ABSTRACT
In 1985 the concept of an NHS trust was not even a speck on the horizon. Community and acute health care were run by a single authority. The staff of the Intensive Domiciliary Care Service (IDCS) have felt that this lack of stability in management has meant that, over time, those with budgetary control have begun to lose their appreciation of the service and its history of changes and, consequently, important areas have remained unclear in terms of responsibility. With the advent of separate NHS trusts, the IDCS has become increasingly separate from acute services, and thereby more isolated. An area of importance within the IDCS has been the continuous training and support given to the care assistants. The Darlington Intensive Domiciliary Care Service has been successful in providing a new quality care service for elderly patients in the spirit of the NHS and Community Care Act.
