Some revolutions shake the world, others change it by stealth. It
is hard to know how to categorise the revolution in social care:
some places it has taken by storm; some in a slower, more measured
way; some never knew there was a revolution in the first place. But
a social care revolution there is and it is coaxing, frog-marching
or, where necessary, dragging the discipline into the 21st century.
It is truly a people's revolution, comprising a public who will no
longer accept abject excuses for the failures of those in
authority, and within it a subset of service users whose
expectations are rising and for whom second best will soon cease to
be an option.
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The information revolution is part of this change. At the heart of
it is the electronic social care record, which maintains records on
individual service users. It is bound up with three important
multidisciplinary initiatives in social care: the single assessment
process for older people, information sharing and assessment (as
identification, referral and tracking has been renamed since the
children's green paper) and the integrated children's system.
According to the Department of Health, the electronic social care
record is designed to ensure a consistent, continuous and quality
service that is relatively unaffected by the comings and goings of
keyworkers and is open to scrutiny by managers and inspectors.
Such aspirations have the inevitable ring of government propaganda,
but if service users and the wider public have their way, they will
have to be realised. If information can be shared more easily and
case records are less prey to human foibles, services will be more
efficient, more effective and less likely to fail. But the public
will not stop with the demand for better information. It will have
to be available when it is needed, whatever the time of day. It
will require a 24-hours-a-day, seven-days-a-week social care
service, not merely of the kind provided out of hours by emergency
duty teams but a proper, comprehensive service paralleling that in
the NHS. Just as 24/7 social care was mooted after the Laming
Inquiry, so the idea has resurfaced to cope with the discharge of
older people from hospital. Eventually social care will have to
heed the wake-up call, because it is set to become, stormily or by
stealth, the service that never sleeps.
