Promises and Pitfalls: Involving Service Users and Carers in Social Work Manager Education

Partnership working occupies an increasing amount of social work managers' time and budget, requiring skills and abilities not always developed previously within social work programmes. Much discussion around partnership working centres on building collaborative inter-agency and inter-professional relationships with less emphasis on the need to ensure good working relationships with service users and carers, despite their being the ultimate recipients of the process. This article explores efforts to develop a focus on service users and carers within a module for social work managers as part of post-qualifying (PQ) social work education. It documents a process where, initially, service users and carers provided personal testimonies of being recipients of services and then subsequently occupied more authoritative roles within teaching, to the current position when they are again less actively involved.

In describing these developments it explores possible reasons why involving service users and carers within this module has proved challenging. The article acknowledges that there is relatively limited literature about the involvement of service users and carers in PQ education. It suggests that lessons learned from involving service users and carers in qualifying social work training cannot directly be transposed to the post-qualifying context.     

Informal care and support for carers in Sweden: patterns of service receipt among informal caregivers and care recipients

This study describes and analyses the kinds of support received by different categories of informal carers, and the kinds of help that care recipients receive in addition to that provided by various categories of carers. Data were collected in a Swedish county in 2000, by means of telephone interviews. The net sample consisted of 2,697 individuals 18–84 years old, and the response rate was 61%. The results showed that relatively few carers in any care category received any kind of support aimed directly at them as carers. The most widespread form of support received by providers of personal care was relief services. Those most likely to be receiving care from the public care system were people also receiving personal care from an informal caregiver. Nevertheless, the majority of those receiving personal care from an informal carer did not receive any help from the public care system or from voluntary organizations or for-profit agencies. These results indicate that social policy and social work need to clarify the aims of the services they provide. They also need to take the needs of both caregivers and recipients into account when discussing support systems.     

Eyes on the account size: Interactions between attention and budget in consumer choice

The context surrounding a consumer decision, such as one’s overall budget available for purchases, can exert a strong effect on the subjective value of a product. Across three eye-tracking studies, we explore the attentional processes through which budget size influences consumers’ purchasing behavior. Higher budgets increased and sped up purchasing even when items were affordable at all budget sizes. Moreover, attention interacted with budget size to promote purchasing at higher budgets. Finally, individual differences in the magnitude of the budget effect related to attentional patterns: those whose decisions depended more on budget exhibited more budget-price transitions and less variability in search patterns compared to those whose decisions were less dependent on budget. These findings indicate that attention moderates the effect of budgets on purchasing decisions, allowing low budgets to serve as self-control devices and large budgets to generate impulse purchases.     

The intersection of employment and care: evidence from a UK case study

Working carers are a key focus of UK policies on health and social care and employment. Complementing national and European evidence, this paper presents a local case study of working carers. It draws on data from a county-wide survey containing a module on caring. Data were primarily categorical and were analysed using SPSS. Three quarters of all carers who responded to the survey were of working age: two thirds were employed and one third had been employed previously. The majority of working carers were mid-life extra-resident women. Over half of cared for relatives were elderly parents/in law; ‘physical illness’ was the primary cause of dependency. A tenth provided intensive care and half reported that caring adversely affected their health. Both were triggers for leaving employment. Two thirds of households received input from services and/or friends/family; being a co-resident carer appeared to mitigate against service allocation. Four issues were identified as pivotal to facilitating employment: access to advice and information, the availability of a matrix of affordable good-quality social-care services, ‘joined up’ needs assessment of the carer and cared for person, and employers identifying carers in their workforce. Europe's ageing profile underscores the study's timeliness.     

Housing Implications of Individual Budget Home Care Models for Older Renters: An Australian Case Study

Policies and programs relating to successful aging in place are premised on the fact that older people's housing is stable and suitable. Home-based aged care delivery models such as individual budgets aim to deliver increased service flexibility, choice, and control for consumers. Little attention has been paid to the consequences of such models for older renters, who often have less stable housing and restricted rights to modify their accommodation. This article reports on a project in Australia that explored the delivery and receipt of individual budget style models of home-based aged care services to older renters.     

Involving carers from minority ethnic backgrounds in carer-led research

This qualitative pilot study investigated the interest of minority ethnic informal carers, with no previous experience of research, in engaging in carer-led research. Individual face-to-face interviews and focus groups were conducted to explore the understanding and attitudes carers hold to research alongside the motivators and de-motivators to their involvement in carer-led projects. The findings reveal that carers are interested in initiatives with a practical beneficial outcome for carers or those they look after. Black and minority ethnic carers identified interpreter and translation resources, gender sensitivity and flexibility around their involvement as major considerations. Carers’ perceptions of their transferable skills from personal or professional experiences to research were also closely linked to their willingness to engage in carer-led studies.     

