Social Care - Health Committee Contents

Annex 1: Conventional modes of social care

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:

—  Residential homes

These provide personal care along with, where appropriate, nursing care from visiting District Nurses (employed by local NHS Community Nursing Services).

—  Supported 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.

—  Nursing homes

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.

—  Shared 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:

—  Homecare services

These provide help with PADLs. Care workers can be visiting or live-in.

—  Home help services

These provide practical help with IADLs.

—  Drop-in / 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.

—  Home meal services (meals-on-wheels)

This service is provided for people who are unable or unlikely to cook for themselves.

—  Professional support

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 daily activities.

—  Short-term 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.

—  Provision 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).

—  Grant Funded Services

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.

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Prepared 12 March 2010