Care of Vulnerable People - Case Study Example

Care of Vulnerable People - A Critical Analysis and Case Study Child – Case Study Gary Denman and David Thorpe’s study (1993) examined 100 child protection cases from the point of initial allegation in a Welsh local authority for a period of nine months. Over half of the child abuse allegations were not substantiated after investigation. It is clear that a considerable amount of professional time and resources were put into this sifting process. The researchers point out those allegations of neglect are the least likely to be substantiated and the least likely to receive ongoing social work input. Similar results are evident in a much larger study on the operations of child protection registers (Gibbons, et al., 1993). The authors concluded that about six out of every seven children who entered the child protection system at referral stage were filtered out without needing to be subjected to the child protection register. Of those actually investigated 44 per cent led to no actions at all. In only 4% of all the referred cases were children taken from home following a court order during the investigation. This is a quite a different representation of social-work practice from that depicted in Cleveland and Orkney. The more one is distanced from forensic evidential concerns the more likely it is that interventions will not take place. In 65 per cent of the neglect referrals (392 in total), the researchers could not identify any protection plans which resulted in a supportive service. Yet these children had the highest number of poverty indicators and just as many indicators of vulnerability as those referred for physical abuse or sexual abuse. Thus the repeated scenario was of children not reaching the threshold for child protection intervention, but not getting any preventive assistance either. The fact that increasing numbers of children and their families are experiencing child protection investigations to little effect is also the finding of the recent Audit Commission report, Seen but Not Heard (HMSO, 1994). Local authorities have been criticised for concentrating resources at the sharp end of child protection work and not therefore fulfilling their responsibilities towards other children in need as defined under Section 17 of the Children Act. The Children Act 1993 report noted that implementation of Section 17 had been sluggish: ‘Some authorities are finding it difficult to move from a reactive social policing role to a more proactive partnership approach’ (DoH, 1994). The Department of Health has expressed the concern that Social Services Departments are focusing on the particular incident of abuse and losing sight of the overall welfare of the child. As a result many children are experiencing investigations without care plans unless the child’s name is placed on the child protection register. Too many people are experiencing the child protection system who could possibly be more effectively assisted under the family support provision of the Act. It is not consistent with the Children Act philosophy for the gateway to family support services to be closed until the problem is presented in terms of child protection and clearly misrepresents the nature of need presented to Social Services Departments (Sone, 1994). CONCLUSION It has postulated that this practice is gradually being isolated from its traditional skills base and is becoming more regulated and technical. The rise of ideals of the ‘new (mainly male) managerialism’, and the bureaucratisation of the service, have led to the discourse concerning child protection being reframed more and more by legal and administrative requirements and away from the concerns of predominantly female practitioners. It could be argued that this would not matter too much if the new emphasis on child protection was producing a service that was both equitable and helpful to children and their families while affording children protection from abuse. However, the studies by Denman and Thorpe (1993), Gibbons, et al, (1993) and the Audit Commission Report (1994), present a different scenario. Their results illustrate the way that processes and concerns are structured and weighted in importance and the consequences these have for the children, parents and professionals involved. The majority of cases are closed, and no further action taken early in the process. Those not subjected to registration receive little monitoring, and the children and families involved receive little or no practical or professional assistance. This is the consequence of child protection policy and practice which is set up essentially to identify actual or potential significant harm or high-risk situations. Repeatedly, such referrals are considered according to legalistic criteria where the assessment and identification of forensic evidence is crucial even when the allegation is not strictly provable. If referrals cannot be constructed according to these legalistic criteria, or where the allegation is not substantiated, the referral leaves the child protection system. While it must be acknowledged that allegations of abuse may be unfounded, many of the situations may well contain a number of observed anxieties and concerns but may not warrant continuing involvement under the authority of current child protection procedures. This is a very different scenario from the more welfare-orientated social work imagined in child care in the 1950s