Author: Andre Coleman

Using PESTLE/Porter’s 5 Forces / Scenario Modelling or any other relevant identify the key strategic Macro challenges the Company faces.

Using Financial Analysis / Marketing Mix / Core Competencies / Balanced Scorecard or any other relevant tools, scan Network Rail’s Internal / Micro Environment to inentify the key Micro challenges the Company faces.

Pull your conclusions regarding parts 1 and 2 together in the form of a SWOT analysis. You could also identify what options an ANSOFF matrix for Network Rail would suggest are the most viable.

Given your analysis, what do you conclude about the relevance of the Key Objectives above (to earn and retain a mandate etc.) and

What should be the strategy of Network Rail in the coming 2-5 years? And what would be the vital few measures which would help to track progress toward achieving your suggested strategy.

Introduction

I have been employed in the UK Rail industry for over 30 years, and am currently based at Saltley Delivery Unit in Central Birmingham. My role is Infrastructure Maintenance Engineer, which gives me overall responsibility for all of the maintenance carried out by Netwrok Rail on its main infrastructure, which is the tracks and Signalling system connected to them. My geographic area of responsibility runs from London Marylebone, through Banbury and Birmingham Snow Hill and onto Droitwich Spa. I have 300+ staff reporting to me through a team of Engineers (3) and Section Managers (9), working out of two main depots, Saltley And Banbury, with smaller depots at Stourbridge, Whitacre, Leamington, Aylesbury, High Wycombe and London Marylebone.

Background

Network rail has been in existence since October 2002 when they took over the running of Britain’s Rail infrastructure from Railtrack. They currently employ over 35,000 people in various aspects of this work, from day to day maintenance to major renewal projects. In

Using PESTLE/Porter’s 5 Forces / Scenario Modelling or any other relevant identify the key strategic Macro challenges the Company faces

When you analyse the macro-environment, identification of the factors that might affect a number of vital aspects that will influence the supply and demand and costs of the company is critically important. (Kotter and Schlesinger, 1991; Johnson and Scholes, 1993)

Various checklists are in use as ways of cataloguing the vast number of possible issues that might affect different industries. A PESTLE analysis is one of that is merely a framework that categorises environmental influences as political, economic, social, technological, legal and environmental. PESTLE examines the likely impact of each of these factors on the industry. The results are then used to take investigate and enable opportunities and to be aware of and to make contingency plans for threats when building business strategy (Byars, 1991; Cooper, 2000).

In a recent study (1998), Kotler claims that PESTLE is a strategic tool that can be useful to help understand market growth and decline alongside business position, in order to decide on potential and future direction

The use of PESTLE analysis reveals that the major external influences upon Network Rail are:

POLITICAL : The recent change in Government could still have a far reaching effect upon Britain’s rail industry, the recent Comprehensive Spending Review has made sure that the industry must change and in a big way.

ECONOMIC : The current economic climate of the United Kingdom is such that a lot of passengers will be thinking of alternative ways to travel, low cost coach and bus services will have their appeal increased, albeit the long term prospects for rail travel are good, given the current lobby against road transport by the green parties. In order to remain an attractive alternative, the rail industry must compete economically with road transport.

SOCIAL : The major social concept in the UK Government’s Sustainable Development Strategy (DEFRA, 2005) is noted as: “ensuring a strong, healthy and just society”, but this can be split into six main aspects:

aˆ? Accommodating the diverse needs of the population both now and in the future;

aˆ? promoting personal well-being;

aˆ? encouraging social cohesion and inclusion;

aˆ? maintaining equal opportunities for everyone;

aˆ? promoting good governance; and

aˆ? engaging the creativity, energy and diversity of the people of Great Britain.

The Rail industry has a major part to play in the satisfaction of these social

goals. Increasingly the industry will be judged on delivering the services, and even more so on the way they are delivered. The UK Railways run alongside houses belonging to a vast array of the population, and it must be seen to engage correctly with all of its lineside neighbours. The industry must also be seen to be an employer that values it’s workforce and treats them correspondingly. Safety of the travelling public is a major social factor in the business, both those travelling by train and the road user that use any of the hundred of level crossings on the network each day. The key causes of accidents on the railway infrastructure are trespass and the misuse of level crossings.

TECHNOLOGICAL : The incredible speed of technology advances has a big effect on any transport industry. The likes of faster and more reliable broadband connections will increase the amount of work done by teleconferences and reduce travel to meetings. Faster and more efficient trains will effect upon the nature of Network Rails infrastructure, and compel the company to look at new ways to maintain the infrastructure, and new forms of powering the trains.

LEGAL : Legally Network Rail is governed by many bodies with an influence, including The Office Of Rail Regulators, The Health & Safety Executive, UK Government, Environment Agency.

ENVIRONMENTAL : Network Rail has a responsibility to maintain it’s infrastructure and the huge number of wildlife habitats alongside the railway. The company also has to become as “green” as possible, ensuring timber that they use is from sustainable sources, and that all depots and offices are committed to reduce their carbon footprint as much as is possible.

Porters Five Forces

The Porter’s Five Forces model is a simple tool that can be utilised to help strategic understanding where power lies in a business situation. The tool can also be used to understand both the strength of a company’s current competitive position, alongside the strength of a position the company may be looking to move into. The Five forces framework focuses on business concerns rather than public policy but it can also emphasise extended competition for value rather than just competition among existing rivals. The ease of its use has inspired numerous companies as well as business schools to adopt it. (Wheelen and Hunger, 1998).

If you have clear understanding of where your power currently lies, you are able to take advantage of a situation of strength or act to improve a situation of weakness.

Porters 5 Forces for Network Rail:

Supplier Power: For Network rail, it supplier power can be said to be relatively high, there is a very strict approvals process to go through before any item can be introduced into the infrastructure. This process can be time consuming and expensive for new suppliers and so those that already have this approval have a large amount of power to wield. There are also very few suppliers that provide the dedicated technology that is used to provide modern signalling systems which again will provide a great deal of supplier power.

Buyer Power: Buyer power with regard to Network Rail would be classed as low. The company is operating in somewhat of a monopoly, giving buyers very little flexibility to shop elsewhere for similar services. Network rail is therefore in a very strong position when it comes to dictating terms.

Competitive Rivalry: Other than companies providing engineering expertise with renewal of rail infrastructure, there are few firms who could provide the day to day expertise that Network Rail has in the safe running of the railway network in Great Britain. The number of staff employed by Network Rail (18,000+) would also be a barrier to the threat of substitution by smaller firms, not willing to take on the huge responsibility that employing this number of dedicated staff would present.

Threat of Substitution: The threat of substitution may be classed as medium as there may be alternatives to a rail system within GB. Other than Road Transport, there is very little realistic direct competition for the services that Network Rail provide. Road transport does present a certain amount of competitive rivalry to Network Rail, but there would be few that would be able to compete direct with leading the GB Rail network. Obviously this puts Network Rail in a position of great strength.

Threat of New Entry: The cost and time elements required for companies to be set up to provide effective competition to Network Rail would be barriers that would prevent this happening. For this reason the threat of New Entry is low.

Using Financial Analysis / Marketing Mix / Core Competencies / Balanced Scorecard or any other relevant tools, scan Network Rail’s Internal / Micro Environment to inentify the key Micro challenges the Company faces.

Using FiMO as discussed during the BES module of the Network Rail business leaders programme to scan the Internal or Macro Environment shows the following results:

FINANCE : Network Rails strengths are based around it’s huge asset base and its growing asset value. Network Rail also owns a massive property portfolio that can be used for diversification. The major weaknesses of Network Rail are based around possible Governmet spending cuts, the Recent Comprehensive spending review and Lord McNulty’s value for money report.

MARKET : Strengths – Currently the business is well thought of by relevant bodies including the Office Of The Rail Regulator, OFT and HSE (BES 2010)

Prime locations for retail developments, Achieving Control Period 4 (CP4) targets to date. Weaknesses – Internal financial process that makes it almost impossible to trade with other parts of the same company.

OPERATIONS – Strengths include an enviable safety record, both for it’s own workforce and for the travelling public. Delivery of it’s own promise “The Timetable is our Promise. When we Promise a train can run, it will run – safely, punctually and reliably. And we Promise that more trains are able to run next year.” Network Rail (2010)

Weaknesses -. The industry is perceived as difficult to work with, by others within the industry.

As part of the BES course a RECoiL exercise for Network Rail as a company was completed, the scores have been reproduced below.

Network Rail

Resources

8

Experiences

7

Controls and Systems

6

Ideas & Innovation

7

Leadership

6

This would seem to highlight issues within two main sectors, those being Controls & Systems and Leadership.

Controls and Systems

There is a school of thought that its processes are far too bureaucratic and that any change can only be effected over a long period of time. This may well have a bearing on the apparent issues with leadership

Leadership

There seems to be a large number of long serving railwaymen in supervisory and management positions. This has the effect of creating a resistance to change. There seems to be a feeling that the processes and procedures inflicted corporately are so rigid that they prevent innovation because of amount of bureaucracy in place.

Pull your conclusions regarding parts 1 and 2 together in the form of a SWOT analysis. You could also identify what options an ANSOFF matrix for Network Rail would suggest are the most viable.

According to Barney (1995), a SWOT analysis is a framework that points to the relevance of external and internal forces to give an understanding of the

sources of competitive advantage. SWOT analysis will help decide if the main problems facing a company revolve around a need to change its strategy, a need to improve its current strategy and the implementation of it, or both of the above.

The tool helps look at the company’s current performance (Strengths and

Weaknesses) and its future (Opportunities and Threats) by accounting

for the factors that exist in the external environment. The framework is a powerful and at times highly successful technique that can be applied to individuals, groups, teams, or organisations (David, 1997).

Introduction

The person who had a significant influence in our life is a person who we consider as a role model. It means the ideal which we would like to resemble. In my life I have to say that my mother, Sumatra was such a kind of model. My mother has most definitely been the biggest influence in my life. She is the only person who always told me to be who I am and had a positive influence in my life. However, I cannot say that I would like to be a copy of my mother or that I fully accept his principles and ideals. In fact, I believe that each person is unique. Anyway, I still appreciate the basic principles. Almost all the day of a person life is an experience. There is always a time in one’s life where a person significantly influenced. I admire my mother because she is the person love and care the most of me. My mother has been the sole guardian of me as long as I can remember. What turns me into the person who I am is all her action. My mum has been never thrown a harsh word or unnecessary punishment even though I have made decisions in the spite of those decisions. She has made me enjoy my life like no other person could.

WHAT KIND OF IMPACT SHE MAKE TO MY LIFE

She has taught me a lot. Due to my mother I learned that there are more important values than wealth and money that people should always remain truly human, regardless, of their environment and the hardships they face in their life. She has thought me how to be kind and loving but not to allow others to take my caring and kindness for weakness. She has also though me to dream big and do everything within my power to make those dreams a reality. First of all, I would like to say that my mother was a person who did not attempt to lecture me. Instead, he just talked to me as a person who had an extensive experience in his life and, frankly speaking I do not know why, I often agreed with her, even though, at first, I attempted to argue with her. Nevertheless, I believe that my mother did not just have a gift to persuade people but she rather made people respect him with his deeds more than with words.

EXPERIENCE AND PERSONALITY SIGNIFICANT INFLUENCED

On looking back into my past, I can hardly remember an episode where I would criticize actions of my mother. In this respect, I recall an episode from my childhood, when I was about to quarrel with my father and I felt really angry at that moment. In fact, I was about ten years old, when I wanted to take a recorder, but my mother totally rejected this idea. I remember that he did not forbid me to take a recorder, but rather persuade me that it would not be a good idea to bring a recorder to our house. At first, I could not agree with my father’s arguments, because I did not take them seriously. Now, I understand that my desire to take a recorder was stronger than my common sense. But my mother managed to persuade me that I was not to recorder at that time. When I first told my mother that I was going to take a recorder, she just asked me to talk like him about my decision. At first, he asked me why I was so eager to have a recorder. I did my best to explain that it would great to have a recorder, but in the course of conversation I understand with the help of my mother that if I took a recorder I would take a great responsibility, which I was not ready to take at the moment. My mother explained to me that I would responsible for the recorder I was going to take and it was the first time when I thought serious about effects of the decisions I was about to take. Eventually, I understand that I could not take care of the recorder.

In such way, I learned from my mother that we should be responsible for our actions because often it is the life as well of others that depend on our decisions and actions. This experience was very important for me and influenced my personality significantly.

WHAT KIND OF A PERSON IS MY MOTHER

My mother is a kind of person that anyone can look up to and say I would like to be like that. She could be described as a short quite round young looking lady although she is 48years old now with always very pretty. She is thin with her curly hair. She usually wears modern and traditional clothes. For me she is so beautiful. Most people describe her as an attractive lady. She is the kindhearted, caring and loving person that she has thought me to become. She is strong willed, hardworking and very dedicated to god. I know that she inspires others as well. She is a great business woman and a speaker with a passion to teach others what she feels life is truly about and I know that her meaning of life is a successful and inspirational way of life.

WHAT MAKES ME ADMIRE OF MY MOTHER

My mother gave me the originality of her character to study the steadiness of her virtues the power of her passions to admire, the truth of her feelings to trust, however, I know that my mother will always be by my side. In spite of this, my mother has never failed to believe that my siblings will soon recover from these setbacks. All these things she had, and for these things I clung to her. I grew up not feeling neglected but admiring my mother more and more for what she has done for my siblings, which I believe no one could have achieved. I admire her for being able to look after the wellbeing of the whole family in spite of this and never failing to be there for me whenever I needed her. Growing up with such a strong role model, I developed many of my enthusiasms. Thus, it is clear that the individual who has had the highest degree of influence on me is my mother. She never once complained about the sacrifices, which she had to make in order to help my siblings. The strength of her principles is evident in the way in which she raised my little siblings who needs the more attention because they are younger than me. I will always respect the influence that my mother has had on my life, and will endeavor to take all that she has taught me as the inspirational to be all that I can be in the pursuit of my dreams. Particularly my passion is to become successful business women. She dedicates me and my siblings most of her time educating us.

REASON WHY MY MOTHER HAS SIGNIFICANT INFLUENCE ON ME

My mother is the most important person in my life. I really cannot express how I feel about her in just words. My mother is not my whole life, but she is really big part of it. My whole world does not only revolve around her, but she is the most influential person who inspires me. My mother is not just another woman. She is extraordinary. I have known her for twenty-two years. I know her very well, and had learned to love her since she gave birth to me. Relatives always tell me stories about my birth. They tell me how important I was to my mom. I was the foundation of her joy, strength, peace and love. She has thought me all I need to know to live. In my life as a twenty-two years old girl I have learned a lot from my mother. She thought me how to feel and recover it. Well, she did not only do that. She showed me how to handle these feelings of anger, fear and sadness.

CONCLUSION

When asked who has had the most extraordinary influence on my life, the most obvious answer would be my mother. It took me all twenty-two years to realize that it is her influence that has molded me to become what I am today. Being a business woman, she has never failed to look after us well. She I the kind of mother who always insists on spending quality family time together, the backbone of the family and the kind of person who helps other children in the neighborhood with their difficulties in their life. She has been my first teacher, my best friend and a role model for the past twenty-two years of my life. In considering my mother’s position and influence as a role model.

