Author: Andre Coleman

This paper looks at the various theories that explain social interactions within the society, such as the gaze model. Other theories are the social model, the medical model and the stigma theory. These theories provide guidance into understanding the various interactions between the disabled and normal individuals within the community.

Another name for the Down syndrome phenomenon is trisomy 21. This condition occurs when there is an extra copy of chromosome number 21 in the body system of an individual. Shildrick (2009) denotes that this condition causes a change in the body make of a child, and this leads to facial disfigurement. This article takes a closer look at the impact of the Down syndrome phenomenon. It analyzes the issues that affect the social construction of people with disabilities, and in this case, children with the Down syndrome phenomenon.

This paper analyzes a variety of theoretical frameworks that explain the behavior of people in regard to the disabled. It synthesis these theories, into various ideologies of inclusion, and helps in answering the question on whether children whose face are disfigured due to the Down syndrome condition are included in the affairs of the society. This paper defines, and critically examines issues surrounding the social constructions of the disabled. Amongst the issues identified are, social identity, facial disfigurement, disability and the notion of the Down syndrome.

DePoy et al (2011) denotes that facial disfigurement occurs when the face of a child takes another form, which is against the normal. It changes the appearance of a person, and the condition has a direct influence on an individual’s perception in the society. Social identity refers to the attitude, or perception that a group in the society, views another person or themselves. Social identity emanates from an individual self-conception. DePoy et al further denotes that this perception of self, results to an individual placing him or herself to a specific social group (2011). John Turner and Henri Tajfel developed the theory of social identity, and they did this after studying the behavior of the society towards the disabled people (Tajfel, 1982).

The theory denotes that social identity is a process that provides guidance on how people behave, within a group or in relation to others. Frances (2004) observes that people within a social group interact by looking at their status in the society. Frances further denotes that the rich tend to interact with the rich, and the disabled tend to interact with the disabled (2004). Their condition in the society gives them the legitimacy to belong to a particular group. According to the social identity theory, the social environment forces the disabled to withdraw from the various social activities within the community (Frances, 2004).

This is because of stigma and discrimination. For instance, children with facial disfigurements will be unable to engage effectively with their peers, either in games or classes. DePoy et al (2011) observes that this is because of the various social groups formed within the society, and these children are unable to fit amongst them.

Selikowitz (1997) denotes that disability arises out of the emotional, physical or mental impairment of an individual’s body condition. Facial disfigurement amongst children with the Down syndrome phenomenon is an example of a physical disability. Selikowitz further denotes that Down syndrome is the main cause of disability amongst children (1997). Pueschel (2006) observes that during the 20th century, children with the element of the Down syndrome were housed in special institutions, and special houses. This is because of the various discriminative policies followed by the government or the society. This had an impact on their exclusion in the society. This changed in the 1960s with the emergence of the Civil rights movements, whose purpose was to advocate for the rights of children with the Down syndrome condition.

To rectify this problem in United States of America, Kathryn McGee formed the National Association of Down Syndrome (Marini et al, 2012). The main goal of the institution was to advocate for the various rights of children with the Down syndrome problem, and ensure their inclusion in the society (Marini et al, 2012). The formation of these associations is an element of the social model theory.

The theory denotes that problems that arise out of the disability of an individual are created by the society. The society is characterized by the presence of social groups, which enhance the notion of self-identity. To help disfigured children, it is essential to use social mechanisms such as peer groups, and civil associations to advocate for the rights of the disabled. The surrounding community must initiate environmental procedures that will protect children suffering from the Down syndrome condition.

This will ensure their participation in all events of their social lives, minimizing the rate of stigma and discrimination that these children suffer from. This theory makes it possible for a change in the perception of the society towards these children. These changes occur in the cultural beliefs, and ideological perceptions. Davis (2006) denotes that the theory recognizes the specific rights of disabled children, and advocates for various measures that will ensure these children are well protected, and included within the society.

Lansdown (1997) denotes that the social model theory advocates for the abolishment of negative stereotyping. It does this through lobbying and holding sensitization conferences to educate people on the various misconceptions about the disabled children. By doing this, they aim to influence their inclusion in the various social affairs of the community. However, medical model theorists argue that disability arises out of the medical malfunctioning of an individual’s body. To these theorists, the facial disfigurement of a child is a medical problem, and it requires a medical solution.

The medical theorists advocate for surgery, and psychological treatment to improve the facial conditions of these children. The theory lobby’s for a health care policy that will address issues that arise because of problems faced by children whose faces are disfigured due to the Down syndrome condition (Marinelli et al, 1991). A good example of such a policy is the American College of Obstetrician and Gynecologists guidance on the procedures of screening pregnant women. This is to identify whether the children they carry will suffer from the Down syndrome condition.

According to this model, for children with abnormal facial characteristics to participate effectively in the social environment, they must undergo surgery. This will correct their facial defects. Mojo et al, (2010) denotes that surgery plays an important role in reducing the facial features of a child with the Down syndrome condition. He further denotes that this leads to a reduction in discrimination, and social stigma because their faces are corrected to the normal (Mojo et al, 2010). The use of plastic surgery to correct the facial condition of disabled children is controversial. The European Down Syndrome society advocates against its use. According to the society, children with the Down syndrome condition must find acceptance in the society despite their abnormality. In as much as surgery is important, it is essential to enact social policies that will make these children gain acceptance in the society. This is because not every people can afford to the high costs associated with surgery.

On this note, it is a moral responsibility for the society to implement measures that will lead to the inclusion of the disabled in the society. This includes enacting policies that will ensure they get better and quality education that compare to their peers. The policies should create special sports and recreational facilities whose main objective is to enable these children to participate in the various social activities of the society.

The European Down syndrome society denotes that through surgery, the medical institutions accelerate discrimination and the stigma that these children suffer from. Bluhm et al (2009) denotes that these children will became aware of their medical problems, and this will result to their withdrawal from the community. On this note, instead of accelerating the inclusion of these people into the society, surgery has made them to suffer exclusion. Stigma is an issue that arises in this article. Stigma is a disapproval or discontentment of an individual by observing the various characteristics upon the person that makes them different from other members of the society. Stigma emanates from the opinions of other people towards people with disability, and these opinions can either be right or wrong.

By critically analyzing the medical model, children with facial disfigurement suffer from stigma. Rennie (2001) denotes that this is the reason as to why the medical model advocates for surgery, in order to correct their facial conditions. Correcting their conditions will make them integrate within the community, and rectify their low self-esteem. They will manage to involve themselves in various social activities, and these results to their inclusion in the society. According to Erving Goffman, stigma is a behavior and reaction of people, towards another person who does not possess the same identity as theirs. Erving Goffman denotes that there are three different kinds of social stigma, and he names them as (Tremain, 2005);

Deviation that occurs due to an individual’s behavior, such as alcohol addiction and drug use.

Stigma arising from negative ethnicity, and stereotyping. This may either emanate from religion, and or cultural influences.

Stigma may arise out of medical conditions that cause external deformations. In this category are people suffering from the Down syndrome phenomenon.

Due to stigma, children suffering from the Down syndrome phenomenon are unable to interact freely within the society. This is because of the facial disfigurements, which cause their peers to view them as outsiders.

Due to stigma, the notion of negative labeling arises. It creates a sense of us vs. them; as a result, these children cannot fully interact within the society. Their condition makes it impossible for the society to fully accept them, and include them in all aspects of their affairs. These activities can either be social, political, religious or even economic. Tremain (2005) denotes that the gaze theory depicts these children as either worthy or unworthy of societal support.

These supports may take the form of home care treatments, special privileges such as the enactment of affirmative actions in employment and school facilities, etc. The gaze theory measures the ability of children with facial disfigurements by their level of interaction in the society (Tremain, 2005). After measuring the abilities of individuals with the Down syndrome problem, the gaze theory then offers a solution to their problems. This solution is based on the acceptance of a disabled person that he or she is unable to survive without the assistance of the community (Mojo et al, 2010).

Tremain (2005) observes that when a disabled person insists on his ability to conduct his own affairs, the society leaves him alone. Tremain further denotes that these people will struggle to get the services they are entitled to, because of discrimination and stigma arising out of their refusal to give some of their rights for purposes of gaining acceptance (2005). Bluhm et al denotes that this situation leads to the exclusion of the concerned disabled person in the social affairs of the community (2009). Gaze theory can also refer to the manner in which an individual looks at images of a person, in a visual medium, and thereafter make a comparison to the same individual on a visual text. Under the gaze theory, there are social codes that regulate the way in which a person ought to look like (Bluhm et al, 2009).

These codes are strictly regulated by culture. For instance, if a person avoids another person’s gaze, it might reflect a sign of nervousness, fear or lack of confidence. Children whose faces are disfigured cannot properly maintain a gaze (Bluhm et al, 2009). The society looks at them as weaklings, and individuals who lack self-esteem and confidence. Basing on this, they are unable to interact fully within a society, and this affects their inclusion in the affairs of the society.

Despite these challenges faced by people with the Down syndrome condition, there are a number of renowned persons who have defied stigma, and discrimination to make it in the society. Most of them are in the media, and particularly in the movie industry. An example is Andrea Friedman and Paula Sage. Paula Sage is a Scottish actress who won fame for her role in the movie After life. She won the BAFTA awards, as the best female actress of the season 2003 (Kulesz, 2011). She also won the title of the best actress in 2004 during the Bratislava International film festival. Andrea Friedman is also an actress, and has starred in movies such as Life Goes On; and the television series known as Family Guy.

In 1996, Stephen Ginnz was the first actor with a Down syndrome problem to lead a motion picture production. As a result of this, Stephen Ginnz won numerous awards, among them includes, the Wasserman award for the best cinematography, the Warner Bros picture best film award, and the Martin Scorsese best film award. Stephen won all this awards in 1996 (Kulesz, 2011). Another actor is Tommy Jessop, who starred in the BBC drama known as Coming Down the Mountain. In 2008, Tommy won the Radar people of the year, human rights media award. He has also appeared in Holby city, Casualty, Doctors and Monroe. All this are British television series programs. In 2010, Tommy starred in the BBC television program, the Stone. Another notable figure is Pablo Pineda. He is a Spanish actor, who starred in the film, Yo Tambien (Kulesz, 2011). In the film, he takes the role of a university graduate, with the Down syndrome condition. Due to his role in the film, Pineda won the 2009 Silver Shell award. These actors won these awards because of the recognition of their talents by their various viewers. This recognition denotes no matter how disable a person is, with talent, and hard work, he will gain acceptance within the society.

To conclude on this paper, children with the Down syndrome condition face a lot of stigma and discrimination in the societal set up. Their peers view them as outsiders, as a result of this; they are unable to effectively participate in the various activities that their fellow children engage in. This leads to an element of exclusion, and not inclusion. Things are changing in the current century. Movements such as the European Down Syndrome association have emerged, and their main objective is to sensitize people on the various misconceptions they have regarding children with the Down syndrome phenomenon.

PERSONAL REFLECTION ON DISABILITY THAT ARIZES FROM THE DOWN SYNDROME CONDITION:

The notion that people who are disable cannot make it in society is false. These people are human beings, and need to live a normal life, just like normal people, who do not possess any form of malfunctioning in their body system. To help this people lead a normal life, it is important for the government and the society to work hand in hand in ensuring that the disabled manage to acquire social services, such as education, health services, etc.

It is the discriminative tendencies, and the stigma that the society faces that make these children to feel as if they are no longer needed in the society. It is important for the government to enact policies that are effective in tackling the mentioned problems. On this note, to help these children feel as if they are part of the society, the government and all social groups in the community must work hand in hand for purposes of making life better for these children.

Domestic Violence is a widespread problem both internationally and nationally (Tjaden and Tjaden, 2000; WHO, 2000; 2002). In the United Kingdom alone it has been reported that one in four women have experienced domestic abuse, at some point in their lives (BMA 1998; Bacchus et al. 2002 and BCS 2006). These statistics found do not represent the true context of the problem encountered by many professionals who may be in contact with these individuals and families. It has been widely reported that with this being a sensitive topic and the nature of the subject, it has been under reported and therefore not truly representative of how serious the problem is (REF).

To define what domestic violence is it may be helpful to understand what kind of behaviours it may entail. The Home Office’s definition of domestic violence is; ‘Any incident of threatening behaviour, violence or abuse (psychological, physical, sexual, financial or emotional) between adults who are or have been intimate partners or family members, regardless of gender or sexuality.’

The issue of domestic violence has no boundaries in regards to gender, age, sexuality, ethnicity, disability or socio economic status. Having said this, it has to be acknowledged that indeed some research does suggest equal prevalence of both male and female perpetrated violence (Straus et al. 1980; Mirrless-Black, 1999 and Morse, 1995). Research has suggested this has failed to account for other kinds of abuse and focused largely on physical assaults. A large error in such studies is in their use of self-completion questionnaires. The use of this tool has been criticised for the heavy emphasis on physical acts that have been taken out of context (Yllo, 1988; Dobash and Dobash, 1992). Thus between acts of self-defence or attack, there is no discrimination nor in the level of impact of the abuse or violence encountered. Mirrlees-Black (1999) however has recognised that the initial findings of her study that showed similar rates for men and women as victims of a violent relationship may not mean that men are equally victimised in the same manner as women. After close examination she found that men interpreted and managed their experiences in a different way to women. In fact men were considerably less frightened, much less injured, and least likely to seek professional help. There are cases of domestic abuse present in same sex relationships, or women as the aggressor towards men but historically, numerically and geographically the most occurring pattern is one of men and their violence towards women (Dobash and Dobash, 1992; and Mullender, 1996). Research has also found that for women the impact of domestic abuse is greater emotionally, psychologically as well as physically (Walby and Allen, 2004; Watson and Parsons, 2005; Women’s Aid and the Women Abuse Studies Unit, London 2001). In addition it has also found steadily that as many as one in three women will experience domestic violence at some point in their lives (McGibbon et al. 1988; Mooney, 1994; Dominy and Radford, 1996).

