| |
| |
| Series editor's preface | |
| |
| |
| Notes about the authors | |
| |
| |
| |
| The policy context | |
| |
| |
| |
| Background developments, 1957-88 | |
| |
| |
| Introduction | |
| |
| |
| What is community care? | |
| |
| |
| Early developments in community care | |
| |
| |
| Community care arising from deinstitutionalization | |
| |
| |
| Community care arising from the 'planning for priority groups' movement in the 1970s | |
| |
| |
| Change towards community care: Myths and realities | |
| |
| |
| 'Planning' becomes localized | |
| |
| |
| The influence of government White Papers | |
| |
| |
| Coordination and collaboration | |
| |
| |
| Joint planning | |
| |
| |
| Joint finance | |
| |
| |
| Community care arising from the continuum of formal and informal care | |
| |
| |
| The 'emergence' of gender | |
| |
| |
| A policy of reliance on the family | |
| |
| |
| Community care arising from the Conservative government's 'care in the community' initiative | |
| |
| |
| Initiatives and incentives | |
| |
| |
| Conclusions | |
| |
| |
| Summary | |
| |
| |
| Further reading | |
| |
| |
| References | |
| |
| |
| |
| The reforms and the mixed economy | |
| |
| |
| Introduction | |
| |
| |
| Background to the reforms | |
| |
| |
| The Griffiths Report: Community Care: An Agenda for Action (1988) | |
| |
| |
| The White Paper Caring for People (1989) | |
| |
| |
| The Community Care Act (as part of the National Health Service and Community Care Act 1990) | |
| |
| |
| A duty to assess | |
| |
| |
| What is meant by 'need'? | |
| |
| |
| Other aspects of the Act | |
| |
| |
| Rhetoric versus reality | |
| |
| |
| Financing the reforms | |
| |
| |
| Joint working | |
| |
| |
| The issue of 'top up' | |
| |
| |
| The funding gap | |
| |
| |
| Implementing the reforms: A success story? | |
| |
| |
| A needs-led service? | |
| |
| |
| Consumerism versus empowerment | |
| |
| |
| Managerialism versus professionalism | |
| |
| |
| Need or risk | |
| |
| |
| Conclusions | |
| |
| |
| Summary | |
| |
| |
| Further reading | |
| |
| |
| References | |
| |
| |
| |
| Towards a conceptual framework | |
| |
| |
| |
| Values, assumptions and ideologies | |
| |
| |
| Introduction | |
| |
| |
| The big picture: Influences and connections | |
| |
| |
| Values and working in community care services | |
| |
| |
| A model of influences on services | |
| |
| |
| External economic, social and value forces | |
| |
| |
| Dominant societal values in the UK | |
| |
| |
| A new religion? | |
| |
| |
| The 'new value system' | |
| |
| |
| Theories, ideologies and assumptions: The impact of shapers of values | |
| |
| |
| Conclusion | |
| |
| |
| Summary | |
| |
| |
| Further reading | |
| |
| |
| References | |
| |
| |
| |
| Values, theories and realities: The case of learning disability services | |
| |
| |
| Introduction | |
| |
| |
| External economic, social and value forces on learning disability services | |
| |
| |
| Overall societal values and learning disability services | |
| |
| |
| The influence of materialism | |
| |
| |
| The effect of individualism | |
| |
| |
| The influence of sensualism and externalism | |
| |
| |
| Shapers of values and their effects | |
| |
| |
| Clarification of terms | |
| |
| |
| Impact on services of alternative theories | |
| |
| |
| SRV and the social theory of disability | |
| |
| |
| The impact of the disability movement | |
| |
| |
| Normalization and SRV theory | |
| |
| |
| Impact on services of two ideas | |
| |
| |
| Advocacy | |
| |
| |
| Inclusion | |
| |
| |
| Politics, legislation and the service system | |
| |
| |
| Conclusion | |
| |
| |
| Summary | |
| |
| |
| Further reading | |
| |
| |
| References | |
| |
| |
