Author: Andre Coleman

The purpose of this essay is to critically analyse a report ‘Listening to Troubled Families’ (Casey, 2012). To accomplish this it will be necessary to give a brief historical overview of social policy and legislative developments from 1979 to the present day. It will go on to debate the drivers for contemporary practice and strategies that promote children safeguarding and family support. The essay will apply legislation, guidance and policies that give social workers a legal mandate to work with families whose children are deemed to be at risk. The essay will also deliberate a selection of social work skills whilst employing ‘theories and methods’ that are in accordance with ‘social work values’ (Teater, 2010, p. 4).

The report entitled Listening to Troubled Families is a snapshot of sixteen family’s lives who have ‘entrenched, long-term cycles of suffering problems and causing problems’ (Casey, 2012, p. 1). The phrase ‘long-term cycles’ is very similar to an expression that the Prime Minister at the time Tony Blair (2006) used in a speech to describe families with ‘problems [that] are multiple, entrenched and often passed down the generations’ (Blair, 2006 cited in Welshman, 2008, p. 77). Both statements can be compared to Joseph’s (1972) ‘cycle of deprivation’ hypothesis (Joseph, 1972 cited in Welshman, 2008, p. 77). This is important because according to Welshman (2012) it is an enactment of the debate concerning the ‘deserving and undeserving poor’ and popular beliefs aimed at ‘scroungers’ in British society. This has led Featherstone et al. (2012, 630) to conclude that previous and successive governments since 1979 have demonstrated ‘a cross-party consensus in regard to reduced political support for the welfare state’.

The families in the report had been compelled to work with the Family Intervention Project or risk ‘facing action on child care proceeding’ (Casey, 2012, p. 3). However, the report is actually based on ‘120,000 families’ that have been identified as ‘troubled’ (Casey 2012, p. 5) and who have cost the Government some ‘?9 billion in the last year alone’ (HM Government, 2012, p. 1). This equates to ‘…around ?75,000 per family’ (http://www.number10.gov). The figure of a 120,000 families is based on a report conducted by the ‘Social Exclusion Task Force (SETF)’ (Levitas, 2012, p. 4). That carried out some ‘secondary analysis’ (Levitas, 2012, p. 4) from the Family and Children longitude study (FACS) in 2004. Which highlighted that ‘2 per cent’ (p. 4) of households in Britain had numerous disadvantages. Levitas (2012) notes that the Coalition government have intentionally sought to mislead the electorate, into assuming that ‘multiple disadvantage’ (Levitas, 2012, p.12) equates to families that are ‘troubled, to families that are or cause trouble’ (Levitas, 2012, p. 5).

In order to work effectively with families where neglect and abuse put children at risk it is essential that the ‘subject knowledge, understanding and skills’ (QAA, 2008, p. 8). That the student has acquired in professional training underpin all interventions with individuals to allow an ‘understanding’ of ‘situations’ (Trevithick, 2012, p. 4). To understand a situation it is important that a social worker has excellent ‘communication skills’ Koprowska, (2009, p. 1) considers that these are a fundamental requirement for ‘social work assessment and intervention’ (Koprowska, 2009, p. 72). Research conducted by Levin (2004, p. 5) substantiates this as service users require social workers who are skilled in ‘listening, counselling, assessing, case managing and finding practical ways’ to facilitate. Sedan (2005, p. 22) notes that communication comprises of ‘an interactive process involving the giving, receiving and checking out of meaning’. Having the skills to communicate would enable the practitioner to engage with caregivers and children to conduct an assessment ‘ensuring an effective and fair process and outcome’ (Holland, 2010, p. 110). Laming (2009, p. 28) reiterates this claim by asserting that the ‘Assessment processes’ should encourage ‘an increasingly clear understanding of a child’s situation’ (Laming, 2009, p. 29).

To accomplish assessments social workers are required to use the Framework for the Assessment of Children in Need and their Families (DoH et al. 2000). This is a ‘holistic’ (DoH et al. 2000, p. 26) and ecological tool that has been influenced by the work of Bronfenbrenner (1979) who proposed that individuals are shaped by their ‘macro, exo, meso and microsystem’s’ (Bronfenbrenner, 1979 cited in Trevithick, 2012, p. 325). When an assessment is conducted with an ecological approach it gives a sociological context to the whole person’s life and can gauge the impacts of government policies on individuals who are often in poverty (Trevithick, 2012). A practitioner who utilises an ecological perspective will understand how the structures of society (Jack, 2011) and the inequalities and adversities that some individuals face within it can impinge on their life chances (Trevithick, 2012). It avoids ‘individualising’ (Trevithick, 2012, p. 326) problems. Using the assessment framework facilitates the practitioner in ascertaining if a child is in need and how best to react (Ward and Glaser, 2010) which the social worker will base on current research findings (DoH et al., 2000). Information is recorded about the child’s ‘developmental needs’ (Ward and Glaser, 2010, p. 160) and the caregivers capabilities to respond ‘appropriately’ (DoH et al. 2000, p. 12). Whilst taking account of all other sources of family support and any environmental influences (DoH et al., 2000, p. 12). Another significant element in the assessment framework is information sharing between multi-agencies for ‘best interest’ decisions for the child and family (Rose, 2010, p. 44). This is to avoid what has often been referred to as a ‘silo’ style of working (Miers, 2010, p. 75). Brandon et al. (2009, p. 49) in their serious case reviews have highlighted the ‘lack of information sharing within and between professional agencies’ (Brandon et al., (2009, p. 49) which has led to children dying or suffering unnecessarily. Moreover, under Working Together to Safeguard Children (DCSF, 2010, p. 31) there is a legal requirement to implement ‘effective’ (DCSF, 2010, p. 31) collaborative ‘joint working’ (DCSF, 2010, p. 31) between agencies and multi-professionals who bring a range of knowledge and expertise into discussions.

However, it is imperative that the social worker consults with the family and seeks ‘appropriate consent’ (Rose, 2010, p. 44) except when or if a child is ‘suffering, or is at risk of suffering, significant harm (HM Government, 2012, p. 22). This would be in concordance with government guidelines Information Sharing: Guidance for practitioners and managers (HM Government, 2012). This is to protect the family from any ‘over-zealous’ (Brammer, 2010, p. 126) interference and a consideration of the Human Rights Act 1998 Article 8 should be applied to the families situation by any professionals involved in their lives. A practitioner should also consider the Rights of the Child under The United Nations Convention 1989 (Brammer, 2010, p. 178). Although these rights are not recognised under the United Kingdom domestic law and usually the ‘Gillick competency’ applies (Brammer, 2010, 179).

Angela and Carl (a case study within) the Troubled Families report had asked for help in relation to their son ‘Sam’, unfortunately this was not forthcoming. An appeal for support and Sam’s presenting behaviour should have been an opportunity for early ‘identification’ of any ‘additional need’ (DCSF, 2012, p.84). Professionals in health or education could have implemented the Common Assessment Framework (CAF) with ‘informed consent’ (CWDC, 2012, p. 20).

Performing a CAF would have identified Sam’s additional needs as above and beyond universal services (CWCD, 2012). The CAF is a combination of ‘integrated frontline’ (CWCD, 2012, p. 8) service provision that is incorporated into ‘statutory guidance’ (CWCD, 2012, p. 8) of the Children Act 2004 under section 10 (multi-agency collaboration) and section 11 (protection and promotion of children) (CWCD, 2012, p. 8). Significantly, the local authority, health and education ignored Angela’s concerns and displayed an ‘individualised approach’ (Davis and Smith, 2012, p. 14) to Sam and his family. This may have been because of the ‘rationing’ (Davis and Smith, 2012, p. 14) of services in social care. As a result of numerous local authorities losing fifty per cent of their child in need budget (Community Care, 2011). Professionals involved should have endeavoured to ‘understand’ the ‘life issues’ (Davis and Smith, 2012: p. 14) for Sam and contacted health and education professionals that Working Together to Safeguard Children (DCSF, 2010) requires.

As an alternative, to an individualised approach the social worker concerned could have employed a selection of ‘politically nuanced holistic models’ (Davis and Smith, 2012, p. 18) to the intervention. These models according to Davis and Smith (2012) would allow the social worker to recognise that they are not the total expert in situations and accept that there are many ‘forms of expertise’ (Davis and Smith, 2012, p. 18). The social worker should have identified Angela as the expert on her family and listened to her concerns. Dolan et al. (2006, 2008) have differentiated several processes to assist the practitioner in ‘family support work’ (Dolan et al. 2006 cited in Davis and Smith, 2012, p. 19). They propose that by identifying a service user’s ‘resilience’ and ‘strength’ (Dolan et al. 2006, 2008 cited in Davis and Smith, 2012, p.19) a promotion of partnership working will be established for all individuals concerned including the child. (Dolan et al. 2006 cited in Davis and Smith, 2012 p 19.). A social worker should be accessible and listen to a child’s requests and views while considering their ‘well-being’ and ‘safety’ (Dolan et al. 2006, 2008 cited in Davis and Smith, 2012, p.19). This is a requirement under section 17 of the Children Act 1989 (CA 1989) as amended by section 53 of the Children Act 2004 (CA 2004) to determine the ‘wishes and feelings’ of the child (http://www.legislation.gov.uk).

Applying an ecological perspective to Sam would have facilitated the practitioner into recognising the impact of ‘poor housing’ on his ‘mind, body and emotions’ (Davis and Smith, 2012, p.16). An opportunity was missed by social services to engage the family with a ‘minimum intervention’ service (Davis and Smith, 2012, p. 18) and connect Angela via a ‘systems approach’ with some ‘community resources and networks’ (Mantle and Backwith, 2010, p. 2381).

