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VALUES & RIGHTS SECTION 3: Values are what people believe is right. Impossible to sustain a valuefree approach in social care. Human Rights legislation makes it impossible for standards of behaviour based on ideas of freedom, citizenship, rights and responsibilities to be protected by law. Awareness of rights and values may help prevent social exclusion. Values can cause dilemmas, conflicts of interest and have contested meanings in social care practice. Case study: Mr Trebus v Haringey Council: Denied human rights, values. Argument: Environmental issues for other in the area ± their rights, etc. WELFARE SECTION 1.2: Concern for others, benefits, provisions, support. µSystem to help people¶s needs which they can¶t organise on their own¶ ± post WW1 institutions power and control - then Human Rights and campaigns for change due to exposure of abuse / costs of institutions changed the welfare state to community care after WW2 to this day. Negative: needy, labelling, scrounging, poverty, idle, charity, demeaning, stigma. SECTION 3 VALUES AND RIGHTS POWER & INEQUALITY: Power to hire or fire, to decide what care type, how to spend direct payments, chose home care / residential, hours required, intensity of care / support / help. Power of carers, family, professionals, etc. Opposite is the reverse of all these. DIFFERENCE & IDENTITY: Cultural / religious differences, age, gender, geographical, demographics, labels, stigma, choice, dignity, resources, information. RIGHTS & RISKS: Choice, needs, eligibility, resources, costs, basic human rights, protection, abuse, neglect, respect. TERRITORIES & BOUNDARIES: Aspects of life divided into compartments by own/ other¶s definitions. Sometimes help, hinder care provided/experienced. CARE SECTION 1.3: Support, empathy, helping, protecting, love, attachment. Informal/formal, home/residential, hospital, day centres. Eligibility criteria, direct payments, free, access (minorities) Established in law and gov policy - 1990 NHS & Community Care Act / 1995 Carers Act. Rights of cared for and carers. Care is identified, organised, regulated and costed. Negative: abuse, controlling, burden, dependency, lack of. Poor reputation since institutions post WW1.



COMMUNITY ± SECTION 1.1: Can be based on who you are, own sense of identity, sense of belonging and not belonging inclusion/exclusion). Mutual interests, sharing, strength, equality. Defined by geographical boundaries. Personal relationships and support. Identity ± spiritual, cultural, class, generations. Negative: control, pressure, exclusion, fear, rejection

‡The words care, welfare and community are part of everyday speech and yet evoke different meanings ‡Identifying these meanings involves acknowledging individual and social difference in experience ‡Exploring the meanings of care, welfare and community helps to identify how people support each other at interpersonal and societal levels ‡Awareness of why and how these different meanings are evoked makes a positive contribution to meeting need and supporting people in ways which they find acceptable ‡The course themes are ideas which help to organise and challenge the evidence and information you¶re presented with in the course material ‡Each of the course themes highlights a significant issue in discussions about care, welfare and community ‡Power and inequality are issues for interpersonal care relationships as well as for the provision of care at national levels ‡Difference and identity help to show that users of care services may have varied ways of describing themselves and that these have significance for how they access and choose to make use of care and support ‡Rights and risk run through all aspects of decision making about care provision where autonomy and protection are at issue ‡Territories and boundaries draw attention to those visible and invisible distinctions which can sometimes help, sometimes hinder, the way care and support are provided for and experienced ‡Values are what people believe is right and underlie the different ways people communicate with one another ‡It is impossible to sustain a value free approach to social care work and is unacceptable also ‡Human rights legislation makes it possible for standards of behaviour based on ideas of freedom, citizenship, rights and responsibilities to be protected in law

R&R: Pamela Coughlan: Human rights: right to a home for life Health authority argued that her needs and those of her co-residents were a risk to their budget and attempted to shift financial responsibility to social services

R&R: Mr Tebus: Human Rights: right to a particular lifestyle. Local council argued that his actions were potential risk to his own and his neighbours health and safety .

D&I / T&B: Meera Syal ³Anita & Me´: Reader article 15 Ideas of community, physical environment, Punjabi community, female community, cultural community. Community as basis for personal relationships and support Community defined by geographical boundaries Community based on identity

P&I / T&B / D&I: Claire & Andrea Michael & Clarice: Ideas about professional and informal care. Caring for and caring about. Andrea is professional carer, cares for Clare. Clare may not like being cared for and may prefer to see it as a service. Andrea may also care about Clare as a client. Michael is informal carer for mother Clarice, and cares about her. He makes sure she is cared for also, but not by him.

CARING ABOUT COMMUNITIES: Amitai Etzoni¶s ideas: ‡ a need for a set of shared moral values ‡A commitment to responsibilities as well as rights ‡Communities which lay claim on their members ‡Fears of the alternatives: state coercion ± moral anarchy GENDERED COMMUNITIES: ‡ Various differences in communities; urban, rural, inner city, middle class, working class, mixed, black, white, multiracial, affluent, poor, fragmented, cohesive. Experiences based on; age, gender, disability, culture, inclusion/exclusion. Neighbourhoods, locality, area, network, interest, identity, support. ‡ Role of men & women can differ but changes have occurred throughout the decades/centuries ‡ Communities ± responsibilities, trust, accepting of outsiders, helping, supporting ACCEPTING COMMUNITIES: ‡ Social exclusion ± mental health problems ‡ Exclusion based on drawing attention to difference ‡Assumption that people need to make contribution to be part of community SECTION 5 ‡Effects of lack of recourses, support for care INCLUSIVE COMMUNITIES SECTION 5 ± INCLUSIVE COMMUNITIES RECOGNISING TRUST: ‡ Etzoni¶s ± trust and co-operation ‡ Shared resources, initiatives, support ‡ Inclusion, involvement, partnerships/relationships, shared interests REASEARCH & FINDINGS: CARE IN, BY, FOR & OF THE COMMUNITY


SECTION 3 SOCIAL NETWORKS OF CARE & SUPPORT: COMMUNITIES AND NETWORKS & SOCIAL NETWORKS ‡At about the time that government INTERVENTION policy was shifting towards the community as a base for care and SECTION 1 ± LIVING IN THE COMMUNITY support, some researchers were LIVING IN THE COMMUNITY: questioning the survival of social networks in some communities ‡In practice, people use the notion of community to refer to shared understandings built around place, culture and ethnicity ‡Distinguishing care in, by, for an of communities helps to identify the interconnections of formal and informal sources of care and support ‡Recent research testifies to the survival of networks of support, for example among older people, but with changed characteristics

‡The resources within a community tend to be those which people identify for themselves or those they work with ‡Making a change in a community depends on recognising what links as well as what divides people from each other and the environment and structures within which they live and work SECTION 2 ± COMMUNITY & POLICY

Key Points : THE SHIFT TO CARE IN THE COMMUNITY & IDEALS AND REALITIES OF COMMUNITY: ‡The shift for community as a basis for care gathered momentum among policy makers in the late 20th century as it became linked with ideas of cheaper and more effective care and support ‡Wider social and economic structural change has sometimes affected the conclusions that sociologists have drawn about the communities they have researched ‡The ways people talk and write help to identify what are perceived as obligations to and expectations (both positive and negative) of community life

Darnall & Tinsley residents - Unit 2, communities ALL COURSE THEMES: Ideas about community in relation to course themes P&I: regeneration budgets; lack power to strengthen bargaining position; competition for resources between 2 communities; health inequalities (health action zone set up) D&I: separate communities, but lumped together; shared language; shared backgrounds; family membership; attachment to place R&R: Idrisullah Bashir at risk without care and support; Catherine Galloway at risk of depression and social isolation; Mohammed Ayub at risk of serious health problems unless traffic pollution reduced T&B: 2 communities linked as one for administrative reasons; but divided by physical environment & motorway through centre; joint territory also divided from main city; lunch club for Asian men requires separate territory Keith Shires, Garth Crooks, Maurice Hayes, Janet Foster, Kevin Hetherington - Unit 2, communities Reader article 11 Ideas about expectations and obligations of different communities Unit 2, care in, by, for and of the community: ALL COURSE THEMES: Care in the community: Bangladeshi Home Care Service; Darnall Elderly Asian Men¶s lunch club; Tinsley Forum; Yvonne¶s walks Care by the community: Catherine¶s family; Catherine¶s support for local youths; volunteers supporting Tinsley Forum Care for the community: regeneration funding; grants for local agencies from the council Care of the community: Bangladeshi Home Care service

‡ Their position conflicts with that of the disabled rights movement which argues that µcare¶ should be replaced by rights and resources for people with impairments. ‡ Feelings associated with giving and receiving care are influenced by power in personal relationships and its interaction with factors such as inequality. finance and the availability of help and support. ‡ Spouses and partners are the first µline of defence¶ in caring. and the nature of the relationship between the carer and the person being supported. but within a framework of rules. It is only where there is no spouse. neighbours and less close relatives. unemployment. The family remains the main source of care for disabled and frail older people. WORKBOOK 1 .GENDERED COMMUNITIES: There are similarities and differences in the experience of individuals who give and receive care. sexual relationship and carers¶ coping tactics. and that residential care can be a positive choice. ‡ Who feels commitment to do what in families may depend on individual histories and feelings of obligation. across time. ‡ It may be possible to reconcile these differing positions through a common agenda ± one which works towards reductions in the effects of a disabling environment. and which recognises that personal support will continue to be provided through informal relationships involving care by women and men. Even in this age group four out of five people do not have substantial impairments.UNIT 3 INFORMAL CARE? ‡ The idea that informal care is the right solution to the problem of providing help and support in the community has been challenged by feminists who have regarded it as being oppressive to women. gender. poverty and racism. Geographical mobility has affected the nature and frequency of caring contacts. and informal helpers who provide practical support for friends. ‡ The UK¶s minority communities differ among themselves in many important respects. independence and interdependence. ‡Two out of five carers are men ‡The way survey questions are worded significantly influences responses. non-relatives. daughter in law. or the spouse is unable to provide care. spouse. daughter. ‡ We are all givers and receivers of care at different stages of our lives and therefore. mental health. type of care being given. SECTION 2 ± CARE BY FAMILY/COMMUNITY WHERE PEOPLE LIVE / FAMILY OR COMMUNITY? ‡ The majority of older people and younger disabled people live in their own homes in the community. we all experience different levels of dependence. . housing. son. ‡ Some of the main differences are as a result of the influence on personal relationships caused by such factors as position in the life course. ‡ Not all disabled people living in private households will necessarily be living independently in the kind of home they want to be in. such as expectations. that other family members are likely to become main carers. SECTION 3 SECTION 4 WHY DO SOME INFLUENCES ± CARING PEOPLE GIVING/RECEIVING RELATIONSHIPS BECOME CARE CARERS? SECTION 1 ± WHO ARE THE CARERS? TALKING ABOUT CARE / THE DEMOGRAPHY OF CARE: ‡Substantial impairment is not common until beyond the age of 80. ‡ Among younger disabled people those with learning disabilities are more likely to live in some form of residential care. There is often reciprocity between the parties in the caring relationship. ‡Two main groups of informal carers can be identified: those who provide personal and/or physical care for people who live in the same household. ‡ Caring for someone who is not one¶s partner is negotiable. SECTION 5 IS INFORMAL CARE THE ANSWER? A HIERARCHY OF OBLIGATION / DIFFERENT RULES FOR DIFFERENT PEOPLE: ‡ There is a hierarchy of obligation which influences judgements about who should care for older people: in descending order. other relative. ‡ Members of minority communities do have greater needs stemming from experience of poor health. ‡ By focusing on problems there is a danger of overlooking the fact that some people from minority ethnic groups may be advantaged or coping well when it comes to caring. ‡ The availability of family support will depend on a number of factors.

programme 1 Jonathan Smith & Jane Weston. but feels rewarded by her son¶s development Les and his wife complain they are often ignored at meetings with psychiatrists about their son¶ mental health problems.UNIT 3 . programme 1 .Anna Manwah Watson & Lily Sau Han Braid . Julie & Les. Territories and boundaries Unit 3. carers Audio 1. carers Audio 1. as he sees carers as people who are not relatives. Al Ideas about meeting minority needs Anna and Lily discuss difficulties caused by the isolation of the Chinese community in N. Difference and identity . and the isolation of individual families ± been no development of services to meet the needs of people whose culture and language is different to the majority.COURSE THEMES AND CASE STUDIES Unit 3. He says he does it out of respect and duty.I. Families provide much of the care because there is no one else. and this gives false impression of self-sufficiency Delays in race relations legislation in N. Carol Ideas about caring relationships Carol distinguishes between being a relative and a carer ± social care workers do not always recognise who the carer is Julie complains about the disbelief about the extent of help she provides her disabled 11yr old son. but says they still have a good relationship with their son Jonathan and Julie run carers projects and see their role as enabling people to recognise their caring role and get the help and support they need. Jonathan says that almost 100% carers do it because they want to because they love the person they are caring for Difference and identity . Power and inequality .I. meant no pressure on authorities to improve services Al is a carer for his parents and is not happy with his label.

