This blog was contributed by Clive Newton, Age UK’s National Development Manager – Care and Communities.
Five years on from the publication of Putting People First and Transforming Social Care, it’s time to take stock. Have older people entered the promised land of choice and control? Are they receiving personalised services, tailored to their individual needs and preferences? Did the £520m Social Care Reform Grant deliver the intended transformation in the way care and support is designed and delivered?
Unfortunately, from the point of view of most older people with care and support needs, the answer to all these questions is a resounding ‘no’. There hasn’t been a ‘strategic shift to prevention and earlier intervention’. The system remains crisis-driven, with ever-tightening eligibility criteria. Self-funders receive little or no support. And even those older people who are eligible for a personal budget rarely experience any real sense of choice and control. What went wrong? Continue reading “Is personalisation failing older people?”
It was with tentative optimism that I read the short paragraph in the Government’s recently published social care white paper that proposed that everyone with a care plan should be allocated a named professional to take responsibility for care coordination. The importance of on-going support to help people access and coordinate services, for example from a dedicated case manager, was a key finding of the research we recently carried out at the Social Policy Research Unit (SPRU, University of York) into good practice in social care for people with severe and complex needs.
For this study we consulted people with complex needs (including older people with dementia), family carers and members of specialist voluntary and user organisations, about what they consider to be good practice when someone’s needs are severe and complex. In addition to a person centred approach to everyday care and support (for example from a known and trusted helper ), participants valued person-centred support to arrange and coordinate care, over time, from a case manager or other individual who knew them well and had expert knowledge of their needs and the services available to them.
When we carried out a literature review to scope the evidence on good practice for people with complex needs, we were disappointed to find little robust evidence about what works. However, there was some evidence in support of intensive case management for older people with severe dementia. In a study by Challis and colleagues (2002), older people using a community mental health service who received case management had reduced needs compared to older people using a similar service with no case management, and their carers experienced less stress. What’s more, after two years 51% of the case management group were still living in their own homes, compared to only 33% of the comparison group.