Making sense of the ‘Social Care’ system
There may be a time in any of our lives when we need some help. Perhaps you or someone you support, has had an accident, leading to a hospital admission or you have a disability or illness that has led to you needing more help.
You may have been caring for someone with dementia and it’s now becoming more difficult. Perhaps you recognise you now need more help or a break, or family/friends have noticed and are encouraging you. For many it can be daunting to not only acknowledge you need support, but to then actually seek this out.
Approaching social services can be frightening and cause anxieties about someone interfering in your private life. To discuss personal matters with a stranger can feel like an intrusion of privacy and be overwhelming. By reaching out for help, it can feel like giving away part of yourself and control over your life (or the life of the person you are caring for).
Approaching social services
Reforms within adult services since 2014 have been aimed at making approaching services more streamlined. This has been through the introduction of single point of access or entry team. The aim of this change was to reduce the need for people to have to repeat the same information to different professionals.
Both the Care Act in England and the Social Services and Wellbeing Act in Wales and the National Health and Wellbeing Outcomes in Scotland, begin with an assessment of needs and subsequently, a decision about whether needs are eligible for services.
On approaching social services, the first step will be for them to gather a ‘proportionate’ assessment. This is basic information and includes information about the current concerns and what matters to the person in need of care and support. At this stage, information and advice may be offered with signposting to third sector organisations. If it is then determined that further assessment is needed, the single point team will refer you or the person you care for to the most appropriate service (e.g re-ablement, short-term support, carer support projects or long-term care and support services).
Social services assessment
Having an assessment from social services should involve a holistic approach considering what matters to the individual, what outcomes they wish to achieve and the support and resources the person currently has in place.
The assessment should be a space for open and honest discussion focused on the person.
For carers supporting someone with dementia, this can be more difficult as you may need to speak on their behalf due to communication difficulties, or their current cognitive difficulties. This can be a tricky situation for the carer when they need to present the reality to the professional, but the person with dementia may not understand what is actually happening in their daily lives.
Health and social services staff need to ensure they have awareness of people’s lived situations and consider the person with dementia’s capacity in relation to their care needs, meeting with them separately to assess their decision-making abilities.
Preparing for an assessment
What is important for carers to consider, is that the legislative reforms in adult services led to carers having the same recognition as those you support. It is an acknowledgement that under these laws, local authorities must consider the impact caring has on the wellbeing of the carer.
This means your right to an assessment is placed on equal footing with that of the person you are looking after. It is also important to remember that under the legislation, it cannot be assumed that you are able or willing to continue caring, that this must be considered as part of your carers assessment.
In preparing for a carers assessment, it may be beneficial to consider the following areas;
- Your personal circumstances.
What are the things that you do as a carer to give support? This includes emotional and practical support, your own health and well-being and the pressures you may be experiencing because of your caring role. As well as, other caring responsibilities you may have.
- Personal outcomes – What do you want to achieve?
How was life before you had caring responsibilities? Within your caring responsibilities what would help you most? What matters to you about being a carer?
- What are the barriers?
How does caring affect what you want to do? Are there things you cant do and what is stopping you?
- What strengths are there to help support you as a carer?
Who helps you?
- What risks are there if you were unable to maintain your own well being and achieve what matters to you?
How could this affect your ability to keep caring?
Care and support plan
If social services identify eligible care needs then the next step would be to work with you to write a care and support plan.
This plan should include consideration of all social needs, considering the person’s own support networks as well as services that the authority would look to provide. This plan should be reviewed a short-time after implementing to check its meeting the outcomes set-out by the person and, dependent on effectiveness, at set periods following this.
Sadly, often navigating the system remains confusing. Despite attempts to simplify and reduce the jargon, there are still improvements to be made.
The ever-evolving integration between health and social services is one area which has ongoing challenges, particularly when there is debate about who is responsible for a person’s care needs.
The attempts to integrate health and social computer systems remains littered with barriers in many areas. In current times, the waiting lists for both assessment and services are having an impact on people’s needs.
If you or the person you care for, are experiencing increased difficulties you need to ensure that social services are aware of this change as well as any health services that may be involved in the care.
If you feel you would find it difficult to talk to a professional for the assessment or there are any barriers with communication or language, please ensure that you have someone you trust to support you, or if needed, seek out advocacy to help you through this process.
If there is somewhere that you or the person you care for would feel more comfortable talking, then reasonable adjustments should be made to ensure that this can be accommodated.
More support online
The Live Online Learning series: ‘Transitions into Care’ explores these issues in more depth. Led by registered health and care professionals, the online webinars support carers through this difficult life event. These sessions help family carers to feel as prepared and supported as possible during this time. There will be time to connect with other carers as well as the professionals in a supportive and protected environment. Please register your interest for the next course.
By Katy Evans, an experienced social worker based in South Wales with a background in local authority and adult social care.