Informal Care Flashcards
What ACT is the present structure of social care set out under?
1990 Community Care Act
What does the Community Care Act (1990) state in terms of social care?
to assist people such as:
- dependent elderly
- physical and learning disabilities
- long term mental health problems
to live as independently as possible
either in their own homes or in residential care
What important distinction must be made in SOCIAL CARE?
care PROVIDED IN the community
carried out by the statutory community services
care PROVIDED BY the community
‘informal care’
What is meant by ‘INFORMAL CARE’?
aka care provided BY the community
based primarily on kinship obligations between members of immediate family
reality of community/social care policy have made informal care predominant
Which organisations are responsible for commissioning social care?
CCG - clinical commissioning group
SSC - social service department
these organises jointly asses the local need and produce an annual COMMUNITY CARE PLAN for meeting these needs
Which groups are now involved directly in formulating the ‘NEEDS ASSESSMENT’? Why was this provision introduced?
individual service users and their carers
provision introduced to:
- reduce readmission rate
- major shift towards focus on service users + carers
What was a final requirement of the COMMUNITY CARE ACT?
in-patients in hospital in need of community care must have these in place when discharged
therefore patients can not be discharged until these care packages are in place
e.g. discharge planning
What is the downside of a discharge planning requirement?
became a ‘bed-blocking’ issue for many hospital patients
actual reality of this is poor especially for the elderly.
These shortcomings have been cited in many reports e.g. Mid-Staffs scandal
What does receiving SOCIAL CARE usually mean in terms of service provision?
Long term care/support
What is defined as LONG TERM CARE/SUPPORT?
Any service which is provided with the intention of maintaining quality of life for an individual on an ongoing basis
This has been allocated on the basis of eligibility criteria
i.e an assessment of needs has taken place, and is subject to regular review
In 2017-18, what was the total number of clients receiving long term support?
857, 770
What has been the trend in long term support supply/demand over the last 5 years?
Steady decline in number of clients receiving long term care/support
AND SIMULTANEOUS
steady increase in requests for long term (adult) social care
= ~ 5000 requests/day
What is the age breakdown for people receiving long term social care?
[community based support]
18-64yr (84%)
>64yr (62%)
[residential-based services]
remainder of clients
What kind of support is included within RESIDENTIAL-BASED SERVICES for adult social care?
- private residential homes
- nursing homes
- local authority provided residential care homes
What proportion of the total social care funding is used in LONG TERM SOCIAL CARE?
in 2017-18
long term care = £14 billion
this equates to 77% of the total social care budget
What are the trends in long term care provision in the different age categories?
more people >65yr are receiving care compared to people aged 18-64yr
but the total expenditure was similar between both age categories
=> long term support for younger ages typically covers complex needs
=> unit costs for nursing/residential care are much higher in the younger group
What are the official/goverment reasons as to why there was a REDUCTION in CLIENTS RECEIVING LONG TERM CARE?
- an increase in the rehab provision service outside of a formal assessment process
- raised eligibility criteria for services
- reduced funding for councils
[OFFICE FOR NATIONAL STATS]
What are different primary TYPES of clients receiving long term social care?
PHYSICAL DISABILITY
66% of clients
MENTAL HEALTH
20% of clients
LEARNING DISABILITY
12% of clients
OTHER VULNERABLE PEOPLE
2% of clients
What types of support are provided by COMMUNITY SERVICES in social care?
- Home care
- Equipment and adaptations
- Meals-on-Wheels
- Professional Support
- Day care
How many people did the 2011 Census find providing unpaid care (carers)?
in England and Wales
5.8 million people providing UNPAID CARE
this is ~ 10% of the population
In which type of unpaid social care, has there been the biggest increase in carers since 2001?
the highest unpaid care category
= ~ >50 hr/week
unpaid care has increased at a faster pace than population growth in the 2001-2011 time period
What is the age breakdown for UNPAID CARERS as of 2018?
