Terms and conditions

The term “social care” is widely used by central government, local authorities and care service providers. It developed from the NHS and Community Care Act 1990, and reflects the changing role of local authorities as care purchasers rather than as the sole providers. But there is a lack of clarity regarding what is meant by social care.

While some may use the terms social work  and social care interchangeably, others would use social care to mean care delivery services as opposed to social workers’ other responsibilities, such as protection and care management.

So why does it matter if there is no clear definition of social care? One reason is the need for clarity between training providers and employers. For example, at Wolverhampton University we run a social care pathway in addition to the BA in social work. While we are clear about the differences, employers may find it confusing. However, it is also important that those involved in the provision of social care (who are often NVQ-qualified rather than registered social workers) can begin to build a separate professional status, appropriate to their skills and responsibilities.

Janet Fink discusses the differences between caring for an individual and caring about them.(1) She outlines a discussion by Lancaster University social policy professor Hilary Graham that identifies the need to be clear about what caring means and what it entails. Or, as another contributor puts it, care should be seen as an activity (doing care) and also a disposition (being caring).

It could be argued that, since the 1990 act, the role of the social worker has become more one of caring about than caring for. Perhaps this new term social care refers to the “caring for” element.

We might be able to reach consensus that social care means the delivery of care services – but what about support services provided to socially excluded groups?

The Social Exclusion Unit website says exclusion happens “when people or places suffer from a series of problems such as unemployment, discrimination, poor skills, low incomes, poor housing, high crime, ill health and family breakdown”.

Do we include those services in our definition of social care? The recent adult care green paper, Independence, Well-Being and Choice, suggests that the answer is yes.

It says the term social care is used to describe  services which help support people in their daily lives and let them play a full part in society. These can include practical assistance to help individuals overcome barriers to inclusion, such as supported entry into work for an individual with a mental health problem. It can also include support in managing complex relationships and emotional distress.

However, if you look at the Department of Health recruitment website for social care, the answer is less clear. It appears to suggest that social care supports people with physical or psychological problems, but there is no mention of support for people who need help to access community facilities. It says: “Social care work is about helping people with their lives. People who have physical or psychological problems often require practical help coping with the everyday business of living. Social care workers provide this practical support.”

The department’s social care page provides the following description: “In England, the responsibility to provide social care services rests principally with local councils. At any one time, up to 1.5 million of the most vulnerable people in society are relying on social workers and support staff for help. Social care services also make a major contribution to tackling social exclusion.”

There are three points of interest in this description. First, it identifies two separate roles in the workforce: social workers and support staff. This suggests that the department intends social care to include both the role of the social worker with the provision of care services.

Second, it states that “social care services also make a major contribution to tackling social exclusion”. Does this mean that services for socially excluded groups are to be termed social care?
If so, this does not match up with the statement on the recruitment website that social care workers provide “practical support to people with physical and/or psychological problems”.

The third point of interest relates to those individuals who, despite considerable care needs, have limited support from their local authority. It may be the responsibility of councils to meet social care needs but the reality might be that these needs are met by their friends and family. However, in the preface to Independence, Well-Being and Choice, Tony Blair accepts the reality of the situation: “It is family and friends, of course, who still take on most of the caring responsibilities.”

A further point to note from Independence, Well-Being and Choice is the reference to psychological and emotional support: “The term social care…can include support in managing complex relationships and emotional distress.”

Does this mean specialist counselling or psychotherapy services? It seems unlikely that such professions would view themselves as part of the social care sector. It seems equally unlikely that there is an expectation that care workers would be in a position to provide this type of support.

A tentative attempt to define social care might conclude that informal care, together with that provided by statutory and non-statutory organisations, forms the major component of social care.

Where social workers are involved in direct delivery of care services, this would also be viewed as within the social care field. However, other social workers’ responsibilities would be classed as part of social work, but not part of social care. It would also appear that working to help people overcome social exclusion is beginning to be included in social care.

In the midst of discussions about definitions and organisations, it is important not to lose focus: it is the quality of the care and support that is important, not definitions. In discussions about restructuring services and new management initiatives, we need to remember that care and support remain reliant on positive one-to-one relationships. Liz Forbat reminds us that the nature of care relies on the relationships involved: “What is common across care is its mode of delivery. Care is always mediated by relationships.”(2)

Fiona Taylor is senior lecturer in social care at the University of Wolverhampton. She has 15 years’ experience managing services for older people and people with learning difficulties. Her initial qualification was in speech and language therapy and she has also worked in further education.

Training and learning
The author has provided questions about this article to guide discussion in teams. These can be viewed at www.communitycare.co.uk/prtl and individuals’ learning from the discussion can be registered on a free, password-protected training log held on the site. This is a service from Community Care for all GSCC-registered professionals.

Abstract
This article discusses the lack of clarity regarding the definition of social care. Although the term is widely used, there is no agreement about whether it includes children’s services, support services for socially excluded groups and the entire range of tasks carried out by social workers.

References
(1) Janet Fink (ed), “Questions of care”, Care: Personal Lives and Social Policy, Policy Press, 2004
(2) Liz Forbat, Talking about Care, Policy Press, 2005

Further information