Personalization in Adult Social Care - Essay Example

Personalization in Adult Social Care Introduction Personalisation is one of the major provisions of adult social care. It is a practice or provision which makes social work practice more personal and more client-centred. It has been recently adopted in practice as an effective application and provision of social care services. This paper shall discuss how the personalization agenda might influence social work practice. It shall provide a critical reflective account of the skills, knowledge and values required of social workers. It shall also define personalization and adult social care; and it shall discuss the influences that personalization has on social work; and the social work skills and values which are needed in personalization. This paper shall also reflect on the skills needed in the personalization of social work skills, including the laws applicable in practice and for the service user. Finally, this paper shall consider what theorists say about the personalisation of social work practice. These points shall be discussed in the hope of coming up with a clear and academic understanding of the subject matter. Personalisation In a general sense, personalisation can be defined as “tailoring pages to individual users’ characteristics of preferences” (Search CRM, 2001). In these cases, personalisation is about the client or about the person and about meeting his specific needs not based on generally applicable practices. Social work practice has traditionally been based on what a person needs as assessed by social workers and other people involved in the social works services. After such assessment is conducted, the social workers would now tell the clients what services and type of support they would receive, who from, where, and when (Squibb, 2009, p. 1). Personalisation in the social work context and based on the personalisation agenda now refers to a change in the system where a person needing social care and support would get to decide the type of support he will receive, who from, where, and when (Squibb, 2009, p. 1). It is also referred to as self-directed support. It is not the social workers who will get to decide what services a person would need, but it is the client himself who would choose and fashion such services to suit his life and his needs. Personalisation “enables the individual alone, or in groups, to find the right solutions for them and to participate in the delivery of service. From being a recipient of services, citizens can become actively involved in selecting and shaping the services they receive” (The Scottish Government, 2009, p. 10). In this type of service, people or individuals who are recipients of social work practice are now more involved in the design and the development of services; and these individuals also receive support and services which are more appropriate and suited to their needs (The Scottish Government, 2009, p. 10). Personalisation can include the use of community resources which may mean that referral to a social work department may not be necessary. It includes the process of prevention, maintenance or intensive support; it means helping people and professionals to work together in order to handle the risks and resources (The Scottish Government 2009, p. 10). Adult social care Adult social care is the delivery of social services for adults, at the same time helping them maintain their independence, control, and dignity (Department of Health, 2010). The program of the government is on putting these people first and ensuring the personalisation of care, dignity in their care, independent living, making local area arrangements, delivering care services efficiently, delivering continuing care, and management of risks of the adult population – especially the elderly and those who are most vulnerable and in need of social care and services (Department of Health, 2010). It is the process of ensuring that the services needed by the adult population, especially the elderly, those under long-term chronic care, and those under palliative care receive the social services essential to their survival and to the improved quality of their life and daily activities. Discussion Personalisation influences social work in the sense that a person’s health and care, as well as the support he needs and expects may be perceived differently by other people (Department of Health, 2010). The personalisation of social services allows a person to have more say on his needs and on the services which may be delivered to him. There is a need to consider social care services to focus on people’s needs and on the preventative approaches which are applicable to them in order to ensure independence and well-being (Department of Health, 2010). Personalisation is a vision or a goal which ensures a shift in the system and in the delivery of social care services. Personalisation influences social work by ensuring that the services offered by the social work practice, whether delivered by statutory services of funded by the client himself, are meant to transform the client’s life and the services they choose in all care settings (Department of Health, 2010). Social work skills are critical in the implementation of the personalisation agenda. Such skills are based on the social work professions’ major values and principles. These core values involve the preventative and reabling approach; the ability to perform various tasks including assessment and support planning; the ability to advocate or establish independent advocacy in order to meet the people’s best interests with the safeguards of law, regulations, and accountability (Twyford, 2009). Social work skills involved in order to personalise one’s relationship with the client is to the ability to develop genuine empathy for the client, to be open and respectful of the client and avoiding a defensive stance (Connolly, Crichton-Hill, and Ward, 2006, p. 28). This signifies an attitude of receptiveness on the part of the social worker. In some instances, a