‡The concepts of care. skills and values. social care is flexible and offers different kinds of support and services according to need. ‡ Ideally. ‡There is vigorous debate over what language to use to describe client groups ± with some believing it makes little difference what people are called.WORKBOOK 1 . stimulated an increase in social care services and a growing recognition of social care as a coherent set of job roles. some of which are shared with other occupational groups. with higher status and pay than social care workers. SECTION 1 ± WHAT IS SOCIAL CARE? NHS & COMMUNITY CARE ACT 1990: ‡ The NHS and Community Care Act 1990. ‡Not all service users volunteer to be cared for. and others arguing that it is essential to get the language right. and its equivalents in Scotland and Northern Ireland. For workers there is a more mixed picture. and attention to small as well as big issues. ‡ Social care involves provision of support to people who require support to lead autonomous lives. SECTION 2 ± WHO WORKS IN SOCIAL CARE? ROLES OF SOCIAL CARE / RELATIONSHIP BETWEEN SOCIAL WORK/CARE / WORKING IN SOCIAL CARE: ‡Social care involves a wide range of roles and tasks carried out in different settings. ‡Joint working has been given high priority in recent health and social care policy. SERVICE. ‡User¶s ability to determine the services they receive can be compromised by the fact that they are not directly paying the bill. service and control are central to social care and many other human service occupations. WHAT USERS WANT / CARE OR SERVICE / WHAT¶S IN A NAME? / SOCIAL CARE & CONTROL: SECTION 4 SHIFTING BOUNDARIES HEALTH & SOCIAL CARE THE TERRITORY OF SOCIAL CARE SECTION 3 CARE. ‡Dismantling boundaries between professions and agencies brings with it advantages and disadvantages. . status and working conditions but is generally under-rewarded when compared with other types of work. CONTROL? Users appear to value a one stop shop. ‡Social workers are a recognised professional group. The advantages for users appear to be considerable.UNIT 4 DIVISIONS WITHIN SOCIAL CARE / WORKING ACROSS BOUNDARIES / CONSTELLATION OF NEEDS: ‡Service users¶ needs are often complex and diverse. ‡Health and social care needs can be difficult to disentangle. ‡Care work varies widely in terms of salary. ‡ Social care may be as much about supporting carers as it is about supporting people who are regarded as service users or clients. ‡ Social care work draws on a combination of knowledge.

negotiating social care .COURSE THEMES AND CASE STUDIES MERIT .1 ± Territories and boundaries Outreach worker who supports people with mental health problems in their own homes Discusses skills needed for the role and the dilemmas Carole faces in making choices and drawing boundaries Highlights that social care work involves complex decision making. speed of service. Mark has needs relating to mental health. normally with older people and disabled people.Territories and boundaries Introduces idea of multidisciplinary teams.UNIT 4 . criminal justice or housing.Service users want: flexibility. social care Audio 1. MERIT also provides social care to people with dementia and people like Marjorie with learning difficulties. one seamless system. but Gladys embarrassed about personal care and only wanted help with housework ± this was denied. Highlights professional territories. Good illustration of how social care services have changed since NHSCC Act. Difference and identity Unit 4. Mavis Murphy suggests social care has become recognised as important since NHSCC Act 1990. wide-ranging knowledge and professional integrity Raj & Gladys . Raj instructed not to do housework.Unit 4. and normally by women . housing. Raj is Asian. service user satisfaction . practice territories. Rights and risk Discusses Raj and her caring relationship with Gladys. care management approach Rosemary Bland . BUT this could potentially leave them both vulnerable and at risk: Raj could lose her job and Gladys¶ health could suffer because more time spent doing unauthorised housework Mark: Unit 4. privacy and risk´ Unit 4.Unit 4. social care or service? reader article 25 Territories and boundaries .Power and inequality . divisions within social care Reader article 33 Territories and boundaries Power and inequality - Ideas about care work and body work: Personal care crossing normal boundaries of privacy and bodily functions. Carole McHugh ³House calls´ .Unit 4. Raj did some housework on request after feeling sorry for Gladys despite it not being authorised because she has some spare time. working in social care Reader article 32. Difference and identity .³Independence. They both ended up feeling good after this. Multidisciplinary team highlights that many people in receipt of social care have needs relating to other services such as health. well developed interpersonal skills. Comparisons with hotel model. social care roles . Gladys is white working class. Territories and boundaries . alcohol use. and boundaries of agencies Julia Twigg ³carework and bodywork´ Unit 4. physical health and learning disability. Territories and boundaries. programme 2 Considers what characterises social care and gives history of community based services for older people with mental illness Social care before 90¶s was meals on wheels and home helps and ancillary social workers.Rights and risk Ideas about the difference between social care and service.

PSYCHIATRY / DECLINE OF ANTIPSYCHIATRY: ‡ Theories underpinning practice may be challenged ‡ Such challenges may be part of a broader ideological movement ‡ In the disputes that follow. rather the are different ways of seeing and knowing ‡ People and organisations may have powerful vested interests in particular theoretical formulations .UNIT 5 AGEISM & THEORY OF STRUCTURED DEPENDENCY / DEPENDENCE & PRACTICE: ‡Social care practice and the theories that underpin it are not value free ‡Being clear about the value base of theories helps social care workers to understand what they are doing and why ‡It also helps to clarify and explain some of the complex dilemmas workers often face SECTION 4 VALUES AND THEORISING THEORY IN CHANGING PRACTICE SECTION 1 ± THEORY & THEORISING? SECTION 3 IDEOLOGY & CONFLICT OVER THEORY DIAGNOSING SCHIZOPHRENIA / CHALLENGING DIAGNOSIS / PSYCHIATRY¶S SCEPTICS / ANTI.WORKBOOK 2 . theoretical issues are raised that have major implications for practice and the values underpinning it ORDINARY THEORISING / GENERALISING & PREDICTING / GENERATING THEORY THROUGH RESEARCH: ‡ Theories are ways of explaining action and reality ‡ We all draw on theory to make sense of our everyday lives and to justify our actions ‡ Through the use of theory we are able to generalise and make predictions ‡ Theory is generated through a mixture of inductive and deductive reasoning SECTION 2 ±DIFFERENT THEORETICAL PERSPECTIVES BIOMEDICAL (medicine & biology) PERSPECTIVE / COGNITIVE/BEHAVIOURAL / DEVELOPMENTAL / SOCIOLOGICAL: ‡ Different disciplines draw on different theoretical perspectives in studying the same condition ‡ Within a discipline. debates centre on alternative theories and on research which tests and develops them ‡ Different theories are not necessarily incompatible.

Frequently left her handbag unattended and manager had offered to look after money for her.COURSE THEMES AND CASE STUDIES Yolande. was Hindu man from Uganda. theory Highlights importance of using theory to inform practice ± in this case theory about importance of activity in later life Mr Patel .UNIT 5 . Stereotyped that he would benefit from mixing with µhis own¶ community and was encouraged to mix with Asian group ± he didn¶t like it and requested to join African-Caribbean mental health group which he greatly benefited from . barriers Structural barriers: why was Mrs Horton in residential care? Environmental barriers: no locks on doors. Unit 6. attitude of care home manager was questioned by daughter Susan & LeonieUnit 5. could have used internet banking Attitudinal barriers: deemed unreliable as a witness. generalising & stereotyping Mr Patel diagnosed schizophrenic. visual impairment and lived in residential home. She then kept her money stored in the Office. dependence and practice Mrs Horton had decreasing mobility.Unit 5.Unit 5. Bag stolen and she was branded unreliable witness. Felt it undermined her autonomy not to be able to handle her own finances. Maeve & Mrs O¶Brien . theory Yolande¶s actions are based on theory that people develop tolerance to painkillers ± but just a personal belief Mrs HortonUnit 5. no where to keep her bag safe.

civil. lack full citizenship rights and are excluded from living in the mainstream ‡Disability discrimination legislation has a role to play in overcoming such exclusion ‡Debates around education. gender. It offers FOCUSING ON THE INDIVIDUAL / alternative meanings of disability which PSYCHOLOGICAL ADJUSTMENT / INTERNAL can be liberating to some disabled and OPPRESION: non-disabled people SECTION 6 CITIZENSHIP AND RIGHTS WORKBOOK 2 .DENIAL OF RIGHTS / DISABILITY DISCRIMINATION LEGISLATION / RIGHT TO INCLUSIVE EDUCATION / LIFE WORH LIVING / RIGHT TO PARENTHOOD: ‡Citizenship comprises political. economic and social rights ‡Many people within society. class.UNIT 6 SECTION 4 LIVING IN THE MAINSTREAM RISE OF DISABLED PEOPLE¶S MOVEMENT / COALITIONS / DISABILITY ARTS MOVEMENT: ‡ The individual model of disability views disability as being a problem residing with the individual ‡ Disabled people do not always view disability in the same way as non-disabled people ‡ The ways in which disabled people are treated by health and social care workers and others can have an impact on their self-identity SECTION 5 CRITIQUES OF THE SOCIAL MODEL NEGLECT OF IMPAIRMENT / /REPRESENTATIVE MOVEMENT/ MULPIPLE OPPRESION: ‡ The meaning of disability is continually being debated within the disabled people¶s movement ‡ Some people believe that the social model of disability neglects the impact of illness and impairment ‡ The disabled people¶s movement has been accused by some people of being non-representative of disabled people generally y It has also been criticised for neglecting issues of race. the right to life and to parenthood highlight issues relating to the inclusion and exclusion of disabled people from mainstream society THE DISABLED PEOPLE¶S ‡ There is evidence of resistance by MOVEMENT disabled people to their situation SECTION 1 ± DEFINING & EXPLAINING DISABILITY throughout the twentieth century and earlier DEFINING DISABILITY / EXPLAINING DISABILITY: ‡ The disabled people¶s movement has achieved changes in practice (CILs) ‡ Definitions of disability are not fixed. including disabled people. but vary widely over time and ‡ Disabled people and the disabled across cultures people¶s movement have been influential in the passing of the ‡ These definitions draw on different models or explanations which ‡ Disability Discrimination Act 1995 and may conflict with and modify each other subsequent disability discrimination legislation SECTION 2 ± THE MEDICAL MODEL OF DISABILITY ‡ The disability arts movement is part of the disabled people¶s movement. sexuality and age and the experience of multiple and simultaneous oppression SECTION 3 ± THE SOCIAL MODEL OF DISABILITY FOCUSING ON SOCIETY / DISABLELING BARRIERS / EMPOWERMENT AND LIBERATION / MAKING CHANGES: ‡The social model of disability views disability in terms of barriers within society which obstruct people with impairments ‡The social model of disability distinguishes impairment from disability and does not regard impairment as causing disability ‡The social model of disability has arisen from the thinking of disabled people themselves and is still evolving ‡The analysis provided by the social model of disability shares some common ground with that provided by other oppressed groups ‡The social model of disability has had a positive impact on the self-identity of many disabled people .

narrow doorways. Family also sceptical about ability as a parent. R&R: potential risks to activities that visually impaired children were engaged in. Structural barriers ± refer to underlying norms. Unit 6. Suggests that being treated like everyone else meant her specific needs not always met. Some disabled may be denied employment if they cannot fit into these µnorms¶. sometimes removed from home communities.Structural. Kate feels having a child has made her feel more included in the community. multiple oppression ± D&I ± P&I People¶s movement´ Suggests that disabled people¶s movement fails to take into consideration of multiple or simultaneous oppression. R&R. linking disability to the course themes T&B: explores different types of educational settings for visually impaired children. .Unit 6. Paul. Disabled people have multiple identities and should not be pigeonholed by the most prominent identity Andrew Hubbard .Unit 6. P&I: maybe attending special school places disabled children in unequal situation. P&I . e. e. Peter never felt special because peers were also blind. Justin using a stove. Mary & Kate . etc Attitudinal barriers ± refer to adverse attitude and behaviour of people towards disabled people ± patronised. Carol Thomas³Living in the borderlands of disability´ . but some argue that access to resources and environment that caters for their needs is better. T&B. meetings are conducted or the time allowed for tasks.Unit 6. Also the way things are done to exclude disabled people.g. identifying barriers D&I.Unit 6. disability and self-identity ± D&I Born without a left hand and was left feeling ashamed of her impairment by attitudes of professionals Ayesha Vernon ³Multiple oppression and the disabled. norm to work 9-5 or for office junior to make director cup of tea. single parent to twins. physically disabled. D&I: Martin & Paul recognise their difference but value being with peers and pleased they can cope with being in mainstream. e. Has experienced no negative attitudes from professionals. stereotyped or harassed.UNIT 6 . Has support from friends and statutory services.³On becoming a disabled person´ . Reminder of what these barriers can be«. Environmental barriers . lack of resource. environmental and attitudinal barriers that Andrew has experienced since becoming disabled. D&I Experiences of parenthood for Mary and Kate. Many would argue that disabled children had the right to engage in these activities. Justin & Stephanie suggest being in a community does not imply inclusion and can be isolating. family or friends. Mary. martin and Stephanie dealing with flames and chemicals. Mental health problems. Stephanie feels she has less choice about going out in the evening at her new school but Justin finds he can do things that he couldn¶t at home.g.refer to obstacles within the environment such as steps.g no Braille books or sign language interpreters. Threatened with having child taken away if she became ill again. Kate has been treated less favourably.COURSE THEMES AND CASE STUDIES The best of both worlds video . disabled parents ± P&I. mores and ideologies of organisations and institutions which are based on judgements of µnormality¶. Peter said he was given no mobility training at all and Stephanie complained about mobility test because she could already get out and about independently. BUT Justin values being the same as his peers in special school.

