Mainstreaming Equality: Implications of the Provision of Support at Home for Majority and Minority Ethnic Older People

This paper explores the potential impact and practical difficulties of mainstreaming equalities in support at home for minority and majority ethnic older people, drawing on two linked empirical research projects. Social care providers have long faced difficulties in catering for diversity of need. Recently, diversity within minority ethnic groups has increased, and there is now a statutory duty to promote equality. Research findings illustrate the complexity of exclusionary processes, with particular reference to the example of health care. There is a gap between the high‐level commitment to mainstreaming equality and people's lived experiences. Autonomy and choice are central to community care legislation, policy and practice guidance, but in reality, the research shows that choices are limited for both minority and majority older people. More user‐focused approaches and grassroots involvement may offer ways forward, despite some limitations of current models. In conclusion, the potentiality of a broad mainstreaming equality perspective is highlighted, but challenges include a need for a more grounded approach, better engagement with user groups and a need to focus on understanding issues of implementation.     

Keyworkers Re-examined: Good practice, quality of care and empowerment in residential care of older people

Correspondence to Rosemary Bland, Department of Applied Social Science, University of Stirling, Stirling FK9 4LA, Scotland Summary Social work definitions of ‘good practice’ in residentialcare which were originally developed in work with children andyoung people have also been applied to residential settingsfor other user groups, including older people. However, anylink between such elements of practice and positive outcomesfor users has not always been demonstrated. The introductionof market principles and orientations into social welfare inthe 1980s re-defined the social work ‘client’ asa ‘consumer’ with the associated power to make choicesin the area of social care. The success with which such an approachcan be applied to services for people who are very often, notin a position to exercise much choice, is debatable. Alongsidethe notion of the ‘consumer’ or ‘user’of services has grown the ideology of ‘empowerment’of people who use social work services. Drawing on findingsfrom a recent study, this article explores the contributionof the keyworker role to good practice and the empowerment ofolder people living in residential homes. It concludes that,because their understanding of the concept and practice is largelyundeveloped, the role as currently interpreted is not consonantwith good practice and tends rather to reinforce the power ofstaff.     

Care Management and Professional Autonomy: The Impact of Community Care Legislation on Social Work with Older People

Correspondene to Mark Lymbery, Centre for Social Work, School of Sociology and Social Policy, University of Nottingham, University Park, Nottingham NG7 2RD, UK. e-mail: Mark_Lymbery{at}nottingham.ac.uk Summary The 1990 National Health Service and Community Care Act appearedto herald a new dawn for social work with older people, whichhad previously been a relatively neglected and undervalued areaof social work practice. The legislation proposed a new rolefor social workers as ‘case managers’, with considerableautonomy and flexibility about the way in which the ‘casemanager’ responded to need. By the time community carepolicy was implemented, the role of ‘case manager’had been transformed into that of ‘care manager’,with a focus which emphasized procedural and managerial requirementsrather than a more flexible professional practice. This paper explores the extent to which this shift has substantivelyaltered the nature of social work practice with older people.It outlines key theories of professions and their applicabilityto social work, and critically analyses the impact of the ‘newmanagerialism’ within social services departments. Thepaper also examines the nature of social workers' practice witholder people following the impact of community care legislation,and concludes that the impact on the social work professionhas been to locate an increasing control of practice with socialwork managers, with potentially serious consequences for thecontinuation of a distinctive social work role in relation toservices for older people.     

What kind of people are we? 'Race', anti-racism and social welfare research

Summary This article argues that, to provide reliable and nationallyrelevant information on which to base policy and practice andto afford the Black population equal access to knowledge aboutits social realities, social welfare research needs to includeaccurate representations of minority ethnic groups and theirchanging needs. Using child welfare and community care as examples,a brief research review indicates the continued scarcity ofsuch research and its potential benefits. The methodologicalsupports available to researchers seeking to include minorityethnic populations and anti-racist perspectives are considered,and it is concluded that such supports are limited and patchy.In exploring the reasons for this, the author identifies someof the political, personal and technical challenges an anti-racistapproach presents. The terms 'experiential affinity' and 'experientialinterdependence' are introduced to help conceptualize the knowledgeand power differentials which may impede researchers pursuinganti-discriminatory aims, and a 'costs and benefits' frameworkis suggested to help understand and confront these issues. Then,drawing on existing research and theory, the article considersin detail some of the technical challenges to be overcome, withparticular reference to sample identification and selection,fieldwork processes and data analysis and suggests practicalways in which some of these challenges might be met.     

