The name of the service user has been changed
SITUATION: Shaun Watson, 42, is registered blind and has suffered from chronic fatigue in the past. He has never had a paid job, although has done some voluntary work. Through his care manager, he joined the social services employment training scheme. Within a year he had found a full-time job (with a six-month probationary period) working on a diversity project with a local home care provider.
PROBLEM: Once in work, Shaun’s assessment from sight-loss charity RNIB took two weeks to happen so he did not get the necessary equipment until later, and then needed time to learn to use it. In his first six weeks he was unable to produce any work. His probation was also put back. The equipment proved to be ineffective but Shaun did not say anything for fear of being seen as incompetent. The employer arranged a mentor from a local access-to-work agency for disabled people, and for the local association for the blind to provide support. But Shaun started taking days off sick with “personal and relationship problems”. He is now off sick with depression and it turns out that he has been in therapy and in and out of psychiatric hospital over the past 15 years with depression. His probationary period ends the week before Christmas and his employer believes that Shaun isn’t up to the job but is aware that not extending the job beyond the probationary period – not least at this time of year – would be difficult for Shaun.
Practice Panel – Physical Disabilities team, Derbyshire Social Services
Julie Heath – Disability Service Manager
The government report Improving the Life Chances for Disabled People says policy should “be designed to ensure that in 20 years’ time any disabled person who wants a job and needs support to get and keep a job anywhere in the country should, wherever possible, be able to do so.”
In Derbyshire, since 2001, a Welfare to Work group has been promoting employment for disabled people as a more positive alternative to welfare and encouraging more people to enter training, try work placements or take up voluntary work.
This multi-agency group co-ordinates the activities of different services and links into mainstream programmes of employment opportunities and support. It also monitors the experience and progress of people in training and on work placement to better understand the range of support needed to make progress in future projects.
Shaun would have participated in an assessment to highlight his needs and aspirations. This would be used to identify his goals and the steps needed to be taken in order to achieve them. In Shaun’s case there would be particular emphasis on support into employment, and rehabilitation workers and employment advisers would have been included.
An outcomes-focused approach puts the person at the centre of their assessment with the care co-ordinator acting as a “navigator” or “facilitator”. It might have been identified that Shaun may benefit from some peer-group support or mentoring, which could be provided by the Derbyshire Coalition for Inclusive Living – an organisation of disabled people.
Having the opportunity to share thoughts and feelings with a peer who has been in a similar position may have helped to prepare Shaun for the difficulties he was about to encounter and could have provided him with the necessary coping strategies. If they come to feel that they are failures it could result in them not wanting to risk another similar experience. That Shaun’s equipment was not provided in a timely fashion and practical support was not forthcoming will probably have led to him not having confidence to try again in the future.
Stuart Drabble – Social Worker (sensory)
Lack of communication and failure to co-ordinate services and support would seem the key issues that have led to Shaun’s difficulties in the workplace. It is not so much a lack of support that is the problem here; it is more the case that he has not had the support or equipment when it was needed to prevent him failing.
In Derbyshire, Shaun would have a care co-ordinator responsible for ensuring that all services and equipment were in place at the time Shaun needed them. Shaun’s case would have been care managed so that all agencies were involved in preventing the situation in which he now finds himself.
Before Shaun started his probationary period, a mobility worker could have helped him to plan routes to his place of work. This would in itself have allowed Shaun to gain confidence and independence.
The care co-ordinator should have worked closely with a disability employment adviser from the job centre to identify Shaun’s needs in the workplace. A sensory social worker or rehab worker could also have been involved in this process to advise on Braille systems or specialist IT equipment. The access to work agency would then have been able to provide Shaun with the required equipment.
It is essential that the equipment should have been tried and tested by Shaun in his workplace. This could have been part of his probationary period, but should have been closely monitored by the care co-ordinator, who should also be involved in meetings between Shaun, his employer and specialists to advise him on using his equipment. Shaun should have been empowered by this experience.
What actually happened was that Shaun was left with equipment that did not meet his needs. Because the situation was not monitored, he was allowed to believe that he was at fault. Also, despite long-term involvement with mental health services, they were not consulted in his return to work, and his history of depression and chronic fatigue was not considered. The result was that he felt he was unable to do his job properly and then found himself in a downward spiral of depression, diminishing confidence and low self-esteem.
Although Shaun has both a mentor and support, I wonder whether anyone has made him aware of his employer’s concerns. I also wonder whether anyone has asked Shaun how he feels about the situation: whether he thinks that he could eventually cope with the work if he received more help, writes Simon Heng.
Moving from long-term unemployment into work has to be a daunting prospect. Even though Shaun has had some voluntary work experience, this doesn’t normally come with the same responsibilities as paid employment. Perhaps for the first time, he is having to take on the responsibility of organising his workload and changing his daily schedule.
Shaun would also have to come to terms with other changes with the move away from dependency on benefits such as taking responsibility for budgeting for items such as council tax, rent (or mortgage) and prescription charges. These may be everyday considerations for most people, but remember how it felt, the first time that you realised that your accommodation, along with everything else, depended on your ability to earn a wage.
The idea of change itself could be part of the problem. As someone with a condition that fluctuates, sometimes I’ve felt that I have been clinging to a rock in a fast-flowing river just to survive: to change, I have to let go, risk losing what I know is safe and being swept away by the current. Sometimes it is easier to hold on to what you are familiar with, however unsatisfactory it might be, because you know that you can survive if you don’t change things.
There may be aspects of the working environment that are difficult for Shaun, either because of his visual impairment, or his mental health. If no one has asked him about this, Shaun might find it difficult to raise these issues himself. He clearly hasn’t felt able to talk about his history of therapy and depression, or even the fact that the equipment provided was ineffective. One of the most important work-related skills is effective communication: some people are naturally gifted at this, but the rest of us need to learn, either through experience or being guided.
If this situation is to have an outcome that is in any way satisfactory to Shaun and his employer, there needs to be clear communication between everyone involved. The onus lies on the employer, the mentor and the support worker (from the local association for the blind) to ensure this happens.
Simon Heng is physically disabled, works on service user issues and writes for Community Care
BOXHEAD: practice panel Physical disabilities team, Derbyshire social services
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