Contents

About the authors

Acknowledgements

Foreword

Introduction

The shortcomings of social care

The need for change

How the book is organised

Part One The Background to Person-Centred Support

1 Setting the scene for social care

Introduction

The nature of social care

Making broader connections

The problem with social care

The ambiguity of social care reform

The Standards We Expect project

Carrying out the project

Summary

2 Person-centred support

Introduction

The origins of person-centred support

Definitions of person-centred support

Person-centred support: what people say

Summary

Part Two Person-Centred Support: Barriers and Ways of Overcoming Them

3 The funding of social care

Introduction

Social care funding problems

The scale of the problem

Summary

4 The social care workforce

Introduction

Training

Supervision and support

Pay

Status

Inadequate staffing levels

The restructuring of social care roles

Summary

5 Social care and carers

Introduction

Restrictions on service users’ say

Barriers to independence

The parallel problems for families

Overcoming the barriers

The problem with ‘informal care’

Summary

6 Institutionalisation

Introduction

Collective disempowerment

Barriers to change

Addressing institutionalisation

Overcoming institutionalisation

Institutionalisation or isolation?

The importance of getting together

Summary

7 Organisational issues

Introduction

Increasing bureaucratisation

Imposing diversions

The emergence of improvements

The issue of ‘risk’

Conflicting responsibilities

Summary

8 Social care practice

Introduction

Avoiding assumptions

A disempowering culture

The importance of flexible practice

Summary

Part Three Broader Issues for Person-Centred Support

9 Service user cameos

Introduction

Reflections

10 Capacity-building for support

Introduction

Increasing access to support

Improving engagement, building capacity

Summary

11 Access to the mainstream

The message of ‘independent living’

Transport

Education

Disability discrimination

Unequal access to mainstream policy and life

Summary

12 Participation

Introduction

Power

Barriers to involvement

The lack of change from involvement

Helpful approaches to user involvement

Working towards better involvement

Summary

Part Four Making Change to Achieve Person-Centred Support

13 Change for person-centred support

Introduction

Person-centred support

Barriers to person-centred support

Overcoming barriers

The problem of funding

Culture change

A systemic approach to person-centred support

Ideas and theories about change

Our approach to change

The process of the project

What we learned

What did we achieve?

Principles for agency change

Drawing on other evidence

The standards we expect

Summary

Appendix One The Standards We Expect. How we did it: project methodology and methods

The proposed project

Our consortium

The services involved

Our research approach

How we carried out the project

The Change seminar

Who took part in the Standards We Expect project

Appendix Two The Standards We Expect: associated publications

Appendix Three The Standards We Expect. How we did it: project materials and resources

Online appendices

Index