Practice implications

Care management

There are practice implications for established professionals and potentially for a new cadre of ULO-based staff. The personal care budget agenda, with its focus upon self-assessment and greater user control over individual resources, obviously challenges the current care management role. The NHS and Community Care Act 1990 saw the implementation of the 1989 white paper Caring for People which identified “proper assessment of need and good case management” as the cornerstone of high quality care, with social workers “designing packages of services tailored to meet the assessed needs of individuals and their carers”. In reality, and especially since the establishment of the Fair Access to Care model in 2002, care management has become a gatekeeping system in which social workers essentially manage access to social care resources by determining the eligibility of those seeking support.

Care manager role change

In the current and dominant model the assessment process, led by a care manager, leads straight into the development of a care plan which is then used to advocate for resources. With personal care budgets, however, the role of the care manager would be a reduced one in which they check and approve the support plan and, in so doing, challenge the plan and help improve it. The new personalisation agenda puts emphasis on the role of social workers (and others) in providing information, brokerage and advocacy, and it might be argued that these responsibilities are much closer to a “traditional” model of social work.

Range of roles

People should have choice in where such support might come from beyond care managers and other professionals. People who work with or in the emerging ULOs/CILs could come from other backgrounds and issues then arise of financial remuneration and career prospects. Some argue for a national system for the registration and accreditation of a range of roles such as disability equality trainers and consultants, service brokers, independent living advisers and advocates. This, along with the gradual development of ULOs, would require a radical re-appraisal of the current dominant model of professional practice.