and to a cycle of devaluation. LANGUAGE & RESISTANCE SECTION 1 ± NORMALITY AND DIFFERENCE NORMALITY & DIFFERENCE: A BIOGRAPHICAL PERSPECTIVE Biographies ± life story . it has subsequently been influential in the design of services of all kinds.important resource of information about a person ± can gain better insight into someone¶s life. DENIAL OR PASSING AS NORMAL / REJECTION OF LABEL / CHANGING LABEL / SIGNIFICANCE OF LANGUAGE: ‡ Labelling. ‡ Stigma refers to a process by which negative attitudes to difference lead to some individuals being negatively valued. ‡ It is a top-down philosophy which justifies the continuing role of traditional service patterns. in particular for people with learning difficulties ‡ Wolfensberger and Tullman¶s model of normalisation (social role valorisation) emphasised the role that services should play in counteracting negative imagery. ‡ It can be misused to justify failure to provide the resources and support people genuinely need. that people should where possible use integrated community service. Yet some stakeholders see these as being a priority. Both have a place. However. and that people should be helped to adopt valued social roles ‡ Normalisation lays little emphasis on challenging concepts of what¶s normal ‡ The five accomplishments represent a set of outcomes that services should aspire to deliver of they operate on a normalisation model ‡ The five accomplishments do not emphasise considerations of safety and risk management. needs. ‡ The social model of disability offers a competing perspective but one that remains to be explored further in relation to people with severe intellectual or cognitive impairments. etc. ‡ Debates about labelling revolve around questions of whether the label described the individual¶s essential characteristics or whether it is the product of social processes which name certain behaviours as abnormal or deviant and treat them accordingly. SECTION 4 WHAT IS NORMALISATION? SECTION 6 QUESTIONS ABOUT NORMALISATION & SOCIAL ROLE 4 CRITICISMS OF NORMALISATION / COMPARING NORMALISATION WITH SOCIAL MODEL OF DISABILITY: ‡ Normalisation has been criticised because defining normal is difficult.NORMALISATION PHILOSOPHY / RELEVANCE IN 21ST CENTURY / NORMALISATION IN PRACTICE: ‡ Normalisation is the name given to a set of ideas developed in Scandinavia and the US during the 1950s and 1960s which asserted that people in receipt of human care services should be able to access normal patterns for living ‡ Normalisation was a response to conditions in institutions at the time. it is hard to capture qualities of compassion and human kindness in such lists.UNIT 7 SECTION 5 STAFF ROLES: ‡ In the normalisation framework staff have an important role to play in fostering positive social roles. WORKBOOK 2 . negative stereotyping and stigma can be damaging. However. ‡ Checklists of what staff should do try to bring technical rationality to bear on significant areas of activity. ‡ Individuals and groups who experience negative labelling do not always passively accept the devaluation. ‡How normality and difference are conceptualised can have farreaching and sometimes extremely damaging consequences. ‡ Changing the terminology used to describe people has been a favoured strategy. SECTION 2 ± THE SIGNIFICANCE IN LABELLING LABELLING & DIFFERENCE / STIGMA ‡ Putting people into certain categories and giving them labels is central to a system of care and welfare which seeks to meet people¶s special needs. NORMAL OR DIFFERENT LIVES? SECTION 3 LABELLING. ‡ It implicitly devalues disabled people and can therefore inhibit the development of a positive social identity. ‡ There is a distinction to be drawn between supporting people and caring for them. . ‡Biographical approaches to constructing individual life stories can counteract the tendency to view people in stereotypical ways. but getting the balance right is not easy. there is debate about whether language alone has the power to fundamentally challenge the negative value placed on disabled people. However. Instead there is a variety of strategies to resist.

Wolfensberger & Tullman ³The principle of normalisation´ Unit 7. Jan has more positive opinion of the move and believes that her son is able to live more normal life now. however she doesn¶t trust the move and feels insecure about his future. five accomplishments Jean and the 5 accomplishments: ‡ Physical presence: clearly loves own home ‡ Choice: doesn¶t need much support in making choices anymore ‡ Competence: work in the memories group gives chance to develop ‡ Respect: described her relationship with husband as important and agreed to use life story to help others ‡ Participation: as for respect Goffman ³Stigma´ Unit 7. life on a locked ward . Jane Hubert . normalisation .Reader article 17 ± T&B / D&I Discussion of difficulties in creating services for older people with learning difficulties that still allow independent µnormal¶ living conditions.Unit 7. character defects and people from certain races and religious groups.Reader article 16.1 ± D&I Discussion of normalisation theory and social role valorisation. group homes and hospital while struggling with abuse.COURSE THEMES AND CASE STUDIES Jean ³Out in the world´ . Argues that stigmatized individuals feel sense of shame. and feeling alone even though surrounded by other people.Audio 2.Reader article 16 ± D&I Discusses concept of stigma with relation to people with physical disabilities.Jan & Philip . aggression and learning difficulties Unit 7.Unit 7.Reader article 23 Discussion of Jean¶s experiences of boarding school.UNIT 7 . programme 2 ± D&I / T&B Ideas about impact of stigma and negative imagery. normalisation and normal ageing . . Stigma . Believe normalisation necessary to counteract negative valuation of people in certain social roles ad do so through behaviour changes Walker & Walker ³Ageing. D&I . Move from locked ward to more homely surroundings. as normalisation of services for people with learning difficulties has made the services better than those for older people. are stereotyped and that stigma helps set up a self-fulfilling prophecy. learning difficulties and maintaining independence ´Unit 7.

RIGHT. . particularly for people with care and support needs. ‡ The lack of affordable and suitable housing puts people at risk of homelessness and may lead those in need of community care into institutions or other forms of supported housing unnecessarily. and this in turn is influenced by the attitudes of staff and the availability of accommodation locally. ‡ The role of supported housing in community care is problematical. together with the increasing costs of house maintenance. There has been debate about whether support services should be attached to housing or to people. ‡ There is also evidence that the legislation itself and the way it is implemented.UNIT 8 SECTION 4 HOUSING & COMMUNITY CARE NEEDS & CICUMSTANCES/ CAUSE OR EFFECT/ SUPPORT DEBATE: ‡ The lives of single homeless people are affected by a multiplicity of factors. ‡ Resources are finite and priorities have to be set in order to control access to services. ‡ There is evidence that many rejected homeless applicants are in as much need as those who are accepted as homeless. ‡Official responses to need are as much about the control of deviant behaviour as they are about meeting the care and support needs of individuals. RESPONSIBILITIES UNIVERSAL & PARTICULAR NEEDS/ SEEING PRIORITIES/ ELIGIBILITY: ‡ The idea that people share basic needs that are universal to humankind dominated 20th century social policy in the UK. HOUSING & HOMELESSNESS SECTION 3 HOMLESSNESS & NEED SECTION 1 ± NEEDS. WORKBOOK 3 . ‡ Needs assessments require close collaboration between social care agencies and housing agencies so that the fundamental importance of housing and home is addressed. may also deter people from presenting themselves to the authorities as homeless. ‡ A biographical approach helps is to understand the links between individual experience and common circumstances. ‡ Eligibility for housing is controlled not only by national legislation but also by the way in which the legislation is interpreted.HOUSING NEEDS/ FAILURE OF HOUSING POLICY/ SUPPORTED ACCOMMODATION/ HOUSING NEEDS IN COMMUNITY CARE ASSESSMENTS: ‡ There is a mismatch between the demand for and the supply of housing. SECTION 2 ± HOMELESSNESS & ELIGIBILITY MEANING OF HOME/ LIGISLATING FOR HOMLESSNESS/ STATUTORY HOMLESSNESS/ HIDDEN HOMLESSNESS: ‡ The designation of official or statutory homelessness is the responsibility of local authority housing departments. ‡ Different needs are met by different agencies. including the poor standard of accommodation on offer. which restrict access and control demand. and which system might offer more choice to recipients. Routes in and out of homelessness are complex and varied. each with its own eligibility criteria. put suitable and affordable accommodation beyond the reach of many people. ‡ The stigma attached to welfare can deter people from seeking help. ‡ The concept of need is closely bound up with the concepts of rights and responsibilities. ‡ Many homeless people have care and support needs in addition to a need for housing. ‡ Women¶s homelessness is often described as hidden. ‡ Voluntary organisations may be in a better position to respond more flexibly to these needs and to assist the development of self-help and mutual support networks. ‡ The decline in availability of subsidised rented accommodation.

Ait .Unit 8. Accommodation was bad in deprived area. both reliant on public toilets for washing and clean water. Seems to be in priority need due to vulnerability because of isolation and suicide attempt. didn¶t seek help from college and lost his job ± possible deportation.Reader article 2 ± P&I. Also has mobility problems and had paid for stair lift themselves. D&I.COURSE THEMES AND CASE STUDIES Elizabeth Unit 8. Paul is more like Ernest as they both have protective housing. She is visually impaired and gets talking books. could be seen as intentional as he gave up his course. failure of housing policy . R&R Ait is an Algerian asylum seeker with mental health needs who is in need of emotional and practical support. Previously received married couple¶s state pension and his occupational pension.Unit 8. . unborn baby died. .Reader article 1. R&R Provided temporary accommodation by housing department because they were homeless.1 ± D&I. seeking and gaining help .Reader article 37 ± P&I. Husband used to read newspaper to her. abusive neighbours. Neither has access to health care and rely on A&E. experiencing homelessness . 82yr old widow now living alone. Both dependent on alcohol. Danny & Paul . Neither has significant relationships and both vulnerable to abuse and violence on streets.Unit 8. P&I Ernest was overseas student who was faced with homelessness several times. meaning of home .Audio 3. neither has protective housing. frightened and insecure.UNIT 8 .Audio 3. Meeting particular needs Elizabeth. Teresa pregnant. However. Christine Oldman ³The importance of housing and home´ . Discussion about the kind of emotional and practical support she needs. Were treated badly by hospital. and whether homelessness would be considered intentional. John. Questions about eligibility for housing. both have access to health care Ernest . Alan Perry ³William and Teresa ´Unit 8. programme 1 ± R&R. programme 1 ±P&I. a voice in exile . whether he would be a priority. and both reliant on charity for food.Unit 8. suffered from stigma. both entitled to social security. Discussion of the different interpretation that can be seen within the eligibility criteria for housing which Ernest¶s case highlights. T&B Discussion of the failures of the housing policy in meeting the community care needs of people who use social care services. Discussion of the process of asylum seeking and impact on mental health. William unemployed. D&I John & Danny are not having many of their basic needs met at all: both unemployed.

‡ Although the actions social services workers can take to alleviate poverty are limited. SECTION 5 . ‡ An approach which combines income levels with other measures might be more revealing. used a combination of income and deprivation measures to measure the extent of poverty and social exclusion in Britain at the end of the 20th Century. ‡ There is evidence that redistributive income policies would be the most effective way of reducing inequalities in health. Both have their strengths and weaknesses but the relative approach was influential in shaping policies towards the poor in the last four decades of the 20th Century. ‡ By the end of 1999. a major survey of poverty and social exclusion. ‡ Social exclusion is a broader concept than poverty. ‡Such schemes have the potential to make a real difference to the financial circumstances of poorer people. POVERTY & SOCIAL EXCLUSION SECTION 1 ± LIVING IN POVERTY SECTION 3 WHAT IS POVERTY? THE EFFECTS OF POVERTY: ‡ The main cause of fuel poverty is low income. measured in terms of low income and multiple deprivation of necessities. physical. community solidarity and voluntary effort. ‡ Using income thresholds alone to measure poverty is convenient but limited. An additional key consequence is stigma. social services increasingly became a poor service for poor people. ‡ Roughly 17% consider themselves and their families to be in absolute poverty as defined by the UN. relational and practical.WORKBOOK 3 . and focuses on social processes and social relations. SECTION 4 EXTENT OF POVERTY & SOCIAL EXCLUSION DEFINING POVERTY/ ABSOLUTE POVERTY/ RELATIVE POSITIVE/ MEASURING POVERTY: ‡ Definitions of poverty are contentious and ideologically loaded: how you define poverty is affected by. ‡ The main effects of poverty on people¶s lives are multiple and farreaching ± psychological. which is itself caused by low wages or inadequate state benefits. they can take steps to improve the financial circumstances of those they serve. ‡ During the last decade of the 20th Century. rather than just lack of resources. what you intend to do about it.RESPONSES TO POVERTY THE EFFECTS OF POVERTY: ‡ How poverty is defined influences how it is responded to at both an individual and a policy level. . SECTION 2 ± FINANCIAL EXCLUSION & COMMUNITY ACTION PROBLEM OF FINANCIAL EXCLUSION/ ALLEVIATING POVERTY: COMMUNITY ACTION: ‡Initiatives such as credit unions and debt redemption schemes are rooted in social justice. and affects. ‡ Two of the main approaches to defining poverty are the absolute and the relative approach.UNIT 9 SOCIAL NECESSITIES/ WHO IS POOR/ SOCIAL EXCLUSION: ‡ The PSE survey. ‡ The idea of social exclusion also directs attention to potential policy changes which could remove the barriers to social inclusion and participation. 26% of the British population was living in poverty.

reducing inequalities ± P&I Discussion of health inequalities in Birmingham Ladywood constituency. People who spend more than 10% of income on fuel are in fuel poverty.´Unit 9.Unit 9.Reader article 4 ± P&I Discussion of the traditional link between poverty and use of social services. relational and practical effects of living in poverty. R&R. fuel poverty . means-testing. programme 2 ± P&I. Mark Drakeford .Audio 3. achieving full employment (save 14 excess deaths). poverty .COURSE THEMES AND CASE STUDIES Angela Yih & Elizabeth Belk. Birmingham Ladywood . physical.Unit 9. and the increasing closeness of social services and social security. stigma of benefits. poverty & social services . credit unions ± P&I Discussion of their debt problem and how they used a credit union debt redemption scheme to clear their rent arrears with the council to avoid being evicted. where it was suggested that 3 policies might save the most number of lives: modest redistribution of wealth (save 17 excess deaths) .Reader article 3 ± P&I / D&I Discussion of the psychological. eradicating child poverty (save 8 excess deaths). Mr & Mrs Martin .Unit 9.UNIT 9 . lack of knowledge of welfare benefits. D&I Discussion about fuel poverty and causes of it: low income.³Poverty and the social services´ . . Peter Beresford ³The effects of poverty .Unit 9.

