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Article

Chris Hatton

The purpose of this paper is to examine trends over time in social care usage and expenditure for adults with learning disabilities in England.

Abstract

Purpose

The purpose of this paper is to examine trends over time in social care usage and expenditure for adults with learning disabilities in England.

Design/methodology/approach

Returns from councils with social services responsibilities in England concerning social care usage and expenditure were analysed to examine the national picture and trends over time for adults with learning disabilities.

Findings

In 2017/2018, 147,915 adults with learning disabilities were receiving long-term social care, an increase of 5.7 per cent from 2014/2015. Social care expenditure increased by 10.2 per cent from 2014/2015 to £5.54bn in 2017/2018; adjusted for inflation this was a 2.7 per cent increase. For adults with learning disabilities who receive social care, increasing numbers of people are living with families or in supported accommodation/living, with gradual declines in the number of people living in residential or nursing care. The number of adults with learning disabilities in temporary accommodation is small but increasing.

Social implications

While councils appear to be attempting to protect social care for adults with learning disabilities in the face of cuts to council expenditure, social care expenditure and coverage are not keeping pace with likely increases in the number of adults with learning disabilities requiring social care.

Originality/value

This paper presents in one place statistics concerning long-term social care for adults with learning disabilities in England.

Details

Tizard Learning Disability Review, vol. 24 no. 2
Type: Research Article
ISSN: 1359-5474

Keywords

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Article

Chris Hatton

The purpose of this paper is to compare data from national social care statistics on day services and home care for people with learning disabilities across England…

Abstract

Purpose

The purpose of this paper is to compare data from national social care statistics on day services and home care for people with learning disabilities across England, Scotland, Wales and Northern Ireland.

Design/methodology/approach

National social care statistics (England, Scotland, Wales and Northern Ireland) reporting the number of adults with learning disabilities accessing day services and home care were reviewed, with data extracted on trends over time and rate of service use.

Findings

Regarding day services, despite some variations in definitions, the number of adults with learning disabilities in England, Scotland and Wales (but not Northern Ireland) using building-based day services decreased over time. Data from Scotland also indicate that adults with learning disabilities are spending less time in building-based day services, with alternative day opportunities not wholly compensating for the reduction in building-based day services. Regarding home care, there are broadly similar rates of usage across the four parts of the UK, with the number of adults with learning disabilities using home care now staying static or decreasing.

Social implications

Similar policy ambitions across the four parts of the UK have resulted (with the exception of Northern Ireland) in similar trends in access to day services and home care.

Originality/value

This paper is a first attempt to compare national social care statistics concerning day services and home care for adults with learning disabilities across the UK. With increasing divergence of health and social service systems, further comparative analyses of services for people with learning disabilities are needed.

Details

Tizard Learning Disability Review, vol. 22 no. 2
Type: Research Article
ISSN: 1359-5474

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Article

Tim Spencer‐Lane

This paper seeks to set out the Law Commission's final recommendations for the reform of adult social care, including the community care assessment process, service…

Abstract

Purpose

This paper seeks to set out the Law Commission's final recommendations for the reform of adult social care, including the community care assessment process, service provision, and the recommendations for a new legal framework for adult safeguarding in England and Wales.

Design/methodology/approach

The paper discusses each of the Law Commission's recommendations for adult social care and contrasts them with the proposals put forward at the consultation phase of the review.

Findings

The paper argues that a single legal framework for adult social care, including adult safeguarding, will have substantial benefits in terms of legal clarity, consistency, and efficiency. A clear and single legal framework is important for older and disabled people, and their carers, in order to understand fully their entitlements, and for local authorities and partnership agencies (such as the NHS and the police) in order to fully understand their responsibilities.

Originality/value

The paper provides a clear summary of the Law Commission's final report – in particular the recommendations for community care assessments and service provision and adult safeguarding.

Details

Social Care and Neurodisability, vol. 2 no. 4
Type: Research Article
ISSN: 2042-0919

Keywords

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Article

Chris Hatton

The purpose of this paper is to compare data from national social care statistics on the living situations of people with learning disabilities across England, Scotland…

Abstract

Purpose

The purpose of this paper is to compare data from national social care statistics on the living situations of people with learning disabilities across England, Scotland, Wales and Northern Ireland.

