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Five Gear Model of Care Management

This model of care management was developed to present a more realistic account of real care management functions and to explore how these activities could be made more person-centred.

The idea was not just to offer a different way of thinking about the tasks in care management - it was also a way of showing that many of the systems associated with personalisation could be seen as ways of making care management more efficient by enabling the care manager to move more quickly up to a higher gear.

For example:

1. Gathering information (or assessment) - If people are able to clarify what they are entitled to more easily, for example by using a Resource Allocation System to clarify an individual budget, then the care manager can move more quickly to...

2. Design service (or support plan) - If people can shape their own plans without needing the support of their care manager because they have good information, peer support or community brokerage then they will be able to move to...

3. Developing the service - If people can get help directly from service providers, centres for independent living, local community services or self help groups then they can move to...

4. Solve problems - If decisions are in the hands of the right people, closer to the disabled person and if resources can be used flexibly then problems will occur less frequently and the care manager will have more time to...

5. Review and learn - If people are more in control then the most important aspect of the care manager's work will become helping people review their experiences, learn lessons and share their lessons with others.

This five gear model is also realistic in that it recognises that life is not always perfect. Sometimes care managers will need to be in a 'lower gear' for longer and sometime care managers will need to go back down the gears in order to respond to problems as circumstances change. However the model offers a way of thinking about care management which does not commit care managers to simply rehearsing standardised processes or getting bogged down in futile assessments.


The publisher is The Centre for Welfare Reform.

Five Gear Model of Care Management © Simon Duffy 2001.

All Rights Reserved. No part of this paper may be reproduced in any form without permission from the publisher except for the quotation of brief passages in reviews.