The Framework for the Assessment of Children in Need and their Families recognises the implications of poverty and is determined to ‘tackle the root causes of poverty and social exclusion’ (DoH et al. 2000, p.1). However, Brewer et al. (2009) challenge this claim, and note that in 2007 – 08; poverty for individuals in the United Kingdom had increased to a ‘total of 13.5 million’. This has led to the highest levels of ‘income inequality’ since 1961 (Brewer et al., 2009 cited in Mantle and Backwith, 201, p. 2380). It is vital therefore that whilst conducting an assessment that the social worker does not exhibit ‘poverty blindness’ (Becker, 1997; Dowling, 1999 cited in Gupta and Blewett, 2008, p. 462) and has awareness of the effects poverty and how it can impact on parenting abilities. Service users in a collaborative research project were asked their views about what makes a good social worker. They wanted practitioners who were ‘open and honest and could ‘demonstrate an understanding that society as well as individuals can create neglect’ (Gupta and Blewett, 2008, p. 465).

The ‘Listening to troubled families’ report was deficient in its lack of reference to poverty or ‘social inequality’ (Palmer, 2010 cited in Trevithick, 2012, p.77). It did not discuss the ‘multiple forms of oppression’ (Hick and Murray, 2009, p. 88) that ‘dominant structures’ (Hick and Murray, 2009, p. 88) create. Hick and Murray, (2009, p. 88) suggest that the social worker who uses a structural perspective would seek to emphasise the ‘class analysis’ of the oppressed individual by the forces of dominant ‘economic power’ (Hick and Murray, 2009, p. 88). They posit that this perspective has been influenced by a ‘feminist analyses’ and the ‘patriarchal’ (Hick and Murray, 2009, p. 88) effects on family dynamics and work environments. As most social workers and the recipients of services are women (Balloch, 1997; Howe, 1986) a social worker could utilise a feminist perspective to inform their practice and advocate for fairer ‘rights and opportunities’ (Orme, 2009, p. 67) with these particular families. The social worker should be politically enlightened to enable them to campaign for the ‘collective interests of working-class’ (Orme, 2009, p. 67) groups. Leading to a recognition of full ‘economic and social rights’ (Bryson, 1999 cited in Orme, 2009, p.67).

Nicole who was a participants from the report had been raped at the age of four by her half-brother, started suffering ‘depression, it all got too much’ (Casey, 2012, 34) and was subjected to domestic abuse and rape by an ex-partner. Nicole was consuming alcohol and a ‘speed addict’ and was presenting with ‘anti-social behaviour’ (Casey, 2012, p.34). Research from Widom Spatz and Sturmhofel (2001) note that the experience of being abused as a child can increase a person’s likelihood for alcohol related problems as an adult. It could be hypothesised that Nicole was using alcohol and drugs as a form of self-medication and to gain control of an oppressive life situation. Research indicates, that ‘Dylan’ Nicole’s son or children of parents who abuse substances may be at risk of poor attachments to caregivers (Brooks and Rice 1997; Klee et al. 1998; Howe et al. 1999; Flores 2001), difficult interpersonal family relationships (Cleaver et al. 1999; Velleman and Orford 1999; Harbin and Murphy 2000) and a substantially increased risk of violence (Brookoff et al. 1997). The chronicles of children whose parents have or are misusing substances have been procured by an evaluation of research studies by Kroll, (2004). Themes that emerged from the research studies were ‘attachment, separation and loss’ (Kroll, 2004, 133) children spoke about being second best and keeping secrets. ‘…When you see ’em do drugs long enough you know you’re not number one; you know you’re always put second and the drugs are put first…’ (‘Jessica’ aged 15, in Howland Thompson 1998, cited in Kroll, 2004, 133). The research highlighted the children’s losses and lack of ‘reliable, consistent and responsive’ (Kroll, 2004, 133) parenting, their lack of ‘confidence’ and self-worth, (Kroll, 2004, 133) and the loss of an ordinary life in which they would be able to invite friends home or attend school consistently (Cork 1969; Howland Thompson 1998). In the children’s narratives they wanted professionals to appreciate their ‘hurt on the inside’ (Kroll, 2004, 136) and not to be ‘invisible’ (Kroll, 2004, 136).

The local authority are compelled under the CA 1989 part III to support families who need help bringing up children and work in partnership with caregiver’s (DoH et al., 2000). However, after the implementation of the CA 1989 it was discovered through Messages from Research (DoH, 1995) that a concentration on ‘child protection’ had created a dearth of services for the child in need (Morris, 2012, p. 14). This was supported by the Victoria Climbie inquiry as Laming (2003, p. 6) asserted that usually the safest protection for the child was ‘…timely intervention of family support services…’ In response to the inquiry, the Green Paper, Every Child Matters (2003) was introduced (Parton, 2006, p. 151). Its remit was to focus on ‘universal’ (Parton, 2006, p. 152) services for all children and ‘targeted’ (Parton, 2006, p. 152) services for children with any further supplementary needs.

The Laming inquiry (2003) made recommendations that were instigated by New Labour who envisaged service provisions that were based around ‘preventative services and early intervention’ (Driscoll, 2009, 335). These services took the form of ‘Sure Start, the Children’s Fund and Connexions (Morris, 2012, 16). However, the provisions that New Labour implemented failed to engage the families’ with the most enduring and ‘complex’ (Morris, 2012, p.16) requirements. Therefore, like the preceding CA 1989 which had ignored ‘children in need’ (Morris, 2012, p. 17) and the subsequent Children Act (2004) which had failed to reach more complex families, ‘policy drivers’ had become ‘confusing’ and sometimes ‘contradictory’ (Morris, 2012: 17).

The debate around ‘early intervention’ (DoH et al., 2000: xi) have evolved from New Labour’s ‘modernisation’ agenda and their attempt to meet the demands of a ‘globalised economy’ (Frost and Parton, 2009, 25). However, these concepts can be traced back, to when the Conservative government who had initially gained power in 1979 (http://news.bbc.co.uk) and introduced managerialism and a mixed economy of care into the organisation of social services departments (Frost and Parton, 2009). As well as promoting ‘economy, efficiency and effectiveness’ (Frost and Parton, 2009, p. 24) the Conservatives were concerned with encouraging services that were ‘transparent’ and ‘accountable’ (Frost and Parton, 2009, p. 25). When New Labour was elected in 1997 they ‘adopted’ (Chard and Ayre, 2010: p. 96) many of the Conservative policies and implemented ‘performance targets, inspection regimes and league tables’ (Frost and Parton, 2009, p. 25). However, Ferguson (2004, p. 4) posits that New Labour went further and ‘has embraced the market with a passion and enthusiasm which often leaves the Conservatives standing’ Numerous commentators (Dixon et al., 1998, cited in Chard and Ayre, 2010, p. 95) assert that managerialism has been regarded as a market driven ‘solution’ to a public service ‘problem’. Lonne et al. (2008) argue that a managerialist perspective does not appreciate the significance of forming trustful, professional, relationships with service users. Ferguson (2010) clarifies this as the absence of social work involvement with children and families as social workers have been increasingly drawn into an office based environment. Therefore, any direct contact with families is limited with the social worker orchestrating services and fulfilling administration duties. This leaves no time according to Peckover et al. (2008) for interpersonal communication between the practitioner and family. Broadhurst et al. (2010, p. 363) bemoans this outcome as ‘the space between help-seeker and help-provider is steadily widening’. Munroe (2011) in her final report on child protection stressed that professionals have found it increasingly difficult to sustain any direct work with children and their families. This is because of the burden of ‘statutory guidance, targets and local rules’ (Munroe, 2011, p. 6). Laming (2009: 10) reiterates these claims by asserting that ‘…ultimately the safety of a child depends on staff having the time, knowledge and skill to understand the child or young person and their family circumstances’.

In conclusion this essay has explored the Listening to Troubled Families (Casey, 2012) report and as Levitas (2012, p. 4) notes ‘The problem is not the research itself, but its misuse’ and the Coalitions attempt to mislead the public.

The social work profession promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being. Utilizing theories of human behavior and social systems, social work intervenes at the point where people interact with their environments. Principles of human rights and social justice are fundamental to social work. (IFSW/ IASSW, 2000/ 2001).

As per the above definition we understand social work as a profession based on certain values, norms, ethics and principles. Applying this theoretical knowledge into practical a social worker can help the people for their happiness, development and attainment at social and psychological level. Human beings are the most prominent identity or unit of any society. The aim of social work profession is to bring social changes in the society and make people aware and independent for their development. Social work practice emphasizes social development, equality, human rights, social justice, social change, community development, fulfillment of needs of every individual as well. On the worldwide social work practice has been developing. To understand the issues in International social work, first we will discuss the global and international. Global social work means the practice pertaining to or involving the whole world, whereas international can mean one of the following: between or among two or more nations, of or pertaining to two or more nations or their citizens, pertaining to the relations between nations, or transcending national boundaries or viewpoints. So, international social work is that it involves any aspect of social work in which there is some relationship between two or more countries or nations. We can understand international social work from following aspects:

When a social worker practice social work in any country other than his/her home country,

Working with various international organizations (whether or not a social worker moves to the different country)

When a social worker do collaborations, networking between countries and they exchange their views and ideas for development of social work profession.

International social work is defined as international professional practice and the capacity for international action by the social work profession and its members. International action has four dimensions: internationally related domestic practice and advocacy, professional exchange, international practice, and international policy development and advocacy. (Healy: 2001, p. 7)

Linkages between international and local social work: – There is a strong connection between international and local social work. As we know that both social work practice are for development of human beings. The integrated approach to international social work and even each dimension of all four perspectives cannot exist without local social work. All the global social problems are raised from local only. The global issues like poverty, human trafficking, HIV/AIDS, Gender discrimination, violation of human rights, ageing etc originates from local. These issues not only affect the local even they raised a question around the globe. So we can say that international and local social work are interrelated to each other.

