Annex 1: Conventional modes of social
Social care services have conventionally (including
in official policy) been categorised in terms of Personal Care
and Practical help. Personal care is help with Personal
care-related Activities of Daily Living (PADLs). These relate
to self-care (washing, bathing, dressing and undressing, etc.;
eating and drinking; continence; mobility; managing prescribed
treatment; behaviour management and personal safety), as well
as supervision, advice, encouragement, emotional and psychological
support, etc. Personal care is sometimes defined as non-healthcare
services that involve "touching the body". Practical
help is assistance with Instrumental Activities of Daily Living
(IADLs), such as cleaning, cooking, shopping and participating
in leisure activities.
These services have been seen (again according to
conventions that have been reflected in policy) as provided in
settings that are either residential or non-residential / community-based.
Residential care settings
include the following:
These provide personal care along with, where appropriate,
nursing care from visiting District Nurses (employed by local
NHS Community Nursing Services).
housing / sheltered housing
In this setting, residents receive personal care
and, where appropriate, nursing care, on the same basis as in
a residential home, but retain a degree of independence. They
live in their own self-contained accommodation with support available
round-the-clock, usually from an on-site warden. "Extra-care
housing" is a form of sheltered accommodation with additional
services, such as the provision of meals and laundry.
These provide both personal care and intensive nursing
care (provided by registered nurses employed by the home; such
care is now funded by the NHS for all nursing home residents).
The distinction between nursing homes and other types of residential
care is becoming less marked as all forms of residential care
increasingly cater for people with high levels of dependency.
Lives Schemes / Adult Placement Schemes
These are a type of "adult fostering" service,
whereby individuals and families in local communities provide,
in their own homes, care and accommodation for one person (or
sometimes a small group of people). This form of care is currently
only provided for a very small number of people.
Non-residential / community-based settings
include the following:
These provide help with PADLs. Care workers can be
visiting or live-in.
These provide practical help with IADLs.
/ day care centres
These communal services provide services including
hot lunches, entertainment and diversionary activities, adult
education, bathing facilities, chiropody / podiatry (footcare),
and facilities for self-help and health education groups.
meal services (meals-on-wheels)
This service is provided for people who are unable
or unlikely to cook for themselves.
This includes services such as occupational therapy,
which assists people with impairments and disabilities to achieve
health and well-being by improving their ability to carry out
residential care or overnight respite care
This entails taking a person into a residential setting
for a very short time, assisting carers, by allowing them time
off from caring. Respite care can be provided as part of Shared
Lives Schemes / Adult Placement Schemes.
of specialist equipment and home adaptations
This includes items such as ramps, hand-rails, hoists
and stair lifts. It is often funded through the Disabled Facilities
Grant (which is administered by borough / district councils where
there is two-tier local government).
These are schemes to help people to live more independently
in their own homes. Unlike other social care services, clients
are able to approach the provider organisations directly, without
assessment, referral or the organising of a package of care.