3.0 INTRODUCTION TO COMMUNITY SERVICE

Community service is a performance volunteered by an individual or an organization. This action benefits a community or institution. Usually community services are done as part of an organized scheme. The true meaning of community service is when we do something without the intentions of getting money or a reward from someone else. The main aspect of community service is volunteering. Getting the satisfaction knowing that you are able to have some sorts of effect in someone’s life is some benefit of participating community service activity.

3.1 THE IMPORTANCE OF COMMUNITY SERVICE

Community service is important because it offers one the opportunity to give back to others and their community. It is important part of college experience and valuable. To view a local community, it is designed to expand while instilling the sense of purpose and pride regarding own interests and abilities. Community service has also become an important part of application in college. To select and separate their application and to determine which receives scholarships, admission officers use community service as a method in many colleges.

3.2 A VOLUNTEERING PROJECT THAT I WOULD DEVOTE

It is not a matter for me if I could devote my time to help peoples in need. I would be more satisfied if I could help student in their education by giving knowledge in school site without any expectation of rewards and money. By this, community service represent a voluntary activity for which are not paid and it helps to match interests, talents and abilities.

3.3 DEVOTE ONE YEAR SERVICE TO SCHOOL-SITE.

An excellent way of meeting the requirement for community service is volunteering and also it helps special needs of a school. I require choosing this kind of school site community service because it is committed to providing on-going support and assistance to the school. With the exception of elective courses in community service, in additionally service must not be completed as a part of regular school course in which a student receiving academic credit.

3.4 I WOULD HOPE TO ACCOMPLISH:

School site community services are included by a lot of activities. I would be accomplishing some student plans, coordinated and monitors a school wide letter writing campaign in support of an issue of local importance. I will also give a help on tutoring other student in their reading skills or math for a semester. With the efforts to implement and monitor community service

experiences, as a community service aide to an appropriate teacher or counselor and assistance I would be accomplishing.

3.5 VALUEABLE PART OF COLLEGE EXPERINCE

With my experience I found it very meaningful to engage my spirit through serving other by giving a community service. Already many students have an experience with community service before coming to college. For my opinion, to spend time with friends while working for a valuable cause, it was required as a part of college curriculum, and others chose to do it to get more experience involving community service. With these I as a student arrive on campus seeking familiar opportunities. In this case, other students of in the college who never been done with any community service maybe interested in trying something new, or will be looking a different way to make friends. Most probably community service organization welcome new members year-round, weather a person have a prior experience or not.

Some students only like to do community service individually, perhaps by tutoring children at local worship center or elementary school. Some activities like running clinics or organizing park cleanup programs often perform by athletes as a part of team membership. But community service is completed through established organizations by most of the college students.

3.5.1 INCLUDE OF ORGANIZATION IN COMMUNITY SERVICE

Some community service organization includes Alpha Phi Omega, Circle K, and Habitat for Humanity, Best Buddies, Amnesty International, and Big Brothers, Big Sisters. Through local agencies student are interested in doing other types of service to do work. There is list of such agencies to get involve with community service and religious life offices which includes several opportunities. These opportunities are providing literacy programs, food banks, domestic violence shelters, public libraries, and homeless shelters. In terms of time and emotional energy, they are tremendously rewarding students for involve significant commitment rottenly. I would prefer volunteering opportunity not to represent on my campus, consider organizing a group of students and pursuing resources to help me engage in that service. I would accomplish to provide greatly enrich college experience by having a positive effect on community, and will leave with many fond memories.

3.6 BENEFITS OF STUDENTS PARTICIPATING IN COMMUNITY SERVICE

Public school youths had a positive effect on the personal development in community service.

Mostly showing increases in measures of personal and social responsibility, communication and sense of educational competence are engaged in quality service learning programs. Ranking responsibilities are more important value and reports a higher sense of responsibility to college than comparison groups who engage in service-learning.

Most probably, students perceive themselves to be more socially competent after engaging in service-learning. Highly ranking, student who involved in service learning were more likely to treat each other kindly, help each other and care about doing their best. Also these students will more likely increase their sense of self-esteem and self-efficacy.

3.7 BENEFITS OF VOLUNTARING IN COMMUNITY SERVICE

Community service benefits others in some ways although it is apparent, before creating and maintaining widespread programs. Students exactly benefited by participating in these community service activities. Research has been done greatly on this subject, resulting in evidence for many kinds of benefits. The most significant gains reported are psychological, social, and cognitive benefits experienced by students.

3.7.1 PSYCOLOGICAL BENEFITS:

Sources indicate that students have shown increases in positive feelings and mental health, and decreases in depression and stress.

3.7.2 SOSIAL BENEFITS

I forge bonds with each other by participating in community service project as well as other members of the community. These bonds enhance increase my social network in my interpersonal skills. Socially volunteerism can lead to increase care for others and a desire to cooperate and get involved in positive ways, even among those who had previously exhibited antisocial tendencies. Another major benefit is the feeling of social connectedness that appears to be winning in increasingly in segmented society.

3.7.3 COGNITIVE BENEFIT

We learn something new every day. Volunteering definitely holds true. Old skills are developed as new ones are learned with new experiences. With past experiences, new information I integrated and one’s knowledge base improve. The lesson learned from volunteering frequently support and enriches understanding of how the community is set up to function additionally. A large part of the reason for incorporating volunteering and community service into various curricular and require cognitive gains.

3.8 CRITICAL THIKING AND PROBLEM SOLVING SKILLS IN COMMUNITY SERVICE

To determine what needs to be done while develop mentally appropriate level of responsibilities in situation which young people learn the most. A responsibility of decision making in a task that is interesting and important to students has given the opportunities. They tend to think more deeply about the issues at hand and use their most complexes thinking skills to solve problems arise in community service. The critical thinking seeks to help faculty move beyond teaching contents and into teaching students to apply complex cognitive skills across a range of topics problems. Faculty participating in this community service will learn strategies for teaching students how to think critically and creatively to solve a problem that arise in a part of discussion in community service. They will develop activities that can be used in the classroom to develop our critical thinking.

4.0 CONCLUSION OF COMMUNITY SERVICE

The major goal of community service in school site explores the comparative effects of service learning and the cognitive and affective development of college undergraduates. It is to enhance our understanding of how community service is enhanced at school site learning service. As what I know thirty percent of students participated in community service during college, and an additional forty-six percent participated in some other form of community service. The remaining 24 percent did not participate in any community service during college. The impact of community service was assessed on several dependent. These are academic outcomes, values, self-efficiency, leadership, career plans to participate in further community service in college. Freshmen are the most outcomes which were presented when a student entered the membership of community service. Subsample of student for who standardized test scores is additional outcome.

For both freshmen characteristics and institutional I Multivariate control were used. In-depth case studies of community service on campus are qualitative portion of community service.

To pursue a career in a service field, service participation appears to have its effects on the student’s decisions. The positive effect of community service can be explained. The fact that participation in community service increase the likelihood that student will discuss their experiences with each other and that students will receive emotional support from faculty.

There have been issues of inequality for centuries such as oppression, discrimination, and prejudices. The government has the task of making certain that those laws are set in place to protect those when conflicts of social justice arise “But the government is a reflection of the majority’s will, so there has been and continues to be a struggle to achieve social justice in our society” (Segal, 2010, p. 93). When it comes to social issues and or problems on behalf of society, individuals and society has a responsibility for the well-being of others. The development of social welfare programs and policies happens by responding when the problem already exists and by preventing the problem before it arises.

Final Exam Essay Questions

Our society as I see it has always been one that has appeared to be a nation concerned with the well-being of members of mainstream society, yet we have always had issues that embark on social justice and inequality for non-mainstream members of society. However we have had those individuals that were and are willing to battle for fairness, advocate and aid those that are in need, single handedly and as an assemblage effort such as the social work profession. As an inspiring social worker I ask, what is the concept of social justice? Moreover, why is it relevant to social work practice, which is responsible for a person’s well-being an individual or society? In addition, I will show the differences between residual and institutional approaches to social welfare policy and programs, for these two models respond when the problem already exist and help prevent problems before they occur.

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What is the Concept of Social Justice? And why it is Relevant to Social Work Practice

As a member of a society, each member should have all the same rights, opportunities, and fairness within. The concept of social justice is society fairness. “Social justice describes the level of fairness that exists in society” (Segal, 2010, p.14). All members in society have the right to this level of fairness. The description, in which our society upholds social justice, unfortunately is not what we all live by. There have been issues of inequality for centuries such as oppression, discrimination, and prejudices.

Fairness has not been our strongpoint among each other. The government has the task of making certain that those laws are set in place to protect those when conflicts of social justice arise with attaining fairness, same opportunities, and rights. “But the government is a reflection of the majority’s will, so there has been and continues to be a struggle to achieve social justice in our society” (Segal, 2010, p. 93). For this reason, social justice has been essential and relevant to social work practice. Social work practice will bring forward those who will advocate, and help to set policies in place to help protect, promote, and advance change for those individuals that struggle with having the same rights and basic human needs that all deserve to have as a member of society,

Social workers should be aware of the impact of the politi-cal arena on practice and should advocate for changes in policy and legislation to improve social conditions in order to meet basic human needs and promote social justice (Segal, 2010, p. 70).

Social work practice works towards changing social conditions, a crucial part of that change is taking the responsibility to improve the social welfare of our society.

Who is Responsible for People’s well-being Each Individual or Society?

Who is responsible for people’s well-being, individuals, or society? The responsibility of a person’s well-being is societies as well as in individual. As a member of society, we have social obligations when it comes to social issues and or problems on behalf of society. Community programs, religious institutions, for-profit and non-profit organizations are in the business of promoting and supporting the well-being of individuals as a person, however from a social work perspective some would beg to differ when it comes to a for-profit organization working toward the well-being of others for it is a private service. For-profit agencies focus is to profit from the services they provide and they provide it from a business principle, therefore even though an individual may need the service they possibly will not receive it if they cannot afford the cost of service. Their mission and the concern drive non-profit social services and care of those, they serve, despite the cost. From a social work perspective, this is ideal for anyone can get the service needed and knowingly the client is going to get the best care possible.

In the Federal, state and local governments there are government agencies and social welfare programs in place to contend with the efforts with providing for the well-being of society, such as Social security, Medicaid and Medicare. “As social work professionals, we have a mission that outlines public support and therefore the provision of social welfare services directly or in partnership with our government” (Segal, 2010, p.89). Basic human needs such as housing, healthcare, and food are some of the biggest social issues in our society. At one time most of the social welfare services were in the private sector by the government. Yet many services, such as providing schools for children, including those with disabilities and metal issues cannot be services by a private sector. Many families are unable to afford the cost therefore public services are needed when it comes to the well-being of people, “Much of the work done by public social service providers would not be done by private organizations” ( Segal, 2010, p. 83).

These social issues bring social welfare policies in to play, “Social welfare programs are the product of social welfare policies” (Segal, 2010, p. 3) When society does not take action to change issues and problems, that exists for people, then individuals step in and attempt to make the change come to pass. It will take individuals and society responsibility for the well-being of others, by public, private social services and through other ways and means. The values and beliefs of those who practice social work, is based on professional principles, ethics and driven by promoting social change for the betterment of social welfare of others and to promote the well-being of others by social welfare policies.

What are the Differences between Residual and Intuitional Approaches to Social welfare policy?

The development of social welfare programs and policies happens by responding when the problem already exist and preventing the problem before it arise, these two approaches is known as residual and intuitional approach. Members of our society confuse the term welfare; they see it as handicap-keeping individuals from moving forward and becoming productive and self-sufficient. The truth is social welfare is to help members in society by addressing their well-being in any area needed, not just monetary or providing food by a residual or intuitional approach, however there are differences between the two.

Residual approach to social welfare policy is provided only when needs are not met by other institutions, families, religious institutions and is viewed as negative. When people are unable to address the problem themselves, then emergency assistance is given once the problem is identified. This is looked at as an individual’s personal issue, not society as a whole. It is a means of intervention. It sees the poor as incompetent, second-class citizens and provides second-class services. The residual welfare is looked upon as the problem of the ‘unfortunate classes’ through middle and upper class benevolence. An example of residual approach would be Work organizations primary function is employment and the social welfare service would be unemployment benefits, which are in the area of residual approach, for the unemployment is the existing problem yet it is only in place temporary, until a person can become employed or other means of financial support.

Institutional approach to social welfare policy is proactive and no stigma is attached, for difficulty is bound to present itself for an individual, therefore it is looked upon as normal to need assistance. Social problems are rooted in social structure and hence planned social change, and seen as a normal and accepted way of fulfilling social needs. It is seen as a preventative effort to a person’s well-being, set in place automatically for society as a whole. An example of intuitional would be national, regional and local government organization primary function mobilization and distribution of goods for collective goals has a social welfare function of anti poverty, economic security, health, education such as government scholarship programs and subsidizes for housing which falls into the area of preventive services.

If we looked at the residual and intuitional approach of social welfare policy by a universal and selective approach, selectively only those who would fall into the criteria needed to qualify for services would be provided therefore even though an individual may need the service now they would not receive it. For this can lead to a permanent problem for an individual. Universally any and everyone would receive the service, which would prevent problems for society.

Conclusion

Social work practice works towards changing social conditions, a crucial part of that change is taking the responsibility to improve the social welfare of our society and individuals. Members of society have social obligations when it comes to social issues and or problems on behalf of society. Social welfare policies and programs are society’s safety net, provide a way to set preventions and interventions in place to help and protect those in need. In order to receive you have to be willing to give, and to help one another collectively and individually.

Psychiatric disorders can lead to many types of problems. These problems can range from housing instability to disease, and even death. Having a disorder and lack of stable living conditions most often further complicates the overall health and the care this is a bit confusing for a homeless adult. Without the proper health care, the mind will become even more unstable. This does not automatically follow logically. Individuals with severe mental illness soften most times with homelessness because of their inability to accomplish daily tasks and earn money. Mental illness is serious and severe and can have a domino effect on one’s life and those surrounding the individual. The hand in hand relationship that homelessness shares with mental illnesses are disturbing. One of the many mental disorders that can lead to homelessness is Schizophrenia.

Stating that an individual has a mental illness can be interpreted many ways, however, it is usually defined and understood as a psychological disease or disorder. The severity of the illness determines how much of an individual’s daily functioning will be affected. The ability to care for one’s self, a home or household and the ability to maintain an intimate relationship are lost. Homeless people with mental disorders remain homeless for longer periods of time and begin to have less contact with family and friends. Mental illnesses, such as schizophrenia or severe depression, can cause a strain on family and other social relationships (Hawkins and Abrams 2007). Studies have examined what the quality of life is like after discovering that one has a mental illness, those who become homeless and other studies focus mainly on treatment options. Suffering from a mental illness makes it more difficult to gain employment. Having poor health also cripples the individual’s desire to seek help, and whether they can receive help or not is another issue.

Studies that take a deeper look into the rates of homelessness could lead to better treatment and help. It is especially important to study mentally ill homeless individuals that have substance abuse since these individuals are one of the most disadvantaged groups among homeless persons (Levine and Huebner 1991). There is no one explanation as to why an individual who is mentally ill will begin abusing their bodies with drugs, it is known though that when substance abuse and mental illness are combined contact with law enforcement is inevitable. All people with mental disorders, including those who are homeless, require ongoing access to a full range of treatment and rehabilitation services to lessen the impairment and disruption produced by their condition (U.S. Department of Health and Human Services, 2003). Most people with the mental disorder do not need hospitalisation, what they do need is better housing options and more treatment options and but can live in the community with the appropriate supportive housing options. Further studies do show however that these community-based services are far and few in between and there is not enough housing to accommodate the growing number of patients affected by a mental illness.

