# 3 The contexts for care

The contexts in which social care is provided are very diverse. The ways in which social care services are provided will depend on a number of elements contributing to the context, as illustrated in Figure 1.

Figure 1 The contexts of social care

From Figure 1, you can see the different contexts for social care provision. This varies depending on service users’ needs, the setting in which services are provided, the provider type and country they are living in.

The delivery of any service depends on the nation where it is delivered. While each of the four nations of the United Kingdom share some fundamental aspects, there are also differences in legislation and policy. Services are provided in many different settings, ranging from people’s own homes or community locations through to residential and day services. The same social care professionals may work across more than one of these settings. Social care services are provided within what is sometimes referred to as a ‘mixed economy of care’, defined by the Social Care Institute for Excellence (SCIE) as ‘provision of services from a variety of sources including the statutory agencies and the private and voluntary sectors’ (SCIE, 2021).

The statutory sector comprises government organisations such as Local Authorities, Health and Social Care Partnerships or Trusts. Voluntary sector are non-governmental organisations such as charities or social enterprises. This sector is also known as the community or third sector and services are based on social purpose, community impact and are not-for-profit. Not-for-profit organisations reinvest income into the organisation, to benefit people in the community. The private sector is also non-governmental but is for-profit, like a business. Many care homes and domiciliary care providers are in the private sector, and there are different patterns of this across the UK. Together the voluntary and private sectors are sometimes described as the independent sector.

Within any setting, services are provided to people based on different needs for care, protection, rehabilitation or support, and these can arise for people for many reasons, including disability, age or family difficulties.

In the next activity, you will hear once more from Natalie and Robyn, and explore further the contexts in which they work.

## Activity 3 Social work and social care in context

Allow 45 minutes for this activity

Look back at the similarities and differences in Natalie’s and Robyn’s roles which were noted in the discussion to Activity 2. Then listen to the following audio in which Natalie and Robyn talk about the context of their work. Both work with older people who are near the end of their lives; however, depending on their roles, their work takes place within different contexts. Note down your answers to the questions that follow.

Natalie (left) and Robyn (right)

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Transcript

1. Natalie is based in Wales, and Robyn works in England. How does the national context in which each of them works affect registration and funding of the services they provide? How does the national context impact on the work for Natalie and Robyn?

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2. Accountability is an important part of both Natalie’s and Robyn’s work. What does each of them say about the meaning of accountability in their roles?

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3. Robyn and Natalie both work with a large range of other services and professionals. How many can you identify?

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### Discussion

National context

Natalie’s professional registration as a social worker is with the Welsh Government, through Social Care Wales. As a social care worker in England, Robyn does not need to be registered; however, the Garth is registered with the Quality Care Commission for Herefordshire as a nursing home and provider of home care services.

Funding

The funding of services at the Garth, where Robyn works, is offered to people who live on both sides of the Welsh/English border. Some funding is private – in other words, the people receiving the service pay for themselves – but some services are funded by the NHS or by social services. For people living in Wales, health funding would be from the Hereford and Worcester Clinical Commissioning Group, while people living in neighbouring Powys would be funded by the Powys Teaching Health Board. Robyn also mentions that some funding comes from St Michael’s Hospice, which is a third-sector provider. ‘Third-sector’ refers to services that are sometimes described as ‘voluntary’, ‘not-for-profit’ or ’charitable’ provision.

Accountability

Robyn’s response captures her understanding of accountability as making sure that people who use the Garth receive ‘the best possible outcomes of their care with us’. For Natalie, social worker accountability is about seeking and responding to feedback on providing ‘support and protection’ for people.

Robyn talks about her role as a carer but also as a manager, and so she both receives and provides line manager appraisals to ensure that the quality of care offered is maintained. She has a responsibility to implement the values statement of the service and to implement quality assurance processes such as spot checks, audits and responding to complaints. Natalie, as a registered social worker, must abide by the codes of practice, legislation and policies applicable to her role. To maintain her registration, she has to continue her professional development through training and supervision. Natalie also talks about the need to be able to justify the decisions she makes that inform her practice.

Other services

Below is a list of the people mentioned by Robyn and Natalie. There may be more, but this gives you an idea of how important building and maintaining networks is in social care work.

- Social workers
- Occupational therapists
- Physiotherapists
- General practitioners
- District nurses
- Domiciliary workers
- Third-sector workers
- Private carers
- Family members/informal carers
- Care home managers
- Speech therapists
- Carers in care homes

Don’t worry if the contexts in which Robyn and Natalie work seem confusing just now. The reality is that the contexts for social care are complex. The roles of social workers and social care workers have much in common, but there are important differences. Differences also arise from the nation in which people work, and these become even more complex when services cross national boundaries, as they do for the Garth.

Robyn and Natalie both support older people and those nearing the end of their lives. As you work through this course, you will become more familiar with specific services that are offered to people with other needs.

While thinking about the challenges of professional accountability, Robyn describes an instance of when she needed to balance risk and the right of a man for whom they were providing services to make his own decisions. This tricky balancing of risk and rights is one way in which practice is guided by professional codes of practice, which you will learn more about in the next section.

OpenLearn - Introducing social care and social work
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