COMMUNITY CARE

Community Care: Literature Review



Table of Content

INTRODUCTION3

THE MEANING OF COMMUNITY CARE AND THE SIGNIFICANCE OF THE HOUSING ROLE6

THE IMPLEMENTATION OF COMMUNITY CARE ACT FROM A HOUSING PERSPECTIVE: THE POLICY SECTOR10

JOINT COMMUNITY CARE PLANNING11

CONCLUSION13

ANNOTATED BIBLIOGRAPHY16

REFERENCES21

Community Care: Literature Review

Introduction

The community care reforms have been referred to as a 'revolution' (Hutton and Trocchio, 2007, pp. 11-12), which is underpinned by the principles of 'normalisation,' 'social role valorisation,' 'independent living', 'social integration', 'empowerment' and a number of others. Housing researchers working within the discipline of 'housing studies'have been particularly vociferous in making associations between the community care reforms and the principles cited above although, sometimes paradoxically, (Wegmiller, 2006, pp.29-33) it is contended that the housing role within the policy framework is ill-defined, ambiguous and therefore marginalised:

The philosophy of normalisation which underpins community care provision emphasises the aims of integration and of keeping people in socially valued environments such as ordinary housing or in homely settings such as small scale, supported accommodation projects (Owens, 2005, 237-250). The lack of structured context within their, apparently unconsciously, eclectic usage of three particular analytical frameworks has led them to draw these conclusions. First, the pluralism inherent in their implicit usage of Easton's 'black box' model of the political process has led to the conclusion that the 'revolution' was prompted by the impact of an anti-institutionalist pressure group movement which, although consensually opposed to the idea of institutional care, lacked agreement pertaining to an alternative model of care (Levenson, 2008, pp. 45-50). Second, their implicit usage of bottom-up implementation theory assumes apparent policy ambiguity, particularly in relation to the housing role, to emanate from the lack of consensus which existed at the policy-making stage, which consequently translated itself into the alleged ambiguous and negative definition of the policy, vis-a-vis institutional care (Sturm, 2007, pp. 118-121). Finally, the substantive 'bricks and mortar' focus taken by housing researchers to the study of the housing role has led them to associate principles such as normalisation, independence and integration with community care. As such, the emphasis on providing services to disabled people within their 'own homes' or 'homely settings' in the community is seen to be a symbolic manifestation of a political commitment to these principles (Barnett, 2004, pp. 6-12)

However, the failure of housing researchers to locate their investigations of the 'policy sector' within a contextual 'world-view', has led them to construct analyses which have misrepresented the meaning and significance of both community care policy, and the housing role within it. In considering which approach to take to the analysis of the policy and implementation of the housing role in community care, the traditional top-down and bottom-up flame works of implementation theory are obvious starting points. However, prescriptive top down theory, which aims to provide advice which enables politicians and policy-makers to minimise the incidence and extent of 'implementation gaps' and therefore 'policy failure' is inappropriate, and furthermore, lacks context. Although descriptive bottom-up theory has useful things to say about the nature of 'policy' and 'implementation' (Bilton, 2005, 39-43) the overarching emphasis ...