Since 1980 the personal social services research unit at Kent University has been the driving force for the development and evaluation of modern community care policy.
Its early work was a major influence on the milestones associated with that policy during the 1980s and 1990s - the Griffiths report on community care, the 1989 white paper Caring for People and the subsequent community care reforms implemented in 1993.
Because of this, there is a temptation to trace all that has been both good and bad during that time back to the work of the unit. Undeniably, its influence has been responsible for the way in which care management, devolved budget-holding and needs assessment have become part of a social services department's way of life.
This latest volume, like its predecessor publications, is a blockbuster of a study, providing information in huge depth and minute detail about how community care is faring following the 1993 implementation of the Caring for People reforms and evaluating what improvements (if any) have been achieved. It provides a wealth of detail about the range and complexity of older people's needs and those of their carers, and examines the impact of different types and amounts of intervention to meet those needs.
Not surprisingly, given the part PSSRU has played in shaping public policy on community care in the past, the report is upbeat about the achievements of the reforms.
It suggests that targeting (matching resources to greatest need) has worked successfully - but acknowledges that prevention and rehabilitation have suffered as a consequence.
It is not easy to reconcile economic hard-headedness with the realities of dependency and client need, and it is arguable that in the past PSSRU placed too little emphasis on the downside of targeting.
Indeed, many older people and many of those working with them have said all along that it is a mistake to cut resources at the 'light' end of the dependency continuum.
A little support at an earlier stage can delay greater (and more expensive) support at a later stage.
It is encouraging to note that the recent emphasis placed on prevention and rehabilitation by health ministers is clear evidence of a change of heart at government level.
This book is not an easy read. It is very long and heavy on facts, figures and analysis. However, as a source book it will be invaluable.
The wealth of detail - ranging from the characteristics of the sample of older people and their carers to the economic analysis of social services departments' resource allocation patterns, and much more in between - is impressive and will undoubtedly be drawn on by researchers and policy-makers for many years to come.
No comments yet