and 1960s, and different in significance from the sections of the Children Act 1989 which stress the need for supplying practical help and support services to families and where the ‘welfare of the child’ is paramount. This is not to suggest that the belief in partnership and trying to consider the interests and wishes of the child are not viewed as important, but that they are crucially viewed in legalistic child protection policies and practices which are principally interested with the assessment of high risk and therefore the weighing and consideration of forensic evidence. Events in Cleveland have illustrated the way that the framing of the particular problem leads to a set of prescribed and specific results; namely, the upholding of male authority in families at the expense of protecting children. Although the public debate that has shaped policies has been about the veracity and admissibility of children’s and medical evidence, the fundamental questions concerning sexual abuse have remained unaddressed, with children not being protected as a result. Unless a better balance can be achieved between ‘surface and depth’ explanations and practice, social work in local authorities will not be able to protect children effectively; women practitioners will be further marginalised and isolated; and the services to children and their families will fragment further, with the private and voluntary sector offering the ‘depth’ and the local authority agency the ‘surface’. COMMUNITIES, POVERTY AND CHILDREN The test-bed for community development lies in its capacity to respond meaningfully to the question: who gets involved, who participates? Arguably it is not that difficult to achieve citizen participation of some kind. But community development should never be understood simply as a mechanism for facilitating general notions of participation. It must always be interested in the quality of participation, particularly as this relates to issues of gender, race and class. Community development exists because it has a value-based commitment to working with the excluded of society, those people who are too poor, too oppressed or too alienated to be confident about getting involved in community activities. And to support this commitment there are tried and tested methods and skills to draw upon in the practice and evaluation of community development. In this sense, community development must judge itself harshly. It must constantly ask the question, who are the excluded and where do they live? From there it can work out the contribution it can make in different arenas: • Neighbourhoods which are being destroyed as a result of the interacting processes of decline: high unemployment, widespread poverty, sub-standard housing, a deteriorating environment, fear, mistrust, high mobility, etc. • Networks of people who share a similar identity, problem or interest; for example, those who have the same faith, people who have the same housing tenure, parents of children at risk of drug misuse, victims of crime, etc. This way of understanding ‘community’, particularly as it relates to race, sexuality and gender, challenges much of the practice wisdom in community development. • Agencies such as local authorities which have the capacity to respond strategically to economic and social problems in their areas. Community development can play a key role within such a framework. In the British context the experience of Strathclyde Regional Council from 1976 stands as an important source of information in this context; when we examine the French context we shall see that there is comparable material on strategic community development. • Policies of government and the European Union which impinge directly upon the lives of people living in deprived communities and which can be influenced by community development ideas and experiences. If the starting point for community development is for it to position itself across these arenas in relation to an analysis of poverty, inequality and powerlessness, then the need for it to respond to the situation of children surely becomes unanswerable: • Poverty. The numbers of children and young people in the poorest families have increased rapidly. In 1979, 1.4 million dependent children were living in households with incomes below half the national average; in 1990/91 the figure was 3.9 million, an increase from one-tenth to one-third of the age group. The extent of child poverty has been confirmed more recently by the major report on poverty and wealth in the UK published by the Joseph Rowntree Foundation (Barclay 1995). • Environment. There is increasing evidence of the effects on children’s health of traffic and other pollutants, as well as of the risks of accidents caused by the expansion of car ownership. • Safety. Children no longer feel as safe in public places as they used to; hence the increase in journeys by car to school and elsewhere. Fear of attack, danger from traffic, concerns about drugs and crime are the key factors. The effects of poverty, environment and fear are to deny children the rights they should have to exist and play in neighbourhoods. This statement provides the opposite picture to media portrayals of some neighbourhoods as being under the control of children and young people; in this scenario it is the adults who are the victims: 10-year-olds harassing adult residents and riot situations developing. Where does the truth lie in this conflicting portrayal of