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By Roger Hadley

This text-book examines the coverage and organizational context for neighborhood care, and comprises interviews and case reports, displaying how neighborhood care is (or isn't really) operating in the parts of deal with the aged, studying disabilities, psychological well-being and actual disabilities.

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Extra resources for Care in Chaos: Frustration and Challenge in Community Care

Example text

In the previous organization, there had been extensive complaints from staff about the complexity of the matrix system and the uncertainty as to who was responsible for what. With this went a feeling of lack of accountability. The new organization went a considerable way to meeting both kinds of criticism. It's a clear management structure, a clear system of accountability and dedicated specialist energy in the business. The home care service is given as an example. [It] is all managed under one lead manager and the whole business is managed under them.

I think the impact has been appalling. Basically it is privatization. Local authority investments in community care services have been treated unevenly and sacrificed to the development of an untested and often unregulated market. It is covert privatization that's hitting many vulnerable people. The poverty gap in this city has been documented and is widening between the rich and the poor. The financial means testing supporting the new legislation has created new rifts. The social services department has had to cut staff and focus its strategy on the defence of the most vulnerable users.

Most interviews took between one and a half and two and a half hours; they were taped and transcribed. Case studies were drafted by the authors and sent to interviewees for comment, changes and corrections. They had full control of whether material should be used or not and of provisions for ensuring their personal anonymity. To protect their identity fully both contextual and personal characteristics have been altered. It is a telling comment on the nature of the worlds in which they work that by far the largest number of changes requested by members of the sample were to strengthen the anonymity of their contributions.

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