Global
Perspective

Movements to internationalise social work: – In present scenario social work is emerging as broad and vast profession with in different countries and on global level as well. To understand the movements to internationalise social work we need to understand the integrated aa‚¬” perspective approach of international social work which is based on four inter related dimensions. It is an integrated approach because every dimension of it is related to each other.

Human Rights Perspective
Ecological
Perspective
International Social work
Social
Development
Perspective
Fig 1.1

The above integrated approach to international social work depicts that all these approaches are interrelated and compliments each other in some way. The integration of these approaches constitutes international social work. We can say that international social work covers or exists the integration of these perspectives. A single perspective cannot constitute international social work. Here we are discussing the movements in each perspective to evolving international social work.

Global: – The importance of global factors can be found at macro level. As it is global perspective so this factor influences the international social work at global levels. Global perspective is itself significant and vast. In the existence of global perspective focused on six dimensions of global perspective. These are unity, diversity, interdependence, globalization, localization and world citizenship.

Unity: – The unity dimension of global perspective shows that all human beings obtain from the same origins and exhibit the same basic needs. However we all are affected in one sense or another but varying degrees we bear, for example issues in the world which affects human beings at global level i.e. terrorism. So these global issues affect the human beings although we all are from same origins.

Diversity: – The other side of coin is that all human beings are diverse with each other in many ways. Although origin is same but at the global we all have different culture, way of living. Around the globe people are different to each other in their behavior, understanding as we know that each individual is unique. This diversity among human beings can be in terms of political, social and economic system which sometimes results in competition or conflicts among systems which affects the human beings at global level.

Interdependence: – These unity and diversity among human beings enables us all to learn and benefit from each other experiences around the globe. We strive to build a world of benefit to all people across all generation.

Having a global perspective and approach to social work practice enables us to appreciate the universals in human experience. Recognition of commonalities and increased respect for differences helps to dissipate fear and distrust and to promote world peace, international cooperation and global justice. A global perspective offers new ways and multiple dimensions of analysis from a multicultural and pluralistic viewpoint. This dimension shows us that people around the globe are interdependent and interconnected to each other. As we know that events exists in any part of the globe does effects all the human beings in other part of the globe. For example the issues of human rights, conflict changes in political or economic systems affect the whole world.

Globalization: – Globalization is a process which diverse people, economies, cultures and political processes which influences people at international level. Globalization affects the social work in different countries. It is a process of global integration of people which bounds and influences them economically, culturally and politically. In the other aspects of globalization it may be useful to highlight the movements at national and international levels including antiglobalization movements. We cannot discuss international social work without globalization as it affects on both social work practices and social systems. For example the actions of social work are contextualized by the impact of economic, political and cultural globalization.

Localization: – It is quite opposite to globalization, as globalization represents or influences around the globe whereas localization exists the changes at local levels. Globalization and localization clearly interdependent to each other. We can understand these as two sides of the one coin.

World Citizenship: – The above dimensions localization and globalization also conceded through the concept of world citizenship. Global citizenship exists at both the local and global level as well. This concept is closely related with the emergence of global civil society. Although a human being can be a citizen of any nation or territory but we are the entire first and most citizens of the world, entitled to the protection of international community also. As we have already discussed that issues at the global or international affects the human society at the local level also.

Human Rights: – The human rights perspective is a prominent dimension of integrated approach of international social work. As it emphasis the values and rights basis of international social work practice. The human perspective consists of four dimensions, these are: values and principles, human rights, universality and a guide to living and behavior. The first dimension values and principles are based on the importance of human rights, philosophical values and principles as well. It highlights the list of the values and principles on which human rights arte based which is given by United Nations Centre for Human Rights. The second dimension emphasis the human rights at global level. There are declarations by UNCHR for the protection of human rights and for their welfare. A set of human rights which embraces the overall development of an individual also highlights the human rights at every aspect. The third dimension of universality says that human rights are entirely universal. The human rights are fundamental and universal which is recognized internationally. These human rights are necessary for every individual to live their life with dignity and protection. This gives universal values, importance and identification to human rights even internationally. The fourth dimension which is related to perspective of human rights i. e a guide which reflects the norms and values to human beings for their living and behavior in the society. This guide basically tells human beings how to behave and treat with each other in society whether at individually or in groups.

The Ecological Perspective: – This perspective has also four dimensions. Theoretically, the ecological perspective gives emphasis on the protection and safety of natural environment where an individual is living his/her life. This is also based on four dimensions.

Holism and Unity: – This highlights the importance of holistic approach for human development which emphasizes the unity among human beings and nature from both a spiritual and a practical perspective as well.

Diversity: – As we have discussed diversity in global perspective. Here also in ecological perspective unity and holism is balanced by diversity. According to this as human beings are diverse in nature, culture etc. So nature should be benefited with diversity of species and conditions within the web of life.

Equilibrium: – Here this dimension is giving emphasis to maintain a balance between the various species and their differing conditions. This basically shows the connection between human beings and environment that they both are interdependent on each other.

Sustainability: – This dimension is the most prominent in ecological perspective. This highlights the sustainable development of human beings. Sustainable development is extreme as it is gives last satisfaction and fulfillment of human needs and improvement of the quality of human life.

The Social Development Perspective: – We can define social development is a process of planned social change designed to promote the well-being of the population as a whole in the conjunction with the dynamic process of economic development. (Midgley, 1996a). This perspective has four dimensions which are as follows:-

Value- based: – The value based dimension highlights that individual is a key important in any society. It accepts the human development by society at every level. It highlights the approaches and key issues for the social development of human beings with their participation. It gives opportunity to every individual for being a part of social development.

Proactive intervention: – According to this dimension social development adopts a development approach, that it creates a society which is elf reliance, independent and empowered. In this sense it represents the proactive intervention dimension which can give opportunity to human beings to make their life better. This shows that it is people- centered and participatory dimension

Multidimensional: – The social development approach is multi-dimensional. As here social development means a development in holistic and integrated manner. This recognizes the development in life of human being in the social, political, economic, legal, ecological manner. On the other side it is highlighting the presumption in development of social structures, social relations, and social values as per the situations in human life. This shows that social development is talking about the multidimensional dimension around the globe.

Multilevel: – This is very prominent as 0it shows the development of human beings at every level such as local, national, regional or global level. Also the development of every units of society. So we can treat it as multilevel dimension.

As we have discussed earlier in the concept of international social work is that when a social worker moves to another country in order to practice social work. Here transmission of social work happened within the countries through various social workers.

International Law: – At the beginning of 21st century, international law remains subordinate to state power which tends to favour economic, political or military interests whenever they conflict with those of justice. International laws are there to protect human rights and the role of state for the protection of these human rights.

Universalization: – It is a process which emphasizes that core values apply to all human beings irrespective of their identity, cultural background, personal preferences and so on.

Human Rights: – Human rights could be generally defined as those rights which are inherent in our nature and without which we cannot live as human beings. Human beings are equally entitled to our human rights without any discrimination. Universal human rights are often expressed and guaranteed by law, in the form of treaties, customary international law, general principles and international law. International human rights law lays down obligations of governments to act in certain ways or to refrain from certain acts, in order to promote human rights and fundamental freedoms of individual or groups.

Erasmus Intensive Programme: – Before discussing this we will understand the concept of professional imperialism which emphasizes the ways in which social work practices and models of professional education have been taken from the global North to global South.

This programme is funded by Erasmus (EU) for 3 years. In this programme constitutes the collaboration of 5 nation states: UK, Germany, Spain, Finland or Poland. This is open for social work and social policy students to make a student exchange visits and to conduct research projects in their respective states which promotes the concept of international social work.

Conclusion: – In conclusion we can say that international social work is a vast concept which we can understand in various ways. International social work refers to education, practice, research, policy and exchanges concerned with the realities of global processes in human well- being. We cannot ignore international social work as there is need to promote it around the globe, so that in collaboration with various international and national organizations social workers can do social development in society and can attain the sustainable development of human beings. International social work represents a modernity perspective, a common understanding of problems, that people are much the same that we are all citizens of one globe and that problems can be understood across borders. The problems at local affect the global and issues which are from global affects local.

‘There are many competing pressures to direct the service in ways that may not be consistent with Social Work principles towards greater penal and correctional models. It is therefore essential to have a clear understanding of the policy and legal framework that creates the remit and legitimacy for the operation of Social Work in the Criminal Justice process’ (Whyte, 2001, p.7).

As Whyte’s views indicate, to practise effectively, it is necessary to have a critical understanding of the law and to recognise limitations as well as strengths in Social Work. The law can lack clarity and can be open to interpretation. This essay aims to discuss Social Work roles and responsibilities in Criminal Justice settings in relation to the increasing number of women involved in the Scottish Criminal Justice system. The law can make the Social Work task complex and issues related to assessment, decision-making, accountability, discrimination and oppression will be considered and the impact on services users, their families and the community.

Social Work involves working with marginalised and disadvantaged service users who can be both vulnerable to crime and susceptible to criminalisation and subsequently, practice involves work with victims or offenders. Local Authorities (LA’s) have a statutory responsibility to provide Criminal Justice Social Work Services to support the Criminal Justice process through assessment of individuals, information to the Courts and supervision of offenders.

Scotland differs from the rest of the UK in that there is a unique cultural and political heritage and a separate legal system. Social Work therefore, has a central role within the Criminal Justice process in Scotland which is in contrast to England and Wales. As McAra (2005) suggests a more welfare orientated approach has been adopted due to Scotland’s legal culture and political history.

