COMMUNITY CARE / Three years' preparation ends with a scramble

IN OXFORDSHIRE they are as ready as they will ever be. The administrative computer systems are in place. The management team have all completed their financial and forward planning - just. And the social workers, home care organisers, care assistants and newly-titled care managers have been trained how to assess, plan and deliver community care, writes Rosie Waterhouse.

For three years they have been building co-operation with other agencies, which must all work together if community care is to succeed - the social services department, Oxfordshire district health authority, the Family Health Services Authority, fund holding GPs, district nurses and hospital doctors.

But even in Oxfordshire there were unexpected last-minute hitches. Until last week the community care planning team had omitted to include the unusually high number of homeless mentally ill people in its budgets. In the city of Oxford 2,500 people use the Luther Street medical centre for homeless people. An estimated 520 people are in hostels for the homeless each night while 100 sleep rough. Hard choices must now be made about which other services must be cut to find pounds 234,000 extra for the homeless mentally ill.

Another cause of last-minute panic was the community care plan that all local authorities must publish annually. One of its most controversial aspects was a list of priorities that showed 'rationing' was inevitable.

Response times range from assessment within 10 working days and some service with 14 days for high priorities, to assessment within 15 days and some service within 28 days for medium priorities, to 'if available, service within one month' for low priorities.

Oxfordshire staff were optimistic that in the long term people would benefit from a more 'user friendly' system, catering for their individual needs. But progress would be undermined by lack of resources.

Ian White, Oxfordshire's director of social services, has a nightmare that they have underestimated the number of elderly people who will need residential care which would upset the rest of the budget. Or they could have miscalculated the number of beds they might need to keep discharges from hospitals flowing. If so, waiting list targets will be missed, and relations with the hospital staff will be strained. Or if the private homes increase prices there will be less money to spend on care in people's homes.

Angela Avis, professional head of district nursing for Oxfordshire, says: 'If the needs are assessed and the social services cannot afford to provide the services then the health service will have to step in to provide the service. For instance the district nurse may find herself helping an elderly person get up, washed and dressed, which should be the home care worker's job.'

Gill Duncan, senior nurse in district nursing, fears for the vulnerable frail elderly: 'Because more money will be tied up in residential homes there will be less money for care in people's homes. From the health side of things the fear is we will be left to pick up the bill, social services can't afford to provide proper care in their own homes, so they must stay in hospital, the system gets silted up and no new people can get into hospital. Those who will slip through the net are those considered lower priorities, people with drug and alcohol problems and the homeless.'

PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
News
ebookA unique anthology of reporting and analysis of a crucial period of history
Arts and Entertainment
Sheeran arrives at the 56th annual Grammy Awards earlier this year
musicYes, that would be Ed Sheeran, according to the BBC
Arts and Entertainment
AKB48 perform during one of their daily concerts at Tokyo’s Akihabara theatre
musicJapan's AKB48 are one of the world’s most-successful pop acts
News
Ian Thorpe has thanked his supporters after the athlete said in an interview that he is gay
people
News
The headstone of jazz great Miles Davis at Woodlawn Cemetery in New York
news
Arts and Entertainment
Brendan O'Carroll has brought out his female alter-ego Agnes Brown for Mrs Brown's Boys D'Movie
filmComedy holds its place at top of the UK box office
News
newsBear sweltering in zoo that reaches temperatures of 40 degrees
Arts and Entertainment
Professor Kathy Willis will showcase plants from the Royal Botanic Gardens at Kew
radioPlants: From Roots to Riches has been two years in the making
Arts and Entertainment
TV The follow-up documentary that has got locals worried
Arts and Entertainment
Eminem's daughter Hailie has graduated from high school
music
Arts and Entertainment
Original Netflix series such as Orange Is The New Black are to benefit from a 'substantial' increase in investment
TVHoax announcement had caused outrage
Life and Style
Swimsuit, £245, by Agent Provocateur
fashion

Diving in at the deep end is no excuse for shirking the style stakes

News
One Direction star Harry Styles who says he has no plans to follow his pal Cara Delevingne down the catwalk.
peopleManagement confirms rumours singer is going it alone are false
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Advertising and Marketing Communications Manager

£52000 - £58000 per annum + benefits, company car: Ashdown Group: Advertising ...

