Social Care Policy Agenda and How Impacts on Future Social Work Provision - Essay Example

?A critique of the social care policy agenda and how it will impact on future social work provision Wordcount: 2753 Introduction Adult social care inthe United Kingdom gears up towards more personalised, preventative, and more focused delivery of best outcomes for users. Various policies and standards have evolved over time to address emerging issues and challenges as well as adjust on demand and evaluation of both users, carers, professionals and their counterparts in the policy-making. More recent moves include the devolution of power from central to communities and individuals with a more inclusive approach to service all those in need. The 2010 report of the Department of Health has assured additional funding of ?2 billion by 2014/15 but there had been programmes which funds were discontinued and without any clear direction as the Department seem to grapple with opposing demands as well as criticisms and evaluation outcomes. This paper will try to identify and evaluate relevant provisions of current adult social community care, critically analyse the current adult social care policy agenda and its impact on social work provisions, and critique the social care policy agenda and how it will impact on future social work provision with a focus on an adult with learning disability. It will also incorporate in the discussion the theories of normalisation, biological, social model/neo-liberal, social valorisation and person centred approach, medical model and social models. Discussion Government Initiatives The most recent effort of the government about social care is to address empowerment of communities and individuals to address local challenges. Adult social care policy applies the “putting people first” (PPF) approach that helps individuals become more independent, and in control of their own lives through their choices. This is called “self-directed support” where individuals choose their options for home care, hiring personal assistant, or use Adult Social Care (East Sussex County Council, 2010, P 1). High quality services are geared towards making people healthy and in-control of the kind of support they are provided. The Department of Health promotes in the system freedom with the aim to strengthen communities and individuals as autonomy replaces dependency. Another value promoted is fairness addressing the question “how do we pay for care?” (Department of Health, p 4). The government vies for clear, comprehensive and modern framework that considers both carers and adults who need support. The third value promoted is responsibility where Communities are encouraged to become innovative in creating networks of support for individuals. As the Department of Health suggested, “Care must again be about reinforcing personal and community resilience, reciprocity and responsibility, to prevent and postpone dependency and promote greater independence and choice,” (p 5). The main goals of PPF are: introduce self-directed support prevent problems through early intervention ensure availability of the different types if support for everyone help people use support networks (East Sussex County Council, 2010) . For social care workers, assessment and eligibility criteria may remain the same but changes may be in the care services and solutions that individuals may chose. Social workers involved in the process may include those working in Adult Social Care, voluntary or independent sector, or personal assistants. Carers are provided more involvement in decision-making through assessment of needs as well as planning for support. This will help the team or group involved in the importance of each contribution as well as understand the support the carer or social worker may need. The support plan involves an action plan that includes the list of things to do, by whom and a time table. The team of professionals will then have their roles defined. Additional funding for the future provides a cushion for policy-making and the implementation of improvement as well as redesigning of services to gain significant productivity. The Department of Health hopes that best practice documents can guide them towards a more personalised service for users and carers as power and control is devolved to communities (DH, 2010). The Principle The Department of health built its modern system of social care on seven P principles of prevention, personalisation, partnership, plurality, protection, productivity, and people. For the prevention principle, the DH believes that by empowering people and communities, they will work together to sustain independence with support from the state when needed. It believes that those who are involved know what is best for the services to work as users and carers work with the council. This encourages “user-led organisations and voluntary bodies to deliver outcomes that are right for them,” (DH, 2010, p 9). In addition, it relies on community action as neighbourhoods look out for those who are in need of support in a Big Society approach. The end result is a vision of stronger communities with less isolated and vulnerable individuals. It is expected that Councils will lead change and inspire their communities. Personalised care is encouraged through provision of users the power to control the services they receive. Their vulnerability is considered in order to protect user privacy. Block contracts are reduced to address individual needs through direct payments for maximum flexibility. Older people will be supported with sufficient information on availability of quality providers for appropriate needs to reduce costs. Being in financial control, users can strengthen their voice in managing for their support needs (DH, 2010). Those who are mentally incapable are addressed through control of a suitable person while those with disability should have the council and the persons closest to them help in evaluation of their needs. Expectation from Carers Professional social workers are expected by the state to be on the first line of prevention in order o prevent escalation of problems. It acknowledges for the need to