Reconciling Cash and Care: Home Care Charges and Benefit Checks in Social Services

Correspondence to Pete Alcock, Health and Community Studies, Sheffield Hallam University, Collegiate Cresent, Sheffield S10 2BP Summary This article contains the report of a small research projecton the development of welfare rights checks for home care clientsin social services departments. Welfare rights take-up activityhas become an important feature of provision by local authoritysocial services departments, frequently targeted on particulargroups of clients known to experience problems in claiming fullbenefit entitlement. Users of home care services are such aclient group. Take-up work with home care clients is also, however,a product of the impact of community care policy changes andof financial pressures on local authority social services. Thesehave resulted in the introduction of charges for home care servicesby many authorities, and the use of rebates from such chargesto protect low income service users. Welfare rights work hasthus become an important feature of the reconciliation of thesenew charging policies with the continued service needs of poorhome care clients. The research examined a successful take-upinitiative, linked to home care charges, in Sheffield and contrastedthis with similar activities in other authorities throughoutthe UK. The conclusion is reached that levels of non-take-upof social security benefits are particularly low amongst homecare clients and that benefit checks can secure significantadditional income for them, which may also have the indirecteffect of increasing the income to social services departmentsfrom the charges for home care services.     

From Children's Departments to Family Departments

Drawing upon his own experience as a child care officer, the author draws attention to the local authority Children's Departments which were established 50 years ago in 1948. To mark the anniversary, interviews were held with 20 former children's officers. From these, it was possible to identify three major achievements of the Children's Departments, namely the restoration of natural parents to child care, the promotion of child care skills, and the formation of a highly committed staff force. The Children's Departments were abolished over a quarter of a century ago and amalgamated into the Social Services Departments (Social Work Departments in Scotland). Despite some notable advances, it is argued that, under these departments, preventative work with children, child care skills and staff morale have declined. As a way forward, the author proposes the formation of a local authority Family Department which would consist of family workers equipped with child care skills, a facility approach which offers open services, and backing for locally run neighbourhood groups. It is contended that this service would be acceptable to and particularly helpful to parents and children living in conditions of social deprivation.     

"Bridging the Gap": New Relationships between Primary Care Groups and Local Authorities

Current policy places great emphasis on the development of "partnerships", particularly between NHS and local authority services, with the aims of increasing service coordination and delivery and improving health. To this end, primary care groups (PCGs), at the forefront of NHS organizational developments, are required to include a social services representative on their governing boards; similarly, primary care trusts (PCTs) have a social services representative on their executive committees. Drawing on a representative longitudinal national survey of English PCGs, the paper evaluates the contribution of these new governance arrangements to the development of inter-agency partnerships. Despite poor histories of collaboration and some major organizational barriers, there are some signs of progress, with social services representatives playing an active part in PCG affairs and having clear lines of communication about PCG matters with their employing authorities. Equally significantly, PCGs have also quickly established a wide range of contacts directly with other local authority services and departments. However, these early gains risk being limited by traditional professional inequalities between social work and medicine and, in particular, by the prospect of further organizational upheaval as PCGs merge with each other and/or acquire trust status.     

A Model for the Comprehensive Assessment of Older People and Their Carers

Correspondence to Beverley Hughes, Department of Social Policy and Social Work, University of Manchester, Oxford Road, Manchester M13 9PL. Summary Although local authorities and social service departments arein the process of developing systems of assessment in relationto care management, there has been little debate about the principleswhich ought to underpin assessment processes, nor about thepurpose, scope, and content of comprehensive assessment witholder people. This article discusses these issues and proposesa framework for comprehensive assessment with older people andtheir carers, derived from development work with social workersin a number of local authorities. Of particular importance isthe need for comprehensive assessment to embody meaningful mechanismsfor user and carer participation and empowerment; to acknowledgenot only need and risk but strengths and resources; to regardthe older person as the centre of a network of personal, familial,and social factors which together determine her or his qualityof life and level of risk. The implications for practitionersare examined.     

Welfare Rights Advocacy in a Specialist Health and Social Care Setting: A Service Audit

Is a specialized welfare rights service, thought important insocial services departments, a valid element of social careservices in multi-professional settings in which social workis increasingly incorporated, where social workers often helpservice users with benefits? An audit of a specialized welfarerights advocacy service, part of social work provision in alarge UK hospice, demonstrated inconsistent referral by nursingstaff, the main referrers, a large workload including frequentcomplex cases and achievement of benefits and grants for patients,carers and families substantially in excess of the cost of theservice. Annual workload for a forty-eight-bed hospice with1,600 home care patients was estimated at 976 typical caseswith nearly 2,928 contacts; about sixty complex cases annuallygenerated a similar workload in themselves. Provision of specializedwelfare benefits advocacy for palliative care patients is foundlikely to meet a substantial need and to require specialistprovision. This may be true of other multi-professional servicesincorporating social workers.     

