INDEPENDENCE, WELL-BEING
AND CHOICE
VISION FOR THE FUTURE OF
SOCIAL CARE FOR ADULTS
HEADLINE POINTS
• Closing date for consultation on Green Paper is
28.7.05
• 10-15 year vision
• No new money
• No prescribed structural changes
• Requirement to have a statutory post of Director of
Adults Social Services (DASS) but Councils free to
decide local structures
• Requirement to have a lead Member whose
portfolio mirrors DASS responsibilities
• Focus on improving and increasing availability and
range of universal preventative services
• Framework to achieve 7 key outcomes
• Focus on putting people in control over their own
lives
• Balancing risks : Individual choice and control - v expectations of a protective stance
BACKGROUND AND CONTEXT
• An ageing population
• Proportion of people living alone will increase in
next 20 years
• An increase in the number of over 85’s
• 10% increase in people aged 60+ with mental
health problems
• 1% increase each year in adults with learning
disabilities
• More middle aged people choosing to move from
towns to rural areas, therefore more older people in
rural areas
• Closure of local shops, pubs, banks and emphasis
on out of town shopping malls (Living in a car
orientated society without a car can be a problem)
 The need for Social Care will increase over the
coming years
DEFINITION OF SOCIAL CARE
“The term Social Care describes the wide range of
services designed to support people in their daily
lives and help them play a full part in society. It
includes practical services (Home Care, Day
Centres, Residential Care etc) and practical
assistance to overcome barriers to inclusion
(supported entry to work for people with mental
health problems, personal assistants) and support
services to those in emotional distress”.
THE 7 KEY OUTCOMES
• Improved health: enjoying good physical and
mental health (including protection from abuse and
exploitation). Access to appropriate treatment and
support in managing long-term conditions
independently. Opportunities for physical activity.
• Improved quality of life: access to leisure, social
activities and life-long learning and to universal,
public and commercial services. Security at home,
access to transport and confidence in safety outside
the home.
• Making a positive contribution: active
participation in the community through employment
or voluntary opportunities. Maintaining involvement
in local activities and being involved in policy
development and decision making.
• Exercise of choice and control: through maximum
independence and access to information. Being
able to choose and control services. Managing risk
in personal life.
• Freedom from discrimination or harassment:
equality of access to services. Not being subject to
abuse.
• Economic well-being: access to income and
resources sufficient for a good diet, accommodation
and participation in family and community life.
Ability to meet costs arising from specific individual
needs.
• Personal dignity: keeping clean and comfortable.
Enjoying a clean and orderly environment.
Availability of appropriate personal care.
SPECIFIC ISSUES
• Supporting and enabling individuals to take
control of their lives.
– Move away from a system where people have to take
what is offered, to having control over the type of help and
support they want, and more choice about, and influence
over, the services on offer.
– Information is the key to decision making - ensuring
people have all the information on what help and support
is available, and how to access it.
– Introducing “the right to request not to live in a residential
or nursing care setting”, requiring providers to state their
reasons if they recommend this option.
– Introducing client self assessment.
– Confining social worker assessments to those with more
complex needs.
– Streamlining assessments across agencies (SSD/DWP).
– Introducing “Individual Budgets”
– Introducing “Care Navigator”
• Extending the range of support to carers
– Providing training and support in the caring role.
– Providing information on available (universal) services
– Support from a care manager/care navigator in identifying
and accessing services.
• Preventative Services
– Early, well-targeted interventions should be developed to
reduce the need for intensive, more costly services. The
local authority well-being agenda can be used to improve
health, social inclusion and quality of life. The wider
resources of the community, including universal services,
should be deployed to support individuals.
• Service Redesign
– Innovative flexible services that have been shown to work
should be developed. These include new technology,
extra care housing, homeshare, adult placement, connect
care centres.
• Strategic Commissioning
– A local `community-wide’ strategic commissioning
framework should be developed by all partner agencies to
provide the right balance in investment between:
• Services for the general population aimed at promoting
health and social inclusion:
• Preventative services that meet low level needs: and
• Intensive support for higher level and complex needs.
• Local Authority to undertake regular strategic needs
assessments to plan ahead for 10-15 years, to include
– care and support needs of whole population, including those
who can pay for services themselves
• Partnerships
– The government will explore mechanisms for improving
collaboration between local authorities and the NHS. It
does not want to impose solutions to improve joint
working, however `doing nothing will not be an option’.
Local Area Agreements are an opportunity to improve
public services. A `strong and vibrant’ voluntary and
community sector is an essential part of the vision, and
the government wants to encourage capacity building in
the sector to help them engage with local public sector
commissioning authorities.
• Regulation and Performance Management
– Regulation, inspection and performance management
frameworks will be modernised to support the vision for
social care. The merger of the Commission for Social
Care Inspection and the Healthcare Commission will
reflect shared objectives. Headline targets will be aligned
across services.
– Creation of “well-being” targets
– Local Strategic Partnerships can establish local
agreements on cross-cutting issues.
• Workforce
– The workforce is critical to delivering improved services.
The government is working to improve leadership,
capacity and skills. Local workforce initiatives should
include training and employment for carers.
SO WHAT WILL IT MEAN IN
PRACTICE …………..
• Councils will not be expected to direct clients to
particular providers, but will need to ensure that
they have all the help and information they need to
make choices - the role of a “Care Navigator”?
• In future, funding for all providers (Local Authority
and Independent Sector) will be decided by client
choice - individual budgets.
• Commissioning will be the key lever to manage the
risk of “Supply Induced Demand”.
• Implications and challenges for a model of service
commissioning and delivery based on fixed roles,
fixed timetables, fixed budgets.
• Commissioning capacity and infrastructure
implications.
• Clients likely to demand more flexible services, with
greater use during evenings and weekends.
• Service levels and budgets will need to be flexed
much more quickly to respond to fluctuations and
demands.
• Changing the way the system operates is essential
for quality and client control, but at the same time
commissioners will have to secure value for money.
AND FINALLY ………………..
“SHARED VALUES ARE NOT ACHIEVED BY
STATING THEM, BUT BY LIVING THEM”.