The presence of children in a household has also shown an association with twice the risk of domestic violence for women (Walby and Allen, 2004). In this sense children cannot help but be affected by their experiences of abuse. Hence, while the focus of study and understanding has mostly been achieved in eliciting women and their views, of shelter workers and of other professionals, it has also pursued a line of investigation directly into children’s experience of contact to domestic violence (Buckley, Whelan and Holt, 2006; Hague and Mullender, 2006; Mullender et al., 2002 and McGee, 2000). A substantial amount of literature in this area exists which concentrates on the effects on children (Hague and Mullender, 2006; Hazen et al. 2006). Edleson (1999) has in fact found more than eighty studies in this area.

Childhood is regarded as an important and significant period in anyone’s lifetime. It is a time that should be guarded. Development and learning during this period should be nurtured and supported in the given environment. If the environment is tainted by fear and violence, the act itself of growing up becomes an arduous task. Osofsky (1995) found that exposure to violence can lead to reverting back to childhood, also known as ‘regressive’ symptoms such as bedwetting, delayed language development and anxiousness over separation from parents. Other researchers have also found links between domestic violence within a household and children having learning and behavioural problems which can affect their health, emotional and behavioural well-being (Wolfe et al. 1988 and Margolin, 1998).

It is important to iterate that no researchers in this area have stated that domestic violence causes these maladaptive behaviours. Often where domestic violence occurs, other social problems have been known to also exist. Devaney (2008) found that domestic violence was present when parental substance and alcohol misuse also existed. As you can see this starts to formulate a slightly less straight-forward area of research where many complexities are involved; though serves to highlight other risk factors which may be helpful to look at.

Research in the area has also indicated that there are links between domestic violence and child abuse. Bancroft and Miller (2002) have found that there is a greater chance of a child experiencing physical or sexual abuse whilst living in a household where domestic violence occurs. Indication of how grave the issue is can be seen in a study by Walby (2004) who found that in 40% of child abuse cases there was also co-occurrence of domestic violence. This is further supported by Hester et al. (1998) who suggested that domestic violence is contributory factor in half of all serious case reviews and 75% for those cases placed on the child protection register. This raises domestic violence as a child protection concern in the field of social work and thus has serious implications for practice.

The high prevalence of domestic violence in child protection cases is not reflected in the same way in terms of health care professionals who have discovered a much lower proportion of domestic violence (Naumann et al. 1999; Mooney, 1993). The low rate of detection by professionals can perhaps be attributable to many factors. So far enquiry in this area has suggested that the level of knowledge a practitioner may hold with regards to domestic violence and abuse may be a crucial factor. Peckover (2003) goes further to highlight that professional’s improper attitudes alongside a general absence of understanding and training regarding domestic violence may also explain the low statistics in uncovering abuse. This highlights a significant gap in an area where research and early intervention should be at its most robust. This could be explained that perhaps there is no infallible distinction or separation in both policy and practice of child abuse from woman abuse (Humphreys and Mullender, YEAR).

A reason why the issue exists in such a context i.e. Children’s services, it may be that there is less emphasis on the use of monitoring domestic violence and is not seen as a child protection concern. The services that are available to children living with domestic violence are based on the presumption that is the women’s responsibility to protect the child from experiencing harm, which characteristically involves forcing the partner to leave or leaving the household with her children herself. This also signifies the narrow understanding of domestic violence in a multi-professional manner but also its response to it. Lack of early intervention and strategies in place to identify children who may be at a risk of harm may also lead to increased social exclusion and increased financial strain on the state (REF).

By addressing such themes in the literature review I will aim to demonstrate how the relationship between domestic violence and abuse is such that, where one is existing enquiries should consistently be made about the other. This will help to form safer, more sensitive assessments and well placed interventions.

In light of research shown it may raises questions as to how far the impact of domestic violence is on children who are exposed to it, what possible interventions exist for such a large social problem.

Methodology – I will use to address the problem

Whilst it has been acknowledged that a fully systematic review cannot be undertaken due to the time constraints of my MSc course I intend to use a systematic approach when reviewing literature.

I will use a literature review to highlight key themes and issues brought to light by using a systematic approach when conducting and forming my search. I have also recognised that a non-systematic approach can lead to misleading conclusions in research which is not accurately verified. In addition a non-systematic review does not undertake critique of the literature which is needed to form a balanced judgement. Whereas a systematic approach will facilitate my research question/ rationale with a well-focused searching strategy to enhance appraisal and fusion of the literature I will be researching.

However, I have realised that whilst a literature review is less time consuming and the least expensive research method. There are advantages and disadvantages to this. The benefit to employing this method is that it will allow me to be rigorous when synthesising relevant data found, and examine the evidence found. Though the weakness is that it will be not me conducting primary research which would be more beneficial to make the social science discipline more evidence based.

In conducting a search so far I have already recognised the implications in using the terms domestic abuse, domestic violence and intimate partner violence. I have so far found that some of these terms only take into account certain aspects such as physical assaults. Therefore I will continue to use these terms when searching for relevant literature as it is used quite inter-changeably.

To help find literature that addresses the research question I will intend to use established search engines and databases such as Google Scholar; DISCOVER; PsychInfo; and CINAHL. These databases will mostly be used to search for primary sources of research conducted. In addition Dawson Era the online university library will also be utilised for secondary sources such as books and other texts.

Through this I will aim to discuss possible themes that have impacted children’s development in relation to domestic abuse and the risk factors associated. I will also aim to look at intervention strategies in place that recognise domestic violence as a co-occurring factor to potential child protection and safeguarding aspects of social work practice.

To exactly utilise a systematic approach when conducting a literature review it may be important to have an inclusion and exclusion criteria to help in analysing relevant data. For inclusion I will keep a time frame in mind that is in line with current policy and research. As it is only as recent as the last three decades that children and young people have been directly investigated and researched when concerned with the impact of violence to them. Therefore, I have decided to limit data found in the past two decades to address the question.

Therefore in light of research found in this area, it has raised key research questions. The question I have decided to focus my review on which is; what are the impacts of domestic violence on children and what are the implications of this for social work practice.

Expected contribution to knowledge

I will aim to further analyse my findings by utilising theories useful to underpin data found. Theories which I will use will be the Crisis intervention theory, Maslow and his hierarchy of needs, and person-centred theory. These will help to identify further recommendations that could help child care services to better meet the needs of children affected by domestic violence.

To keep from going off topic, I will aim to meet with my dissertation supervisor on a regular basis to uncover and discuss issues in more detail with work presented.

Residential services for people with disabilities are a nationwide and found all over Ireland and abroad. The Health Information and Quality Authority understands the significance “of increasing the quality and safety of care and support for people with disabilities” (www.hiqa.ie) in residential care. HIQA is informed by the Health Act 2007; it was set up to provide the registration and inspections of “designated centres” (www.hiqa.ie) and ensures that standards and policies are complying with the Health Act 2007. They promise that each service will provide a safe, efficient and supportive care to people with disabilities.

This essay aims to critically review the residential services available for people with disabilities in Ireland and abroad. It will look at how these services are delivered, what these services promise to provide, if they are implementing what they have promised and the standards of the service. It will also explain what residential care is and what the residential services used to be like in the past and how people with disabilities were treated.

Residential care for people with disabilities is a service to provide a safe and caring environment for both adults and children who are unable to live at home. According to the Health Service Executive or the HSE residential care “aims to meet in a planned way the physical, educational, emotional, spiritual, health and social needs” of each person (http://www.hse.ie).

Unfortunately it was not always like this, in the past people with disabilities were often sent into residential institutions and treated with abuse. They were not cared for and because very institutionalised as they were often made do the same thing day in and day out, they had no rights and were not allowed make any decisions for themselves (http://www.community-living.info).

There are many different residential settings, as I said above back in the past many residential services were institutions or asylums based care, however as the country has developed most have been changed to homes that are based within the communities, this is where between 3-5 service users live within a home with staff members how care for them when needed. These are better suited as it allows a better quality of life for each service user and gives them a sense of community and of home and most importantly it allows the service user have independence in their own lives.

Residential services for people with disabilities are there to help support people with disabilities in Ireland. Residential services in Ireland are expected to provide people with disabilities with a good quality of life, safety, to uphold rights, to be anti-discrimination, provide support the person to live a life as an equal, enable community integration and to give a responsive service (www.hiqa.ie).

Quality of life is a key element when providing residential services, making sure that people with disabilities have their privacy and dignity are maintained and respected, that they feel their residential service is home, they are not excluded from been given opportunities or been part of the community and that they are supported by staff and that their needs are provided. Equally important is ensuring that each person with a disability in the service has a sense of safety, that they do not receive any mistreatment such as abuse, bullying or neglect. They also need to be reassured that they will not be subjected to favouritism or personalised criticism (www.hiqa.ie).

These areas are both very important and it vital they be included in residential service practice as ensuring that people who have a disability know they are equals and that they will not be treated with insult and that their dignity will be maintained will take away the feeling of being vulnerable to each service user.

Another point stated about is that residential services are to ensure that a person with a disability has all their rights maintained and that they will be treated as equals. They have promised that each person will have the same rights in making decisions and choices about the service they receive such as if they wish to leave the service and live independently the residential service promises to support the person’s right to this. Following this the residential services in Ireland promise to ensure that no person is exposed to discrimination and that the same service and rights is given to each service users and that if discrimination arises they support the person by advocacy (www.hiqa.ie).

Additionally, having these points included in residential care services is significant as we must remember some if the services users are away from home and need to be assured that they will not be harmed and will be supported in all of their decisions. To not have these included would mean that many service users would be open to maltreatment and discrimination which is not a fair way to live.

The Health Information and Quality Authority also informs us that residential services are they not only provide people with disabilities with a good quality of life and upheld rights but they also promote person-centeredness which is a concept that the service builds their particular service to an individual which centres around their characteristics (www.hiqa.ie). They also encourage each service user to be involved in the community and to have their own social network. Finally, they state that the residential services are to be managed in a way that each service user will have good experiences.

Guaranteeing that each service user has a voice if not their own but given to them to ensure they can have the same rights and opportunities as every other person in the country and within the service is also important to have contained within the residential services. Furthermore, not excluding people with disabilities from society is a positive standard which works as it will encourage changes in attitudes in communities.

This next section of the essay will focus on the standards that Irish residential service are to follow, these are also used when looking at the various centres to see if they are meeting these standards or not.

Furthermore, these expectations are part of the development of standards for residential services, they also impact the way a service is delivered. The Health Information and Quality Authority have set up some standards that each centre and service use to inform their practice. These standards consist of seven sections which are quality of life, staffing, protection, governance and management, the physical environment, rights and health and development.

Each section adds up to 19 standards; they are developed with the help of those that work in the sector as well as families and people with disability. Each section is important, as I have already discussed quality of life I will give an example of the Staffing standard. This standard explains how each service user needs members of staff that are qualified, have experience are competent to achieve the goals they wish too with the support from these staff members (www.hiqa.ie). Another vitally important standard is under the heading Protection, this discusses how both staff and service users are safeguarded from mistreatment this includes finances.

Following on from this we need to see if the residential services in Ireland do their job and if they provide the service they are suggesting they do. The one thing that makes these effective are that the HIQA establishes that inspections will be regularly to ensure they each service and its staff are applying these correctly. This makes certain that the safety and precise care are provided to each service user. However one subject that could be added is, it does not state how often and extensive these inspections will be.

After reading through these standards, they are very clear and easy to understand. They are appropriate guidelines for workers to use to ensure the best care for their clients. They seem to cover most areas of care and various situations that may arise such as discrimination. It explains who the Health Information and Quality Authority are and what Acts they were guided under. The aims of what the Health Information and Quality Authority were clearly stated and it also included what their responsibilities are.

The section set out under complies of whether the various services and centres in Ireland follow these standards and if they provide what they have said they do. It will focus on one service in Ireland called Brothers of Charity.

To get a better understanding of how they are implemented and if they work we can apply it to a services like the Brothers of Charity. Brother of Charity state in their mission statement that they “value the uniqueness, and respect the rights of each person in our community” (Brothers of Charity 2012). They are known for been one of the most respected organisations for working with adults and children with disabilities. This services aims are similar to that of the standards in the Health Information and Quality Authority. This is a positive thing as it shows they have the intention to comply with these standards and to follow the Health Act 2007.

Brothers of Charity manages each of their centres and provides each service user with appropriate care while maintaining each individuals dignity, they manage each client well and have the correct documentations and professionalism when working with both clients and other staff members. They create a safe, healthy, caring environment through-out the service centres.

Subsequently, this section will compare the Irish residential services to those in Europe. It will focus on the differences between them and the similarities. It will also discuss the various changes and the reasons behind them.

Comparing the Health Information and Quality Authority to other residential services outside of Ireland, other countries focus more on having people within residential care be more interactive in their daily living as well as being more involved within the community. The reason for this is because in the past many people with disabilities were not respected in residential services and were mistreated.

The final section will look at how the service to best practice in social care and also concentrates on how the service contributes to professionalism.

Having reviewed the residential service in Ireland I have learnt some key elements of social care. There are many practice methods that social care practitioners use when working within residential services for people with disabilities. There are various approaches that social care practitioner’s use however one in particular that work best for residential care are person-centred practice.

