Welfare Reform on the Web (August 2009): Care of the elderly - UK

Explaining about ... individual budgets and self-directed support

L. Close

Working with Older People, vol. 13, June 2009, p. 9-12

This article explains how In Control has worked with a group of local authorities to develop a new system of social care based on individual budgets used to procure self-directed support. The new system consists of seven steps:

1. assess need and set the personalised budget
2. plan support
3. agree the plan
4. manage the budget
5. organise the support
6. live life
7. review and learn.

How social enterprises can make a difference in caring for older people

C. Jones

Working with Older People, vol. 13, June 2009, p. 13-16

At present large private companies are dominating the elderly care market in the UK. It is argued that they should be replaced by social enterprises which reinvest profits back into the business in order to further their mission. They would be more motivated than private providers to deliver innovative and personalised care, rather than seeking to maximise profits.

Independent advocacy with older people: what will be the impact of personalisation?

J. Miles

Working with Older People, vol. 13, June 2009, p. 28-31

Considers the role of independent advocacy for older people in the development of individual budgets for service users.

The informatization of welfare: older people and the role of digital services

M. Hardey and B. Loader

British Journal of Social Work, vol. 39, 2009, p. 657-669

Concern about population ageing across Europe and the potential demands on state resources have made services for older people a key target for information technology initiatives. This paper examines the role of older people as users in the increasingly information-led area of health and social care. It is suggested that while IT initiatives may have facilitated the integration of services, they have at the same time marginalised older people as users. However, it is argued that the recent advent of Web 2.0 and the consequent rise of user generated content may transform the role of the user in such systems.

The Mental Capacity Act 2005 Deprivation of Liberty Safeguards and people with dementia: the implications for social care regulation

G. Boyle

Health and Social Care in the Community, vol. 17, 2009, p. 415-422

The Mental Capacity Act 2005 introduced legal safeguards aimed at protecting the liberty of people lacking capacity admitted to institutional care in England and Wales. This paper explores the adequacy of the Deprivation of Liberty Safeguards for protecting the liberty of residents in social care settings, with special reference to older people with dementia living in care homes. It is suggested that the capacity of the safeguards to adequately protect the liberty of residents with dementia may be limited by under-recognition of the extent to which deprivation of liberty actually occurs in care homes, insufficient resourcing, and a lack of critical independence in their proposed implementation. In addition, the planned contraction in regulation – especially a reduction in inspections - will constrain the regulator's ability to ensure that residents' right to liberty is protected.

Navigating the new social care market place

I. West

Working with Older People, Vol. 13, June 2009, p. 32-34

For the personalisation agenda to be realised, service users need access to a vibrant social care marketplace, as well as the information and skills required to navigate it. The author explains how Warrington has developed its local market in social care provision by working with partners, focusing on outcomes and enhancing the role of information for users.

Personalisation within a housing context

J. Head

Working with Older People, vol.13, June 2009, p. 25-27

The author explains Hanover Housing Group's approach to personalisation of supported housing services. The article also points out that individuals may lack power to have any significant impact on how services are delivered, and that providers may be driven out of the market because individual budgets put economies of scale at risk. It concludes by emphasising the importance of engaging supported housing residents in service commissioning.

Shaping the future of care together

Department of Health

London: TSO, 2009 (Cm 7673)

This consultation paper addresses the perceived unfairness of the current system of funding social care for older people, and seeks to avert a looming crisis in its financing as the population ages. The document rules out funding a 'minimum care entitlement' through general taxation, as this would place an intolerable burden on younger workers. It presents three options:

1. requiring all adults over 65 to pay a lump sum of between £17,000 and £20,000 to guarantee free care if required in later life. The sum could be paid on retirement or taken as an 'inheritance tax' after death or even taken from a deferred state pension
2. a basic partnership model under which the state would pay up to a third of care costs
3. a voluntary insurance scheme under which adults would receive free care as required once they had paid £20,000-£25,0000 in premiums

None of these options would cover food or accommodation costs of residential care, which would still have to be met by individuals. It is also unclear whether the scheme would cover costs of home care for older people with moderate needs.

(For comment see Health Service Journal, July 16th 2009, p. 4-5 and July 23rd 2009, p. 12-13)

Tackling social exclusion through neighbourhood networks

D. Klee

Working with Older People, vol. 13, June 2009, p. 35-38

Government policy emphasises the need to recognise the valuable contribution that older people can make to their community, and to reduce social isolation while promoting good health. This article looks at some innovative projects in Leeds which aim to develop older people's social networks.