Matches and Mismatches: The Contribution of Carers and Children to the Success of Foster Placements

Correspondence to Professor Ian Sinclair, Social Work Research and Development Unit, University of York, York YO10 5DD. E-mail: acs5{at}york.ac.uk Summary Data were collected on 472 foster children at an interval of14 months. The children's social workers, the family placementsocial workers and the foster carers reported on disruptions,and the reasons for placement success or lack of it. These views,combined with comments from the children, led to hypothesesabout the origins of successful placements. Statistical testsof these hypotheses suggested that success depended on threeaspects of the placement. First of these was the children'scharacteristics. Children, who wanted to be fostered (had attractivecharacteristics and low levels of disturbance), did better.Second were the qualities of the foster carer. Placements withwarm, child-oriented carers were more successful. Third wasthe interaction between carer and child. The findings emphasizethe crucial importance of the foster carers to outcomes. Theyalso support the need to pay close attention to children's views,and the potential importance of early intervention to preventnegative spirals of interaction between carer and child.     

Carers of People with Learning Disabilities, and their Experience of the 1995 Carers Act

Summary This paper seeks to highlight the impact of the Carers (Recognitionand Services) Act of 1995 on carers of people with learningdisabilities. It draws on research conducted in the south westbetween 1997 and 1999, which examined the views and experiencesof carers who had an assessment of their needs, together withthose of the person they care for and the professional conductingthe assessment. It concludes that the Carers Act is not widelyused, or understood, by this group of carers. Recommendationsfor improving practice include changes to the current terminology,new triggers for a carer's needs assessment, and a greater inputfrom other agencies, especially health services. Although thecurrent paper focuses on the views and experiences of carers,an exploration of the Carers Act, and its effect on potentialconflicts of interest with the person with learning disabilities,is available elsewhere (Williams and Robinson, 2001).     

Informal Care in Asian and Afro/Caribbean Communities: A Literature Review

Correspondence to Karl Atkin, Social Policy Research Unit, University of York, Heslington, York YO1 5DD. Summary The multi-racial nature of British society can no longer beignored by those responsible for planning and implementing socialcare policy, particularly since community care is presentlyat a crossroads. Informal care provides a useful starting pointfrom which to introduce the notion of race into social caredebates. The paper, by reviewing a mix of empirical studiesand policy debates emerging from the literature on informalcare and black communities, examines the experience of informalcare within black communities. By discussing topics such asthe demography of care, the nature of informal care, and serviceprovision to black carers, it gives coherence to a fragmentedliterature and illustrates gaps in present understanding.     

The assessment relationship: interactions between social workers and parents in child protection assessments

Summary This paper is concerned with a relatively unresearched areaof child protection practice: the comprehensive assessment.The study comprises qualitative research of social workers conductingthese assessments. Sixteen assessments are analysed in detail.It is noted that these assessments, like many other in-depthsocial work assessments, are mainly based on verbal interactions.Some of the core evidence cited by social workers as formingthe basis of their assessment decisions is based on verbal interactionbetween social workers and parents. Such verbal interactionsare viewed as being inextricably intertwined with the socialworker-client relationship. A particular aspect of the relationship,the ability to agree a plausible explanation for the familysituation, is highlighted as particularly important in determiningthe outcome of the assessment. The possible implications ofthese findings for assessment practices are outlined.     

Social Work and Child Mental Health: Psychosocial Principles in Community Practice

Correspondence to Steven Walker, Senior Lecturer, School of Community Health and Social Studies, Anglia Polytechnic University, 2nd Floor, Ashby House, Brook Street, Chelmsford, Essex CM1 1SQ, UK. E-mail: s.walker{at}apu.ac.uk Summary The increased prevalence, complexity and earlier onset of childand adolescent mental health difficulties, has prompted governmentinitiatives to reconfigure current provision for this clientgroup, their parents and the carers who try to support them.Social workers have an important part to play in respondingto the needs of these individual children and families. A residual,care management role is not adequate in these circumstances.This paper describes the development of social work in childand adolescent mental health, and suggests that a synthesisof psychosocial principles and community practice, offers theoptimum social work model of assessment and intervention. Sucha model embraces the most useful aspects of psychodynamic theoryin the context of practice consistent with anti-discriminatory,children's rights and partnership principles.     

Dependency and its Relationship to the Assessment of Care Needs of Elderly People

Correspondence to Dr Ian Gibbs, Social Policy Research Unit, Department of Social Policy and Social Work, University of York, Heslington, York, YO1 5DD Summary A number of previous studies of old people in residential homeshave suggested that a substantial minority are not in need ofthat form of care. The rapid growth in the number of peoplein private homes, supported by social security payments andentering without any independent assessment, has led to concernthat many more people enter residential homes without needingto be there. Social workers were employed in four areas to assess the needsof residents newly admitted to homes in the independent sectorand over eighty per cent were found to be in need of residentialcare. It is suggested that the measures of dependency used toindicate need in some previous studies fail to take into accountthe complex factors involved in deciding whether a person needsresidential care.     