‡ Self-assessment has a positive role to play in assessment arrangements. ‡ Much can be learned about how assessment works from asking people about their experience of it. ‡ the concept ³risk´ has become increasingly important in assessment. ‡ Financial assessment leading to charging for community care remains a disputed area. ‡ In the attempt to meet a range of objectives. raising service users¶ expectations can be seen as both a necessary challenge and a potential minefield. SECTION 1 ± SEEKING HELP SEEKING PERSONAL ADVICE OR SUPPORT/ EXPERIENCE OF ASSESSMENT/ SUCCESS STORY: ‡ Seeking help can be quite stressful for many people.UNIT 10 MAKING THE CONNECTION/ BIOGRAPHICAL ASSESSMENT/ RAISING EXPECTATIONS/ ASSESSMENT AS DEVELOPMENT/ SELFASSESSMENT: ‡ There is a need to strengthen the connection between people¶s lives and their assessment experience. . Poverty may be one factor associated with this. ASSESSING NEED SECTION 3 POLICY INTO PRACTICE REASONS FOR ASSESSMENT/ ASSESSMENT AS PART OF A PROCESS: ‡ Assessment has been given a key role in the allocation of social care resources. ‡ A biographical approach to assessment can lead to more individual and appropriate social care. ‡ Assessments muct focus on the individual. ‡ Increased emphasis on formal and detailed assessment arrangements had curtailed the discretion of Local Authorities and individual assessors. but take into account family relationships and interdependencies. ‡ Assessments which take place over longer periods of time can provide a fuller picture of the reality of people¶s lives than oneoff events. SECTION 4 MAKING IT WORK USERS & CARERS/ COMMUNICATION/ MANAGING ASSESSMENT/ RISK: ‡ There is considerable variation in the level of users¶ participation in their assessments.WORKBOOK 3 . ‡ For assessors. community care assessment has become a complex process. SECTION 2 ±THE ROLE OF ASSESSMENT ‡ Implementation of the single assessment process has critical implications for all those involved.

cares and their organisations. Mr & Mrs Hanley¶s experience of assessment William & Beryl Hargreaves . Neither Sylvia and Brian.Unit 10.COURSE THEMES AND CASE STUDIES Brian & Sylvia Anne .Involving service users and carers ± P& I Sylvia and Brian. better provision of information. good coordination respite care should be spent. William argued in a judicial review that the council failed to find out between hospital and area staff. experiences of assessment . Anne participated in her assessment also. Brian was present at initial assessment. communication ± P&I was far more positive than that of Brian and Sylvia and of Anne. Sylvia¶s first attempt at seeking help was not successful but Anne (who had a background in social services) knew what she could apply for and so had more success. power in assessment rests with the agency and the assessor through the formal and informal Discussion of the practical process rationing devices used. Power and inequality choices during their assessment. Brian found the assessor spoke only with Sylvia and not to him. culture. greater involvement of users.involving service users and carers ± P&I Mrs Haynes . carer and assessor? In what circumstances and how far do people have a right to take risks? What is the value of positive risk taking? .³health and health and social care? D&I: how far can assessment and care management take sufficient and sensitive social care assessment in action´ account of race. R v.Unit 10. managing assessment assessment forms provide a realistic picture of the whole person and the context within which support and car . or Anne were given appropriate information by their doctor. and had to initiate their own assessments. and that they had numerous assessments and were not happy with some of the questions they were asked. sexual orientation and other aspects of difference? Can standardised . assessment and the course themes .UNIT 10 . communication ± P&I Mrs Haynes had communication difficulties because of profound disabilities and denied problems during her assessment because she was ashamed of them. people have to assessment as a result of assessments? How is risk defined by user. the role of users and the role of carers. but was not really involved. The judge found in favour of the Hargreaves¶ and said that where a user is unable to actively Mr & Mrs Hanley had many opportunities to raise participate it is even more important that they should be helped to understand what is involved and and talk through their concerns and were given the intended outcome. religion. programme 1 . Course themes .T&B: who wants care and who gets care. experiences of assessment . rehabilitation what Beryl¶s feelings were.Unit 10. even though the assessment wasn¶t carried out in appropriate circumstances (in corridor). Mr & Mrs Hanley Unit 10. and Anne discuss their experiences of assessment with Gaynor & Liz.Reader article 36 ± T&B might be needed and provided? What role can assessment play in building identity and awareness of choice? P&I: in general. their arrange respite care for his sister Beryl. the user or carer? R&R: what rights of access do assessments.Unit 10. even though she desperately needed help. Sylvia was proud of her assertiveness and initiative and played a large part in their assessments. was arranged and other requests met. Power and inequality.Unit 10. greater between NHS and social work use of advocates? Who is accorded power by the assessor. but there was a dispute with the council over where this interests dealt with sensitively. Anne was disappointed she did not get a home assessment. but the council argued that he had not permitted her to give an opinion. North Yorkshire County Council ex parte William Hargreaves (1994)William wanted to They were included in the meetings. can the single assessment process overcome the barriers between Alison Worth . Can the power relationships be shifted at least partially by clear guidance from of assessment and the difference government. by requesting Occupational therapy assessment and responding to their questions.Audio 4.

the private for-profit sector is diverse. So its fortunes are strongly influenced by Government policy. are under pressure because of cuts in public subsidies and rising costs. ‡ Local authorities have to juggle the conflicting interests of central government and local taxpayers in trying to match needs and resources. council taxes and service charges. ‡ It has also highlighted concerns about the quality and nature of care provision. ‡ Private care home providers. drawing in the main on charitable donations and government grants and contracts. advocate and innovator on the one hand. CHARGING FOR RESIDENTIAL & NURSING HOME CARE. ALLOCATING BUDGETS/ MONITORING PERFORMANCE/ MANAGING BUDGETS: ‡ The main sources of funding for local authority services are government grants. ‡ Social security has a centrally funded and open-ended budget. RESOURCES/ NATIONAL & LOCAL DIFFFERENCES: ‡ The voluntary sector comprises an extremely diverse range of organisations in terms of their functions. ‡ Most of the changes involve redefining the territory of services. But unlike the voluntary sector. ‡ Since implementation of the NHS and Community Care Act 1990 the private sector has come to dominate the mixed economy of care provision. . SECTION 3 ± CHARGING FOR CARE SECTION 4 THE VOLUNTARY SECTOR DIVERSE ACTIVITIES. its activities are focused on the most commercially viable forms of service provision. ‡ One of the outcomes of the shifting boundary between pubic and private provision is that the cost to users has increased. ‡ There is a tension between the role of the voluntary sector as critic. ‡ The increased use of charging has highlighted serious concerns about equity and impoverishment and about access to care provision. ‡ The Labour government of the late 1990s introduced 'Best Value' as an alternative to market competition to control quality and costs. ‡ Central government closely controls local authority income and expenditure. activities and sources of funding. and ownership has become more concentrated. RESIDENTIAL & NURSING HOME CARE/ DOMILICIARY CARE: ‡ Like the voluntary sector. indicating that the costs of social care are being shifted from the state on to care service users.UNIT 11 SECTION 5 SECTION 6 THE PAYING FOR FUNDING MATTERS PRIVATE LONG-TERM SECTOR CARE SECTION 1 ± MIXED ECONOMY OF CARE REINING-IN PUBLIC EXPENDITURE/ RISE & FALL OF SOCIAL SECURITY SPENDING/ DEVELOPING MIXED ECONOMY: ‡ Social security benefits are one source of funds for care. ‡ One way of controlling and containing care costs has been to shift funding away from this open-ended budget to fixed. ‡ Front-line workers are engaged in a constant struggle of trying to balance quality and cost. DOMICILIARY & DAY CARE / ANOMOLIES IN CHARGING POLOCIES: ‡ Charges have become an increasingly significant source of revenue for social services departments. ‡ Home care contracted out to the private sector has become focused on those requiring intensive packages of care. ‡ A further strategy for improving efficiency was to introduce competition between service providers through the development of a mixed economy of care. ‡ Most voluntary organisations are multi-funded. particularly the smaller ones. ‡ The sector is financed both by investments and loans and by charges to consumers. locally administered budgets. SECTION 2 ± FINANCING LOCAL AUTHORITIES WORKBOOK 4 .HEALTH TO SOCIAL CARE/ FUNDING LONGTERM CARE/ EUROPEAN COMPARISONS: ‡ Awarding amounts of money to eligible people is named µdirect payments¶. ‡ The majority of income accruing from charges comes from older people in receipt of long-term care. and implementer of state policies and programmes on the other. ‡ Where money comes from significantly affects what voluntary organisations can do. and redrawing boundaries between them. of long-term care. and where the boundary between free health care and means-tested social care should lie.

Mr Tosh had some health problems and a fall and is relying on wife and daughter for support and transport. Commissioner said that this implied a service user may never receive treatment. Irene and the Tosh¶s are trying to come to a decision about how best to utilise their resources to get the most additional help.Reader article 34 ± T&B Discussion of the similarities and differences between social care policy here and in Europe.Unit 11. Irene is care manager and is asked to assess them. live in isolated part of Aberdeenshire. but she can only come weekdays.UNIT 11 . but Irene¶s budget is limited to the cost of a residential care place. Argued that he needed continuing long-term care and believed this should be provided by local health authority. managing budgets ± P&I / T&B / R&R Mr & Mrs Tosh in their 80¶s. NHS said that they had a duty to determine priorities within the financial resources available. . Caroline Glendinning ³European policies compared´ . said they had failed the man. and it has been decided that they are a category A case for domiciliary care. and upheld the complaint. Health Service Commissioner & service user . comparing funding with Europe .COURSE THEMES AND CASE STUDIES Mr & Mrs Tosh and Irene. Mrs Tosh then falls ill and Mr Tosh is not recovering well.Unit 11.Unit 11. Hospital social worker has arranged for home carer to help Mrs Tosh. funding long-term care ± T&B / P&I / R&R Health Service Commissioner investigated a complaint from wife of a man with severe brain damage.

‡The overtly 'partnership-based' approach of the Labour Government shows continuities with the past. ‡In Labour's reformed structures there are controversies about directions of change. although it has also offered important new incentives to joint working. remain uneven and different traditions in health and social care are still visible. however. ‡Questions of history.UNIT 12 SERVICE USERS AS CUSTOMERS/ EQUAL PARTNERSHIP A MYTH/ CITIZENS TO THE FORE: ‡User and carer involvement is now widespread in health and social care and there are examples of good practice in partnership working. WORKING TOWARDS PARTNERSHIP SECTION 1 ± LEGACIES THAT LINGER BORN DIVIDED ± NHS. ‡There have been moves away from a consumer perspective towards a wider notion of citizens in partnership for health and social care. ‡Divisions have been. HEALTH & WELFARE/ AFTER 1979 ± NEW DIVISION/IDENTITIES/ AFTER 1979 ± PARTNERSHIPS IN SHARPER FOCUS: ‡The creation of the Welfare State both unified and divided services. ‡Successful partnerships involve working at building relationships and recognising the different worlds of participants and the different power they have. and remain. organisation and funding need to be considered as 'drivers and barriers' to change. ‡Successive attempts of governments to encourage coordination and integration have been only partially successful. ‡Variations in service structure across the UK are becoming greater and may affect possibilities for partnership. . administrative. SECTION 3 PARTNERSHIPS WITH SERVICE USERS INTEGRATED CARE IN SECTION 2 SCOTLAND/ ANOTHER LOOK AT PARTNERSHIPS = TURF WARS/ GETTING BEHIND RESULTS? THE RHETORIC: ‡ There was a sharp increase in joint working initiatives after 1997 and the range of agencies and sectors involved in partnership projects is now immense. ‡Developments. financial and professional. ‡There are now many examples of efforts to join up services across all sectors and for all client groups.WORKBOOK 4 . and they intertwine. ‡Important issues remain of responding effectively to user challenges and developing the capacity to rethink services in an imaginative way. culture.

Unit 12.Unit 12.Unit 12. it wasn¶t published in an accessible format and they were not involved from the beginning stages. Aim was to create a user-focused service for occupational therapy for adults in the area with the exception of mental health and learning disabilities. A whole host of professionals are involved. health and social care divide . equal partnership myth ± P&I Discussion of the inequality despite the equal partnership approach.COURSE THEMES AND CASE STUDIES Jane Lewis . This includes basic information about them and their circumstances and about the services that are provided to them. partnership working ± T&B Discussion of the setting up of a steering group to explore joint working between Stobhill hospital and East Dunbartonshire Council.´Unit 12. Developed a sheltered housing scheme that filled the gap in services and fitted well with strategic plans of health board and local council.Reader article 38 ± T&B / P&I Discussion of strategies for addressing inequalities of power when trying to include service users. partners in service delivery . organisational and professional boundaries. Creating a joint occupational therapy service . partnership working T&B Discussion of local minister of religion becoming aware of needs of older people who were having to move away for increased support with living. Frances Hasler ³Partnerships between disabled people and service providers . There is a communication sheet for the staff to fill in and inform other team members.UNIT 12 . White Paper for Valuing People was not fair to people with learning difficulties. . East Ayrshire personal record of care . Worries about confidentiality were ironed out through training and discussion.Unit 12. Central England People First .³The boundary between health and social care for older people . Howard Doris Centre.´Unit 12. partnership working ± T&B Discussion of the scheme set up in east Ayrshire to allow people who receive care from more than one organisation or from more than one home help to have the option of a personal record of care in their homes.Reader article 35 ± B&T Discussion of the boundaries between health care and social care for older people: financial. Wester Ross .

