Social services Childrenadults separate areas of activity Social

Social services Children+adults –separate areas of activity

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 • 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) • 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 • “It seems like they have to do all this form filling. Their bosses make them do it but it makes them forget about us” – 16 -year-old in care

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) - coordinate 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 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

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

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

SCRs – when? • If child sustains a potentially lifethreatening 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 interagency working to protect children

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 in Kent • 2006 – 96 children adopted • 2010 – 57 children adopted But only 28 approved adopters And… 90 other children waiting “It is clear that there is a desperate imbalance between the number of those children and the number of approved adopters. The fundamental weakness in Kent is clear. ” Martin Narey, ex-head of Barnados

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 • 10 m people are over 65 – by 2050, forecast is 19 m • 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-80 s • Currently, 3 m are over age of 85 • Forecast is that will double to 6 m by 2030 • Of govt spending on benefits – 65% of DWP budget goes on older people (£ 100 bn in 201011) • 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. 7 bn

Govt. response to Dilnot • Accepts principle of a cap • Treasury said cap will be £ 75 k not 35 k • £ 35 k cap would cost govt. £ 1. 7 bn 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