Adult Care Blog

Tool to help carers share out support tasks

By Mithran Samuel, adults' editor, on May 25, 2012 2:35 PM | No Comments

This is Cura, a new free online tool to help carers share out support tasks for the people they support among friends and family.

The way it works is that a carer sets up an account and invites people to join a community of support; they can then put in tasks that need doing on a calendar - doing the shopping, helping with the gardening, taking a loved-one to an appointment - and community members register to perform these tasks if they can.

The person behind it is called Neil Burgess, who was inspired to create the site by the need to find ways of making it easier to support his grandparents, and start-up funding was provided by UnLtd, a charity which supports social enterprises.

It seems a neat idea, similar to the "slivers of time" approach we have reported on in the past, and hopefully carers will find it useful, though it is still early days.

How good is support for BME learning disabled people?

By Mithran Samuel, adults' editor, on May 25, 2012 2:27 PM | No Comments

Social care practitioners' views are being sought on that very question through a survey launched by organisations including the Association for Real Change, which represents learning disability providers.

It is part of the Here to Stay project - a five-year study of the experiences of people with learning disabilities from black and minority ethnic communities.

The survey, which is open until 30 June, is designed to inform a consultation on guidelines for services who support this group. Do take a few moments to answer it if you can.

Support, not coercion, is the route to moral responsibility

By Mithran Samuel, adults' editor, on May 25, 2012 9:11 AM | No Comments

Cameron Social responsibility poster 1.jpg

Access to welfare is increasingly dependent on people's behaviour, on the grounds that this promotes responsibility. However, in this guest post, Viv Ashley, from Essex University, argues that this penalises people for factors beyond their control and erodes responsibility.

As austerity cuts bite ever deeper, there are indications that society's tolerance of people receiving welfare is wearing increasingly thin - even towards those traditionally considered to be deserving of support, like disabled people.

This is causing policymakers to raise more and more questions over whether the state can afford to support people who are seen as creating their own welfare need through choices perceived as reckless.

They argue unconditional welfare support only encourages irresponsible behaviour and that withdrawing support is a cost-effective way of rationalising scarce resources. However, the feedback we received from social workers and other practitioners who attended our workshop on autonomy and responsibility in social welfare last week shows that this approach might be mistaken and even counter-productive - possibly damaging the life-chances of extremely vulnerable people and their children. Practitioners felt that extra support might be needed, not less.

Those attending the workshop explained how the principle of 'welfare conditionality' is becoming increasingly dominant in social welfare policy. This principle presumes that the claimant could have made a prudent decision, and should therefore bear the costs of their choice - for example, those found to have caused their own homelessness are excluded from re-housing.

But, practitioners say there are fatal flaws in such a presumption. They pointed out people often fall foul of welfare conditionality because of troubled childhoods, social exclusion or personal crises that undermine their ability to make choices which effectively promote their wellbeing.

I would argue that such people could be said to fall into the 'grey area' between 'capacitous moral failure' and 'psychopathological incapacity' - where someone lacks mental capacity due to mental impairment. Laws such as the Mental Capacity Act aim to catch those who fall into the latter category, whilst welfare claimants capable of making wise decisions are caught by the first

But, policymakers need to be more aware that there is a significant group of individuals whose ability to make 'good' decisions is hindered by circumstances beyond their control.

Continue reading Support, not coercion, is the route to moral responsibility.

How a 14-25 disability service will help improve transition

By Mithran Samuel, adults' editor, on May 24, 2012 4:55 PM | No Comments

Northamptonshire Council is seeking to overcome problems with transition by setting up one of the country's first services for disabled people aged 14-25. This guest blog explains how this will work and its possible impact.

In Northamptonshire we are working hard to transform the way we support young disabled people. We know there have been historic weaknesses in transition arrangements for such young people, which have resulted in relatively few being appropriately prepared for adult life.

Consequently, we are currently creating a new multi-professional county-wide transitions team for disabled young people aged 14-25, which will give high priority to close liaison with parents and carers alike.

