Intended for healthcare professionals

Education And Debate

Caring for Older People: Community care and social services

BMJ 1996; 313 doi: (Published 05 October 1996) Cite this as: BMJ 1996;313:869
  1. D Renwick, senior registrara
  1. a St James's University Trust Hospital, Leeds LS9 7TF
  1. Correspondence to: Dr D Renwick, Department of Medicine for the Elderly, Camborne/Redruth Community Hospital, Redruth, Cornwall TR15 3ER.

    The aim of community care is to enable people with various types of disability to live in their own homes, rather than in institutions. This involves the provision of support and services at home by various agencies. After a critical report in 1986 identified problems with coordination and flexibility of community care services, the white paper Caring for People (1989) stated the government's aim to provide a “needs led,” responsive range of services, promoting maximum independence of those wishing to live at home rather than enter institutional care. New arrangements were introduced in 1993, involving a formal assessment procedure and the production of a personalised care plan for each individual, incorporating services provided by private and voluntary agencies as well as by social services departments. This article describes the components of community care services supplied by local social services authorities, including housing adaptations, equipment, telephones and alarms, home care, meals, and respite care.

    Before April 1993, social services departments had been involved mainly in the provision of care. With the new community care arrangements, social services became responsible for assessing need, designing care plans, and securing delivery of appropriate services.

    To increase the spectrum of care available, social services departments were encouraged to purchase care from private and voluntary agencies, thus becoming “enabling authorities” rather than simply providers of care. In addition, financial support for people in residential or nursing homes also became the responsibility of social services departments.

    This article describes the community care services supplied by social services departments. Services available from the health authority and from voluntary or private organisations are considered in other articles in this series.1 2 As there is substantial overlap between services provided by these organisations, and as local social services authorities have been encouraged to develop their own arrangements for the …

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