Social Services: Providing Care for Vulnerable Individuals

2. Social services Children+adults – broadly separate areas of activity

3. Social services – in the news • Baby P • Social worker shortage • 13-year-old boy becomes father • Increasing elderly population(impact of medical advances) • Arrival of asylum seekers • Should we pay for residential care?

5. Social services: who for? • Elderly • Disabled • Children esp. those at risk • Mentally ill • Long-term ill • Anyone “vulnerable” – asylum seekers

6. Social services: who provides? Social care – “multi agency approach” – often more than one provider involved. Central govt. sets framework of duties/responsibilities/standards Providers are: • Local authorities (social services providers are counties; unitaries; London boroughs) • Health bodies – Primary Care Trusts • The Police (children at risk/abuse issues) • Education authorities • Charitable groups eg NSPCC

7. Children’s Services • Protecting at risk children one of most important jobs of social services • Arrangements changed fundamentally by Children’s Act 2004 (post-Lord Laming inquiry into death of Victoria Climbie) • Safeguarding children is overseen by Local Safeguarding Childrens Boards • Act also established Children’s Services Departments for local councils – bringing education and social care for children together

8. Care of children Role of social services (the council): • 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)

9. Children’s services – Local Children’s Safeguarding Boards • Set up by each local authority following Children’s Act 2004 • Set out how different agencies will collaborate to deliver services/monitor effectiveness • Boards have three levels of action to ensure welfare of children:

10. Safeguarding boards ii Levels of action: • Activities to prevent maltreatment or impairment of health or development (eg better mechanisms to identify cases of neglect/abuse) • Pro-active work to target specific groups – children in need but not suffering abuse/neglect • Reactive work to respond to neglect/abuse

11. Children’s Trusts • Multi-agency groups • Include representatives of all statutory bodies/agencies with role in looking after children • > social workers (relevant local council) • >health visitors (NHS) • >paediatricians (NHS) • >child psychologists (NHS) • Eg Kent county council has 12 trusts

12. Children at risk - Child Protection Plans • Child Protection Plans have replaced child protection registers • 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

13. 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

14. Care Orders • Only for children under 17 • Applications for such orders go to Family Proceedings Court (normally Magistrates Court) • Orders are applied by councils where: Child is at risk of significant harm and care is below reasonable parental standard

15. 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

16. Supervision Orders • Where child is placed under supervision – but not necessarily taken into care - with councils having a lesser duty to “advise, assist and befriend.” • Families must be allowed to bring up child if possible • Can be made for abandoned/lost children

17. Emergency Protection Orders • Where child is deemed to face an immediate danger and harm • Made by courts • Last up to 8 days • Can be extended by court if satisfied risk still exists • Parents can challenge after 72 hours

18. Serious Case Reviews • Purpose of SCRs: • Are there lessons to be learned from the case about how professionals and agencies worked • Identify clearly what lessons are, how they will be acted on, and what is expected to change as a result • Improve inter-agency working

19. SCRs – when? • If child sustains a potentially life-threatening injury or serious injury through abuse or neglect • If child has been subjected to serious sexual abuse • A parent has been murdered • A child has been killed by a parent with a mental illness • If case gives rise to concerns about inter-agency working to protect children

20. 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)

21. 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

22. 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

25. 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 • Birth parents lose legal rights/cannot take child back

26. 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

32. Adult social services

33. Growing pressure • We are an ageing society – people now living much longer than they were (+ have high expectations of what care they should get) • More people over 65 than under 16 for the first time • Fastest growing sector of the population is the over-80s • In 1900, 1% of popn. was > 65; 2000 it was 7%; by 2050, it will be 20%

34. 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

35. Community Care: How it works • Anyone with disability or any other social care need is entitled to a needsassessment: • Old age/physical weakness • Physical difficulties • Sensory difficulties • Learning disabilities • Mental health problems

36. 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”

37. Care plans • Services to be provided • Who will provide them • Contact for issues or problems • How reviews can be asked for if circumstances change

38. 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

39. 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

40. Who regulates – the Care Quality Commission (CQC) • Independent regulator that replaced Healthcare Commission and the Commission for Social Care Inspection (CSCI) • 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.

41. 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