Social Care For Older Adults In England Social Work Essay

accessible C atomic number 18 For Older Adults In England Social Work EssayDuring the exsert two decades hearty concern for older braggart(a)s in England has witnessed m whatsoever profound reassigns. Implementation of the friendship supervise clear up, privatisation of the favor fitted vexation and Direct Payments establish had an impact on the favorable work as a trade to date. In the first part of the literature review I would alike to give an any overview how all of these initiatives shaped present societal work do for older adults and whence focus strictly on individualised reckons and fresh explore of the practice.Traditional social work characterises working closely with the keep uper expendr, building very much contained relationship, assessing problems, making a purpose ab prohibited coping abilities, looking on range of re consultations and at the suppress making an informed professional judgment closely the topper force to entertain ut ility user (Lymbery, 1998). Dustin (2006) presents tralatitious set of skills much(prenominal) as communication and interpersonal skills, use of self, negotiation and mediation skills as hearty as appreciation of organisations and procedures as a core of the practice. In the eighties presidential terms concerns ab break increasing number of older large number as salubrious as running very expensive residential c be consent been a driver for transformation delivery of social awe (McDonald, 2010). Further more(prenominal), and more or less fundamentally, a new Conservative political view includeda belief in the greater economy, efficiency and effectiveness of private sphere centering consumerism the virtues of competition and the benefits of a social aid market and a deep mistrust of public serving professions and their claims to special knowledge and expertness (Lymbery, 1998, p. 870)had its reflection in implemented legislations and community care reforms. The White piece Caring for wad biotic community Care in the Next ten dollar bill and Beyond and The NHS and Community Care process 1990, implemented in 1993, introduced care pick offment and changed the part of the social worker in statutory sector. Hugman (1994, p.30) argues that the care management is a drive away from professionally defined responses to need to carriageialist responses dominated by resource priorities. McDonald (2010, p. 28) in like manner states that professional discretion has to a large ex guide been replaced by formulaic approaches to estimation and return eligibility. Community care reform imposed on practitioners to focus more on the processes and on more complicated bureaucratism what affected some other aspects of care managers/social workers practice such as particular and formal tinct with the answer user and thusly difficulties in building up relationships with the client, trim bandaging emotional maintenance, counselling role, advocacy role, group work, less attention to observe and reviewing (Lymbery, 1998 Postle, 2002 Weinberg et al. 2003 Carey, 2008). Carey (2008, p. 930) states thatthe quasi-market arranging has also helped to create a compound administrative system base around the management of contracts, assessments, care plans and a seemingly space variety of bureaucratic regulations and procedures. Most such tasks are relentlessly svelte by often perplexed care/case managers, many of whom quick begin to question any initial motivations to enter social work.Lymbery (1998) points out that more administrative system and budgetary constraints took away from practitioners a mind of traditional role and increased monitoring of social workers decisions. It has been argued, that key community care reform objectives such as a wider range of excerpt of avails, reducing unnecessary paperwork, comelying man-to-man ineluctably in a more flexible and innovative way grant not been achieved (Scourfield, 2006 Carey , 2008).The adjacent authoritative step for the shape of present social care has been inlet of direct payment schemes. The British Council of Disabled People (BCODP) presented findings of their research in publication Cash in on independence with evidence that forthwith provided services were inflexible, unresponsive, unreliable and take away service users control over the assist (Zarb and Nadash, 1994). The BCODP also proved that direct payments can be cheaper and at the same time can provide a higher(prenominal) calibre of take hold (Glasby and Littlechild, 2009). Under the pressure of sustained and strong campaign for reform from the BCODP and other bodies, the government finally implemented The 1996 Community Care (Direct Payment) Act (Glasby and Littlechild, 2009). The Act fall by the waysideed making cash payments by local politics to individuals to piece their own wear (McDonald, 2010). In 2000, direct payments were extended to other service user groups and from now on older adults could also benefit from it (Glasby and Littlechild, 2009). future(a) direct payments, in 2003, the charity organisation in work, foc utilize on mountain with learning disabilities, developed the new way of organising care called autonomous substantiate (Glasby and Littlechild, 2009). Browning (2007, p. 3) states that the introduction of self-directed support is potentially the biggest change to the provision of social care in England in 60 years. The spoken language has developed during the process of effectuation of this concept. By 2004 in Control started exploitation the term individual budget which describes budget from several different streams such as the Access to Work the Independent Living Fund sustenance People and the Disabled Facilities Grant local Integrated Community Equipment Services, adult social care and NHS resources. In the pilots where funding streams were not integrated and projects relied on social care funds the term personal budgets was being used (Glasby and Littlechild, 2009). The in Control Partnership desire was to hurt their