We are one of the first in the country that is replacing separate services for disabled young people and young adults with one service. This will give continuity to young people and reduce anxiety for them and their family, who will be supported by the same team as they grow older and progress into adulthood.

Our vision is for the team to be a one-stop-shop; people will no longer have to navigate numerous teams. We intend this to reduce duplication of activities, such as assessment and planning and attending decision-making panels. This, in turn will make better use of ever-diminishing resources.

The new team will support young people and their families in planning and leading their own support, while also using personal budgets to give them more power and autonomy over their lives.

For professionals, being part of a 14-25 service means that it will be easier to share information, ideas and best practice, resulting in increased knowledge of adults' and children's legislation/polices, together with their application to practice.

This will include continuity of safeguarding from a child to a young adult, as well as a detailed knowledge of services and opportunities available within the 14-25 age range. In turn, young people will build in confidence that their skills and experience can be transferred across both professional and organisational boundaries.

As we remove the disjointed systems that have previously caused frustration, we also hope that the team will experience increased job satisfaction, as they work collaboratively with other practitioners to deliver a consistently efficient, good quality, holistic and person-centred support process.

This programme of work is organic and we expect changes to be made as we move forward and gather more intelligence. However, what will not change is our commitment to ensuring that, within Northamptonshire; the transition journey for younger adults meets their outcomes and is a good experience.

For further information about Northamptonshire Council's transitions project email Ann McGale, service manager for transitions; Maria Faller, transitions co-ordinator, or Carolyn Kus, assistant director, adults and transitions.

The image is of a sculpture made by people with learning disabilities and their families about what they want from services.

Demonstrating the value of social work with adults

By Mithran Samuel, adults' editor, on May 24, 2012 2:22 PM | No Comments

You may well have spotted this already but Research in Practice with Adults' (Ripfa) today launched a manifesto on demonstrating the value of adult social work.

Its view appears to be that social work is of value to service users and carers, but that much more work needs to be done to demonstrate that - the 10-point manifesto seems to be a route map for demonstrating this value.

Here are some of the points:-

Value cannot be demonstrated without considering the difference made to service users and carers;
There is an obligation to demonstrate value from money spent on social care;
Evidencing value is the responsibility of people doing practice as well as those undertaking research;
Value and impact should be captured by front-line social workers who know what is happening with individual service users and carers, as well as at a population level;
Demonstration of value should include experience [of users and carers] as well as the outcomes themselves.

It's very much a starting point for a wider debate on how adult social work can prove its worth, that Ripfa will take forward on Twitter (#socialworkvalue), through online contributions and face-to-face events.

Have a look if you have a moment.

What would Labour do with social care?

By Mithran Samuel, adults' editor, on May 24, 2012 10:03 AM | No Comments

I've been pretty neglectful of what Her Majesty's Opposition has been saying about adult social care, mainly because we are three years from a general election and, to state the obvious, the rhetoric of opposition tells you little about what an incoming government would do.

However, I've just been sent a speech that Labour's shadow minister for care and older people, Liz Kendall, delivered at provider association the National Care Forum's annual conference this week, and thought it might be worth a quick post.

One thing that is obvious, from this speech and her work as shadow minister more generally, is that Kendall knows her onions - perhaps unsurprisingly as a former director of the NHS Confederation's Ambulance Service Network and social care lead at think-tank the Institute for Public Policy Research. And she also has a genuine interest in the sector and what happens to it, like opposite number, care services minister Paul Burstow.

The speech eloquently diagnosed the problems with the current care system, including people receiving support too late due to tightening thresholds and the deterrent effect of higher care charges; pressure on wages and training budgets driving high turnover rates; the squeeze on social care adding pressure to the NHS etc; the squeeze on providers from councils leading to ever greater use of top-up payments and increased costs for self-funders.

She has a ready grasp of statistics and uses them well and is good at talking about social care in a wider context that includes health, housing and family life more generally, particularly in respect of the role of women as low or non-paid caregivers.