The legal framework outlining powers and duties of Criminal Justice Social Work is the Social Work Scotland Act 1968 (as amended). Section 27 of this Act outlines the duty by LA’s to provide specific Criminal Justice services (for example social background reports, supervision of offenders on an Order or Licence) in respect of central government funding however, it does not explain the objectives of these services or provide guidance on their exercise. Section 12 gives LA’s discretion to provide additional services for example to victims, as part of the general responsibility to ‘promote social welfare.’

Probation or offender services became the responsibility of the LA Social Work Departments in 1968 and had a general duty to ‘promote social welfare’ in their locality (S12, Social Work (Scotland) Act 1968). This was due to the Kilbrandon Committee (Kilbrandon, 1964) being appointed to investigate increasing juvenile crime. The Kilbrandon Report recommended a new approach to children’s services with children who offend being treated the same as children requiring care and protection. Kilbrandon also suggested diversion and early voluntary intervention as crime prevention and one department for children and adults. This merge of work with adult offenders was pivotal in recognising work with offenders as having a welfare component admittedly with a level of control. The Kilbrandon philosophy advocated rehabilitation and treatment of offenders and an awareness of the social causes of crime which is still relevant to today’s practice.

From the 1980’s onwards Criminal Justice in Scotland has undergone major legislative and

policy change. As there was concern for public protection and community disposal

effectiveness in 1991, 100 per cent central government funding was introduced and the

National Objectives and Standards (NOS) were published which set out core objectives,

service provision and guidance on their delivery (Social Work Group, 1991). This resulted in

the government committing to Social Work delivering this role.

Due to recent rising prison populations, there has been growing political concern that custody rates need to decrease and should be replaced with community based alternatives. Women are only a minority of the prison population but their imprisonment is increasing more than that of men (McIvor, 2007), although their offending is less serious and less frequent.

Prison sentences are inappropriate for female offenders, with the exception of serious or violent female offenders as their fragile situation in the community can be exacerbated and this can have a long-term negative impact on women and their families (Corston, 2007).

Social Work with offenders should aim to address and reduce offending behaviour. Whilst the law provides a framework for practice, effective work with offenders requires skills such as communication, therapeutic relationships in supervision, assessment and risk management. The task is varied and complex as Social Workers have the power to control the individuals who are referred via the Courts and enforce Court Orders but must also work with an offender in a holistic, inclusive way to have a positive impact on their offending behaviour (Scottish Executive, 2004a). This can be through support and assistance in relation to personal and social problems but also the individual taking responsibility for their actions. Effective and ethical practice is therefore, about considering and managing the needs and rights of the Courts, the general public, victims and offenders.

Although Social Workers have statutory duties and powers to intervene in people’s lives this is not always welcome but is necessary in promoting public safety. Under the Scottish Social Services Council (SSSC) Code of Practice, Social Workers have an obligation ‘to uphold public trust and confidence’ and the Criminal Justice Authorities (CJA’s) are required by Scottish Executive guidance to develop a strategy to address this (Scottish Executive, 2006b). This strategy includes both offenders and their families and Social Workers should engage these individuals and recognise their views in the development of services.

Both Criminal Law and Social Work recognise the autonomy of individual’s choices on how they lead their lives and with this capacity is criminal responsibility. Those who lack capacity e.g. children and the mentally disordered, are not culpable in the eyes of the law and may be treated differently. It is therefore recognised that criminal behaviour is not just a choice but may be about social circumstances to which they have minimal control. Social Workers should assist in allowing individuals to improve their capacity for making choices together with consequences to their actions (ADSW, 1996a).

Although Social Workers are obliged to protect the rights and interests of service users there is a belief amongst the general public that they have forfeited these rights when they have offended. All Criminal Justice agencies must comply with the Human Rights Act 1988 which incorporates into domestic law the fundamental rights set out in the European Convention of Human Rights (ECHR). Public Authorities are required to respect all of the provisions however, the two articles with particular relevance to Criminal Law and Social Work are ‘the right to liberty and security’ (Article 5. ECHR) and ‘the right to a fair trial’ (Article 6, ECHR). However, restrictions can be imposed on those who breach criminal law or are a threat to public safety as long as the detention is authorised by law and there is balance between the individual, their victims and the general public. The Social Worker must assess this balance through rigorous assessment and analysis of risk. The role requires respect to offenders as individuals and ‘ensure that the offender’s ability and right to function as a member of society is not impaired to a greater extent than is necessary in the interests of justice’ (ADSW, 1996a).

Criminal Justice Social Work services are delivered in partnership with various statutory and non-statutory agencies and this presents challenges due to conflicting professional values and aims. The Management of Offenders etc. (Scotland) Act 2005 was introduced to improve joint working and co-ordinate the management of offenders in the transition from custody to community supervision and places a duty on Criminal Justice Authorities (CJAs) to have an information sharing process in order that relevant information is shared between agencies (s.3 (5)(g)) for improving offender and risk management. However, sensitive personal information must be handled carefully and be under the principles of the Data Protection Act 1988 and local agency protocols.

Practitioners must ensure that any information sharing decisions are fully explained and understood by the offender even when their consent to disclosure is not required.

Organisations who deliver public services have general duties to eliminate unlawful discrimination and promote equality of opportunity on the grounds of race (Race Relations (Amendment) Act 2000), sex (Equality Act 2006), and disability (Disability Discrimination Act 2005). Individuals who are involved with Criminal Justice organisations are entitled to the protection of discrimination laws which relate to sex, race, disability, religious beliefs and sexual orientation, with exception to exercising judicial functions or carrying out Court orders. In these circumstances, it may be within Article 14 of the ECHR which prevents to the right to liberty and security of the individual or the right to a fair trial being interfered with on a wide range of discriminatory grounds. Criminal Justice is still influenced by prejudicial and discriminatory views.

Research carried out by both the Social Work and Prisons Inspectorate for Scotland (1998) highlighted concerns about the treatment of female offenders in the Criminal Justice process. In addition, several inquiries in England and Wales in relation to racial discrimination by the police and prison services have subsequently raised public awareness (Macpherson, 1999; Keith, 2006). The Scottish Government has a duty to publish information of discrimination of any unlawful grounds (s.306 (1)(b) Criminal Procedure (Scotland) Act 1995) and therefore, all workers need to practise in an anti-discriminatory way.

The law outlines the limits of Social Work intervention and knowledge of the law is essential to anti-oppressive practice.

‘The only legitimacy for intervening in the life of the individual within the criminal justice process is the individual’s offending behaviour…if individuals have social needs which require to be met but are not crime related or crime producing, or if the offence is not sufficiently serious to fall within the criteria of the ‘twin-track’ approach, services should be offered, as far as possible, through voluntary provision…No-one should be drawn into the criminal justice processes in order to receive social work help’ (Moore and Whyte, 1998, p.24).

Risk assessment and offence based practice is an ethical approach. It aims to ensure that ‘the most intensive and potentially most intrusive services are focused on those service users who pose the greatest risk of causing harm to others'(ADSW, 2003) and prevent socially disadvantaged individuals being taken further into criminal justice control which can result in further social exclusion. There is often a complex relationship between social exclusion and offending behaviour and often the Criminal Justice process displays existing injustices within society. It is important that issues in relation to class, age and social context should be recognised together with vulnerability to discrimination.

The Social Worker’s role should be to address issues of social exclusion and empower individuals to lead law abiding lives by addressing their offending behaviour. Social Work can help offenders develop capacity to make informed choices by actively encouraging engagement with improving their current situation and their participation in the supervision and change process (McCulloch, 2005; McNeill, 2004). Assisting offenders to focus on their strengths as opposed to their risk and needs can have a positive impact as they learn to recognise the value in their own lives and respect the value of others.

The sentencing stage in the criminal justice process generates the majority of Criminal Justice Social Work through provision of information to the Court in the form of Social Enquiry Reports (SERs) and the administration of community disposals, with the exception of liberty orders (tagging). SERs have no legal basis but there is a statutory duty on criminal justice social work to provide reports to the Court for disposal of a case (s.27(1)(a) SWSA 1968. ‘Reports provide the court with the information and advice they need in deciding on the most appropriate way to deal with offenders. They include information and advice about the feasibility of community based disposals, particularly those involving local authority supervision. In the case of every offender under 21 and any offender facing custody for the first time, the court must obtain information and advice about whether a community based disposal is available and appropriate. In the event of custody, the court requires advice about the possible need for a Supervised Release order or Extended Sentence Supervision on release’. (Scottish Executive, 2004d, para. 1.5)

The Criminal Procedure (Scotland) Act 1995 sets out when the court can or must obtain an SER. Failure to request a report, where required by law, can result in a sentence being quashed on appeal. The Court is not obliged to follow recommendations or opinions in the SER however, Social Workers can have a direct influence on the sentence passed.

‘Preparing SERs demands a high standard of professional practice. It requires skilled interviewing, the ability to collect and assess information from different sources, and the art of writing a report which is dependable, constructive, impartial and brief’ (Social Work Services Inspectorate (SWSI), 1996).

The law imposes time limits in compiling reports, which in practice creates more demands on a worker’s time and places increased pressure in the preparation of SERs especially if there are high numbers of worker absence or whether the offender is known to the worker and their individual circumstances. Whilst conducting interviews the worker must ensure that the offender understands the purpose of the report, the relevance of questions (health, addiction issues, and personal relationships) and the limits to confidentiality of this information. Social workers must balance between an informed recommendation and an awareness of the severity of the offence. The report author should be impartial and not minimise the seriousness of the offence and its impact (NOS, Scottish Executive, 2004d, para 5.5) and phrases that imply moral judgements, label or stereotype offenders should not be used (para. 5.1).