Design/methodology/approach

National social care statistics (England, Scotland, Wales, Northern Ireland) reporting the living situations of adults with learning disabilities (residential and nursing care, living with family, other forms of accommodation) were accessed, with data extracted on trends over time and rate of service use.

Findings

There were substantial differences in the statistics collected across the UK. Overall, there were higher reported rates of adults with learning disabilities in residential/nursing accommodation in England than Scotland or Wales, but much lower reported rates of adults living in other forms of unsupported and supported accommodation and much lower reported rates of adults living with their families. In all three countries, trends over time suggest that reductions in residential care towards more independent living options may be stalling. In Northern Ireland reductions in currently extensive residential and nursing care services are continuing, unlike other parts of the UK.

Social implications

Despite similar policy ambitions across the four parts of the UK, statistics on the living situations of adults with learning disabilities report substantial differences.

Originality/value

This paper is a first attempt to compare national social care statistics concerning the living situations of adults with learning disabilities across the UK. With increasing divergence of health and social service systems, further comparative analyses of services for people with learning disabilities are needed.

Details

Tizard Learning Disability Review, vol. 22 no. 1
Type: Research Article
ISSN: 1359-5474

Keywords

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Article

Ed Mitchell

In 2010, the Department of Health announced its intention to pilot arrangements for independent adult social work practices to exercise local authorities' adult social care

Abstract

Purpose

In 2010, the Department of Health announced its intention to pilot arrangements for independent adult social work practices to exercise local authorities' adult social care functions. Supporting legislation was not made until August 2011. This paper seeks to illustrate the legal obstacles that local authorities ordinarily face if they intend for third‐party involvement in adult social care to extend beyond the provision of services.

Design/methodology/approach

This paper is an analysis of the Contracting Out (Local Authorities Social Services Functions) (England) Order, 2011.

Findings

The principal findings of this paper are twofold. After some delay, the Department of Health has put in place a legal framework to support the piloting of independent adult social work practices. The need for new law illustrates the general limitations faced by authorities that wish to contract out their adult social care decision‐making functions.

Originality/value

The paper's value lies in the analysis of the legal obstacles faced by local authorities who wish deeply to integrate their adult social care functions within the activities of third‐party providers.

Details

Journal of Integrated Care, vol. 19 no. 6
Type: Research Article
ISSN: 1476-9018

Keywords

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Article

Randall Smith, Robin Darton, Ailsa Cameron, Eleanor K. Johnson, Liz Lloyd, Simon Evans, Teresa June Atkinson and Jeremy Porteus

The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at…

Abstract

Purpose

The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at the strategic level followed by a section on operational or micro-commissioning. The rest of the paper focusses on the emergence of ideas about outcomes-based commissioning (OBC) in the field of adult social care and ends with critical consideration of the effectiveness of OBC in adult social care as applied to support and care provided in extra care housing.

Design/methodology/approach

The review of strategic and operational commissioning in adult social care in England (and Scotland in brief) is based on both policy documents and a review of the literature, as are the sources addressing OBC in adult social care particularly in extra care housing settings.

Findings

The core of this paper focusses on the challenges to the implementation of OBC in adult social care in the context of provision for residents in extra care housing. Of central importance are the impact of the squeeze on funding, increasing costs as a result of demographic change and the introduction of a national living wage plus the focus on the needs of service users through the idea of person-centred care and resistance to change on the part of adult social care staff and workers in other relevant settings.

Originality/value

Addressing the implementation of OBC in adult social care in England in the context of extra care housing.

Details

Housing, Care and Support, vol. 20 no. 2
Type: Research Article
ISSN: 1460-8790

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Article

David Hewitt

A recent Law Commission paper claims that the law on adult social care is complex and based on outdated concepts, and therefore needs to be reformed. The boundary between…

Abstract

A recent Law Commission paper claims that the law on adult social care is complex and based on outdated concepts, and therefore needs to be reformed. The boundary between health care and social care services is less clear than it once was, but its existence can be damaging to service users. Although there is good evidence of integrated working, more needs to be done. Existing duties could be consolidated, or health care and social care bodies ‐ and perhaps others ‐ could be placed under a general duty to co‐operate.