| |
| Users' and carers' perspectives | |
| |
| |
| |
| Users' perspectives: Do services empower users? | |
| |
| |
| Introduction | |
| |
| |
| Constructing the user of community care | |
| |
| |
| Constructing the term 'user' | |
| |
| |
| Not simply a service user | |
| |
| |
| Engaging with services | |
| |
| |
| Patterns of engagement with services by individuals | |
| |
| |
| The effect of the National Health Service and Community Care Act 1990 | |
| |
| |
| Users of mental health services | |
| |
| |
| Towards user-led services | |
| |
| |
| Empowerment | |
| |
| |
| Empowerment and older people | |
| |
| |
| Empowerment and physically disabled people | |
| |
| |
| Empowerment and mental health service users | |
| |
| |
| Empowerment and people with learning disabilities | |
| |
| |
| Empowerment and disabled children | |
| |
| |
| Exclusion and inclusion | |
| |
| |
| Money | |
| |
| |
| Sexuality | |
| |
| |
| Empowerment and advocacy | |
| |
| |
| Learning from users | |
| |
| |
| Conclusion | |
| |
| |
| Summary | |
| |
| |
| Further reading | |
| |
| |
| References | |
| |
| |
| |
| Carers' perspectives: Do services support carers? | |
| |
| |
| Introduction | |
| |
| |
| Defining caring, carers and care | |
| |
| |
| Discovering carers | |
| |
| |
| Caring: A social problem | |
| |
| |
| Emergence | |
| |
| |
| Legitimation | |
| |
| |
| Mobilization | |
| |
| |
| Formulation | |
| |
| |
| Implementation | |
| |
| |
| Evaluating the community care reforms | |
| |
| |
| Taking a break | |
| |
| |
| The quality of care | |
| |
| |
| Carers and copers | |
| |
| |
| Gender | |
| |
| |
| Socioeconomic factors | |
| |
| |
| Differing perspectives | |
| |
| |
| The rewards of care | |
| |
| |
| Distinctions and difficulties | |
| |
| |
| The challenge to carers | |
| |
| |
| Ethnicity issues | |
| |
| |
| Communication issues | |
| |
| |
| Learning from carers | |
| |
| |
| Conclusion | |
| |
| |
| Summary | |
| |
| |
| Further reading | |
| |
| |
| References | |
| |
| |
| |
| Professional directions | |
| |
| |
| |
| Professions in community care | |
| |
| |
| Introduction | |
| |
| |
| The professionals | |
| |
| |
| GPs | |
| |
| |
| Social workers | |
| |
| |
| Nurses | |
| |
| |
| The impact of community care | |
| |
| |
| Nursing | |
| |
| |
| General practice | |
| |
| |
| Social work | |
| |
| |
| Interprofessional collaboration | |
| |
| |
| Professional knowledge-base and collaboration | |
| |
| |
| Possible realignments | |
| |
| |
| The demands of working together | |
| |
| |
| Professional values and ethics | |
| |
| |
| Values of community care | |
| |
| |
| Who has the responsibility to provide what? | |
| |
| |
| What is the legitimate focus of professional obligation? | |
| |
| |
| How should resources be distributed and prioritized? | |
| |
| |
| What should be the role and status of the professional in this context? | |
| |
| |
| Principles for interprofessional collaboration | |
| |
| |
| Conclusion | |
| |
| |
| Summary | |
| |
| |
| Further reading | |
| |
| |
| References | |
| |
| |
| |
| Teams in community care | |
| |
| |
| Introduction | |
| |
| |
| What is a team? | |
| |
| |
| Small groups working | |
| |
| |
| Key features of groups which affect teamwork | |
| |
| |
| Decision making in groups | |
| |
| |
| Teams working | |
| |
| |
| Factors which influence performance | |
| |
| |
| Teams in community care | |
| |
| |
| Interprofessional teams | |
| |
| |
| Teams and organizations | |
| |
| |
| Interorganizational teams | |
| |
| |
| Sustaining the team from within | |
| |
| |
| Conclusion | |
| |
| |
| Summary | |
| |
| |
| Further reading | |
| |
| |
| References | |
| |
| |
| Glossary | |
| |
| |
| Index | |