The hardest challenge to face with helping mentally ill patients is that the illness causes other cognitive problems. Dr Yuodelis Flores states that “the most serious barrier to treatment is lack of insight,” persons with serious mental illness may not understand that they are ill and need care. Severe and persistent mental illnesses (SPMI) – including schizophrenia, bipolar disorder, major depression and dementia – impair judgment, conceptual understanding and the capacity to make appropriate behaviour decisions (HCH Clinician’s Network, 2000). A patient, who is now learning of their illness, reacts irrationally and with anger and then instead of trying to understand the illness they just shut out those closest to them.

Schizophrenia is a serious disorder of the mind and brain but it is also highly treatable. There is a constant flow of improvement on the medications for this illness. In addition to that, there are many new and improving psychosocial treatments and cognitive therapies for schizophrenia that are being tested and approved for use. One of the theories of what causes schizophrenia is that it is a result of a genetic predisposition combined with environmental exposures and or stress (The Internet Mental Health Initiative, 1996-2010). Stress can trigger a preexisting illness into existence, which in the case of Schizophrenia makes sense in terms of one having a genetic predisposition to the disease. Schizophrenia-like most other illnesses do not develop until after the age of 18, however, an age range is given due to the fact that illnesses have developed earlier in some. Men tend to develop schizophrenia slightly earlier than women; whereas most males become ill between 16 and 25 years old, most females develop symptoms several years later, and the incidence in women is noticeably higher in women after age 30 (The Internet Mental Health Initiative, 1996-2010). Taking a closer look at an individual’s support system also determines if a homeless result is possible. Mental illnesses, such as schizophrenia or severe depression, can cause a strain on family and other social relationships (Hawkins and Abrams 2007).

Society is well aware of homeless people, but many are unaware of the reasons why and then many do not care to know the reason. When a homeless individual is seen many shy away especially if that homeless individual is acting out. This passive attitude towards the homeless does not help them nor does it help society. In 2002 the cost of schizophrenia was estimated to be $62.7 billion, with $22.7 billion excess direct health care cost $7.0 billion outpatient, $5.0 billion drugs, $2.8 billion inpatients, and $8.0 billion long-term care (The Internet Mental Health Initiative, 1996-2010). Being out of sight and out of mind, these numbers do not reflect the homeless. About 1% of the population is affected by Schizophrenia (The Merck Manuals, 2008). Schizophrenia affects men and women equally having no racial or socioeconomic preference. In the United States, schizophrenia accounts for about 1 of every 5 Social Security disability days and 2.5% of all health care expenditures (The Merck Manuals, 2008).

Brandt (1995) studied how actively working with homeless who are suffering from schizophrenia can better their lives. He focused on the “bag ladies” as they are deemed social outcast as they have a tendency to act out when help is offered. Quite outspoken about his distaste on societies role in helping those in need, he began to roam the streets gathering individuals to be a part of his study. 35 homeless individuals were chosen between the ages of 22 and 70 and consisted of 17 women and 18 men. The results were significant enough to show that being proactive with these individuals is helpful no matter the age or gender. The only remaining issue however with treating homeless individuals just like with any other patient, is the need to want treatment. When someone is in need of help in whatever form of therapy needed, it is the patient that makes the initiative and this is unable to be the case with homeless individuals. Brandt (1995) acknowledged that “Many different groups must be involved in the work. [This includes], psychiatrists, hospitals, general practitioners and the entire social welfare system. And the best possible contact must be maintained with the patient” (p. 1).

Antipsychotic drugs, rehabilitation, and psychotherapy are the major parts of treatment. Community support activities, such as job coaching, teach the skills needed to survive in the community. These skills enable people with schizophrenia to work, shop, care for themselves, manage a household, and it also rehabilitates their social abilities. Hospitalisation is seen more when patients relapse. Forced hospitalisation is also rare and is only seen when the individual is a threat to themselves or others (National Coalition for the Homeless, 2006). The death rate for homeless people is about four times greater than the rate for the general population and among young homeless men, the rate is even higher (National Coalition for the Homeless, 2006). According to the National Coalition for the Homeless (2006), “average homeless adults die twenty years earlier than their non-homeless counterparts. Over half of homeless adults die violently and one-quarter of those is murdered” (p.2). The appropriate housing can provide the framework necessary to end homelessness for many individuals (National Coalition for the Homeless, 2006).

A study done in 2002 by Folsom, McCahill, Bartels, Lindamer, Ganiats and Jeste not only examined the death rate in schizophrenic homeless individuals, but they then compared the preventative and primary care to those with severe depression. While depression is a mental illness, it does not cripple one’s abilities the way that schizophrenia does. The stages of withdrawal from friends and family are the same, however an individual with depression is more likely able to describe their feelings to a doctor, and there is no stigma placed on this illness like those with schizophrenia. Schizophrenic patients can go undiagnosed for years and then when they are, many providers are uncomfortable with treating them and some do not even see a point. Folsom et al state that (2002) “serious mental illnesses, including schizophrenia, are much more common among homeless people than in the general population. Investigations have consistently found higher rates of substance abuse, schizophrenia, bipolar disorder, and major depression among homeless people than in the general population” (p.1). This is why preventive treatment is very important along with better housing. The growing number of homeless people is unknown, implementing better shelters that can provide the mental treatment needed will be a big step in helping these people. Folsom et al also noted that there is a direct correlation with schizophrenia and homelessness with death, “the age-adjusted mortality rate for people with schizophrenia is about two times that of the general population; cardiovascular disease is the most common cause of death among people with schizophrenia. Homeless people have been reported to have a mortality rate [that is] 3.5 times as high as that of the general population” (p.1).

With this study and with all studies, the best care depends on the patient to supply the proper medical history along with any medical symptoms. Middle-aged and older homeless people with schizophrenia received less primary and preventive health care and were treated for fewer chronic medical problems than a comparison group with depression (Folsom, McCahill, Bartels, Lindamer, Ganiats, & Jeste, 2002). Going forward with other research, monitoring the health care of schizophrenics should be compared to all the different types of mental illnesses as well as comparing them to those who have no mental illness at all.

Any one of the homeless people that you see on a daily basis can be suffering from a mental illness, that fact is quite disturbing. It is something that should not be taken lightly for it comes in many forms and can affect anybody. Being able to identify the symptoms and seeking help is a key fundamental towards regaining your health back. There still is great difficulty in caring for schizophrenics and the only way for it to get better is to continue the research and find ways for all the branches in the healthcare system to work together so that the patient can have the best treatment available. In the next 20 years hopefully, there will be a cure for all types of mental illness that we see today until being able to understand what it means for those who are suffering is just as important.

I have always been deeply committed to helping others, especially helping those who come from similar backgrounds such as mine. Several experiences have stimulated my attraction to the field of social work. The first step towards my passion to study social work was formed when I was about four. My parents were unfit to raise my siblings and me, which consequently led to foster care. At age four I had no idea that day would lead me on the path of becoming an effective agent for social work. While in foster care, I met some amazing social workers who went beyond the call of duty. My social workers were talented, committed, and hard working. As I became older, my interest in social work grew. I started asking my social workers how do I become a social worker. In so many words, they explained that I have to do well in school, and go to college. While in college, I can major in the field of social work or closely related field. My social workers were my first insight to what a social worker is and what a social worker does. The fact that my social workers were committed to my well-being and pushed me to my full potentials demonstrated their concern for me as well as their ethical commitment. Secondly, are the three premises on which social work is based on. Which are very straightforward. First is that the person or group is important. The person or group has a problem that may arise from many different factors, and lastly finding a solution to help solve those problems so that person or group can live a better life. Finally, is the range of opportunities for a social worker in the field of social work. Social workers can be found in hospital, schools, community health agencies, and international organizations just to name a few. I give my social workers credit for the knowledge they have shared with me as well as encouraging me to reach my personal goals to become a social worker.

2. What influences, persons, or work/life experiences guide your choice of social work as a profession?

I have not always been the strong confident person I am today. My outside involvements were my social workers, and independent living coordinator. They play a huge role in my influence to study social work and to become a social worker. Sometimes I often wonder

how different my life would be now without my social workers involvement. I adopted many things from my social workers, things such as how to be compassionate and caring towards others, how to set and reach my goals, as well as how to be a hard worker.

Some people fail to realize the impact of encouraging words to others. I can remember when I was in the twelfth grade my social worker Tameko was picking my sister and me up from school to help us fill out some important paper work for college. On the way home, she explained to us that we are smart and beautiful girls who can be anything we put our minds to. Do not let our circumstances define who we are. That moment of encouragement has not only stuck with me but has changed the way I think about my life. I then realized that I determine my future and should not be ashamed of my parents mishaps. Studies show that the cycle of poverty repeats it self for at least three generations. I new at a young age I did not want to repeat the cycle of abuse, poverty, and addiction so I worked hard to accomplish my goals. In practice, I have had an opportunity to work with Independent Living Program. Which is a program that helps youth ages 14-21 with career training, educational opportunities, personal finance, job-hunting skills, independence skills, and so much more. I also took a Counseling Practicum class, which gave me an opportunity to observe and experience working within the Augusta Pregnancy Center. Which is a non-profit agency that provides services to women who are facing challenging situations? In this course, I was able to learn the specific skills required to care for the women and their unborn child, ethical principles, and ethical standards. These experiences has only increased me love for the field of social work and given me valuable experiences working with women and children.

3. Discuss personal strengths you possess which will make you an effective helping person.

I chose social work, but in retrospect, I think social work chose me too. I often wonder what kind of career I would be interested in if I was never in foster care. My own personal background would make me an effective helping person. Growing up in the foster care system I will be able to relate to the youth and families I will be serving. I know what it feels like to be sent to different foster families. I know how it feels being afraid to trust people and being afraid to talk about being in foster care. I believe that children who have been abused and neglected find it difficult to trust people. I believer children in foster care would feel a sense of understanding, being that I have came from similar backgrounds. My personal strengths that I posse are the willingness to help others unconditionally. My social workers were very committed to me, and I want to share that same commitment with others who are vulnerable. My experience has taught me how to be non-judgmental, how to demonstrate empathy, and how my improbable journey can inspire others. In addition, my undergraduate study in Psychology-Counseling has provided me with a better understanding of why people think, feel, and act the way they do. I believe that understanding the behaviors of people is very important tool to posses in the fields of social work. I also understand the importance of volunteering to help improve my community and neighborhood. I am currently a foster care club member as well as an on line message board member for foster care. I also volunteer in the Jefferson County Public School system and Woodhaven Place social committee. Volunteering is one of my most rewarding experiences for me and it gives me an opportunity to help my community as well as gaining skills to better help others. With my experiences during my undergraduate studies and currently I know that social work as a profession is ideal for me.

4 Discuss your vulnerabilities as these influence your development as a professional social worker. Specifically discuss any history of substance abuse, problems in a work setting, criminal activity, and/or help-seeking for personal issues.

We are all vulnerable at any given point in time because of life circumstances. For example, illness, humiliation, harassment, natural disasters, poverty and abuse; however, some of us are more vulnerable than others. In my case, I was susceptible to physical abuse and neglect which has made me a strong person. My life experiences has not crippled me, but has inspired my concentration in public welfare so I can serve others. My past vulnerabilities will help me because they provide me with a better empathy of what children and families are going through in disadvantage situations. I thank God for my fears. One of my biggest fears in life was to end up like my parents. My fear has led me to never have an interested in drinking or using drugs. I never had any problems in a work setting nor have I had any criminal activities. I never seek any professional help for any personal problems that I have had in the past, however, there was a group that I was involved in call ILP that stands for Independent Living Program. This organization is amazing. This is where I met my Independent Living Coordinator who has been such an influential role model. The Independent Living Program is where I got my voice. In this program, I learned how to be more confident as well as how to share my life story with other youth that were in similar situations as me. I think this program help me cope with the personal issues that I was experiencing at that time.

5. Describe your special work practice as you anticipate it five years from now.

Five years from now I see myself helping abused and neglected children who are in need of a positive social worker. This is with out a doubt the right vocation for me. I am passionate about working with this selected group, because of my own personal experience as an abused and neglected child. I have a special place in my heart for children especial those who are suffering because of their parentsaˆ™ inability to protect and provide for them. I often wished I had a magic wand to protect the kids who are being abused, but realist I do not. However, what I can do is take the necessary steps to become an accomplished social worker, which will enable me to help protect children from all forms of child abuse. In the years ahead, I also see myself volunteering to help educate foster parents on how to be equipped foster parents. To often there are foster kids placed with families who are not properly trained. In order for me to succeed in my endeavors towards protecting children, I realize that a masteraˆ™s degree in the field of social work is essential. After attending your information sessions, I had the opportunity to better understand how Spalding University can help me reach my academic and personal goals. I became more aware of the importance of social work principles. I was able to learn more about your Masteraˆ™s in Social Work program. I was so impressed with Spaldingaˆ™s devotion and history to their Social Work program. I am very excited about learning the fundamentals which will help me sharpen my skills as I pursue my dream of becoming a professional social worker as well as sharing my knowledge. I look forward to using the knowledge and skills that I will develop at Spalding University to help abused and neglected children reach their greatest potentials. I promise to uphold and exceed all that is expected of a student at Spalding University, as well as a professional social worker.

The Welfare state in Britain as we know it was formed in the twentieth century but its origins can be traced back to mediaeval times; welfare was delivered collectively, free of the state many local churches ran hospitals; however the word hospitals should not be understood in today’s terms. In mediaeval times these places were communities. Were the sick, frail and elderly in particular were looked after. Back then Parishes in Britain had a responsibility to their poor, In 1598 Elizabeth I, passed an Act for the Relief of the Poor, this is known as The Elizabethan Poor Law. It offered the poor some protection, and less sturdy beggars were sent back to their parish of origin for help, every parish appointed overseers of the poor who were responsible for setting up parish houses for those unable of supporting themselves and finding work for the unemployed. Around the time the industrial revolution came, the rapid population growth and development of the towns, and the first experience of modern unemployment, along with this came increasing poor rates, In 1833 Earl Gray Prime Minister, set up a Poor Law Commission to scrutinise the working of the poor Law system that had been put in place in Britain. In his report published in 1834, the Commission made several recommendations to Parliament. As a result, the Poor Law Amendment Act was passed. (The poor Act of 1598 continued till 1948)

This Essay will discuss the theories in social policy, which underpin welfare provision and to what extent have these theories influenced the delivery of welfare services and met the demands of a changed and changing society this essay will also examine the welfare provision of Community care and Health.

The Poor Laws were very much disliked, a great deal of the development of social services in the 20th century including means tests, health care and national insurance were designed to avoid having to rely on them and in many industrialised societies social exclusion and poverty are alleviated to some degree by the introduction of a welfare state. The majority of industrialised and industrialising countries in the world today are welfare states, this means that the state plays a central role in the provision of welfare; it does this through a system that offers benefits and services to ensure that people’s basic needs such as Income, Housing, Education and Healthcare are meet.