UNIT 13 DIRECT PAYMENTS/ BARRIERS TO REALISING POTENTIAL/ LOCAL VARIATIONS/ SEAMLESS SERVICE: ‡ Since 1997 local authorities have been able to make payments legally so that people assessed for community care can pay for their own help and support. ‡ For many carers and people being cared for there is a tension between identifying the costs of care and the feelings of love and friendship which caring involves. including pressure from carers. is increasingly being costed as a commodity. ‡There are rights and risks on both sides. having clear and agreed statements about what is expected can help to prevent misunderstandings and bad practice. ‡ Informal care has a cash value which carers are aware of. SECTION 3 BUYING & SELLING ‡Care. ‡ Some user groups face extra barriers when it comes to being assessed for direct payments. ‡Governments . disabled people and feminists as well as government policies seeking ways to reduce costs and regulate care. ‡ Help that people get in their homes is now provided by a variety of paid and unpaid carers. like any other employment arrangements. ‡ Direct payments offer the possibility of breaching the boundaries between health and social care for service users.SECTION 5 DIRECT PAYMENS WORKBOOK 4 . ‡Personal assistance. ‡Some disabled people regard personal assistance as a human right. BUYING CARE AND ASSISTANCE SECTION 1 ± TRENDS FOR CARE AT HOME ‡ Budgetary restrictions have led to a change in what is defined as necessary support. ‡ Low-intensity services are important to most people.welfare states . ‡ Local and national variations mean that direct payments are not equally available within or between authorities and regions. ‡Typologies help to identify differences and similarities between social phenomena. is open to exploitation. something to be bought and sold. like other aspects of life. ‡ A focus on rehabilitation may mean that the valued help which 'keeps people going' is no longer provided. SECTION 4 PERSONAL ASSISTANCE CASE FOR PERSONAL ASSISTANCE/ MAKING PERSONAL ASSISTANCE WORK/ RIGH & RISKS FOR BOTH PARTIES: ‡ Using personal assistance has a long history but has only recently been recognised as an established alternative to receiving care services. ‡Wages for care recognise the value of work but may affect the nature of the care relationship and the range of choices open to carers .have increasingly looked for ways of identifying and paying for the costs of informal care. SECTION 2 ± ORGANISING CARE ARRANGEMENTS FOR CARE & SUPPORT/ VALUING CARE: ‡ People who give and receive help and support depend on a mix of paid and unpaid sources. ‡Being able to employ personal assistants can turn round a disabled person's situation. but particularly to some older women for whom evidence of managing their home may be central to their sense of identity. ‡ Someone's capacity to manage or understand direct payments should not be judged on the basis of their ability to manage other aspects of their lives. ‡ For most carers and people being cared for finding out about 'benefits and entitlements is a constant struggle. ‡ Often it is quite ordinary and everyday things that make a difference to how autonomous people feel in their living arrangements. ‡Payments for care have come about as a result of a number of factors.

She thinks that by calling it care can make it sound like dependence. Sarah gets direct payment topped up by Independent Living Fund. Sarah also gets help from her disabled mother at home and help from other students. John says Mr Ashgar gets Attendance Allowance. D&I: Sarah has strong sense of identity as a disabled person and as a student. R&R: both Alex and her carer are aware of risks to them in enabling Alex to live life she chooses. Enid also gets help from friends and relatives.Alice Kadel Ruth Bailey ³Good Companions´ Unit 13. but she¶s worried she won¶t be entitled once she turns 60.Unit 13. Diane says that she gets help with dog minding. They had a discussion with the local Independent Living Advocate and realised they would be able to use direct payments to enable David to do the things he wanted with the people he wanted to.Reader article 40 ± T&B Discussion by the three writers of a situation in which social and personal distance is being maintained between employer and employed person in circumstances where quite personal tasks of assistance are being carried out. John describes the basis of caring as a mutually beneficial relationship. The Local Authority recognised David¶s trust as a good way for people who may not have the capacity to consent to take advantage of direct payments as there are safeguards for him to be able to make choice and control. care giving and receiving . He had choice in what to spend the money on and chose to use it for holidays and weekends away with supporters.COURSE THEMES AND CASE STUDIES Diane Mallett & Paul .Audio 4. He gets long term friendship from Mr Ashgar. Daphne du Maurier . She uses it to pay for personal assistances and uses her pension and savings to pay for taxis and train fares. personal assistance .Sarah Fletcher .John Avery & Mr Ashgar .Unit 13. Depends on her helpers to sustain her student identity. but thinks he is unable to get ICA as it may affect his other benefits. Clare Ungerson .Ruth Bailey ³Good Companions´ . programme 2 ± T&B / P&I / D&I Diane says she doesn¶t get any payments although used to get invalid care allowance (ICA) when mother-in-law was alive. she saves her son¶s money and buys them clothes and other things with it. The difficulties with respite care is that it is often about carers needs and not the needs of the person with learning difficulties or other disability. gardening. shopping an other jobs around the house. They set up an Independent Living Trust with a close family member acting as the 3rd trustee and David¶s care manager made all the arrangements. She is self-reliant and doesn¶t really need any extra help.³Care as a commodity´ . but Diane thinks he would have got more if he had been assessed before she intervened. programme 2 ± T&B Discussion of Alex and Kathryn¶s care relationship as care user and personal assistant.right to support and the course themes P&I: Alex has power to hire and fire assistants ± they rely on her for employment. His parents didn¶t want to use a traditional respite facility and decided that direct payments would be better. personal assistance . a working relationship . She looks on caring as a parental responsibility.Unit 13 . She tries to keep the care she gets to a minimum and she likes to be in charge.Reader article 39 ± T&B Discussion of the trend towards the commodification of care.Alex Zinga . Daphne du Maurier . Alex also gets direct payment. . care transactions . Paul gets lower level DLA. direct payments ± T&B / P&I / R&R David¶s parents felt he was getting older and that he and his family needed a break from each other. BUT if they did their job badly Alex could be left feeling vulnerable. Possibility of inequality and exploitation.Alice Kadel . Potential clash between R&R for each of them. Neither of them mention anything in their discussion about professional skills or training. She spends her ICA on herself. Her money goes towards her volunteer helpers at Uni.Unit 13. Sarah & Alex .Reader article 40 ± T&B Discussion by the three writers of a situation in which social and personal distance is being maintained between employer and employed person in circumstances where quite personal tasks of assistance are being carried out. Alex & Kathryn . and wonders if they do care. Diane says she cannot imagine being paid for what she dies and feels obliged to do it.Audio 4.Enid Francis & son . who help her get around and do some personal care.Unit 13.UNIT 13 . He got to choose his supporters. David . Sarah and her helpers live in same accommodation. Enid¶s son gets higher DLA and she gets ICA. Disabled people tend to prefer to train their assistants themselves.Unit 13. advice and support. T&B: Alex mentions she is keen to maintain her privacy and goes to bed early to avoid having more people coming round in the evenings BUT she also has to accept help with personal and intimate care.

‡Questions of cost also added to the pressure to shift care into the community. including personal care. are low paid. ‡Home carers. However. Though training opportunities have improved. like home helps. ‡Users¶ rights are now at the forefront of community care debates following the development of service users¶ movements . ‡ The 1913 Act introduced state control into the lives of people with learning difficulties and their families for the first time SECTION 3 HUMAN RIGHTS & WRONGS NEW VOLUNTARY ORGANISATIONS/ MENCAP/ PRESSURES TO CHANGE INSTITUTIONAL CARE/ MENCAP & HUMAN RIGHTS AGENDA/ RIGHTS INTO POLICY/ COST PRESSURES ‡Reaction against the institutional forms of care created a context to reform both the law and practice surrounding community care. often nonexistent. ‡In the past the work of home helps was confined to housework and training was basic. it was public disclosure about abuse in institutions and scandals that credited enormous pressure for change.WORKBOOK 5 . there is evidence that both home helps and home carers do and did more than the job description formally allows. ‡ Opposition to the 1913 Mental Deficiency Act came from those who were concerned to protect individual liberty. ‡ There are a number of enduring issues in social care: who should provide care. and the balance between care and control. ‡Today¶s home carers take on a wider range of duties. it is still seen as women¶s work with skills transferable from the domestic sphere PRESSURES FOR CHANGE SECTION 1 ± THINKING ABOUT CHANGE. and housework is a minor element of the job description.UNIT 14 SECTION 4 HOME HELP TO HOME CARE ORIGINS OF HOME HELP/ DEVELOPING CARE IN THE COMMUNITY/ LIMITATIONS OF GROWTH/ CLEANING OR CARING?: ‡The home help service began as a voluntary sector initiative and was only slowly taken into the statutory sector as part of the turn to community care. who deserves care. from changing ideas. SECTION 2 ± THE 1913 MENTAL DEFICIENCY ACT IDEAS AS A PRESURRE FOR CHANGE/ CAMPAIGNING FOR CHANGE/ POLICY INTO PRACTICE: IMPACT OF THE ACT: ‡ Eugenics. ‡ The campaigns which sought to control µfeeble-minded¶ people in the first two decades of the twentieth century generated public fears and drew on the development of a new body of expert knowledge. ‡ Getting questions on the agenda that challenge the dominant ideology is a way of exerting power. POLICY & POWER POWER/ FORCES FOR CHANGE/ ENDURING ISSUES IN SOCIAL CARE: ‡ Pressures for change come from stakeholders. was a popular and powerful force throughout much of the 20th Century. and from underlying social structural changes. ‡However. the idea that human perfection can be attained through managing breeding. ‡From the second half of 20th century the voluntary sector has played a significant role campaigning for the rights of service users and their families.

prostitutes and criminals. from home help to home care Audio 5.Shirley and Ann talk about their work as home helps in the 70s and it seems their identity as housewives and mothers was enough of a qualification for home help.Reader article 1.Unit 14. . They also know their boundaries and roles when it comes to handling medication.Unit 14. programme 1 ± D&I / P&I Shirley Maddrell & Ann Collingwood.UNIT 14 . community care under the mental deficiency act Reader article 6 ± P&I / T&B / R&R Discussion of the period from 1913 to 1946 where families were expected to care with little financial help. Ann & Michael Tombs.3 ± P&I Discussion of David¶s experiences within a long-stay hospital where punishment. The second woman he had children with was µnormal¶ and they went on to have µnormal¶ children.³From community to institution ± and back again´ . Beryl McLennan. programme 2 ± T&B / D&I. and they had no rights in law.Lee & Eileen see things differently today as home carers. and place emphasis on the personal care tasks they carry out. Kim Bell . institutional life under the mental deficiency act . and on the other land owners. They have training courses and work with other trained staff like district nurses. expected to exercise control over their family member. The study of the family generations found on the one side drunks. David Barron . Mencap . the need for respite care and leisure provision and the need for contact with other parents going through the same thing.Unit 14. Lee Davidson & Eileen Dixon . campaigning for change ± D&I / P&I / R&R Discussion of eugenics and the Kallikak family.³The history of community care for people with learning difficulties´ . P&I Discussion of the differences and similarities between home help and home care in the past and more recently. subjected to critical surveillance and threatened with having their relative removed. ban on mixing with the opposite sex and absence of rehabilitation meant there was a power imbalance. Discussion of Bedfordshire Mencap and why change was needed.COURSE THEMES AND CASE STUDIES The Kallikak family . the need for campaigning.Beryl talks about the needs of parent for information. the ignorance of the medical profession. They concluded that this evidenced the belief that feeble-mindedness was hereditary and such people should not be allowed to procreate.Ann & Michael talk about the need for more services. the importance of a pressure group. Brenda talks about the lack of support when her son was young. judges and lawyers.Unit 14. Brenda Nickson. for practical support in benefits and the needs of Asian families. with no formal training. They keep a professional distance even though they speak with sensitivity about their clients for which they provide intimate care. and the need for alternatives to hospital for long-term care provision. Marrying and having children with a µfeeble-minded¶ girl produced a son with social problems and a mental defect in each subsequent generation.Kim talks about Mencap needing more radical change to reflect the needs and interests of younger people who expect more than special schools and residential provision. for befriending.Audio 5. Jan Walmsley & Sheena Rolph .Unit 14. She believes Mencap is too dominated by older people who are not representative of the younger people like her son.

. ‡Managing transitions successfully demands a high level of skill and sensitivity on the part of workers. status and relationship may be challenged. such as a move into residential care. in some care contexts. TRANSITIONS & CHANGE SECTION 3 MODELS OF TRANSITIONS SOCIAL ADJUSTMENT SCALE/ INDIVIDUAL CHARACTERISTICS: HARDINESS/ COPING RESOURCES & RESPONSES: ‡ Theories which seek to explain how people adjust to transitions and change tend to emphasise individual characteristics such as µhardiness¶. while other theories recognise a multiplicity of factors combining to determine the individual life course. such as the role of key workers. and can facilitate sensitive individualised practice. are particularly hard to end. SECTION 4 LINEAR MODELS OF CHANGE & ADJUSTMENT HOPSON & ADAM¶SMODEL OF CHANGES IN SELFESTEEM/ BEREAVEMENT & PEOPLE WITH LEARNING DIFFICULTIES/ IMPLICATIONS FOR PRACTICE: ‡ Linear models of adjustment to change posit a fairly predictable cycle of responses to personal transitions. and staff who are TRANSITIONS & CHANGE prepared to listen to what people want. ‡ Friendship and the fostering of social skills may be a key to a successful transition. or a failure to apply them.SECTION 5 TOWARDS BETTER PRACTICE? WORKBOOK 5 . such as learning disability services or dementia care. ‡ Indiscriminate application of models of linear adjustment run the risk of setting a rigid norm against which individual¶s actions are judged. ‡ Receiving care at home can mean that people¶s accustomed territories and boundaries of space. ‡Roles.UNIT 15 LEAVING HOSPITAL/ MANAGING RELATIONSHIPS/ PRACTICE LINKS: ‡People in care settings inevitably experience numerous changes as they or the staff move on. role. ‡ Transitions usually refer to changes in an individual¶s life that involve discontinuities in place. may not always be experiences negatively. not force upon them what the service wishes to provide. ‡Life maps are a tool for sequencing the main events in a person¶s life. role and status. ‡ However. ‡At the same time the ability of people to cope with change also depends on their access to resources such as social networks and mutual help. ‡ Techniques like a video diary allow the teller to project his or her own identity. ‡ Some normative theories of human development predict and describe what should be happening at a given time in an individual¶s life. ‡ Theories of modernity contrast with more traditional understandings of fixed life stages arguing for a more fluid approach as people construct their own identities and biographies. relationships. SECTION 2 ± TRANSITIONS USING RESEARCH SETTLING IN & MOVING ON/ SPATIAL ODERING OF CARE & HOME: ‡ Some transitions. ‡Enhancing people¶s ability to bring their personal resources to bear on managing change require robust. can lead to highly unsupportive and inhumane practices. well-resources systems. AUTOBIOGRAPHY & DEVELOPMENTS IN PRACTICE: ‡ Transitions are a process of personal change which requires inner adjustment. rather than one imposed by others. ‡ Both individual agency and social structural factors are important in explaining life course perspectives. SECTION 1 ± TRANSITIONS USING LIFE STORIES INDIVIDUAL MEANINGS / IDENTITY & DIFFERENCE / GLENDA: VIDEO DIARY/ INDIVIDUAL ACCOUNTS: STRENGTHS AND WEAKNESSES/ BIOGRAPHY. ignorance of linear models. which require close relationships to be built up for their success. ‡ It is important to be aware of the wider contexts and particular design when evaluating research.