concept to be fitted to the breathing social care arrangements, to free up available resources, which were tie up in existing buildings and pre-paid services and to allow people to use them flexibly and creatively (Glasby and Littlechild, 2009, p. 77). The aim of personal budgets was to shift power to service users by adaptation to the way of allocating resources, controlling and victimization the support (Routledge and Porter, 2008).At the same time the government was facing scraps such as agedness population, care within the family becoming less an option, more diverse communities, higher expectation form the service as hale as move desire to retain by people control over their lives as much as possible, including riskiness management (DH, 2005 HM Government, 2007). Older adults are the largest group of recipients of social care with more than a one one million million in 2 006 (Leadbeater et al., 2008). The number of people of state pensionable age is piecemeal increasing with twelve million in mid-2009 (ONS, 2010). Some of the above factors stick out been a drive for governments increasing interest in a personalise system as a way of saving cost in already constrained budget (Glasby and Littlechild, 2009). From 2005, numerous documents such as Independence, upbeat and Choice, Our Health, Our Care, Our Say A New Direction for Community Services, Opportunity mount up and Improving the Life Chances of Disabled People, Transforming Social Care stated governments support and shift towards personalisation (Routledge and Porter, 2008). In 2007, The Putting People graduation compact car informs nigh reforms to transform the system, based on 522 million Social Care amend Grant, to include service users and carers at every step of organising care (HM Government, 2007). Although the government states the way forward, it gives miniature explanation wha t it leave mean for the front-line practitioners, for their roles and tasks required under new arrangements (Lymbery and Postle, 2010). It statesthe time has now come to build on best practice and replace paternalistic, reactive care of variable quality with a mainstream system focussed on prevention, early intervention, enablement, and high quality in person tailored services (HM Government, 2007, p 2).The Putting People First concordat (2007, p. 3) also says some more active role of agencies, emphasises greater role of self-assessment, therefore vigorous-favoured social workers more time for support, providing information, brokerage and advocacy. It also underlines grandeur of person centred planning, self directed support as wellhead as personal budgets being for everyone. Glasby and Littlechild (2009, p. 75) define personal budget asbeing clear with the person at the start how much capital is available to meet their needs, then allowing them maximum choice over how this silver is spent on their behalf and over how much control they want over the money itself.The recently published, in 2009, Working to Put People First The Strategy for the Adult Social Care Workforce in England states a bit clearer roles and tasks of front-line supply under new arrangements and recognises social workers role as a central in delivering personalised service.Social workers play a key role in early intervention, promoting inclusion and developing social capital as well as fail-safeguarding adults in vulnerable slew. They are practised at identifying models of intervention, some therapeutic, some task centred and working by with people the outcomes to be achieved. They also undertake navigator and brokerage roles as well as supporting self-assessment (DH, 2009, p. 34).However, Lymbery and Postle (2010) points out that the strategy does not condone who will be undertaking specified roles and tasks, we have the right people doing the right roles and not employ hig hly skilled workers for lower skilled tasks (DH, 2009, p. 33), and therefore the situation from community care reforms replicates where introduction of care manager denied the unique position of social worker. On the other hand, Glasby and Littlechild (2009) point out that the change of the social workers role from focusing on assessment to support planning and review will give more chances to work in partnership with service users to support them, what was the reason for many to come to the social care profession.ImplementationThere is an agreement that social workers motivation and support are crucial for the success of personalisation and based on their education and vex they are best-placed to fulfil roles and tasks in the new arrangements (Tyson et al. 2010 Samuel, 2010). Results from Community Care and consent this year batch regarding impact of personalisation on social workers reviled that 88% of respondents had appreciate some impact on their job, with 40% saying it had been demonstrable and 29% ban (Samuel, 2010). Two years ago in similar survey, negative impact of personalisation claimed only 18% of respondents (Samuel, 2010). One of the to the highest degree important evaluation of personalised budgets undertaken by IBSEN (2008) indicates that practitioners attitude towards the new system was based on the positive experiences of service users, strong leadership from managers or slaying team. On the other hand, hindrance for positive experience included high workloads, low information and training about IBs, and the lack of clarity about exact processes as new systems were put into place (Glendinning et at., 2008, p.22). The IBSEN conceive also indicates that inclusion of front-line practitioners in developing documentation and processes was key factor for successful implementation. The limitations of the IBSEN discover are that it have been conducted in very tight timescales and with continues policy changes and delays, so far it is a crucial research on the early impact of individual budgets (Glasby and Littlechild, 2009). My research study will visualize in depth the experiences of front-line practitioners of implementation of