social worker’s assessment of a client’s needs may reveal that the latter needs certain services. However, the client may disagree with the social worker’s assessment and judgement. It is important for the social worker to understand why the client expresses such different needs; and to empathise with the client in order to allow a more open exchange of ideas. This will also help eventually build a relationship of trust and confidence between the client and the social worker – one that is based on a healthy exchange of ideas and a client-centred process. A social worker’s communication skills are sorely needed in order to ensure the personalisation of services. In this case, more often than not, a social worker’s interview skills will also be tested. The communication process should be dynamic and should work both ways. A social worker may suggest needs to the client which the latter does not realize he needs and through the expert skills of the social worker may be deemed necessary in order to ensure quality care for his needs. The role of social workers in this program of personalisation of care will now change in emphasis “from assessment and gate keeping of resources to advocacy, information, advice, and brokerage, helping people to arrange their own services” (Beint, 2009, p. 4). This means that in application, the social worker’s role in the client’s life would be to assist the client in coming up with a support plan, if the client needs help with this. A carer of a person needing support may opt to provide most of the care himself and then utilize the personal budget in order to cover domestic support (Beint, 2009, p. 4). Other carers may also choose respite care for the person needing care and then choose the rest of the time for her personal needs and to be with friends – generally to maintain her independence. The social worker can also suggest that the carer place the client under care of a voluntary organization who can then issue a sitting service in the client’s own home (Beint, 2009, p. 4). This would give a chance for the carer to still be independent, at the same time, be within the client’s or patient’s easy reach. The role of social workers is crucial to the success and the implementation of the personalisation agenda. “Social workers will want to help that the new arrangements are strong and practical, and that answers are given to the difficult questions about how the move from dependency to independence and control can be resourced and managed” (General Social Care Council, 2008). The role of social workers at this point is to ensure that the initial transition from dependence to independence on the part of the client/patient is smooth and manageable. Those who have already been covered by social services before the introduction of the personalisation agenda may not find the new program favourable for them. But with proper care and guidance, the transition may prove to be easy and less alarming for the clients/patients, their families, and the carers. The personalisation agenda means that social workers involved in the mental health services need to establish effective leadership and governance in order to improve their confidence in their skills, their knowledge and their values and consequently be able to contribute to integrated mental health teams (Ray, et.al., 2008). The different agencies involved in the social work practice must also recognize and acknowledge the fact that some people may still prefer access to the traditional contributions of social workers (Ray, et.al., 2008). This implies therefore, that involved agencies must try to integrate the traditional non-personalised services with the personalised ones. The sustenance of good mental health and support for those with mental health issues is a complex task because it often involves different factors which impact on a person’s life. The role therefore of a social worker may overlap with other professions and professionals in the process of wanting to gain stable and safe accommodations for clients (Ray, et.al., 2008). Social service organizations are therefore challenged to maintain their existing skills base, giving opportunities for appropriate training and developing the workforce. The main challenge for social workers in the personalised agenda is that of responding “effectively to the shift in service provisions towards self-directed and personalised services, and to develop the skills required for working in integrated teams where there are overlapping responsibilities and expectations” (Ray, et.al., 2008). In some cases, social workers may be called on to improve access to therapeutic training, including cognitive behavioural therapy and psychosocial remedies. “Developing the skills and knowledge to support individuals in accessing and commissioning personalised services may require mental health social workers to adopt and adapt what has been learned in other adult social services” (Ray, et.al., 2008). There is a need therefore for the social worker to coordinate with other social services agencies and professionals in order to ensure that the application of personalised services is something which is worked into the social work practice (Ray, et.al., 2008). Social workers are in the best position to work in coordination with individuals who use and require mental health services. These social workers can develop service evaluation and carry out research which can be used to evaluate the traditional power arrangements in the delivery of mental health services (Ray, et.al., 2008). Any finding of fault or areas of adjustment can be used as opportunities for the social workers to promote and encourage change in the social work practice. The personalisation agenda is the perfect prod for the social workers to initiate changes in the practice and to ensure that the traditions within the practice are adjusted to accommodate the personalisation of the social care services. Moreover, practitioners note that the “changing occupational location of social workers in regard to