books

Community care practice andthe law

Second edition

By Michael MandelstamJessica Kingsley 647 pages£22.50

Community care and the law is one of those heart-sink topics that will, I suspect, cause many NHS managers to pass over this book and head towards their late summer holiday reading.

The title implies it might be unpleasant, dealing with disputes and legal challenges that are a nightmare for anyone working in public services these days. Perhaps it will be irrelevant to anyone in the NHS - after all, local authorities are responsible for community care and they are the ones liable to land up in court, aren't they?

This second edition of Community Care Practice and the Law is certainly very long, but it is far from dull or irrelevant for it deals with a subject that concerns health, housing and social care agencies struggling to meet the needs of vulnerable people within available resources.

Mandelstam sets out to inform service providers and users about the legal framework within which community care operates. He says he wants the book to be used in a way that will avoid formal disputes arising: he believes that a well-informed service manager is unlikely to try to implement a legally dubious policy. But he recognises that the information may also help people already involved in disputes, or who may want to challenge particular decisions or policies.

There are two excellent chapters providing a good foundation for anyone interested in legal aspects of community care. The first gives an overview of the law and the uncertainties that are open to interpretation and challenge. The second discusses the law as it relates to key themes, such as rights and responsibilities, rationing and good practice.

There are useful chapters on assessment and care plans, residential and nursing homes, charges for services and joint working.

The section devoted to health services will interest anyone who is hoping to manage their budget by closing down a unit for disabled people, by ending the provision of incontinence pads, by withholding expensive drugs from people with chronic conditions or by discharging more hospital patients into the means-tested world of social services. A digest of cases shows what has happened when these and other decisions have been challenged in the courts or brought before ombudsmen.

Mandelstam's style is reasonably accessible, but it is not always easy to find your way around this book. The index, for instance, does not show you where to find the famous Leeds case that led to continuing-care guidance. And the practical checklist that can be used to judge the potential lawfulness of decisions, policies and eligibility criteria is also rather impenetrable in its layout and detail.

Nevertheless, every health agency ought to have a copy so that managers and practitioners can consult it when they are in doubt about the decisions they are about to make.

Janice Robinson

Director of community care,King's Fund.