Special Report: Green paper on adult services

The social care sector has broadly welcomed the long-awaited
green paper on adult services which was finally published by health
secretary John Reid last week, writes Amy
Taylor. 

As in the children’s green paper before it the government
has set a number of key outcomes for adult social care that it will
use to ‘test and challenge’ how far it is moving
towards its vision.

These outcomes consist of:

John Reid

* Improved health

* Improved quality of life

* Freedom from discrimination or harassment

* Economic well-being

* Personal dignity

* Making a positive contribution

* Exercise choice and control

The government wants these to be achieved through a system where
adults receiving social care have more control over their lives and
are able to live more independently. The green paper outlines a
number of ways to achieve this.

Putting people into control

The government sees the role of social workers changing so they
are navigators of services rather than gatekeepers to them – the
way it says the profession is currently perceived. As navigators,
social workers would be required to find out what people want and
help them to find services to meet their needs.

Adults with a disability or an assessed need for social care
support will be offered individual budgets so they can choose and
buy the services that they want. This could include conventional
services, but also more diverse purchases, such as a holiday. The
government says that individual budgets should drive up the quality
of services as people will not buy services that do not meet their
needs or expectations. It plans to pilot the scheme and says that
it could be up introduced for people with disabilities by 2012.

The document proposes putting service users and carers at the
centre of assessment procedures and says that their views and
wishes should form the starting point of assessment. It adds that
some people may be able to assess their own needs but recognises
that this might conflict with the findings of a professional
assessor when negotiation, due to limits of resources or other
factors, would have to take place.

Strategic Commissioning

Tony Hunter would welcome extra                       funding

The government expects local health and social care services to
work together with other voluntary and statutory agencies to form
commissioning partnerships to ensure that the right balance of
services for a particular area is struck. How agencies do this is
up to them but doing nothing will not be an option. Suggestions on
how to do this include creating a virtual care trust or a
partnership board of local agencies.

The strategic leadership role of local
government

The document proposes that the director of adult social services
and the local authority should carry out regular strategic needs
assessments to enable them to plan ahead to ensure that adequate
services are available in the future.

A separate consultation on the director of adult social services
role, which was launched simultaneously, suggests that they could
take responsibility for lifelong learning, housing and other adult
services.

Improvement in services

The design and delivery of services is identified as needing
improvement. The government says that this will require radically
different ways of working, redesign of job roles and
reconfiguration of services. To achieve this it aims to spread good
practice across the system. The document also identifies examples
of innovative practice and  hopes that these will “simulate a
wider debate”.

The role of the wider community

The government wants to encourage a more flexible approach to
putting together care packages which could include a mix of
traditional social care services but also universal services
already provided by the local authority and a contribution from the
voluntary and community sector.

It would like this to involve a greater focus on preventive
services through better targeted early interventions that prevent
or defer the need for more costly intensive support.

Amongst the praise for the document one predictable issue has
raised concerns.

There will be no extra resources to deliver the green paper
measures until the end of the current spending review period in
2008.

Ladyman: No funding for now

However, community care minister, Stephen Ladyman has said that
there could be extra funding after that.

Tony Hunter, president of the Association of Directors of Social
Services, agrees that the green paper’s proposals for savings
to be made by providing better targeted low-level support early on
will work in the long-term but that such savings will
“probably not” be able to be produced quickly in some
client group areas.

He says that adult social care has been shifting in the
direction of the green paper for “some time” but adds
that some extra money to help it along would be welcomed.

“We would be very keen to be looking for pump priming
money of some sort to get the momentum behind the green paper going
even though it’s [adult social care] not a green field
site,” he said.

Ian Johnston, director of the British Association of Social
Workers, described the lack of funding as
“disappointing” and suggested that where the document
states that the government expects the proposals to be
“cost-neutral” for local authorities it actually means
“cost less”.

Independence, Well-being and Choice from: www.dh.gov.uk