She says that the system is designed to support weakness rather than strength. Control: Glenda puts a lot of emphasis on control.³Places in between´ .Unit 15. her story does leave bits out and this is a danger with subjective accounts. Found that the key to a successful adjustment was social relationships (networks). Julie promised to still have involvement in a friendship sense rather than as staff. transitions T&B Discussion intended to develop understanding of how older people accommodate the idea and experience of moving into a care home. Glenda doesn¶t present her identity as a mental health survivor or as someone who has an illness. and then using evidence found in case records to help her to understand why she was in care ± fill in the gaps.Unit 15. Difference and identity Julia Twigg ³Care work and bodywork´ . This was probably just his way of coping with the transition. However. Challenge: Glenda relishes in challenge. Control: she fought to gain sense of control. fighting for the kind of support she wanted.Unit 15. Reed et al ³Settling in and moving on´ . She describes the impact on her identity as profound. his behaviour became more and more disruptive. Scale seen as too general and of limited use in helping people understand their own lives. Cas and Korbasa¶s model ± T&B Relevance of Korbasa et al¶s model: Challenge: rose to challenges of navigating the benefits system alone. and control of space is easier at home.unit 15 hardiness D&I Glenda¶s experience using Korbasa et al¶s model. Being at home alters the power relationship between client and worker. managing relationships . Twigg argues that being at home with personal possessions mitigates against loss of identity. Mabel Cooper .Audio 2. Glenda . programme 2 ± T&B. Existing social skills were also a factor in enabling residents to build up social resources.P&I / T&B / D&I Discussion of the processes that care givers and receivers should go through when recognising the need for institutionalisation. As she had to gradually withdraw from her involvement with Stephen due to her new job role and demands. Cas had resources available to her to be able to cope with the transition.2 ± D&I/P&I Cas¶s story of her own battle to successfully leave hospital.COURSE THEMES AND CASE STUDIES Glenda . Glenda . Mary tries to resist pressure to institutionalise Nina. which adds meaning to her account. Cas Alland . transitions as linear process Reader article 24 . care´ .Unit 15. transitions D&I Discussion of Mabel¶ life story from memory.Unit 15. However. She attributes her life course to chance and personal qualities. and she had successfully built up a good and trusting relationship with Stephen. and the system is flawed as was misinformed about eligibility criteria and entitlements to benefits. Mary in Gubrium ³The prospect of residential. She talks of determination to regain some control over her life. Cas believes she was strong or µhardy¶. which explain her life in terms of personal misfortune and her willpower to succeed. transitions Reader article 33 ± P&I / T&B / D&I Discussion of whether receiving care at home is a different experience to receiving care in residential setting regarding transitions. when the time came for her to move on she did not handle it well.Unit 15. Commitment: commitment isn¶t mentioned much and her family have not given her consistent support.unit 15 and social adjustment theory D&I Holmes and Rahe scale of social adjustment. Glenda¶s account makes use of a life map to help her explain significant changes and stages in her life which were important to her. her life has been a challenge and she takes pride in rising to it. which Julie should have managed more professionally and imposed some boundaries far earlier on. .UNIT 15 . Julie & Stephen . a middle aged woman who spent most of her life in mental health system. Stephen had a dependence on Julie. Commitment: she marshalled important personal relationships to support her. details why she resists the pressure and explains the tension caused by the resistance. leaving hospital Reader article 1. and is important for her to be in control of her life now also through having her own car and administering her own medication. transitions Video ± D&I Discussion of Glenda. Glenda¶s head injury would feature on this scale.Unit 15.

‡Effective achievement of new objectives requires understanding of the dilemmas which social care workers experience in their practice. there are many continuing issues. ‡ More emphasis on the views of users and carers has led to changes in work relationships and the planning of training. if social care workers are to seek out research and draw on it effectively. but is often accompanied by uncertainty and stress. retention and training strategies. and in local populations. SECTION 2 ± ADAPTING TO CHANGE ORGANISATIONAL CHANGE/ PRACTICE CHANGE: ‡ Organisational change can provide valuable new opportunities. ‡ Statistics are an invaluable tool ± but caution is required in interpreting and drawing on them . from individual social care agencies to the European Union. ‡ A questioning approach and critical capacity are necessary. ‡ Shifting health/social care boundaries have encouraged rethinking of training structures and aims.UNIT 16 ‡ Good quality research is indispensable as an aid to understanding. ‡ The available information about characteristics of the workforce suggests questions about who gains access to the social care workforce and what their experience is once in post. but so too do shifts in ideas and policy priorities. education and other opportunities for learning are critical aspects of such support THE CHANGING SOCIAL CARE WORKFORCE SECTION 1 ± THE VOICE OF WORKERS CHANGING RESPONSIBILITIES/ EASING BOUNDARIES ‡ Some workers have had to develop new skills to meet new demands. ‡ Training.SECTION 5 A ROLE FOR RESEARCH WORKBOOK 5 . ‡ Organisational change may have implications for practice. ‡ Such issues are being tackled at many levels. and can make an important contribution to improving practice. ‡ Workers need to be confident of appropriate support in order to meet the expectations of the quality agenda. SECTION 3 WHO ARE THE WORKERS NUMBERS & EMPLOYMENT PATTERNS/ CHARACTERISTICS & EXPERIENCE/ EVALUATING STATISTICS ‡ Information about the social care workforce is needed to judge the effects of past policies and to plan recruitment. SECTION 4 CHANGING ORGANISATIONS WORKING CONDITIONS/ ARRANGEMENTS FOR SUPPORT/ OPPORTUNITIES FOR LEARNING: ‡ However great the changes in social care.

lack of sensitivity to employees and service users Positive: staff functioned as a team.UNIT 16 . staff identities threatened or compromised. changes in the training of nurses. R&R. training and other opportunities. skills used.COURSE THEMES AND CASE STUDIES Audio 5. continuity with service users. confusion and low morale. P&I Relates to relationships with service users. Possible problems ± health/social care have different values ± create animosity/resentment/threat. Audio 5. instability and uncertainty. medical needs & social needs vary. health and social care under one umbrella. meetings more holistic. conflicting individual cases biased on two different approaches/models. more specific skills. R&R. joint training seen as another encroachment on their territory. Skills ± more paperwork. D&I. joint training for health and social care needs. . . service users experienced upheaval. Barbara . drew on each other¶s experience/knowledge. better meet individual needs. preparation for working in the community. more innovative. holistic way to provide services to users using wide knowledge and experience base from medical/social professionals. Programme 3 (track 3) ± changing responsibilities & relationships ± T&B. availability of diverse services.Relationships ± closer contact with service users before NHS and Community Care Act. clearer job descriptions. D&I. boundaries between health and social care. Programme 3 (track 4) ± interprofessional learning ± T&B. increased stress. Boundaries ± most caring tasks by nurses not undertaken by family or social care workers. social carers not nursing carers ± a difference in social and medical models of care. Wider range of resources.3 Being reorganised ± all course themes Negative: Established relationships disrupted. increased staff turnover. 1990. dilution of established boundaries The reader Chapter 32. had to be rebuilt. P&I Positive aspects ± closure of long-stay hospitals. wider skill base and training. more chiefs fewer Indians. more tarining and development.

SECTION 2 ± COMMUNITY DEVELOPMENT HISTORY/EXAMPLES/METHODS/EVALUATING DEVELOPMENT: ‡ Community development seeks to release the potential within communities and to change the relationships between people in communities. negotiation. provision of jobs. ‡ The main forms of community initiatives (e. ‡ Communities tend to be defined as much by identity and support as by space. which is an activity (or µprocess¶). credit unions) are community businesses and social enterprises (e. ‡ Community development methods are essential to building caring communities. can be innovative and flexible in ways which meet the needs of carers (members) and users. networking and resourcing. goods or services ± and to secure long-term financial independence. ‡ Creating caring communities means taking a broader view of communities and their needs. capacity building.UNIT 17 COMMUNITY INVOLVEMENT/CARING COMMUNITIES: ‡ Community involvement is a prerequisite for the success of regeneration programmes.g.g. ‡ Two key concepts in regeneration are capacity building and sustainability. LETS. such as home care co-ops. professions and social movements. ‡ Community development has had an impact during the last 50 years through its methods and goals ± particularly on public authorities. WORKBOOK 5 . co-ops). ‡ Community development has adopted and developed a range of methods and techniques.SECTION 4 COMMUNITY INITIATIVES BUSINESSES/SOCIAL ENTERPRISE/EXAMPLES: ‡ Community regeneration initiatives aim to address a local unmet need ± for example. ‡ From different perspectives the idea of community can generate issues which may both divide and unite people. communication. ‡ Involvement of the people in a community is usually considered essential to healthy and sustainable community development. CHANGING COMMUNITIES SECTION 1 ± WHAT IS THE COMMUNITY? ‡ Memories of past communities illustrate the significance of community and its meanings for community members today. ‡ µStrong¶ communities are not necessarily immune from problems. organising. ‡ The greatest benefit of community businesses may be in capacity building and meeting social needs unmet by the market economy. ‡ Caring for communities means involving everyone from bottom to top. skills. ‡ Social care co-ops. as well as the institutions that shape their lives. ‡ Community regeneration is a goal (or µtask¶) that depends on community development. . SECTION 5 COMMUNITY INVOLVEMENT & DEVELOPING CARING COMMUNITIES SECTION 3 REGENERATING COMMUNITIES POLICY/CAPACITY BUILDING/SUSTAINABILITY: ‡ Regeneration started with a concentration on economic initiatives but has now broadened to include a range of social activities. These include community profiling and policy analysis.

regeneration of communities ± Offprints ± D&I/ P&I Discussion about capacity building and the Sandwell project. Darnall and Tinsley qualify for government assistance under the Single Regeneration Budget and there are a number of projects of a community development nature ongoing. Steve Clarke . Yvonne and Shaffaq have local knowledge and are aware of changing needs.Unit 17. programme 4 ± D&I/ T&B/ P&I Discussion about the idea of community for the women of Butetown. Disadvantages include: tendency towards closed and similar types of membership. community development ± P&I/ T&B Discussion of the advantages and disadvantages of LETS scheme. getting help with gardening. regeneration of communities . developing organising and networking skills. Shepshed carers Co-Op . awareness by a community of its capabilities. Training was seen as vital. . By 2004 there were 75 carers and 250 clients and the co-op provided over 1000 hours of care a week. programme 1 ± D&I/ T&B/ P&I Discussion of Yvonne and Shaffaq¶s community development roles in comparison to the women of Butetown.Reader article 12 .UNIT 17 . Keen to build on community strengths and stress the importance of bringing people together.Unit 17. home of one of the earliest established Black communities in Britain.Unit 17. They compare the past to now and discuss the impact of racism. Sandwell Regeneration Partnership .Unit 17. Capacity is referred to as something to develop in the local population so that it plays a fuller role in regeneration and development. Yvonne¶s health project for example. 61 were social services referrals and 51 private arrangements. Yvonne Wells & Shaffaq Mohammed from Darnall & Tinsley . household and computing problems. LETS as community development . sense of community from shared hardship and neglect. Suggests success in regeneration depends on: defining the community.D&I/ T&B Discussion of the process of community regeneration as opposed to community development. improvements to the members¶ self-esteem and better social contact. By 1995 the co-op had 41 carers and 112 clients. community initiatives ± T&B Discussion of a carers co-op and how it works. As with Butetown. stigma attached to postcard. Advantages include: skills outlet.COURSE THEMES AND CASE STUDIES The Butetown Women . poverty and stigma on their community and on the relationships of the residents of the community who seem to have thrived in sticking together through the years against oppression. Tinsley described as close knit community. Of these.Audio 5.³The regeneration of communities´ . They were experienced members of St John¶s Ambulance and were encouraged by district nurse to fill a gap between social services home care and family support. Formed in 1994 through two women who had lost their jobs.Unit 17. involving people in the process of planning and decision making. In 1997 the co-op found an office space. They have an organising and campaigning role. community development Video 1. what is the community? .Unit 17.

