The implications of an ageing population are wide-ranging, but it is far more complex than a simple increase in numbers. The ageing population coupled with the high prevalence of long term conditions means that people will be increasingly dependent on health and care support to enable them to stay in their own homes for longer. Whilst it is acknowledged that work is progressing to develop the sustainable, modernised, appropriate public services in Scotland that are built around people and their communities the question remains whether it will be too little, too late to face up to today’s scenario. The findings within this dissertation point to that conclusion as the initiatives and strategies introduced most recently, such as enablement, have now been subsumed in the increased numbers of ageing, dependent people seeking the essential care and support required to maintain them within their own homes. Consequently, it is this researcher’s view that immediate, reactive measures are needed now to prevent the challenges escalating into a crisis situation that will only be addressed by greater investment. However, it is contended that these projects or initiatives will require time to become effective and that the results will not be immediate. Time is the one factor that cannot be controlled in this debate.
This researcher, therefore, concludes that there is a need create the environment over the next few years that will allow the initiatives the opportunity to bed in, but also to be better understood against measurable outcomes. To achieve this, the researcher suggests that there is a need to realign the additional monies provided by the Scottish Government through the Change Fund to “purchase” additional care and support to offset the increase demands. By doing so equilibrium can be maintained in the short term but it will allow the policies to take full effect and realise the outcomes that will allow more people to be supported in the community in the years ahead.
The overall aim of this research project was to explore what factors that are impacting on the effectiveness of enablement. This researcher acknowledges that within a dissertation that is limited by a word count then it has not been possible to write about all the factors that are at play. However, based on the researcher’s background in social care, and having drawn from the multiple sources of data and evidence available, then the most important factors and their consequences have been presented. This dissertation, therefore, only provides an overview of what is occurring within LA. Had time permitted, a more detailed analysis of the cost implications of establishing and maintaining an enablement service would have been carried out to establish a cost benefit analysis for the LA. Similarly, there is a need to understand the differences in approach between targeted support and an intake model to determine the most effective approach. The findings from this research, however, would suggest that an intake approach is less effective at meeting stated enablement outcomes but is better placed to deal with the volume of referrals. However, a longitudinal, comparative study is required to fully understand the dynamics.
In terms of future research, there is a need to understand the national picture to allow policy makers the opportunity to align (or realign) priorities for the future. The development of a framework to consider what is actually happing within each local authority based on demography, finance and enablement outcomes would then allow the 32 local authorities to measure the success of the policies and initiatives that have been introduced.