Details

Journal of Integrated Care, vol. 17 no. 3
Type: Research Article
ISSN: 1476-9018

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Article

Tim Spencer‐Lane

This article discusses the Law Commission's proposals for the reform of adult social care, with a particular emphasis on the specific proposals relating to adult

Abstract

This article discusses the Law Commission's proposals for the reform of adult social care, with a particular emphasis on the specific proposals relating to adult protection. It argues that a future adult social care statute should clarify the existing legal position by placing a duty on local social services authorities to make enquiries and take appropriate action in adult protection cases. The definition of an adult at risk for the purposes of the duty to investigate is also considered and a proposal is put forward for how this might be defined in the statute. The article also proposes that the compulsory removal power under section 47 of the National Assistance Act 1948 (HM Government, 1948) should be repealed, that adult safeguarding boards should be placed on a statutory footing and that duties to co‐operate in adult protection should be introduced. Finally, concerns are raised that the current lack of statutory provision for adult protection may mean that there is confusion over the precise legal status of the guidance No Secrets (Department of Health & Home Office, 2000) and In Safe Hands (Welsh Assembly Government, 2000) and what actions this can authorise.

Details

The Journal of Adult Protection, vol. 12 no. 1
Type: Research Article
ISSN: 1466-8203

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Article

Caroline Norrie, Jill Manthorpe, Cher Cartwright, Pritpal Rayat and David Petrie

The Health and Social Care Information Centre undertook the development and piloting of a new adult safeguarding outcome measure (a face-to-face survey) for local…

Abstract

Purpose

The Health and Social Care Information Centre undertook the development and piloting of a new adult safeguarding outcome measure (a face-to-face survey) for local authorities (LAs) that could be added to the adult social care outcomes framework (ASCOF). The ASCOF is a national collection of social care outcomes performance indicators collected from the perspective of people receiving partial or total funding from a LA for care services. The projected costs of introducing the survey as a new statutory measure in England were assessed. The paper aims to discuss these issues.

Design/methodology/approach

An outcome measure (a face-to-face interview based survey consisting of seven questions) was piloted during 2014 in 40 LAs with 20 adults at risk (or other informant) in each site who had been the subject of a safeguarding investigation (n=382). LAs were asked to estimate the cost to their LA of conducting the survey for two years, interviewing at least 15 per cent of their completed safeguarding cases each year.

Findings

Extrapolating cost findings to the full 152 LAs in England would give an estimated total cost of implementing the survey of approximately £3 million in Year 1 and £2.1 million in Year 2. Set-up costs for the survey can therefore be estimated at around £900,000. Wide variations were identified in the costs per interview between LAs and reasons for this are discussed.

Originality/value

The benefits of this unique survey are it enables LAs to measure how they are undertaking their adult safeguarding work from the perspective of adults at risk and others with a close interest. It also enables LAs to meet their new obligations under the Care Act 2014 Guidance to “understand what adults at risk think of adult safeguarding”.

Details

The Journal of Adult Protection, vol. 18 no. 2
Type: Research Article
ISSN: 1466-8203

Keywords

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Article

Lisa Pinkney, Bridget Penhale, Jill Manthorpe, Neil Perkins, David Reid and Shereen Hussein

This article reports on the views of 92 social workers about their practice in adult protection in England and Wales as part of a wider study of adult protection working…

Abstract

This article reports on the views of 92 social workers about their practice in adult protection in England and Wales as part of a wider study of adult protection working and regulation that took place between 2004‐2007 in 26 sample local authorities. The article explores social workers' reported experiences of partnership or multiagency working and how this, along with overarching regulatory frameworks, affected their practice within and across agencies. Among findings from the study were that social workers considered that sharing information and responsibilities led to positive outcomes for service users and that the incorporation of different agency perspectives supplemented sharing of best practice.

Details

The Journal of Adult Protection, vol. 10 no. 4
Type: Research Article
ISSN: 1466-8203

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