Carers of People with Mental Illness from Culturally and Linguistically Diverse Communities

Australia is a multicultural country and it is common for families from culturally and linguistically diverse (CALD) communities to care for their relatives with mental illness. However, there are limited Australian studies examining the experiences of informal carers of people with mental illness from CALD communities. A scoping review was conducted to search for peer-reviewed articles reporting the perception of carers regarding their caregiving experiences, wellbeing, and needs. Using cultural responsiveness as a conceptual framework, this study analysed the findings of the identified studies to generate themes. Findings show that carers experience severe caregiving challenges and face considerably poor culturally oriented services in mental health. Social work implications concerning the need to provide culturally responsive practice in mental health services are discussed.     

“I don't feel shy because I will be among others who are just like me…”: The role of support groups for children perinatally infected with HIV in Zimbabwe

As access to paediatric antiretroviral therapy (ART) continues to improve in sub-Saharan Africa, a new historically specific cohort of HIV-perinatally infected children surviving into adolescent has emerged. Although remarkable successes have been made clinically in keeping this cohort alive and in reasonable health, their social support experiences are still unknown. The research being reported here sought to explore peer social support experiences of HIV-perinatally infected children in Harare, Zimbabwe. In this article, we draw on 56 repeat in-depth interviews (IDIs) conducted in three phases and two focus group discussions (FGDs) with HIV-infected children (11–13 years). Additional interviews were held with 10 carers. Study findings suggested that both children and carers perceive support groups as a safe social space for learning and acquiring HIV information as well as gaining confidence. Additionally, findings highlighted the importance of consistency of participation. Structural and personal barriers to access and participation in support group were also identified. We conclude that support groups are a useful resource for HIV-infected children and therefore should be supported by stable funding.     

Gearing Up for Personalisation: Training Activities Commissioned in the English Pilot Individual Budgets Sites 2006–2008

The transformation of social care in England is taking place though changes affording greater choice and control for people using services. Individual budgets were one key element of these changes and were piloted in 13 local authorities in 2006–2008. This article reports on interviews with training leads in these local authorities that took place in 2008 as part of an independent evaluation of the individual budget pilots. The aims of the interviews were to explore the role of training as part of the processes of transformation, the use of resources and establishment of training strategies within the local authority. Participants revealed that the subject of training was acquiring higher profile within their authorities, although uncertainties remain about the extent of local authority responsibilities for training. Within local authorities, training resources were yet to be determined and models of training were not fully developed. The article concludes that training will remain a central issue when implementing personalised social care services and that models of training for such changes should be shared and evaluated over the long term.     

Engendering Government Budgets in the Context of Globalization(s)

This article considers the strengths and weaknesses of attempts to 'engender' government budgets in the context of globalization, drawing on my own personal engagement in such attempts, and on the work of many gender budget initiatives (GBIs) all around the world. GBIs have sought to improve the distribution, adequacy and impact of government budgets at national, regional and local levels; and to secure greater transparency in the use of public money; and greater accountability to women as citizens. Their spread has itself been an example of globalization, in this case the globalization of action for gender justice; facilitated by e-mail, the Internet and air travel; supported by international foundations and international development cooperation funds. But, it may be argued, GBIs have begun to engage with government budgets just at the time when governments, especially in the South, have less and less control over public finance decisions, due to other aspects of globalization. This article considers whether there is any point in GBIs if economic power lies in international markets, rather than in the Ministry of Finance, and draws on examples from a wide variety of countries.     

User and Carer Experiences of International Social Care Workers in England: Listening to their Accounts of Choice and Control

Abstract

This paper develops a typology of people using social care services’ preferences for care workers and satisfaction with social care services from a large multimethod study that explored international recruitment to the English social care sector (home and health care, including residential homes). We developed this typology with two questions in mind: (a) what led to satisfaction of care and (b) what led to preference and satisfaction with workers? Data were collected from face-to-face interviews with 35 people who were using social care services and carers (2007–2009) and these data were used to develop the typology. Using the theoretical concept of homophily, we explored contentions that people might prefer to receive care and support from individuals resembling themselves. We observed that preferences for care workers and satisfaction with social care services may be linked, but highlighted that the concept of meeting a preference is personal to the individual. The implications of users’ preferences for certain care workers at a time where policy is promoting greater consumer-led care or self-directed support are discussed.     

