Adult social care

Adult social care

The role of adult social work in adult mental health was defined by The College of Social Work in 2014 as falling into one of five categories (Department of Health, 2016):

  • ‘Enabling citizens to access the statutory social care and social work services and advice to which they are entitled, discharging the legal duties and promoting the personalised social care ethos of the local authority.
  • Promoting recovery and social inclusion with individuals and families.
  • Intervening and showing professional leadership and skill in situations characterised by high levels of social, family and interpersonal complexity, risk and ambiguity.
  • Working co-productively and innovatively with local communities to support community capacity, personal and family resilience, earlier intervention and active citizenship.
  • Leading the Approved Mental Health Professional (AMPH) workforce’.

There are a range of roles social worker may take on which fit within these categories – as shown in the diagram below. For example:

  • Some people with mental health conditions may be supported by social services to meet their health or social care needs.
  • Social workers make up 95% of Approved Mental Health Professionals (AMHPs), who coordinate Mental Health Act assessments (125).
  • Some social workers based within mental health services, with one 2018 survey of NHS trusts finding that 80% of community mental health teams included social workers (Abendstern et al., 2022). National research suggests that service users and carers value social workers for their holistic and person-centred approach (Abendstern et al., 2022).
  • People who have been detained under certain sections of the Mental Health Act are entitled to free health and social care after they leave hospital, which is known as Section 117 aftercare.

Figure 1: The social work contribution to health settings. Image source: Health Education England

Pressures on adult social care have a direct impact on the NHS. Workforce pressures can make it harder to meet people’s mental health needs in the community, leading to poorer outcomes and making it more likely that people will be admitted to hospital. Similarly, pressures on social care can also delay discharge from hospital (NHS England, 2023).

What is the local picture?

The analysis below provides an overview of key measures relating to mental health social care across Cambridgeshire County Council and Peterborough City Council, from 2021/22 to 2023/24.

  • It is difficult to interpret trends in data due to the impact of the COVID-19 pandemic on social care provision and assessments; and potential differences in data recording between the councils. It is also important to note that these analyses primarily focus on people with a primary support reason of mental health, and do not cover people with other primary support reasons who may also require support around mental health.
  • The rate of Care Act Assessments where mental health was the primary support reason did not significantly change for people aged 18 – 64 in Cambridgeshire in 2023/24 to 2022/23, but significantly declined for those aged 65+. Comparatively, the rate of assessments completed for mental health has increased over the last two years for people aged 18 – 64 and 65+ in Peterborough.
  • In Cambridgeshire and Peterborough in 2023/24, the rate of assessments where the primary need was mental health which had the outcome of long-term care was 2 – 3 per 10,000 for people aged 18-64 and 6 – 7 per 10,000 for people aged 65+.
  • The most common long-term support type for service users with mental health as a primary support reason was community-based support. Adults aged 65+ were more likely to receive nursing and residential support.
  • Most service users with a primary support need of mental health also required support for their physical health. The next most common additional needs were around having a habitable home and accessing community facilities for people aged 18 to 64; and around nutrition and hygiene for people aged 65+.

Additional resources

References

Full list of references is included at the end of this chapter.

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