Partnership boards and generic care workers at centre of services reform

Older people have been pushed out of the social care spotlight
in recent weeks as the children’s green paper has dominated the
headlines. But that could be about to change with the publication
of a report commissioned by the Association of Directors of Social
Services and the Local Government Association.

All Our Tomorrows concludes that a modern social care
workforce, which plans and commissions joined-up older people’s
services, is essential if social services are to meet the needs of
an ageing population.

Older people should be given an active role in the planning and
commissioning of services through the creation of older people’s
partnership boards, the report argues. The boards would be similar
to the children’s and learning disability partnership boards, which
already plan, evaluate, and make decisions about services.

Members of the older people’s partnership boards would be drawn
from directors, assistant directors and senior managers from
departments such as social services, leisure and transport, as well
as senior representatives from health, voluntary agencies and the

The report, due to be launched this week at the national social
services conference in Brighton, says: “Consulting with community
members, including older people, about services is not enough. They
need to be actively involved in making decisions about the
priorities, strategies and financing of services and should be
appropriately represented on the older people’s partnership

Older people’s partnership boards would be part of local strategic
partnerships, set up to ensure that public services meet the needs
of local people. They would help to build a “whole systems”
commissioning process based on, and shaped by, the needs of

Andrew Cozens, incoming president of the ADSS and director of
social services at Leicester Council, wants councils to have a
statutory duty towards the “well-being” of older people. “At the
moment, councils are able to do things but they don’t have to. The
idea is to have a much more comprehensive view of engaging older
people so that the approach is not just based on welfare but on how
older people can shape their own lives. We need to be planning not
just for a small proportion who need care assistance but for the
wider population. It’s more than prevention,” he says.

Other recommendations include local performance indicators so
communities can measure their own progress against their own aims
to improve services. Performance indicators should also be
developed on a cross-agency basis; they could feed into both the
comprehensive performance assessment for councils and the
star-rating assessment for health trusts, for example.

The report also backs the modernisation of the workforce and the
creation of generic care worker posts with shared induction and
training programmes across social services, health, voluntary
agencies and private care homes.

The report says: “Many of the traditional roles and skills of staff
need to change. Tasks such as rehabilitative work for disabled
people, including older people, are shared between different
professional groups and can include occupational therapists, social
workers, care staff and nurses. What is required are new roles,
which bring together a number of the skills related to
rehabilitation and reablement.”

Consultant and report co-author Alison Painter adds that a generic
care worker would have the key skills associated with care home
workers and nursing assistants, thereby promoting a joined-up and
inter-agency approach to the care of older people.

Payments for care budgets for older people’s services need to be
clarified and streamlined, the report also suggests. It calls for a
single approach to payments involving collaboration between the
Department for Work and Pensions and social services departments to
avoid “duplication”. The DWP currently pays minimum income
guarantee, attendance allowance and retirement pension, while
social services top up benefits payments to pay for care.

One solution to the duplication of work carried out in relation to
payments, put forward by Margaret Goldie, director of community
care and housing at West Berkshire Council, is to invite a DWP
representative to sit on the proposed older people’s partnership
boards. Although West Berkshire, which has 22,000 residents aged
over 65, already holds “service improvement days” where older
people voice their opinions, Goldie welcomes the idea of a more
focused and comprehensive board. “It should be about how we can
best serve older people and not about how we can best fit older
people in around what we already do. In the same way that the
government has streamlined children’s services, there should be
something for older people – they need a one-stop approach,” she

In Norfolk, a children’s partnership board has been running
successfully for two years. Norfolk’s director of social services
Lisa Christensen would welcome the setting up of a similar forum
for older people. “Most people don’t come anywhere near social
services and older people’s lives are about much more than
community care,” she says. “Older people should have influence over
the services that we deliver, including things like transport,
environment and access to recreation.”

Charity Help the Aged has called the report’s recommendations a
“positive move” in working towards a whole systems approach, but
warns that partnership boards might not put enough emphasis on
health. Kathryn Willmington, community health and social care
policy officer at the charity, says: “We would be concerned if the
boards linked up with local authority partners and forgot about
health. We need to make sure that health is still seen as

She also has worries about the roles that generic workers would be
expected to carry out. “Older people want to see one person. They
don’t want different people coming in and out all the time all
doing different things. But the worry would be that these workers
are expected to do things that they are not trained to do and
wouldn’t feel confident doing. We would have to make sure that they
have the right training.”

Willmington adds that Help the Aged has been pushing for a local
performance indicator system to put older people in the “driving
seat” and so welcomes their inclusion in the recommendations.

Gillian Crosby, director of independent research centre the Centre
for Policy on Ageing, also finds the recommendations on local
performance indicators encouraging – so long as they are
“accessible”. She adds: “It’s good that older people are being
brought into the planning process. But we don’t want this to just
be another excellent idea and that’s as far as it goes.”

Cozens is determined that the report will provoke debate and will
help to change society’s attitude towards older people. “Many
councils view older people as a demographic time bomb or a burden.
But as with the green paper Every Child Matters – the principle of
All Our Tomorrows is that everybody matters.

“We want to start a debate on this and we want a cross-government
approach. It’s about changing the mindset of the way older people
are seen as people who cease to be actual citizens.” 

All Our Tomorrows available from

Key report recommendations:

  • Setting up older people’s partnership boards with a
    cross-departmental focus to get older people actively involved in
    the planning and commissioning of services.
  • Developing local performance indicators to monitor outcomes for
    older people.
  • Jointly developing local health delivery plans with social
    services in conjunction with older people, resulting in joint
    health and well-being plans for older people.
  • Creating generic care workers with core skills and shared
    training and induction programmes across social services, heath,
    the voluntary sector and the private sector.
  • The government should determine a budget to promote well-being
    and the development of preventive services for older people.
  • Legislation should be introduced so that all agencies have a
    duty to ensure the protection of older people at greatest
  • A national charter for older people should be developed
    detailing national standards for all products and services to
    ensure that problems around access to information, rural transport
    and accessible housing are overcome.

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