When compiling an SER workers are required to consider the suitability of disposals in relation to the risk posed by an offender and to target appropriate resources which are most appropriate and successful in addressing offending behaviour. Risk assessment is complex and there has been a shift from concern for the offender and their needs to concern about public safety and the offender being a potential source of risk to others. Although the legislation is not explicit about offending behaviour, NOS state that SERs should provide ‘information and advice which will help the Court decide the available sentencing options…by assessing the risk of reoffending, and…the possible harm to others. This requires an investigation of offending behaviour and of the offenders’ circumstances, attitudes and motivation to change’ (Scottish Executive, 2004d, 1.6).

The most widely used assessment tools are The Level of Service Inventory – Revised

(LSI-R) to assess risk of re-offending and the Risk Assessment Guidance Framework (RAGF) to assess risk of harm. However, worker’s vary in their use of risk of harm assessment tools, with some workers using the Risk Assessment 1-4 (RA1-4) due to lack of training on the RAGF assessment tool, lack of confidence or personal choice and in personal experience some workers fail to address the risk of harm in SER’s for fear of being questioned about the validity and reliability of the assessment. LA Criminal Justice Services have opted for one or other, or a combination of both approaches in their offender management. However, the national implementation of a common tool is now planned, with the proposals for The Level of Service Case Management Inventory (LSCMI) (Scottish Government, 2007).

These risk assessment tools are inappropriate for women offenders, as their development is based predominantly on populations of men (McIvor and Kemshall, 2002: Maurutto and Hannah-Moffat, 2006), tend to over predict the risk of re-offending and fail to identify health and other needs that are of particular relevance to women. Even where needs are identified it is unclear whether or how they relate to women’s offending. Actuarial calculations can result in inappropriate and harsh responses from the Courts but can also deny that a woman is in the process of desisting from crime or that her offending is a symptom as opposed to a cause of other additional problems in her life. It could be argued that focus should be more about needs which stablise an individual’s lifestyle than on offending, which results from that lifestyle, and could be seen as a better way to inform both sentencer and practitioner decision making.

Professional judgement also varies widely depending on the assessor. Differences can emerge due to worker’s age, length of service and experience and some use their professional judgement more than actuarial methods (Barry, 2007a). Risk assessments are standardised tools which fail to take into account how appropriate interventions are or the availability of services but form the basis on which the need for and access to interventions is determined. These differing needs and circumstances mean that available interventions are not appropriate for a lot of women.

The assessed needs of women are not always taken into account in the sentence they receive. Women predominantly, are given harsher sentences that are disproportionate to the offence in comparison to the treatment of male offenders. Community Service is a high-tariff disposal which is legislated to serve as an alternative to custody. However, research carried out in Scotland concluded that women were more likely to receive a Community Service Order in their involvement in the Criminal Justice system than men (McIvor, 1998; McIvor and Barry, 1998).

Community Service is traditionally male dominated, is mainly heavy manual duties such as painting, landscaping and joinery and many women struggle with this disposal for several reasons. Firstly, in terms of child care arrangements whilst undertaking their placement, women can be wary due to past experiences with Children and Families Social Workers even although they have no access to childcare through their own social networks and therefore, organising childcare facilities becomes the responsibility of the Social Work Department.

Additionally, there is lack of female supervisors to oversee Community Service placements for women and many women are reluctant to be supervised by a man and this greatly reduces the number of placements appropriate to their skills and capabilities.

The use of effective and appropriate sanctions for female offenders presents some challenges. Interventions and services are typically developed for male offenders but are unlikely to meet female offenders’ needs and there is increasing recognition that gender appropriate provision is required. As argued by Sheehan et al. (2007) gender specific responses may encourage a reduction in imprisonment for this vulnerable group as women tend to offend through necessity than choice (Barry, 2007b; Home Office, 2004).

Support from Social Workers’ should be given to reduce involvement in offending, but underlying problems must also be addressed such as low self-esteem, mental and physical health, financial restraints and limited educational and employment opportunities.

A study of probation with female offenders in Scotland, found that practitioners recognised that interventions with women need to be more informal, less structured and more focused on issues other than offending behaviour. Community sanctions work more effectively if there is flexibility as women tend to breach orders as a result of non-compliance as opposed to further offending (Scottish Government, 2007).

Probation can be seen as access to a package of welfare measures which might not otherwise be available to women who need support as opposed to punishment (McIvor and Barry, 1998). An ongoing challenge for practitioners is the absence of alternative welfare orientated disposals and that some women view probation negatively based on previous episodes of supervision or involvement in relation to child care issues and may not embrace support made available. Probation Orders vary in length and this can cause difficulties in client motivation over a long period of time and increases the risk of non-compliance resulting in Breach.

Although the law is crucial in framing Social Work practice in the Criminal Justice process it is equally important that Social Work skills and values are central to effective interventions. Crime has become increasingly prominent both in the public and political agenda and therefore, Social Work has become more prominent and complex. Social Workers have a professional responsibility towards victims, the Court, community and offenders however, community based resources are scarce for women as their offending rarely presents a significant public risk (Scottish Office, 1998).

The needs presented by women appear to be less about offending and more about the underlying problems in their lives such as former or current abuse, poverty, parenting difficulties, mental health and addiction issues and this can increase the likelihood of offending (Carless, 2006). These problems due to their nature and complexity often make it difficult for professionals to work effectively within the confines of the Criminal Justice system. Priority should be given to offering practical and emotional support to women rather than focusing on their offending behaviour and their ability to comply with strict requirements. The Criminal Justice system cannot solely provide effective responses to vulnerable women leading often chaotic and damaged lives within an increasingly risk averse and punitive environment however, Social Workers need to have a critical understanding of the law to practice effectively and to recognise its limitations as well as strengths.

The drive towards the provision of ‘person-centred’ services for people with learning disabilities, has acquired a vast amount of policy maker’s attention in the United Kingdom (Cambridge, 2008). Valuing People (UK Department of Health, 2001) has been the most fundamental government paper that has prompted a change in the way current health and social care services operate. Collaboration can be seen as an important facilitator in delivering quality healthcare and achieving an holistic care service (Xyrichis et al., 2008). However, previous research focusing on teamwork in healthcare has been criticised for lacking a basic understanding of what this concept represents. This assignment aims to address the importance of inter-professional and multi- professional collaboration within the health and social care domain, when working with adults with learning disabilities.

The concept of working together originated under the umbrella term mutli-agency team working; this term dominated the discourse of policy and practice in the first years of the 21st Century. Mutli-agency teams were drawn together from distinct agencies for a set period of time and for a particular task whilst other groups of professionals came together as interagency teams simply for a particular project or case (Anning 2006). An example is a group of health practitioners, social workers and carers, reviewing and monitoring service provision and access to person-centred services for adults with learning disabilities. The government have advocated for Learning Disability Partnership Boards to be set up so as to make it a priority that service users don’t fall ‘between the gaps’ and that they receive sufficient support and access to person-centred services.

Clark (1993) states that inter-professional and inter-disciplinary practice can be used interchangeably. Inter-Professional working occurs when two or more professionals collaborate together in order to provide patient-centred care and a better quality of care; for instance the interaction between a general practitioner and a nurse. Multi-professional working occurs when professionals from health related occupations and varying backgrounds come together for a particular case. For example a diabetes team, whose primary function could be to assess, monitor and inform all people with diabetes within a particular catchment population. The team would mostly comprise of a consultant endocrinologist, two diabetes specialist nurses, a dietician and podiatrist. The UK Department of Education (2003) conducted research which shows that a person with a disability is likely to be in contact with more than ten different professionals in their lifetime. Throughout this time, issues can arise which may lead to a lack of continuity and co-ordination of care services. This is the main reason why the government advocates for an integrated approach for health and social care provision. This is not limited to healthcare but also outside of the domain, as different organisations have their own role to play. For instance, disparate services such as education, training, housing and employment need to work together and have a certain level of access to information about a client, whist maintaining patient confidentiality. For example the transition from secondary care to tertiary care such as from hospital to a residential home would require varying levels of expertise. An occupational therapist to examine the environment that the patient will be moving to, a medical practitioner to identify the need for the patient to be moved, a nurse to ensure continuity of care and a social worker to ascertain the level of support required on a day to day basis.

The National Health Service (NHS) is the largest organisation in Europe, and is recognised by the World Health Organisation as one of the best healthcare services in the world (Department of Health, 2000). The Healthcare Act (1999) requires NHS organisations to work together in partnership (Glendinning et al, 2001) yet evidence such as the Lord Lamming report suggests that barriers to inter-professional and multi-professional practice still exist. Lord Lamming’s findings of the Victoria Climbie inquiry highlighted that poor co-ordination and a lack of communication between agencies, was central to her untimely death.

Since the publication of Every Child Matters (Department for Education and Skills 2003) local authorities are now developing innovative solutions for information sharing known as an ‘Information Hub’. Clear and effective communication between all parities is required for this to be successful, with specific reference to learning disability, care providers work and plan in different ways such as PATH (Planning Alternative Tomorrows With Hope) therefore it is even more important to clearly document and share information freely in order to foster the implementation of care plans and create value in the best interest of service users, service providers and other professionals.

Traditionally, the NHS relied on paper records such as patient files, letters and referral forms. This was subject to unauthorised access, loss, a breach in patient confidentiality and a lack of accurate and up-to-date information. However due to the National Programme for Information Technology (UK Department of Health, 2005) and advances in technology, information sharing is more accessible due to the use of electronic databases which has security mechanisms to prevent malpractice and unauthorised access as well as upholding clinical governance. As outlined in the Nursing and Midwifery Code of Conduct (2008) quality record-keeping and evidence based policies are necessary for effective communication. However, this can in turn result in ‘inactive collaboration’ (Daly 2004) with each professional group having a ‘singular input into patient care’. Purtilo and Haddad (1996) state that verbal communication is important in sustaining the relationship between patients and healthcare professionals. Regular meetings of a multi-professional team with a common care pathway can aid the teams’ collaboration.

