The Local and the National in Community Care: Exploring Policy and Politics in Finland and Britain

International literature on community care tends to focus on the national level of welfare institutions and policies. However, community care is largely a locally tailored service and this paper makes a case for local comparisons of community care policies. Using local case studies from Finland and Britain, the paper argues that focusing on the local level contributes to the comparative study of community care in two ways. First, local comparisons highlight the often distinctively local nature of community care policies and thereby add to our understanding of community care. Second, local comparisons extend existing cross‐country explanations of community care by showing that community care is largely shaped by local politics, together with indirect structuring by national contexts. As such, the local case studies highlight the importance of the relationship between policy and politics, which has often been neglected in comparative research.     

The Role of Housing Managers in the Implementation of Community Care

This article will outline the response of housing management to the implementation of community care policy in the North East. It will locate housing's role within the broader development of community care policy, and briefly review the reasons for housing's relatively late arrival as a key partner, alongside social services and health, in the planning and delivery of services. Using information gathered from interviews with housing professionals, part-time housing students, voluntary organizations, and workers within health and social services, it outlines and evaluates five main factors which appear to be affecting the successful integration of housing management into the process of planning and delivering community care services in the North East.     

Bathing and the Politics of Care

Though providing baths in the community for disabled and older people has long been an area of service dispute, it has received little academic or policy attention. This is partly because bathing and washing are assumed to be common-sense activities. This paper suggests instead that washing and bathing are far from straightforward or common-sense and that specific meanings attach to them in ways that affect how people experience the receiving of help in these areas. It explores the history of bathing and washing and the significance of touch and nakedness in service provision. It then turns to the service providers who have traditionally undertaken such work—the community nursing and home care services—exploring the rationales that underlie such patterns and the implications of current changes in community care.     

Sheltered Housing and Community

This paper considers the role of sheltered housing following the introduction of new community care arrangements in 1993 and examines the continuing uncertainty about its exact role as community care continues to develop. It reports on a study conducted in Shropshire, using a postal survey and interviews with older people and service professionals. The study highlights the importance of sheltered housing for older people, particularly in relieving them of concerns about maintenance and repairs, social isolation and security. These factors were crucial for their overall peace of mind and quality of life. While only a small proportion of tenants received help under social services' community care arrangements, the additional support, monitoring and service coordination provided by wardens helped some of them to remain in sheltered housing when residential or nursing home care might otherwise have been necessary. Sheltered housing was overwhelmingly popular with older people — but their satisfaction was closely associated with the availability and quality of the warden service. Although sheltered housing is not currently in vogue in housing policy, the paper argues that it plays a vital role in local provision for older people and needs to be more closely integrated into community care policy, while at the same time preserving the characteristics that make it popular with its residents.     

社区照顾在残疾人社会保障中的运用

社区照顾最早产生于英国,自诞生以来,便以其新型的理念与模式日益受到各国学者和政府的重视。社区照顾作为一种专业化的照顾模式,在残疾人社会保障方面具有广阔的发展空间。本文试图将社区照顾的制度安排应用于我国残疾人社会保障事业,并探析我国残疾人社区照顾的模式,以推动我国残疾人社会保障事业向人性化、社会化、专业化方向发展。     

社区老人—儿童共养模式可行性分析

本文主要探讨了老人—儿童共养这一新型社区养老模式。在探索了中国老年问题现状以及目前社区养老的总体情况后,笔者结合存在的问题和资源,提出了这一特殊的社区养老模式,并从必要性、具体操作和可行性分别进行了考量。藉此逐步拓宽社区养老服务的内容和形式,发挥出社工的专业作用,促进养老事业的发展。     

Facing Up to Underfunding: Equity and Retrenchment in Community Care

Local social services departments in the UK are expected to distribute their cash-limited budgets for community care in ways that achieve an equitable allocation of resources in situations where, with present levels of funding, they cannot meet all the needs with which they are presented. This paper discusses a case study of the introduction of a "needs-based" formula to allocate a local authority's budget for home care services and a follow-up survey to investigate whether services reached the people intended to benefit. The article argues that the "gatekeeping" role of community care assessments is important to safeguard equity without the inflexibility of highly standardized tests of eligibility. However, with the new Labour government seeking to reduce dependency on public expenditure, and a growing lobby for national standards of social care, it will be increasingly important that local authorities justifiy their different practices with evidence about how they relate to local needs.     

Halfway There? Policy,Politics and Outcomes in Community Care

The community care reforms which followed the 1989 White Paper "Caring for People"were apparently focused on addressing the needs of people requiring long-term care, and on achieving improved outcomes and better quality of life.
The agenda set out by the White Paper was for community care in the next decade and beyond. Half way through this decade, we question the extent to which the objectives of promoting choice and independence for users and carers have been achieved. The paper draws particularly on a programme of monitoring conducted jointly by the Nuffield Institute for Health and the King's Fund, based on national and local focus groups meeting over a two-year period. It proposes a framework for evaluation which consists of four components: the definition of desired outcomes; specification of service systems necessary to deliver such outcomes; promotion of access to services; and the development of supporting operational policies and resource allocation mechanisms.
This framework offers a substantial step beyond much of the monitoring of the community care reforms which has taken place to date. This has assessed progress largely in terms of the establishment of new systems and processes. We conclude that such changes were essential building blocks for delivering better-quality community care services, and in the short term it may have been legitimate to view their establishment as proxies for progress towards delivering user-centred services. However, monitoring and evaluation should now be increasingly oriented towards ensuring that these changes are in fact producing the desired service outputs and urn outcomes. We propose that our framework offers one such way forward.     