‡ Insensitivity to victims and to the trauma they may have suffered may make it difficult for them to give an account of what has happened. ‡ Respect for autonomy and self-determination has to be weighed against the overall goals for ultimate benefit and empowerment. one designed to prevent vulnerability and promote resilience. SECTION 3 SOCIAL MODEL OF VULNERABILITY VULNERABILITY & PROTECTION ‡ Vulnerability can be compounded by a failure of individuals and organisations to respond. ORDINARY RISKS/COMPUNDING FACTORS: ‡ Seeing vulnerability as located in individuals may give a distorted impression of what is happening to them. sexual or financial exploitation. ‡ Some actions described as abuse would in other circumstances be labelled as crimes or other illegal acts. SECTION 4 CRIME AND ABUSE WHO IS RESPONSIBLE/DENIALVICTIM BLAMING: DIFFERENT PERSPECTIVES/ LABELLING PEOPLE VULNERABLE: ‡ Any intervention designed to protect should lead to acceptable outcomes. ‡ We may also fail to recognise that people not specifically labelled as vulnerable can experience abuse.SECTION 5 SYSTEMS TO RESPOND TO ABUSE WORKBOOK 6 . ‡ Such judgements may be influenced by whether an action or a failure to act is seen as deliberate or malicious. ‡ A sensitive response is important in terms of gathering evidence so that others can be protected in the future and criminal charges brought when necessary. ‡ Heavy-handed and insensitive responses can leave people worse off. compounding the vulnerability. ‡Inter-agency coordination is important if the systems are to be effective. material and political resources.UNIT 18 SECTION 6 CRIME AND ABUSE SPECIAL PROCEDURES/REDRESS THROUGH ORDINARY CHANNELS: ‡A number of different systems are available for policing the wrongful treatment or abuse of vulnerable adults who are users of services. . neglect. ‡ Deciding whether or not something should be termed abuse is often a matter of judgement. such a label may be interpreted as stigmatising. SECTION 2 ± WHAT IS MEANT BY ABUSE? DEFINING / RECOGNISING ABUSE: ‡ Abuse may involve physical or psychological harm. ‡ On the other hand. ‡ Thinking in terms of a social model of vulnerability draws attention to the way vulnerability is created and compounded by a lack of social. ‡ Being labelled a vulnerable adult may entitle someone to additional support or services. ‡ We may forget that many risks are ordinary risks and include crimes. ‡Access to ordinary systems of justice is problematic for vulnerable adults. negligence or discrimination. ‡ A social model vulnerability suggests a radical agenda for protection. SECTION 1 ± WHAT IS VULNERABILITY? DIFFERENT PERSPECTIVES/ LABELLING PEOPLE VULNERABLE: ‡ Vulnerability may be seen as resulting from a range of different personal and social factors. by how serious the consequences are. ‡ People are more vulnerable when they have limited access to resources to help them to recover from crime and abuse. which should be seen as such. who are often excluded from opportunities to seek redress and lack the support needed to enable them to take part successfully. appropriately to victims of violence ‡ One response is to blame the victim for what has happened. or by how powerful those responsible may be.

vulnerability and abuse . Michael Preston-Shoot . stopped attending day centre as he got bored. got behind on rent and landlady was threatening eviction. Eric & Nancy . programme 2 ± R&R/ T&B Discussion of Mrs Willis¶s daughter in law¶s concerns about the care she was receiving.³Evaluating self-determination´ Unit 18. . No one thought it necessary to get Clifford¶s injuries checked out properly. Lives near brother but other family not around. Became depressed and displayed signs of PTSD. Falls between 2 services and on borderline of being classed as vulnerable adult. began drinking and was too scared to leave house even to sign on or cash his giro.Reader article 22 ± R&R / P&I Discussion about older people living at home in at risk situations with their carers. programme 2 ± R&R/ P&I Discussion of Eric and his wife Nancy who lives in a care home.Audio 6. the police officer was responsible for dealing with the proprietor¶s wrongdoing and the district nurse was responsible for Mrs Willis¶s care. vulnerability and abuse ± P&I/ R&R Discussion of Clifford. which could have led to serious repercussions. Landlady lives on site. an African-Caribbean man with learning difficulties and hearing impairment.Unit 18. Mike and David . but Eric knew what questions to ask to find out from her what had happened and he managed to get to the bottom of it. Wasn¶t until later when police returned his wallet that they realised his learning difficulties and offered a proper interview with the support Clifford required. The police did not pick up on his learning difficulties or his deafness and so was not offered the appropriate support for his interview. Positive freedom allows for self-determination.Unit 18.Unit 18. Mike had to ascertain the situation on behalf of social services. and his own brother believed that Clifford must have brought it upon himself. The author discusses positive and negative freedom.COURSE THEMES AND CASE STUDIES Clifford . He was though considered an unreliable witness and his case never made court. but he didn¶t want to. but who do not want to take any action or receive any intervention. and the police should have had a duty of care to Clifford. Clifford eventually consented to social services being contacted and they decided it would be best for him to go back to day centre. vulnerability and abuse . Unreliable for work.UNIT 18 . In the meantime he had lost his job and brother was annoyed with him.Audio 6. Gets attacked. I t is possible that Clifford was assumed to be in some way responsible for his attack as he appeared to be in a drunken state. Mrs Willis. vulnerability and abuse . and difficulties in walking resulting in awkward gait. the social services did not want to bother getting involved at the early stages for what they deemed was a trivial incident. autonomy and choice.Nancy¶s bracelet had gone missing and she had some bruising and the staff were unable to make sense of what had happened.

including health and social care work.UNIT 19 RIGHTS & DANGEROUSNESS SECTION 3 MANAGING RISK & DANGEROUSNESS POLICY/HIGHRISK INDIVIDUALS/STRATEGY: ‡ Different risk policies have different implications for practice. WORKBOOK 6 . Numerical scoring can give the impression of accuracy. ‡ Our perceptions of risk are influenced by the way in which blame is allocated in society. ‡ A model of risk assessment which combines these approaches and encourages practitioners to be explicit about severity and likelihood can be useful. ‡More attention is being given to the rights of users in relation to the assessment of risk and dangerousness and ways of making those rights a reality. . ‡ The concept of risk is often confused with the concept of dangerousness. ‡ Anti-protectionists argue that blanket strategies will inevitably threaten the civil liberties of some individuals. ‡An overemphasis on dangerousness and safety can obscure the needs and strengths of service users. ‡ It is important to critically examine the quality of evidence used in assessment of risk and dangerousness. ‡ Assessing risk in the context of everyday life involves weighing possible negative outcomes against possible positive ones. ‡ Risk taking can have positive as well as negative outcomes. ‡ The media and campaigning organisations play a key role in influencing individual values and perceptions of dangerousness. but can also be ambiguous. ‡ Professional values are significant in shaping decisions about risk and dangerousness. ranging from empowering practice at one extreme to highly protectionist practice at the other. SECTION 2 ± RISK ASSESSMENT IN HEALTH/SOCIAL CARE TWO APPROACHES/POTENTIAL OUTCOMES/EXAMINING EVIDENCE/IMPORTANCE OF VALUES: ‡ Two main approaches to assessing risk and dangerousness in health and social care are the actuarial and the clinical. ‡ Strategies for managing groups identified as high risk or dangerous have advantages and disadvantages.SECTION 4 INVOLVING SERVICE USERS USERS/CARES¶S VIEWS/ RIGHTS/ETHICAL FRAMEWORKS: ‡Technical approaches to risk management and assessment can position service users as objects rather than subjects of the process. ‡ Risks and dangers which are characterised by fright factors tend to get more attention than others. ‡ Evaluations of dangerousness are strongly influenced by personal experience and values. ‡ Written reports may contain ambiguous language. ‡The assessment and management of risk has to be placed in an ethical framework and informed by the perspectives of those subject to decision making. ‡ A transparent and explicable model of risk assessment goes some way towards combating the uncertainty inherent in predicting risk and dangerousness and helps to generate constructive interventions. SECTION 1 ± RISK/DANGEROUSNESS IN EVERYDAY LIFE EXPLORING MEANINGS/EVALUATING/MEIDA¶S ROLE: ‡ Risk taking is a feature of everyday life.

Carla Thompson. risk and dangerousness and the media ± Offprints ± R&R Media report about the case of Daniel Joseph. Reluctant to move to a nursing home.Unit 19. Evidence from his father and other associates was ignored and not recorded as it was subjective material. They agree in the end to allow him so much for scratch cards and the rest for his other needs.UNIT 19 . who murdered a girl. risk assessment ± values in decision making . James argues he should be allowed to spend his money how he pleases.R&R Joy and Nadine work in residential home. unemployed and history of depression and at possible risk of harming himself. James is spending a lot of money on scratch cards and lottery and not on personal hygiene items. He has been treating Ernie aggressively.Unit 19. Been drinking heavily and the other women have been complaining about her. John . 33. Ernie is 78 and physically frail. 34. Daniel Joseph . including homelessness.Reader article 21 ± R&R Discussion of the difference between lay and professional perceptions of risk. and although Ernie has not complained. He finds Ernie irritating and winds him up. living in supported housing with 2 other women. with learning difficulties. Nadine is key worker for George who recently moved in. risk and dangerousness ± R&R/ P&I Discussion of James. Brenda Unit 19. risk policies ± R&R Discussion of relevant risk policies for Brenda. so GP is anxious at John¶s sudden comments about self-harm and suicide. was reported to be carrying weapons regularly. was deaf and was also Black. Nadine and Joy feel it is a risky situation. He is 72 and has had an unsettled life. Joy and Nadine.COURSE THEMES AND CASE STUDIES James . . Wanting to go on holiday with friend Louise who also has learning difficulties.Jenny.Unit 19.³Risk and dangerousness´ . He has a history of mental health problems. Parents have been in contact to say he shouldn¶t be allowed to spend his money in this way as it will lead him to gambling addiction. and suffers from depression. She recently set the chip pan on fire after trying to cook drunk. risk and dangerousness . risk assessment ± R&R Discussion of John.Unit 19. History of mental health problems. Ernie and George . Andrew Alaszewski. risk management strategy ± R&R Discussion of Jenny and trying to find a risk management strategy for her. risk assessment ± evidence ± Offprints ± R&R Report on Anthony Smith who killed his mother and step-brother.Unit 19. John¶s father killed himself. Residents were frightened and the staff are now concerned that Jenny may be a danger to herself and others. Jenny .Unit 19. and Joy is Ernie¶s key worker. moderate learning difficulties living in supported accommodation. The article is presented to show that he was let down by the services and was a vulnerable young man and did not allude to the usual stereotypical reports of madmen on the loose. lives in group home for people with learning difficulties. 35. 45. Anthony Smith .Unit 19. but this could have provided valuable clues. A neighbour saw the smoke and called the fire brigade.

. SECTION 2 ± REGULATION SECTION 3 REGULATING WITH LIGHTER TOUCH ‡ Maintaining the boundary between a domestic and an institutional setting is an issue that concerns owners. ‡Managers and care staff need to feel accountable for the care practices in the care settings where they work. ‡ Nationally agreed minimum standards of care have taken time to achieve because of the sometimes conflicting interests of different stakeholders and variations in how quality has been assessed. ‡ Observers may use many different ways of judging quality of life in residential settings. focus groups. is commonly used in assessing quality of life in residential settings. ‡ In small homes a lighter touch approach to inspection has supported more informal styles of residential care for vulnerable adults INSPECTION/REGULATION/STANDARDS: ‡ The main purpose of regulation and especially inspection is to guarantee that standard of care being provided to service users. WORKBOOK 6 . the Scottish Commission for the Regulation of Care in Scotland. interviews and observation. ‡ A combination of approaches. including objective and subjective measures of experience and care environments.SECTION 4 ASSESSING QUALITY MEASURING QUALITY/USERS¶S VIEWS/OBSERVATION: ‡ Quality must be defined and assessed for it to be incorporated into regulatory standards. SECTION 5 ESTABLISHING STANDARDS REGULATING FOR QUALITY SECTION 1 ± WHAT IS QUALITY OF LIFE? OBSERVING QUALITY OF LIFE/RESIDENT¶S & EXTERNALVIEW/PERSPECTIVES: ‡ Residents and other parties¶ views on what constitutes quality of life differ because of their different interests and perspectives. ‡ A major issue in assessment is the distinction between subjective and objective dimensions of quality of life. ‡ Inspectors have to weigh up competing and sometimes conflicting interests as part of the regulatory process. residents and the inspectorate. and the Northern Ireland Health and Personal Services Authority in Northern Ireland. ‡Comparisons across service user groups can help to develop a more critical approach to assessing regulation and inspection as a process. ‡Recent legislation about whistleblowing should help workers to voice concerns about abuse and malpractice. ‡ The regulation and inspection of care services against care standards is carried out by the CSCI in England and Wales. ‡ Ways of eliciting users¶ views include questionnaires.UNIT 20 MEETING STANDRADS/INSPECTION PROCESS: ‡Standards are only the base against which quality of life in care settings is judged.

They were all concerned about the difference in age groups between staff and residents and the fact that they were all young and black. and Mary who also worked there and was abusive to the residents and staff.Unit 20. However. Elizabeth Russell and Theresa Lefort. Stella suggested you couldn¶t really say what you thought.Each of the ladies had a different opinion about the home. The inspector on hearing the evidence from Jane and other workers referred the matter to the police and Mary was suspended. The resident died and Brenda resigned. The owner was arrested. and of how Hannah gathers information from them to ascertain quality of life in the home. she was not taken seriously and found the whole system to be corrupt and uninterested in the allegations. regulating with a lighter touch Reader article 28 ± T&B/R&R Discussion of the process of regulation in smaller residential homes as opposed to larger ones. a care assistant in a residential home for older people. She was welcomed back at work and all action was dropped. Brenda in John Burton ³Exposing abuse in care homes´ . Jane was also suspended in case she hindered the investigation.Unit 20. and Hannah Hanley.UNIT 20 . a day care assistant at a private rest home.Unit 20.Hannah has to check records and make a mental checklist when looking round the home. However. She decided to inform the inspectors when they visited. Jane was then told she faced disciplinary action for breaking confidentiality and damaging the reputation of the home. Holland and Peace ³Regulating informality: small homes and the inspectors´ . Gladys Unit 20. There was a lack of magazines and flowers and tea making facilities which made her feel as though there was an assumption that people couldn¶t do it for themselves.Audio 6. police and social services. who tried to report abusive behaviour she had witnessed. Elizabeth and Theresa think of their residential home. Her job is to make an objective assessment of whether it meets statutory standards. Jane contacted Public Concern at Work who assured her of her legal rights and drafted her a letter. whistleblowing Reader article 27 R&R Discussion of Brenda. quality of life . as well as talk to the residents. .Unit 20. The inspector received an anonymous phone call from a member of staff and later contacted the district nurse.COURSE THEMES AND CASE STUDIES Stella Best.Jane witnessed a catalogue of abuse from Mary towards the residents. whistleblowing ± R&R/P&I Discussion of Jane. a resident in a care home who was being abused by the manager. whistleblowing ± Offprints ± R&R Discussion of Gladys. Gladys died shortly after. programme 3 ± T&B/R&R Discussion of what Stella. Plenty of evidence led to the owner¶s appeal being denied and the home was shut down. Jane and Mary . Elizabeth thought it lovely while Theresa found it clinical.