The Tension between Mainstream Competence and Specialization in Adult Protection: An Evaluation of the Role of the Adult Protection Co-ordinator

With the implementation of No Secrets (Department of Health, 2000),the question of how far to specialize in adult protection hasbeen raised for social services departments. Related issuesinclude the extent of specialization within the vulnerable adultclient groups as well as between adult protection specialistsand other workers. This paper draws on an evaluation of therole of the adult protection co-ordinator across two local authoritysocial services departments (the case study) who share adultprotection policies, protocols and procedures but where thespecialist role has only partially been implemented and hasevolved in different ways. It identifies a number of criticalconsiderations for the local implementation of national policy,including the particular model for adult protection specialization,working relationships with district management and care management,decision making and accountability, adult protection case managementand the development of mainstream competence in adult protection.     

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.     

To be or to be trained to be: On emerging and diverging ideological traditions in organizing day care activities for people with severe mental disorders in Sweden

Organized activities for people with severe mental disorders have until recently been the societal task of one human service organization, the medical speciality of psychiatry. With former psychiatric impatients moving out into the local community and with heavier dependence on outpatient polyclinic care, the situation is slowly changing. Day care activities for people with severe mental disorder are organized with an increasing involvement of the social services. The aim of this article is, using data from a national survey carried out in 1991 in Sweden, to describe and categorize how day care units interpret their task. Results show that claims-making activities still adhere largely to a therapeutic paradigm in spite of the outspoken social character of the work of organizing everyday life activities.     

Participation of Disabled Children and Young People in Decision Making Within Social Services Departments: A Survey of Current and Recent Activities in England

A survey of all social services departments in England was undertakenin order to identify and investigate current work concerningthe participation of disabled children within decision makingregarding their own care and in service development. Developinga culture of, and good practice in, children’s participationis integral to government policy. Results demonstrate that disabledchildren are being involved in a range of decision-making areas;however, participation is not yet embedded or sustained acrossall social services departments, and the involvement of disabledchildren at a higher strategic level is still rare. The participationof disabled children needs further development including moreevidence on which factors can support and promote disabled children’seffective participation.     

Integrating Health and Social Care at the Micro Level: Health Care Professionals as Care Managers for Older People

A common problem in the provision of coordinated long‐term care is the separation of health and social care. The present government has been increasingly concerned with promoting convenient, user‐centred services and improving integration of health and social care. One arrangement that could contribute to this for some older service users is for health care staff to act as care managers, coordinating the provision of both health and social care. This paper presents the findings of a survey of arrangements in place in local authorities for health staff to work as care managers for older people. This was designed to provide details about the range and scope of care management activities undertaken by health care professionals. Key areas of enquiry included: which kinds of health care staff undertook care management and in what settings; how long the arrangements had been in place and how widely available they were; whether there was a distinction between the types of cases and care management processes undertaken by health care staff compared with their social service department counterparts; and what management and training arrangements were in place for the health care staff.     

Spouse Liability for a Partner's Long–term Care Costs: Local Variations in Policy and Practice in the UK

Under the 1948 National Assistance Act a husband and a wife are liable to maintain each other and so can be required to contribute towards a spouse's care home costs. A national postal survey of social services finance officers showed that only a minority of local authorities pursue liable spouses. These authorities have often developed individual policies with widely different treatment of capital and income. Discretion is being exercised in the pursuit of liable spouses within these authorities. Social workers do not necessarily bring liable spouses to the attention of finance officers and articulate and knowledgeable spouses can either decline to pay or pay only token amounts. Only the unlucky and ill–informed spouses end up contributing. Such variation in the treatment of spouses is at odds with the development of fairer policies to meet the costs of long–term care.     

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.     

Contract Management and Community Care: A Negotiated Process

Correspondence to Jackie Powell, Department of Social Work Studies, University of Southampton, Highfield, Southampton, SO17 1BJ, UK. Summary Drawing on a wider study of community care arrangements forvisually impaired people in England and Wales, this paper exploresthe implementation of contractual arrangements as part of thedeveloping formalization of partnerships between local authoritysocial services departments and voluntary organizations. Itargues the importance of conceiving contract management as acomplex set of social processes involving a diversity of interestsand inequalities of power, where skills in negotiation are centralto promoting greater participation in community care policyand practice. It concludes with a brief discussion of the relevanceof social work to the implementation of this key area of contemporarycommunity care arrangements.     

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.     

