First published in 1986, Matching Resources to Needs describes the PSSRU’s community care approach and analyses the first of the community care projects, a seminal set of experiments in the care of the elderly at high risk of institutional long-term care. The experiments create field structures which provide incentives to improve efficiency, decentralised power over resources being balanced by enhanced accountability. The first part explains the approach, analyses the causes of inefficiency in ~British social care, and reviews British and American evidence about the relationships between resources, recipient characteristics and outcomes. The approach is compared with some two dozen American experiments hitherto unknown in the UK. It describes the design of the project and its evaluation. The authors then examine the experimental results. They show that cost and welfare effects are better and the costs of outcomes are lower for recipients of community car. The third part of the book uses observational and other data to explore the relationships between structures, assumptive worlds, causal processes and outcomes and their costs. It also analyses the performance of the core tasks of entrepreneurial case management for types of case. The book concludes with a discussion of the broader implications of this approach to community care.


This title was first published in 2000: Caring for Older People provides a unique insight into the world of community care in the 1990’s. It presents findings from a national study of social care from the perspectives of older service users, their carers and care managers. Descriptive findings from this longitudinal study - conducted by the PSSRU from 1994 and funded by the Department of Health - are set in the context of the history of community care and developments since the passage of the 1990 NHS and Community Care Act. The study’s findings highlight important challenges for policy and practice development in the new millennium.


This title was first published in 2003: This book provides an evaluation of the Gateshead Community Care Scheme which was devised as an alternative to residential and hospital care for frail elderly people. An important feature of the scheme was the decentralization of control of resources to individual social workers acting as care managers, with defined caseloads and expenditure limits to ensure accountability. The initial social social care scheme was subsequently extended to provide both health and social care to clients from a large general practice based in a health centre. The social care team was enlarged to include a nurse care manager and part-time doctor and physiotherapist. The study examines the operation of care management in both settings, the use of devolved budgets and services developed, the outcomes for clients and carers and the costs of care. Admissions to residential care were reduced and the elderly people who received the scheme’s support experienced a better quality of care and greater well-being when compared with elderly people receiving the usual range of services. This was achieved at no greater cost. The characteristics of those for whom the scheme was most appropriate are described. In addition, the pattern of development of the scheme as it was incorporated into the mainstream of the Social Services and after the implementation of the NHS and Community Care Act are examined. Final, the implications for the development of care management are considered.