Professional identity and patient power, is another factor which must be considered. Leathard (1994) points out that the rivalry between professional groups can inhibit collaborative working. Power struggles within society for example between, experienced colleagues and inexperienced colleagues are barriers towards successful inter-professional working. However, new approaches in care provision such as skill-mixing and a drive towards person-centred services utilises the authority of the patient to govern the priorities of an inter-professional team as well as valuing each member of a team and their contribution. A difference in philosophies of care is also a key factor, as different professional groups have different moral and ethical philosophies in care provision. Such as, the paternalistic approach of a medical practitioner versus the approach of a public health advocate (Daly 2004).Recent research suggests that inter-professional working can lead to verbal abuse; professional autonomy is challenged when professionals work together in groups. A study conducted by (Joubert, Du Rand, VanWyk.., 2005) reported that ‘nurses experienced high levels of verbal abuse by physicians’. A tense environment can lead to poor working conditions and a higher risk of errors (Celik et al 2007).

Professionals have different pay brackets, which is defined according to their professional group and then their role within the group. Issues that may arise include resource allocation and funding for staff. At present the UK is involved in global crisis and the economy is central to restoration as jobs are at risk and services are being cut which is a hindrance to mutli-professional working. There staff shortages within the NHS, which can damage interaction between groups and see a decline in collaboration. However, Leathard (1994) states that that advantage of inter-professional lies in the more efficient use of staff.

Integrated care lies at the heart of health and social care provision and is at the future management of people with learning disabilities. The Care Programme Approach (CPA) was introduced in 1991 as a framework for people who require support from a range of different care service providers. The aim of the approach was to promote personalisation by consolidating services into a single service known as a ‘care co-ordination model’ (Goodwin, 2010). The concepts of inter-professional and mutli-professional teamwork can promote effective and efficient patient care. A patient is able to receive expertise specific to the individuals’ problem, and a team can provide co-ordination which can prevent any aspect of the patients’ care being overlooked. Professionals are able to share knowledge and skills however it is important to understand how professions can work together amicably as ethical dilemmas can arise. Core values such as altruism, advocacy and integrity are important in health and social practice and all staff should adhere to professional codes of conduct.

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This essay will discuss the student’s role within a residential care home in relation to legal and ethical aspects of health and social care. The essay will be looking at legislation that is in place to protect both the residents and staff of the home which is run for the care of young children. This will also look at values and ethics and why they are important. This will then go on to discuss the student’s role as a support worker and their duties towards the residents. This essay will also look at ethics and values and how we learn these throughout our lives.

Ethics is about making commitment towards positive values to help with the well being of the individuals within the society Warnock (19980) cited in (Banks 2006). Ethics refers to beliefs and value system to moral community, social and professionals groups. To live in the society and to have flourishing people within the society individuals must have rules and regulations in place so that people can be prevented from any kind of harm and so that they can live a healthy life style. Ethics promotes education and training to assist individuals to develop the skills needed to compete and to achieve the response for moral action. Warnock (19980) cited in (Banks 2006) states that are three types of ethics and these are Metaethics which relates to moral judgement, it comprises of critical and analytical thinking of whether something is good, right or duty. Normative ethics is about morals; it attempts to find answers for problems for example the morally right of action in some cases could be if an individual is a morally good human being or if lying is always wrong. Descriptive ethics is about individual’s moral opinions, beliefs and how people would react with certain issues. For example in Britain people always morally believe that abortion is wrong.

Values are about the standards of evil and good and they govern people’s choices and behaviour. People’s values are derived from the government and the society Timms (1983) cited in Banks (2006). Values are mostly used to refer to moral cultural, religion, ideological beliefs, attitudes, political, options and preferences. Values can be regarded as several types of beliefs that individuals hold about what is valuable or worthy. Giddens (1993) cited in Kirby et al (2000) sates that values can be seen as a fundamental belief that underpins communities, societies and provide general principle for the human behaviour.

Individuals are socialised through the family, community, peer groups, education and mass media. According to Giddens (1993) cited in Kirby et al (2000) there are two types of socialisation: primary and secondary socialisation. Primary socialisation is given to the child from parents, grandparents and siblings. This involves learning the basics of communication and the language the child is born in. This is the first stage in a lifelong process and the child is taught the basic norms and values. Secondary socialisation is followed on from primary socialisation and this is given through many multiplicities of agencies that involve in secondary socialisation. This is given through education, religion, mass media, peer groups and books. Children who are socialised will know how to behave and to interact with people from different backgrounds and will learn to become independent and acquire both personal and social identity.

I do voluntary work at a private residential care home which is not a part of the NHS. The home provides twenty four hour care for young people. It also has the facilities for an onsite private school, where the young people are provided with an education according to their ability. Some of the young people have never been to school or have had a fractured education. The principle teacher plans lessons for each individual young person and provides one to one to support to help them meet their education requirements so that they can achieve one of the five outcomes of every child matters. These young people are in residential care due to many different circumstances some have suffered abuse, neglect, behavioural problems, misuse of substances and disadvantaged backgrounds.

Ethical issues within a work place come in many different forms. Banks (2006) identified four types of issues that frequently have resulted in ethical problems or dilemmas. There are issues on public welfare, issues on individual rights and welfare, issues around relationships, boundaries and professional roles.

There are many ethical issues within the residential home. My role as a student support worker is to assist the teacher in preparing and delivering lessons to the young people, as these young people have a history of absconding, vandalising and could harm themselves or others, the home has to ensure they are under strict supervision twenty hours a day. During the week l take the young people for various activities, such as going to the gym, swimming, bowling and shopping so that they are given the opportunity to interact and socialise with other members of their community. While we were at the gym, one of the service users, who is thirteen years old started a conversation about his personal life. A service user divulge to me that when he absconds from the residential home he goes to see a young woman and has unprotected sex with her, when I questioned him about how old this young women was, he said fifteen years old, I was shocked to discover this and asked him where her parents were when he goes to see her, he told me that her parents were at work and she is on her own. The service user then asked me to keep this confidential. I explained that I could not make this promise, as part of my role was to report concerns to qualified staff, if l discovered information which could be potentially dangerous to a service user or other members of the public (REF – job description). Therefore I made him no promise as this was an ethical issue, where both these young people were having unprotected sex and were under age.

Miller (2000) argues that it is very important to promote anti-discriminatory practice. The advantages of implementing anti-discriminatory practice would be that staff would be able to work together as a team, communicate with each other, improve their practice, would acknowledge any problems or concerns and would agree with each other on appropriate changes. Team work can provide opportunities to take collective actions based on consensus. This will look good and benefit the service users. However if a practice does not promote anti-discriminatory practice it will suffer lack of support from colleagues or management, lack of interest, resources, time and staff. If staff is unable to communicate with each other they will not be able to provide a good standard of service and as a result service users can leave the practice and go somewhere else where they would feel they are receiving better service. The residential home promotes anti-discriminatory practice and all the staff communicates and supports each other, because of this it was not difficult for me to approach my manager about this issue, my manger took immediate action to protect both young people. She made the young woman’s parents aware of the issue and then contacted the relevant department and reported this incident and also asked me to update the log book, where everything is logged to keep an up to date record.

There are many legislations relating to looked after children. The residential home has to comply with all of them to ensure that the young people are protected and safeguarded. The children’s Act (1989) was an act to reform the law relating to children in community homes, voluntary homes, residential care homes or any other organisation. The Care Standard Act (2000) is an act to institute a National care Standards Commissions and it replaces the registered Homes act (1984). The National Minimum Standards for Children’s Homes (2000) are the latest standards that the Children’s home should work towards. The Children’s Homes regulation Act (2001) is an act where OFSTED observe on how the standards and regulations work together in practice. The Data protection Act (1998) is an act for the service users so that they safeguard the integrity of the young people, other workers and clients. The Protection of Children Act (1999) is an Act where everyone who is involved in working with the children has to complete a CRB check to ensure that they are the right people and trusted to work with the young service users.

The residential home follows a code of conduct (see appendix) where all employees have to follow the rules and regulations accordingly as it is a guidance for safe working practice for adults who work with young people and children distributed by the government. All members of staff and visitors have to adhere to the policy as to ensure that everyone’s behaviour constitute a safe practice and which behaviours should be avoided. It aims to ensure that the duty of promoting and safeguarding and wellbeing of the young people is achieved. All staff at the home have duty and are accountable for the ways in which they exercise authority, use resources, manage risk, and how to protect young people and children from physical, sexual and emotional harm. All employees must understand the responsibility of their role and be aware that disciplinary action can be taken against them if these provisions are breached. All employees have access to the confidentiality files and can only be shared with other agency when it is in the best interest of the young person. If for any reason things goes wrong or the children make a complaint through advocacy or social workers, the residential home would be accountable to the OFSTED and any further action would be taken from there. The code of conduct sets clear boundaries between the employees and the service users. (See appendix code of conduct)

There are many theories based on how a person should act morally. According to Kant (1948) cited in Edwards (2009) Deontological theory emphasis on moral duty. Kant argues that lying is morally wrong. Kant only believes in telling the truth regardless of what the circumstances and consequences are. Whether it makes someone happy or sad, one should not morally lie For example telling a very critical person that he has not long to live, would be the last thing they want to hear, but on the other hand it will give them a chance to do things as informing their member of family about his last wishes.

