Direct Payments and Disabled People in the UK: Supply, Demand and Devolution

Direct payments have brought new opportunities for self-determinationand independent living to disabled people in the UK, featuringprominently in government strategy and the 2006 White Paper,‘Our Health, Our Care, Our Say’. However, ten yearsafter direct payments legislation, take-up remains low and implementationvaries greatly. Rates of take-up in England remain more thandouble those in other parts of the UK, raising questions aboutdevolution and equity. This paper presents data from a nationalstudy to examine some of the mechanisms underlying uneven outcomesfor disabled people in different parts of the United Kingdom,with particular reference to the politics of devolved governance.The analysis focuses on scope for interpretations of policy;resources for information and training; the impact of mandatoryduties and targets; extensions to new user groups; and the roleof support organizations and disability activism. The evidencesuggests that local variations have been produced not only by‘local’ factors, but also by different opportunitystructures for policy development in England, Scotland, Walesand Northern Ireland. This raises questions about the impactof devolution on equity and opportunity for disabled peoplein the UK.     

How to be Modern: New Labour's Neoliberal Modernity and the Change for Children programme

In England the New Labour administration is seeking to embeda ‘transformational reform agenda’ within children’sservice. Social workers, among others appear, however, to bewary of the agenda which is now rhetorically rooted in the EveryChild Matters: Change for Children programme (CfC). The mainsocial work practice elements of this programme are associatedwith the introduction of a Children’s Index, a multidisciplinaryCommon Assessment Framework and the role of Lead Professional.In terms of the promotion of this programme, the governmenthas maintained that the focal aim is to create a ‘modern’children’s workforce. However, the entire ‘transformationalagenda’ can be interpreted as reflecting New Labour’sneoliberal modernity. This is particularly apparent in the termsof the ideas associated with ‘flexibility’ whichare so central to the CfC programme.     

Social Care and the Modern Citizen: Client, Consumer, Service User, Manager and Entrepreneur

Since coming to power, New Labour has embarked on a programmeof modernization. Few areas of state activity have been morevisibly subjected to New Labour’s modernization agendathan the personal social services. Local authority social servicesdepartments have largely ceased to exist as separate organizationalentities. However, modernization has also required that therelationship between state and citizen be reconstructed. Thisis evident in New Labour’s vision for adult social carewhich envisages a move towards individual budgets. The individualizingnature of such schemes may be thought hard to reconcile withthe discourse of integration and partnership prominent elsewhere.However, a key linking concept is that of ‘person-centredness’.It is often assumed that this simply means that public servicesbecome more flexible to meet the needs of ‘the person’.This paper uses the example of direct payments to demonstratehow modernization also requires flexibility of ‘the person’.It would appear that inherent in New Labour’s projectof modernization is the assumption that the modern citizen shouldbe both managerial and entrepreneurial. What were once publicresponsibilities are being transferred to the individual. Theimplications for the users of adult social care are discussed.     

Exploring Potential 'Extra-Familial' Child Homicide Assailants in the UK and Estimating their Homicide Rate: Perception of Risk--The Need for Debate

High-profile child murders lead parents to fear for their children’ssafety, but perception of risk is often at variance with reality.We explore the numbers of potential ‘Extra-familial’child homicide assailants in the United Kingdom and estimatetheir actual murder rate to determine risk levels. A South ofEngland study, equivalent to a 4 per cent sample of the UK population,of a decade of consecutive child homicides identified the characteristicsof child homicide assailants, finding that the most frequentassailants—the ‘Intra-familial’—werevery different from ‘Extra-familial’ assailants.‘Extra-familial’ killers were all males, aged nineteento forty-two, with convictions for Violent-Multi-Criminal-Child-Sex-Abuse(VMCCSA) offences and Multi-Criminal-Child-Sex-Abuse (MCCSA),whose victims were aged seven-plus years. Projecting these characteristicsonto the male UK population enables us to estimate the numbersof potential UK ‘Extra-familial’ assailants, whichare set against known UK child (five to fourteen) homicides(WHO, 2005). To account for any ‘hidden’ child homicides,deaths in the ‘undetermined’ violent death category,designated ‘Other External Cause’ (OEC), are calculatedto provide a ‘maximum’ child homicide rate. Therewere potentially 912 VMCCSA and 886 MCCSA ‘Extra-familial’offenders in the United Kingdom, who could be responsible forthe WHO-reported UK three-year average of ‘Extra-family’fifteen child homicide and seventeen OEC deaths per annum; ahomicide rate of 12,061 per million (pm) for VMCCSA and 3,386pm for MCSA, which is 1.21 and 0.34 per cent; however, the VMCCSAhomicide rate was 403 times greater than the all children accidentand cancer death rates. Though the vast majority of these potentialassailants did not kill, comparatively, they are extremely dangerous.Practice and ethical issues are debated, which considers activeoutreach for the ‘treatable’ to possible ‘reviewable’custodial sentences for the VMCCSA.     

