Gray Ann Marie - Transforming adult social care

TRANSFORMING ADULT SOCIAL CARE

Contemporary policy and practice

Ann Marie Gray and Derek Birrell

First published in Great Britain in 2013 by

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ISBN 978 1 84742 799 1 paperback
ISBN 978 1 84742 800 4 hardcover

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Ann Marie Gray:

To my granddaughter Chloe

Derek Birrell:

To my granddaughter Lucy

Overview

Adult social care has emerged as a distinct area of provision following the separation from childrens services after 2006. This decision was driven by concerns relating to childrens social care and services, not to adult services. In the first instance this meant organisational separation from the area of child protection and children and family services in local authorities in England. Social care in general had had a distinct existence from the National Health Service (NHS) in the United Kingdom (UK) from 1948. The separation from childrens services was to lead quickly to a clear focus on the notion of adult social care as a distinct entity and the use of the term became established in most governmental, professional and academic writing. The term adult social care has largely replaced the former general terms of personal social services and community care with new attempts to define the term. The distinctiveness of adult social care services has not, however, meant a reduction in the importance given to the relationship of adult social care to health or other cognate services. Adult social care services are expected to work closely in partnerships with the NHS, other public services and the independent sectors. As adult social care has become established as an area of provision, a number of factors have pushed adult care into a major issue on the government agenda and in public debate. These include demographic change, growing needs, pressure on public expenditure, welfare retrenchment, promoting independence and the balance with health. The debate on problems, principles and policy options has led to the adoption of major strategies in terms of modernisation, vision statements and more recently a transformation of care. Underpinning principles under debate relate to the balance of responsibilities between the individual and the state, the role of contracting out and funding arrangements and changes, reliance on unpaid care and law reform. The potential for further transformation lies in developing the emerging key values of personalisation, integration and user participation. Further key delivery issues relate to safeguarding, outcomes, diversity, the role of carers and the nature of the workforce.

Definitions of adult social care

The emergence of the distinct area of adult social care led government bodies to define the area for official purposes. The Department of Health adopted originally a broad enabling definition in the key paper Our health, our care, our say (DH, 2006a). This defined adult social care as the wide range of services designed to support people to maintain their independence, enable them to play a fuller part in society, protect them in vulnerable situations and manage complex relationships (2006, para 2.5). Attempts at definitions have tended towards purpose-based statements rather than a listing of provision. Thus, the current definition used by the Department of Health refers to promoting peoples wellbeing and independence and giving them control over their lives (DH, 2012a, p 8). The Law Commission, in a major study of the legal status of social care, decided that it was not possible to provide a single definition. It examined a service-orientated definition that adult social care means the care and support provided by local authority social services pursuant to their responsibilities towards adults who need extra support (Law Commission, 2011, para 1.5). Also examined was an approach based on tightly defined processes, which served to determine the scope of adult social care, for example, community care assessments and care planning. In the end the Law Commission preferred to define the purpose of adult social care as promoting or contributing to the well-being of the individual (Law Commission, 2011, para 2.1), although it also noted the developing range of non-traditional services such as art therapy, personal assistance and life coaching. Other contributions to definitions have stressed the importance of social care. In 1998, the landmark White Paper