The Beckford Report: A Critical Appraisal

Correspondence to Nigel Parton, Department of Behavioural Sciences, The Polytechnic, Queensgate Huddersfield HDI 3DH. Summary This paper provides a critical analysis of the Beckford Reportand its implications for social work and the personal socialservices. Four interrelated themes are explored: the relationshipbetween social work practice, statutory responsibilities andthe law; the attitudes of social workers towards children andfamilies; the social work skills required; and the assumptionsthat are made about child abuse and the role of social workers.This is then related to recent research findings in the areaof policies and decision making in child care. It concludesby arguing that the report is in great danger of misdirectingour attentions from the major issues concerned with social workwith children at risk.     

A qualitative study of the practices and experiences of staff in multidisciplinary child sexual exploitation partnerships in three English coastal towns

This article presents findings from a qualitative study of the practices and experiences of people working in multidisciplinary child sexual exploitation (CSE) partnerships in three coastal towns in England. The study is based on focus groups conducted with 36 practitioners from a range of professional groups, including police, social work, substance misuse, education, specialist youth workers, sexual health, and statutory and non-statutory children's services. The article begins with an overview of the three towns and the structure of their responses to CSE. It goes on to explore a range of factors, which contribute to the local issues around CSE and which affect and direct multiagency working. These include practitioner perspectives on CSE vulnerability, the discrepancy between young peoples' and practitioners' views about “exploitation”, a discussion of how CSE perpetrators initiate and develop contact with young people and the role of incentives—including drugs and alcohol—as part of CSE exploitation. We finish by drawing out some general conclusions.     

Social Work and Criminal Justice in Scotland: Developments in Policy and Practice

Correspondence to Dr Gill Mclvor, Social Work Research Centre, Department of Applied Social Science, University of Stirling, Stirling FK9 4LA, Scotland. Summary In the last five years major changes have occurred in the provisionof social work services to the Scottish criminal justice system.The present article charts recent developments in statutoryand voluntary community-based social work services to offenders,locating them in the context of contemporary penal policy. Thecontribution of social work at various points in the criminaljustice process is discussed with particular reference to theintroduction of national standards and full central fundingof statutory social work services. The new funding arrangementshave, it is suggested, provided an impetus to the developmentof statutory services but at the expense both of services notcurrently subject to the 100 per cent funding mechanism andof increased central government control. The article concludesby outlining the challenges to be faced by social work departmentsover the next few years, including an ever-widening remit andthe uncertainties surrounding local government re-organization.     

Working in the Social Services: Job Satisfaction, Stress and Violence

Correspondence to Professor Jan Pahl, Department of Social and Public Policy and Social Work, Darwin College, University of Kent at Canterbury, Canterbury CT2 7NY. Summary A major survey of the social services workforce (Balloch etal., forthcoming), carried out in the Research Unit at the NationalInstitute for Social Work, has produced new data about sourcesof job satisfaction and about the incidence of stress and violence.The survey took place in five different local authorities inEngland, and interviews were carried out with 1276 individuals,selected from four groups of staff: managers, social work staff,home care workers and residential staff. The results suggestedthat those who work in the statutory, social services do experiencemore stress and violence than workers in other parts of thehealth and welfare services. However, different jobs presenteddifferent hazards. In general, home care workers were the mostsatisfied with their jobs, and were also the group least likelyto be stressed or to experience violence in the course of theirwork. By contrast, residential workers, especially those withmanagement responsibilities, were most at risk of both violenceand stress. Men were more likely than women to experience violence,while other groups with a higher than average risk of stressincluded younger members of staff, and managers and social workstaff responsible for elderly people.     

Social Work in Accident and Emergency Departments: A Better Deal for Older Patients' Health?

Correspondence to Eileen McLeod, School of Health and Social Studies, University of Warwick, Coventry CV4 7AL, UK. Summary Well-established internationally, the current development ofsocial work in UK accident and emergency (A&E) departmentsis part of a conjoint health/social care policy drive to divertolder people from ‘unnecessary’ admission to acutehospital care on social grounds. However, from older serviceusers' standpoint, the prime criterion for assessing A&Esocial work is not its powers of diversion, but its contributionto optimum health and social care. Our account indicates thatA&E based social work can provide important benefits, includinghelp with negotiating the A&E environment and readier accessto social services. Nevertheless, continuing professional–serviceuser power imbalances, together with shortages in health andsocial care services, undermine its positive contribution bothwithin A&E and following discharge. Notably, under-resourcedcommunity based health and social care can lead to servicesimplemented through A&E, swiftly unravelling. This has seriousconsequences for older service users facing interlinked healthand social problems, and may be implicated in re-attendanceat A&E.     

Capacity Building and the Reconception of Political Participation: A Role for Social Care Workers?