Person-centred practice is an approach that allows a service user to be involved in their own care i.e. “treatment and care provision by health providers that place the person at the centre of their own care and considers the needs of the person as carer” (Lane, R 2012) It works best with residential services as it has a positive outlook on people with disabilities, it also works with the service user to develop goals that both service users and key-worker share, it is an empowering practice as it gets the person with a disability involved with their agencies and the wider community.

Additionally, it involves the family as well which is important in residential service as many of the service users miss family members therefore having them involved helps with this. It also is set within the standards of the Health Information and Quality Authority which implies they also agree it is the best practice. We see through the standards how they include this mention several times to respect the service user’s ideas, choices and needs. Person-centred practice also is about getting the service user involved in the community; this is also expressed several times in the standards.

Furthermore, P.O.Ms which stands for Personal Outcome Measures, this offers “people an opportunity to define their own quality of life outcomes and exert choice and self-determination” (Lane, R 2012). This has a beneficial effect on the service user involved, similarly to person-centred practice is focuses on the person, however the difference is when the program is being reviewed it is the service users critique that is taken into account. Likewise it is all about supporting the client and ensuring the quality of life of the client is defined by them and only them (Lane, R 2012).

This is a suitable practice for a residential services it benefits both the service users and the service, this is because of the feedback given from the service users which ensure that the service delivers a better quality of service and that the service users receive a high quality of service (Lane, R 2012). It also informs staff how best to support each individual service user. Moreover, it forms a better relationship between service user and staff member as it involved the key member to learn and listen more attentively to the needs of the service user.

Finally, by placing policies within the residential services for recruitment to ensure that each staff member knows these standards and upholds a professional manner both with staff and with their client. Keeping a professional manner is vital as you will be working with a large number of people that may be vulnerable. When working with other professionals and team members professional behaviour needs to be maintain to assure that you are capable of working within a team, if a problem arise is it necessary to sustain a professional conduct as it is important so show you are able to deal with conflict. In addition, when working in residential care it will be require from time to time to advocate on behalf of your service users, obtaining and preserving a professional demeanour is key to make certain you are speaking correctly and clearly in getting the best solution for your service users.

In conclusion, the Health Information and Quality Authority are vital for people with disabilities. Without it many people would be made exposed to risks and other are open to been subjected to abuse. With frequent inspections it assures that these do not arise and that service users are receiving the best possible care that can be given.

International countries are very similar to Ireland, they aim to help people with disabilities obtain their rights and make sure they are being fulfilled. Overall Europe is striving to continue changing the way of life for people with disabilities for the better.

Finally, certifying professionalism and best practice are implemented aids residential services. They advise staff on how to best facility each service user.

Introduction: –

The term community has various meaning. We can define community is a place where people living in the particular geographical area and they shares their common values, interests and they follows a particular way of living. The term community may refer to the national community or international community. In biology a community is a group of interacting people sharing a populated environment. Apart from a geographical area a community is a group or society, helping each other. In human communities belief, resources, needs, interest and a number of other conditions may be present in common, which also affects the identity of the participants and their degree of cohesiveness. In every society various types of communities may take place. Some categorizations are as follows:-

Geographic communities: It ranges from the local neighborhood, suburb, village, town or city, region, nation or even the planet as a whole. These refer to communities of location.

Communities of culture: It ranges from the local clique, sub-culture, ethnic group, religious, multicultural or pluralistic civilization, or the global community cultures of today. They may be included as communities of need or identity, such as disabled persons, or frail aged people.

Communities are nested; one community can contain another-for example a geographic community may contain a number of ethnic communities.

Identity is also one of the important factor to assess the type of community. For example if a group of people shares the common identity other than the location, we can call that as community based on their common interest.

Likewise, in present scenario we can see that various communities exist in society based on the certain profession. A professional community is a group of people where they are with the same or related occupations.

Not on the basis of above things, There are different things that bound people together to their different communities or that they may have in common with the other people living around them, which includes beliefs and values, traditions, common interest, language, territory, religion, culture and occupations.

Community Mobilization:

A strong community feeling one can identifies at the time of crisis and occasions like change for families, such as marriage and death. In a community people shared their ‘we feeling’ with each other. As we know that proper management and utilization of resources is the best possible way for the development of the community. Therefore community mobilization is always prominent for the development and upliftment of any community. For mobilizing the community people make their plans and then do the things accordingly. They take charge, transforming, developing their community and their lives as well. Community mobilization is a process which allows people in the community to identify their needs and problems and bring them together for a social action and their community development.

Communities can mobilize to work for changes that will fulfill the social, emotional, financial and physical needs of people. Community mobilization is an organized process through which people can aware regarding the present situation of their community also how to bring positive changes within the community by using various resources. Nutshell, community mobilization is one of the strategic method which helps the people to attain maximum community development. For community mobilization communication is one of the important tool to achieve it. Through proper and effective communication various methods of mobilizing the community can be implemented. Here we are discussing the various methods for community mobilization by given actors as per the fig 1.1.

Mobilizing the community

Political Parties

Social Movements

Individual groups

Political Parties

The use of social networking sites by political parties and other politically active groups has been increased in these days. All these political and other groups realized that by suing of social networking sites many people can be mobilized. The internet has become the strongest communication tool even at the global level. Even various politicians also used Twitter, Flicker, You Tube, and Facebook among people to communicate and mobilize people. As political parties using of social networking sites is one of the effective method to mobilize the people.

In the present scenario, the use of social media is really important to mobilize the people and communities for collective action. We know that today millions of people are connected in one way or another to the internet. People are easily accessible on internet. It is another way of reaching large numbers of people to mobilize them for a group effort. Facebook, Mixit, Twitter can also be effective for the above. To generate awareness among people and to mobilize them in large number to make a community independent. Newspapers, radio stations and the TV have the authority to inform thousands more people about various campaigns for mobilizing any community.

By writing a press release, a political party can highlight the facts, people’s demands, and what people want the media to talk about regarding the development and continuous empowerment of their community. Parties can also organize a press conference. So they can invite the reporters to come to a meeting where spokespeople from the community organization speak out publicly about the problem and the solution of the problems of community.

Apart from above, Political rallies and the use of local languages are instrumental in the mobilization of groups for social action.

Social Movements

Social movements are a type of group action. They are large informal groupings of individuals or organizations which focus on specific political or social issues for their development. In other words, they carry out, resist or undo a social change in the society. Social movement campaigns play a critical role in mobilizing and maintaining the submerged networks of social movement communities. A social movement refers to collective effort organizing from the people for their development and to bring social change in the society. Community mobilization is often used by grassroots-based social movements, which includes revolutionary movements.

Through Social movement for mobilizing the people in community we can apply various methods like large public gatherings such as mass meetings, marches, parades, processions and demonstrations. These gatherings usually are part of a protest action. These are the different ways by which a community can be mobilized and can raise voice for the demand of development of the community. In other words, community mobilization seeks to facilitate change within the community for its development.

Modern Western social movements became possible through education (the wider dissemination of literature), and increased mobility of labor due to the industrialization and urbanization of 19th century societies. Social movements have been and continued to be closely connected with democratic political systems. Occasionally, social movements have been involved in democratizing nations, but more often they have developed after democratization. Modern movements often utilize technology and the internet to mobilize people globally. Adapting to communication trends is a common theme among successful movements. Research is beginning to explore how advocacy organizations linked to social movements use social media to facilitate civic engagement and collective action.

Social movements are any broad social alliances of people who are connected through their shared interest in blocking or affecting social change. Although social movements do not have to be formally organized. Social movement is always an important tool to bring the change in society and as well as to mobilize the communities for their own development.

By arranging people in mass meetings, parades, marches, discussions on various issues, movements for stressing the education of people, bringing the concept of democratization in light communities can mobilize through theses social movements. Social movements are always a part of society, and people may compare their options and make rational choices about which movements to follow. As long as social movements wish to be success, they must find resources (such as money, people, and plans) for how to meet their goals.

Furthermore, for organizing successful social movements and mobilizing the people there should be strong and effective networking with other organizations especially the organization which are exist in the local community. There has to be proper networking and strong communication even on the grass roots organization which are working locally in the community such as Church groups, clubs, special interest organization, local schools, hospitals , recreational groups and other community groups can support the social movement and through effective and strong networking with the above organizations we can mobilize the communities.

Physical concentration is also necessary for organizing successful social movement and for mobilizing people. We should bring people into closer proximities in cities, factories, local university campuses which help the social movement to get into the right direction for mobilizing people for their betterment in society. Also a co-optable communications network should be there to speed up the social movements for mobilizing the people and to spread awareness among the people. As we know that the greater the number and excessive participation of people builds a strong network which leads to mobilizing the greatest number of people. Also for maintaining the above and to get a fuller participation of people and to mobilize them we need to able ourselves to maintain the resources within and outside the community. We should also provide the equal opportunity to each and every unit of the community. We cannot let the youth and other units to go. We need to encourage every individual with no matter of his / her own personal identity. We need to motivate people to participate actively in the social movement and consider the point of availability in our mind. As

People with full time jobs, marriage and family responsibilities are less likely to participate in social movement activity. Autonomous individuals with few personal responsibilities such as college students and single professionals are much more likely participants. On the other hand, for mobilizing people without considering them as particular unit of society, we need to encourage them for their maximum participation. Through motivation and encouragement we can mobilize people and can make them ready for their community development.

Individual groups

It is always easy to start a fire and involve a number of people. Community members need to choose certain people whose role will be to keep the fire of community mobilization burning. In this guide these people will be called ‘motivators’. People in the community know each other very well. Take time to carefully choose honest people who are respected by others, and who can encourage others to work well together. They need to have some time and energy available, have a desire to bring change and be willing to work free of charge. Each community should select two or three motivators. The people chosen will need equipping and support in their role. Each local area has a number of different kinds of resources. People use these resources to keep alive and to cope with changing seasons, political change and cultural pressures. Helping people to understand and to value the different resources they have is very important. These are the main kinds of resources:

_ Natural resources include land, trees, forests and water.

_ Human resources include the skills, knowledge, understanding and labour of local people.

_ Financial resources include money, access to credit and loans, credit unions and government support.

_ Social resources include the culture, traditions, organizations, friends and extended family.

_ Physical resources include buildings, tools, roads, water pumps and transport.

_ Spiritual resources are the strength and encouragement that people gain from their faith.

Local people already know more than any outsider about their community and the people living there. Many people assume they know everything about their local area, but there is always more to learn and understand before making new plans. Take plenty of time to help people in the ‘community’ to tell their story together. One very effective way of doing this is to draw maps, either using clear ground with sticks, leaves and stones, or if available, large sheets of paper and pens. Encourage small groups to draw different maps to show:

– the natural and physical resources in the area (hills, forests, roads and rivers, for example)

-where people live, noting important people and organisations

-how the area looked 50 or 20 years ago (only for older people).

So for mobilizing communities, individual groups can do the social mapping of the community so that the people can aware about the present problems in the community.

Another helpful way to focus on key issues within the local area is to encourage people to prepare a role-play to express their concerns. As people discuss what subjects to use, they will often focus on important issues. However, they are also likely to share these in funny ways. Laughter has a way of taking the pressure out of a situation, helping people to discuss sensitive issues, sometimes for the first time. Again, encouraging people to work in small groups is another way to mobilize the communities.

Having chosen their first priority for action, local people need to decide whether they have enough information to take action. For example, if education is identified as the priority, people may need more information about the problems and whether they are at primary or secondary level. The problem may be poor attendance and, if so, there is a need to find out why.

Considering electing teams of local people to gather relevant information is another way to mobilize the communities. Choose people who can be trusted and who know their community well. Before sending teams out to gather information, take plenty of time to decide exactly what kind of information is needed. Apart from this, conducting role plays- street plays in the community is always a good strategy to mobilize the maximum number of people and to preparing them for a social action.

By Arranging a community meeting to share all the information gathered is showing information clearly to the people. A large number of people can mobilize for the collective action after getting all the facts and problems of the community.

Also, motivation plays an important role in this activity. As keep motivating the people in right direction is always worthy and will be fruitful for attaining maximum development of the community.

Initial contact with the community is another way to mobilize people. Understanding community practices and traditions prior to establishing contact can help identify the appropriate approach for engaging with different groups and members of the community. It is important to focus on learning from the community, especially during the initial contact. Taking every opportunity to meet informally with diverse members of the community (at the health post, during registration, at distribution points, in the queue for water). Also utilizing community leaders also increases the chances of reaching a cross-section of the population and not just a narrow representation. It is essential that all members of the community receive word about mobilization and how they can be involved. Outreaching to those who are isolated, vulnerable or considered. If they cannot personally attend a meeting, it is important that they be represented in some way. So as per the above discussion, motivating people, arranging meetings, initial contacting with the communities, utilizing the community leaders, conducting role-plays, street plays, community outreaching are different ways to mobilize the maximum people of community by individual groups.

Also, identifying an existing committee or a community-based organization which can give individual groups access to the community and facilitate distribution of messages. Meeting the host community and the authorities is important to reach out the goals for community development and mobilization. Messages might only reach certain groups, such as community leaders, and not all members of the community. Developing outreach strategies with the leaders and others to ensure that everyone is informed, including women, girls and boys, minority groups, and people with mental and physical challenges. Making sure that information is delivered in a language everyone can understand, is culturally sensitive and is correctly perceived and understood. As always communication should be effective and strong for the mobilization. Arranging meetings at mutually convenient times. As far the mobilization concern, for development of any community individual groups should make positive rapport building among the community with key people- like facilitator, leaders, service providers etc. and whole community as well. A good rapport building is effective strategy to mobilizing the people. Transparency, respect and consistency are essential for building trust, confidence and collaboration between organizations and partners, including members of the community. Also individual groups have to make ensure that after the first contact immediate follow-up action is taken or not.

