Social services

Children+adults –separate areas of activity

Children’s Social Services

Social services: who for?

• Elderly

• Disabled

• Children esp. those at risk

• Mentally ill

• Long-term ill

• Anyone “vulnerable” – asylum seekers

Children’s social care

Social services: who provides?

Social care – “multi agency approach” – often more than one provider involved.

Central government sets framework of duties/responsibilities/standards

Providers are:• Local authorities (social services providers are

counties; unitaries; London boroughs)• The NHS – Primary Care Trusts• The Police (children at risk/abuse issues)• Charitable groups eg NSPCC/Barnados

Children’s Services

• Arrangements changed fundamentally by Children’s Act 2004 (post-Lord Laming inquiry into death of Victoria Climbie)

• Policy of “Every Child Matters” introduced• Local Safeguarding Children’s Boards• Act also established Children’s Services

Departments for local councils – bringing education and social care for children together

Baby P – Lord Laming report 2009

• Failure of agencies to share information• Social workers over-stretched• Red-tape+form filling hampering front-line staff• “Over-complicated, lengthy and tick-box

assessment+recording system.”• Child protection seen as ‘Cinderella Service’• Too many authorities failed to adopt his reforms

following Victoria Climbie report in 2000

Care of children

Role of social services (the council):

• Protection (safeguarding)

• Promote general welfare of children

• Encourage children to be brought up in family setting

• Work with parents in child’s best interests

• Provide accommodation for children where necessary (Tracy Beaker, fostering)

Local Children’s Safeguarding Boards

• Set out how different agencies will collaborate to deliver services/monitor effectiveness

Children at risk - Child Protection Plans

• Plans are drawn up by professionals following initial child protection conference

• Social services – (the council) - co-ordinate action to safeguard children through “inter-agency” plan

• Plans set out how child is to be protected

• Children may be taken out of home

Children taken into care – why?

Underlying principle:

Where children are at significant risk of harm and there is on-going risk

Types of harm:• Neglect• Physical Abuse• Sexual abuse• Emotional abuse

• Children can be registered under more than one category

Care Orders

• Only for children under 17• Applications for such orders go to Family

Court • Orders are applied by councils where:

Child is at risk of significant harm and care is below reasonable parental standard

KCC – 261 care orders sought in 2013-14 at average cost of £5,000

Care Orders

• Social services assume parental responsibility but parents must have reasonable access

• Interim care orders: where council is seeking full care order. Last max. eight weeks, unless court grants renewal

• Supervision orders: where child is not taken into care but monitored by social services

Serious Case Reviews

• Purpose of SCRs:

• Are there lessons to be learned from the case about how professionals and agencies worked?

• Identify clearly what those lessons are, how they will be acted on, and what is expected to change as a result

• Improve inter-agency working

Care Homes

• Councils must provide Community Homes for children in care

• Private homes must be registered by the Commission for Social Care Inspection

• Homes may be run by charities, eg Barnados

• Usually mixed (boys and girls)

Fostering

• Can be short or long term• Seen as preferable to care home

environment• Foster parents: no legal custody or full

parental rights (but may choose to adopt later)

• Must be approved by social services• Are paid+have allowances for

clothing/holidays etc

Fostering ii

• Prospective foster parents vetted by social services to assess if appropriate

• Social services retain right to make regular spot checks – can remove children if necessary

• Required to undergo statutory training

Adoption

• Eligible children must be < 18

• And be a child for whom returning home is not possible

• Adoption orders sever all legal ties with natural birth family

• Confers parental rights and responsibilities on new adopting family

Adoption ii

• Adoptive parents must be > 21• Be able to provide stable + permanent home• Need not be married; can be single; same sex

couples can adopt• No upper age limit• No bar against those who are disabled adopting• Adoption must be through an approved Adoption

Agency or Voluntary Adoption Society approved by Secy. Of State

Adoption scorecards

• Government publishes “scorecards” for council adoption rate (2012)

• Figures from 2012: • 72 failed to meet target to place children in

adoptive families within 21 months overall and within seven months of being cleared for adoption by the courts