Criminal law is generally concerned with a deliberately evil intent and usually enforced by the police. although increasingly the primary reasons tend to be political and social factors. ‡ These rights are now part of UK law as a result of the Human Rights Act 1998. ‡ Disputes between private individuals are known as private law matters. access to the Ombudsman procedures and to the courts. the right to a fair hearing and the right to family life. approved by parliament) or are derived from the ancient common law (i. DUTIES & POWERS/STATUTE. RIGHTS. how to access it and understanding the difficulties using the law may entail. ‡ Many disabled people and their carers have immense problems in using these remedies for non-legal reasons such as exhaustion. ‡ EC law has previously concentrated upon harmonising economic arrangements among its member states: increasingly it is now requiring other common standards such as sex equality and nondiscrimination on the grounds of race and age. ‡ Local policies can be influenced by the use of social services and NHS complaints procedures and their respective Ombudsmen. . ‡ Governmental guidance. whereas legal issues that involve a public authority are known as public law matters. in general.UNIT 21 SECTION 5 MAKING CHANGES CHANGING NATIONAL LAW/SETTING PRECEDENTS/CHANGING LOCAL GUIDANCE: ‡ There are many reasons why laws are introduced or amended. a sense of powerlessness and fear of indirect repercussion. regional and political forces. SECTION 3 . NATIONAL & REGIONAL DIVERSITY: ‡ Your perspective of the law depends on your socio-political status: for the poor and socially excluded the law can be an oppressive instrument. ‡ The law sometimes leads (as with race relations legislation) and sometimes follows public opinion. ‡ Many important social welfare laws have originated as private members¶ bills.e. judge-made). ‡ Test case strategies have been used by lawyers to clarify in a positive way the interpretation of many social welfare statutory obligations. ‡ Social care workers can help people to make changes by knowing about law. even within states such as the UK there are significant local variations in the law. ‡ Social welfare guidance falls into two broad categories: policy and practice guidance. Judicial review is an example of public law proceedings.COMMON.SECTION 4 OBTAINING PRACTICE REMEDIES/GAINING ACCESS/EQUALITY & JUSTICE: ‡ The law provides victims of injustice with various remedies. if you know what to look for. WORKBOOK 7 .e. ‡ Although the law can be accessed via the internet and libraries. ‡ The political philosophies underlying the UK¶s social welfare laws have changed radically over the last 50 years and the territory of the law has changed accordingly. such as the right to use a social services department or NHS complaints panel. SECTION 2 ± TYPES OF LAW EUROPEAN UNION/EUROPEAN CONVENTION ON HUMAN RIGHTS (ECHR): The ECHR protects important negative rights such as the right not to be the victim of degrading treatment. to clarify what are the key issues. including judicial review.RELEVANCE OF EUROPEAN LAW USING THE LAW SECTION 1 ± THE FUNCTION OF THE LAW? CULTURAL. is of crucial importance in the development of local social welfare rights and services. ‡ Most disputes concerning social welfare services are civil law matters. Policy guidance has a higher legal status and must in general be followed by local councils and NHS bodies. although lacking the status of law.CRIMINAL & CIVIL LAW/PUBLIC & PRIVATE LAW: ‡ UK laws are either statutory in origin (i. ‡ Laws are shaped by cultural. ‡ Social welfare law is predominantly governed by statute law. the use of expert intermediaries (including care workers) is helpful. if not essential.

As a result the law was changed in Ireland. Kulvinder was told she was wasting her time and interfering. Kulvinder.³Community care law and the Human Rights Act 1998´ . Ireland . and his community care assessment which was reassessed and saw his care hours cut by 20 hours per week. A member of the public visiting another patient witnessed Mrs Clarke being force fed and Mrs Clarke was left breathless and in tears. ombudsmen ± R&R / P&I Discussion of Mr Grant. identifying legislation . Kulvinder called the ward manager and reported the problem.Unit 21. London Borough of Southwark (99/A/988) Unit 21. the advocate. arguing that it was the only way he could find out about his early life. She took the authorities to a tribunal and won.COURSE THEMES AND CASE STUDIES Margaret Forster . Mrs Clarke & Kulvinder . She argued that this would mean she had an unfair hearing as she was unable to afford a lawyer.Reader article 10 ± P&I Discussion of Margaret Forster.Unit 21. Luke Clements . or was simply unable to say.Unit 21. who has multiple disabilities and health problems. but she was very upset and appeared to have forgotten what had happened. legal aid ± R&R Discussion of the case of Airey. advocacy ± R&R / P&I Discussion of Mrs Clarke. He won and the Data Protection Act 1998 was enacted to make the changes identified by the European Court as being necessary into UK law. who successfully managed to gain access to his records of his time in care. and the failings of the Acts for disabled people. who fought to have the charges for her father¶s nursing care covered by the authorities. European Convention on Human Rights . in hospital.Unit 21. United Kingdom . The visitor approached the hospital advocacy service. She tried to communicate with Mrs Clarke.Reader article 29 ± R&R / P&I Discussion about the ECHR and the UK Human Rights Act with relation to health and social welfare. despite Mrs Clarke not having consented to this. and had been purposely left in there to prevent her being disruptive to the other patients.³Paying for nursing home care´ . This meant he would no longer be entitled to a grant from the ILF. Gaskin v. He then complained to the Ombudsman.Unit 21. He also disagreed with the way the assessment had been done and made a formal complaint. The European Court upheld that she could not have a fair hearing without legal aid. The visitor then saw the same member of staff taking Mrs Clarke to the toilet and was still being rough. severe dementia. who wanted to divorce her husband but was told she could not receive legal aid to assist this. European Law ± D&I / R&R Discussion about Gaskin. The Ombudsman found in favour of Mr Grant and recommended that he be compensated and his care plan be reviewed immediately. arrived on the ward 2hrs later and Mrs Clarke was still in the toilet. Kulvinder said she would be making a formal complaint. .UNIT 21 . Staff were suspended and ward procedures were reviewed. as the divorce rules in Ireland were such that a lawyer was needed for a fair hearing. Airey v.

changing local guidance ± R&R/ P&I Discussion of the council¶s charging policy for disabled people. Gateshead Metropolitan Council (99/C/02509) Unit 21. changing local guidance ± P&I / T&B Discussion of the case of a severely disabled person and carer. A court case later suggested that they were entitled to help under section 21 of the National Assistance Act 1948.Unit 21. and all the ones that would do it wanted travel expenses covering. both in 90s. The council would only waive the community care service charges for disabled people if they could prove hardship.CONTINUED R v. An assessment was made that he needed help to get in and out of bed but because of recruitment problems the agency proposed to withdraw its service to him.UNIT 21 . Complaint 99/B/00799 against Essex. The council wouldn¶t do it as it was against their policy. setting precedents ± P&I / D&I / R&R Discussion of the case of asylum seekers who were barred from receiving social security payments or assistance with housing. The council then amended its charging policy and the changes also sparked other councils to do the same as Ombudsmen reports are copied to other councils. The complainants provided evidence. London Borough of Hammersmith and Fulham ex parte M .Unit 21. The Ombudsman nevertheless found in favour of the couple and decided that the council was guilty of maladministration.COURSE THEMES AND CASE STUDIES . 29/3/2001 . The Ombudsman concluded that the council had acted improperly and misunderstood the law. The council couldn¶t find another willing agency. . but the council decided to impose full charges anyway.

peer. and more empowering for oppressed groups to engage in. crisis. citizenship. ‡ Support for self-advocacy draws on skills one would expect from any good care worker together with awareness of political context and values of justice and empowerment. DEBATES. some claim for it the status of a new social movement. Citizen. (See case studies for campaigning) SECTION 3 & 4 SKILLS FOR ADVOCACY CAMPAIGNING . professional. ‡ Different types of advocacy are popular with different groups of people. and how differences can best be represented . autonomy. ‡ Uncertain funding means that advocacy is not available to all who need it. ‡ Self-advocacy is viewed as qualitatively different to advocacy. ‡ There are pros and cons to advocacy as a paid professional role. whether advocacy should be short or long term.. ‡ Whether or not service-based advocacy can do more than address immediate concerns is much debated.UNIT 22 ADVOCACY AND CAMPAIGNING SECTION 1 ± DEFINITIONS. inclusion) (Selfadvocacy.WORKBOOK 7 . SECTION 2 ± SPEAKING FOR OTHERS/YOURSELF RANGE OF ADVOCACY TYPES/SERVIC-BASED/INDEPENDENT SELF-ADVOCACY/DIFFERENCES: ‡ Advocating for people with limited mental capacity or who have limited means of communication requires great sensitivity and high ethical standards. POLICY/CAPACITY BUILDING/SUSTAINABILITY: ‡ Advocacy requires a wide range of skills. parent/carer advocacy ± P72/73 Unit 22) ‡ There are arguments over who should be advocates. how advocacy should be funded. ‡ Self-advocacy supporters often work in isolation with few opportunities for training and reflection and are frequently accountable only to the self-advocates they support. DILEMMAS DEFINITIONS/TYPES/SERVICES/PRINCIPLES/POLICY/ PRACTICE ‡ Advocacy means speaking up for yourself or others (advocates speak/act on behalf of others) ‡ There are many different types of advocacy. all share common values (Empowerment.

Unit 22. She suggests that self-advocates only challenge practice in a particular context and have a naïve view of power on an individual level. Cheryl . MK SUN: service for mental health service users which believes that being a service user in the mental health sector is disempowering. . It is independent of health and social care services. WASSR: started by older people who saw that some older people lacked confidence to manage their affairs and needed support to assert their rights to health and social care. skills for advocates MK SUN focuses on individual advocacy and campaigning. and to be able to subscribe to the principles of autonomy. persistence. It relies on paid workers to support and train volunteers. decision and choice making and assertiveness. Most volunteers are women. WASSR needs to be able to set boundaries to their role and focus on short term crises. Cheryl began to find her voice . Both need to people skills. It is a long-term service and want to improve services. informing users of changes in legislation etc. self-advocacy -Reader article 30 ± P&I/D&I Critical discussion of self-advocacy for people with learning difficulties. advocacy for people who cannot speak up for themselves ± P&I/D&I Discussion of Cheryl. as is lack of information about the law and rights. They teach communication skills. and was thought to be unable to communicate verbally. programme 2 -± All course themes Discussion of 2 advocacy services. Befriended an advocate who after building up a relationship over a few months realised that Cheryl could talk quite well. listening skills. assertiveness.UNIT 22 .Unit 22. It is a shortterm crisis advocacy service. They adapted a system of communication using advocates elbow so that Cheryl could signal when she wanted to say something. a young woman who has always lived in institutional settings.³self-advocacy for people with learning difficulties . No one is taught about challenging policy. She sees self-advocacy as a tool to find out what people want of a service rather than a chance to challenge the philosophy of services and the system that creates them. Their advocates have a broader educational role. Simone Aspis . MK SUN needs networking skills to spread the word about advocacy and to be willing to engage in long-term relationships outside the boundaries of the service. Unit 22. law or power relationships. She believes that people are the victims of internalised oppression and that self-advocacy should be about challenging society to change the way it values people within learning difficulties and fighting for an ideal. empowerment and inclusion. relying entirely on volunteers. advocacy Video 2. The author describes speaking-up courses and what they entail. ability to locate and communicate information. although from all ages. She suggests that teaching about rights is idealised and impractical. It limits its recruitment to survivors of the mental health system and is a peer advocacy service.COURSE THEMES AND CASE STUDIES WASSR & MK SUN .´Unit 22. She criticises that these individualise self-advocacy skills and confine them within a particular context. It is entirely independent from health and social care services. It is mainly concerned with individual advocacy and has a desire to improve services.

supporting self-advocacy ± P&I/R&R Scenarios to show how supporters and advisors can help self-advocates to make decisions for themselves.Unit 22. personal campaigning ± P&I/T&B Discussion of individual campaigning. One of the group members shouted up and said it was right.´Unit 22.UNIT 22 . Carers campaigning for recognition ± target general public and government.COURSE THEMES AND CASE STUDIES Vignettes 1-8 . Imran retorted angrily to a joke a supporter made about not burning his house down with a lighter he had found.Unit 22.³Campaigning and the pensioners movement . Chrissie Maher founded Plain English campaign to have benefits forms etc written in plain English for ordinary people to be able to understand she now runs a worldwide operation to do the same. Lillian wanted to order herself a taxi but one of the supporters was worried she would get the address muddled up.A young Asian man wanted to join a social group but one of the members suggested he wouldn¶t understand and wanted him to go away. Cliff was overheard verbalising violence towards a member of staff ± one of the advisors suggested he go to anger management classes. . They wanted to double check on her address. and one of the members of the group asked if that included hitting her. Ken was told to stop making tea in case he scalded himself ± the advisor suggested the staff at the home show him how to make it safely. The supporter agreed and said that some people don¶t listen. not believing she would be right. Virginia explained problem behaviour as when people have a bad day or get upset and might feel angry. campaigning ± P&I/R&R/D&I Tinsley residents campaign to improve the quality of air and to reduce the traffic ± target Sheffield City Council. The campaign by NAPWF which resulted in the 1913 Mental Deficiency Act ± target general public and MPs. The advisor reminded her that the person had a lot of problems at home and she should bear that in mind. Denise was complaining that one of the other members was a pain. Mavis Murphy in Middleton for support for carers ± target health authority. Dave Goodman .Unit 22. campaigning Reader article 8 P&I/R&R Discussion of a successful campaign in Stoke-onTrent by pensioners for the restoration of the link between pensions and earnings. Campaigning by disabled people for accessible transport and against negative imagery ± targets were transport providers and ITV. Local campaigns against the provision of a mental health unit ± target local politicians. The advisor spoke up and suggested that know one knew what he would be able to understand. Campaigning in K202. Community Care campaigning for the continuing contribution of a social care perspective following publication of NHS Plan in 2000 ± target was government and social care workers. Chrissie Maher . Rudi said it wasn¶t always easy to stick up for yourself against nasty people. The Labour council supported them.