properly identify and support carers as well by offering valuable range of personalised support for the carers. By being mindful, appropriate levels of care are expected from young carers for their adult users. This recognises the vital role of the carer in the process although carers have their own lives to consider. The telecare system has been tapped for carers and users. This will help users to live independently for longer periods with limited visits from care professionals. Through the re-enablement program of the government, temporarily disabled or sick users are helping adults to regain their independence in their own homes with reduced social care packages. This has been channelled throughre0enablement programs through the National Health Services or NHS. By 2010-11, it has allotted ?70 m and up to ?300 m for the next spending year. Good helping partnership and cooperation is also encouraged between user and carer. This is the focus of the DH’s Quality, Innovation, Productivity and Prevention (QIPP) programme that helps promote self-care, preventative care, early intervention, and minimisation of hospital and residential care (DH, 2010). The programs are topped with employment and housing services to improve well-being and address new needs. Direct payment approach are employed for users and their carers to address bureaucratic issues about reduced budgets as well as unnecessary expenditures for unseen services of previously hired professionals. Community Initiatives The state through the DH also hopes to tap the creativity and enthusiasm of local communities hoping that councils could enable people, their carers, families and the communities in general. This will be achieved through local networks based on communities’ history of building capacity. It cited Japan’s example of communities that have their elderly adopted by their neighbourhood families The Timebanking system in London has also been lauded by the report. Timebanking allows people from all backgrounds and abilities to give what they want by sharing their skills serving as “deposited” time. One hour of giving earns them one time credit and they can ask back any needed skills from other local people. It has about 250 local time banks all over the UK. DH also cited as good example the Southwark Circle. It is a network of about 1,000 individuals and families delivering flexible support of practical tasks from gardening to technology. It serves as an opportunity to build relationships around interests and hobbies, learn, and build social networks. The scheme was complementing one type of skill with another between members so that new relationships are built and qualities of lives are improved. The service network is called the Neighbourhood Helpers supported by the London Living and Local Authority. Another organisation that has shown positive results is the Asian Welfare and Cultural Association or AWCA. It works towards improvement of the quality of life for older Asian men and a=women in the Eastleigh are of Hampshire. The members have established a meeting place where they socialise and participate in activities. User-led organisations and activities such as those mentioned have been supported by local councils and help people come together to decrease social isolation especially in rural areas in order to produce happier, socially-connected adults with enhanced quality of life and are proud of their neighbourhoods (DH, 2010). The DH also encourages communities in this manner to be able to pool their budgets to deliver desired results. This will reduce costs as compared to individual services such as when organisers are hired to provide a group tour or project for a group of users (DH, 2010). Advantages of the Programme There had been seen improved outcomes and value from community-based services that include the preventive schemes funded through the DH's Partnerships for Older People Projects (Popp) (Community Care, 2010). Aside from published reports, the examples provided by the Department of Health about actual user-led initiatives in communities exemplify the feasibility as well as the positive outcomes of community and individual empowerment approach. The approach of personalising care impacts on the users’ normalisation process as they are not only afforded to decide for themselves or through their most reliable family members or relatives but also through their carers. Every member of the team – the user, their family, the carer, and the community in general are expected to play their own role towards achievement of the development of user as an independent and even productive member of society. Biological developments are also encouraged in the process as each individual in need are addressed whether in institutions or home care settings in order to access much-needed support. Their social lives are best addressed by engaging them in community activities with volunteers and professionals who work not for personal gains but for social and personal development. Here, social valorisation and person-centred approaches become social models of care and service. Challenges and Recommendation The Department of Health acknowledges the financial issues existing in adult care programmes, so that in their 2010 Social Care report, it has committed to: “break down barriers between health and social care funding to incentivise preventative action; extend the greater rollout of personal budgets to give people and their carers more control and purchasing power; and use direct payments to carers and better community-based provision to improve access to respite care” (DH, 2010, p 6). In the early implementation of the individual and community empowerment approach, the shift of health and social care out of institutions and into the community were seen as hampered by risk-averse commissioning and lack of government policy direction. This was reported by the Association of Directors of Adult Social Services and the Department of Health based on fieldwork in seven English council areas - Blackpool, Islington, Sandwell, Hampshire, Knowsley, Leeds and Oxfordshire. Their “closer to home” approach had no specification about how far and fast commissioners