children’s lives in neighbourhoods? We have to look for the answer, it seems to me, in the value society puts, or does not put, on children and their need to develop and express themselves. When children and young people riot (Campbell 1993) or when pranks go wrong and cause injury or death, it is surely because children feel that they have been let down by adults. We are in danger of cutting off ways in which adults can communicate and undertake joint activities with children outside home and institutional settings. In many areas resources for youth work, play schemes and adventure playgrounds have been reduced to an alarming extent. There appears to be a retreat by policy makers from supporting local people at the local neighbourhood level in terms of building relationships between people, especially those between children and adults. Ironically the experience of community workers is that the motivation of adults to become involved in community activities which benefit children directly is normally very strong. Hasler shows how important it is for community workers to take up children’s issues and to avoid using them as a means of simply getting at the adults: ‘The challenge is to see children and young people as part of the community in their own right’ (Hasler 1995:181).This challenge needs to be taken up by a number of professions, particularly social work, education and youth work, and in terms of how practitioners and managers seek to work with children. Community development has the experience, knowledge and skills to contribute to such a developmental process so that, at the same time as it puts forward the case for more work to be done with children, it can also show what that work might look like and specify the knowledge and skills needed for it to be effective. WORKING WITH CHILDREN Community development ‘reconstructed’ so as to work more seriously, strategically and skilfully with children would need to make at least two paradigmatic shifts: • A move away from a narrow social work interpretation of the phrase ‘working with children’; • A move towards integration with economic and regeneration programmes. Advocates of these shifts can draw upon a significant cluster of practice experiences, research and policy evidence to support their case. Some practice experiences are included and referenced in Children and Communities (Henderson 1995). Another key resource is the writings of Holman (1981, 1996) who has made a unique contribution to this area because he has combined the roles of practitioner, writer and theoretician. Both of these are the tip of the iceberg in terms of practice experiences across the UK over a period of more than twenty years: a few are recorded in case-study form, most are held in the memories of the community workers and local people involved. In terms of research there is now important material contained in reports on family centres, especially those which have adopted an open access, neighbourhood-based approach. Teresa Smith’s study of six family projects run by The Children’s Society found that ‘Given the levels of disadvantage evident in many areas, “open access” and support for community resources is likely in the long run to benefit more families as part of a preventive neighbourhood-based strategy not restricted to referred families’ (Smith 1993:10). Research by Gibbons leads her to state that family projects had ‘strengthened local community resources, by providing new activities and advice points, by drawing in new volunteers, and by opening up new opportunities for local people’ (Gibbons 1990:158). And Owen Gill has shown how research into child protection is pointing to the need for a neighbourhood-based approach: There should be more emphasis on working to support and strengthen those neighbourhoods which produce high rates of child protection cases. Such work would be based on the approaches of bringing people together, developing a sense of neighbourhood identity, articulating the demands for resources, and playing a part in creating the complex criss-crossing of relationships which is the sign of a mature and supportive community. (Gill 1995:30) The international research led by Quortrup (1991) into childhood, as well as research findings from children’s projects in developing countries (Boyden 1991), are also key sources. The policy aspects of children and neighbourhoods are to be found most obviously in the policy statements and strategy documents of the four main child care voluntary organisations; The Children’s Society, Barnardo’s, NCH Action for Children and Save the Children. All of these, in varying degrees, have committed themselves to a neighbourhood- based approach to working with children and families. A small number of local authorities have demonstrated an interest in moving in that direction. Child – Case Study THE DISCURSIVE CONTEXT OF DIFFERENCE IN WELFARE Such struggles over difference outlined in the previous section do not occur in a vacuum but in a context in which there are competing meanings and discourses around notions of diversity and difference. ‘Cultural diversity’ might be one such discourse, with its understanding of the potential for the peaceful coexistence of different cultural groups. However, this notion often ignores the external relations of dominant and subordinate cultural groups (indeed, often the word ‘ethnic’ only ever applies, in Britain to those whose cultures lie outside or subordinate to the