Patterns of Provision in Respite Care and the Children Act

Summary This article presents the findings of a three-year study intorespite care services to disabled children and discusses thesein the light of the 1989 Children Act. The aims and methodsof the research are first outlined and the various servicesincluded in the study are described. Access to services was found to be uneven, with families fromlow socio-economic groups and from black and ethnic minoritycommunities apparently having less choice. The characteristicsof users are identified: some of these varied according to typeof facility used or amount to care received. Agency records and registers were often found to be inaccurate:the Children Act will require authorities to maintain updatedregisters. New powers to charge for services may create furtherbarriers to access although requirements to take account ofchildren's racial and cultural background should extend it.The Act will help authorities regulate the amount of respitecare children receive and introduces certain safeguards. Itsemphasis on consulting young people is to be welcomed. Overall,the new legislation has the potential to improve many aspectsof respite care; its ability to do so will depend on havingadequate resources.     

Social workers' attitudes towards family group conferences in Sweden and the UK

The New Zealand family group conference (FGC) approach to decision making in child welfare and protection has attracted strong interest among policy makers and professionals all over the world. While New Zealand’s legislation makes use of FGCs more or less mandatory in child protection, other countries permit social workers to refer families to an FGC at their own discretion. Knowledge about social workers’ attitudes towards the model is thus paramount if we want to understand implementation and evaluations of FGCs outside New Zealand. This study looks at attitudes towards and actual referrals to FGCs amongst 219 social workers from 18 local authorities in Sweden and the UK. Results reveal an overwhelmingly positive attitude towards FGCs in both countries. Given these attitudes it was striking that only 42% of the social workers had initiated at least one FGC over an 18‐month period. The number of implemented FGCs was almost exactly the same in Sweden and the UK, after adjusting for time and number of social workers. Possible explanations for this paradox are discussed, using data from the survey and child welfare literature.     

Complex home care: challenges arising from the blurring of boundaries between family and professional care

Over the last 50 years, increasingly complex care (such as tracheostomy management, dialysis or enteral feeding) has shifted from hospital to home, with a concomitant rise in patient self-management and care given by family members. Recognition of the importance of the contribution of family care to the health system is also growing. This article reports the findings of a New Zealand study which explored the experiences of family carers who manage technical health procedures at home. It then draws attention to some broader issues raised by shifting complex care from professional management in hospital settings to family care at home, namely the ways in which complex home care blurs the boundaries between professional and family care (creating the ambiguous position of the expert carer) and questions of safety and responsibility in family care. We also discuss the implications for policy around family caregiving in New Zealand. Given the potential physical and mental health impacts of caring, it is time for renewed consideration of what family carers should be expected or allowed to manage and how the health system can support them in their important role.     

Communication in Care and Coercion: Institutional Interactions between Family Supervisors and Parents

Summary In this study the interaction of 51 videotaped professionalcommunications between Dutch family supervisors and parentsof children under family supervision were analysed. Family supervisionlies at the interface of care and control. This is evident inthe communication of professional child welfare workers withtheir clients for whom they have to clarify their rights. Theanalysis shows some of the strategies used by Dutch family supervisorsin cases of formal decisions and other interactions where theyanticipate confrontation with the client. In this way, familysupervisors separate their caring from their repressive functions.Nevertheless care and control were found to be successfullyintegrated in some communications.     

