ABSTRACT
This chapter considers the first two settings - generic and dedicated care management. The community care settings were studied through the process of care management and the data were gained through discussion with care/case managers. The hospital-based generic care managers were attached to hospital rehabilitation units, and principally specialised in working with younger disabled people. The care managers/social workers criticised the limited help given by the home care service based in the social services department. An extended complex community care assessment, rather than a standard assessment, was usually carried out to set up a care package for people with a severe disability. A head-injured man lived in a Middleshire local authority residential unit for nine years, awaiting a compensation settlement so that he could live independently and buy his own care. Traumatic brain injury patients’ average level of need when leaving hospital was perceived as significantly higher than the average provision of home care services or residential care combined.