The welfare state has a daunting task of managing the risk faced by people, over the duration of their lives such as: Job loss, old age, sickness and disabilities, the level of welfare services and spending vary from country to country, a number of countries have a highly developed welfare systems and allocate a large proportion of their national budget to them, over the years there are many theories and Political views on welfare and are often divided into right and left wing views over the welfare state and some have shaped the policies that we have in place today.

The right wing: is against public provision of welfare and are for residual welfare They are seen as individualist on the other hand the left wing: is for public provision of welfare and residual welfare and are seen as collectivist, however this is not so straight forwards as it first seems this might also be dependent on The positions that might be held by people. There is an individualistic left wing, and a collectivist right wing. Many right-wingers accept the principle of institutional welfare, and many left wingers are uncomfortable about institutional measures, like student grants or earnings-related pensions, which favour richer people over poorer ones, Left-wingers however support social security (which enable people to buy food in the private market) rather than soup kitchens (which are more of fern than not publicly provided). The main political perspective of welfare positions are: The Marxist, The Conservatism and The Liberal individualism.

The Marxist:

Marxist core beliefs are that welfare concentrates principally on its relationship to the exercise of power. Marxist argues that welfare has been developed through the strength of working-class resistance to exploitation they further argue that the state can be seen as an instrument of a complex set of systems which reflects the contradictions of the society or as a ruling capitalist class or at least a pert of it.

The Conservatism:

Conservatives core beliefs lie in the importance of the social order. This is reflected in a respect for tradition, an emphasis on the importance of religion, and a stress on the importance of inequality – such as inequalities of caste or class – Conservatives believe that Welfare is a secondary issue and the basis for structured social relationships.,

The Liberal individualism:

Liberalism believes that the premise that everyone is an individual, and that individuals have rights. They mistrust the state and they also believe that society is likely to regulate itself if state interference is removed. The liberalism central core belief is freedom. All freedoms are not equally important; their main values and concerns are with certain particularly important freedoms, such as freedom, of worship, of speech, and. of assembly.

The welfare state stretched further under the pre First World War, from the outset the Liberal government’s principle emerged that the state should eliminate the worst causes of poverty and introduced a number of policies these included: Health, Housing, Education, Pensions and unemployment insurance and minimum wage boards and other measures on a strictly limited scale, these minimum standards had been introduced to give a basic level of assistance which was assumed no one would be allowed to fall below, the principle of a national minimum standard of life looks very different today form how the legislations and public policy was originally formulated, it was an attempt to prevent destitution and to deal with poverty. In 1911 the first National Health Insurance Act was passed, Lloyd George, Liberal Chancellor of the Exchequer assured employers it would ease the unsettled workforce and in turn would raise productivity by reducing sickness absence. World war one put a temporarily halted workers’ growing militancy. With the women’s work force increased the factory workers produced an even greater mood for change and with the horrific suffering soldiers coming home from war blind and with out limbs other suffering from mustard gas poising, In 1917 Lloyd George, by now prime minister, warned: that the Russian revolution has already inspired workers across Europe. Lloyd George Argued “The working class will be expecting a really new world. They will never go back to where they were before the war”. He promised a “land fit for heroes”, he was hoping to convince workers that life would improve without them following their Russian cousins.

In today’s society we have been increasingly aware of the many diverse needs of people needing help from a partly or non finical kind these would include: the blind, the deaf, long term sick and the handicapped, single parent families, unmarried mother, and newly arrived emigrants est. Although the principle of a national minimum standard of life is still in place it has immensely improved in comparison over the last 90 years.

The British political history of social policies since 1940’s have been many and varied, before the 1945 elections some new social policies had already been put in place there were three critical developments that took place during the second world war, the early drive towards the establishment of a national health service, the Beveridge Report and the Butler education act of 1944.

The Beveridge Report one of many efforts to plan for the forthcoming peace, it was widely acknowledged within Coalition Government that after the war Brittan would need to rationalise and improve its income maintenance policy; the report itself was a combination of detailed proposals for a comprehensive social insurance system and significant needs for future social policy.

Beveridge” described the road to social reconstruction after the war as involving ‘Slaying the five giants’ of’ Want, Disease, ignorance, squalor and idleness”.

The report had set down, had three conditions that were necessary to the development of a satisfactory system of income maintenance. The introduction of setting up a comprehensive health and rehabilitation service, a system of family allowance and the maintenance of full time employment, at the time these accompanying conditions made more political impact than the social insurance proposals.

The Beveridge Report (1942) The Beveridge Report launched the introduction of the Welfare State. The core reforms included:

The Education Act 1944 – provided free secondary education for all children.

The Family Allowances Act 1945 – provided universal benefits for families with two or more children.

The National Health Service Act 1946 – provided free and universal health care.

The National Insurance Act 1946 – provided unemployment and sickness benefits.

The Children Act 1946 – gave local authorities to set up social work for children.

Beveridge social insurance proposal involved flat rate benefit payments to the unemployed, widows, pensioners and the sick. This was a fixed amount for individuals with additions made for dependants with no graduation In relation to past earnings however this was to be funded by flat rate contributions from the insured, their employers and the state.

Health

On the 5 July 1948, The National Health Service started (The National Health Service Act 1946) The NHS was based on principles unlike anything that had gone before in health care. It was a historic achievement; however at that time majority of doctors were opposed to the idea, they believed that they would lose money as a result of it. Their belief was that their professional freedom would be jeopardised i.e. Doctors believed they would treat fewer private patients and the outcome meant they would lose out financially. Added to this was a strong belief that the NHS would not allow patients to pick their doctor however this was not to be the case and 95% of all of the medical profession joined the NHS. Others countries at that time still tended to rely on insurance based schemes

Before the introduction of the National Health Service (NHS), family doctors (General Practice) charged for their service. The majority of families that were Low-paid asked for a GP as a last choice, often they had to borrowing money from their families, neighbours or the pawnbroker to pay the bill. However more affluent workers paid into ‘Friendly Societies’ as insurance. In some parts of Brittan, workers joined together to pay a doctor with a weekly stoppage out of their wages. The trade unions also organised clubs like this were the worker could see a GP when they were sick the trades unions realised that keeping a healthy work force was more hands on tools. Some cottage hospitals were built with workers’ contributions, particularly in mining areas like South Wales.

However the NHS was to be financed almost 100% from central taxation. Bevan regarded this as a crucial part of the scheme that the rich should pay more than the poor for comparable benefits and People could be referred to any hospital, local or more distant also everyone was eligible for care, even people visiting the country or temporarily resident. Care was entirely free at the point of use. This proved to be a costly mistake as the government underestimated the demand on the NHS with most people it proved to be extremely popular as it quickly found that its resources were being used up from NHS earliest days it seemed to be short of money the annual sums that had been set aside for glasses and for treatment such as dental surgery were quickly used up. The ?2 million put aside to pay for free spectacles over the first nine months of the NHS went in six weeks estimates of the cost of the NHS were soon exceeded and within three years some although prescription changes and dental charges were subsequently introduced a charges of one shilling (5p) and a flat rate of ?1 for dental treatment. This was a small amount if you compare the price of a prescription in the United Kingdom today is ?7.20 per item. The cost of NHS dental care most courses of treatment cost ?16.50 or ?45.60. The maximum charge for a complex course of treatment is ?198. The government had estimated that the NHS would cost ?140 million a year by 1950. In fact, by 1950 the NHS was costing ?358 million.

Over the years the NHS went through many rough periods over finances and in the 1970s things managed to go from bad to worse, Brittan was in the gip that can only described industrial unrest It was the decade of strikes, piles of rotting rubbish on the street and electricity shortages for thousands of people the 70s was a time when people were just trying to make ends meet in difficult economic conditions, when industrial action hit the NHS and Financial problems also hit the service in 1978 and 1979 as oil shortages in the ‘winter of discontent’ took hold. This was not help when the consultants went up in arms over the proposals to reduce the amount of private work they undertook.

The 1970s started the ongoing debate on the best way for the NHS to evolve. With this in mind GPs introduced the first charter to encouraging the growth of primary care in the UK match local health authority boundaries with the new boundaries created in local government. A new system of distributing the resources of the health service more evenly was also implemented in 1974, a few months later a Royal Commission was appointed to look into the problem.

The NHS was slowly changing its mind set looking at people as customers and not as patients and turning towards private investors to help fund and shape the NHS; however before the introduction the first wave of 57 NHS Trusts came into being in 1991and By 1995 all health care was provided by trusts. The majority of family doctors were given budgets to buy health care from NHS trusts and they could also buy health care from the private sector this scheme was called GP fund holding. Patients of GP fund holders were often able to obtain treatment more quickly than patients of non-fund holders. Becoming a NHS trusts this was the new future was to be a ‘provider’ in the internal market, health organisations, independent organisations with their own management, competing with each other.

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Community care

Community care as we know it today came in the 1950s and 1960s; this was the result of political realism and progress in the understanding of mental health and the treatments now available this also includes social changes civil rights campaigns and a rise in the patients’ rights movement, moving away from the isolation of the mentally ill in old Victorian asylums towards their re-integration into the community.

The 1959 Mental Health Act encouraged the development of community care and abolished the distinction between psychiatric and other hospitals. This was seen as the biggest political change in mental healthcare in the history of the NHS, During the 1960s the populist continued to move against the big hospital institutions Psychiatrists questioned traditional treatments for mental illness, with the introduction of new psychotropic drugs also meant patients could be more easily treated outside of an institution.

Enoch, the former health minister was dubbed by some as the Father of Community Care; he argued that mental hospitals were effectively prisons, preventing the patients return to normal life. Powell also belief that community care would be cheaper than hospital care the new district general hospitals contributed to the reduction in the number of beds in mental hospitals from 150,000 in the mid-1950s to 80,000 by 1975.

The Mental Health Act 1983 set out the rights of people admitted to mental hospitals, the introduction of legislation would give the mentally ill more rights allowing them to appeal against committal.

In 1984 Sir Roy Griffiths led a government inquiry into community care, after the murder of social worker Isabel Schwarz she had been killed by her former client. In 1998 Sir Roy Griffiths report outlined the Community Care: Agenda for Action’ was the forerunner to the Community Care Act of 1990, major legislation which sets out the basis for community care as we know it today.

The government invested an extra ?510m in mental health services in England, Frank Dobson the then Health Secretary said the extra ?510m for NHS mental health services over the following 3 years would add to the ?180m announced for social services care of the mentally ill. This would include a revision of the controversial care in the community policy. He also told the House of Commons that mental illness was not “an obscure, minority concern”, but affected one in six people at any one time.

The ?700m will be broken down with at least ?500 million being ear-marked within for targeted change in the way services are delivered, around ?120 million will be spent on new and effective drug therapies and ?70m will go towards training mental health nurses and psychiatrists, and other care and clinical staff.

The government’s drive to Modernising Mental Health Services strategy document included a new national service framework it laid out guild lines on how they can best treat people and it clearly spelt out the range of services needed for the mentally ill.

The new strategy included: More mental health beds, more supported housing and hostels, More training for health workers, Improved services for adolescents and young people Access for the mentally ill to the NHS Direct helpline Access to new mental health drugs More day centres for the mentally ill and more outreach teams and a 24-hour crisis teams.

In the last five years mental health services in England is going through an unprecedented change. A Government programme has been launched to improve on the quality of mental health care, and improve the mental well-being of people in England; the policy has implementation guides and good practice examples.

New Horizons: a shared vision for mental health is a comprehensive initiative that will be delivered by ten national Government departments.

New Horizons forms an alliance of, local communities and individuals and the voluntary sector and professionals, to work towards a society that values mental well-being as much as physical health and it outlines the benefits of unlocking the benefits of well-being in terms of physical health, educational attainment, employment and reduced crime and in turn reducing the burden of mental illness.

Conclusion

As the population continues to age, it is becoming increasingly important to focus on policies and practices that support and enhance the wellbeing of the older population in later life. One sad reality for many seniors in later life and an increasing cause for concern is elder abuse. Elder abuse is one of the most disturbing and rapidly growing areas of crime throughout the global. It is extremely difficult to exactly quantify the extent of elder abuse because many such cases go undetected and under-reported.

The World Health Organization reported that it is generally agreed that abuse of older people is either an act of commission or of omission or neglect, and it may either be intentional or unintentional (Krug et al., 2002). It results in unnecessary suffering, injury, the loss of violation of human rights, and a decreased quality of life for the older person. Like any other form of domestic violence, abuse of the elderly initially remained as a private matter hidden from public view. It was initially seen as a social welfare issue and latter on a problem of ageing, but now has developed into a significant public health and criminal justice concern. The value of loving family institution has been tarnished by greed, position-struggle and impatience.

Despite elder abuse is not entirely a new issue; it is time to find out the prevention ways to be implemented and effective interventions to emerge. There are a few welfare needs that will be highlighted after so that the young generation have a strong sense of love and care towards the senior citizen.

Elderly

Nowadays, Malaysians are living longer; they are on an average of 74 years for men and 78 years for women. In others words, their life expectancy has increase. With the advances in medical care and better nutrition, older people are living longer, they are more visible, more active and more independent than ever before and they are in better health. Therefore there is a growing concern regarding the global phenomenon of aging. A decline in the birth as well as death rates has resulted in an increase in the elderly population. Given that the elderly population is on the rise, it is of paramount importance to examine the care of the older persons.

2005
(%)
2010
(%)

Total Population

26.75 m

28.96 m

65 and above

1.15 m

4.3%

1.36 m

4.7 %

This table shows that the total population and the aged of 65 years or above in Malaysia between the year of 2005 and 2010. In 2005, the total population of Malaysia was 26.75 million, and which 1.15 million or 4.3% was aged 65 years and above. Moreover, in 2010, Malaysia currently has a population of approximately 29 million, and aged 65 years and above has increased to 1.36 million or 4.7%. With the projected population growth of 2% annually, it expected that the total population in 2020 will rise to 34 million, of which 3.2 million or 9.5% will be the age of 65 years and above. In the year 2035, the country is expected to have a total population of about 46 million of which 6.9 million or 15% will be the aged 65 years and above. This is evident that Malaysia’s demographic ageing pattern is emerging. Based on the figure showed in this table, the real numbers of older person have increased lately, which also means that the number of elderly will continue to grow over the coming year. As the populations of older Malaysian grows, so there has a hidden problem of elder abuse. Further, the number of elderly with chronic illness is likely to increase. This can pose an increased burden on their caregivers such as family members, and it could lead to a higher risk of elderly abuse.

