People and concepts in social care
‘Care worker’ is usually a better term than ‘staff’ or ‘employee’ because ‘worker’ includes temporary workers, volunteers, bank or agency workers, etc. These are all people whose care practice we want to improve and support just as much as that of employed staff. We must be cautious about how we use ‘staff’ as in some workplaces it explicitly excludes those other types of workers, e.g. “Agency workers must be supervised by a member of staff until…”
‘Carer’ has two distinct meanings in social care, and Skills for Care is very definite in using only one of those meanings. When we say ‘carer’ it can mean only family or friends who provide care and support, as distinct from care workers. This is the same as the meaning in “Carer’s Allowance” and “Carer’s Assessment”, and in the organisation Carers UK, which has a seat on our board.
This means that we must distinguish our use of ‘carer’ from a widespread use, particularly in the private sector, where carers are care workers. In many cases, then, we need an explanatory sentence or footnote: “‘Carer’ is used throughout to refer to family or friends who provide care and support, as distinct from care workers.”
We can no longer refer to carers as unpaid, as direct payments have allowed payment to carers in some cases. ‘Family carer’ as a generic term does not do justice to non-family friends who act as carers, and risks confusion over what different people and communities might call ‘family’.
Skills for Care’s standards promote understanding the ‘social model of disability’, as distinct from the medical model. This means that we see disability as distinct from impairment. Disability is the social condition(s) imposed upon a person by external factors such as environment, economics, employment, housing, social attitudes, etc., arising from the person being perceived (accurately or not) to have someimpairment. This understanding needs to be reflected in the way that we write about people and their care and support.
So we refer to ‘disabled people’, rather than to ‘people with disabilities’; the disability pertains to the social environment, not to the person it is imposed upon.
individual and individual employer
There are two cases in which we call people ‘individual’.
In standards, such as national occupational standards and diploma standards, the person who is being supported is commonly referred to as ‘the individual’ as this is in keeping with similar types of standards used in other sectors.
Where a person who needs care and support is employing their own care workers (often with the aid of a direct payment), we call them an ‘individual employer’. This term was agreed with the Department of Health in 2012, and replaces our former term, ‘direct employer’.
learning disabilities or learning difficulties
In general, Skills for Care says ‘learning disability’ rather than ‘learning difficulty’, e.g. the “learning disability pathway” in the health and social care diplomas.
But it is worth knowing that the British Institute of Learning Disabilities (BILD) says:
“Many people with learning disabilities prefer to use the term ‘learning difficulty’. The two terms are interchangeable when used in the context of health and social care for adults.
“However, in UK education services, the term ‘learning difficulty’ also includes people who have ‘specific learning difficulties’ (e.g., dyslexia), but who do not have a significant general impairment in intelligence. However, the Special Educational Needs (SEN) codes of ‘moderate learning difficulty’, ‘severe learning difficulty’ and ‘profound multiple learning difficulty’ all refer to generalised learning difficulty of varying severity. Taken together they can be considered to be interchangeable with the adult health and social care term ‘learning disability’. However, people with specific learning difficulties such as dyslexia do not have ‘learning disabilities’.
“The UK is the only country that uses the term ‘learning disability’ in this way.”
(K Holland, BILD Factsheet: Learning Disabilities, Feb 2011)
People needing care or support are often older people, but never ‘elderly’. This is required standard practice across social care. It is technically ungrammatical because it is a ‘hanging comparator’ (it doesn’t say older than what), but it is nonetheless the required usage.
people who need care and support, and carers
‘People who need care and support and carers’ is unclear. It is often incorrect to lump the two groups of people together, in any case. Where they are genuinely to be referred to together, it is important to put in acomma, so that the carers are distinguishable from the categories of needs. So, “People who need care and support, and carers, often say…”
When we are referring to a person’s impairment, rather than the fact of them being disabled by it, taking a social model view means that we want to refer at least as much to the person as to the impairment. So ‘person with mental ill-health’ rather than ‘the mentally ill’, and ‘people with long-term conditions’. People with HIV, in particular, are often referred to as ‘living with HIV’ (where ‘living’ is contrasted with the Aids mortality rate in the 1980s and ’90s, which continues in many other countries).