dominant white Christian culture). It also implies a static and essentialist notion of cultures which ‘coexist’ rather than inter-relate and transform one another. Similarly, while it may be helpful in legitimating other cultures, it may obscure the relations of power within those cultures and fix people too readily to an identity they may hold with great ambivalence. This is one example of such a discourse, but I want to look more closely at the discourses of diversity which operate within recent developments in welfare. There are three key ways in which the notion of diversity or difference is mobilised within social welfare in Britain in the 1990s. The first is an individualist notion of diversity which operates through choice. The second is managerialist and focuses upon the management of differentiated needs. The third is anti-discriminatory and mobilises difference as political identity. The individualist approach to diversity has emerged from the New Right’s development of the mixed economy of welfare in Britain. Notions of diversity and difference are mobilised to counter the monopolistic and universalistic characteristics of the Keynesian welfare state. They enter welfare discourses in two main ways; through the pluralism of welfare providers and through the diversity of choice offered to welfare users through the mechanism of the market. The opening up of the voluntary and private sectors is supposed to create a diversity of provision which is able to meet the diverse choices and needs of the population. In this approach the notions of diversity and difference are quite unexplained: different needs and different choices are collapsed into one and are supposed to find their expression through the market. The welfare consumer in this scenario is totally individualised; few distinctions are made between carers and people who receive care, between pupils and parents, or between the economic constraints on parts of the population. In so far as differences of a less individualised nature are acknowledged, these are often ascribed to essential behavioural or cultural difference. For example, in some places the provision of Muslim schools has been supported on the grounds of recognising essential cultural differences in the population. Differences in types and quality of school have also been defended on the basis of differences in the ‘cultural aspirations’ of parents. Differences, too, between those users who are compelled to use welfare services (claimants, clients) and those who are not are explained in terms of the ‘dependency culture’ of the first group. In this approach, then, the market is seen to encourage diverse provision and the expression of differentiated needs. Differences within the population are seen as natural or voluntaristic. Unequal needs are interpreted as the expression of the constructed provision of morally inferior choices (the choice to be dependent upon the state), which in turn create groups identified as social problems; single parents, scroungers, ‘yobs’, and so on. The managerialist notion of diversity and difference has entered welfare discourses largely through the 1990 NHS and Community Care Act and the restructuring of health and social care. Much of the implementation of recent policy centres upon the introduction of a ‘needs-based’ service, where the separation of the roles of purchasers and providers has been accompanied by a requirement that purchasers assess the needs of potential service-users on a needs-led basis. Although this breaks with past practice where services were based on providers’ definitions of need, here needs, and the diversity and differences of those needs, are again largely recognised on individual terms: individuals have different needs for which individual care packages can be organised. Again, while this breaks with past practices which emphasised uniformity of need rather than individuality of circumstance; financial, physical, support and so on; the approach to the definition of difference still lies firmly rooted in professional or managerially defined categories; old, sick, at risk, disabled, people who are dangerous to themselves or others, vulnerable and so on. Even the category ‘ethnic minorities’, having eventually achieved recognition, has found itself wedged uncomfortably into a rather discrete, essentialist and managed client group. Nevertheless, there may exist within this approach spaces for the collective articulation of differentiated needs in which different patterns and meanings of diversity and difference emerge; for example, through local needs audits (see Percy-Smith and Sanderson, 1992), or through the collective organisation of service-users. This will depend largely on the strength of the third discourse of diversity, discussed below, but in general within the context of efficiency and economy individuals are increasingly being displaced into administrative categories; the elderly, children with special needs and so on; and the assessment of needs may become yet another assessment of means or of physical or mental incapacities. The third discourse of diversity and difference has emerged from the demands for equal opportunities policies and for anti- discriminatory practices, especially around gender, race and disability and, in some places, sexuality. These have been important in raising issues of discrimination within welfare organisations and, where they have been translated into anti-discriminatory