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 needs assessment: 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