Orienting the Community is another way to mobilize the people. The first step in mobilizing the community is to orient them to the process. This can be done in a number of ways, including written communication, television, radio, or an organized meeting. Meetings are more personal and conducive to building relationships. They also facilitate two-way communication where questions can be answered efficiently. As groups can motivate community people for their maximum participation in every discussion as they should feel that they are the key part of it. Also to start these meetings as soon as possible, so that trust and a positive working relationship can be built between parties. Having the meeting sponsored or hosted by a respected individual or group within the community can add credibility to its agenda. This may happen through a church, school, tribe, or other local group. Utilizing community leaders also increases the chances of reaching a cross-section of the population and not just a narrow representation. It is essential that all members of the community receive word about mobilization and how they can be involved. Outreach is prominent to those who are isolated, vulnerable or considered marginal is critical. If they cannot personally attend a meeting, it is important that they be represented in some way. Individual groups should take care of these things before conducting any activity as part of the community or within the community. An only arranging meeting is not as sufficient. The goals of the meeting must be carefully considered and reflected in the agenda. Community leaders can provide assistance presenting the information in a culturally appropriate manner. Some of the community leaders may be chosen to convey topics with which they are familiar. During this meeting, it is important to invoke the input of the community. Identify their needs and begin to priorities how those needs will be met. Individual groups should know that this meeting will be an opportunity to develop an awareness of what the contributing organizations can provide, and also an opportunity to learn about the strengths and resources of the community. It will be important to define mutual goals and develop a plan as to how to reach these goals. This will include organizing individuals to work together and coordinate services. Proper organization of every resources and management is necessary to mobilize the people. Also individual groups should develop ongoing ways to communicate for mobilizing the people. Once goals have been defined and a plan has been developed, it will be important to identify ongoing ways to communicate. Rather than having large meetings, cluster meetings of project staff, community leaders and community members working on similar tasks are more manageable and efficient. The groups should begin team building with all team members (international and national staff, community leaders and community members). It is vital that marginalized and vulnerable people are included in these teams. Intervention with the community may be required for them to ‘allow’ marginalized or isolated members of their community to participate in a team. Working in small teams that include affected people as well as outside helpers. Team leaders should meet daily for sharing of information, planning and coordination. Not all teams will be required for all emergency response projects. Some people may be a member of more than one team.

Conclusion: – It is to be concluded that for continuous community development mass awareness, people mobilization is very important. In our society there are different resources which can perform to mobilize the community. But one should only need to generate these resources within the community or outside the community. Maximum resource utilization and mobilization of people are key things for developing any community.

Community development emphasizes participation, initiative and self-help by local communities but should be sponsored by national governments as part of a national plan.

The purpose of this essay is to examine the historical and political perspective of social work provision in relation to people with dementia. It will explore how the development of social work practice has transformed these groups, the impact of social exclusion they experienced that lead to discrimination and/or oppression and the benefit of listening to service users’ views.

The primary mission of social work profession ‘is to enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed and living in poverty’ (Baker 1999 Pg 55). Social work has an important role to play in coordinating efforts to support people with dementia who may often have negative experiences of mental health services. As a result, it will be a challenge to provide effective social support to these groups in an environment where their views are being seen as significant and where they do not receive services fairly and uniformly (SCIE July 2008).

The medical terms ‘dementia’ has developed since the 19th century and was used to describe people whose mental disabilities were secondary to acquired brain damage, usually degenerative and often associated with old age (Tibbs 2001). Before the 19th century, a person with dementia would probably have been confined to the workhouses. (Marshall et al 2006). During this period, many sufferers were taken away to a Workhouse Infirmary with medical care on hand and given outdoor relief (Denney 1998). Whereas charities began to emerge during this era however there were no good measures in place to deliver social work services; no criteria to determine who the ‘deserving and ‘undeserving’ poor were, therefore help provided were viewed as indiscriminate (Howe 2009).

As the 1940s progressed, there were new developments and approaches in the treatment of people with mental disorders. Poor houses for destitute elderly people were slowly replaced by old people’s homes (Marshall et al 2006). The period after the Second World War saw the development of the welfare state. There was a national agreement that the state has an obligation to provide full services in order to respond to problems of poverty, mental health, old age etc (Tibbs 2001).

The implementation of Beverage report published in 1942 directed at abolition of squalor, want, ignorance, disease and idleness. The National Assistant Act 1948 laid a foundation upon which future social work was built and created departments to meet the needs of different client groups (Tibbs 2001). During the late 20th century, both conservative and New Labour legislation have an impact on Mental Health reformation. The establishment of Social Service Departments introduced in 1970 reviewed in Seebohm reports (1969), enabled Local Authorities to promote welfare services for the elderly which had not already been included within the framework of some other statutory body. (Tibbs 2001).

The 1983 Mental Health Act introduced during the conservative regime mark a further move towards legislation to improve matters with statutory requirements and procedures for social workers to be properly trained in order to carry out professional assessments. The Act ensures professionals who work with elderly people with dementia and indeed those who suffer from mental disorder have a basic understanding of the Mental Health Act, even if they do not act as Approved Social Workers (Tibbs 2001).

The role of carers have also been crucial in the field of dementia care through the introduction of The Carers Act 1995 & 2000, which gave statutory recognition and right to carers, and funding through provision of Direct Payment (Marshall et al 2006). The Mental Capacity Act 2005 is also a relevant Act to people with dementia and their carers. It includes the provision of independent Mental Capacity Advocates (IMCA) to protect vulnerable people and dementia sufferers to gain more control over their lives, plan for the future and have their retained abilities recognised.

It is important to address the impact of discrimination on these service groups as they suffer disability and as a result are subject to degrading treatment from the relatively powerful groups within the society. (Tibbs 2001). Research shows that the society’s fear towards dementia causes them to avoid people with the condition making them feeling isolated and stigmatised (BBC 2010). According to Thompson (2006), discrimination is a process through which a difference is identified, and can be positive or negative. He suggests that negative discrimination also involves making a negative attribution and attaching devalued label to a person.

Dementia is one of the major causes of disability in the elderly, affecting personal care, everyday cognitive activities and social behaviour. To be diagnosed as having dementia involves a great deal of stigma, often resulting in disadvantage and loss of life chances by the sufferers. (Kitwood 1997). Although, dementia is strongly associated to elderly but research shows that increase number of people diagnosed with the ill-health are under 65 years of age and are referred to as ‘young onset dementia’ (SCIE not dated). These service users are likely to experience inequality because society and professionals fail to recognise that dementia exists in this age group and they can continue to integrate within the society (SCIE not dated). They will have different circumstances in life from older people with dementia because they are more likely to be in paid employment, have young children and have financial commitments.

They will have to discontinue employment as most services are not able to cope with their condition which means promotion prospect and pension entitlements are lost. (Marshall et al 2006). Feelings of discrimination and oppression may also be a barrier to people asking for support (Downs et al 2008). From experience, some people from black minority ethnic groups (Asian and Black Community) diagnosed with the ill-health would rather keep it in the family than to get help because they see it as being shameful (BBC 2010). Furthermore, accessing services can be complicated because there are no age-specific services available as most of the developed services are for older people with dementia (Tibbs 2001). Lack of access to services could result in extra burden being placed on families when the care needs exceed the ability to provide (Downs et al 2008).

Emotional impact is one of the significant factors experienced by dementia sufferers. There is also a prejudice with sufferers because of the association with madness and psychiatric disorder that the label creates. (Brooker 2007). They also experience social isolation due to withdrawal of friends which diminishes their social networks and inability to meet a perceived societal expectation. (Crawford 2004). From experience with elderly, people sometimes hold ageist view against them by the way they talk to them e.g. name calling as ‘sweet old lady’. According to the Alzheimer Society publication, ageist societal attitudes compound the experience of elderly people with dementia who already appear to be prejudiced because of their age and intellectual decline. (Crawford 2004).

Health professionals often consciously or otherwise oppress elderly with dementia because of their position of authority which could prevent them from making their own choice thereby disempowering them (Crawford 2004). From experience, professionals sometimes in their attitudes assumed elderly people with dementia are incapable of providing valid information or making decision for themselves, by constantly focusing their attention to their carers instead of the service users. They are often seen as being a burden to the state economy resources and are subjected to considerable pity as they are deemed to be ‘out of their mind’ Crawford (2004).

Research shows that it is often assumed that people with dementia are not articulated enough to express their opinion or views on any aspect of their lives because of problems with communication through speech (Brooker 2007). As a result, practitioners inclined to rely on alternative views, usually provided by family carers, rather than their view. However, the needs, experience and perception of the carer might be different from that of the person they are caring.

Empowerment and giving voices to people with dementia is a vital part of anti discriminatory/oppressive practice. (Tibbs 2001). The needs for communicating and empowering dementia sufferers by involving them in decision making became major considerations within social works field. It is anticipated that the Mental Capacity Act, 2005 will address some of these issues. Begum (2006, P.3) defined user involvement as ‘participation of users of services in decisions that affect their lives’. People with dementia voices can be valued by promoting active participation within care relationship regardless of their age or cognitive impairment rooting out discriminatory practice. (Marthorpe et al 2003). Involving service users in decision making often leads to increased self-esteem and confidence. (Chaston et al, 2004, P.19) quotes that ‘It is good to feel valued and to be somebody, not just anybody’

Effective service therefore must be provided to change the needs of people with dementia (Cantley 2001). One of the main principles to consider in social work code of practice as stipulated by the General Social Care Council (GSCC) is the right of service users to be treated with dignity and respect in order for them to make informed choices about the services they received. Practitioners must therefore acknowledge who they are, listen to their circumstances; treat them as a unique person with worthy of dignity and respect. It is therefore imperative that during intervention with service users with dementia, health practitioners should go beyond safety to promote their choice, maintain independence, autonomy and their self determination Cantley (2001).

It is essential to encourage these service user groups to express their views and preferences in order to build their personal strengths and confidence. Listening to them will provide them the opportunity to express their views on how dementia affects them, what they consider important in their lives, including how services should meet their health and social care needs (Tibbs 2001). People with dementia, either independently or in small groups, should be given the right to participate directly in service planning and development processes (Warren 2007). Practitioners can provide a range of methods and approaches which will enable them to make a choice that will influence future service provisions. They can be engaged to make decision through direct observation and communicating using specific tools or systems (Warren 2007).

This will enabled the practitioners to have a better understanding of individual needs particularly, of people diagnosed with dementia that have complex needs and communication impairment. Research shows that these service users’ groups can still articulate their opinions about their well-being and quality of care even though they are severely cognitively impaired (Mozley et al 1999). For example, Talking Mat is an innovative method of allowing their views to be heard in order to make decision about managing different aspect of their life (SCIE not dated). They can also be involved in activities through collective approach which will provide them the opportunity to be in control by acting collectively to influence services and the broader communities. Such activities are often combined with elements of peer support and empower them through collective involvement (Cantley 2001).

It is also important to devise services that will fulfil their needs by obtaining the necessary information from them, which could be by occasionally adjusting services that were designed to meet their needs as perceived by others. Information about their routines, choices, preferences, culture before, during and after they are diagnosed with the ill-health, which is important to their well-being and at their best interest must be documented in their care plan in order to meet their needs and to organise their care support effectively. (Cantley 2001). Organisations such Alzheimer Society and Social Care Institute of Excellence provide support to carers and health professionals to improve the quality of life of people affected with Dementia through web resources, free e-learning programmes etc in order for their voice to be heard (Alzheimer’s Society). Also, The National Dementia Declaration for England has made a pledge to improve services for service users and carers by ensuring that they have choice and control over the decisions that affect them and live in a supportive environment (Community Care 2010).

Overall, it can be concluded that over the years, there have been changes in development of social work provision which has brought about important legislations to tackle the issues of discrimination and oppression on people with dementia. It has been evaluated that public and professional attitudes towards ageing and the ill-health are now changing rapidly. It was also recognised that through good social work practice, involving dementia sufferers in decision making would enhance empowerment; promote their choices and self determination while maintaining independence. This provided me with understanding of how services’ views are essential in improving social service provisions. It is therefore imperative to encourage further learning within social work provision to ensure good practice is sustained.

The origins of professionalization of social work date back to post Civil War era and the emergence of two opposing approaches to dealing with the needs and struggles of society: Charity Organization Societies (COS) and Social Reform. Charity Organization Societies (COS) – later developed into casework – offered a more individual approach, and Social Reform, represented by the Settlement House movement, which focused on addressing the societal causes of poverty. Initially working together for the so much needed social change, both movements eventually separated their actions due to the distinctiveness in their approaches (Axinn & Stern, 2008).

The end of the 19th century was about individual change and voluntary relief action. Herbert Spencer’s application of Social Darwinism with its two key attributes – “struggle for existence” and “survival of the fittest” – to social work has gained forceful influence (Axinn & Stern, 2008). The widespread perception held that poverty was simply a factor of natural selection and aiding poor would make them indolent and unproductive (Hofstadter, 1955). Over time, however, the “scientific charity” approach faced an increased hostility because of its administrative methods that lumped together all the poor in order to save tax money (Axinn & Stern, 2008). Still, the efforts of Mary Richmond and her Social Diagnosis were a crucial development for the social work profession. The book was an answer to Abraham Flexner’s report from 1915 declaring that social work was “not yet” a profession, and turned casework into a major form of social work practice (History of Social Work).

