information was collected on all publicly-funded admissions to residential or nursing care in both boroughs over a three-month period. With the written consent of clients or their carers, a detailed questionnaire was completed on each individual at the point of assessment, by the client's social worker or care manager. The questionnaire was based on the instrument developed for the Personal Social Services Research Unit national study and included data on personal and household characteristics, levels of dependency (including cognitive impairment) and social and healthcare needs, and the assessment and care-planning process.

4A postal questionnaire was sent out to all managers of residential and nursing homes in Barking and Havering, based on a similar study carried out by O'Dea et al in Merton, Sutton and Wandsworth.

5Details of access to, and funding arrangements for, NHS and non-NHS services were requested for GP and district nursing services, chiropody, physiotherapy, occupational therapy, speech and language therapy, palliative care, community psychiatric nursing services and specialised equipment, as well as health and activity programmes.

The overall response rate to the postal questionnaire was 88 per cent, comprising all but one of the 16 nursing homes, all five dual-registered homes, all 14 local authority residential homes and 34 of the 42 private sector residential homes.