The Case for a New 'Case' Management in Services for People with Learning Disabilities

Micro-organization is currently fragmented in services for peoplewith learning disabilities. Care management, person-centredplanning (PCP) and direct payments have developed through separatepolicy strands, with tasks and agency responsibilities blurred.A wide diversity of care management arrangements currently operate,with the relationship between care management, PCP and directpayments imprecisely defined. PCP and direct payments have alsobeen variably implemented. This paper argues for a new ‘person-centredcase management’, with these different devices betterintegrated and decision-making and action more person-centred.Drawing on practice experience from the original British casemanagement experiments, the new ‘case’ managementwould be centred on the needs and wants of individuals, be conductedindependently from assessment, operate outside the public sectorand be able to access personal budgets. It would consequentlyhave the capacity to further de-institutionalize services andsupport and transfer more control to people with learning disabilities.     

Irish Social Workers in Britain and the Politics of (Mis) Recognition

The article focuses on the perceptions of Irish social workersworking in ‘children and families’ settings in Britain.These respondents cannot be seen as representative of all Irishsocial workers in Britain, yet they do provide insights intofive significant themes: the approach to ‘race’and ethnicity in social work education; Irish identities inBritain; racism and stereotyping; children and families whoare Irish Travellers; and an agenda for the future. The discussionconsiders some of the issues raised in the context of what hasbeen referred to as the ‘politics of recognition’.     

The Supervision of Child Protection Work

Correspondence to Alan Rushton, Course Director, M.Sc. in Mental Health Social Work, Social Work Department, The Maudsley Hospital, 101 Denmark Hill, London, SE5 8AZ, UK Summary It has frequently been recommended that statutory child protectionservices in Great Britain need greater provision of specialistsupervision to support front line social workers. This qualitativestudy, based in social services departments in London, usedthe focus group method to explore the provision of supervisionby team managers in a very pressurized work environment. Thestudy highlights the difficulty of protecting adequate supervisiontime but shows how supervisors can use their skills to conductcase related discussion concerned with developing professionalskills. ‘Inquisitorial’ and ‘empathic-containing’functions are identified and an approach is proposed for combiningthem in training courses for child protection supervisors. Thepaper recommends that supervision training needs to be expanded,to be more precisely targeted, and that outcomes need to berigorously and appropriately assessed.     

Making 'Anti-Social Behaviour': A Fragment on the Evolution of 'ASBO Politics' in Britain

The British Association of Social Workers has actively opposedAnti-Social Behaviour Orders (ASBOs). It is the contention ofthis article that there is a pressing need to interrogate factorswhich are influencing and driving the ASBO agenda during theperiod of New Labour in Britain. The discussion begins by referringto the significance of keywords and phrases in social work andsocial policy. This is followed by an examination of the recent(re)appearance of concern about ‘anti-social behaviour’.A critical overview of the White Paper Respect and Responsibility:Taking a Stand against Anti-Social Behaviour (Home Office, 2003a)is then provided. It is then argued that Tony Blair and formerhome secretary, David Blunkett, played distinctive roles increating Britain’s ASBO politics. This, moreover, is apolitics which potentially narrows social work’s roleand purpose.     

Whose Wishes and Feelings? Children's Autonomy and Parental Influence in Family Court Enquiries

The importance of the child’s right to be heard and fortheir wishes and feelings to be taken notice of is now acceptedacross a broad professional and research terrain. Increasingly,children are being treated as active participants in the processesand decisions that affect them. In cases of divorce and separation,especially where parental relationships are conflicted, theaccepted wisdom in the UK for many years has been for childrento be protected rather than empowered. More recently, practitioners,policy makers and researchers have looked for ways to involvechildren, although the ‘welfare’ of the child hasremained paramount. In this context, the question of how toensure that wishes and feelings expressed are those that authenticallybelong to the child, rather than to their parent, sibling orother, has achieved a new significance. This article presentsfindings from recent research to illustrate how the tensionbetween protection and empowerment is being played out in thisaspect of welfare report enquiries carried out by CAFCASS (Childrenand Family Court Advisory and Support Service) private law practitioners.     

