The evaluation of outcomes, monitoring and review are essential components of the ‘production of welfare’ approach to care management exemplified by early research into community care in Kent and elsewhere (Payne, 1995). The successful evaluation of outcomes of course depends upon the clarity of objectives at the care planning stage, where clear goals are specified and strategic plans are worked out in order to achieve those goals. The monitoring process will then check that services are on target to meet those objectives. A review, however, is an opportunity for change by allowing participants to stand back and reconsider what those goals should be, adjusting interim plans accordingly. Any method of social work practice which fits this model will need to give as much emphasis to monitoring and review as to initial assessment. If a mechanistic approach is taken to case monitoring and review, the complexities of relationships involved in supporting people in the community can become stereotypical. Short-term pragmatic issues will also tend to predominate over long-term aspirations. Searching for Service (SSI/DoH, 1996a) identified this as a particular problem for young people with a learning disability, where ‘getting through the week’ took precedence over the longer-term evaluation of educational and social needs. Monitoring and review are thus essential tools for good social work practice. They also assume that the effectiveness of social work intervention can be evaluated. Proper monitoring and review means that care packages should be reviewed as a whole and not, as they often have been, by way of separate reviews, for example, in residential care and day care. The contribution of day care, home support services and residential care is however evaluated in this chapter in terms of their efficiency and effectiveness in supporting vulnerable people in the community, and in the recognition of their pivotal role in contributing to care packages.
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