Journal of Social Policy · 2008 · 122 citations · 21 references
Public AffairsSocial PolicySocial WorkHealth Services ResearchIntegrated CareWelfare PolicyCare PolicySocial ReformSocial Welfare PolicySocial Welfare Service DeliveryWelfare ReformWelfare State PolicyAdult Social CareSocial Welfare Reform
Abstract This article reflects on the process and outcomes of modernisation in adult social care in England and Wales, drawing particularly on the recently completed Modernising Adult Social Care (MASC) research programme commissioned by the Department of Health. We begin by exploring the contested status of ‘modernisation’ as a descriptor of reform. We then outline some of the distinctive features of adult social care services and suggest that these features introduce dynamics likely to shape both the experiences and outcomes of policy ambitions for modernisation. We then reflect on the evidence emerging from the MASC studies and develop a model for illuminating some of the dynamics of welfare governance. Finally, we highlight the emerging focus on individualisation and on user-directed and controlled services. We argue that the current focus of modernisation involves a reduced emphasis on structural and institutional approaches to change and an increased emphasis on changes in the behaviours and roles of adult social care service users. This focus has implications for both the future dynamics of welfare governance and for conceptions of citizenship.
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