A common peculiarity in social care parlance is to refer to ‘people with mental health’. In conversation, professionals and many people being supported by them know what this means, but in writing we should say what we mean: ‘people with mental ill-health’ (or illness).
person/people who need(s) care and support
For well over a decade now, Skills for Care has tried to avoid using the term ‘service user’. This is partly from concern about its association with ‘user’ as a pejorative term, but increasingly also about the changing shape of social care, in which traditional ‘services’ are being replaced by people choosing their own care and support.
Wherever possible we should simply say ‘person’ or ‘people’. However, often we need to distinguish one person from another, so we need to say the most suitable of the following, depending on the sense of the sentence and the type of care:
- person/people who need(s) care and support
- person/people being supported
- person/people who use(s) the service(s) (but only if there is a reference to a particular service, to put this in context)
- resident (again, only in context).
If we are quoting someone else’s work or comments, we might have to say ‘service user’, and no-one seems to have a viable alternative to ‘user-led organisations’ (or groups), not least the ULOs themselves.
All social care should be person-centred, not just that delivered by PAs (see below).
Note the hyphen in person-centred. This is not only correct for constructing a single adjective from a noun+adverb, but also allows ‘person-centred’ to be distinct from the use of those two separate words together, as in “My work with this person centred on their need for…”
social care (lower case)
Social care includes:
- social work (see separate entry)
- residential care which may be with or without nursing, depending on how the home is registered with CQC
- domiciliary care (NB spelling: three ‘i’s, one ‘l’) that is delivered on the person’s own premises by visiting care workers who are not to be called ‘home helps’. ‘Home care’ is sometimes used instead of ‘domiciliary care’, but there is a risk of it being misread as ‘care home’.
- day centres for people with various social care needs (transport to and from a centre might be part of a person’s social care provision)
- personal assistants (PAs) who are employed by the person they support. That person – theindividual employer – could be a direct payments recipient or a self-funder. They should be being supported to self care as far as is appropriate for them.
Note that all these types of social care are written in lower case.
social care, rather than ‘the sector’ (lower case)
It is much clearer to say ‘social care’ than ‘the sector’. It may be necessary to say ‘adult’ and ‘in England’ in some contexts. ‘Sector’ is best avoided because it is used both for care sector or health sector, and for independent sector or public sector. As we are part of a sector skills council, however, sometimes we have to say ‘sector’, but we should restrict its use to writing for technically aware audiences who already use it themselves.
social work (lower case)
Social care includes social work, so we do not say ‘social care and social work’ unless we need also to separate them from each other in the same document. It is a long-standing point of Skills for Care policy to keep social work within wider social care, so we must not undermine that by our use of language.
Again, it may be necessary to say ‘adult’ in some contexts, e.g. when working with agencies such as the College of Social Work that deal with both adults’ and children & families social work.
Terms about work and learning
There is a huge array of technical terminology associated with apprenticeships, so refer to our Apprenticeships team to get it right. In general, ‘apprenticeship’ and ‘apprentice’ are general nouns and should be lower case. However, the National Apprenticeship Service, which funds some of our work, likes to distinguish its schemes by using an upper case ‘A’, and it can suit our purposes in some instances to do so too, linguistically incorrect though it may be.
assistive living technologies (lower case)
Technological methods for assisting people’s daily lives. The phrase sounds as though there is such a thing as ‘assistive living’, but there is not. Formerly called ‘assistive technologies’, this includes well-established technologies such as hearing aids and wheelchairs, as well as more recent telephone and online sources of help for disabled people of all ages.
