Introduction

‘Adult social care’ is a broad term to describe the practical assistance that is provided to people over the age of 18 who are assessed by a social worker as needing various forms of care and support. This can often be to do with activities of daily living, such as getting up, getting washed, eating and other personal care needs. Typically, groups of people using such services include older people, disabled people, people with mental health problems and people with learning difficulties, and traditional services have often taken the form of home care, day care, meals services and residential care. Whereas a qualified social worker would typically assess people's need for support, any subsequent services might be provided by social care providers in the public, private or voluntary sector. Given that so much care and support is provided within families, adult social care also works with family carers to help meet their needs and those of the person being cared for. However, issues such as child protection, work with so-called ‘troubled families’ and welfare rights advice would typically be provided by other services, and these are covered elsewhere in this book.

Of all the service areas explored in this edited collection, adult social care is arguably one of the most neglected and the least well understood. While the National Health Service (NHS), for example, is usually seen as a service that provides care to people when they are most in need, adult social care has tended to have a more mixed reputation, based on a combination of ‘care’ but also of state ‘control’. With origins in the Poor Law and in the workhouse, it is based, in part, on a history of stigma, of segregation and of potentially very intrusive attempts to distinguish between ‘deserving’ and ‘undeserving’ poverty (for an overview of the history and nature of adult social care, see Means and Smith, 1998; Means et al, 2002; Payne, 2005; Glasby, 2012). Whereas health services are provided free at the point of delivery to people we see as being ‘sick’, people who are somehow merely frail or disabled are left to rely on local authority adult social care services, which are means-tested and typically incur significant user charges.