A Model for the Comprehensive Assessment of Older People and Their Carers

Correspondence to Beverley Hughes, Department of Social Policy and Social Work, University of Manchester, Oxford Road, Manchester M13 9PL. Summary Although local authorities and social service departments arein the process of developing systems of assessment in relationto care management, there has been little debate about the principleswhich ought to underpin assessment processes, nor about thepurpose, scope, and content of comprehensive assessment witholder people. This article discusses these issues and proposesa framework for comprehensive assessment with older people andtheir carers, derived from development work with social workersin a number of local authorities. Of particular importance isthe need for comprehensive assessment to embody meaningful mechanismsfor user and carer participation and empowerment; to acknowledgenot only need and risk but strengths and resources; to regardthe older person as the centre of a network of personal, familial,and social factors which together determine her or his qualityof life and level of risk. The implications for practitionersare examined.     

Identification of and Responses to Problem Drinking Amongst Social Services Users

Correspondence to Alan Lawson, Research Officer, Department of Social Services, London Borough of Hounslow, Civic Centre, Lampton Road, Hounslow, Middlesex TW 3 4DN. Summary The NHS and Community Care Act (1990) has required local authoritiesto plan for social care aspects of services for alcohol misusers.Research was therefore commissioned by senior managers of theLondon Borough of Hounslow's Social Services Department to investigatethe effect of alcohol misuse amongst Social Services users onthe work of the Department. Research methods are summarizedand the main findings and their implications are discussed.The importance of relevant training was highlighted, in particularin relation to the identification and assessment of alcoholproblems and to child protection issues.     

SETTING OBJECTIVES AND MEASURING ACHIEVEMENT IN SOCIAL CARE

Correspondence to Tony Bovaird, Public Sector Management Research Centre, Aston University, Aston Triangle, Birmingham B4 7EJ Summary This paper examines a systematic approach to formulating andevaluating policies for social work practice in social care.A hierarchy of aims and objectives is advocated, based on theassumption that a clear statement of desired outcomes in socialwork practice with groups of service users is required, togetherwith the establishment of indicators by which their achievementmay be measured. The purpose of the hierarchy is to generatean integrated policy for change and to give a full sense ofdirection to all staff involved, both in policy making and insocial work practice.     

Informal Carers of Adolescents and Adults with Learning Difficulties from the South Asian Communities: Family Circumstances, Service Support and Carer Stress

Corrrespondence to Chris Hatton, Research Fellow, Hester Adrian Research Centre, University of Manchester, Manchester M13 9PL, UK. Summary On the basis of a total identification survey in two metropolitanboroughs, 54 people from the south Asian communities caringfor people with learning difficulties aged 14 or over were interviewedregarding family circumstances, service supports and levelsof stress. In general, families were living in circumstancesof material disadvantage and reported a high need for services,due to a lack of informal support and the considerable supportneeds of many of the people with learning difficulties. Carerawareness and receipt of specialist intellectual disabilityservices were, however, low. A lack of information and staffwith appropriate language skills, coupled with a general neglectof the cultural and religious needs of service users and carers,appeared to result in low service uptake and low levels of satisfactionwith services. Eight per cent of carers reported levels of stressindicative of psychiatric problems, and also reported high levelsof contact with health services. There was some evidence thatservices were not allocated according to need; carers with lowhousehold incomes reported higher levels of stress, but carerswith higher household incomes received a wider range of services.The implications of these findings for services are discussed.     

Parenting Assessment in a Psychiatric Mother and Baby Unit

Correspondence to Dr Gertrude Seneviratne, Section of Perinatal Psychiatry, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. E-mail: G.Seneviratne{at}iop.kcl.ac.uk Summary Courts and social services often seek the advice of mental healthprofessionals in deciding whether a mentally ill mother shouldremain the primary carer of her infant. This paper describesthe referral pathways, outcomes at discharge and subsequently,of a sample of mothers referred for parenting assessments toa psychiatric Mother and Baby Unit. A further aim was to examinefactors predicting outcome. A casenote study of sixty-one consecutivereferrals for in-patient parenting assessment over a six-yearperiod is described. Social Services were contacted to establishdevelopments at least nine months after discharge. Fewer thanhalf of the mothers were discharged together with their babiesat the end of the assessment period, and at follow-up, lessthan a third were still caring for their children. Diagnosisof the mother's illness was the main factor determining whethershe continued to care for her child both at discharge and atfollow-up; mothers with depression were more likely to remainprimary carers. Variations in the timing and process of referralsrelated to a lack of antenatal planning were associated withincreased rates of separation of mother and infant before theassessment. The findings illustrate the need for more integratedco-ordination between professionals in mental health and children'sservices to ensure early planning for mothers and infants atrisk.     