As always, oppositions are better on diagnosis than prognosis. However, besides the expected calls for greater personalisation and prevention, she seemed to endorse the odd controversial policy, such as national standards to ensure a "fair and realistic price for care". This may have been playing to the provider gallery, but if she's serious, it would be quite a significant move.

Continue reading What would Labour do with social care?.

What does Paul Burstow think about social work?

By Mithran Samuel, adults' editor, on May 23, 2012 12:31 PM | No Comments

This is care minister Paul Burstow at last week's Community Care Live on the government's vision for the future of social work with adults. It fleshes out some of the comments made in his speech to the conference, which we covered on the site last week.

15 ways to make life better for people with learning disabilities

By Mithran Samuel, adults' editor, on May 22, 2012 2:15 PM | 2 Comments

You may have caught today's report from Mencap about cuts to day services for people with learning disabilities, which found that 57% of people known to social services did not receive any day service in 2011-12, compared with 48% in 2009-10, among other things. A quarter of people with learning disabilities were spending no more than a hour outside of their house each day.

Well, the Learning Disability Coalition, of which Mencap is a member, has simultaneously produced a list of 15 ways to improve the lives of people with learning disabilities (see below), drawn up by service users themselves, which the coalition is going to campaign on.

This is basically a restatement of the aims of the government's 2001 Valuing People White Paper and 2009 Valuing People Now strategy - that people with learning disabilities should have the right to the basic everyday goods that others take for granted. However, as the Mencap report makes clear, things could be going backwards rather than forwards in this regard.

The Learning Disability Coalition campaign is accompanied by a report in which nine service user leaders state why the 15 statements are important to them. Among them is Ismail Kaji (below), who works as a campaigns assistant for Mencap

He says: "There are very few people with learning disabilities who have a job. It's not good enough. People with learning disabilities should get the right opportunity and support if they want a job and if they can work. Employers need to give people a chance and be willing to adapt to people's needs. It's really important to me to have a job as I have a family and it is my responsibility to look after them and make sure that all the bills are paid."

The coalition is launching its "contract for the future" today at the House of Lords and is urging Parliamentarians who attend to sign up.

Continue reading 15 ways to make life better for people with learning disabilities .

Ending loneliness and cruelty for learning disabled people

By Mithran Samuel, adults' editor, on May 21, 2012 12:27 PM | No Comments

Sad Woman Jeff Blackler Rex Features.jpg

Social workers must support people with learning disabilities to develop friendships, confidence and personal interests to protect them against the loneliness and cruelty that often characterises their lives, says Carwyn Gravell.

There has been a welcome policy shift over the last 30 years away from placing people with learning disabilities in institutions, hospitals and care homes and towards independent living, supported housing and other community-based accommodation. But the society and the communities in which people have found themselves have also changed significantly over the same period of time, becoming in many ways selfish and unwelcoming.

My report, Loneliness and Cruelty, based on in-depth interviews with frontline practitioners across the country, shows that people with mild or moderate learning disabilities living independently in the community experience a disturbing range of abuse and harassment and related crime with alarming frequency.

The perpetrators in the main are local people and neighbours, often young people and school-children. Incidents happen when people are out and about, but also in and around their homes. These incidents - ranging from name-calling and taunting to financial abuse, assault and attacks on property - above all else can be characterised by cruelty.

The loneliness of some people with learning disabilities - one in four interviewed didn't have any friends - puts them at particular risk, as it leads them to spend time in hostile public spaces and brings them to the attention of bullies, exploitative people and criminals.

In addressing this fundamental and underlying social problem of loneliness and cruelty - and a broader range of experiences than is described by 'hate crime' - there are limits to what criminal justice and equal rights can achieve. Additional approaches are needed that enhance social capital, in particular in creating relationships, ties and bonds for people with learning disabilities within their communities.