However Mill (1962) cited in Edwards (2009) Utilitarianism theorist disagrees with Kant, as he argues that acts are morally right if by lying you can make someone happy. For example telling someone that a member of their family died peacefully, although he died with a lot of pain, would make them feel a bit better, however if they reveal that he died in a lot of pain and agony can also jeopardise the relationship with the professionals and they would not trust them.

This essay has demonstrated how values and ethics are an important part in people’s lives and how individuals are socialised through primary and secondary socialisation. It has also discussed the student’s role within a residential care setting and how important it is to follow recognised codes of conduct. The issue of reporting moral or ethical issues, respecting all individuals and maintaining confidentiality at all times has also been addressed. This essay has also looked at different theories and how they can contradict each other. It has also looked at legislation that protects the service user and employee. Working in a care profession you must always make sure that every individual is treated with respect and not to make judgements on anyone regarding their backgrounds, sexuality, race, culture.

Interprofessional working (IPW) in health and social care is essential for effective service provision and is a key driver of modern healthcare. In a changing and more pressured working environment, health and social care professionals need to be partners in delivering services, embracing collective accountability, be flexible and adaptable and have shared goals in integrating care around service users (Fletcher 2010a, Pollard et al, 2010).

According to Tope and Thomas (2007), analysis of policies from as early as 1920 in health and social care have recommended professional collaboration, improved communication and teamwork to improve outcomes for service users. There have been similar recommendations in government policy since this time (Tope and Thomas, 2007).

High profile investigations since 2000 highlight deficiencies in IPW across health and social care. Inadequate communication between professionals in cases of the Bristol Royal Infirmary Inquiry (HM Government 2001), the Victoria Climbie Inquiry Report (Laming, 2003), and The Protection of Children in England: A Progress Report (Laming, 2009) have caused nationwide concern beyond the professions and services involved, causing a frenzy of media comment and public debate. Core recommendations are for professionals to improve communication between agencies, to have an ethos based around teams and working together and to improve professional accountability. The investigations provide evidence that collaborative working can only improve outcomes and underpins the real need to find out how best to develop a work force that can work together effectively (Leathard, 1994, Anderson et al, 2006 and Weinstein et al, 2003). Policy also recommends putting service users at the forefront of care and coordinating services across the authorities, voluntary and private sector organisations (DoH, 1997, DoH, 2000a, DoH, 2000b, Doh, 2001a, DoH 2001b, DoH 2001c, DoH, 2002a, DoH, 2006, DfES, 2006, HM Government 2004, HM Government 2007).

Literature suggests that IPW improvements begin in interprofessional education (IPE) (DoH 2000b, DoH 2002b, Fletcher 2010a, Freeth et al 2002, Higgs and Edwards 1999, HM Government, 2007 Reynolds 2005,). IPE has been defined as learning which occurs when “two or more professions learn from and about each other to improve collaboration and quality of care” (CAIPE, 1997). The need to produce practitioners who are adaptable, flexible and collaborative team workers has focused attention on IPE, which aims to reduce prejudices between professional groups by bringing them together to learn with and from each other to enhance understanding of other professional roles, practice contexts and develop the skills needed for effective teamwork (Barr et al. 2005; Hammick et al. 2009, Parsell et al, 1998).

At our interprofessional conference, we worked in teams of mixed student professionals. We introduced ourselves, our disciplines and our course structures, elected a chair and a scribe and set about to complete our tasks. Cooper et al (2001) identify one of the benefits of IPE as understanding other professional roles and team working. In their study, they found evidence to suggest that early learning experiences were most beneficial to develop healthy attitudes towards IPW (Cooper et al, 2001). None of the members of my group knew what a social worker did and I explained my training and professional role to them. McPherson et al (2001) describe how a lack of knowledge of the capabilities and contributions of other professions can be a barrier to IPW.

In our discussions, we talked about our preconceived ideas. Social workers were described as ‘hippies’ and doctors described as ‘arrogant’. Leaviss (2000) describes IPE as being effective in combating negative stereotypes before these develop and become ingrained. Atwal (2002) suggested that a lack of understanding of different professionals’ roles as well as a lack of awareness of the different pressures faced by different team members could make communication and decision making problematic. The conference provided an opportunity for us to interact with each other and was conducive to making positive changes in intergroup stereotypes (Barnes et al, 2000, Carpenter et al, 2003). Barr et al (1999) describe how IPE can change attitudes and counters negative stereotyping. The role play exercise gave us an understanding of differing pressures faced by each professional.

Our team worked well together, taking turns to let each other speak, listening, challenging appropriately when needed and creating our sentences by the end of the conference. I feel that our friendly and motivated characters made communication and thus teamwork easy in the group. Weber and Karman (1991) found that the ability to blend different professional viewpoints in a team is a key skill for effective IPW. Pettigrew (1998) emphasises that the ability to make friends in a group of other professionals can reduce prejudice and encourage cooperation in future IPW. We agreed that teamwork was essential to IPW and can assist in the development and promotion of interprofessional communication (Opie, 1997). We felt that IPE allowed us to teach each other while encouraging reflection on our own roles (Parsal et al, 1999).

We were very clear on how we worked as a group and effective as meeting our tasks and I feel we reached the Tuckman’s performing stage (Tuckman 1965). Baliey (2004) describes team members who are unable to work together to share knowledge will be ineffective in practice. Although, there is an argument that this is more likely to happen in teams where the concept of IPW is new and team members lack skills to understand the benefits of IPW or adopt new ways of working (Kenny, 2002). Being in our second year of study and having all had experience of working in an interprofessional setting, we were very motivated at the conference and in achieving our objectives. It is noted that personal commitment is important for effective IPW (Pirrie et al, 1998).

We acknowledged the issue of power in our professional social hierarchies. In our role play exercise, we found that we all looked to the doctors first for management of the service user’s treatment and they commanded the most respect. We agreed that medicine was the most established out of all the healthcare professions (Page and Meerabeau, 2004, Hafferty and Light, 1995) and that other professions have faced challenges in establishing status (Saks, 2000). I felt this was especially relevant to social workers who have recently extended their professional training to degree status to bring it in line with other professions. Reynolds (2005) suggested that hierarchies within teams could contribute to communication difficulties; for example, where input from some of the team members were not given equal value. Leathard (1994) describes that rivalry between professional groups especially in terms of perceived seniority are a barrier to IPW. The Shipman Report (2005) noted the importance of ensuring all team members are valued, recommending less hierarchy in practice, more equality among staff, regardless of their position. We talked about valuing and respecting each other’s professional opinion. Irvine et al, (2002) discuss how IPW can break the monopoly of any single profession in providing sole expert care, promoting shared responsibility and accountability. We discussed understanding, supporting and respecting every individual in the workplace to promote diversity and fairness.

We also concluded that institutions and differing professional pressures could be a barrier to IPW. Having previously worked in an interprofessional HIV team for Swansea NHS Trust, I found that team members were given priorities from their managers which impacted on their availability to attend team meetings. Wilson and Pirrie (2000) suggest that a barrier to IPW can be a lack of support from managers and the workplace structure. Drinka et al (1996) describe how during times of work related stress, individuals can withdraw from IPW. We acknowledged that institutional support would be essential to effective IPW. Dalrymple and Burke (2006) discuss that different professionals have different priorities, values, pressures and constraints, obligations and expectations which can lead to tension, mistrust and go on to cause to discriminatory and oppressive practice in IPW.

In light of the above learning, we all felt that IPW had occurred naturally in our first year placements, where it was considered the norm in our working environments and where the concept was understood and encouraged. The conference had highlighted some of the barriers to IPW and we will take this knowledge into our practice settings.

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Section 2

How would you take what you have learnt about IP working into practice?

The conference highlighted some key issues about IPW that I will take into practice. One of the most significant developments in health and social care policy in recent years has been the move away from the professional being the expert with the power and knowledge to the patient centred care with professionals applying their knowledge to the needs and rights of the service user (Barrett et al, 2005). The social model of care identities issues of power in the traditional medical model approach to care and looks at how dependency on the professional can be a side effect of the helping relationship and be disempowering for service users (Shakespeare, 2000). Informing, consulting with and incorporating the views of service users and carers is critical to effective interagency interprofessional practise. There is a drive in recent policy for service users and carers to be engaged in service provision and the recent white paper Liberating the NHS (HM Government, 2010a), calls for more autonomy for service users, making them more accountable through choice, being able to access services that are transparent, fair and promote power and control over decisions made.

“Nothing about me without me ” ( HM Government, 2010a, page 13) is a commitment that will shift power from professionals to service users, a huge change in current culture. The service user is the central vision, a team member involved in decisions made about their care, transforming the NHS to deliver better joined up services, partnerships and productivity (HM Government, 2010)

My learning has reiterated the importance of service user involvement and I have reflected on ways to implement this in practice. In previous employment, I helped to run a patient public involvement group at the HIV service, Swansea NHS Trust. This enabled service users to give feedback and make suggestions for improvements (i.e. having evening nurse led clinics, introducing the home delivery of medication). In my experience, service users were actively involved in shaping services in their communities and it was very successful. In my practice, I will continue to value the service user as part of the interprofessional team as well as encourage this practice in my places of employment. In my placement at a supported housing charity for young mothers, ways to achieve service user involvement were being introduced. One of my roles was to carry out a questionnaire with the aim of getting feedback and empowering the service users. Reflecting on this, I can now see how valuable this exercise was and I will continue to see the value in gaining service user feedback and always aim to do this in practice. I discussed this with my group and this added to our learning.