Elder abuse

Elder abuse is a single or repeated act or lack of appropriate action occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person (Action on Elder Abuse 1995). The “wilful infliction of injury, unreasonable confinement, intimidation or cruel punishment with resulting physical harm or pain or mental anguish, or the wilful deprivation by a caretaker of goods or services which are necessary to avoid physical harm, mental anguish or mental illness” (1985 Elder Abuse Prevention, Identification & Treatment Act). According to the Swanson (1999), elder abuse refers to the mistreatment of older people by those in a position of trust, power or responsibility for their care. This is a global problem that is likely to intensify in view of the increasing number of older people and the changing socio-economic and environmental conditions worldwide (Randel et al. 1999). Further, Hazzard (1995) described elder abuse as cruel and inhumane treatment of the elderly. Kapur (1997) defines it as a kind of harassment or an injustice done to the elderly by the family members themselves. In fact, there is too many definition of elder abuse but despite this, most would agree with this definition “an action or inaction by someone in a position of trust; often a family member or unrelated caregiver”. Normally, more than two-thirds of the abusers are their family members and are typically giving their basic needs or care support such as food, shelter, personal care or transportation. In others word, someone who commits elder abuse usually has control or influence over the older person. The older persons often know and trust the abusers. Some victims of elder abuse depend on the people who hurt them, sometimes for food, shelter, personal care, or transportation. Therefore, the abusers could be their family members, friend; someone the older people relies on for basic needs or staff in group residential settings such as care homes or in long term health care facilities.

The Prevalence of Elderly Abuse in Five Developed Countries
Country
Prevalence (%)

USA

3.2

Canada

4.0

Finland

5.4

Netherlands

5.6

United Kingdom

5.0

The accepted prevalence rates of abuse of older people are drawn from five community surveys carried out in developed countries, which are USA, Canada, Finland, Netherlands and United Kingdom. The prevalence of the elderly abuse in USA with percentage is 3.2%, in Canada is 4.0%, in Finland is 5.4%, in Netherlands is 5.6% and United Kingdom is 5.0%.

But in Malaysia, the information and data of elderly abuse is scarce. There are no reported cases of elder abuse to the Department of Social Welfare as well as no agency keeps proper records of the incidence of elder abuse in this country. Although this ‘epidemic’ is virtually unheard of in Malaysia, we are challenged to be aware of the many faces of elder abuse in our own society and this issue is much more common than societies admit.

Types of elder abuse

Elder abuse referred to an inappropriate action that causes harms or distress to an elderly which the older person has expectation trust onto the person. Elder abuse can take in several forms. Elder abuse may take form in physical, psychological, financial, sexual abuse, neglect and abandonment that cause distress to a person who is past retirement age.

Physical Abuse

Physical elder abuse is non-accidental use of force against an elderly person that results in physical pain, injuries, or impairment (Ellen, Tina, Jeanne, 2008). This abuse includes not only physical assaults such as hitting or shoving but the inappropriate use of drugs, restraints, or confinement. The physical acts of violence commonly include slapping, hitting, and striking with objects. Indicators of potential physical abuse are broken bones, sprains, or dislocations, unexplained signs of injury such as bruises, welts, or scars, especially if they appear symmetrically on two side of the body, signs of being restrained, such as rope marks on wrists (Elder Abuse.com, 2009). Diagnosis may be difficult even at autopsy as findings may be subtle and invariably some chronic or debilitating disease would be present. The case of an elderly lady from a nursing home referred to the police for suspected physical abuse. Investigations showed that osteomalacia and spontaneous fractures could have accounted for her injuries. However, recognition of physical abuse may not be straightforward, as injuries may be secondary to falls to which the frail elderly are more prone.

Emotional abuse

Emotional abuse is defined as the infliction of anguish, pain, or distress of elderly. Emotional abuse also referred as an act with the intention that causing emotional pain or injury which often accompanies physical abuse. This abuse may be happens in verbal or nonverbal acts. Verbal forms are included humiliation and ridicule, intimidation through yelling or threats and habitual blaming or scapegoating. Nonverbal emotional elder abuse can take the form of ignoring the elderly person, isolating an elder from friends or activities and terrorizing or menacing the elderly person (Ellen, Tina, Jeanne, 2008). Therefore, an elderly person who shows fear, passive, withdrawn, low self esteem, reluctance to talk openly, insomnia, fatigue and listlessness or behave mimics dementia, such as rocking, sucking, or mumbling to oneself may be abused in the form of emotional abuse.

Financial Abuse

Exploitation of the elderly is also considered as an abuse which includes acts of material or financial exploitation. Financial or material exploitation is defined as the illegal or improper use of an elder’s funds, property, or assets (Elder Abuse.com, 2009). Elder financial abuse is one of the most difficult types of elder abuse to recognize due to its lack of obvious symptoms. Some of these include misuse an elder’s personal checks, credit cards, or accounts, steal elder’s cash, income checks, or household goods. Most common example case is the announcements of a “prize” that the elderly person has won but they need to pay money to claim (Ellen, Tina, Jeanne, 2008). Besides that, theft of pension checks, threats to enforce the signing or changing of wills or other legal documents, and coercion involving any financial matters also consider as the example of the financial abuse. Indicators of potential financial abuse may include unusual bank account activity, sudden changes in the elder’s financial condition, or worsening medical conditions due to lack of follow up or unfilled drug prescriptions. Exploitation may also occur in the form of fraud schemes; someone may persuade the elderly person to withdraw their life savings in a “get rich quick” scheme, or ‘contractors’ convincing the elderly that the house needs repairs which in reality might be unnecessary. Financial abuse is one of the most difficult types of elder abuse to diagnose as the victim may not be aware of its occurrence or may not know how to seek help.

Abandonment and Neglect

Abandonment is defined as the desertion of an elderly person by an individual who had physical custody or otherwise had assumed responsibility for providing care for an elder. It also referred to the action of withdrawing a person or a thing entirely; putting aside all care for him or it. Neglect of the elderly is also a form of abuse and is often referred to the refusal or failure to fulfil any part of a person’s obligations or duties to an elder. This may be intentional or unintentional neglect. Active neglect is the intentional withholding of basic necessities or care, while passive neglect is not providing basic necessities and care because of a lack of experience, information or ability. Another area to consider is self-neglect where older adults, by choice or ignorance, live in ways that disregard health or safety needs, sometimes to the extent that the disregard also poses a hazard to others. For example, the caregiver may be unable to perform care giving duties such as bathing or changing an incontinent elderly person. Therefore, an elderly person with unusual poor hygiene, loss in weight, poor nutrition, skin breakdown, unsuitable clothing, unsafe and unclean living conditions such as no heat or running water, faulty electrical wiring, other fire hazards and smelling of urine may be neglected either intentionally or unintentionally.

Sexual Abuse

Sexual abuse is defined as non-consensual and unwilling sexual contact of any kind. This includes all unwanted sexual activity, such as verbal or suggestive behaviour, fondling, sexual intercourse or a lack of personal privacy. Besides that, activities such as showing an elderly person pornographic material, forcing the person to watch sex acts, or forcing the elder to undress are also considered sexual elder abuse. Indicators of potential physical abuse are unexplained venereal disease or genital infections, bruises around breasts or genitals, unexplained vaginal or anal bleeding and torn, stained, or bloody underclothing (Ellen, Tina, Jeanne, 2008). Sexual abuse usually implies a physical sexual relationship with an elderly person without that person’s informed consent, though this is not restricted to sexual intercourse but includes other forms of intimate sexual contact. It is often difficult to establish whether sexual abuse has occurred, unless the individual has cognitive impairment.

Signs and symptoms of elder abuse

Signs and symptoms of elder abuse should be taken seriously. It is vital that we are alert to the possible indicators of abuse. In assessing any situation, it is important to realize that an indicator may be present for reasons other than abuse or neglect. However, if a combination of the following indicators is present there is a need to further explore why those indicators are present. Increase awareness of abuse signs and symptoms as well as monitor the progress in suspected cases of abuse. Home care community nurses can play a critical role in detecting suspected cases of elder abuse. However, in Malaysia, we do not as yet have a health care system in place for such purposes, although these types of services are only now slowly emerging. Hence the only opportunity for detecting abuse is when the older adult visits a primary care setting or an emergency department.

Characteristics of the Abused Elder

Most victims of elder abuse are mentally competent and able to make decisions for them. Most of them able to taking care of their own health needs and do not need constant care. Although some victims of elder abuse are generally dependent on their abuser in some way, their dependency is not necessarily because they are mentally incapable or physically frail (Al Loney, 2006). However, if the older people who having mental or physical disability, they may be more vulnerable to be abused. Those at risk are most likely to be female, widowed, frail, cognitively impaired, and chronically ill. The older adults who poor in physical health, highly dependence on the abuser, functional or cognitive impairment and a living arrangement shared with the abuser are consider as risk factors for elder abuse. Normally, older women are more vulnerable to abuse than older men and are burdened with a lifetime of experiences and beliefs that may increase their susceptibility. In most instances, violence and abuse against older women can be sexual, physical or psychological and also can include material or financial abuse and neglect. It can occur in the home, in institutions or as a result of harmful cultural practices that specifically target older women (Breatheinspirit, 2006).

There are various studies have looked at factors associated with elder abuse. In the NEAIS report, females and those aged 80 and above were more likely to suffer abuse, family members were the most likely perpetrators and victims of self-neglect were usually depressed, confused or extremely frail. Other studies have similarly reported vulnerable elderly as those with physical and mental weaknesses, advanced age, women, those with previous abusive relationships in the family, financial strain and caregiver stress and burnt out.

Characteristics of the Abuser

The abuser is most likely the person with whom the elderly person stays with. More often, the abuser is a close relative; 80% being spouses and children of the victims, or a close relative. In some cases, elder abuse may be caused to abusers’ over use of drug or alcohol, history of anti-social behaviour, or mental illness problems. Abuse is more likely to happen when the abuser is going through a period of high stress. It may be the stress of looking after the older person due to old age is a time of weak health, low income, meaningless role, or the death of loved ones (Al Loney, 2006). These problems may be creating great unhappiness for older people and then damage the relationships with their family. In extreme cases, this may lead to abuse.

Elder abuse often happens because of the abuser’s power and fully control over an older person. Family members who depend on the elder for financial, housing, or other necessities have a higher risk of become an abuser. A caregiver’s inexperience, a history of family violence, economic dependence on the elder or a blaming personality and unrealistic expectations often contribute to elderly abuse. The abuser may be lack involved in community activities, social services, and even contact with other family members. Besides that, they may lack of family support, facing marital conflict, overcrowding and the high burden of care placed on the caregiver. In most of elder abuse cases, the abuser may not allow people to visit or talk to the older person alone.

On the other hands, staff in long-term care homes, such as homes for the aged and charitable institutions, might involved in abuse the older people in physically or mentally. Abusers are more likely to be staff members who are not able to do their jobs properly (Al Loney, 2006). This may due to poor of training, low salary, over-work without pay, or under-staffing. Besides that, it also could be the staffs have personal problems that influence their services to older people which under their care. But, there is no excuse for abuse. The personal circumstances or problems of the caregiver can’t be an excuse of elder abuse. These problems may be factors in the abuse, but they do not try to recognize it. It is unmoral because the older people are fully trusted and relies on the caregiver, but the caregiver misuse the trust of the older people to do something that threaten to the older people.

Common Reasons Elder Abuse Is Not Reported

The actual and prevalence of elder abuse is unknown and difficult to measure. Elderly abuse exists in our society but it is seldom reported, and perhaps even less so in an Asian society where filial piety and respect for the elderly is traditionally highly regarded. This problem often remains undetected because of poor public awareness and lack of knowledge among health care personnel. This is because it can cause some adverse effects on the health and quality of life of the elderly. Due to their mental capacity, they are unaware of the help available to them. Therefore, elder abuse is seldom reported. In most situations, elderly are unlikely to report that they are abused as they are fear of embarrassment and fear of losing care support. They are mostly completely under the control of the abuser and depend on the abusers for food, shelter, clothing and health care. Furthermore, they also fear of harm by the abuser. Some of them are lack of awareness; they are only suspect but uncertain that is abuse, therefore, the cases of elder abuse is hardly to report and also seldom reported.

Risk Factors for elder abuse

Abuse of older adults is such a complex issue with no single explanation. However, there are many factors seem to contribute to these critical issues and each case has its own unique mix of factors.

One of the most obvious factors is the family dynamics. The habits, values, emotional and coping skills are learned early in life and largely through family interaction. In other words, if unhealthy or violent behaviours go unchecked, abuse may continue when roles are reversed. Therefore, if a child who was previously abused becomes a primary caregiver, there is a probability that the cycle of abuse will continue and be inflicted on a dependent parent.

Besides that, inability to cope with stress especially for those non professional caregiver such as spouses, adult children, other relatives and friends find taking care of an elder would caused many responsibilities. This may be extremely stressful to cope with the demands of elder care giving. As a result, the stress of elder care can lead to mental and physical heaths problems that caused caregivers impatient, burned out, and sometimes are unable to keep from lashing out against elders in their care.

Next, problem of elderly abuse may also happen in the nursing home when the staffs who worked are those lacks of experience and training. This is because even caregivers in institutional settings can experience stress at levels that can lead to elder abuse. The nursing home staff may be prone to elder abuse if they lack training, have too many responsibilities and are unsuited to care giving, or they are work under poor conditions.

Social isolation can also conceal and perpetuate abuse or neglect. An older person may become isolated due to physical or mental illness, or through the loss of friends and family members. Therefore, isolation does not just conceal abuse and neglect; it perpetuates the problem. The result of this isolation can make it easier for an abuser to exploit, neglect or abuse an older person. There is a significantly higher risk for elder abuse if without a caring support network. In addition, if a caregiver imposes isolation to avoid uncovering the abuse, this is also a form of abuse.

In addition, sometimes caregivers who are unable to cope with the long term care giving may react to the stress of too many responsibilities in appropriate ways. These unusual releases way are such as abusing, neglecting the older adults in their care. Also, most of the caregiver’s perception is that taking care of the elder is burdensome and without psychological reward. Thus, many of them choose to neglect the older adults.

The society’s acceptance towards violence can also be a form of factors in contributing the elderly abuse. For example the Canadians see violence in the news, movie and television shows. This wide exposure often leads to a general acceptance or tolerance of violence as an acceptable way of venting frustration or anger. Thus, this tolerance creates an environment which can contribute to abuse and neglect of older adults.

The welfare needs of elderly

Welfare needs are necessary for elderly in order to stop the growing elder abuse issue. The government, law and legislation, mass media, school education, health care providers, family and also elderly have the responsibility to give support the rights of old persons.

The government

The National Service Program or Program Latihan Khidmat Negara (PLKN) was established since started in 2004 as a response to the Malaysian Government’s desire to inculcate the spirit of patriotism in the hearts and minds of Malaysian youths. Besides to develop the spirit of patriotism, it instils a spirit of caring and volunteerism among members of society as well as to develop positive characteristics among younger generation through good values. The three-month program is aimed at shaping young people into disciplined, independent and resilient citizens capable of advancing the nation.

From this programme, the young generations could learn how to respect the elderly.

Welfare pension should be introduced in Malaysia. If elderly do not have the ability to claim maintenance from their financially-able children, they have the pension as a security. It is seen as a way to eradicate poverty. The senior citizens are still able to take care of themselves in spite of they are abandoned by their merciless children.

Abuse prevention programme could be introduced by Malaysian government as well. Its purpose is to provide and arrange for services to protect adults who are unable to protect themselves from abuse and provide older adults with information about their rights. For example, Abuse Prevention Programme (APP) in Australia which supports older adults who are being abused, or who are at risk of being abused, by someone with whom they are in a relationship of trust, such as family and friends. APP advocates work in consultation with the older adult, either directly, or with someone else the older person has chosen (their representative). APP can assist them to identify and understand the issues related to abuse of their rights as well as discuss information about options which they can implement to assert their rights. Besides, it suggests action they can take to stop abuse of their rights and give them with appropriate advocacy support that enables them to have their rights met.