The Settlement House movement was more focused on the malfunctioning of society. Guided by the “three Rs” – Research, Reform, and Residence – the movement provided a variety of services including recreational, educational, legal, and health services. Settlement workers also became involved in social research and social action. As social reformers, they joined forces with labor, women’s organizations, socialists, and others. Many of them, such as Lillian Wald, Florence Kelly and Paul Kellogg, rose to national prominence. Jane Addams became one of the most well known figures in the nation (Axinn & Stern, 2008).

The Great Depression and New Deal steered the newly created profession toward public welfare. As social workers realized the seriousness of the depression and they re-embraced reform and social work organizations began lobbying the national government for action. New type of social work – rural social work – was also created (Axinn & Stern, 2008).

In the early 20th century, social work strove to advance its status, define its purpose, and establish educational standards. With Mary Richmond’s efforts of developing training programs, the social work profession was on its way to becoming recognized as a profession. Settlement leaders continued their commitment to social reform, but after Flexner’s report the practice of social casework was identified as the core of the new profession (History of Social Work).

Modern social work practice emanates from both traditions – individual and social reform. Today, social work is a professional and academic interdisciplinary field that is dedicated to the pursuit of social change and improving the quality of life of individuals, groups and communities (Morris, 2008; Simon, 1994). The profession strives to help “the individual to become the best he can be – the community to become the finest and fullest expression of social life that it can be, with no one left behind” (Morris, 2008).

The History and Role of Field Education

Field practice casework has always been a central aspect to the profession of social work. As education for social work became more formal in the 19th century, the field education – where classroom knowledge is applied in a social environment with real clients – has been regarded as an essential component of social work profession. It is in the field practicum that the student social workers begin to apply knowledge skills, and principles, and grasp the complexities and subtleties of assessment, intervention, and evaluation within diverse social and organizational settings.

From the 19th century origins of social work as an outgrowth of charitable organizations working with the poor, field practice in casework has been central to the profession. As education for social work became more formal, a field practicum in which classroom knowledge is applied in a social environment with real clients has been regarded as an essential component. Through Field Education, social work comes alive and students begin to see the real faces and stories behind the important issues they have read so much about, and they also begin to take responsibility for their chance to affect change.

SINCE 1968, the Council on Social Work Education (CSWE) has required schools of social work to achieve cultural diversity in enrollment of students, hiring of faculty, and development of curricula (McMahon & AUen-Meares, 1992).

The National Association of Social Workers (NASW) has recently published standards in cultural competence that oblige social workers to strive to deliver culturally competent services to increasingly diverse client populations (NASW, 2001). Through its curriculum policy statement, CSWE provides a broad mandate for the infusion of multicultural content into academic courses (Carrillo, Holzhalb, & Thyer, 1993; Julia, 2000). It is, however, in the application of knowledge about cultural differences through a supervised internship or work environment that the training in multicultural competencies is integrated (Van Soest, in press). Although the role of field instructor is considered pivotal to student learning in social work (Bogo, 1993; Kadushin, 1991), little practical information exists to guide field instructors on approaches to infuse cultural diversity issues into the supervision process (Arkin, 1999; Cashwell, Looby, & Housley, 1997; Leong & Wagner, 1994).

The purpose of field instruction is to help you integrate the theory and knowledge base of social work learned in the classroom with the practical experience gained through work in social welfare settings. The purpose of the field education department is to provide students within the MSW program with an opportunity to learn hands-on through an internship work experience. Students that complete the foundation field practicum which focuses on generalist social work practice and arrive in the advanced year with a solid knowledge of theoretical frameworks that guide generalist practice, an understanding and acceptance of social work values and ethics, and well developed skills related to beginning social work practice. Field education in the foundation years provides the student with an opportunity to gain firsthand knowledge of social service systems to access appropriate community resources. In addition, students learn to communicate in urban settings, apply theoretical knowledge to urban problems such as poverty, and to determine how oral, written, and technological information reflecting professional social work skills. To become effective social work practitioners, students need to experience working directly with individuals, families, groups, organizations and communities and working collaboratively at every client system level to assess needs and to develop plans for addressing them. The field placement provides opportunities for experiential learning consistent with the more cognitive approaches provided in the classroom. This paper reviews the critical importance of field education in social work and will suggest incremental steps through which state, county and university partners may work together to shape a structural plan that will preserve and enhance the quality of the field component and the program as a whole.

The goal and purpose of field education

The purpose of the field education department is to provide students within the MSW program with an opportunity to learn hands-on through an internship work experience. Students that complete the foundation field practicum which focuses on generalist social work practice and arrive in the advanced year with a solid knowledge of theoretical frameworks that guide generalist practice, an understanding and acceptance of social work values and ethics, and well developed skills related to beginning social work practice. Field education in the foundation years provides the student with an opportunity to gain firsthand knowledge of social service systems to access appropriate community resources. In addition, students learn to communicate in urban settings, apply theoretical knowledge to urban problems such as poverty, and to determine how oral, written, and technological information reflecting professional social work skills.

Purpose

The purpose of the field practicum is to provide students the opportunity to work in a professional setting to develop and demonstrate skills in social work, to integrate the theories and practices learned in and out of the classroom, to develop a sense of commitment to the social work profession and Code of Ethics, to develop an understanding of the diversity of a community population and the role of diversity in social work practice, to develop an understanding of how administrative processes and policies impact delivery of services, to develop professional relationships within the community to better understand local resources to benefit future clients, and to confirm personal interests and abilities in the social service field.

As students undertake learning within the reality of agency life, a vehicle is established whereby use of theory and conceptual frameworks acquired through course work is applied, skills are developed and refined, and attitudes and values are examined. Additionally students are afforded opportunities for analysis of the effects of social welfare policy on programs and services, opportunities for the development of research questions in relation to practice efforts, and opportunities for evaluation of practice interventions. Field practicum courses enable students to personally affirm the validity of content presented in the classroom. The progressive, reciprocal relationship between theory and conceptual frameworks and practice becomes a dynamic in the teaching-learning process of field instruction. Field Instruction enables students to integrate the knowing, feeling and doing aspects of their social work education. It is designed to produce a knowledgeable, skilled, self-evaluating and professionally reflective social worker.

Objectives

Knowledge:

1. Basic understanding of how generalist social work practice is applied in a specific agency setting.

2. Knowledge about the application of theories to client situations in the agency setting.

3. Knowledge regarding the use of culturally sensitive practice methods with diverse and at-risk populations.

4. Knowledge about the social work system and structure in an agency, and how the structure impacts the provision of social work services.

5. Awareness of practice issues, policy issues, and related research information relating to the student’s field setting as well as to the placement settings of other students.

6. Awareness of appropriate methods for social action related to the agency purpose and function and participation in these when appropriate.

7. Awareness of social service resources in the area to enable students to broker services to enhance client functioning and well-being.

Skills:

1. Enhancement of interviewing skills to enable the student to develop working relationships with diverse types of clients and client groups, to formulate initial and on-going assessments at the micro, mezzo, and macro levels, and to modify relationship styles to fit the client situation.

2. Ability to prepare an appropriate intervention/service plan for actual clients based on person-in-environment and strengths assessment and the availability of agency services.

3. Increased self-awareness of the student’s own intrapersonal and interpersonal attributes that enhance or interfere with therapeutic relationships or the social work role.

4. Application of practice and program evaluation skills for purposes of accountability, outcome monitoring, improvement of practice, and program development.

5. Development of the ability to use supervision in an appropriate manner for continued growth and development.

6. Development of the ability to work collaboratively with a variety of helping professionals.

7. Development of appropriate documentation skills within the agency setting which are clear, organized, and meet professional standards for the profession and the particular agency setting.

Values:

1. Respect for an individual’s worth and dignity and their unique characteristics.

2. Importance of advocating for the client with organizations and systems to ensure protection of rights and procurement of needed resources.

3. Appreciation for professional ethics, especially confidentiality, regarding clients, peers, agencies, and recognition of the individual’s right to self-determination and active participation in the helping process.

Council on Social Work Education’s 2008 Education and Policy Standards (promotes classroom and field learning as equally important for student learning) – its effect/impact on SW field education

The Council on Social Work Education (CSWE) is the entity that accredits all social work programs in U.S. universities at the BASW and MSW levels. All California university graduate social work programs have CSWE accreditation. In its recent educational policy statement, the CSWE concluded as follows:

Signature pedagogy represents the central form of instruction and learning in which a profession socializes its students to perform the role of practitioner. Professionals have pedagogical norms with which they connect and integrate theory and practice (Shulman, 2005). In social work, the signature pedagogy is field education [italics added]. The intent of field education is to connect the theoretical and conceptual contribution of the classroom with the practical world of the practice setting. It is a basic precept of social work education that the two interrelated components of curriculum- classroom and field-are of equal importance within the curriculum, and each contributes to the development of the requisite competencies of professional practice. [1]

Several fields have a signature pedagogy, a method by which knowledge is traditionally imparted to students: the case method and moot court in law, student teaching at the primary school and university levels, even minimum flight hours for student pilots.

The importance CSWE attributes to the fieldwork component of any social work program is reflected in the hourly field requirement for each university degree. For a two- year accredited MSW program the requirement is 900 hours of MSW supervised field work. The BASW degree requires the student to complete 400 hours of supervised field. To become an accredited program of social work, a school must, among other stringent requirements, demonstrate how its field program “connects the theoretical and conceptual contribution of the classroom with the practice setting, fostering the implementation of evidence supported practice.” Further requirements include the candidate school’s providing “orientation, field instruction training, and continuing dialog with field education settings and field instructors.”

Structure for Field Practicum – The Anatomy of an Internship

(short review of a few MSW Internship Programs (or maybe just Rutgers’s?)

There are two semesters of field practicum for all social work majors. Students typically enter field their senior year. Students complete both semesters of field concurrently in the same agency unless there are extenuating circumstances which necessitate a change.

SWK 488: Internship Practicum I and SWK 489: Internship Practicum II each require 225 documented hours, for a total of 450 hours of agency work over the course of two semesters. Even if a student completes 250 hours prior to the end of either semester, that student is required to complete 15 weeks of field placement during both the fall and spring semesters. Students may accumulate internship hours between the fall and spring semesters. This arrangement must be made with the field instructor and approved by the NCU Field Coordinator. If this situation should occur, students may count accumulated hours toward the spring semester, but will still be responsible for completing the 15 week internship at a reduced number of hours per week. Students are not required to work during fall or spring holiday breaks or final exam weeks; however, they may choose to schedule hours with the agency during these periods. SWK 488: Internship Practicum I and SWK 489: Internship Practicum II, meet weekly throughout the entire period of the field placement. In addition, there are other required social work courses students take each semester (Fall: Pysch 460 – Research Methods and Spring: Psyc 495 – Senior Project).

The NCU Field Education Coordinator, in conjunction with the student, and the agency field instructor, will make decisions regarding students’ changing agency placements at any point.

Field Practicum Seminar

During a student’s field placement, he/she participates in a weekly Field Instruction Seminar. The seminar serves a very useful function by combining students from a variety of field of practice settings. This enables the student to have a broader perspective in terms of practice settings, client populations, and treatment methodologies than they might not otherwise experience.

Each seminar class is organized around a theme, such as racism within society, the value of practice evaluation and evaluation techniques which can be easily implemented and enrich practice, sexism within the profession, and goal setting and contracting with clients. The student may be assigned readings related to each topic. Discussion is geared toward enhancing students’ experiences in their internship, assisting them in making linkages between the knowledge they have obtained in the classroom and their experiences in the field, and facilitating their ongoing professional development.

A weekly component of each field seminar is a group discussion of the student’s experiences during the week. The discussions enable the student to share the high points and low points of their week, successes and frustrations. The students serve as a support system and provide constructive feedback to each other. This aspect is considered by the students to be an especially valuable component of the class.

In addition to the discussions, there are written components to field instruction seminars. For instance, students are required to submit weekly logs in which they describe and analyze the activities of the week in their field placements. Confidentiality of clients is protected as identifying information is omitted. Each student is required to do a comprehensive analysis of the policies that operate in the agency. All assignments and the grading scale are identified in the course outline.

Individualized Learning Plan

In addition to the goals and learning objectives of the Internship Practicum, it is very important that each student be aware of and verbalize individual goals for field instruction which are pertinent to personal learning needs and the particular field agency. Near the beginning of each semester of placement, the student develops an individualized learning contract that includes learning goals, objectives, activities/tasks, and evaluation measures that address areas of professional knowledge and skills in need of development or improvement. Agency field instructors and the NCU Field Education Coordinator are available to assist students with this process.

Students complete three copies of the Individual Learning Plan. One copy is submitted to the agency field instructor and one to the faculty liaison. The third copy is to be retained by the student. The learning goals can be modified or others added at any time during the placement, and progress toward goals is evaluated at regular intervals.

Recommended Field Learning Experiences

Each field agency offers a unique opportunity for students to experience social work in all its many facets. Populations served will vary as will the make-up of the staff and the types of services provided. Within this broad range of field learning experiences, it is highly recommended that certain types of experiences be made available to students in field instruction settings.

The following is a list of recommended field learning experiences:

Orientation to the agency – includes staff, facility, office procedures, filing system, types of services provided, agency’s place in the social service network, methods of intervention, etc.

Experiences in developing and managing effective relationships – includes opportunities for students to observe a number of staff with their own individual styles of intervention, participation in a variety of helping relationships, and the use of supervision to assist students to determine how they can develop an effective working relationship with a variety of client systems.

Recording experience – includes case summaries, letters to clients and other agencies, process recordings of interviews, and eventually direct entry of students’ recordings into the agency’s records, etc.