Writing in this area includes references to ‘assisted living services’ which help people to obtain and use ‘everyday living devices’.
awarding organisations (formerly ‘awarding bodies’)
Do not capitalise. This is the generic term for bodies licensed by Ofqual to award qualifications. They also work in partnership with sector skills councils on creating and updating qualifications. Some 26 awarding organisations are active with Skills for Care in this work; we aim to be even-handed among them as they compete with each other.
care workers (lower case) (not ‘carers’, see above)
The workforce (one word) works in workplaces (one word). Workplaces and settings are different from each other; the setting is the type of workplace or indeed the type of work, so settings include ‘residential’, ‘domiciliary’, ‘community’, etc.
The care workforce includes employees, volunteers, agency and bank workers, and ‘temps’. In some workplaces, these workers are distinct from ‘staff’, so we should say ‘workers’ if we mean to include them all.
We should remember that a care employer’s workforce might also include workers who are not involved in direct care delivery, such as ancillary workers including kitchen, maintenance, garden, transport and administration workers.
common core principles
Lower case, unless writing out a full proper title, e.g. the Common Core Principles for Self Care. Common core principles are statements of the overall objectives and values to be applied in particular types of social care work; they are at a higher level than the workers’ specific competences. Often they are joint with the health sector.
Common Induction Standards
Upper case, as this is their full proper name. These are Skills for Care standards for care workers to complete in their first 12 weeks in a new post. They are given regulatory weight by the Care Quality Commission.
competence/s, preferred over competency/ies
Competence / competences and competency / competencies are both correct English, but it is incorrect to get the singulars and plurals mixed-up—you should never have one competence and two competencies, or one competency and two competences.
For the sake of consistency, Skills for Care tries to stick to competence/competences, but if we are writing about or in partnership with something or someone whose term is competency/ies, it may be sensible to use that form instead.
Competence in any particular activity is the combination of knowledge and skills that a worker should have to undertake that activity. We often use the word ‘competences’ to mean the technical descriptions of those combinations of knowledge and skills, which are published in standards or units that the worker’s learning and practice can be assessed against. Some competences are categorised as ‘knowledge only’ for qualifications purposes.
continuing professional development (lower case)
CPD; note continuing, not continuous.
Ongoing work-related learning, by a wide variety of methods, by workers at who are already in the workforce at any level.
It is very difficult to keep up with changes in language in the education, training and development world. In social care we usually use ‘education’ to refer to the academic part of social work training, everything else being training and/or development. Social work has ‘students’, the rest are ‘learners’
Use hyphens (‘full time’ without a hyphen is the end of a football match). Only rarely do we want to refer to ‘full-time equivalents’, i.e. where two part-time workers are regarded as one full-time post, because we want all the workers to have all the skills appropriate to the care they deliver, regardless of how many hours they work. Best avoid the alternative, ‘whole-time equivalent’, which means the same thing.
‘Learning’ has become a difficult word in recent years. It still has its traditional meaning of the activity undertaken by a learner, but it has also acquired a new meaning, as in ‘learning provider’. This indicates the provision of conditions in which a person can be a learner, and is well established on the ‘supply side’. However, it is worth remembering that this new and ungrammatical-sounding form might not be familiar to all your audiences, so in many cases it may be clearer to stick to ‘training provider'.
152 of these in England each incorporate an adult social services department (so they are officially ‘Councils with Social Services Responsibilities’, CSSRs). Do not capitalise. Our work on community skills development may lead us to refer also to lower levels of local government that do not have social services responsibilities, e.g. district councils. These are also local authorities, however, and can be members of the Local Government Association (which has a seat on our board).
Manager Induction Standards
Upper case, as this is their full proper name. These Skills for Care standards are for new and aspiring care managers; they are highly recommended, but have no regulatory requirement and so no time limit.
national occupational standards
Published by Skills for Care and Development, as they are UK-wide. Do not capitalise except for formal use of full title of a suite of standards. NB. Our England-only Common Induction Standards and Manager Induction Standards are not NOS.
newly qualified social worker(s)
Lower case – generic term. Usually in their first year of practice after qualifying.