This paper explores a citizen-based approach to social workwhich may counter modern negative managerialist pressures onpractice. It links the discourse concerning the growth of userinvolvement in public policy with the discourse about participationin political activity and suggests a role for social workersin supporting service users in initiatives such as self-help,campaigning and community action which offer a new interpretationof community-based social work. By engaging in this activity,health and social care professionals can support people to participatein emerging forms of active and inclusive citizenship. Whileparticipation in traditional political activity such as votingand political party membership is declining in the UK, peoplein marginalized groups are finding ways to have their voicesheard about issues which directly concern them. Increasingly,groups such as disabled people, older people and mental healthservice users/survivors are taking part in activity which marksa shift of focus to include both self-help and campaigning.In contrast to their disillusion with traditional politicalactivity, people across a range of groups have gained strengthand encouragement from campaigning achievements. The paper drawson a national research study which offers fresh insights onthese issues as a basis for exploring participative approachesto social work practice.     

'Anti-oppressive practice': emancipation or appropriation?

Summary This article offers an initial critical discussion of the conceptof anti-oppressive practice - AOP - from the perspectives ofservice users. Whilst acknowledging the emancipatory aspirationsof anti-oppressive practice, it also considers its regressivepotential. AOP has become central in social work theory andpractice and indeed is sometimes presented as a key approachand theory of social work. This discussion highlights the failureso far significantly to involve service users and their organizationsin the development of anti-oppressive theory and practice. Itconsiders how the ideology and structures of anti-oppressivesocial work impact upon service users; the problems raised by'expert' appropriation of users' knowledges and experiencesand the issues raised by the failure so far to address the useof social work and social care services as an area of differenceand category of social division. Finally, the article examinesalternatives to existing notions of anti-oppressive practicebased on the equal involvement of service users.     

Understanding 'Going Missing': issues for social work and social services

Correspondence to Malcolm Payne, Professor of Applied Community Studies, The Manchester Metropolitan University, 799 Wilmslow Road, Didsbury, Manchester M20 8RR. Summary Recent research about young people and adults who ‘gomissing’ raises important issues for social work and thesocial services. Large numbers of young people go missing eachyear, becoming vulnerable to exploitation and at risk of committingcrime and suffering from other social difficulties. Adults leavebehind families with practical and emotional difficulties. Adefinition of ‘going missing’ should focus on absencefrom social expectations and responsibilities. Five groups ofmissing person are identified: runaways, pushaways, throwaways,fallaways and takeaways, reflecting different social situationsin which going missing occurs. It is argued that going missingis one of a range of choices which people in difficulties maymake, depending on their approach to problems in their livesand the availability of opportunities. Effective local co-ordinationto focus on reasons for going missing, on reunions and returnsto residential care or home, and to provide emotional and practicalhelp to people ‘left behind’, are required, providedthat care is taken to protect people who go missing becausethey are subject to abuse and violence.     

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.     

Citizenship, Volunteering and Active Ageing

Many voluntary organizations depend greatly on the unpaid services of older volunteers, a significant number of whom are women. At the same time, shifts in welfare policy have been towards emphasizing individual economic autonomy and self-provisioning, often to the detriment of older, more vulnerable members of society. Using data from an organization working for and with older people in the North-East of England and through in-depth qualitative interviews, our study found that volunteering is an expression of citizenship for older people. In our analysis, we identify two strands in the meanings of citizenship for older people: volunteering as leisure and work, and volunteering as care and civic consciousness. These correspond with liberal conceptualizations of citizenship and republican models of citizenship. Data from our in-depth interviews demonstrate a strong commitment to society and fellow citizens among older people that counterbalances individualistic and instrumental reasons for volunteering promoted by the state and market. Our findings suggest that government views of volunteering as a route to paid work, as a panacea for society and therefore needing to be more 'work-like', are discordant with the perspectives of older volunteers. Rather than the neo-liberal views of the 'citizen-worker' or 'citizen-consumer', citizenship that is based on the 'common good' and feminist perspectives of 'caring citizenship' are arguably more beneficial to society. Finally, we describe the pressures and constraints facing older people that could discourage formal volunteering in the future.     

Micro‐provision of Social Care Support for Marginalized Communities – Filling the Gap or Building Bridges to the Mainstream?

As English social care services reconstruct themselves in response to the personalization agenda, there is increased interest in the contribution of micro‐providers – very small community‐based organizations, which can work directly with individuals. These micro‐providers are assumed to be able to cater for the ‘seldom heard’ groups which have been marginalized within mainstream social care services. This article reviews recent literature from the UK published in peer‐reviewed journals from 2000 to 2013 on support provision for people with protected characteristics under the Equality Act 2010. It considers the marginalising dynamics in mainstream, statutory social care support provision, and how far local community, specialist or small‐scale services are responding to unmet need for support and advice among marginalized groups. The review found that there is a tradition of compensatory self‐organization, use of informal networks and a mobilization of social capital for all these groups in response to marginalization from mainstream, statutory services. This requires recognition and nurturing in ways that do not stifle its unique nature. Specialist and community‐based micro‐providers can contribute to a wider range of choices for people who feel larger, mainstream services are not suitable or accessible. However, the types of compensatory activity identified in the research need recognition and investment, and its existence does not imply that the mainstream should not address marginalization.     