In addition, the government can launch adult day care programme, which it enables the caregivers to get time off during the day. Adult day care is a planned program of activities designed to promote well-being though social and health related services. Adult day care centres operate during daytime hours, Monday through Friday, in a safe, supportive, cheerful environment. It not just provides older persons an opportunity to get out of the house and receive both mental and social stimulation but also gives caregivers a much-needed break in which to attend to personal needs, or simply rest and relax.

Law and legislation

Malaysia law and legislation also play a vital role in overcoming the elderly abuse problem. Malaysia law can establish a legislative “Elder Protective Act” which is warranted to protect our vulnerable elderly from untold suffering. They have the right to live with dignity and security. For example in all 50 US states have specific adult protection legislation within which issues related to elder abuse and/or neglect are addressed. This legislation is influenced by child welfare models, and is characterised by legal powers of investigation, intervention and mandatory reporting. In the absence of federal mandates, states have been developing their own responses to adult abuse, neglect and exploitation. Legislative “Elder Protective Act” should be implemented by the government to safeguard the rights of our vulnerable elderly.

Suggestion has been made for the government of Malaysia to adopt a law which allowing the elderly parents to claim maintenance from their financially-able children. This can be learned from the country of Singapore where the Maintenance of Parents Act enables parents above 60 years old who cannot support themselves to seek legal action forcing their children to provide maintenance for them.

The government of Malaysia should also tighten the law and can used country of India as an example. In India, children could be imprisoned or fined or be subjected to both if they abandon their elderly parents. The Tamil Nadu government is set to notify rules for the Maintenance and Welfare of Parents and Senior Citizens Act, 2007, to help tribunals in each district decide on the order of maintenance for elderly citizens, who complain about being neglected by their children. Therefore, the government is committed to develop such services and formulate policies against elder abuse in Malaysia.

Malaysia, being one of a few countries that uphold Syariah Law has Islamic Law that governs the welfare of family matters including the ageing parents, following the case in which a couple sued their daughter for not providing sufficient maintenance as what they have agreed.

Elder abuse is a national problem with far reaching consequences for individuals, families, communities, and institutions. The state courts must play a critical role in addressing the needs of victims of elder abuse. The court’s ability to assist older persons essentially determines whether individuals live their remaining years with respect and dignity, or are further alienated from the justice system with personal safety.

Mass Media

Mass media also plays a quite significant role in minimizing the problem of elderly abuse in Malaysia. The media was often blamed as one of the sources of the negative images of older adults in society. It was seen as important to work with the media to change these negative images, to raise awareness and to educate the population about elder abuse. They are able to inspire the public to be aware of this social issue by utilizing mass media such as televisions, radio networks, internet, newspaper, magazines, etc.

Nevertheless the problem often remains undetected because of poor public awareness and lack of knowledge among healthcare personnel. Therefore, the print as well as electronic media are to play active roles to increase the society’s awareness of the elderly.

Media coverage of elder abuse cases can make the public knowledgeable about-and outraged against-abusive treatment in those settings. Due to most abuse occurs in the home by family members or caregivers, there needs to be a concerted effort to educate the public about the special needs and problems of the elderly and about the risk factors for abuse. Within mass media cultures, social issues such as elder abuse, have key reference points which can attract concentrated coverage of the topic and carry influential associations in public perceptions. For example, in USA, the Indochina Sino-American Community Centre formed a coalition called “Chinese Americans Restoring Elders”, they used mass media to encourage the public to contact the Community Centre for matters related to elder abuse; provided some individual counselling sessions; and conducted a press conference and distributed brochures and flyers in Chinatown to commemorate World Elder Abuse Awareness Day.

The television networks always played the advertisements that have the influence on the public over the caring of the elderly. Like the PESTRONAS during religious or cultural holidays (namely Aidilfitri, Chinese New Year, Deepavali) are often accompanied by touching advertisement that convey the message to show love and care to our parents.

School Education

Education is the cornerstone of preventing elder abuse. This education needs to start very early, in primary school.

The students need to be educated to perceive to older adults more favourably as positive contributors to society. The elderly do not necessary mean burden to the family or society. With their wealth of knowledge and experience, they can still contribute to economic development and wealth creation. They have contributed to the development of the nation in their earlier years and they can still continue to be productive in their golden years. The students should consider senior citizens are an important and integral part of our society.

Students need to understand the interpersonal dynamic of care-giving. For example, they need to be award of the value placed on the dependency and inter-dependency in care-giving; role reversals in care-giving; and how unresolved emotions between the elderly and the care-giver influence the care-giving process.

The school curriculum is to include education on the family to enable the younger generation to understand and appreciate the elderly. They need to be encouraged to form closer relationships with older adults. The general population also needs to be aware that elder abuse happens and is a problem. Students need to understand the subtle difference between abuse, neglect and abandonment theoretically as well as operationally. The moral education teachers not just teach theoretically but also operationally. What is more, the schools should organise a numbers of the activities like visiting old

The Case Study: The Webster Family, A Family In Crisis?

This assignment requires me to outline what model of assessment I will use when working with the Webster family. I will also give a description on how the family was referred to social services for a Section 47 (S47) investigation. There will be a strategy meeting and the details of this meeting will be outlined along with instructions given. There will be a case conference held to discuss whether the children are at risk of significant harm or the likelihood of significant harm. There will be a clear recommendation as to whether I will register these children on the child protection register, justifying my decision. Whilst working with the Webster family I will explain what legislation I used, my research into the theories involved and also I will provide details of any anti-oppressive practice and any anti-discriminatory practice whilst working with this family.

Ms Webster and Mr Webster have lived together for twelve years. They have three children, Faith and Hope who are twins and are aged ten and Charity who is seven years old. Charity has Cerebral palsy, is doubly incontinent and is a wheelchair user. Mrs Webster is a teacher and Mr Webster was a probation officer who up until twelve months ago worked full time. Following an accident a work he has taken early retirement on health grounds and is now employed full time as a househusband looking after the children. The family are not known to social services or any other welfare agencies. There have been many tensions building up within the family home since his accident and after a violent row Mr Webster left the family home.

After speaking to the headmaster it appeared there had been an incident of domestic violence in front of the children and staff.

Previous to this incident, the day before Charities class teacher had had reported to Mr Perry that over the last two weeks Charities appearance had deteriorated, her clothes were unclean and her nappies were soiled and Charity smelled of urine. Charity had also began being aggressive to her friends and to the staff. A staff member had also discovered pressure sores on Charity. When Charities teacher telephoned Ms Webster to tell of their concerns, Ms Webster was frosty in response.

After the incident outside the school Mr Webster explained that Ms Webster had attacked him on two other occasions and these incidents again where witness by the children. On both occasions the police were called, however Mr Webster was concerned about social services and did not press charges.

After the incident, later that afternoon The Education Welfare Officer (EWO) Ms Murray, went to visit Ms Webster at home but was refused entry. Ms Webster was verbally abusive. Ms Murray then tried to speak to Charity but she refused to talk to her. Ms Murray then went to visit Mr Webster where the twins were staying. The twins seemed fine but a little subdued. Mr Webster stated that he would be looking after the twins and he would like custody of all three children.

Following the visit a strategy meeting was formed. A strategy discussion will take place if there is reasonable cause to suspect that a child is suffering or is likely to suffer significant harm. This will involve The Local Authority Social Care, the Police and other bodies as appropriate for example, a headmaster or a teacher (Working Together to Safeguard Children, 2006). Present in the meeting was myself (duty care social worker), Ms Gold (my team manager), WPC Bond (family protection unit), Mr Perry (headmaster) and Ms Murray (EWO). A strategy discussion is to share information regarding the situation at hand and another aspect is to plan how the S47 enquiry, if there is to be one, should be carried out. We can also agree action is required immediately to safeguard and promote the welfare of the child. The Domestic Violence Unit reported they did not refer these incidents to Social Services as they did not see the children to be at any risk, however Working Together states that children may suffer directly and indirectly if they live in households where there is domestic violence and domestic violence is likely to have a damaging effect on the health and development of children. It is often appropriate for such children to be regarded as children in need S17.

Mckie (2005) makes some interesting observations on the terms ‘perpetrator’ and ‘victim’ in an analysis of domestic violence. The policies and practices connected with domestic violence become gendered in so far as women are conceptualized as those who should act. Mckie (2005).

Working Together also says that children who witness domestic violence have been shown to be at risk from behavioural, emotional, physical, cognitive functioning, attitude and long term developmental problems.

We do know that Charity has become aggressive and abusive.

After the strategy meeting and because of the concerns regarding Charity, It was agreed after a discussion with my team manager that I would visit Ms Webster to discuss the referral from school. From this I would then make an assessment as to whether the child/children are at risk of significant harm or the likelihood of significant harm. The overall decision was that a S47 enquiry should proceed with immediate effect.

Some children are in need because they are suffering or likely to suffer significant harm. Concerns about maltreatment may be a reason for a referral of a family to social services. In such circumstances, the Local Authority is obliged to consider initiating enquiries to find out what is happening to a child and whether action should be taken to protect a child. This is set out in Part V S47 of The Children Act 1989 (Protection of Children).

The Framework for the Assessment of Children In Need and Their Families (2000), section 1.28 states that the LA has a duty to respond to children in need to provide services to minimise the effects of disabilities, this applies to Charity. We also have to take steps to prevent neglect or ill treatment. There does appear to be in this, in relation to Charity’s case.

Section 17 of the Childrens Act says that services may be provided to assist a child in need. This would refer to Ms Webster if she is agreeable because the needs of parent carers are an integral part of an assessment because providing these services which meets the needs of the parents is often the most effective means of promoting the welfare of children, particularly disabled children. My role now is to recommend which route we proceed down.

When I went to visit Ms Webster, She was hostile towards me. Ms Webster said she had never been violent to her husband before and denied the incident outside school. Ms Webster claimed she had no problems looking after her children but showed a negative attitude towards Charity. She spoke about Charity as if she was not there and referred to Charity as “she” instead of by her name. Ms Webster said Charity was hard work and was always soiling her nappies, shouting and crying. Ms Webster seemed angry as she was explaining this. Whilst we were talking, Charity did not say anything but looked as if she wanted to cry. Charity’s appearance was unclean and she smelled of urine. Ms Webster was clearly upset about her husbands’ sexuality, more than for the safety of her children. When entering Charity’s bedroom which Ms Webster had reluctantly agreed to, I found bed clothes stained with urine and stools. The en-suite and bath were both unclean. The rest of the home however was clean and tidy. I spoke to Ms Webster about my concerns and told her that she would be entitled to help if she would accept it. This empowered Ms Webster and allowed her to feel there was help if she wanted it and she was not alone. Ms Webster did say that she thought Charity may have been affected by witnessing the recent arguments and she would make sure Charity was not further stressed that day. It was discussed that Charity had pressure sores; from this Ms Webster became ‘frosty’. Reluctantly she agreed to take Charity to see her doctor and I arranged to visit the next day.

The following day on the 20th January 2008 I visited Ms Webster, but there was no answer. When I tried to telephone her there was still no answer. As a result from this, there were concerns regarding the domestic violence and the condition of Charity and it was decided that a Child Protection Case Conference was to go ahead.

I will explain this model of assessment I used in this case before I go on to the case conference. The model of assessment used is The Framework for The Assessment of Children In Need and Their Families (DOH 2000) more commonly known as the assessment framework. The assessment framework will be integrated into the revised Working Together to Safeguard Children. A key principle of this framework is that it is child-centred; this means that the child is seen and kept in focus throughout the assessment. The child or children are my main priority as a child social worker. It is also rooted in child development which includes recognition of the significance of timing in a childs life. Calder, M and Hackett, S (2003).

This particular assessment model is dynamic, fluid and continuous, this helps the intervention because as changes occur in a person’s life, it can adapt to the changes and my care plan can also be adaptable. A criticism of this model is the timescales can force social workers towards a procedural model whereas the Exchange Model offers an empowering dialogue with parents.

Smale et al (2000) identify a weakness in this model in that this approach may not work if the service user is not engaging in the process or are unable to articulate themselves. It also denies that workers have a professional responsibility and can be time consuming, which may create difficulties given the time constraints of The Assessment Framework. It also overlooks the need to adopt a procedural approach given the various questionnaires/scales utilised.

Changes have appeared to have happened over the last two weeks for Ms Webster and her family. Domestic violence, with both parties blaming each other and the deteriation of Charity’s appearance and her temper towards others. This leads me onto another concept of my assessment, which is parenting capacity. This is done using the assessment triangle, which includes child developmental needs, family and environmental factors. The DOH dimensions of parenting capacity has six core dimensions of parenting capacity, three of these provisions suggest that Charity is not receiving emotional warmth, Charity’s needs for secure, stable and an affectionate relationship, appropriate physical contact to provide comfort and warmth and stability of attachments and basic care to provide food, drink, warmth, appropriate clothing and personal hygiene. Ms Webster’s capacity concerns me because of her response to Charity and her circumstances involving her cleanliness and her appearance, the way she speaks about Charity, whilst Charity can hear her mother, and her reaction to use support and accept help and the relationship between Ms Webster and Charity.

Children’s chances of receiving optimal outcomes will depend on their parent’s capacities to respond appropriately to their needs at different stages of their lives Calder, M and Hacket, S, (2003).

Some of the above factors are included in the integrated model for assessing parenting capacity. The parenting style I would suggest of Ms Webster is neglectful parenting as she is neither responsive nor demanding of Charity. Ms Webster lacks the monitoring and the supervision duties surrounding Charity at the moment.

Neglect is the persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development. Working Together To Safeguard Children (1999).

From my assessment I would put forward in my opinion and recommend that Charity to be put on the child protection register S47 but not her two twin sisters, but would offer support under S17. This is because of the declining condition of Charity’s physical condition and appearance, due to her persistent soiled nappies, the urine smell on Charity, her dirty clothes, her pressure sores and her aggressive nature toward others. Charity has suffered some the physical neglect of because of the delay of being taken to a doctor by her mother. Charity also suffered abuse due to witnessing the domestic violence and therefore there is a h3 possibility of emotional abuse.

Research shows that ‘prolonged and/or regular exposure to domestic violence can have a serious impact on the child and/or children’s development and emotional wellbeing and can lead to serious anxiety and distress and in some cases the repetition of violent behaviour. Department of Health (2006).

All these factors could lead to significant harm. These are the categories for registration. The twins will not be registered as they are not in any immediate danger as they are both cared for by their father and his partner at the moment, a police check has been carried out and neither is known, the EWO has no concerns regarding the twins. However this situation needs to be monitored and regularly reviewed to safeguard the children as this situation may change. My reasons for recommending registration are the three incidents of domestic violence over the last three months, one known to have been witnesses by the children. Ms Webster’s reaction outside school when she was verbally abusive, erratic and aggressive. There are neglect issues. We also need to take account of Charities additional needs.

A definition of disability is children and their families whose main need for services arises out of the children’s disabilities or intrinsic condition (DOH 2000). This applies to Charity as she falls within the category and she has a medically diagnosed condition, which is Cerebral Palsy.

Both parents are blaming each other for the domestic violence issues. There are concerns by school staff regarding Charity’s decline in appearance and her aggression. There is also the issue of family attachments which I noted earlier in parenting capacity.