Good Practice in the Education of Children in Residential Care

Correspondence to The Directors, New Horizons (Child Care) Ltd., Unit B, Silkmoor, New Street, Frankwell, Shrewsbury, Shropshire SY3 8LN, UK. E-mail info{at}new-horizonschildcare.co.uk Summary Research shows that the education of children in residentialcare is generally poor, in terms of both process and outcome.This has highlighted the uncertainty over how best to educatethese children and a pessimism over what they can achieve. Drawingupon the findings of an evaluation of a children’s home,this paper argues that children in residential care can havegood educational outcomes. It also shows that it is possibleto identify the processes by which these outcomes can be broughtabout. However, this largely positive assessment is predicatedupon education being defined broadly in respect of ‘process’and ‘outcome’. Moreover, it is important not tounderestimate the formidable challenges inherent in this work.While the multi-agency nature of this work gives rise to oneof the most significant, it has to be recognized that responsibilityfor the education of children in residential care falls primarilyto children’s homes. If children’s homes are tomeet the increasing expectations that are being made of them,national and local government will have to undertake a radicaltransformation of residential childcare, especially in termsof attitudes towards, and resources invested in, this sector.Central to this is the establishment of a qualified and properlysupported workforce.     

Applying Single-Case Evaluation in Social Work

Summary This article reports on a research project involving the useof single-case designs on an agency-wide basis within KirkleesMetropolitan Education Social Work Service. Following a programmeof training, 21 social workers (69 per cent of the service)applied the methodology in 83 cases. The extent of practitionerinvolvement in this project prompted Bruce Thyer (Professorat the University of Georgia, USA and editor of Research onSocial Work Practice and author of Thyer, 1993) to state ina letter to the authors, ‘Please allow me to offer mycongratulations on a most valuable project. To my knowledge,this is the largest agency-based study of this type which hasever been conducted. Your agency social workers are especiallyto be commended for their implementation of single-case designswith real life clients and families’ (6 May 1994). Theproject's strategy was to concentrate on the prerequisites ofsingle-case methodology which include specifying target problemsand selecting an appropriate measure to monitor progress. Thetype of single-case design used was determined by the courseof natural practice, hence indicating the flexible nature andviability of this methodology in the evaluation of social workpractice. The use of single-case designs encouraged a systematicapproach in the definition of target problems, identificationof goals, selection of intervention procedures and in monitoringoutcomes. The practitioners found that single-case designs enabledcontinuous assessment of outcome data by both the clients andthe practitioners, providing a model of accountability and collaborativeworking. A paper based on this article was presented by MansoorKazi at the ADSS Research Group Conference, Stafford, 17–18November 1994.     

Closing the Circle: Social Workers' Responses to Multi-Agency Procedures on Older Age Abuse

Correspondence to Professor Michael Preston-Shoot, School of Law and Applied Social Studies, Liverpool John Moores University, Liverpool, L7 4DN, UK. E-mail: m.prestonshoot{at}livjm.ac.uk Summary This paper reports findings from a project which examined howinter-agency procedures on older age abuse in domestic settingswere used in one local authority. Observations about the useof procedures and about practice with older people who had beenabused are placed in the context of national policy developmentsand are reviewed alongside the available literature. The researchquestions the extent to which guidance is effective in providingdirection for practitioners who encounter older age abuse, andhow well guidance and practice combine to protect victims.     

The Protective Environment of Children: Towards a framework for anti-oppressive, cross-cultural and cross national understanding

Correspondence to Department of Social Work, School of Applied Social Studies, University of Bristol, 8 Woodland Road, Bristol BS8 1TN. Summary The article explores the strengths and limitations of existingcross-cultural, cross-national and anti-discriminatory theoryand research in the child protection field. The way in whichstructural, cultural, personal and inter-personal factors combineto create the child's protective environment is analysed anda framework for an integrated approach to anti-oppressive understandingand practice is suggested. The framework identifies four factorswhose impact at national, community and family levels needsparticular consideration. These factors are the value attachedto children, the status of women and carers, the social interconnectednessof children and carers, and the extent and quality of the protectivesafety nets available. Examples are provided to illustrate theframework's usefulness in practice. It is argued that childprotection theory and practice in Britain needs to take moreaccount of collective and community-based approaches if anti-oppressiveand user-empowering practice is to be achieved.     

