Social care – an overview

Rosemary ChessonProfessor in Health Services Research

MS – Making the Connections

Influences on social care

Social Changes Scientific, medical & technological developments

Influences on social care

Social Changes Scientific, medical & technological developments

Changes in:

Health and social care policy & legislation

Influences on social care

Social Changes Scientific, medical & technological developments

Changes in:

Health and social care policy & legislation

Organisational culture

Influences on social care

Social Changes Scientific, medical & technological developments

Changes in:

Health and social care policy & legislation

Organisational culture

Health and social care structures

Cross-cutting agenda in Scotland

• Joint Future Agenda

• User Involvement

• Social Inclusion

• Community Planning

Legislative development affecting people with MS & their carers

1999 Strategy for Carers in Scotland ‘The promotion of new and more flexible services for carers including respite care at a local level’

2002 Community Care and Health Act

Free personal care in nursing homes

Carer assessment in own right

Direct payment schemes

Carer information strategies

Changes in social care provision

Enhanced role for the voluntary sector

Partnership with statutory sector

Greater consultation with users

Across both statutory and voluntary sector, emphasis on:

- evidence-based practice

- cost-effectiveness/value for money

- recognition of importance of evaluation & research

Social CareCase Study: Respite Care

Legislative Framework

• Strategy for carers double funding for carers’ services

• Social Justice Annual Report 2000: funding for 22,000 extra weeks of respite care.

• Expanded access to the direct payment schemes, enabling people to purchase their own non-residential services.

• Regulation of Care (Scotland) Act 2001

- care commission to regulate and inspect all care services

- national care standards introduced

- local outcome agreements

Policy/Implementation• Ever changing scene

• Local authorities developing strategies, eg Aberdeen

• Mapping and provision

• Strategies now being implemented

MS Society and Respite Care

• Definitions and policy review (2000)

• Review of MS Society Holiday Homes in Scotland (2001)

• MS Society Respite Care Directory (2003)

Key issues in social care for ppl with MS and their carers

• Accessing information on social care

• Accessing social care services

- availability of service

- ‘late on the scene’

- confusion regarding costs/funding

• Direct payments

• Equity

MS & Respite

Psychosocial aspects of caring (Who’s there for carers?)

• Carers expressed a need for a regular break

• Dissatisfaction with current provision, esp hospital units

• Some expressed reluctance to use respite

• Services not sufficiently flexible

Seeking respite

‘I would like some respite care on a weekly basis. I would like to go to (the city) shopping for a whole day. I haven’t been able to do that for ages. I would like to have some relief care. My mother was ill recently and I had to go away and my daughter had to go off school on study leave. I could not stay with my mother for more than 24 hours. My husband’s mother is also concerning us now, but the nurses cannot give us a solution. I would like to be able to lift up the phone, when I am in that situation, and ask someone to come and stay with my husband, to take responsibility for him too’

Carer V

Co-ordination between health and social care

‘I think that most of the problem of support in this country is that, and I am seeing it more and more, is that it is not cohesive. Even the assessment that we are going through now is split between services. And actually, all of the benefits are split between the NHS and the Council, it depends whether it is a nurse, etc.

Carer X

Postcode lottery?

‘We got the information mainly from the district nurse. She told us about the Independent Living Fund Scheme and now we have just started The nurse told the lady in charge of the Independent Living Fund Scheme and she helped us fill in the forms and so on. Now it is paying for two ladies to come 20 hours a week. Before, volunteers from Crossroads were coming in and out. Now we can more or less choose who is coming and for how long.’

Carer G

Direct payment(Scottish League)

local authority No of Clients Ranking

Fife 127 1Scottish Borders 33 2Angus 24 3

Glasgow 15 19Argyll & Bute 2 20Renfrewshire 3 21

The future

? Priorities determined by public consultation

? Costs/resources

? Effects of Join Future Agenda (? r/ship between health and social care)

? Closer working between voluntary and statutory sector

? Extension of befriending

? Community rather than individual focus

Copies of this presentation can be found on:

http://www.rgu.ac.uk/hsrg