Social workers, social care practitioners, and colleagues in supported housing have a key role in developing and delivering these approaches:

Firstly, people with learning disabilities need support to develop friendships that will make them less vulnerable to harassment and abuse. There are examples of good practice that can be built on here, in making use of 'circles of support' for example to help people develop longstanding relationships within the community.
Another crucial area is promoting the self-esteem and social confidence of people with learning disabilities through practical advice and guidance on staying safe and through positive self-image.
Finally, people with learning disabilities need to be supported in developing interests and activities that enhance their sense of positive identity - beyond being a person with learning disabilities, or a victim of hate crime - and that have universal appeal (things like cooking, gardening, reading, painting, fishing, football, walking, dancing, singing, etc). As well as contributing to more fulfilling lives, actively pursuing an interest would also provide opportunities for making new friends in the community.

Carwyn Gravell is a partner at social research organisation Lemos&Crane, which today publishes Loneliness and Cruelty. The report has been produced in partnership with the Foundation for People with Learning Disabilities and was supported by Esmée Fairbairn Foundation.

Image: Jeff Blackler/Rex Features

Ending prejudice in the care system against older gay people

By Mithran Samuel, adults' editor, on May 17, 2012 12:39 AM | No Comments

On International Day Against Homophobia, what can care providers do to support older gay people, asks Joseph Rowntree Foundation policy and research manager Philly Hare.

Today, International Day against Homophobia, challenges us to reflect on the effects of ignorance and discrimination on all lesbian, gay and bisexual (LGB) people. One group that is often sidelined and forgotten is those who are older. While an estimated 5-7% of older people are LGB, their views are rarely sought and their particular needs and perspectives are all too often overlooked.

Sally Knocker's recent JRF perspectives paper shines a spotlight on this issue. I'm struck by the huge impact that prejudice has had on older people's lives - and by the impact that the norms of their youth still have on their present experience. In their younger days, many LGB people faced imprisonment; were classified as mentally ill; lost jobs, homes and relationships with family; led double lives; and lived in constant terror of being discovered or blackmailed. At the very least, many were under intense pressure to conform.

Given this context, it is not surprising that issues of trust and safety are critical, and that older LGB people seek this within their own community. Sadly, poor health and mobility in later life can cut many off from these networks (often described as 'family'), though many do use email, Skype and instant messaging to keep in touch virtually.
Older LGB people have greater need for support than their heterosexual peers because they are much less likely to have their own children to help care for them; they are over twice as likely to live alone; and (statistically) they drink and smoke more and are thus more susceptible to some chronic conditions. In spite of this, they are - shockingly - five times less likely than heterosexual older people to access services.

Sally found that many fear needing services, believing (rightly or wrongly) that their identity will become invisible or that they will experience prejudice from care professionals or their own peers. This is particularly true for those who are HIV positive. A national survey found that many HIV-positive older people fear that social care services, care homes and sheltered housing might be HIV prejudiced and/or homophobic. One in five reported experiencing age- or HIV-related discrimination in the past year, and HIV discrimination was worst in healthcare and goods and services.

So what can we do? At JRF and the Joseph Rowntree Housing Trust, we are trying to ensure that our work on older people is alive to issues of diversity and equality, including those of sexual identity.

There are also many simple, practical things we and other service providers can do to make things better:

We can ensure that the images and language we use include and reflect older people who are LGB:

We can be welcoming and inclusive to people's 'families of choice' and LGB visitors, so that our residents never feel they must choose to either 'come out' again, or 'go back into the closet';
We can ensure LGB residents feel free to have personal photos and possessions out in their rooms without fear of comment or stigma from staff;
We can use checklists for social care settings and health services to look at staff development, organisational structures, assessments and health issues;
And we can involve older LGB speakers or 'ambassadors' in opening up difficult conversations and challenging prejudices - more effective than any theoretical training.

As Maggie, an older person quoted in Sally's report, puts it: "I think one of the big issues is to encourage and enable people who have anxieties and fears to come out with it and say what it is. What is it you are so afraid of, what terrifies you so much?"