53% of unpaid carers are of working age
37% are aged 65-84
9% are >85
1% are <18
What legislation was published by the Labour government in 1999 as a national strategy for Carers?
Caring about Carers
[HMG 1999]
What are the objectives set out by the ‘Caring about Carers’ legislative document?
- carers should be supported in combining paid employment with caring responsibilities
- employers to be persuaded by benefits of carer-friendly policy
- carers to be informed + consulted about professional decision making for those they care for
- health professionals to consider the health of the carer as part of their duty of care
- support to carers to be enhanced e.g. improvements/adaptations to housing, training (H&S), and respite
What was the aim of the CARERS EQUAL OPPORTUNITIES ACT in 2005?
to build on existing legislation
ensure all carers were to nee informed of their entitlement to an assessment of their needs
duty was placed on councils
to consider a carer’s external interests when carrying out the assessment
promoted joint working between local councils and the NHS
ensure carer support was delivered in a more coherent manner
What was the purpose of the 2014 CARE ACT?
[came into force in April 2015]
to build upon recent reviews to provide a more coherent approach to adult social care
What NEW responsibilities were set out by the CARE ACT (2014)?
[for local authorities]
- prevent
- reduce
- delay
the need for care and support to all local people
What NEW STATUTORY PRINCIPLE in incited in the CARE ACT (2014)?
concerned with INDIVIDUAL WELLBEING
- Personal dignity
- Physical and mental health and emotional wellbeing
- Protection from abuse and neglect
- Control by the individual over day-to-day life (including over care and support)
- Participation in work, education, training or recreation
- Social and economic wellbeing
- Domestic, family and personal relationships
- Suitability of living accommodation
- The individual’s contribution to society
Also for collaboration between local authorities and housing and NHS
And seamless transition for young people moving into adult social care services
At what level was criteria to be introduced from the 2014 Care Act?
national eligibility criteria
for both the carers and the person being cared for
legislation covers:
- how people’s care support need should be met
- right to an assessment for anyone (inc. carers and self-funders)
What is the impact of a care-giving role?
- financial (if self-funding, or only partially funded)
- physical strain
- psychological strain
- reduced independence
- reduced social participation
- have to give up their own time to combine paid employment and caring
- loss of social status
- increased social isolation
- more demanding for an elderly carer for eg
- carers may lose autonomy, and increased dependence on others due to their caring role
- increased tension in relationship (e.g. if partner has become informal carer)
- frustration/anger towards carer due to dependence on them (which wouldn’t happen with a professional carer)
- constant, unrelenting dependence
What ASSUMPTIONS underpin the social care system?
- state vs. family responsibilities in care provision in the home
- distinction between care, personal care, body care and domestic work
e. g financial support is not provided for the latter - weak boundaries between all types of care IN PRACTICE
- burden of care often falls on the informal carer (related to stereotype of ‘women’s work’ in the family)
- in some countries, there is no formal distinction between the different caring roles (reflected in their state financial support)
In which countries, is there no difference in the different caring roles? How is this reflected?
- Netherlands
- Sweden
reflected in their STATE FINANCIAL SUPPORT
What is the trend with payment for caring roles in the UK? Why is this?
there is a reluctance of many to accept payment for caring
[not the case in Sweden or the Netherlands]
INFORMAL CARE PROVIDERS:
=> ‘contamination’ of love and money deemed unsettling
=> gains in self-esteem and respect when care becomes work
How have the intro of DIRECT PAYMENTS aided social care?
was introduced in 2010
these contributed to a ‘personal budget’ for social care
created widening role for the ‘FOR-PROFIT’ PRIVATE SECTOR care companies
How have these changes (at present day) in social care infrastructure affected formal care employees?
these formal carers are no longer part of the public sector (more like to be private sector)
has therefore shifted the service ethic/ethos
more likely for scandals to occur as not centrally regulated