Administrative experiences – includes observation/participation in staff meetings, funding hearings, public relations functions, budget planning, grant writing or reading grants already funded, lobbying efforts, board meetings, contracting requirements, etc.

Experience in resource/referral management – includes overall orientation to services available to client population being served by the field agency; telephone contacts with other agencies providing support services to clients; scheduled visits to key agencies with whom linkage for clients is most common; and learning procedures for effective referrals.

Interviewing experiences – includes observing, planning, and conducting interviews for a variety of purposes (intake, with staff, for volunteer programs, assessment, intervention, etc.), with diversified client systems in a variety of places (agency, home, school, hospital, etc.) The use of process recordings, observation, and tape-recorded sessions provides the field instructor with data to aid students in further developing interviewing skills.

Experience with procedures for evaluation of individual practice and agency programs – includes designing a plan for evaluating own practice, client progress, and effectiveness of interventions; data collection and analysis; becoming familiar with procedures for agency program evaluation; and conceptualizing/ developing a system for program evaluation if none exists, such as evaluation of service by clients.

Experience with groups – includes observation and participation in groups such as client groups, staff meetings, client staffing, and groups available in the broader community for the purpose of developing an understanding of group processes and skill in interacting in groups as a member or facilitator.

Experience in community activities – includes observation and/or participation in assignments that facilitate understanding of the community and its social service network, the field agency’s role in the community, as well as assignments that draw attention to unmet community needs and provide opportunity for community planning.

All learning experiences have, as a long range goal, the opportunity for students to develop increased skills, a greater level of independent functioning, and the development of a sense of professional identity with its accompanying values and guidelines under which the profession operates. Enabling the student to learn to utilize the supervisory relationship is central to the student’s growth in this area as well as all the other areas recommended for field learning experiences.

These suggestions can provide the student with sufficient opportunities to experience all facets of the agency as well as to create a structured learning experience. Other experiences of particular interest to a student can be incorporated into the student’s individual learning goals and contract at any time during the placement.

Current delivery of field education

contextual factors affecting field education

the nature of professional social work practice

theories and evidence-based practice related to field education

formats and methods of field instruction

the nature of student learning and effective approaches to student learning and competence in field education

the important relationship of the field instructor and student

Evaluation of student competence and methods of measurement in field education

It is recommended that the field site supervisor and the student review the evaluation tool used in the practicum as one of the first tasks of their supervisory sessions. This will help focus the teaching and learning of both parties. The field practicum is graded on an A – F scale. This grade will be determined by the NCU Field Work Coordinator with input from the field site supervisor.

The NCU Field Work Coordinator will meet with the student and the field site supervisor at least twice during the semester and more frequently, if needed. The regularly scheduled meetings will occur around mid-semester and again at the end of the semester. The student evaluation form should be completed prior to the evaluation meeting.

Student’s final grades will be determined by the overall evaluation from the agency and progress made on their learning plans that are developed early in the semester. (Learning plans can and should be modified throughout the semester with mutual consent from the student, faculty, and NCU Field Work Coordinator.)

If, at the midterm evaluation meeting, the field supervisor and Field Work Coordinator agree that the student is not displaying appropriate social work skill and therefore at risk of failing the Practicum, the student (with input from the field supervisor and Field Work Coordinator) must write a corrective action plan to address deficient areas. This plan must be signed by the student, field supervisor, and the NCU Field Work Coordinator.

Challenges and Potential Solutions

Field education is the primary interface between the school, the agency and the community within which both reside (Glassman, 2008). Field work provides the occasion for the student’s application of knowledge, values, theory, problem-solving skills, and affect to inform his or her practice ( Schon, l987). Stressing the essential character of field education for the future, authors Reisch and Jarman-Rohde observed, “As economic safety nets are dismantled, remaining agencies will have more clients but fewer staff to address their needs . . . field instruction will become an even more significant component of social work education.” (2000). To meet the needs for well-prepared staff members in economically challenged agencies, these authors argue that enhanced university-agency cooperation is needed to make certain students have the skills, values, experience and personal qualities to work effectively in an increasingly stressful work environment (Reisch & Jarman-Rohde, 2000).

In addition to providing students the opportunity to acquire practice skill, field instruction is also the primary domain for informing curriculum and faculty of practice issues and needs, particularly practice effectiveness (Glassman, 2008).

The positive aspects of a high-functioning, agency-university field program reverberate to the benefit of all involved: students, agency staff, faculty, and community. Consequently, greater interface and field program development that involves all partners to the educational process is particularly appropriate and valuable to a program like CalSWEC, in which the future employer has the direct opportunity to participate in preparing the new recruit. Under current economic conditions, CalSWEC agency and university partners will need to rethink how best to structure field programs around the state and more clearly articulate the roles of the individual entities involved.

A high quality field work experience is essential to give the entering child welfare social worker the tools to use both his/her education and the agency and community resources effectively. The NASW has noted that “practitioners and researchers are continually challenged by the difficulties agencies face in recruiting and retaining a competent child welfare workforce. “Part of that challenge is insuring that entering staff are equipped with adequate practice in working with actual clients under realistic agency conditions. Preparation in the form of high quality supervised field work has a beneficial effect on workforce retention, as demonstrated by the excellent CalSWEC retention rate of its MSW graduates, all of whom have experienced field practice as well as classroom preparation ( California Social Work Education Center, 2007).

Conclusion – the importance of integration of theory and practice in social work

CalSWEC’s Title IV-E Program, noted as a national model for agency-university partnerships in social work education, is at a crossroads. National economic forces that threaten the operation and staffing of social services agencies throughout the country now threaten the Program’s capacity to supply its students with the kind of high quality field experience they require to become effective child welfare social workers. In this climate, schools of social work may need to reconfigure the university-agency relationship, develop more field -centered education, and re-assert the community-based origins of the profession (Glassman, 2008). Schools of social work need to consider the possible benefits of creating rotating field sites, developing new agency forms for the purpose of education, and modifying existing agency structures to integrate service, education and research more effectively ( Reisch & Jarman-Rohde, 2000).

Recommendations:

For the large and diverse state of California, a number of different models may need to be devised for conducting field education and building placement capacity to accommodate regional needs and resources. Rather than a reactive, crisis-based response to changing economic conditions the following set of recommendations are proposed to move forward:

Initiate a multiyear CalSWEC initiative to develop a systematic, long-term structural plan for creating and sustaining high quality field placement opportunities statewide. The initiative would encompass the following:

Engage agency directors and university faculty in dialogue to examine regional needs and resources then develop field placement models that meet the regional needs and resources. Models may include rotating field sites, field units and unified content and competency development that will be operated by agency and university partners, at pilot sites designed to address particular regional needs.

Through careful pilot development, test the efficacy of the models.

Leverage the university/county/CDSS partnership

Social work is a profession that focuses on people of all ages. The definition given by the International Federation of Social Workers is,

The above definition states that social work values include solving problems, enhancing well-being, human rights, social justice, empowerment, social change and liberation. The definition of the word ‘values’ differs depending on whether you are talking about personal values or professional values. Personal values are a set of principles that support peoples actions or behaviours. Professional values are guidelines like the Code of Practice set up by the Care Council for Wales that all social care workers must adhere to. As a social worker our personal values must not interfere with our professional values. We must be professional at all times.

The role of a social worker is to shield vulnerable people, develop relationships and where possible help families to stay together while sticking to these guidelines. They also support people to enable them to live a happy life as possible. Social workers work as part of multi-disciplinary teams with other professions such as education, health and probation services. This is to make sure that all aspects of the service users life is taken into consideration when help is being discussed. If this is completed effectively no aspect of the service users life if left without any help if it is needed. Social workers work in various different organisations. Some work for local authorities in children and adult services departments there are also social workers working in hospitals and the voluntary and private sector.

The above value of social justice includes the need for resources to be distributed evenly amongst all members of society, to ensure that basic human needs are met. It is the members of society that are socially excluded that find it difficult to access these resources. Many people that social workers work with are socially excluded and discriminated against for a number of reasons. Social exclusion is defined as,

Social exclusion describes a way of life where opportunities are few, services are difficult to access and people lose hope. It is caused and upheld by a set of linked, and often recurring, problems like low income, lack of work, poor health, low educational attainment, living in a poor physical environment and high levels of crime. As a result of social exclusion it is difficult to reduce poverty and malnutrition due to the people who are socially excluded being more difficult to reach. People with less money are more likely to have poor levels of health and education. This is particularly true when lack of money is paired with lack of basic needs.

Discrimination is also a big part of being socially excluded. Discrimination has been apparent as far back a 1834 with the Poor Law Amendment Act where people where categorised as either deserving or undeserving poor. The deserving poor included widows, the very old and the very ill, the undeserving poor included unmarried mothers. Some members of society still hold these views today. Members of society can be discriminated against for many reasons including age, race, ethnicity, gender and sexual orientation. Discrimination has negative affects for both the individual and society. It could result in the individual being too scared to leave the house for fear of being called names or in some cases attacked due to their race. This could cause them to become isolated which could cause depression.

It is the responsibility of a social worker to see past the age of a service user or their race and to help them as an individual. The Quality Assurance Agency for Higher Education (2000) cited in Horner (2007, pg 141) talks about social work values and states that,

It is important that at all times social workers practice in an anti – oppressive and anti -discriminatory way. Both terms are often used interchangeably but the meaning of oppressive is different to that of discriminatory.

Anti-discriminatory practice is compulsory by legislation. This started in the Sex Equality Act 1975, the Race Relations Act 1976 and the Children Act 1989.

Equality is a basic principle with regards to the work the Welsh Government are doing. Before devolution there was no logical approach to inequalities in Wales. In Wales: A better country, it states that,

There are differing levels of social exclusion depending on the area in which you live. Access to resources is easier If you live in the centre on Cardiff as you are close to all of the amenities you may need, for example a Doctors surgery if you are felling unwell or a supermarket selling copious amounts of fruit and vegetables to help provide a healthy balanced diet. If you live on the outskirts of the city where there are less houses and more open fields, you have further to travel to see a doctor or access fruit and vegetables, in most cases you need a car to access these and need to have good health in general to be able to make the journey.

In 1998, twelve out of twenty-two Local Authorities in Wales had a higher percentage of unfit housing than the Welsh average of 8.5 percent (Welsh Government, 2006). This means that more than 8.5 percent of housing in over half of Wales wasn’t suitable for people to live in.

The issues social workers in Wales may come across are not only different depending on where in Wales they work but with Wales being a multi-cultural society they may come across a service user whose first language is different to their own. This does not just refer to people speaking Welsh but also people speaking other languages from all over the World, for example, Polish and Indian amongst others. Without prior knowledge of this, it is difficult to accommodate and you may find that your questions are now fully being understood or you are not fully understanding the questions. If you know in advance it may be possible to arrange for an interpreter, this would mean that the conversation is understood and you are more likely to give that service user the help that they need.

Social services in Wales are delivered to the people by the twenty-two local authorities and around 1,800 voluntary and private organisations. The law requires Local authorities to provide Social Services. There are 150,000 people in Wales that are supported by social services. The Welsh Government’s responsibilities for funding, setting the policy, reviewing, inspecting and regulating social services, cover, adult and child care, support and advice, grants and community voluntary care. The foundation of the Welsh Government’s Social Services and Social Care work is the 10 year strategy Fulfilled Lives, Supportive Communities. The strategy is put to local authorities who have a responsibility,

In conclusion, the role of a social worker is very varied and complex. Social workers face many issues while working with service users and their families. They work with people of all ages. There are many values that social workers must work to which can be found in the code of practice, outlined by the Care Council for Wales. Promoting social justice is a very important value that all social workers but work towards with service users. Everyone had personal values that they have developed as they have grown older but it is important that social workers stick to the professional values that they have agreed to uphold at all times and that their personal values do not interfere with these. Social workers work with the most vulnerable members of society and to ensure professionalism they stick to guidelines at all times. To help service users, multi-disciplinary teams are set up. These make sure that all aspect of the service users life is taken into consideration when trying to help them. It is not only Local Authorities that have social workers as part of the teams, there are also social workers working in the voluntary and private sector. The value of social justice includes the need for resources to be distributed evenly to all of society. It is the members of society that are socially excluded that find it hard to access these resources. People who are socially excluded have fewer opportunities and very often lose hope. It can be difficult to address social exclusion as people who are socially excluded are difficult to reach. Discrimination is a big part of social exclusion. People can be discriminated against because of their age, race, ethnic origin, gender and sexual orientation amongst others. There are only negative effects of discrimination which could lead to depression. Levels of social exclusion can be different

depending on

where people live, so no two social workers work with identical service users because they just do not exist.

This paper reviews on how the death of child could affect the parents’ psychological well-beings as well as other factors that could influence their daily lifestyles. It is said that some parents might go through a five-stages of grief cycle during their bereavement period. The five stages of grief cycle include the denial, anger, bargaining, depression, and acceptance. There are a few short term and long term effects of death of child on child being discussed in this paper. Besides, intervention programmes and their effectiveness were also being mentioned in this paper.

Keywords: death, bereavement, parents

Every parents love their children. Parents would do anything for the sake of their children. However, sometimes, unexpected loss of children could bring a great effect on parents. For example, the death of children. Some parents might go through the grief period for a few years. Death in human is defined as the permanent loss of a person’s life (DeGrazia, 2011). Death is also what people mean by pass away. Death of a child is like losing a part of the parents’ lives. When the parents lose their child, it does not only mean losing a child, but also losing their identity as parents. Every parent would deal with their bereavement period differently. Bereavement is the word being used to describe the condition of grief when a loved one passed away (Christiane, 2005). Some parents would be well prepared to accept the truth while some might just stay in the stage of denial.