After making a recommendation to register Charity an Initial Child Protection Case Conference was set for 28th January 2008. Ms Webster was informed of the decision by telephone and I arranged with her to visit and give her a copy of the notes before the meeting, this will empower Ms Webster and give her some idea of what will happen. I will also keep the family fully informed throughout, invite parents to meetings and explain procedures in an open and honest way. But I will ensure the parents are fully aware of my concerns regarding the risks towards Charity.

The function of a case conference is to bring together the child (where appropriate), family members and those professionals most involved with the child and family, following a S47 enquiry. One purpose of this is to decide what future action is required to safeguard and promote the welfare of the child and how action will be taken and what the intended outcomes are. The core group members are I, Ms Webster, Mr Webster, Ms Gold (team manager), WPC Bond (family protection unit), Mr Perry (head teacher) and Ms Murray (EWO). All the above people involved will all play a part in monitoring and safeguarding the surrounding concerns for Charity. During the case conference I will be looking at recommending the following care plan:

Behavioural support, some schools have these implemented by way of school mentor, this could help Charity with her aggression.

Anger management counselling for Ms Webster due to the domestic violence issues.

Family Resource Centre for Ms Webster and Charity, this could help them both have contact with other families experiencing similar issues.

Counselling for mum due to loss and separation and the children.

Counselling for Charity to give her a chance to talk to someone about her experiences and how she feels.

Charity spending quality time with her father and sisters.

With the care plan identified, this can only go ahead if Ms Webster will give her consent as she has parental responsibility.

The legislation I have used is Childrens Act 1989/2004 with S47-Duty to asses risk and S17-Duty to assess need. I have also used Working Together to Safeguard Children, this sets out clear guidelines for multi-agency working to protect children from abuse and neglect, this was needed in relation to Charity.

I will now move on to theories and research. Neglect can have major long term effects on all aspects of a childs health, development and well-being. Maltreatment is likely to have a deeper on the childs self image and self esteem. Difficulties may lead on into adulthood and the experience of long term abuse could lead to difficulties in forming or maintaining close relationships, one of the skills needed to be an effective parent (DOH 2000). DOH 2000 also says that the child could have feelings of isolation and the feeling of being unloved. Stress could affect the parents’ capacity to respond to their childs needs. This relates to this case as Ms Webster is very stresses since her husband left her for another man. In relation to physical abuse and Charity witnessing this, this could be the reason as to why Charity is showing aggression towards people. Physical abuse has been linked to aggressive behaviour in children, emotional and behavioural problems (Working Together).

Further research that relates to the case is the Attachment Theory because of Charity’s relationship with her mum and vice versa. Bowlby believed that the primary caregiver is the mother. He said that children deprived of maternal care would nearly always be affected in some way. Bowlby (1953). However Ainsworth identified three types of attachment, securely attached, insecurely attached (avoidant) and securely attached (ambivalent). As its core, attachment theory is about the way that childhood needs are met and the long term effects of needs being met or otherwise. Ainsworth (1970). In my opinion I would say Charity is negatively attached. A criticism of Bowlby is that he says that the mother has to be the primary caregiver; this is open to much subjection. Children can have attachment figures other than them receiving it from their mother. In some cultures the childcare is shared, not only by mothers but by fathers, grandparents, aunts, uncles and friends Beckett, C, (2002). Another criticism is that it is sexist, it tends to lead to maternal deprivation rather than paternal deprivation, it excuses absent fathers from any imitation of parenting skills. It ignores gender bias and how family make ups can change. This is significant in this case as Mr Webster left the family home. Theory on domestic violence is gendered natured in that, it ignores the facts that female to male violence is increasing. This is significant in this case because Mr Webster had suffered domestic violence issues with his wife. Charity also witnessed domestic violence. Helping victims and children to get protection from violence, by providing relevant practical and other assistance is one of the considerations to include when involved in a child protection case (Working Together pg 2004).

There are contradictions within the legislative framework. The Children Act 1989 contravenes the Human Rights Act because S8 of the Human Rights act states that in absolute certainty children should not be removed from their family and the Children Act defines harm but not significant harm. The Framework for the Assessment of Children in Need and their Families is not without contradiction. The Joseph Rowntree Foundation 1999, points out that it would be helpful to strengthen the assessment framework by stating that the responsibility of the local authority is not only to promote and safeguard the welfare of the child but also the rights of the child.

Throughout my work I will continue to reflect on my practice and how my own values and assumptions may unconsciously affect my decisions.

This essay will look at the ethical considerations present for a social manager faced with budgeting decisions. This essay will consider evidence on social care management priorities and ethics as well as any available guidance on budgetary decision-making in order to complete the assignment. Theoretical perspectives on social care priorities will be examined to see if these provide any additional insight into making difficult decisions about priorities of care. The practice context will be considered in order to see if there may be other previously ignored factors at work here.

The case study is about a social care manager who is faced with having to reduce their service’s spending. Budgeting options may include the rationing of care, the priority of preventative services, the assessment of needs to determine resource allocation and other possibilities. The manager must take ethical considerations into account when making their decision as well as theoretical perspectives and practical realities.

A consideration of ethical factors is a wide-ranging remit including the consideration of all factors that have some moral bearing on the situation. In the case of social care, this is likely to be almost any aspect of the services as much of the service’s activities affect the wellbeing of vulnerable people: this is the reason for the services in the first place. Anything that does not have a direct impact on service users is likely to affect the work conditions of staff or the economic cost of the service to the taxpayer. So ethical considerations in this context are really the moral factors to consider in any change of social care services.

When looking at changes to budgets and cutting, the social care manager is relatively limited in the scope of what they may be able to do. Guidelines about which groups can be considered to be the most vulnerable and about priorities and responsibilities for services are centrally devised. Basic standards are set and money provided in the expectation that certain provisions will be made. In order to avoid ‘postcode lotteries’, the government makes quite a lot of aspects of care services centrally proscribed. However, there are within this many aspects of local decision-making such as the categorisation of care needs, which is one way local authorities may adjust their definitions in order to manage their costs. The day-to-day running of services and the potential for efficiencies in this area is also in the hands of the local authority, as is the pooling of resources with other services and the training and support of staff.

Much of what the social care manager will have to do in order tackle budgetary changes is an assessment of the priorities of their local service and an analysis of how the current reality of service meets these priorities. It is considered to be common sense that when resources are scarce (money, time or physical and organisational resources) then they should be used in order to do as much good as possible (Williams, 1998). This is the ages old motto of housekeeping and the modus operandi of many public services in times of lean.

Before making decisions about budget changes, the social care manager must make an assessment of the service’s priorities, which will include the health and wellbeing of services users. Yet it is appropriate to question whether the social care manager has the moral authority to make decisions about the best interests of service users and the right to decide what is in the best interests of other people (Seedhouse, 1989). They are likely to assume that health is a good thing and that the promotion of health is also a good thing. However, even such a basic concept as this cannot be assumed in the case of other individuals who may have competing rationales. For example, this becomes a particularly difficult question when working with older people, who may for example prefer to retain their independence at a lower level of health than experience higher levels of physical health but lose the ability to care for themselves in their own home.

Rationing is an emotive term, and describes the inability to give all things to all people all the time and so the need for decision-making about where to focus resources. Most often in social care services, rationing comes about as a consequence of a financial limitation, but there may also be rationing as a result of staff shortages or a lack of other resource such as cars for home visits. Rationing may often be described as “priority setting”, “resource allocation” or other similar euphemisms, particularly by those who seek to limit the blow of its reality (New, 1996).

Theoretical frameworks

Many of the decisions that a manager needs to take can be considered ethical decisions. Improving efficiency can be seen as an ethical decision taken in the interests of the society as a whole, applying service objectives universally and fairly can be seen as an ethically justified decision, and a consideration of the relative benefits of different groups from services is an ethically justifiable process as long as it is undertaken to ensure the most ethical distribution of resources (New, 1996).

Many managers would adopt management theoretical techniques to enable them to develop an overview of the context in which their decisions must be made and to better prepare them for reporting and justifying their budget decisions. Theoretical perspectives can enable a more objective view of the context and the tools to make cooler and more balanced assessment of the decision to be made. Examples of frameworks include a SWOT analysis of the service’s strengths, weaknesses, opportunities and threats that allows a strategy for improvements or changes to be developed (Gill, 2006). A SWOT assessment may help the manager in their assessment of how to balance budget changes with the maintenance or even the improvement of standards. Identification of the strengths and weaknesses of a service may allow a focus to be given to the thrifty improvement of weaknesses while maintaining the strengths of the social care provision.

Individuals can be seen to be under obligation to provide certain healthcare steps in order to reduce their burden on others and are morally obliged to make certain, usually public health, decisions in order to ensure their minimal use of resources. The most common example given is that of vaccination, where herd immunity for all can be obtained once individual levels of protection exceed a certain point. The obligation could also apply to the economic costs to society as a whole of poor health and so the requirement to maintain a good level of health, or to retain personal independence for as long as possible as a way of reducing dependence upon others. There may therefore be wider ethical considerations for the prioritising of certain types of care over others, particularly where difficult questions arise of which individuals have made the most effort to reduce their burden to society as a whole and whether they should be somehow rewarded (Dawson, 2007). Many would argue that it is not the place of the social care manager to make such moral judgements and that any such decisions can only be made with the backing of society as a whole through political mandate.

Priority setting is one of the most preoccupying roles of management (Dracopoulou, 1998) and this decision about priorities is usually taken with the assumption that all service users will be treated equally in terms of the assessment of their financial and care needs. It is important when a manager is setting priorities for services that this is done with the input of those whose professional responsibilities lie with the best interests of the service user. There should be no moral gulf between practitioner and manager. If there is, this implies either a misunderstanding of the objectives of the service by the manager or a failure to consider the best interests of the service user by the management. An assessment of priorities must take into account the reality that changes to the balance of costs spent on one aspect of services also imply the sacrifices that will be made by other potential service users whose needs were then either not treated, not treated for free, or not treated in the same way (Williams, 1998).

Effective decisions will often rely on the application of evidence-based knowledge in order to conclude. For example, the provision of effective treatments relies on an independent and reliable assessment of their relative efficacy in order to make cost-benefit assessments and decisions. Much of this work, particularly for the clinical aspects of care, is carried out by the National Institute for Health and Clinical Excellence (Nice) who use scientific evidence in order to make judgements about the value of a particular therapy or treatment. To a large extent, the existence of a national body such as Nice allows the problem of a postcode lottery to be overcome and assists managers in managing their scarce resources better. However, there maybe instances where the evidence is inadequate for the types of decisions being made when the manager will not have the assistance of a Nice guideline in making the best decision, such as where the process of decision-making itself may be important in terms of encouraging and developing user involvement in care, autonomy and self-sufficiency (Hunter and Marks, 2002).

There are standard measurements of priorities, particularly those related to clinical activities, which have been developed in order to assist with the kind of decision-making being indicated here. For example, QALYs (Quality Adjusted Life Years) are used in order to measure the benefits of health care against a scale of cost. These scales may seem stark to the casual observer: “For the purpose of priority setting in health care, being dead is regarded as of zero value” (Williams 1998, p21). Other, less nuanced, measures include survival rates and illness incidence rates as well as service user satisfaction measures.

Decisions such as this have been criticised as really a kind of paternalism. Some have said that health policy must always be considered from the perspectives of power as well as processes (Walt, 1994). Regarding power balances enables a proper consideration of the influence of government and other institutions over the lives of individuals and a conscious assessment of whether such power is justified in particular instances and always in the best interests of the service user.

Some have sought to tie down all the ethical factors a manager must take into account when making health or social care decisions. Seedhouse’s Ethical Grid (see fig 1) is one such example. This diagram displays the layers of ethical factors that may be taken into account. The blue layer describes the purposes of health care, the red layer looks at duties and motives, the green layer is consequences and priorities of proposed outcomes, while the black layer is the external environment and practical considerations. Such a model may be helpful to a social care manger in order to help them order priorities and ensure that all factors have been taken into consideration.

Fig 1: The Ethical Grid (Seedhouse, 1989, p209).

The subject of rationing of services is probably the most emotive part of a manager’s decision-making role and there has been and continues to be huge debate about this issue. One of the main contentions of the debate is whether care can and should be explicitly rationed, or whether decision-makers must come to the best professional decisions they can without expecting or even seeking consensus or approval at a societal level. Hunter (1997), for example, believes that even if explicit rationing delivering public and stakeholder consensus were desireable, it would not be realistic to implement because of the inevitable lack of consensus and frustration of service users are being unable to impose their view on the services they are being offered and were told they had a voice within. Many have sought to set the priorities for rationing in a clear way, but the conclusion of most is that while a system of principles may help to guide the professional, decisions can only really be made on a case-by-case basis, for whoever the care worker is making the decision: the time poor practitioner, the cash-strapped manager or the capacity-scarce administrator (Klein et al, 1996).

Many believe rationing in public sector services such as health and social care is inevitable and that the decisions of the manager are constant and integral to budget management rather than exceptional and significant in relation to cost savings (New, 1996).

Practice context

In a practice context, the most important thing in an assessment of the distribution of resources and the management of costs is that the decision-maker should have a clear understanding of the objectives of the service and so the criteria relating to these objectives (New, 1996). Many see it as a relatively easy task for the well informed public sector manger to ration the service they provide, because of the close central control operated by government and the routine focus on a multitude of factors aside from profits. These decisions and the implementation of them are a different matter when the inputs of private sector organisations must also be taken into account and the demands of customers satisfied or risk loss of loyalty (Payne, 2000).

In a practice context, there are ways in which money can be prioritised in order to have least impact on services for users. For example, the reduction of waste is the first, most efficient, effective and least painful step towards working within a budget set centrally rather than according to profit margins (Dracopoulou, 1998). Waste reduction would be for example the cessation of a treatment that is not effective. In practice, however, there are unlikely to be enough areas of waste reduction to be made in order to cover a significant budget shortfall, and inevitably the manager will have to look at service reductions, which are in practice usually closely related to management priorities. These priorities may include preventative working, personalisation and multi-professional working.

Preventative working, which may include practices such as the support of older people to enable them to continue living in their own home, are an important aspect of managing care budgets in the longer term. The effective addressing of preventative working such as support for independent living requires a multi-disciplinary approach with the same goal in its sights (Dawson and Verweij, 2007). Multi-disciplinary working may in itself also save money and there have been suggestions that the poling of budgets between services, such as the NHS and social care agencies, can help to release savings and ensure better coordination of care (DH, 1998).

Previous research has found that some counter-intuitive methods of practice can be the most beneficial for patients, such as teaching them coping skills, health education and stress management upon diagnosis which has been seen to lower the incidences of depression, fatigue and confusion in cancer patients as well as to increase the vigour of the individuals and may even have an impact on their demonstrable health and survival (Buckley, 2002). New research such as this must be welcome to the social care manager attempting to balance improvements in care quality with reductions in cost.

