Social care is defined as the provision of social work, personal care, protection or social support services to children or adults in need or at risk, or adults with needs arising from illness, disability, old age or poverty and their families and carers. That provision may have one or more of the following aims: to protect people who use care services, to preserve or advance physical or mental health, to promote independence and social inclusion, to improve opportunities and life chances, to strengthen families and to protect human rights in relation to people's social needs.[1]
There are many different types of social care available. These include residential and domiciliary care, community support and activities, information and advisory services and advocacy, as well as support for carers.
Social care is frequently used as a synonymous term with social welfare, and as an alternative to social work.[2] The term often implies informal networks of support and assistance as well as services provided by social services and other professionals.
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Social care has long existed as an informal concept, through family and community support and charitable works. The earliest Act in England to offer formal support was the Elizabethan Poor Law of 1601, which referred those in need of health or domestic care, housing, or employment to the care of their parish. This ‘care’ could include payments, food, apprenticeships, boarding or referral to a workhouse.
Social care became more formalised with the advent of social work in the USA and UK in the 19th century. This shift is attributed to the end of the feudal system and the rise of industrialisation, which bought greater social deprivation. It also bought a decline in the support provided by family and close-knit communities as people became more mobile and moved to different areas for work.[3] Social care was often provided by voluntary organisations, but some services were financed through health insurance contributions collected through mutually owned societies.[4]
The development of social sciences such as psychology and sociology in the early 20th century bought social structures under further scrutiny and opened the way for social work to become an area of academic study.
When the UK Liberal Government came into power in 1906, the first means-tested pension came into force for people aged 70 and over. Further formal health and social care provision followed with the creation of the NHS and the welfare state in England in the 1940s, making statutory health and social care free at the point of access.[4]
Social care encompasses many areas of work, each with their own specialist services. These can be broadly categorised as follows:
Adults – this includes support for older people, people with mental health problems, learning or physical disabilities, those with alcohol and substance misuse problems, the homeless, victims of domestic abuse and families and carers
Children, young people and families – this includes fostering, adoption and child protection services, working with young offenders, young people who are unemployed or homeless and those who have learning or physical disabilities, as well as support for families and carers
Workforce – this includes the provision of resources, training and support for those working in social care.
The social care workforce broadly encompasses those who work in public services that are provided, directly or commissioned, by local councils to discharge their personal social services (PSS) responsibilities.
In England, the social care workforce comprises over one and half million people. An estimated two thirds of the workforce work for some 25,000 employers in the private and voluntary sectors. The remaining third work in the statutory sector, largely for 150 local councils with personal social services responsibilities.[5]
The range of work settings includes the community, hospitals, health centres, education and advice centres and people’s homes.[6] Social care practitioners frequently work in partnership with staff from other professions, including health, housing, education, advice and advocacy services and the law.
The Care Standards Act 2000 bought greater recognition for the profession of social work with the introduction of a social work degree and social workers’ register. To become a social worker in the UK, you need to complete an Honours degree or postgraduate MA in Social Work. There are access courses for mature students, trainee schemes and employment based routes to gaining the qualification.[5] Qualified social workers are currently required to register with the General Social Care Council (GSCC) before commencing practice. This membership must be renewed every three years. Social workers are also required to ensure that they keep their training and knowledge up-to-date with current developments in the field.
There are many other social care roles for which a social work qualification is not required, but other qualifications, experience and training may be necessary.
Examples of the range of professions within this field include policy makers, researchers, academics, project workers, support workers, carers (in residential or domiciliary care settings) and personal assistants.[7]
The Department of Health is the government body that delivers social care policy and guidance for England and Wales. Liberal Democrat Paul Burstow became the Minister for Care Services in 2010 under the Coalition Government. The Department of Education is the government department with responsibility for children's services, families, schools, 14-19 education, and the Respect Taskforce in England and Wales.[8]
UK Social workers are currently registered with the General Social Care Council, which sets codes of conduct and practice. From 2012, the GSCC will no longer exist and regulation of social workers will be carried out by a renamed Health Professions Council. Through the work of the Munro Review, the Social Work Reform Board and the piloting of social work practices, Government aims to give greater autonomy to social workers. The Reform Board has recommended the development of a professional college. The proposed College of Social Work will seek to improve and support social work by leading the development of the profession and represent it in discussions with organisations that regulate, train, work with, and are affected by social work. The College is under development for England and expects to negotiate a relationship with other UK nations. Social care services are regulated by the Care Quality Commission.
Other social care organisations include the Social Care Institute for Excellence - an independent charity that identifies and transfers knowledge about good practice, and Skills for Care, a government funded organisation that focuses on skills and training.
The National Skills Academy for Social Care, launched in 2009, provides learning support and training practice for social care workers and employers in England.
In Wales, the Welsh Assembly Government controls health and social care. This is structured similarly to England, with local authorities commissioning and delivering services.
In Scotland, social care is delivered through the Scottish Government Health and Community Care department.[9]
In Northern Ireland, health and social care are provided as an integrated service, through four health and social services boards (North, South, East and West) under the Department of Health, Social Services and Public Safety. Health and social care services are monitored by a Health and Social Service Council in each area.[10]
There are many other voluntary and independent organisations that exist to support the delivery of social care. These exist to support both the social care workforce and people who use services, and include user-led organisations.
Social care is high on the British government’s agenda, with a focus on the integration of health, social care and education to reflect the overlap between these areas of life.[11]
The Coalition Government's plans for adult social care services are set out in 'A vision for adult social care: capable communities and active citizens', which was published in November 2010.[12] The aim is to make services more personalised, more preventative and more focused on delivering the best outcomes for the people who use them. The Government wants to encourage care and support to be delivered in a partnership between individuals, communities, the voluntary sector, the NHS and councils. The rollout of personal budgets will be extended, and councils and NHS organisations will be expected to work together to commission services. The Health and Social Care Bill published in January 2011 outlines these changes in more detail.[13]
A 10-year strategy for mental health, New Horizons (England)[14] was published in December 2009 by the previous government. The current government is due to publish a new mental health strategy for England.
Dementia care is an area that has received increasing attention, following the launch of the National Dementia Strategy in February 2009. This strategy focuses on ‘living well’ with dementia and aims to provide those living with dementia and their carers information and support that maintains dignity and increases choice. The Coalition Government has indicated that dementia remains a priority.
In children’s services, Government will focus on helping the poorest and most vulnerable families, through targeted and early intervention. Ministers across Government have made a commitment to end child poverty by 2020.
The establishment of the Centre for Excellence and Outcomes in Children’s and Young People’s Services (C4EO) will support this agenda in England.
Developing the skills of the social care workforce is a continuous priority, specifically in response to changes in the social care sector and media coverage of social care issues. Following the recommendations of the Social Work Taskforce (2009), a College of Social Work is being set up. The College will represent and support social workers and help maintain standards for the profession.