User Empowerment or Family Self-Reliance? The Family Group Conference Model

Correspondence to Carol Lupton, Social Services Research and Information Unit, University of Portsmouth, Halpern House, 1/2 Hampshire Terrace, Portsmouth PO1 2QF, UK. Summary Towards the end of the 1980s, the concept of ‘user’empowerment emerged as a central idea in debates about the organizationand delivery of health and social care services. Politicallyattractive to left and right, the concept contains both ‘liberatoryand regulatory’ implications (Baistow, 1994/5). Whileoffering the possibility of greater control and self-determination,it may also involve expectations about increased self-relianceand individual responsibility. Although not inherently contradictory,these different objectives may prove difficult to reconcileif the promotion of self-reliance is primarily driven by a concernto reduce the provision of state services. This paper sets out to explore the issue of empowerment in thecontext of the new Family Group Conference (FGC) initiative.Originating in New Zealand (NZ), the FGC model explicitly aimsto shift the balance of power between families and professionalswithin the child-care dicision-making process. Political interestin the model, however, may also be generated by its perceivedpotential for reducing the dependency of families on state-providedservices. Drawing on research from NZ and the UK, the paperexamines the quality of empowerment provided by the FGC modelfrom the perspectives of the families involved and sets outto assess the particular balance that obtains within the modelbetween the different and potentially contradictory objectivesof promoting user empowerment and encouraging family self-reliance.     

Community Treatment Orders for People with Serious Mental Illness: A New Zealand Study

New Zealand legislation allows for the involuntary outpatienttreatment of people with serious mental illness. This studyexamines the views of service users, family members and mentalhealth professionals (MHPs) about the impact of this regime.Semi-structured interviews were completed with forty-two serviceusers, twenty-seven family members and ninety MHPs, with recentexperience of the regime. Participants were asked to commenton the functions of community treatment (or non-resident) orders,their benefits and restrictions, decisions about their terminationand any impact on relationships. Most service users believedthe main purpose of the order was to ensure they took medication.They also believed the order provided better access to othertreatments, supported accommodation and care from MHPs. Familiesconsidered the orders provided relief for them and a supportivestructure for their relative’s care. MHPs found the ordersuseful for engaging service users in a continuing therapeuticrelationship, and for promoting treatment adherence. In eachgroup, a majority of those interviewed viewed involuntary communitytreatment in a generally positive light, while acknowledgingthe restrictions imposed on service users’ freedom.     

1998 Human Rights Act: Social Work's New Benchmark

Summary The 1998 Human Rights Act makes the European Convention on HumanRights directly enforceable by the United Kingdom's courts andtribunals. This represents a major constitutional change andwill allow statute law and common law to be assessed, or reassessed,according to the rights laid down in the Convention. This hasmany implications for social work policy makers, managers andpractitioners. It will require the Convention rights to be atthe heart of social work practice. The ability of service usersto challenge decisions by social services departments will nolonger be dependent upon the traditional approach to judicialreview. Compliance with the Convention will now feature in legalchallenges. It is essential that the practice of social workembraces the principles outlined in the Convention. In manyrespects, they are rights that practitioners and others recognizeas being basic expectations of service users, and making themdirectly enforceable can only be for the good. However, we shouldnot underestimate the effect that the legislation will have.This article outlines the legal effects of the 1998 Human RightsAct and illustrates them by reference to examples from socialwork practice.     

The dynamic,complex and diverse living and care arrangements of young New Zealanders: implications for policy

The living arrangements of young people in New Zealand are diverse and often complex. In this article we report the range of care and living arrangements of 209 15-year-old New Zealanders, 47 of whom identified as Māori. These young people were participants in the second generation of a cohort study. Data were collected from their parents via a life history calendar and analysed for variety and consistency of care arrangements, household membership and transitions. Few participants had a consistent pattern of parental care arrangements and most had experienced multiple changes in household composition and frequent changes of address. We conclude that the whānau/family lives of many young New Zealanders are complex and dynamic. These observations contrast with the conventional notions of family life that form the basis for New Zealand’s family policies. We argue that social policies and services impacting on young people need to reflect the lived reality of young people if they are to meet young people’s needs.     

Temporary Foster Care

Summary In order to improve outcomes in temporary foster care the authorbelieves there is a need to develop alternative models for practicethat would (a) define the social work task (b) specify in operational terms how that task would be accomplishedand thus would be amenable to empirical testing. (Temporaryfoster care is defined as the provision of substitute familylife for a child received into care, where there is a clearintention to re-unite the natural family at a future date). This article deals with the essential preliminaries to the developmentof a practice model. The first part surveys the relevant literature;part two develops a theoretical framework for practice aroundthree themes which are considered central to a considerationof foster care. These are the separation experience, the placeof the natural family, and role clarification. Other crucialvariables such as the age of the child, the nature of the problem,or the parents' potentiality for change are not dealt with withinthese papers, but are nevertheless seen as important issuesto be considered at the stage of designing a model for practice.     