New Labour, Social Justice and Children: Political Calculation and the Deserving-Undeserving Schism

Correspondence to: Barry Goldson, Department of Sociology, Social Policy and Social Work Studies, The University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool L69 7ZA, UK. E-mail: b.goldson{at}liv.ac.uk Summary Within a context of national prosperity and relative economicstrength, poverty and inequality is rife in the UK. This paperconsiders the broad contours of such social injustice, beforesharpening the focus to examine the specificities of child poverty.The New Labour government has made an ‘historic pledge’to end child poverty within a generation. The paper traces thekey policy initiatives that are being directed to this end and,by drawing on the latest research evidence, it attempts to assesstheir early impact. Whilst it is acknowledged that the government'ssocial justice agenda has made some progress in ‘tackling’child poverty, it is further proposed that a more rigorous redistributiveapproach is required if substantial and sustainable improvementsare to be made. Furthermore, it is argued that the social justiceagenda is conditioned by wider political calculations, whichlimit its scope. In this way the imperative to be seen to be‘tough on crime’ has meant that policy responsesto children in trouble have taken a distinctive and increasinglypunitive form. By developing the argument that New Labour'selectoral ambitions have led it to re-engage with a specious‘deserving’ ‘undeserving’ conceptualdichotomy, the paper assesses the implications for the treatmentof child ‘offenders’ in particular, and the broadersocial justice project more generally.     

Gaining Satisfaction? An Exploration of Foster-Carers' Attitudes to Payment

The payment of foster-carers has long been controversial, reflectingboth philosophical debates as to whether fostering should bea voluntaristic or professional activity and concerns aboutplacement provision and service delivery for children. Althoughmany research studies have touched upon the question of foster-carers’satisfaction with payments, this has not been explored in anydepth. Drawing on findings from a study involving 1,181 foster-carersin twenty-one agencies, this article attempts to provide suchan analysis with four main objectives. These comprised: examiningassociations between attitudes towards payment and demographic,socio-economic and fostering career variables; comparing responsesbetween carers based in local authorities (grouped accordingto levels of payment and performance criteria) and independentagencies (IFAs); gauging the influence of carers’ ‘orientations’towards foster-care as a ‘professional’ task; andanalysing payments in terms of their different components, suchas fees, maintenance and certain designated expenses. Amongmany detailed findings to emerge were the generally low levelof satisfaction among local authority carers, especially incomparison with their IFA counterparts and the growing supportamong carers for salaried status. There was mixed evidence onlinks between attitudes towards remuneration and the performanceof agencies.     

Social Work, New Public Management and the Language of 'Service User'

The purpose of this paper is to offer insight into the possibleconsequences of language developed at the political level byan authoritative body for the purpose of designing social policythat is then adapted as discourse in social care. The focusis on the UK government’s policy toward the language of‘service user’ in the context of New Public Management(NPM). It begins with a brief introduction on the importanceof language. Next, it outlines the move towards NPM and changesthat have facilitated the shift from ‘client’ to‘service user’, presenting some of the implicationsthese changes have had on social work in Britain. Finally, itdetails the possible detrimental effects of labelling language,and discusses research from other countries on preferred termsof reference for individuals who use health and social careservices.     

Evaluating Children's Services: Recent Conceptual and Methodological Developments

This article considers recent innovations and challenges withrespect to the evaluation of children’s services interventions.It sets out a method for designing and evaluating services thatis based on research evidence gathered on individual cases andthat permits revision of those services in the light of emergingresults. It starts by describing briefly different ways of identifyinga discrete group of children with similar needs. It then outlinesapproaches to ensuring that an intervention for those childrenis underpinned by theory and research evidence–includingthe idea of ‘logic modelling’–before discussingthe importance of capturing accurately how well the interventionis implemented. Experimental and non-experimental methods ofassessing an intervention’s effectiveness are considered,with particular emphasis on techniques for enhancing the causalinference that can be drawn from studies and the importanceof matching method and purpose. The article also demonstrateshow the principles and methods used in relation to evaluatingservices for groups can be applied in clinical work with individualcases, and identifies the benefits of this general approachto evaluation over and above the information that it provideson what works.     