The Abuse of Elderly People: Considerations for Practice

Correspondence to Ms. B. Penhale, Team Leader, Social Work Department, West Norwich Hospital, Bowthorpe Road, Norwich NR2 2TU. Summary Within the last six years, concern about the abuse of elderlypeople by their informal carers has increased in Britain. However,problems remain in the identification and treatment of boththose who are abused and their abusers. The purpose of thispaper is to consider some of the barriers to the identificationof abuse; to look at the similarities and differences betweenthe abuse of elderly people and other forms of family violence(in particular child abuse) and to discuss the implicationsof these for social work practice.     

Case Finding and Screening for Social Work in Acute General Hospitals

Paul Bywaters, Senior Lecturer, Department of Social Science and Policy Studies, Coventry Polytechnic, Priory St., Coventry, CVI 5FB. Summary Since the first appointment of a ‘Lady Almoner’social workers in hospitals have complained about the problemof obtaining referrals appropriate to their skills and knowledge,and sufficiently early in the patient's stay to allow for effectiveintervention. Often, due to shortage of staff, workers haveto rely on referrals from other staff, patients and carers.But where social workers find their own cases, a wider rangeof problems and patients are selected. In the United Statesduring the past twenty years there has been a rapid spread ofscreening at the point of admission or pre-admission, to identifyhigh risk patients for social work assessment. The evidencefor the effectiveness of this approach to case finding is examined.     

Man-made Care: Community Care and Older Male Carers

Correspondence to Mike Fisher, Department of Social Work, University of Bristol, 8 Woodland Road, Bristol BS8 1TN. Summary Recent evidence about the extent of caring for older peopleby older people themselves, and about the importance of spousecare, has challenged existing debates about gender and care.Male carers, particularly older husbands, have been ‘discovered’.This paper attempts to reconceptualize the debate about genderand caring to take account of these developments, particularlyto develop an understanding of the caring activities of oldermale carers and to elaborate the implications for communitycare policy. The evidence suggests there are circumstances where men acceptthe obligation to care, undertake intimate personal care, andderive identity and reward from their caring work, driven bysimilar motives and experiencing similar struggles as women.Rather than seeking maximum distinction between the motivesand experiences of women and men carers, the paper suggeststhat one important way to promote non-sexist community careis to explore the conditions where men's caring is undertakenand how it can be understood and developed.     

Show Me the Way to go Home: A Narrative Review of the Literature on Delayed Hospital Discharges and Older People

Correspondence to Jon Glasby, Health Services Management Centre, University of Birmingham, Park House, 40 Edgbaston Park Road, Edgbaston, Birmingham B15 2RT, UK. E-mail J.Glasby{at}bham.ac.uk Summary This Research Note reports findings from a narrative reviewof the literature on the rate and cause of delayed hospitaldischarge in the UK. In addition to summarizing our knowledgeto date in this important area, the Research Note raises a seriesof questions about aspects of current hospital discharge policyand practice (and in particular, the recent reimbursement policyto charge social services departments for delayed discharges).     

Anti-Discriminatory Practice: Pedagogical Struggles and Challenges

Correspondence to Narda Razack, Assistant Professor/Field Education Coordinator, School of Social Work, Atkinson College, York University, 4700 Keele St., North York, Ontario M3J 1P3, Canada. E.mail: nrazack{at}yorku.ca Summary Transnational alliances and changing global realities have resultedin a proliferation of material relating to diversity and socialwork practice. More recently the focus has rested on anti-oppressionand multicultural social work. Although there is growing acceptanceof the need to be sensitive to diverse populations, the struggleoften lies in pedagogical and practice considerations. Coursesdealing with oppression have emerged and the emphasis has beento encourage student and teacher to examine their own biasesand understand their ethnicity and culture while seeking todevelop a framework for sensitive practice. Issues relatingto power and subjugation are highlighted along with an understandingof history and present realities. Pedagogical and practice strugglesneed to be addressed on a consistent basis to ensure that theslippage towards a more didactic approach is not adopted inorder to avoid dealing with sensitive material and issues. This article represents a synthesis of my experiences of developinga half credit course on anti-discriminatory practice and teachingit over a period of five terms. The guidelines and approachesused for teaching this course include journals, reflective papers,coalition groups and small group discussions. These approachesare discussed, together with an examination of the locationand struggles of staff and students, and ongoing challengesto effect social knowledge production that is premised on ananti-discriminatory and anti-oppressive framework for practice.Excerpts from student journals, my observations, and feedbackfrom student evaluations are utilised to promote a criticalreflection of pedagogical and practice concerns necessary forsustaining an anti-oppression framework for social work practice. The ways in which groups, individuals, and ideas come to bemarginalized in a given culture, society, and/or place has muchto do with what is considered to be knowledge and who is consideredto possess it, who is perceived as knower and who is known (Edgerton,1993, p. 222). Curricula are revised but rarely transformed from the insideout (McGee, 1993, p. 281).