Child Placement Policy: Some European Comparisions

Summary There is consensus among European countries that the first aimof a social policy for families should be to enable childrento remain in their own homes. However, in all countries somechildren require placement apart from their parents, but thereis no agreement as to the best mode of care for these children.Some countries rely entirely on residential care, others almostentirely on family placements in the community. The articlecompares Sweden (high fostering) with Belgium (low fostering),and England and Wales, which is midway between the two, andsuggests that some European models are relevant to English practice.     

Parental Rights Assumptions, The Passage of Time and 'Natural Justice': The Use of Section 3(1)(d) of the Child Care Act 1980

Summary This paper reports a study carried out in two Social ServicesDepartments, of 63 children in care under Section 2 of the ChildCare Act 1980, in respect of whom parental rights had been assumedunder Section 3 on the ground that they had been in Section2 care for three years or more. Some of the arguments put inthe debate about ‘natural justice’ in relation toparental rights assumptions are briefly considered in the introduction;recent changes in such assumptions are then outlined. The studyand its main findings are then presented, with reference tothe findings of other studies of parental rights resolutionswhere appropriate, Finally, the implications of the study forthe ‘natural justice’ debate are discussed. Theauthor's main conclusion is that the existing procedure is anomalousalthough Departments' use of it may be acrupulously careful.The grounds for assuming rights should be revised and the procedureshould be carried out by a family court.     

The role of family care-givers for an older person resident in a care home

Summary A sample of 61 relatives of residents admitted during the precedingthree years to 35 independent sector nursing or residentialcare homes in four local authority areas was interviewed. Thissample included spouses, daughters and sons. Five discrete rolesfor family care-givers in the care homes were described: checkingthe quality of care, companionship, handling the cared-for personwith personal care. Although family care-givers described themselvesas very satisfied with the care homes as a whole, as many ashalf were worried about some aspect of care. A third of theoffspring felt that their relationship with the cared-for personhad improved following the admission to a care home. None ofthe spouses felt this to be the case and most felt that theirrelationship had deteriorated. Spouses tended to visit veryfrequently. Unlike offspring, spouses rarely took the cared-forperson out of the care home. Because of the lack of privacy,visits could be a difficult experience. Those wanting to continuegiving their partner practical support were discouraged by stafffrom doing so. The research has implications for social workers,care home proprietors and registration and inspection unitsin encouraging care homes to adopt more 'relative friendly'policies.     

The Problems of Managing the Family Contacts of Children in Residential Care

Summary The study explores the problems of managing the family contactsof children in residential care. It focuses on the family linksexperienced by two children undergoing a two month long periodof observation and assessment. It is seen that the family linksof these children take a low priority, particularly as socialwork plans change and the informal world of the institutionbecomes pervasive. The outcomes of the two cases are charted.     

Key Issues for Social Workers Placing Children for Family Based Respite Care

Correspondence to Dr. Carol Robinson. Summary This paper seeks to address some of the issues surrounding theplacement of children with handicaps who, at their parent'srequest, go to stay with paid carers working in a family basedrespite care service. The content of the paper derives froma detailed evaluation of the Avon Respite Care Scheme. Thisevaluative study began in April 1984 and was completed in July1986. In order to provide an adequate picture of the contextin which the research was conducted, a brief outline of theliterature and the organization and philosophy of the serviceis provided. Thereafter, the aims of the research and the sourcesof the evidence used are described. In the latter part of thepaper. the results and their implications for social workersinvolved in placing children in family based respite care schemesare discussed.     