health services will provide them with opportunities to advocate with and for people who use services when they directly witness inadequacies in in-patient care” (Ray, et.al., 2008). The NHS Community Care Act of 1990 saw the 1989 ‘White Paper Caring for People’ be implemented. Such document emphasized that “proper assessment of need and good case management [is] the cornerstone of high quality care, with social workers designing packages of services tailored to meet the assessed needs of individuals and their carers” (Department of Health Care Networks, 2007). Such policy did not specify as yet the requirements for the personalisation agenda and of the social work practice. However, it was able to lay down sound principles which are the very basis of the current personalisation agenda. The provisions also point out the crucial role of social workers in the process, how their responsibility is so much hinged on fashioning the delivery of services and care to the needs of the patients/clients and their carers. The personalisation agenda will influence the social work practice by helping to identity the gaps in the social work practice and the need for re-training in these areas where gaps are seen. Personalisation also helps identify the consideration of new roles for the social worker which now shifts towards being an advocate, a broker, a counsellor, a risk assessor and designer (The Scottish Government, 2009, p. 13). It also helps in the recognition of the role of unpaid carers as a crucial part of service provision and support for such carers as partners in the social care services. The personalisation agenda impacts on the social workers and front line practitioners because they play an important role in engaging individuals and carers in order to extend the right kind of support services at the appropriate time. In order to ensure the success of the personalisation agenda, the social worker is called on to encourage the carers and their families to “actively participate if this is to be effective and work done by the User and Carer Forum to recommend principles and standards for Citizen Leadership can aid this” (The Scottish Government, 2009, p. 14). The standards for the personalisation agenda cover a wide range of principles which affect the social work practice as a whole. And the social worker is pressured and challenged to make the adjustments in order to ensure that the needs of the clients are met and the independence and client outcome is improved. Practitioners function on a broad environment and this environment is often affected by systems which eventually impact on personalisation. These elements include: tools, finance, workforce, mixed economy of care, and performance measures (The Scottish Government, 2009, p. 14). These different elements imply the diversity of the range of people and functions which are needed in order to understand the personalisation agenda and how such elements impact on the different functions and people involved in the social work practice. The personalisation agenda influences the social work practice in the sense that the workforce involved is called on to make adjustments in its policies. Such adjustments or changes include recruiting and retaining; reinventing; reshaping; relating; and regulating (Hudson & Henwood, 2009, p. ii). The recruiting and retaining process are considered difficulties in the adult social workforce. The progress and success of personalisation cannot be achieved when there are insufficient workers who are committed and trained to meet the needs of the people using social care services (Hudson & Henwood, 2009, p. ii). The social workforce is now called on to resolve the main difficulties in relation to the gender-related element and the low-paid character of employment in the social workforce. The personalisation agenda can only be successful after these issues in employment have been resolved. The personalisation agenda will also further spread out the employer base and “increase the isolation of the workforce with the growth in the number of people employed as personal assistants” (Hudson & Henwood, 2009, p. ii). There is a need then to increase availability of trained social workers in order to ensure that sufficient services are delivered to clients in accordance with the personalisation agenda. Reinventing is also a challenge posed for the social workforce as a result of the personalisation agenda. The current practice is based on a bureaucratic rationing program and does not fit the personalisation program and agenda (Hudson & Henwood, 2009, p. ii). Personalisation affects the direction of social work and the adverse forces seen in the public often signal impending catastrophic failures. Such a situation will not present a constructive situation or the personalisation of social care services (Hudson & Henwood, 2009, p. ii). It is important then for social care services and social workers to address the structure and the culture of social care services in order to implement effective changes and improved outcomes for the clients. The personalisation agenda also affects the social work practice in the sense that, it demands the development and the acquisition of new skills and competencies for commissioners, managers, and senior leaders (Hudson & Henwood, 2009, p. ii). In order to implement the personalisation agenda, those who are called on to implement it are expected to “create conditions for others to transform realities, to galvanise innovators and to inspire, communicate and operationalise the new vision” (Hudson & Henwood, 2009, p. ii). There is a need for the social workers and for the social work practice to be committed in their roles. And by training and support opportunities, it is possible to enhance the skills of the workforce and the different leaders involved in the implementation of the policies under the personalisation agenda. Personalisation is also hinged on ‘relating.’ The application of personalisation to the social work practice calls on front to middle and senior management and system wide levels management to relate with one another (Hudson & Henwood, 2009, p. iii). Although interpersonal relationships have not been explored in the personalisation agenda, these issues are very much important in the success of the agenda. The personalisation agenda calls for the assessment of the whole system, how the different parts interact and how “it can secure major cultural change and transfer of power from professionals and providers towards people who use services and their carers” (Hudson & Henwood, 2009, p. iii). The workforce strategy has to be broadly directed towards professional and agency boundaries and even beyond the traditional roles in the workforce. The personalisation agenda influences the social work practice because it sets forth how important regulation is and how it needs to be addressed in terms of social care. The understanding and beliefs in the regulation has met a huge challenge in the Financial Services regulation and the emphasis has now been brought back to the importance of regulation which is proportionate and also sufficient for the needs of the clients (Hudson & Henwood, 2009, p. iii). With the implementation of the Health and Social Care Act of 2008, the personalisation agenda has undergone various changes and through the Care Quality Commission, the process of unifying health care and social care services has been made possible. Many sectors are involved in the funding and regulation of social care services and the implementation of the personalisation agenda (Hudson & Henwood, 2009, p. iii). The personalisation agenda implies that social workers have to make a strong and determine effort towards the implementation of regulations essential towards meeting client needs. These regulations are already in place, and the social workers are the best implementers for such laws. Adult service users are also crucial elements to the success of the personalisation agenda. An assessment of several service users and social care services firms reveal that the services which people want in their social care system is one which is based on user involvement; improved workforce with better wages, conditions of work and training (Beresford, 2010). And such adult service users point out that sufficient infrastructure for customised care have to be in place in order to ensure that meaningful services are available for all clients and patients. The personalisation agenda has the most impact on service users because these service users are the ones most likely to point out the value of independent living and people’s entitlement to support (Beresford, 2010). These service users point out the importance of people receiving services as whole people, locally based and already linked up and coordinated with other services like housing, health benefits, education, and leisure (Beresford, 2010). The personalisation agenda has called on the Department of Health to make adjustments in its workforce. These adjustments have been made in order to address the main “workforce priorities in the short and long-term to underpin and enable delivery of the personalisation agenda” (Department of Health, 2008, p. 8). The personalisation agenda also implies that it is crucial for those in the frontline, the managers, and the members of the workforce to consider the importance of these changes, and the importance of having to actively participate in designing and developing the development of such changes and the skills to make such changes happen (Department of Health, 2008, p. 8). The personalisation agenda also sets forth the importance of developing skills in relation to effective leadership, management, and commissioning skills. The Department of Health has not shied away, so far, from this challenge as it has developed the Social Care Skills Academy in order to develop such skills (Department of Health, 2008, p. 8). It has also issued several grants for the years 2007 and 2008 in order to help cover costs of training the staff and of arming them with the essential skills for the implementation of the personalisation agenda. Such funds have also been released for the primary purpose of developing their human resource capacity and capabilities (Department of Health, 2008, p. 8). It has also been brought to the attention of the Department of Health and of the social care services workforce that they have recognised that it is important to “raise the skills of the workforce to deliver the new system, through strengthening commissioning capability, promoting the new ways of working and new types of worker and remodelling the social care workforce” (Department of Health, 2008, p. 24). These aspects are essential elements in the personalisation agenda because they help ensure that the social work clients receive the most client-centred services possible. Conclusion The personalisation agenda has been a valuable addition to the delivery of social care services to the people. With this new policy, the skills and the values of social workers and those involved in the social workforce had to be adjusted. The personalisation agenda has implicated the enhancement of social worker skills in relation to advocacy, strong leadership, and retraining. So far these changes have slowly and gradually been implemented by the Department of Health. Some of these changes have already been set in place, and the other adjustments are still ongoing. The personalisation agenda has been touted by those involved in its implementation as a crucial addition to social care services because it helps ensure that the care delivered fulfils the needs of the clients and that all possible remedies are implemented for the client and based on his disabilities and current ailments. Works Cited Beint, V. (10 March 2009) Putting People First: The Personalisation Agenda, Shropshire.gov, viewed 27 April 2010 from http://www.shropshire.gov.uk/committee.nsf/0/2CD85A9257CEB8638025756A0037AB75/$file/Putting%20People%20First%209.3.09.pdf Beresford, P. 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