| |
| |
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 | |