‘Boy, 15, Divorces Parent’: Irreconcilable Difference Applications in Victoria

The provision in Victoria's child welfare legislation, which allows parents or children to apply to the Children's Court on the ground of irreconcilable differences, is examined in the light of a much publicized case in Melbourne. Similar legislation exists elsewhere in Australia, and in New Zealand. The number of irreconcilable difference applications has declined in recent years due to the provision of counselling. A few cases still reach court. It is argued that legal proceedings serve little useful function. Cases of family breakdown are better handled by the provision of services including alternative accommodation, without a change in the child's legal status.     

Controlling for Care: Private and Voluntary Homes Registration and Inspection--A Forgotten Area of Social Work

Summary The size and growth of private and voluntary residential careprovision for the elderly make it, despite past neglect, a subjectof great importance to social workers. Drawing on exploratoryresearch data, the origins and role of registration and inspectionare discussed and some of the shortcomings of the present systemhighlighted. The paper discusses necessary requirements to preventfinancial exploitation of the elderly and makes two modest suggestionsfor improving and maintaining the quality of care-designatedliaison officers and a complaints procedure. In conclusion,however, it is pointed out that quality is not the only issuein the regulation of the private and voluntary sectors, thereare also issues of quantity, type and location. None of theseare being addressed by recent legislation and Code of Practice,but their resolution is important in ensuring that elderly peoplereceive the care they want and need, when and where they wantit.     

Parental Contact with Children Fostered and in Residential Care after the Children Act 1989

Correspondence to Andy Bilson, Department of Social Work and Social Policy, University of Northumbria, Newcastle NE7 7XA. E-mail Andy_Bilson{at}Unn.AC.UK Summary Research carried out since the implementation of the ChildrenAct 1989 based on a sample of 848 children looked after by localauthorities indicates that previous estimates of the numberswho have no contact with parents may have underestimated theextent of the problem, and that despite the emphasis placedon contact by the Children Act there is still much work to bedone to improve practice. The research not only confirms earlierfindings about the instability of placements in care but alsoshows differences in face to face contact which depend on thelength of time in care or accommodation and the reason for entry,as well as differences between children placed in residentialand foster care. Finally it was found that where children havespent long periods in care they tend to have little contactwith fieldworkers, and it is suggested that there is a needto redefine the social work agenda for this vulnerable groupof children.     

Regulation or fragmentation? Directions for Social Work under New Labour

Summary This article reviews the modernizing agenda of New Labour forsocial work which has been articulated in the various changesfor social work and social care announced in the ‘QualityStrategy’. Focusing predominantly on arrangements foreducation and training, the article argues that, rather thanpresenting a coherent strategy, the structures and proceduresare fragmented and unco-ordinated at many levels. A major weaknessis that New Labour has failed to clarify where it places socialwork in the structures of a ‘modernized’ welfarestate.     

Protecting children in Scotland: examining the impact of the Children (Scotland) Act 1995

This paper discusses findings from a small‐scale study of the impact on child protection practice following implementation of the Children (Scotland) Act 1995. The Act introduced three new measures to allow the state to intervene in families to protect a child where there is a risk of significant harm. These include the child protection order, the child assessment order and the exclusion order. The child protection order provides for the removal of a child to (or his or her retention in) a place of safety. In the first two years of the operation of the 1995 Act fewer applications were made for this order compared with similar provisions under the previous legislation. This reduction in applications appears to be related to unfamiliarity with new legislation; greater scrutiny resulting from the more formal application to the sheriff court; and the introduction of a new legal criterion for intervention, the presence or likelihood of ‘significant harm’. The introduction of the ‘no order’ principle into Scottish child care law is also likely to be a factor.     

The Other Italian Experiment: Neighbourhood Social Work in the Health and Social Services

Summary Following recent legislation, most social workers in Italy arenow responsible for giving a service to the population of agiven geographical area rather than to any particular categoryof client. The findings suggest that there is some experimentationwith regard to the organisation and composition of neighbourhoodteams and that the trend, not without problems, is towards socialworkers becoming the ‘gatekeepers’ to financialand other resources in the Social Service Sector for the localpopulation.