Lower case – generic term. Hyphenate. Usually refers to social work, so it may be preferable now to refer to the Professional Capabilities Framework (upper case, as it is the proper name of an individual thing) rather than to particular PQ awards.
private and voluntary, or independent, not both
In the private sector (meaning commercial for-profit care businesses), the employer is the proprietor(s) of the business who, in small businesses, may or may not also be the registered person or the manager. In the voluntary sector (meaning not-for-profit care providers, such as charities and social enterprises) the employer is the trustees of the organisation, who again may or may not include the registered person or the manager.There is no such thing as the PVI sector, although that is a common term. PVI stands for private, voluntary, independent, but in fact ‘independent’ includes both private and voluntary (this is reflected in the categories used by our own NMDS-SC). So, it is clearer to say either independent, or private and voluntary, but not all three together.
public / statutory
The public sector and the statutory sector are generally the same thing, so far as social care is concerned. Both terms include local authorities and the NHS (which is a major provider of social care, as well as of health care). Technically, it would be possible for a public sector body to provide a non-statutory service, but in reality this distinction rarely matters for us.
Since 2011, Skills for Care has promoted the diplomas, certificates and awards in health and social care. These have replaced the former NVQs. Refer to our Skills Team for technical information on these; it is an area in which Skills for Care is the authoritative source, so our documents must be absolutely correct in all references to qualifications.
sector skills council (lower case)
There are 23 SSCs at the time of writing, between them representing the employers of some 80 per cent of the national workforce. SSCs are licensed by the Department for Business, Innovation and Skills, and are each by definition UK-wide. As social care is fully devolved across the UK, our sector skills council is an alliance of ourselves for adult social care in England plus the Scottish Social Services Council, the Northern Ireland Social Care Council and the Care Council for Wales. The other countries’ bodies combine adults’ and children and families social care workforce concerns, and are also the statutory regulatory bodies for their territories. In England, children and families social work comes under the Department for Education, and the statutory regulator for social work is the Health and Care Professions Council, but neither of these bodies is part of our SSC.
Hyphenate, as in ‘work-based learning’.
Terms used in commissioning social care and health services
Adult Social Care Outcomes Framework (ASCOF)
A national framework that sets out the outcomes and corresponding indicators against which achievements in social care and health will be measured.
The provision of independent support , helping people to speak up for themselves and ensuring their views are heard, understood and taken into account.
A process which identifies the capacity, skills, knowledge, potential for connections and social capital in a community.
clinical commissioning groups (CCG)
The bodies which will carry out local commissioning of NHS services. They are public bodies holding their meetings in public. Their members will be primary and secondary care doctors, nurse specialists, lay people and others.
clinical networks and clinical senates – the NHS commissioning board
Clinical networks will advise on distinct areas of care such as cancer or maternity. The board will also host new clinical senates which will provide expert multi-disciplinary input to strategic clinical decision-making to inform local and national commissioning.
A management role in social care or the NHS who oversees the day-to-day process of commissioning services.
The process of ensuring that care and health services are provided so that they meet the needs of the population.
Commissioning for Quality Indicators (CQUIN)
A payment framework used in the NHS by commissioners to reward high quality services, by linking healthcare providers’ income to the achievement of quality improvement goals.
community support groups
Organisations providing active help to help vital community organisations to develop their services to the community.
A succinct, easy view graphic display of key performance indicators. For health and wellbeing boards the dashboard may include health and wellbeing outcome measures including of quality and equalities, and of the experiences of people who use the services.
Budgets paid directly to people in need of social care services.
Health Education England
Responsible for the education, training and personal development of every member of staff, and recruiting for values.
Health and wellbeing board (HWB)
Statutory committees of local authorities, which lead and advise on work to improve health and reduce health inequalities among the local population. They have a performance monitoring role in relation to NHS clinical commissioning groups, public health and social care.
Public and patient engagement bodies which have replaced local involvement networks (LINks); they are supported by Healthwatch England, which is part of the Care Quality Commission.
