ABSTRACT
As far as the Conservative administration and the Griffiths Report was concerned, the rise in public expenditure on residential care services which resulted from the social security system rules (Laing, 1993) needed to be addressed. The proposed solutions set out in the 1989 White Paper included the driving principle that the provision of services to disabled and older people should be needs-led rather than based on income. Local authority social services departments were therefore firstly allocated the responsibility for assessing the needs of individual disabled and older people who appeared to need their services (s47 NHSCCA). Secondly, they became responsible for the process of care management, whereby a care manager put together a package of services from a variety of providers to meet that individual's needs, a process developed following innovative pilots in Kent, Gateshead and Darlington (see for example Challis et al, 1995).