the personalisation and will also look at their positive and negative drivers. bureaucracyThe Community Care survey has found that two-thirds of respondents experience increase in bureaucracy as a result of transformation (Samuel, 2010). There has been an recital in the IBSEN study, two years earlier, that completing assessment and other office based duties was time consuming, however this increase was not significant. Although increased bureaucracy was an effect of more administrative approach of care management later community care reforms (Weinberg et al., 2003), it has been pointed out by Richard Jones, president of the ADASS, that some councils had over-complicated processes such as self-assessment and support planning (Samuel, 2010a). My research will provide in depth insight of the administrative role of the front-line practitioner in underway system.ProcessesThe social workers experiences varied significantly regarding assessment process based on self-assessment, with some seeing it as a complete transformation, where for others it was a move towards further learning of practice (Glendinning et al., 2008). At the beginning working in dual assessment systems has been recognised as a major challenge (Glendinning et al., 2008). Moreover, the view of social workers from Community Care survey match with whim form IBSEN study that self-assessment was not giving complete effect of a persons needs, with no focus on risk, issues regarding carers and their needs, and putting at risk social workers skills and professionalism (Glendinning et al., 2008 Samuel, 2010). The in Control report of the Second chassis (Hatton et al., 2008) sees self-assessment approach as the way to reduce the process and at the same time social workers time on this task. On the other ha nd, Lymbery and Postle (2010, p. 11) point out that assessment is at the heart of what social workers do and that not all service users have a ability and knowledge to recognise their needs and then to find appropriate ways to address these needs. Front-line practitioners reported that self-assessment usually has been undertaken with support from a family member or a friend, which has been seen as essential support (Glendinning et al., 2008). It can be seen as a potential ground for betrothal of interest between service users and carers with examples such as need for hiatus care or risk within home setting (Lymbery and Postle, 2010). On the positive side, some front-line practitioners indicated that self-assessment shows that peoples views were taken seriously and as having the potential to come back positive discussions about needs and outcomes (Glendinning et al., 2008, p. 147). The IBSEN study recognises that social workers involvement in this process in work with older adults whitethorn be of more importance. Older people become more isolated, have less available support from family, they tend to under-assess their own needs as well as do not perceive their behaviour as creating risk (Glendinning et al., 2008, p. 147). CSCI (2009, p. 137) back up above points regarding assessment stating that In practice, and particularly for people with complex needs, self-assessment entailed intensive support from care managers, more demanding of staff time and skills than traditional professional assessment. However, Community Care survey (2010) showed that two-third of social workers did not have enough time with service user to support self-assessment.In support planning process, exploring options, co-ordination, building confidence and empowering service users and carers were the main roles and tasks mentioned by care co-ordinators (Glendinning et al., 2008, p. 147). Many co-ordinators taking part in IBSEN study admitted that the focus on outcomes had an important impact on their practice. Some participants tell that one of their roles was to fork out the information given by service user in erect to produce a meaningful plan. One of the key issues, raised by practitioners, was confusion whether allocated monies based on for example personal care needs could be used flexibly to purchase other services. Further source of confusion and frustration for front-line staff as well as service users and carers, reported in the IBSEN study, was regarding the material good allowed to be purchased and whether family member could be paid for provided support. Specifically regarding older adults, the issue has been raised that their needs tend to change much faster, therefore a support plan may be out of date within a couple of months (CSCI, 2009, p. 140). In relation to support planning, the Resource Allocation System (RAS) has been perceived by front-line staff as purely mathematical, easy to use tool, on the other hand, some practitioners said that such mechanical approach to allocation of resources cannot sensibly and accurately distribute resources due to complexity of service users needs and circumstances (Glendinning et al., 2008). This research will look at the experiences of front-line staff regarding assessment process, support planning as well as resource allocation in new arrangements.Risk managementIn CSCI report (2008) there is extension that the new arrangements for social care might increase the level of risk for service users. This issue arise oddly where service user with complex needs is involved, as he/she might not be able to show distress (CSCI, 2008). Lymbery and Postle (2010) state that critical in terms of safeguarding in new arrangements is to retain professional engagement with service user. The IBSEN study states that giving service users more responsibilities and therefore more risk was in personalisation doctrine from the very beginning and also recognises that it is a difficult shift for care co- ordinators (Glendinning et al., 2008). Front-line staff had concerns that money could be spend inappropriately by service users, that they might not have appropriate skills and experience to employ PAs, that PAs had straight-laced training to provide for example personal