Family carers' views of services for people with learning disabilities from Black and minority ethnic groups: a qualitative study of 30 families in a south London borough

In 2001, the UK Government identified the widespread neglect of the needs of people with learning disabilities from Black and minority ethnic communities. In this qualitative study informal interviews were held with 30 family carers of adults with learning disabilities from Black and minority ethnic communities. Their views were sought regarding services received and services needed, and cultural or communication barriers faced in accessing appropriate services. The study showed that although carers were largely satisfied with services actually received, service provision was highly inadequate and ineffective. Even very elderly and ill carers and those caring for people with severe disabilities received little support. Social worker support was negligible, and future planning rare. It is clear that the needs of carers from Black and minority ethnic communities are not being met. The situation would be considerably eased by adequate social worker support. Stereotypes of supportive family networks, (especially regarding south Asian families) proved to be unfounded.     

Comparing Public and Private Sector Decision-Making Practices

Public and private sector decision making is studied with anexperiment. The study compares decision making in a tax-supportedgeneral purpose governmental agency with that done by a businessfirm selling to a market, using a simulation to capture differencesin the preferences and practices of mid-level managers workingin the two sectors. The simulation calls for participating managersto assess the risk and prospect of adopting budgets tailoredto match each sector. A cognitive culture that stresses analysis,speculation, bargaining, or networking is employed to fashiona budget appropriate for a public and a private sector organization,each with a controversial and a noncontroversial budget amount.The literature on public/private differences was consulted tomake predictions, suggesting that public sector managers wouldfavor bargaining and networking and private sector managerswould favor analysis and speculation. The cognitive style literaturesuggests that managers favor budgets constructed with an approachthat is consistent with their preferred cognitive style andsee less risk in the choice, except in a public setting whererisk would be unaffected. The study finds that private sectormanagers are more apt to support budget decisions made withanalysis and less likely to support them when bargaining isapplied. Public sector managers are less likely to support budgetdecisions backed by analysis and more likely to support thosethat are derived from bargaining with agency people.     

Social and Health Factors Affecting Community Service Use by Vulnerable Older People

Abstract

This article reports on Outcomes for older people with complex or chronic care needs, a study undertaken by the Brotherhood of St Laurence and La Trobe University, examining older Victorians’ use of community services following Aged Care Assessment Service (ACAS) recommendations that they remain living at home. The paper reports on interviews with older people and carers undertaken at three-monthly intervals, over 12 months. This paper contributes to understanding the factors that impede or facilitate uptake of community aged care services that are critical to meeting the needs of older people and their carers. The study found that among other factors social isolation, high carer burden, and the older person reporting low mood were important barriers to service uptake. Cost, waiting lists, and service satisfaction were also identified in qualitative data as influencing factors. The study concludes there is a need for better means of identifying and supporting older people and carers at risk to improve community service uptake.     

'We're not asking for anything special': direct payments and the carers of disabled children

1997 saw the introduction of the Community Care (Direct Payments) Act in the UK. This piece of legislation introduced a mechanism that enabled local authorities to make cash payments to disabled people aged between 18 and 64 in lieu of directly provided services. The years since 1997 have seen the introduction of additional legislation resulting in direct payments now being an option for many more groups of people, including the carers of disabled children. Following the changes in the legislation, government now wishes to see local authorities significantly increasing the numbers of families that receive direct payments. This paper will report on a research project carried out within one local authority in the north-west of England that has one of the largest numbers of carers of disabled children receiving direct payments in the UK. Using a variety of methods this paper explores how the local authority has made direct payments so widely available to carers and the effect that this has had on their own and their children's lives.     

Coping strategies and changes in the satisfaction of consumer needs in Poland

During the process of transformation members of households face multiple new challenges, including the necessity to make new decisions and verify previous actions that were undertaken to fulfil their needs. These new requirements are reflected in active or passive strategies adopted by households to balance their budgets. The first behaviour, the fox strategy’, invokes individuals’ adaptation of outside conditions to their own needs and preferences, such as doubling their work efforts in order largely to preserve the earlier patterns of consumption. The second reaction, the ‘hedgehog strategy’, involves the ‘cultivation of a balanced budget’, that is, taking care that expenses do not exceed income by restricting the use of many goods and services and limiting expenses and any symptoms of waste. The third response is a crisis or ‘lemmings’ strategy. This strategy may be observed in situations of drastic fall in a household's real income, where the household must reduce its consumer property (sale of household goods, taking on a pawn loan), or resort to outside help, e.g. institutional assistance (benefits, relief). Looking at each type of strategy, it may be said that from 1989 to 1994, the percentage of households implementing active strategies did not change, the group of households putting an effort into the ‘cultivation of the family budget equilibrium’ increased, and the group of households adopting the ‘lemmings’ strategy’ grew decidedly.     