According to United States Child Mortality (2007), out of 100000 children in United States, 53287 of the children died in years 2007. A few common causes of death on children are by accidents, cancer, and some developmental disorders that are presented during their birth (Medline Plus, 2007). All these causes are considered as unexpected causes of death. None of the parents would expect their children to pass away at their young age.

It is very common for parents to have mental distress when they have experienced the loss of their loved ones such as their children. It could be a tough period of time for the parents to accept the fact that their children have passed away. Some of them would even stay in stage of denial for a long period of time. The process of grief includes five stages which is also known as the grief cycle. Grief cycle model was introduced by Kubler-Ross in year 1969. This model explains how the individuals go through the process of accepting the fact of death and bereavement as well as how they cope with them.

The first stage in the grief cycle is named as denial. Denial is the condition when a person either consciously or unconsciously refuses to acknowledge the facts or the reality (Kubler-Ross, 1969). Denial is a natural defense mechanism that exists in every individual. An individual could stay at this stage when he or she experiences some traumatic changes that they can ignore. In death, a person might choose to avoid the fact that someone has passed away or going to pass away.

The second stage of grief would be anger. The individuals might get angry once they are informed that someone’s life is going to end (Kubler-Ross, 1969). They might have the thought that why such an incident would happen on themselves or to the person they love. The individuals could express their anger in different ways. Some individuals might get angry at themselves while some may express their anger on others. They might project their anger on others by blaming others’ faults on the unlucky incidents.

The third stage of grief is known as bargaining. This is the stage when the individuals bargain with God and hope that they could get a negotiation to have a longer life span (Kubler-Ross, 1969). When the individuals know the fact that they have limited time to live, they would start to pray or hope that they could have more time to fulfill their dreams or to work on their unfinished business. For example, if the individuals are told that they only have three months left to live, they might negotiate with God by asking for another three months to live so that they could have more time to find the solutions for their problems as well as to spend more time with their friends and family.

The next stage of grief is the state of having depression. It is the stage which the individuals are prepared to have the feeling of grief. At this stage, the individuals are usually emotionally prepared to accept the facts. They might get upset, feel fearful or insecured, and so on. This stage is a sign of the individuals to start accepting the truth (Kubler-Ross, 1969). It is the time for the individuals to adjust their feeling to be emotionally prepared for the worst to come. For example, they could be feeling fearful of losing their loved ones.

The last stage would be the acceptance. This stage indicates that individuals are well prepared for their condition (Kubler-Ross, 1969). The individuals could stay at this stage for a long period of time. They might be readily prepared for loss of one’s life and calmly deal with all the challenges that have in life. Acceptance is a tough stage as the individuals are expected to accept the reality that they are dying or losing someone whom they love.

However, not all individuals would experience all the five stages of grief. It depends on how they interpret the problems and how they deal with them (Kubler-Ross, 1969). Some individuals might skip a few stages and go into acceptance while some may stay in a certain stage for some period of time (Kubler-Ross, 1969). Some individuals might even do not reach the stage of acceptance at the moment they are ending their lives or losing someone. It is possible for the parents to experience either all the five stages of grief or some of them when they are about to lose their child or when they have loss their child.

It is found that parents could develop the mental distress even though their children have passed away for five years. Some parents could even develop posttraumatic stress disorder (PTSD) after the death of their children. However, there is gender difference in the duration of parents to bereave over the death of children. Study shows that women would bereave for a longer period of time as compared to men (Murphy, Johnson, & Lohan, 2002). These mothers are diagnosed to have mental distress such as anxiety and depression. These mothers reported that they have difficulties in making decision and to remember things (Murphy, Johnson, & Lohan, 2002). Mothers are said to score higher scores in PTSD as compared to fathers. Mothers are always those who would have more emotional problems as compared to fathers. This could be due to the fact that females tend to be those who would have higher level of anxiety (Craig, 2005).

Another study stated that parents who have experienced loss of child were found to have higher level of depression, weaker psychological health, and higher level of physical health problems as well as having marital problems as compared to those who did not experience the loss of child (Rogers, Floyd, Seltzer, Greenberg, & Hong, 2008). The parents might get too upset by the death of their child and some may even blame themselves on the death. They might blame themselves for not giving proper care to the children and cause them to pass away. The parents could keep having this thought in their mind and lead them to develop the symptoms of depression. In terms of physical health, because of the bereavement period that the parents are experiencing, they might just give up on their lives and do not take good care of themselves (Rogers, Floyd, Seltzer, Greenberg, & Hong, 2008). They might not take in healthy food and cause them to have poor health. Besides, some parents might blame their partners for not taking proper care of their child and eventually cause their child to pass away. The worst situation could lead to the divorce of both the parents.

The conditions mentioned in the above are the long-term effects on parents with loss of child. Besides those stated in the above, there are a few short-term effects that could take place as well. For example, death of child could affect the job status of the parents (Rogers, Floyd, Seltzer, Greenberg, & Hong, 2008). When the parents experience the loss of child, they would not be able to focus on the job that they’re doing. Most of the time, they would eventually make mistakes and lose attention in their work.

In addition, the social life of the parents would also get affected during the bereavement period (Rogers, Floyd, Seltzer, Greenberg, & Hong, 2008). The parents would try to avoid from the public and do not get involved in any of the social activities. They would try to avoid themselves from participating in the events that could lead them to think of their loss child.

In order to help parents to pass through the bereavement period, interventions could be provided to them. According to Rowa-Dewar (2002), interventions could help to reduce the level of depression in mothers. Effective interventions should be developed in order to help parents to reduce their psychological distress level due to the death of their children.

As the parents are going through the period of bereavement, a chaplain could be introduced to them in order to provide emotional support to the parents. A chaplain plays a role in providing advises and counseling to individuals who need them (World Fellowship Church, 2003). A chaplain is usually being introduced by churches and hospitals. Sometimes, if the families have their own religious leaders, they could be introduced to the parents at this stage as well. A chaplain serves as a person to provide emotional support to the parents. The parents could spend time to express their feeling to the chaplains as well as to discuss on the problems that they have with them.

Besides, support groups could be established for parents who are experiencing the bereavement period. The parents could meet up once in a week to share their feelings with each other. The support group acts as a place for the parents to emotionally help each other rather than calling it a therapy group (YMCA Orange Country, 2012). By attending the support group, the parents are able to obtain emotional support from the other parents, to reduce their depression level, to decrease their feeling of loneliness, to make new friends, to share similar experiences, and also to cope better with the grief process (YMCA Orange Country, 2012). It would be easier for the parents to socialize with each other as they could have the similar experience hence can understand each other better. Most of the time parents do not share their feelings with people who do not have the same experience like them. They often have the thought that others could not understand how upset they are.

Murray (1996), whom is a researcher and psychologist from University of Queensland, developed an intervention for parents who have undergone the death of child and to examine the effectiveness of her intervention. Murray (1996) aimed to use the intervention to reduce the mental distress of the parents. Parents who participated in the intervention reported to have reduced in level of depression and decreased in the feeling of separation as well as better satisfaction towards their marital status as compared to those who did not receive any interventions. Murray (2006) mentioned that in the intervention, mothers found to look for emotional support from many other relationships while fathers tend to depend on their marital relationship. This study indicates that effective interventions are suitable to help the parents who have loss child to recover better from the bereavement period.

In conclusion, there are five stages in the grief cycle, which include denial, anger, bargaining, depression and acceptance. Parents who experienced the loss of child could pass through some of these stages. Studies showed that parents could have high level of depression, fearful, and anxiety after the loss of their child. Long-term effects could last for a long period of time. In terms of short term effects, loss of child could affect the parents’ job performance as well as their social lifestyles. In order to help the parents to overcome the bereavement period, interventions could be provided to them. Counsellors, chaplains, and social support group could help the parents to recover from the grief period. It is important to provide emotional support to the parents as they might be psychologically affected severely due to the incidents experienced by them. Physical health is an issue to be focused on as well. This is because parents could neglect their health after the loss of their child. Hence, parents who experience the loss of child should not feel hesitate to seek help from the professionals.

From the findings of our group presentation, it can be said that quality means doing things right, but the things which the operation needs to do right will vary according to the kind of operation. For example, in the hospital, quality could mean making sure that patents get the most appropriate treatment, that the treatment is carried out in a medically correct manner, it would also include such things as ensuring that the hospital is clean, and that the staff are well informed and friendly towards patients.

It’s not surprising that all operations regard quality as a particularly important object. In some ways quality is the most visible part of what an operation does. Furthermore, it’s some thing that a customer finds relatively easy to judge about the operation. By asking is it right or wrong? Is it the way it’s supposed to be? There is some thing fundamental about quality. Because of this, it’s clearly a major influence on customer satisfaction or dissatisfaction.

Quality then is simple meeting the customer requirements, and this has been expressed in many ways:‘Fitness for purpose or use’, ‘Conformance to requirements’, and in many other ways.

Clearly, part of the acceptability of a service will depend on its ability to function satisfactorily over a period of time, and it is this aspect of performance that is given the name reliability. It is the ability of the service to continue to meet the customer requirements. It is important to realize that the ‘meeting the customer requirements’ definition of quality is not restrictive to the functional characteristics of services.

A report on your contribution to the group and to the work that was presented

I contributed a great deal in the planning and writing up of the presentation. Our group communicated amongst itself both efficiently and effectively. Although we gathered on only one occasion outside academic hours as a whole group, the meeting was extremely constructive as we were able to discuss and arrange the main sections of the presentation.

My role within the group was to design the slides and research on the topic I was allocated as a member of the group. Firstly, I decided to research on the theory of variation and the Deming cycle, and attempted to link these theories to the results of the care quality commission report on the two care homes of our choice. The other role in the work of the group involved introducing the main points of the presentation and writing up on one of the key points in the conclusion.

A report on how the group worked together

Group work has been defined by various authors, however Kurland and Salmon (2003) states that for some group work is just another way of talking about teamwork, however, working in groups is often presented as a good way of dividing work and increasing productivity. It can also be argued that it allows for the utilization of the different skills, knowledge and experiences that people have, (Cory and Cory, 2002). Kurland and Salmon (2002) describes team work as partnership, therefore he goes to describe partnership working as a variety of arrangements with different purposes, time scales, structures, operating procedures and members between groups and the community as a whole. Lowndes (2002) adding that partnership/group working achieves what would be difficult or impossible for a single person to do on their own therefore collaborative working is also known as partnership working. However, (Wildridge et al, 2004) argues that partnership working is not in and of itself a good thing. Yalom (2005) claims that for a group work to be effective 10 characteristic should be present: Develop goals and plans, Enhance communication among members, Develop and maintain positive relationships among members, Solve problems and make decisions on a timely basis, Successfully manage conflict, Facilitate productive meetings, Clarify roles for team members, Operate in a productive manner, Exhibit effective team leadershipand Provide development opportunities for team members. Our group work lacked the communication skills, hence working in a group proved difficult. Donovan (2005) states that good communication is critical to effective teamwork; it is far more than talking and listening. It is sometimes a complex and puzzling process. However, effective communication is possible with the right approach, techniques and some practice.

Our group could have worked better as a team. The main flaw was our inability to meet up, discuss ideas and become all aware as to which stage of drafting we are. We at times thought different things were occurring and we didn’t all pull in the same direction until towards the end when editing the slides.[1] These are the sessions where we worked well as a group. When editing, we looked at the slides and any idea brought up by one of our group members were considered. This process happened several times and this ensured us that we were all happy with the final copy of our presentation.

Another disappointing thing about our group was the lack of met deadlines. However, this directly came as a consequence as a lack of deadlines set. Although the work was shared between the group, it was much disorganised as to when it should be done. It was very difficult for this reason to know whether we were ahead or behind schedule with the only dates determined was the final deadline for all work (15/04/2010).

My experience in group work has showed that there are many problems that accompany group work that is people don’t pull their weight and one person who don’t turn up leaving other person to complete the task. There are problem’s with time management as some people might not attend time set because of other commitment and lack of commitment towards the task resulting in people not doing what was given to them, this is a big de-motivation factor in group as it pulls the whole group down and effects work.

The day we met for the first time to prepare our presentation, our strategy involved first gathering all information on Deming using research skills like using reputable sources from the Internet, newspaper and articles for the next meeting. On the first of three meeting we covered what points were relevant and how would we structure the presentation and had an agreement on the type of care home we will use for our presentation.

The following week we gathered our research together and highlighted the important and relevant information and set our specific points for each person to cover and what to research, we also began our PowerPoint presentation. My point was to design the slides and prepare a clear explanation of the theory of variation and the Deming cycle.

On the final week we brought in our final version on what each of us would cover and finalised the presentation and practice our presentation and corrected each other if there were any faults and gave inputs to each other on how they improve it even further.

What I learnt in group work with my colleagues while preparing for presentation that people who have good decision making skills will set a vision of what need to be accomplished and setting a structure of how should we aim to achieve it. This part involves being good at making decisions, as it is very crucial part in-group work and a good academic skill to have. This motivates other to decisions rather then leaving it to the end, as it helps’s set a goal to aim for. There are also couple of skills that are crucial they include setting prioritise, communicating between colleague and inter personal skills. For example giving constructive criticism like our group did when we were carrying out presentation to each other.[2] (Rose et al,1989) It could have been wise to adopt Tuckman’s literature on group development, based on a meta-analysis of the complex models which had previously been developed. It has the virtue of being memorable, but the limitation of being rather rigid.[3](Tuckman, 1965)

[1] Davis,B.G.(2009)(2nd ed.) Tools for teaching. San Francisco: Jossey-Bass

[2] Brower,A.M.,Rose,S.D.(1989) Advances in Group work research. London: Eurospan/Haworth.

