This essay will examine several issues that surround provision of community care. It will explain relevant government legislation and policies which are involved in the process of care management and how these can be used to meet the needs of different service users. It will also describe some of the changes in the way community care is delivered following the National Health Service and Community Care Act 1990, and how the changes impact on professional practice within the social work field. The social model of disability will also be discussed as well as how service users can become actively involved in securing the services they need. This will be done in relation to the case study we were provided with.
With the introduction of the National Health Service and Community Care Act 2000, community care was updated and improved to cater for service users needs, in order for them to stay at home. Prior to this time there was confusion surrounding who was responsible for care between the local authority government and health care sector’s. The legislation meant that services are provided by a local authority and are used in order to improve an individual’s situation, with preference on service users staying in their own homes, rather than care homes as was previously preferred. According to Brammer (2003) other legislation which is used to provide services are the National Assistance Act 1948, the Health Services and Public Health Act 1968, the Mental Health Act 1983 and parts of the National Health Act 1983.
The care management process is undertaken in seven different stages, each of which plays an important part in providing appropriate services. At the start of the process information is made available to the public about the services available, and this encourages ‘un-referred’ individuals to request an assessment, thereby enabling all members of society to be included. The level of assessment required must reflect the level of needs that are being assessed and therefore individuals with few care needs will not undergo a lengthy assessment and those who do have complex needs will have a more comprehensive one (Pierson and Thomas 2002).
Following on from this, the type of assessment needed is identified which could be a contact, overview, specialist or comprehensive assessment, the last of which would be the most suitable for Mr and Mrs Brown. The assessment is then used to prepare a unique care plan for the service user which takes into account their individual circumstances (Department of Health 1991). There are elements of failing health and eyesight in the case study which would create a need for a specialist assessment by health care professionals, so that Mr and Mrs Brown can receive the appropriate services.
The care plan will include details of the identified needs, and the perceived outcomes for the service user. This may mean the provision of a carer to help Mr Brown care for his wife. The fifth stage in the care management process is that of monitoring which is used to establish the effectiveness and quality of the care services provided. Regular reviews of the care package is then undertaken in order to re-assess the care needs originally provided for, taking into account any changes which may impact on the level of care required. The last stage is that of care co-ordination which is preferably done by someone with a long-term involvement with the service user, and is particularly beneficial in more complex areas of community care work. Horder (2002 in (Davis 2002)) states that the care management process ‘includes good practice and promotes choice’ which are both important factors in effective service user participation.
During the process of care management a service user should be encouraged to become fully involved in the work done with them. This can be achieved by an effective working relationship being built,...