• But improvements since then – eg Kent (KCC) has seen adoptions of under-twos treble since 2012

Adult social services

Growing pressure

• We are an ageing society – people now living much longer than they were

• More people over 65 than under 16 for the first time

• 10m people are over 65 – by 2050, forecast is 19m

• In 1900, 1% of popn. was > 65; 2000 it was 7%; by 2050, it will be 20%

• Number of people working beyond retirement age (65) has doubled in 10 years to 900,000

Growing pressures…

• Fastest growing sector of the population is the over-80s

• Currently, 3m are over age of 85• Forecast is that will double to 6m by 2030• Of govt spending on benefits – 65% of DWP

budget goes on older people (£100bn in 2010-11)

• NHS spending on retired households: £5,200• NHS spending on non-retired: £2,800

Who should pay?

Dilnot Commission – fair funding

• Government set up inquiry because of concerns about affordability of care – sustainability+fairness

• Driven by concern that anyone with £23,000 assets faces unlimited care costs

• Reported in June 2011

Dilnot Commission - recommendations

• Each person’s contributions to care costs should be capped. After cap reached, state support kicks in

• Cap should be between £25,000-£50,000. £35,000

• National eligibility criteria about who qualifies for care – currently set locally

• Cost to UK – approx £1.7bn

Govt. response to Dilnot

• Accepts principle of a cap• Treasury said cap will be £75k not 35k• £35k cap would cost govt. £1.7bn

Issues…• Would insurance companies come in at that

level?• Public not interested in planning for their care

Adult social services - Community Care

• NHS and Community Care Act 1990: shifted responsibility from NHS to local govt.

• Aim: to move away from institutional living to independent living

• Care is provided for problems associated with:• Ageing• Mental illness• Learning difficulties• Physical/sensory impairments

• NHS+Social services required to make Partnership Arrangements for care of individuals

Community Care: How it works

• Anyone with disability or any other social care need is entitled to a needs assessment:

• Old age/physical weakness

• Physical difficulties

• Sensory difficulties

• Learning disabilities

• Mental health problems

Community care: how?

• Assessments gauge what kind of help might be needed and can be provided in accordance with “eligibility criteria.”

• Councils usually have a system that grades level of need: for example, critical, substantial, moderate or low

• People most at risk given priority• Individuals are given a care plan setting out what will be

provided and by who• Care may be secured through system of “direct

payments”

Care plans

• Services to be provided

• Who will provide them

• Contact for issues or problems

• How reviews can be asked for if circumstances change

Community care – what kind of care?

Domiciliary care services: such as –• Meals on wheels• Help with personal bathing or shopping• Respite care (for carers too)• Special equipment added to home –

ramps; adapted furniture; stair rails• Services often contracted out to private

sector/voluntary sector. Charges can be made; often free

Community care – other help

• Support for deaf and blind• Day care services – organise activities for people• Recuperative and intermediate care services: short-term

(few weeks) and intensive help to help recovery after illness; fall or other crisis. May be at a care home

• Respite care for carers, who may themselves need help (such as a break or holiday)

• Residential care in home – often bought in by council but how much is paid subject to means-testing

Who regulates – the Care Quality Commission (CQC)

• Independent regulator

• Regulates all health and adult social care services in England provided by NHS, local authorities, private companies or voluntary organisations

• Protects the rights of people detained under the Mental Health Act.

Care Quality Commission

• Care homes

• Domiciliary care providers

• Hospitals

• In all cases to “ensure compliance with required standards of care and welfare”

CQC ii

• All health and adult care providers must register with CQI (Health and Social Care Act 2008)

• Includes NHS trusts• Registration designed to ensure compliance with

essential standards of quality and safety• Has power to conduct unannounced inspections• Can issue fines and fixed penalties• Withdraw registration, for eg from hospitals failing to

meet cleanliness standards; close down departments or withdraw operating licences from entire hospital

Adult Safeguarding Boards

• Multi- agency: councils; police; NHS

Role:• Approve policy, procedures and guidance for

safeguarding• Approve a training strategy   • Monitor performance of statutory agencies• Hold agencies to account• Publish annual report