The probation service and the press: the curious incident of the dog in the night-time

Correspondence to: Meryl Aldridge, School of Social Studies, University of Nottingham, University Park, Nottingham NG7 2RD. Summary The preoccupation with adverse media coverage in many sectorsof social work is not shared by the probation service. On thecontrary: increasing resources are being devoted to trying toraise its profile in both national and local news media. Basedon an analysis of press coverage and interviews with staff involvedin probation external relations work, the paper opens with anexamination of a number of incidents which might have been expectedto result in unsolicited negative coverage but did not get takenup. What parallels can be drawn between national press reportingof the controversial child murder trials involving local authoritysocial services and the only probation equivalent: the ColinEvans case? Pro-active news management by the service both locallyand nationally is then discussed and, in the final section,the likely success of this strategy given the existing mediatreatment of the probation service is considered.     

Investing in the relationship: practitioners’ relationships with looked‐after children and care leavers in Social Work Practices

Providing more consistent and continuous relationships for looked‐after children and care leavers is a current preoccupation in social work in light of many criticisms of the quality of such relationships. Recommendations for more direct work have spurred new models of service delivery in children's services aimed at improving individual outcomes. Independent Social Work Practices (SWPs), a new organizational model piloted in some areas of England between 2009 and 2012, were established to enable social workers and other practitioners to spend more time in direct work and thus to improve the practitioner/child/young person relationship. This paper uses findings from interviews with 169 children and young people across 11 local authorities and 5 SWPs, undertaken as part of a 3‐year national matched control evaluation of pilot SWPs, to identify key elements of good quality practitioner relationships with children or young people. Focusing on children's and young people's perspectives and experiences, the study demonstrates that more direct work and consistent relationships are valued. The paper deploys Recognition Theory to further understanding of effective practice as defined by children and young people.     

The nature and culture of social work with children and families in long‐term casework: Findings from a qualitative longitudinal study

Social work in the United Kingdom is preoccupied with what social workers cannot do due to having limited time to spend with service users. Yet remarkably little research has examined what social workers actually do, especially in long‐term relationships. This paper draws from an ethnographic study of two social work departments in England that spent 15 months observing practice and organizational life. Our findings show that social work some of the time has a significant amount of involvement with some service users and the dominant view that relationship‐based practice is rarely achieved is in need of some revision. However, families at one research site received a much more substantial, reliable overall service due to the additional input of family support workers and having a stable workforce who had their own desks and were co‐located with managers in small team offices. This generated a much more supportive, reflective culture for social workers and service users than at the second site, a large open plan “hot‐desking” office. Drawing on relational, systemic, and complexity theories, the paper shows how the nature of what social workers do and culture of practice are shaped by the interaction between available services, office designs, and practitioners', managers', and service users' experiences of relating together.     

A New Look at Home Care and the Hospital Social Worker

Clinical, administrative and social action reasons for expanding social work services in hospital based home care programs are persuasive. Hospital departments of social work should consider carefully how they may expand services in home care and coordinate and integrate such activities with social work and discharge planning processes occurring throughout the hospital. It is necessary for social work leadership to be present on professional advisory, quality assurance and similar committees and to use these committees as arenas for expanding the social work role in home care.     

Social Work Education in Mainland China: Development and Issues

The present paper gives an overview of the current trend of social work education in Mainland China, a fast-expanding academic subject of higher education in Mainland China during the last 20 years. This rapid development was brought about by the increasing recognition of the use of social work knowledge in tackling some of the social problems arising from the social and economic changes induced by the open door policy of China. New initiatives were undertaken by government departments, academic institutes and service providers, to explore possible reform of service delivery models in serving the elderly, children and youth, women and other vulnerable groups. It thus creates demands for personnel with new skills and knowledge. It has also led to the promulgation of government policies in 2006, in establishing a strong work force of social work, by setting up an accreditation system for social work as a vocation, making available funding for service development and setting up of NGOs. This paper also highlights some of the imminent issues that cause concern, such as the search for a theoretical model of social training and practices suitable for Chinese society, standardization of curriculum design, teaching and learning, consolidation of accreditation examination and career structure, and creation of a working environment conducive to the professionalization of social work in terms of motivating and retaining social work graduates to stay in the service sector.     

Social Networks and Social Service Workers

Correspondence to Peter Sharkey, School of Law, Social Work and Social Policy, Liverpool Polytechnic, 98 Mount Pleasant, Liverpool, L3 5UZ. Summary ‘Networks’ is a word often used in the discussionof social work practice and within social services departments.It was a word which was central to the Barclay Report (1982)and important within the more recently published Griffiths Report(1988) on community care. It is a word also known to sociologistsand anthropologists through the development of ‘networkanalysis’. There is, however, a fairly wide gap betweenits use within social work and its use within social science.This article tries to explore this gap and the ways in whichsocial science ideas might have some use and relevance to socialservice workers. It does this by using some illustrative datafrom a study done of the personal networks of thirty elderlypeople who were all clients of a social service district office.