[3] Tuckman,B. (1965) “Developmental Sequence in Small Groups” Psychological Bulletin 63 pp. 384-399

Child abuse was formally recognised between the1940s-60s, it was acknowledged as being a social problem and viewed within a medical framework. ‘Casework’ by social workers developed as a means of ‘treating’ affected families (Parton, 1985 p.48; Scourfield, 2000).What we identify today as child protection social work evolved through the professionalism of the role in the 1970s and supporting legislation and local procedures established to safeguard children (Corby, 1993). Since its inception, child protection has been subject to controversy and continually placed under intense public and media scrutiny adding pressure to teams (Ferguson, 2004). As such systems appear to be in a continual crisis of confidence; when things go wrong teams are criticised for negligence, whilst conversely, social workers are criticised for being too intrusive or failing to manage demand (Mansell, 2011). Given this perpetual balancing act there is a never-ending wave of reform which to date has failed to address the public lack of confidence or media focus on shortcomings.

Child protection aims to keep children safe from ‘harm’ and, while this term is heavily debated (Dolgoff et al, 2012); the Working Together guidance (2010) identifies ‘harm’ as developmental impairment or ill-treatment which should be compared to potential impact on a ‘similar child’ (Children’s Act 1989 S.31). Of abuse reported, neglect accounts for 43.5% of cases in the UK, making the most common form of maltreatment (Swift, 1995; Ferguson and O’Reilly, 2001; Munro, 2011).

While there is no an expectation for families to avert all harm to children, parents do, as Kant writes, have an obligation to do what is necessary to aid development (1996). This is in essence the ‘parental thesis’ (Bluestein, 1982: 104-114) which suggests, rather than ‘rights’, parents have a ‘duty’ to protect their children. Fox-Harding’s (1997) seminal work on child care perspectives identifies four different positions on the relationship between state and the family; ‘laissez-faire and patriarchy’ aligns with this thinking; suggesting that the family is largely self-governing and state intervention ought only occur in cases of serious maltreatment, and in these cases the child should be removed (Goldstein et al.,1979). Below thresholds of serious maltreatment, intervention from the state is considered interfering and undermining (Fox-Harding, 1997). Whilst fair in terms of observing rights, Kirton (2009) argues that this view is somewhat idealistic and perhaps naive, as whilst no system can guarantee freedom from abuse, it has been shown that some of the most severely abused children were known to agencies charged with child protection responsibilities (Johnson and Petrie, 2004). Indeed, in the cases of Victoria Climbie and Peter Connelly the harm suffered was considered entirely preventable (NSPCC, 2001; Laming, 2003; Munro, 2011).

Child protection systems in the UK have largely been punctuated and shaped by deaths of children open to services making these incidents catalysts for reform (Beckett, 2007). The death of Maria Colwell (1973) for example, saw the thresholds for intervention lowered with the aim of ensuring that more children at risk were not missed. The result of this was an inevitable increase in the volume of children and families involved with services. Social workers were accused of being over-involved in service user’s lives, likened to Nazis and McCartyhite persecutors, and accused of involvement in ‘hysterical witch hunts’ (Meyers, 1994; Munro, 1999 p. 119). Enquiries into Kimberley Carlisle (1987), Tyra Henry (1987) and Jasmine Beckford (1985) identified failings of agencies to work together, poor assessment of risk, a need for child-centred practice and failure to intervene, particularly when parents avoided contact (Broadhurst et al, 2009). The Children’s Act followed, re-framing child abuse processes as child protection (Corby, 1993), whilst concurrently introducing the notion of ‘likelihood’ of harm and in doing so contributing to making ours’ an age of inquiry (Stanley and Manthorpe, 2004).

Though some distance from Plato’s collective rearing ideal (1993); Fox-Harding’s ‘State paternalism and child protection’ supports higher levels of intervention, postulating the state has a duty to scrutinise and promote the care of children as well as have the capacity to intervene and ‘provide something better for the child’ (Fox-Harding, 1997 p 41; Dingwall, 1983). Coming from a position of mistrust, this perspective largely ignores difficulties for parents and the potential for families to feel oppressed, as well as overlooking bonds which the child may have and the potential of developmental damage arising from removal (Fox-Harding, 1997; Kitson, 2009). Such processes can cause ‘suspect’ families unnecessary distress through investigation which can affect relationships and generate ethical and legal dilemmas (Munro, 1999b, p 120). Preoccupations with information gathering have also been accused of being beaurocratic, alienating of the natural family, failing to see the child and ultimately getting in the way of ‘real’ social work (Lonne et al, 2008; Munro, 2004, 2011).

Conversely, Dingwall discusses a ‘rule of optimism’ suggesting that in order to keep tensions between state and family to a minimal (and promote responsibility); intervention should reflect the least intrusive measures (1983). While this is the widely adopted stance since the 1980s, it was disregarded by a case in Cleveland when 121 children were removed from their families in an act of ‘over-enthusiasm and zeal’ (1988: 244). The Cleveland ‘scandal’, as it became known, was criticised for breaching the family’s right to a private life (Human Rights Act, Article 8) as, while there were concerns pertaining to some children, it was concluded that there was no substantial evidence to support their actions. This exemplifies the tension between over and under-protection and the need for social work to establish appropriate balance, between family autonomy and state intervention (Parton et al, 1997).

In an attempt to avoid ‘missing’ children or being needlessly intrusive, predictive models emerged during the 1980s (DoH, 1991; Corby, 1993). Professor Cyril Greenland assisted in the development of a checklist for practitioners to identify high-risk situations (Parton, 1991), which along with the recognition of likelihood of harm under the Children’s Act 1989, substantiated the need for authorities to consider risk. Terms such as ‘risk’ and ‘harm’ are now synonymous with social work which now holds a mandate not just to support families, but to assess dangerousness and risk (DH, 1988). Identification and assessment of risk (as well as implementing management plans) involves balancing respect for individuals’ rights alongside public safety requiring collaboration, transparency, sensitivity, openness and a non-judgemental attitude with clients, particularly where there is use of statutory powers (Beckett, 2010; GSCC, 2010).

As such, assessment is a crucial element of social work and fundamental to child protection. The Framework for Assessment of Children in need and their families (DOH, 2000b) targets children at risk with focus on encouraging practitioners to adopt holistic approaches and consider family and environment, as well as the child’s development (Hamilton and Browne, 2002). The framework lends itself to the exchange model of questioning where service users are viewed as the ‘experts’ in their lives (Milner and O’Bryne, 2002). While this is thought to empower and support engagement from the family; Calder (2003) argues that the strict timescales requiring core assessments to be completed in 35 days are too short to build meaningful relationships. Such timescales, which coincided with the introduction of local authority performance cultures (Ferguson, 2005) can result in practitioners having to adopt a questioning model which is not as conducive to engagement and potentially damaging for relationships. Calder also discussed how differing cultures and attitudes must also be considered and how these may require additional time, sensitivity and cultural awareness. Indeed, the enquiry into the death of Tyra Moore found social workers who failed to detect her abuse were inherently trusting and made assumptions about her extended family because they too were black (Batty, 2003).

The recent trial of Lucy Adeniji and inquests into Victoria Climbie and Kyrya Ishaq established similar findings and, despite significant training, there are still concerns that many social workers are not fully equipped to work with families from ethnic minorities and, in particular, are wary of tackling cultural and religious practices and beliefs they do not fully understand (Munro, 2011). While the Children Act 1989 encourages consideration of the family and child’s needs arising from their race, culture and religion, social workers must still prioritise safety and risk in child protection cases. Additionally, the use of interpreters, multi-agency working, information sharing can support defensible decision and professional judgement.

Despite inclusion in both 1989 and 2004 Children’s Acts, failure to ‘see the child’ has been a common feature in serious case reviews (Munro, 2011); as such social workers must acknowledge the needs of the child and also, where possible, meet with children in the absence of their parents (NSPCC, 2011). Fox-Harding’s ‘Children’s rights and child liberation’ perspective asks us to acknowledge the child’s voice; an ethos which is embedded much recent literature including Working Together 2010, Children’s Plan 2007, Article 10 of the Human Rights Act 1998 and ratified under the United Nation Convention on the Rights of the Child (1989). The child’s best interests should therefore remain the focus of child protection systems (Munro, 2011), and research from the NSPCC suggests children’s views are central to assessment and should be considered in all decisions which affect them (2011). Whilst progressive, the view has also been criticised for sometimes tokenistic inclusion and assumptions made regarding a child’s ability to be autonomous. As such, assessment should adopt a healthy professional cynicism not to over-estimate parental capacity (Forrester et al, 2008); to do so is collusive and, as witnessed in the case of Peter Connelly potentially fatal.

Child protection processes are stressful for families and can generate resent internally and towards services. Social workers must walk a ‘delicate tightrope’ (Dingwall et al, 1983: p19) between liberation and authoritarian positions operating within society’s values, but in accordance within their legal obligations. Families involved in child protection cases frequently have a myriad of issues including single parental responsibility, poverty, substance misuse, mental ill-health and domestic violence (Ferguson, 2004). The three latter mentioned areas are referred to as the ‘toxic trio’, which have been identified as significant risk factors in families where abuse has occurred. Brandon’s 2009 study found domestic violence present in two thirds of the sample families, parental mental ill health present in 57% and parental substance misuse in 55% of cases respectively. Three quarters of the serious case reviews analysed reported that the child lived in a home with one or more of these factors, while a third lived with families where all three were present (Brandon et al, 2009).

Even with risk management tools, predicting abuse is not straightforward and therefore it is crucial that practitioners have confidence, as well as skills and knowledge in the application of theoretical frameworks. Knowledge of attachment and ecological theory (Bronfrenbrenner, 1979) for example support practitioners’ awareness of how factors manifest and help recognise developmental delays which can indicate abuse (Trevithick, 2012). Brandon (2009) writes that thinking systematically and methodically helps avoid the sort of over-reaction which can be caused by the media frenzy surrounding high profile deaths and is best achieved by quality, holistic assessment and inter-agency working.

Thresholds to maltreatment vary significantly across the UK indicating complexity and professional anxiety (Broadhurst et al, 2010). Cases such as Victoria Climbie and Peter Connelly influenced an understandable spike in referrals and Ayre (2001) discusses a climate of fear, blame and mistrust within child protection. The enquiry into Victoria Climbie’s death established 12 possible occasions where she may been rescued (Ferguson, 2004), seeing blame placed on ‘non-existent’ multi-agency working, and as with Peter Connelly, local authority social workers and leaders named in the media (Guardian, 2002). Such outcomes can contribute towards a culture of over-referring which puts additional pressures on already overworked child protection teams (Beckett, 2011).

Recommendations from the Laming report (2003) called for increased emphasis on multidisciplinary teams, (as well as promotion of universal services) reflecting the mantra joined-up solutions to joined-up problems (Buchanan, 2007). Local Safeguarding Children’s Boards were subsequently set up to ensure safeguarding of children by all agencies, awareness promotion, training and a focus on vulnerable groups (DfES 2006). Working Together replaced previous guidance for professionals, providing detailed protection procedures and promoting multi-agency coordination such as strategy discussions, child protection conferences and core groups as part of investigations. Effective child protection is a multi-agency responsibility and working alongside teams and professionals promotes shared responsibility, accountability and most importantly knowledge and skills.

By definition, child protection systems must be able to keep at risk children safe from harm. However increasing reports of vulnerability around ‘looked after children’ suggest failings; Rochdale local authority for example recently acknowledged that they were unable to guarantee the safety of looked after children (BBC, 2012), yet rates of children entering care continue to rise. At the end of 31 March 2011, a total of 65,520 children were looked after by local authorities in England with up to 90,000 passing through in any year. This marks an increase of 9% since 2007 (HCOMS, 2012); the highest in history. Furthermore, while the majority of looked after children (74%) are in foster care placements, children who have been taken into care are more at risk of poorer outcomes and more likely to suffer mental disorders, achieve less well academically, become involved in the criminal justice system, use substances and suffer health inequality (Meltzer et al, 2003; HCOMS, 2012). This raises the argument of whether the protection that the state provides is actually effective, as the outcomes for ‘protected’ children tend to be, on the whole worse.

Human growth arguments state that the child should, as far as possible remain with the family as children are inherently vulnerable and dependent at early states, thus needing dedicated care, protection and nurturing (Bowlby, 1969; Archard, 2003). This is reflected in the Fox-Harding perspective of ‘Modern defence of the birth family’ which is, like laissez-faire, concerned primarily with the rights of the family (1997). Article 33 of the Charter of Fundamental Rights of the EU provides expressly that families should have legal, economic and social protection and therefore ‘should’ be inherently private. However, social work exists within a balance of risk and need, thus while familial privacy is, as Archard writes, an ideal; it should not detract from the protection of children who are at risk (2003).

While numbers of cases increase; CAFCASS report that neglect is being detected more promptly and local authorities were not only making more care applications, but also completing them sooner (2012). However, government cut-backs, fewer staff and resources, increasing referrals and external scrutiny continue to place demands on child protection teams and further impinge on the fragility of morale and social worker’s ability to recognise and understand dynamics of abuse (Brandon et al, 2008; Gilbert et al, 2008). Thus, while the death of a child may be more important than the death of a profession, the future safety of many children is linked to the effectiveness of social work as the primary statutory agency for child protection (Ferguson, 2004). Therefore while it may be criticised for overly bureaucratic systems, child protection’s tight procedural frameworks protects staff as well as children as such practitioners must find a way to exist within these systems, requiring understanding colleagues, managers and family to ensure workers continue to be effective and unaffected by disillusionment.