人口老龄化背景下的社区养老服务

人口老龄化的趋势不断加快是当前人口发展的态势,在传统家庭养老功能趋于弱化的同时,如何有效地建立满足老年人需求的服务体系是老年工作面临的挑战之一。本文结合老年人的身心特点阐述了社区养老服务的内涵及优越性,在分析了社区养老服务的现状及问题的基础上,提出了社区养老的发展思路和建议。     

An integrated system of engaging social workers and community volunteers in social care for the elderly: case studies in Taiwan

Integrating volunteers into social care is widely expected but rarely successful in practice. This paper discusses how the Community Care Centre Plan organising community volunteers to provide services to the elderly in Taiwan. This plan successfully integrated social workers and volunteers in a national system to offer service in local communities, showing a systemic practice of community care and a unique case of community-based and volunteer-based service. The purposes of this paper are to introduce the programme design and to understand how to integrate the mission of social workers and volunteers’ performance. The governmental policy and requirements, the role of social workers and the provision of voluntary community service which contributed to form the system were examined in this paper.     

城市社区认同感的培育——对南通市崇川区学田街道的调查分析

城市社区为满足社区居民的需求而建立,凝结着社区居民各方面的利益。居民本应具有较强的社区认同感,然而当前城市社区认同感的缺失却日益严重。通过对南通市崇川区学田街道的实证调查,本文认为培育城市社区认同感,既要加强城市社区文化建设,主要包括社区服务文化建设和社区管理文化建设;同时需要鼓励、支持和动员居民参加社区建设。     

社会资本与社区治理：城市社区中的制度、组织与价值

社会资本和社区、社区治理具有内在的关联性,城市社区面临的很多问题都与社会资本的缺失或下降有关,集中体现在社区空间、社区组织和社区文化层面上的社区社会资本。因此,城市社区社会资本要培育作为制度空间的社区公民社会、作为组织资源的社区民间组织、作为价值机制的信任、规范、互惠等社区公民文化,发挥居民、社区各社会组织、政府行政组织以及社区文化价值的功能,从而实现社区治理的共治、善治和长治。     

探讨医务社会工作在社区养老中的作用

社区是老年人生活和活动的主要场所,在提供养老服务方面具有很大优势。由于政府投入社区养老的资源有限和人们观念认识等方面的问题,使得社区养老没有达到预期的效果,即没有满足老年人的有效需求,特别是老年人的医疗需求,使得老年养老问题再次陷入困境。医务社工的介入,是解决当前社区养老中追切需要解决的问题的有效元素,也是使得社区养老资源发挥更大效用的关键因素。     

和谐社区建设的内容和路径探索

和谐社区是和谐社会的基础。建设和谐社区,要加强社区的就业和社会保障功能的建设,加强社区的城市管理功能的建设,加强社区的社会服务功能的建设,加强社区的社会治安综合治理功能的建设。就和谐社区建设的路径而言,当前,自上而下的政府推动型与自下而上的社区参与型相结合是现实的需要,此外,推动社区建设的专业化与社会化相结合,加强“资源共享、共驻共建”,建立健全社区居民参与机制,也是和谐社区建设的重要途径。     

论加强社区建设与促进社会和谐

加强社区建设,是构建社会主义和谐社会的基础。它是社会主义现代化建设的迫切要求,是"以人为本"理念的重要体现,是社会主义民主政治建设的重要途径。要开展社区建设,就必须建立专业的社区工作队伍,提高社区管理水平;加强社区规范化建设,完善社区管理体制;引导社区自治,增强居民的社区认同感;鼓励社区志愿者的参与,推动社区精神文明建设;培育非政府组织,促进社区建设的社会化。     

Community service provision for the elderly under the context of competitive contracting in Guangzhou

Contracting is a prevalent trend in the delivery of public and social services around the world. International experience shows that contracting has positive and negative impacts on service provision. While local experiments on social service contracting are currently emerging in China, the implementation and effects of contracting are worthy subjects of examination. This study delves into this area by focusing on community service provision for the elderly in the context of competitive contracting. A street community which is located in Guangzhou, Guangdong Province of China serves as a case study to show the implementation of competitive contracting, the provision of community service for the elderly, and the implications of contracting for care.     

优势视角下的社区分析

传统社区分析以外部专家评估为主,关注社区问题诊断,缺少居民能力建设,不利于社区问题的解决。优势视角下的社区分析将重点放在关注社区资源和社区居民能力方面,在进行社区分析时常采用的方法和工具包括:欣赏性访谈、社区资产图、问题解决与需求满足清单。     

关于社区制的再思考——兼论社区自治的单元归属

文章就社区制理论的两大分野、实践中的三种模式、三大领域以及社区自治的单元归属这四个方面的问题作了重点分析与深入思考。     

Mergers and Acquisitions in the Private Sector: What Are the Lessons for Health and Social Services?

In seeking a more seamless provision of health and social care, the government is promoting the merger of the functions of primary and community health services and social services. In the private sector, mergers have been commonplace. The primary aim of this paper is to identify the key concepts and explanatory frameworks in the literature on mergers and acquisitions in the private sector that are relevant to the development of new organizational structures in health and social care. The evidence suggests that it is difficult to merge two organizations successfully. Reasons for this are explored and the implications for health and social care mergers drawn out.     

社区残疾人服务现状调查——以武汉市为例

残疾人社区服务是残疾人服务体系的重要组成部分。掌握当前社区残疾人服务的状况是完善社区残疾人服务的重要环节。本文以武汉市36个社区为样本,从社区工作人员的专业认知情况、社区工作人员参与社区残疾人服务情况、社区实际提供的残疾人服务内容、残疾人对服务内容的反馈等方面进行了抽样调查,以期为政策的制定提供参考。