care tasks in safe and effective way (Glendinning et al., 2008). Contrary to that, in Control Third Phase evaluation (2010, p. 73) evidence suggests that people feel and are safer when they are In Control of their support and their money and they can determine what happens around them on a sidereal day-to-day basis. In in Control study 60% of professionals said that there was no change in risk management from the start of Personal Budgets (Tyson et al., 2010). On the other hand, Community Care survey (Lombard, 2010) found that 37% of social workers do not know what to do when care arranged by service user puts him/her at risk. My research project will examine in depth the view of front-line staff regarding risk as sessment and implication, if any, of shifting more responsibilities to service users.Training, knowledge and skillsThe IBSEN study found out that most of the care co-ordinators had training provided before implementation of the individual budgets, however there was some who did not have any before undertaking first IB case (Glendinning et al., 2008). The participants in the IBSEN study said that training was focused more on the idea and philosophy tin can individual budgets, and did not concentrate enough on processes (Glendinning et al., 2008). Successful in terms of informal training were recognised interactive activities such as team meetings, meeting with IB team workers and development officers and peer support development groups (Glendinning et al., 2008 Lombard, 2010). The Community Care survey on personalisation shows that there are significant knowledge gaps amongst social workers (Lombard, 2010). 63% of respondents admitted the need for brokerage skills, with only 31% sta ting that they have them. An understanding of the key terms and overall knowledge about personalisation has improved (57%), however 14% of social workers lock away understand little or nothing about individual and personal budgets (Lombard, 2010). Only 49% of practitioners said that they feel they have enough knowledge about employing personal assistant (Lombard, 2010). My research will examine the experiences of front-line practitioners regarding received training as well as subjective opinion about skill gaps in their practice.Mindset, cultureThe need for cultural shift and change of mindset of service users and practitioners has been recognised in several publications as one of the most important issues (Glendinning et al., 2008 CSCI, 2009 DH, 2010). The CSCI report (2009) shows that it was not expected from older adults that they will appreciate superfluous responsibilities in managing individual/personal budgets, however in some sites more older people decided to have Direct Payment and to manage the money by themselves. In addition, in Control report (2010, p. cxxxv 136) shows that by the end of 2009 30.000 people were having Personal Budgets across 75 local authorities with older people being the largest group of receivers (53%). The in Control evaluation was based on online data voluntarily shared by local authorities, however there was no requirement on authorities to share data as well as not all authorities included breakdown by social care group, therefore the information from this report does not show an accurate national picture (Tyson et al., 2010). The Personal Budgets for older people making it happen guidance (2010) emphasises importance of sharing successful stories and cases in order to challenge front-line practitioners stereotypes and increase positive attitude towards older people as a recipients of personal budgets.ResourcesIn this year Community Care survey 36% of respondents said that resources have been the biggest barrier for su ccessful implementation of personalisation. Moreover, based on the information about planned cuts in public sector by the current government, 82% of respondents said that this will slow down the progress of personalisation (Samuel, 2010). It has been pointed out in several publications (Glendinning, 2008 Carr and Robbins, 2009 Samuel, 2010) that front-line practitioners using only public resources face significant challenges in exercising choice, control and independence of service user and his/her own creativity. It is well pictured in this quote this is more difficult when a budget is strictly for personal care that is essential the equivalent of 30 legal proceeding washing and dressing a day is not going to allow much creativity (Fighting Monsters, 2010). Social workers under new arrangements will still be responsible for control expenditure with funding targeted at those most in need (HM Government, 2008, p.9) what clashes with one of the key principle Putting People First whi ch is prevention and early intervention (Lymbery and Postle, 2010). This research project will examine in depth the view of front-line staff about using of existing social care resources in order to fulfil policies principles and meet older adults needs.ServicesIn the CSCI report (2009) it has been emphasised that to allow people to exercise choice and control and to feel independent, together with transformation of the system, the existing services need reconfiguration. At the moment services are limited and insufficiently flexible, where day services are traditional and predominantly based in buildings, and where block contracting arrangements limit the range of services on offer (CSCI, 2009, p. 148). The Community Care survey (2010) found out that 56% social workers have noticed that services such as day centres are being closed down on the assumption that using personal budgets will mean reduced use of such services. Services, especially from local authority, will have to by att ractive, flexible to needs, affordable, price competitive, sustainable, well structured and managed to meet service users needs (Tyson et al., 2010). My research will examine social workers experiences of changes in structure of services for older adults with the emphasise on increasing their choice, control and independence.