should shift care out of acute settings (Community Care 2010). Other negative results include the under-resourcing and a lack of expertise in the approach; the design that make councils accountable downwards to users and the public for results instead of upwards to government; there had been smaller set of outcome measures; rehash of evaluation methods from the compulsory annual quality ratings for providers replaced by an “excellence” standard assessed by the CQC on application from providers; projects that require services users to keep diaries on their experiences of social care are expensive to administer (Community Care 2, 2010); the Panorama programme has poor management, poorly trained staff and tight schedules; professionals are undervalued, service is grossly underfunded, and commissioned on a time-to-task basis (Bryce, 2010). While home care staff were seen as committed, enthusiastic and dedicated, they are undervalued outside of the sector and afforded low status within it. To address council readiness issues, the DH has proposed the following for council members to seek: “good quality, up-to-date and accessible information direct from the council, especially on websites; working with local voluntary and/or community organisations and experts in user-led organisations, including carer-led organisations, to provide support, advocacy and brokerage services; advocacy, which helps people express views and receive the services they want as a result. This can range from a person helping a disabled person speak up for themselves to a paid advocate employed by the Independent Mental Capacity Advocacy Service; and recognising that provision of information and advice is a universal service, and that people funding their own care have a particular need for information and guidance to help plan how their care needs are met” (DH, 2010, p 18). Several recommendations were noted: a firmer direction from the DH; need to be “realistic” in the expectations about the evidence needed to shift services into the community (Community Care, 2010); provide regular salary to workers (Bryce, 2010). Analysis and Critique Overall, the policy on empowering communities and adult care users through various programmes and approaches are seen as better than a complacent or indifferent state. The localisation of the services and approach will not only engage councils but also the communities in general to become sustainability-centred for their own good as communities are made up of peoples from various ages, stages, and backgrounds. As the Department of Health report and vision has provided, the problem of exclusion is addressed. The direct-payment approaches likewise afford a more independent user and their processional carers in such a way as bureaucratic expenditures are reduced greatly. Block-approach to providing services that may not be necessary for some or even the majority of users will not only drain resources but waste them as well. Individual scheme of assessment, evaluation and provision of necessary care will streamline expenditures and use of community resources. However, as noted by community-based users and their families, the approach has been adopted with decreasing funds as users grow in number and costs increase. Another issue that needs to be properly addressed is the passing-on of responsibility and probably ineptness from the state down to the councils as the system does not guarantee more experienced or knowledgeable council members that can properly address adult social care issues. The biggest problem about the program is also pointed out earlier: compensation and treatment of carers as they are marginalised and majority were engaged in per session manner that reduces not only their self-esteem and confidence but also their means to professionally and personally growth. This has been seen as an inherent issue as bureaucratic systems only switch approaches but do not actually address issues of transparency, and marginalisation of the social care professionals. By recommending several actions that councils need to address, the state or the Department of health appears once again to encourage expenditures of the “officials” that may result to funds for salaries of social care professionals being set aside. Conclusion Empowerment is an issue in the government system that will remain a challenge rather than a solution. While it is true that various approaches to adult social care may be adopted over time to conform to demands and needs of users, it will not always be able to deliver actual needs with meagre payments for professionals. As mentioned, social care professionals are currently paid in per session basis which may be a far cry from the desired regular employment compensation system, defeating the Department’s empowerment campaign. It should be noted that empowerment emanates from within, from the core of an individual’s self-esteem. Thus, where lack of self-esteem may be an issue, there can really be no empowerment. It is true that communities and individuals in it may tap voluntary community members’ support to address adult social care issues through organisations that increase social cooperation and sharing. This can greatly contribute to increased positive outcomes in the community level. However, without the full-time guidance and intervention of well-paid social care professionals, there is no guarantee to the continuity and sustainability of these efforts as coordination and continuing assessment, evaluation and reporting are necessary to solidify networks and initiatives. Reference: Bryce, Mary. 2009. ‘The real trouble with home care.’ Community Care 160 (2009). General OneFile. Web. 4 Jan. 2011. Community Care. 2010. ‘News.’ General OneFile. CC 210. Community Care 2. 2010. ‘News.’ General OneFile.. CC 418. East Essex Community Council. 2010. ‘Key policies for adult social care.’ Accessed December 2010 from http://www.eastsussex.gov.uk/socialcare/policiesandplans/default.htm Department of Health. 2010. ‘A Vision for Adult Social Care: Capable Communities and Active Citizens.’ 16 November. Accessed from http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_121971.pdf Read More