Editorial

Citation

Klee, D. (2015), "Editorial", Working with Older People, Vol. 19 No. 2. https://doi.org/10.1108/WWOP-03-2015-0009

Editorial

Article Type: Editorial From: Working with Older People, Volume 19, Issue 2.

Deborah Klee

This April saw the implementation of The Care Act (2014) in the UK. It will result in significant changes in the way that care services are delivered and have an impact on older people.

Central to The Care Act is a focus on putting the person at the centre of care so that they have control over their care and are supported to make decisions. Personalisation has been the mantra of adult social care for over a decade and has been supported by all political parties. It means giving the person choice and control over the care that they receive. Despite this long history of personalisation the change in culture needed to make it a reality across the UK has been slow.

Personal Budgets were introduced by the Department of Health in 2008 but they have not been popular with older people (Norrie et al., 2014). Personal Budgets allow the person to buy the care that they want up to an amount agreed by the local authority following an assessment of the person�s care needs. Older people now have a right to request a personal budget.

In the UK local government only fund care for people who meet an eligibility criteria, that is a level of need for care and support. This has been different for each local authority area, but now there is a national eligibility criteria. Regardless of whether or not a person meets this criteria, the local authority has to carry out a free assessment of a person�s needs. Carer�s must also have an assessment of their care and support needs. Access to an advocate should be arranged when a person needs support in communicating their views and wishes.

Until The Care Act was introduced there was no limit to the amount a person paid towards their care if they had the financial means to do so. This has changed and now there is a cap of �72,000. When this figure has been reached the local authority will pay for care costs. However, the local authority must agree that the care is needed. So, it is important that older people and carers ask for a free assessment of their needs before they start paying for their care and that this assessment is regularly reviewed. The local authority will set up a care account so that they know when the �72,000 limit has been reached.

Older people who fund their own care can now ask the local authority for help in finding suitable care. Until The Care Act introduced these changes there was very little help for people who funded their own care.

Prevention of the need for care by enabling people over 50 to live well, and enabling people to make decisions about how they live when they are in need of care and support, are key features of The Care Act. Changing the culture of health and social care in the UK to achieve this will be challenging. In a time of austerity The Care Act will increase demand on health and social care services without additional funding. So, The Care Act brings opportunities for older people and carers but the success of its implementation will be challenged by what has been a paternalistic, process driven culture in care services and limited resources to bring about real change. Working with Older People will provide commentary on the difference The Care Act is making to older people through the publication of papers by academics and practitioners at the leading edge of change and organisations representing older people and carers.

This issue of the journal has three papers on care homes. Malcolm Fisk discusses the controversial topic of surveillance technologies in care homes and recommends seven principles for their use. The use of hidden cameras and under cover reporting has publically exposed the abuse and neglect of older people in some care homes. The most recent of these was the Panorama Behind Closed Doors � Elderly Care Exposed programme broadcast on 30 April 2014. Fisk explores the rationale for using surveillance technologies and reports on the views of older people, their carers and care home staff.

Sutton Clinical Commissioning Group (CCG) received a national award this year for their work in improving the quality of care in the care homes commissioned by Sutton CCG and the London Borough of Sutton. Christine Harger�s paper shares this best practice in commissioning care.

Sally Boyden reviews what makes a difference for people living with dementia in care homes and how care home staff are able to respond to this. Her research found that staff presence is essential to facilitate social interaction but staff are often too busy providing physical care to meet this important need.

A personalised approach to improve the life experience of people living with dementia is also discussed in Elaine Argyle and Tony Kelly�s paper on using musical interventions.

This issue has two papers on the commissioning of care services. In addition to Christine Harger�s paper there is one by Valerie Lipman who reviews the current provision of care services targeted at Black and Minority Ethnic (BAME) older people. Her findings give cause for concern as evidence shows that voluntary organisations providing care for BAME elders are experiencing disproportionate cuts in funding compared to mainstream voluntary organisations. Lipman makes recommendations for commissioners and providers of services to improve access to services for BAME elders.

Jill Manthorpe et al. explore the challenges for an older person when they are caring for their child because they have a life long disability or health problem. The need for practitioners to support older carers in meeting their needs and to balance this with the autonomy and choice of the person being cared for is discussed. It highlights the complexities of supporting a person in making decisions and meeting the needs of the family carer and the person being cared for.

The line up of papers for this issue of the journal reflects the challenges of delivering person centred care with limited resources. It is important that research findings on how we need to improve the quality of care to older people and examples of what is working well are shared. Working with Older People brings together policy and research with examples of practical implementation and reports back on what older people and their carers say is important. Please share your experience in implementing The Care Act and tell us about the difference it is making to older people and their carers. Information for contributors to the journal can be found at www.emeraldinsight.com/wwop.htm

References

The Care Act (2014), �The Care Act�, available at: http://services.parliament.uk/bills/2013-14/care.html, www.legislation.gov.uk/ukpga/2014/23/contents/enacted (accessed 18 March 2015).

Department of Health (2008), Transforming Adult Social Care LAC (DH1), Department of Health, London

Norrie, C., Weinstein, J., Jones, R., Hood, R. and Bhanbro, S. (2014), �Early experiences in extending personal budgets in one local authority�, Working with Older People, Vol. 18 No. 4, pp. 176-185, available at: www.bbc.co.uk/iplayer/episode/b042rcjp/panorama-behind-closed-doors-elderly-care-exposed (accessed 19 March 2015).