Bringing together the work of partners so that their efforts can be combined. Most commonly applied to the NHS, public health, housing and social care. However, all sectors could potentially have a role in working with people in need of care and support. Integration can avoid the disadvantages of working in silos and offers a joined-up experience to people in need of support services, such as assessment.
Joint strategic needs assessment (JSNA)
The process and documents through which councils, the NHS, people in need of support services, communities and the voluntary sector reach and agree a comprehensive local picture of health and wellbeing needs. Development of JSNAs is the responsibility of health and wellbeing boards. Clinical commissioning groups (CCG) and the NHS national commissioning board will be required to have regard to Joint strategic needs assessment (JSNA) when developing their commissioning plans.
Joint health and wellbeing strategy (JHWS)
Health and wellbeing boards are required to produce a JHWS for the local area based on the needs identified in the JSNA.
local area agreements (LAAs)
Agreements between public sector partners and national government about priority outcomes for local areas, measured by a national indicator set and locally agreed indicators. LLAs are no longer required by government, although councils may wish to retain indicators to assess their health and wellbeing work.
market position statement (MPS)
The MPS brings together, into a single document, material from the Joint Strategic Needs Analysis (JSNA), commissioning strategies and other market intelligence.
It presents the data and analysis the market needs if it is to plan its future role and function. The MPS also identifies the needs and preferences of different people in need of support services in the market, including people privately funding their use of services. It suggests the necessary change and innovation required to service design and delivery in the future. Finally, it provides information on the likely level of future resourcing.
National Health Service England
NHS England sits at arm's length from the government and oversees local GP consortia. It makes sure that consortia have the capacity and capability to commission successfully and meet their financial responsibilities. It also commissions some services directly.
An approach to planning services and assessing their performance that focuses attention on the results, or outcomes – as distinct from inputs and outputs – that the services are intended to achieve.
An approach focusing on the results of investing in a service or providing it in a certain way. Commissioners can be clear about the real benefits they are seeking by defining the outcomes being sought in terms of improved health and wellbeing.
One of a range of options to support the integration of social care and health. While partners such as local government and the NHS can delegate some functions to each other, they may also commit a single or ‘pooled’ budget which is separate from other budgets and is for a specific purpose, thus helping to avoid funding disputes and creating greater flexibility in the use of budgets.
Organisations which are commissioned to provide services direct to people who need them, including hospitals, mental health services, GP surgeries, social care services, etc.
“The science and art of promoting and protecting health and well-being, preventing ill-health and prolonging life through the organised efforts of society.” (UK Faculty of Public Health, 2010). Public health is generally thought of as being concerned with the health of the entire population, rather than the health of individuals – and therefore requiring a collective effort – and as being about prevention rather than cure.
Public Health England
The new national public health service which will integrate the work of a large number of disparate public health organisations into a single, expert body providing advice and services across the range of public health. It will allocate ring-fenced funding to local authorities and will also act on behalf of the Secretary of State in the process of appointing directors of public health (DPH) at the local authority level.
quality outcome framework
Voluntary reward and incentives programme for all GP surgeries in England, detailing practice achievement results.
resource allocation system (RAS)
System each council has for allocating social care budgets to individuals, based on need determined by assessment or self-directed assessment.
A budget where the purpose for which the money is given is defined and the money must be spent on that and not on any other area.
single assessment process
A process for assessing an individual’s social care and health needs without assessment procedures being needlessly duplicated by different agencies.
social determinants of health
The social and economic conditions in which people are born, grow, live work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which themselves are influenced by policy choices.
All the information that collectively enables judgements to be made at a strategic level. This might involve data which is processed and presented so as to become information, evidence, best practice or forecasting.
Universal services are made available to everybody, including those who need social care and support. For example, people who are not eligible for free social services (those who are ‘self funders’) can access advice and information on where they can find services, such as home care or residential care, for which they will pay themselves.
“Feeling good and functioning” (New Economics Foundation, 2008). Creating wellbeing requires mobilisation of the widest assets to ensure community cohesion and safety.