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Friday, September 25, 1998 Published at 12:57 GMT 13:57 UK


Health

What the social care reforms mean

The proposed reforms will affect thousands of vulnerable people

Many of the issues leaked in the draft Social Services White Paper have been debated for some time.

But, although they will have a major impact on wide numbers of the people, they have received little public attention.

BBC News Online looks at the debate on the main proposals:

General Social Care Council

Junior health minister Paul Boateng announced in April that the council would be phased in gradually.

It will establish codes of practice for all social care staff.

It will also decide who is registered and when. The register will cover not only social workers, but other care staff. Being on it will depend on possessing the relevant qualifications and training.

All employers will have to sign up to a code of good employment, which will emphasise their responsibility to check that new staff are properly trained.

Social services chiefs are keen to have a national register in order to reassure the public. And they want it to begin with child care staff.

Recent child abuse cases and the Utting report, an important report on children in care, have undermined confidence.

Around 80% of Britain's 1.2m social care workers do not have professional qualifications.

Social work trainers warn that giving them up-to-date training will be an enormous task.

Qualified staff are already registered, but the government wants to use the GSCC as a way of encouraging more training and qualifications.

The GSCC will have a lay chairman and members appointed by the Health Secretary.

Independent inspections

While the 1984 Registered Homes Act requires private and voluntary homes to be registered, inspected twice-yearly and regulated by the local authorities, local authority homes have no such statutory requirement - although they do have to be inspected under the 1991 Community Care Act.

Inspections are carried out by local authority inspectors.

The same is true of small children's homes (with fewer than 4 children run by for-profit orgs) and domicilary services (care given to people in their homes - home helps or whatever).

Under the proposals, nine independent regional authorities will be created and will have sole responsibility for regulating care services for both adult and childrens' services.

They will replace the estimated 250 local authority and health authority inspection teams which exist at present.

The government will draw up national standards for the inspectors to monitor.

They will have powers to serve improvement notices, to prosecute and de-register.

Care home managers will have a right of appeal against any decision.

The services covered will include care homes, foster agencies, boarding schools and home care services.

National frameworks

There will also be national frameworks on charging for domiciliary care, on carers and on access to services.

Currently, eligibility for care services can be altered according to a local authority's financial position.

Many cash-strapped local authorities have changed their criteria and effectively rationed care so that only the most vulnerable receive services.

Some have introduced charges or raised charges for domiciliary care. Age Concern says the current system is "a lottery determined by your postcode".

Its director general, Sally Greengross, said: "It is essential to reduce the variation in quality and levels of service which older people in different parts of the country receive."

Long-term care charter

The proposed long-term care charter has been promised for some time.

Several private and voluntary care homes have their own charters which operate along the lines of the NHS Patient's Charter.

The National Care Homes Association has a code of conduct and residents' charter for its members.

The charter spells out residents' right to privacy, dignity and other issues such as religious worship.

The Association says it is going to offer the charter to the government as a blueprint for the proposed long-term care charter.

Other issues concerning long-term care are being discussed by the Royal Commission on Long-Term Care which should report its findings by the end of the year.



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