Senior Marketing Executive (B2B/B2C) - London

£32000 - £35000 per annum + benefits: Ashdown Group: Senior Marketing Executiv...

JavaScript Developer (HTML5, Ext JS, CSS3, jQuery, AJAX)

£40000 - £70000 per annum + Benefits + Bonus: Harrington Starr: JavaScript Dev...

Dynamics CRM Developer (C#, .NET, Dynamics CRM 2011/2013)

£40000 - £60000 per annum + Benefits + Bonus: Harrington Starr: Dynamics CRM D...

Day In a Page

Super Mario crushes the Messi dream as Germany win the 2014 World Cup in Brazil

Super Mario crushes the Messi dream

Germany win the 2014 World Cup in Brazil
Saharan remains may be evidence of the first race war, 13,000 years ago

The first race war, 13,000 years ago?

Saharan remains may be evidence of oldest large-scale armed conflict
Scientists find early warning system for Alzheimer’s

Scientists find early warning system for Alzheimer’s

Researchers hope eye tests can spot ‘biomarkers’ of the disease
Sex, controversy and schoolgirl schtick

Meet Japan's AKB48

Pop, sex and schoolgirl schtick make for controversial success
In pictures: Breathtaking results of this weekend's 'supermoon'

Weekend's 'supermoon' in pictures

The moon appeared bigger and brighter at the weekend
Iraq crisis: How Saudi Arabia helped Isis take over the north of the country

How Saudi Arabia helped Isis take over northern Iraq

A speech by an ex-MI6 boss hints at a plan going back over a decade. In some areas, being Shia is akin to being a Jew in Nazi Germany, says Patrick Cockburn
The evolution of Andy Serkis: First Gollum, then King Kong - now the actor is swinging through the trees in Dawn of the Planet of the Apes

The evolution of Andy Serkis

First Gollum, then King Kong - now the actor is swinging through the trees in Dawn of the Planet of the Apes
You thought 'Benefits Street' was controversial: Follow-up documentary 'Immigrant Street' has got locals worried

You thought 'Benefits Street' was controversial...

Follow-up documentary 'Immigrant Street' has got locals worried
Refugee children from Central America let down by Washington's high ideals

Refugee children let down by Washington's high ideals

Democrats and Republicans refuse to set aside their differences to cope with the influx of desperate Central Americas, says Rupert Cornwell
Children's books are too white, says Laureate

Children's books are too white, says Laureate

Malorie Blackman appeals for a better ethnic mix of authors and characters and the illustrator Quentin Blake comes to the rescue
Blackest is the new black: Scientists have developed a material so dark that you can't see it...

Blackest is the new black

Scientists have developed a material so dark that you can't see it...
Matthew Barzun: America's diplomatic dude

Matthew Barzun: America's diplomatic dude

The US Ambassador to London holds 'jeans and beer' gigs at his official residence – it's all part of the job, he tells Chris Green
Meet the Quantified Selfers: From heart rates to happiness, there is little this fast-growing, self-tracking community won't monitor

Meet the 'Quantified Selfers'

From heart rates to happiness, there is little this fast-growing, self-tracking community won't monitor
Madani Younis: Five-star reviews are just the opening act for British theatre's first non-white artistic director

Five-star reviews are just the opening act for British theatre's first non-white artistic director

Madani Younis wants the neighbourhood to follow his work as closely as his audiences do
Mrs Brown and her boys: are they having a laugh?

Mrs Brown and her boys: are they having a laugh?

When it comes to national stereotyping, the Irish – among others – know it can pay to play up to outsiders' expectations, says DJ Taylor