Belonging to the library: humanising the space for social work education

Abstract

This article describes the running of four Living Libraries on a UK postgraduate social work course. A Living Library is a metaphoric remodelling of a conventional library where people, as authors of their experiences, provide specialist knowledge based on authorial areas of expertise. In the Living Libraries discussed here, ‘Living Books’ carried stories of social work—their narratives were of lived experiences as people using social care services; as carers in personal relationships with others who use social care services; or, as social work practitioners. The focus of this article is on those Living Libraries involving the participation of the first two of these groups. Drawing on social psychology, phenomenology and human geography, we propose that a Living Library can act as a connective space within social work education by engendering a discursive forum where all participants—people with experiences of services, students, practitioners and social work educators—are given both the freedom and obligation to talk openly about their differential experiences, fears and hopes for social work. Through this process, opportunities are created to consider how improvements that meet all stakeholders’ interests may be achieved.     

WORKING CARERS OF OLDER ADULTS

Juggling work and care presents particular challenges to carers and employers. Employers are increasingly under pressure, both from within organizations and from recent government legislation and policy, to develop family-friendly policies to support informal carers in the workplace. Yet existing ‘family-friendly’ schemes and services are still primarily designed for working parents of young children and rarely address the needs of employees who care for older or disabled adults. This paper reports on a study which investigated how working carers and managers in two public sector organizations — a Social Services Department (SSD) and a National Health Service (NHS) Trust — combined their work and caring responsibilities. A multi-method approach was adopted consisting of five phases. First, a profile of the two organizations was established, followed by a short screening questionnaire to all employees to identify who was caring for an older adult over the age of 60. Third, a lengthier postal survey was sent to the 365 carers who had indicated a willingness to participate further. In the fourth and fifth phases, carers and managers were interviewed in depth about their experiences. This paper reports briefly on the survey, but then concentrates in particular on what was said in the interviews about what helps and hinders working carers of older adults. Despite the existence of policies to support carers, our findings suggest that these were far less important than informal support from colleagues and a sympathetic manager in the workplace. Commuting distance between work, home and the older person also posed difficulties for carers, along with inflexible schedules and work overload. Employers are urged to explore these issues further if they are serious about recruiting and retaining employees, and developing the work – life balance agenda to meet the needs of those caring for older and disabled adults.     

Effects of the awareness of social dilemmas on advertising budget-setting: A scenario study

In this study, which examines the dynamics involved in setting advertising budgets, the social dilemma theory was applied in an attempt to understand the interdependency problems of advertisers in their investment decisions. In an experiment, a budget decision was made for a company after a period in which the company's market shares had either increased, decreased, or remained stable. Subjects were pre-screened with regard to their social value orientation (cooperative vs competitive). Half of the subjects were informed of the threat of social dilemmas and of the possible negative consequences; the other half were not informed. Budget decisions can be predicted on the basis of subjects' social value orientations and the awareness of the threat of social dilemmas. Subjects with a relatively strong competitive orientation are more zealous in setting their budgets. However, the awareness variable shows the strongest effects, especially in conditions when subjects experience a declining market share. It was concluded that knowledge about the dynamics of social dilemmas may prevent advertisers from a competitive reaction to the loss of share and may thus prevent them from becoming trapped in a competitive (social) dilemma.     

Stereotypes about caregiving and lessons from the Swedish panorama of care

This article analyzes the panorama of care provision in Sweden from the informal carers' perspective. We consider informal care, publicly financed services, for-profit agencies and voluntary organizations, using a survey conducted in 2009. Most cared-for persons with minor needs living in a separate household are helped also by others, but only a tenth use public services or other providers. About half of cared-for persons with major needs living in a separate household receive care also from other informal carers as well as public services. Only 1 in 10 of them relied on no one else beyond the carer interviewed. Among intra household carers—a minority of all persons cared for—it was common that the carer was alone in his/her commitment, without any contributions from public services or others. For the large majority of informal carers it is not a solitary undertaking as the commitment is often shared with family members and others and/or public services. The results suggest that ideal types about complementarity and substitution may understate the complex interplay between informal care and the public services (and potential other providers). The findings may suggest a need for more empirical research about ‘Care Cultures’ and expose simplistic representations of welfare societies; informal care plays a major—and increasing—role also in Sweden, a country with extensive public services.