Values in Social Work: investigations of the practice of family placement

Professor Noel Timms, University of Leicester, School of Social Work, 107 Princess Road East, Leicester LEI 7LA. Summary This study explores values in social work distinguishing valuesat the levels of practice and of rhetoric A small scale projectwas undertaken in family placement work in two local authoritiesand four voluntary agencies. A pattern of activity was foundcommon to both voluntary and statutory workers engaged in familyplacements. Workers in both agencies rendered comparable accountsof a distinctive practice which stressed virtuoso skills inthe collection, appraisal and use of knowledge. The practicedepended on confidence in the ability to make good within theform of work known as family placement, and on the recognitionof what people are owed. The work was undertaken in a socialcontext which acknowledged—in the eyes of the social workers—theobvious (rhetorical) goods of the proper flounshing of children,and respect for rights. Beliefs about certain aspects of thesocial context, particularly in relation to religion, differedbetween the two groups, but such differences could not be seento reverberate in the practice.     

Research Review: Child and family support services with minority ethnic families: what can we learn from research?

This paper considers some of the available published research on family support services for minority ethnic families. In addressing this aspect of social work with minority ethnic families, we seek to make a contribution to the knowledge base of practitioners. The paper begins with an overview of what is known about family support services for particular minority ethnic groups, before exploring three specific areas: family centres, a home visiting service, and family group conferences. The paper finally examines what research says about the qualities sought in social workers by minority ethnic parents.     

Risk Management Paradigms in Health and Social Services for Professional Decision Making on the Long-Term Care of Older People

Risk management systems and structures are developing rapidlywithin UK health and personal social services. However, therisk management strategies of organizations need to take intoaccount the conceptual frameworks used by professionals. Thisgrounded theory study used data from nineteen focus groups andnine semi-structured interviews (ninety-nine staff in total)to explore perspectives on risk and decision-making regardingthe long-term care of older people. Focus group participantsand interviewees comprised social workers, care managers, consultantgeriatricians, general medical practitioners, community nurses,occupational therapists, home care managers and hospital dischargesupport staff. Social work and health care professionals conceptualizedrisk and its management according to six paradigms that appearedto be in a state of reciprocal tension: (i) Identifying andMeeting Needs; (ii) Minimizing Situational Hazards; (iii) Protectingthis Individual and Others; (iv) Balancing Benefits and Harms;(v) Accounting for Resources and Priorities; and (vi) Warinessof Lurking Conflicts. The effective translation into practiceof risk management strategies needs to address the complex andoften contradictory issues facing health and social servicesprofessionals.     

Mental Health and the Asian Communities: A Local Survey

Correspondence to Barbara Hatfield, Lecturer in Psychiatric Social work, Department of Psychiatry, 12th Floor, Mathematics Building, Manchester University, Oxford Road, Manchester M13 9PL Summary The survey of people from the Asian communities in ‘Milltown’included people who used mental health services, family membersof service users, and members of the Asian general public. Personaland social stresses of the group were explored, as were theirperceptions of the ‘causes’ of mental ill-healthand appropriate responses. Although most people saw family andsocial stress as central, a religious dimension was also prominent,in terms both of causes and treatment of mental ill-health.There was no evidence of rejection of mainstream services becauseof a choice on the part of Asian families or communities tobe self-servicing. A range of issues identified by respondentssurrounded the cultural acceptability of services in ‘Milltown’to Asian people. A lack of knowledge of service availabilitywas also apparent, with a heavy reliance upon GP services formental health care in the community. The findings of the surveyare compared with similar studies, where available, which focuson indigenous white British service users. Some findings arecommon; other issues are specific to this Asian group.     

Prevention: the Victorian Legacy

Summary The personal social services did not receive a statutory mandateto undertake preventive work with deprived children until 1963.This paper looks at the history of child care services in thenineteenth and twentieth centuries to find some explanationsfor the delay in promoting prevention. The two major child caresystems during the Victorian era were the Poor Law and the voluntarychildren's societies. In terms of methods of care and philosophy,the two are often held as contrasts. But, in terms of wishingto rescue children from evil parents and of changing their charactersby educating them while completely removed from their naturalfamilies, they had much in common. Thus, both state and voluntaryservices exerted a strong force opposed to policies of helpingnatural parents to cope with their own or of rehabilitatingthem. Changing social and political conditions in the earlypart of the twentieth century appeared to give the prospectof different practices. However, these failed to emerge andsome explanations are put forward with particular referenceto the survival of the Poor Law and the stagnation of the voluntarybodies. Finally, an analysis is made of what steps had to betaken at the end of the 1930s if prevention was to become apart of the social services.