practice, for service-users. Along with the development of equal opportunities has been the emergence since the 1980s of local, national and international movements of the collective organisation of welfare constituents based outside the statutory services. For example, the disability movement comprises a range of disabled people’s groups such as the Union of the Physically Impaired Against Segregation (UPIAS) or the British Council of Disabled People (BCODP); ‘Survivors Speak Out’ exists for users of psychiatric services and ‘People First’ for the development of self-advocacy for people with learning difficulties. These groups have their own individual histories but they also have their political roots in the emancipatory movements around gender and ‘race’ oppressions. Their practice has also been influenced by some of the self-help welfare initiatives to emerge from these movements. In terms of the categories of difference discussed in the previous section, what is interesting about these groups is the fact that they have grasped the administrative categories (or subject positions) imposed upon them by policy-makers, administrators and practitioners and translated these into political identities and new subjectivities. However, for some groups this process has moved in the opposite direction. As mentioned above, claims for difference and struggles by black and minority ethnic groups against racist practices have sometimes been appropriated within the new social services management as part of a strategy of managing difference, using the expertise of black social workers. Conclusion In practice, whereas the emphasis in recent policy upon services sensitive to needs creates, rhetorically at least, the space for the articulation of needs, its practices and procedures of assessment and its context of tightening budgets mean that the political claiming of difference can be shifted back into an individualised problem group or a managed category. The capacity to resist this shift depends upon the ends to which difference is claimed. Some of the difficulties associated with the development of equal opportunities can be analysed better within both the understanding of the different meanings of claims for difference and an understanding of competing welfare discourses of diversity. The shift in emphasis from equality of opportunities to ‘control of quality’ is part of the context in which equal opportunities policies and units have been displaced or dispensed with. However, some attention should also be paid to the tendency of equal opportunities policies to organise around discrete categories of oppression; to ‘freeze’ differences; which, within the context of financial constraints, has slipped all too easily into competing claims of need. It has also inhibited the recognition of the inter-relatedness of oppression and to a tendency to ossify difference as rigid and essential and thereby to a difficulty in linking common needs (for improved general services) to particular interests (for the meeting of specific needs). The capacity of the new welfare mobilisations around gender, race, sexuality and disability to generate a resistance and/or an alternative to the current rhetorically named ‘needs-led’ approach will partly depend upon their capacity to ‘freeze’ into solidarities of specificity and ‘melt’ into loosely attached units of commonality, according to the political contingencies of time and space. We have argued that postmodernist thinking has offered us important insights into the understanding of these specificities of time and space and the fragmented nature of the self. However, in so far as feminist thinking has also struggled through these new complexities and conceptualisations it has, by and large, still retained its commitment to challenge the unequal power relations inherent within them. And that, too, is important. Works Cited 1. Barclay, P. (1995) Joseph Rowntree Foundation Inquiry into Income and Wealth, York: Joseph Rowntree Foundation. 2. Boyden, J. (1991) Children of the Cities, London: Zed Books. 3. Quortrup, (1991) Children as a Social Phenomenon: An Introduction to a Series of National Reports, Vienna: European Centre for Social Welfare Policy and Research. 4. Gill, O. (1995) ‘Neighbourhood watch’, Community Care, 8-14 June 1995. 5. Gibbons, J. with Thorpe, S. and Wilkinson, P. (1990) Family Support and Prevention: Studies in Local Areas, London: HMSO. 6. Smith, T. (1993) Family Centres and Bringing up Young Children: Six Projects Run by the Children’s Society, London: Children’s Society and Department of Health. 7. Holman, B. (1981) Kids at the Door, Oxford: Basil Blackwell. 8. Campbell, B. (1993) Goliath; Britain’s Dangerous Places, London: Methuen. 9. Denman, G. and Thorpe, D. (1993) Family Participation and Patterns of Intervention in Child Protection in Gwent, Department of Applied Social Science, Lancaster University. 10. Gibbons, J., Conroy, S. and Bell, C. (1993) Operation of Child Protection Registers, report to Department of Health, Norwich: Social Work Development Unit, University of East Anglia. 11. Health Committee Second Report (1991) Public Expenditure on Personal Social Services and Child Protection Services, vol. 1, Report together with the Proceedings of the Committee, London: HMSO. 12. DoH (1988) Protecting Children: a Guide for Social Workers Undertaking a Comprehensive Assessment, London: HMSO. 13. DoH (1994) Children Act Report 1993, London: HMSO. Read More