Personalisation of care and the focus on the individual which is now such an important part of the working of care services (DH, 2006) may become more of a challenge when looking at budget restrictions and wanting to be fair. Health care practice encompasses ideas of the empowerment of individuals to control their own destiny, as a healthy life may include all kinds of medically sub-standard conditions, such as ageing and death (Illich, 1975). The important thing is how the individual adapts to changing environments and not how ‘healthy’ they are objectively assessed to be. This awareness that health and wellbeing may not be the same for all individuals and that many individuals want to have control over the priority setting of their own health care has been a huge cultural change that is still ongoing in health and social care services. The Department of Health has said that the providers of services are now less important in the consideration of care than the user, and that the quality of services from a user’s perspective and the levels of independence that they are able to maintain should be a primary indicator of the success of caring services (DH, 1998).

If it becomes impossible for the social care manager to reduce spending in a way that does not seriously impact on the welfare of individuals or on the equity of services, there may be other factors they can consider in order to manage budgets. The most likely but perhaps least palatable of these is a reassessment of the sources of funding for services. By taking a look at the potential opportunities for changing the balance of contributions made by service users at various levels of need and wealth, the manager may be able to demand more contributions and so better balance their budgets (Care Quality Commission, 2010; Bryans, 2005). There are minimum standards set, such as the level of free care set at an asset level of around ?23,000 or less, but most other rationing decisions are left to the discretion of the local authority provider.

Conclusion

In the field of social care, ethical decisions must influence all management decisions. In our specific example of the need to reduce service spending, it has been seen that almost any decision made in this regard could be observed to be a value judgement or a moral or morally condemnable decision.

Budgets are a constant battle for health care managers, even when cuts are not being demanded. This is because there are constantly rising levels of expectation and significant increases in the user population, eg because of changing societal demographics (Bryans, 2005). Decisions on the rationing of care, changes to focus on preventative methods and alterations to patterns of contributions from service users are very unlikely to reach unanimity, both among society and even among different professionals. This reality should be known and accepted, and the decision-maker therefore empowered to make whichever fully informed decision they believe to be best (New, 1996).

While lists of service priorities are a useful tool for social care managers, the most beneficial next step for research is likely to be a better assessment of the cost-efficacy of personalised services and the best ways to approach the delivery of messages about preventative behaviours and the moral burden upon each individual to carry them out.

In the context of Shona and her family, this assignment will firstly review the powers and orders necessary to bring the children to be looked after by the local authority along with the governing principles. It will then discuss relevant areas for review and the required order to ensure good care for the children, including how and when these should be reviewed. Finally, looking at the significance to the case study of s17 of Children Act, 1989 along with considering the different services presented to each sibling whilst in care.

Police Powers

Shona’s case is discovered by police officers under-taking ordinary duties when social services departments and the courts are closed (Masson, 2001). CA, 1989 s46(1) gives the police power, without going to court, to remove or detain children for 72 hours if they have reasonable cause to believe that the children are likely to suffer significant harm (Brammer, 2010; Powell, 2001).

Social Service Managers recognise the value of s46 as an emergency intervention but have criticised its excessive use as a result of police anxiety (Masson, 2001). The principle is that courts should make a decision to remove children wherever possible; therefore, s46 is to be used in exceptional circumstances. The local authority should have in place with the Clerks to the Justices an out of hours Emergency Protection Order (EPO) application process (HO Circular, 2008).

Emergency Protection Order

EPO is a short-term emergency measure, lasting up to 8 days with a possible extension of a further 7 days, whilst the local authority under CA, 1989 s47 investigates the children’s welfare. S44(1) of the act outlines the grounds for applications for an EPO of which there are two forms (‘any person’ and ‘likely to suffer significant harm’). The local authority’s application for Shona and her siblings is on the grounds that they are likely to suffer significant harm due to domestic violence. Although the court may agree that there are grounds for an EPO, it still needs to apply the principles contained in Part 1 of the act.

Principles governing the decision-making
Welfare Principle

CA, 1989 s1 states that, “the child’s welfare shall be the court’s paramount consideration”. The meaning of s1 has been closely examined and criticised due to its wide range of interpretations (Brammer, 2010; Brayne and Carr, 2010). “Decisions based on the welfare of the child are ultimately value judgements” (Ryan, 1998: 8) Therefore, a checklist was added to maintain consistency and provide clear understanding (Ryan, 1998 and Brammer, 2010). For an EPO the court must consider the welfare principle but it does not have to consider the checklist (Brayne and Carr, 2010).

Non-Delay Principle

CA, 1989 s1(2), supported by European Court of Human Rights article 6(1), emphasises that any delay in court proceedings is potentially harmful to the welfare of the child (Brayne and Carr, 2010), therefore, the court needs to have regard to the non-delay principle.

The Public Law Outline (PLO), 2008 attempted to address case management and avoid delays in court proceedings by setting a timetable. Masson argues that “Legislating against delay did not change working practices; adult parties continue to create advantageous delay” (2010; 55).

No-order Principle

CA, 1989 s1(5) directs courts to make no order, even if the harm threshold condition is satisfied, unless it considers that making an order would be better for the child than making no order at all (known as the ‘no-order’ principle). The principle recognises the need for proportionality with three foundational aims: 1) “discourage unnecessary court orders”, 2) “to ensure that the order is granted only where it is likely positively to improve the child’s welfare” and 3) discourage the making of unnecessary applications (DCSF, 2008: 7).

If government guidance ‘discourages unnecessary applications’, this may account for research findings showing a general misunderstanding of this principle amongst local authorities who interpret it to mean that cases should not be taken to court unless it is totally necessary. The recent increase in court applications may demonstrate that the principle is not preventing Social Workers from carrying out their duties (DCSF, 2008; Brayne and Carr, 2010). The majority of court proceedings have resulted in orders being granted, therefore Mason argues, “Neither the public nor the courts themselves have accepted the ‘no order’ principle” (2010, 57).

Areas Needing to be looked at:
Threshold Question

As Shona has been in care for approximately three years, the local authority would have applied for a court order. This cannot be obtained without meeting the threshold criteria of CA, 1989 s31: identifying significant harm, cause for the harm and no order principle (Ryan, 1998; DOH, 1999). Significant harm has to be found to exist before the court will intervene in family life, however, as the term is not defined it causes considerable problems of interpretation. The Adoption and Children Act, 2002 s120 broadened harm to include witnessing or hearing it, which would be relevant in the case of Shona (Brammer, 2010).

Assessment

The children would be assessed under the child protection structure due to the physical abuse Liam endured and his sisters witnessed. This structure has evolved through a series of reports and government circulars. In 2008, the Children Act Guidance Volume One was revised and issued under s7 of the Local Authority Social Service Act, 1970 which provided clarity for what should be completed before making an order application (Brayne and Carr, 2010). Working Together to Safeguard Children, 2010 provides interagency guidance on assessment and investigation. The Framework for the Assessment of Children in Need and Their Families, 2000 provided, under one structured system, a “holistic assessment” and planning tool for all children in need (Thomas, 2005: 83).

Using the framework, the local authority, through the core assessment process, will need to consider both the children’s and parent’s needs along with those in the wider family and community, to reach a decision that an order is necessary to safeguard their welfare. The local authority would also need to seek legal advice and communicate to the parents their concerns (DCSF, 2008).

Care Plan

ACA, 2002 amended s31 of the CA, 1989 so that an order cannot be made until the court has considered a care plan (Brammer, 2010). A separate plan would be required for Shona, Liam and Siobhan so the court can consider their individual needs. The plans should be based on findings from the initial and core assessments with the structure, as guided by Local Authority Circular 99(29), 1999, being: 1) overall aim, 2) child’s needs, 3) views of others, 4) detail on placement and 5) local authority management. The court’s decision on the no-order principle will take into account the care plan for verification as to how the order would be applied (DOH, 2000).

What Orders May Have Been Necessary
Care Order

In having met the threshold criteria, completed assessment and care plan the local authority under s31 would apply for a care order for the children. A care order, rather than a supervision order, involves the children being removed from their home and provides the local authority with shared parental responsibility for the children alongside the parents (Brayne and Carr, 2010).

Reviews by Local Authority

Upon granting an order, the court has no influence in the plan being carried out (Brammer, 2010). ACA, 2002 amended s25(a) CA, 1989 by requiring an Independent Review Officer (IRO) to be appointed to “chair all review meetings of looked after children, ensure the child is involved in the review and will challenge poor practice, and any drift in implementing the Care Plan” (HMG, 2003: 45). If the plan is not implemented the IRO can pass the case to CAFCASS who can now return it to court (Brammer, 2010).

CA, 1989 s26 makes it a legal requirement for local authorities to regularly review the children’s care plans. Reviews “ensure that it [plan] is being effectively implemented and to make any changes that have become necessary” (Thomas, 2005: 76). All involved in the care of the children, including the child, should be involved in the review. The minimum requirements which reflect the no-delay principle, are set out in the Review of Children’s Cases Regulations 1991, amended in 2004. The first review should be held within four weeks of the children becoming looked after, followed by a further review at three months later and then six monthly (Brammer, 2010; Ryan, 1998).

Relevance of s17 to case study
Views of Parents

Under s17 of CA, 1989, the local authority has a general duty to promote the upbringing of children in need by their families and with article 8 of the Human Rights Act, 1989; they would need to justify any interference in family life. Working Together, 2010 re-emphasized the commitment of partnership with parents in making plans for the welfare and protection of their children. There are a number of ways the local authority can work in partnership with Shona’s parents; through consultation, taking into consideration their views, attendance at case conferences and being notified of any public proceedings (Brayne and Carr, 2010).

CA 1989, s17 also makes clear that the first priority is to promote and safeguard the children’s welfare and then try to keep them within their family (Brayne and Carr, 2010). Provided that the welfare and safety of the children is paramount then potentially there should be no conflict between the principles of family support and child protection (Parton, 1997). However, research has shown that full partnership is difficult to reach when risks are high and families disagree with the perceived risks (Bell, 1999). The recent case of Baby Peter has highlighted the importance of Shona’s Social Worker having the skill to recognize when partnership with the parents is failing to protect them (Brayne and Carr, 2010). The father’s violence towards the children could be a reason to exclude him from any conferences but his wishes can be obtained by other means (DCSF, 2010). It is also important to recognise that the children’s views and wishes may be different to their parents.

Child’s wishes

The Children Act, 2004 s53 amended s17 of CA, 1989 making it a requirement that before deciding what services should be provided the children’s wishes should be obtained and given consideration (DCSF, 2010). CA, 1989 s22 by mentioning the child before the parents suggests that the child’s wishes are to be the first consideration (Brayne and Carr, 2010).

The law has also been criticised for assuming that it is possible to know objectively what is in a child’s best interest but instead should give the children themselves a role in determining what happens (Thomas, 2005). However, the emphasis of listening to the child’s wishes has recently been criticised as it undermines the courts authority to make a best interest decision (Times, 2010). “Laws, policies and procedures continue to reflect he tension between these twin goals of safeguarding children and advocating their rights” (Adams, 2009; 304). To ensure that the child’s interests, wishes and rights are upheld in court, CA, 1989 s41(1) contains the duty, if required, for a Children’s Guardian to be appointed from CAFCASS (Brayne and Carr, 2010).

Placement Details

The local authority whilst taking into consideration the views of the children and parents, will have regards for s17 when considering placements for the children. The CA, 1989 s44(a) was amended by the Family Law Act, 1996 giving “power to include exclusion requirement in emergency protection order”. This could have been an option looked at in the case of Shona with the father being excluded from the family home (Brayne and Carr, 2010). Consideration of family members and friends as potential carers for Shona and her siblings should be explored and clearly demonstrated in their care plans before making a court order application (DCSF, 2008). S23(7) CA, 1989 promotes contact between parents and children with local authority, as is reasonably practicable, providing accommodation near to the family home and keeping siblings together. Under schedule 2 of CA, 1989 there are powers given to the local authority to assist in maintaining links between children and their family (Brayne and Carr, 2010).

Options Available to each child
Family Group Conference

There are several methods for compiling the children’s care plans, with one such option being Family Group Conference (FGC) (Thomas, 2005). FGC has been described as a, “realistic methods for merging the needs and interests of children and families and the protection concerns of public child welfare agencies, the courts, and the community” (Chandler and Giovannucci, 2004: 217). Although there is no factual data, reviews of FGCs have implied that it is not a suitable option for domestic violence cases due to the welfare of the child. However, in the case of Shona, FGC may have been a viable option when initially becoming children cared for to help explore the welfare concerns, deciding what services are necessary and to take into consideration the children and parents views when considering permanency so to prevent the children becoming entrenched in the care system (Chandler and Giovannucci, 2004).

Accommodation

The local authority has a power under s20 CA, 1989 to provide accommodation to the three children (Ryan, 1998). From initially coming into care (the sisters going to foster care and Liam to residential care) up until their current situation (Shona and Siobhan different wishes to return home) decisions on the provision of accommodation have been paramount with the options to be explored being: kinship, foster care, residential, reunification, adoption and independence. ACA, 2002 provides guidance on the “timescales for decisions about adoption” with permanence, including adoption, needing to be considered at the second care plan review (Brayne and Carr, 2010: 378).

Education / Crime

Due to the highly publicised statistics of children in care’s educational underachievement, crime rates and employability, the recent government has made a number of changes to legislation. Under s20 of the Children and Young Persons Act, 2008 all three children will have (had) “a designated member of staff” at their school “responsibility for promoting the educational achievement”. The local authority under s22 should provide for under 25 year olds “assistance to pursue education or training” which is relevant to Liam and Shona’s current situation (Brammer, 2010: 356). Although the agenda for change is not without criticism, “Its policy recommendations are framed within a social investment approach which values education as the route out of exclusion and into employability” (Williams, 2004; 423).

Schedule 2(7) of CA, 1989 puts an onus on the local authority to “take reasonable steps designed to reduce the need to bring criminal proceedings against such children” (Brammer, 2010: 369). Therefore the Youth Offending Team (YOT) could be a service considered for Liam. Adams argues that the number of detained children is high in the UK with, “policy and practice regarding children and young people who have committed offences remain stubbornly resistant to welfare principles” (2009; 318).

Legal Requirements

In 2003 the government published Every Child Matters (ECM) which introduced five outcomes for service providers to make arrangements to improve the well being of children: “being healthy, staying safe, enjoying and achieving, making a positive contribution and economic wellbeing” (2003:6-7). CA, 2004 was passed to provide a statutory framework for applying ECM with the five outcomes included in s10(2) of the act (Brayne and Carr, 2010). The act also introduced the requirement for working together of statutory departments and other relevant bodies for achieving the five outcomes (Brammer, 2010). In theory this provides Shona, Liam and Siobham with greater opportunity for services from public, private and voluntary sectors, however, this legislative change did not come with an increase in budget (Williams, 2004). The responsibility of the local authority to provide services to the children is outlined in schedule 2 of CA, 1989. The wording is moderated for example ‘reasonable steps’ or ‘consider appropriate’, therefore the local authority can prioritise services based on what is available rather than having to meet every need (Brammer, 2010). When more than one agency is involved in the children’s care a lead professional will be appointed to “be responsible for ensuring a coherent package of services to meet the individual child’s needs” (HMG, 2003: 9).

Conclusion

In the situation of Shona and her family, this assignment has highlighted the current social and political thinking towards safeguarding children with the balance in the CA, 1989 between welfare and children’s wishes; the emphasis on partnership with parents; the importance of accountability through reviews and the value placed on children remaining with their families. The five outcomes for children in care provide a framework for the provision of services, however, the limitation in budgets does not support the political agenda.