Reforming Professional Training and Protecting Vulnerable Adults from Abuse: A Thematic Analysis of the New Social Work Degree's Prescribed Curriculum

Correspondence to Phil Slater, School of Health and Social Sciences, Middlesex University, Queensway, Enfield EN3 4SF, UK. E-mail: p.slater{at}mdx.ac.uk Summary This paper analyses the Prescribed Curriculum of the new Degreein Social Work in relation to the Department of Health themeof ‘protecting vulnerable adults from abuse’. Areview of post-war social policy first establishes the significanceof these terms, both individually and in varying combinations.Subsequently, the phrase as a whole provides the focus for acontent analysis of the three constituents of the PrescribedCurriculum, namely, the Secretary of State’s Requirementsfor Social Work Training, the employment-focussed National OccupationalStandards for Social Work, and the academically oriented BenchmarkStatement for Social Work. With the exception of ‘abuse’,the key terms are all registered, albeit unevenly. This presenceis subsequently enhanced via strategic considerations of ‘logicalimportance’ and ‘organising rubrics’. Finally,terminological variants of ‘abuse’ are traced, withparticular regard to the emerging language of ‘rights’.     

Technicality and Indeterminacy in Probation Practice: A Case Study

Correspondence to Department of Law, Crookesmoor Building, Conduit Road, Sheffield S10 1FL, UK. E-mail: g.j.robinson{at}sheffield.ac.uk Summary ‘Technicality’ is a theoretical construct which,in the context of professional practice, refers to those aspectsof the work which can be prescribed, ‘programmed’or subject to routine practices. This paper considers the purportedrise of technicality in probation practice, with particularreference to the relationship between increasing technicalityand perceptions of ‘professionalism’. The paperpresents a case study of one ‘technical’ initiativein the probation context: namely, a structured risk/needs assessmentinstrument. The case study examined the implementation of thisinstrument in two area probation services, with a view to establishingits impact both on the exercise of professional judgement (‘indeterminacy’),and on perceptions of professionalism among users and theirmanagers. On the basis of the case study it is argued that,contrary to many recent commentaries, neither significant reductionsin indeterminacy nor an inevitable process of deprofessionalizationcan be automatically ‘read off’ from attempts tointroduce greater structure and/or standardization to socialwork and probation practice. The tentative conclusion of thispaper is that the professional future lies not in a wholesalerejection of technicality, but rather in achieving a positive,workable balance between technical and indeterminate aspectsof practice.     

Black, with a White Parent, a Positive and Achievable Identity

Correspondence to Beverley Prevatt Goldstein, Centre for Applied Social Studies. University of Durham, 15 Old Elvet, Durham DH1 3HL, UK. Summary This paper focuses on black children with a white parent inBritain. It is based on historical, research and theoreticalmaterial deriving largely from anti-racist and psychologicalframeworks and synthesizes and critically reappraises the existingresearch on black children with a white parent, living withtheir original families, in Britain. The objective is to ‘normalize’black children with a white parent by identifying and rejectingthe forces that pathologize them. The paper therefore highlightsthe racism, marginalization and alienation which are likelyto impact on their world so that action may be taken to combatthese. A lack of clarity as to the personal and political complexityof identity has hampered professional perspectives and intervention.The paper consequently explores, from a postmodernist blackperspective, the ‘racial’ self-concepts that areavailable to this group, identifying their underlying agendasand their consequences. It concludes that the availability ofthe self-concept ‘black, with a white parent’, offeredin the framework of change, multiplicity and individuality,is beneficial. However any consideration of ‘racial’self-concept or identity is deemed productive only when combinedwith efforts to reduce racism, marginalization and alienation.     

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.     

Yes Minister: Reviewing the 'Looking After Children' Experience and Identifying the Messages for Social Work Research

Correspondence to Paul Michael Garrett, Centre for Social Work, School of Sociology and Social Policy, University Park, Nottingham NG7 2RD, UK. E-mail: paul.garrett{at}nottingham.ac.uk Summary The heavily promoted Looking After Children: Good Parenting,Good Outcomes (LAC) project continues to exert a powerful influenceon social work in the UK and elsewhere. Despite the repeatedassertions that the documentation associated with LAC is embeddedin ‘objective’ research, this not sustainable onaccount of the failure of the researchers to interrogate theirown normative assumptions and judgements. Specific criticismscan also be levelled at the ‘community study’ connectedto the evolution of the Action and Assessment Records (AARs)which are the key part of the scheme. The system should alsobe viewed in the context of wider pre-occupations about ‘outcomes’.In addition, the project needs to be politically situated andthe researchers' relationship with the Department of Healthshould be more fully explored. In conclusion, it is suggestedthat the LAC experience contains important ‘messages’for the future of social work research.     

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.