Informal unpaid carers, the voluntary and private sector are also essential team players and the value of their contribution is being acknowledged increasingly as the success of an interprofessional workforce (Tope and Thomas 2007). In my role within the HIV service, Swansea NHS Trust, I coordinated an interprofessional team and ran a support group for African women living with or affected by HIV in conjunction with social services and the Terrence Higgins Trust. I understand the value that the third sector organisations can be for service users, often filling gaps in statutory services. The Terrence Higgins Trust were able to provide funding for activities as well as support sessions, training opportunities and counselling. Social Care Institute for excellence (2010) in a response to the white paper, Liberating the NHS (HM Government, 2010a) discuss how around 90% of direct social care services are delivered in the private and voluntary sector. The Joseph Rowntree Foundation, a social policy research and development charity, discuss that the state is withdrawing from many welfare functions and increasingly relying on the voluntary sector to fill gaps in care (Joseph Rowntree Foundation, 1996). The recent strategy document, Building a Stronger Civil Society (HM Government, 2010b) discusses how integration with the voluntary sector will be essential to meet the challenges faced by the health and social care provision. The report focuses on our society being able to access wider sources of support and encourage better public sector partnerships, shifting the power from elites to local communities. The government are also keen to support and strengthen the sector and promote citizen and community action (HM Government, 2010b) .

My learning has made me aware that future teams will include professionals across all sectors and communication with these sectors will be essential to our professional roles. Working with the voluntary and private sector as well as statutory services, will require skills to acknowledge different agencies’ focus on care. Petrie (1976) acknowledges that each profession holds a direct focus to care and it can be challenging to communicate.

Laming (2003) called for the training bodies for people working in medicine, nursing, housing, schools, the police etc to demonstrate effective joint working in their training. I feel that it would be useful in the future to incorporate more of these professional groups in IPE conference. Fletcher (2010a) discussed how he would hope this could be achieved in future IPW programmes at UWE. I feel that the addition of these extra professions would really add to the learning.

Fletcher (2010b) discusses the central dilemma in ethics between health and social care professionals about having a different focus and the best angle for patient care. These value differences can cause conflict (Mariano, 1999). I feel, in practice, it will be important to take time to find out what each agency/ professional does and I will always remember that in IPW, we have a common goal – providing a good service for the service user. Leathard (2003) identities that what people have in common is more important than difference, as professionals acknowledge the value of sharing knowledge and expertise.

In my practice, I will uphold professional responsibility and personal conduct to facilitate respect in IPW. Carr (1999) explained that the professional has to be someone who possesses, in addition to theoretical or technical expertise, a range of distinctly moral attitudes and values designed to elevate the interest and needs of service user above self interest. According to Davis and Elliston (1986), each professional field has social responsibilities within it and no one can be professional unless he or she obtains a social sensibility. Therefore, each profession must seek its own form of social good as unless there is social sensibility, professionals cannot perform their social roles (Davis & Elliston, 1986). The conference highlighted the benefits of professional codes of ethics, setting of standards for our professional work, providing guidance as to our responsibilities and obligations and obtaining the status and legitimacy of professionals (Bibby, 1998). I feel that is in important to always uphold our values and ethics to create respect in our communities and with this comes respecting each other’s roles. I believe that shared values will underpin this in practice. Darlymple and Burke (2006) discuss that we have a shared concern that the work we do makes society fairer in some small way and we have a commitment to social justice. I feel that IPE has facilitated respect and mutual understanding across our professions. It has made me aware of the importance of professional development, about how we are part of the wider team of health and social care services and how our common values can underpin effective partnership working. It reinforces that collaboration is required as not one profession alone can meet all of a services (Irvine et al. 2002).

My social work degree is a combination of theory and practical learning. It is through combining this learning and by reflecting on my experiences throughout the course, that will set my knowledge base, allow me to relate theory to practice, allow me to test my ideas and thinking while identifying areas that need further research becoming a reflective practitioner (Rolfe & Gardner, 2006 and Schon, 1983). As a group we discussed that there we all value continued professional development, reflection and awareness and personal responsibility for our learning (Bankert and Kozel 2005). It is this that we agreed we would carry forward as we start our working careers.

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Section 3

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To begin with I would like to focus on the policies and legislation which have identified partnership working. There is a large body of policies and legislation that focuses on collaboration and partnership working; some include duties for statutory organisations in relation to inter-agency working. I have examined only some of the key polices and legislation as there are too many to examine for the purpose of this essay. First of all I looked at the UK wide policies/legislations and then I focused on Welsh policy; these are set out in chronological order.

To start with the Seebohm Report (1968) argued for a co-operation across the spectrum of welfare state services and more effective co-operation by different professionals. It proposed a major restructuring of personal social services into a unified social service department. The National Health Service and Community Care Act (1990) gave a duty to local authorities to assess and where applicable meet a person’s needs for community care services by collaboration with other agencies. Following this Building Bridges (1995) encourages interdisciplinary and multi-agency care planning.

The Health and Social Care Act (2001) aimed to develop partnerships and provide integrated care by building on existing health and local authority powers to develop care trusts. The National Service Framework for Older People (2001) set out standards for care of older people across health and social services. It aimed to remove age discrimination, provide person centered care, and promote independence, fitting services around people’s needs. Means for achieving these aims included the single assessment process and integration in commissioning arrangement and service provision. Valuing people: a new strategy for learning disability for the 21st century (2001) highlighted partnership. Working through local partnership boards and inter-professional/inter-agency co-operation are seen as central to achieving the four key principles; rights, independence, choice and inclusion for people with learning disabilities. National Service Framework (NSF) for Older People (2001) highlighted that professionals should become more engaged in assessments and for agencies to minimise any duplication of work.

Community Care (Delayed Discharge) Act (2003) introduced a new dynamic in interagency and inter professional relationships. It made Social Services authorities liable to reimburse the NHS for delays where patients in hospital are medically fit but unable to be discharged due solely to Social Service’s inability to provide assessment and community care services within a required timescale. Every Child Matters (2003) in response to the Victoria Climbie inquiry proposed: improved interagency information sharing and co-operation; work in multi-disciplinary teams; a ‘lead’ professional role; creation of local safeguarding boards. In the long term integration of key services for children and young people in children’s trusts will be under a director of children’s services. Children Act (2004) allowed the creation of database to support professionals in sharing information. The Carers (Equal Opportunities) Act (2004) placed a duty on Social Service’s to inform carers of their right to an assessment. It also enabled Social Services to ask other public bodies including the health organizations to provide services to carers. Single Assessment Process Implementation Guidance (2004) sets out how the single assessment process described in the Mental Capacity Act (2005) where social workers and care professionals acting on behalf of someone who lacks capacity, must act in a person’s best interest.

Working Together to Safeguard Children (2006) addressed to practitioners and managers, sets out how organisations and individuals should work together to safeguard and promote the welfare of children, stressing shared responsibility and the need to understand the roles of others. It described the role of local safeguarding children’s boards (LSCBs), training for inter-agency work and the detailed processes for managing individual cases. These elements are ‘statutory” guidance, which required compliance. Mental Health Act (2007) amended the 1983 Act broadening the group of professional practitioners who undertake approved social worker (ASW) functions, to be known as Approved Mental Health Professionals. Concurrently, the code of practice of the 1983 Act was updated, stressing inter-professional collaboration in assessment and after care planning and involvement of patients and carers. Building brighter futures: next steps for the children’s workforce (2008) sets out components of integrated working as they emerged from Children’s Trusts. It considered the contribution of the Common Core of Skills and Knowledge and the pros and cons of professional identities and boundaries. It looked forward to achieving a broad vision of integrated working that has support across the whole children’s workforce.

Now I would like to focus upon the policies that are specifically within Wales. Firstly, The Review of Health and Social Care in Wales, (WAG, 2003) emphasized the importance of multi-agency working. It looked at decision-making processes, the capacity and effectiveness of existing services, the capacity of management, the processes governing standard setting, information management, resource flows, and incentives and sanctions. The Report of the Wanless Committee (WAG, 2004) focuses on shared decision-making between professionals and users and patients. It also highlights that there needs to be integrated thinking across health and social care boundaries. It also highlights the need for a new approach for funding health and social care. Making the Connections: Delivering Better Services for Wales: The Welsh Assembly Government Vision for Public Services (WAG, 2004) policy aims to involve communities and people by putting them in the centre of service planning and delivery, it hopes to achieve this by having effective and efficient co-operation between public services.. Children and Young People: Rights to Action, Stronger Partnerships for Better Outcomes (WAG, 2005)is paper outlines the expectation from the Assembly Government for local agencies to take a joint approach in planning services to make them as effective as possible. Fulfilled Lives, Supportive Communities: Improving Social Services in Wales from 2008-2018 (WAG, 2006) this focuses on partnership arrangements which put the citizen at the centre and work effectively across sectors and organisations using care pathways to support people. Lastly, Sustainable Social Services for Wales – A Framework for Action (WAG, 2011) highlights the importance of developing more integration of health and social services for children, young people, and frail older people, and in respect of re-ablement services. Joining up in this way will help break down barriers that can often get in the way of providing services and drive out duplication. This sets out the current vision for partnership working within Wales until 2016.

As highlighted above there are many key pieces of legislation and policies which focus on the importance of multi-agency working. Since the 1960’s there has been a focus on partnership working for social services. The main emphasis is that welfare services could be improved if statutory organisations worked together (WAG, 2003). There appears to be a fastening pace to make partnership working more effective. Perhaps this is down to the increased budget cuts therefore eliminating duplication of work and improving service delivery may be more important than ever before.

There are some key principles and ethical issues to partnership working that are highlighted below. Gasper (2010) highlights that partnership working can improve access to services and avoid duplication; this means services can be delivered in more of a cost-effective way. Although Gasper reflects positively on partnership working there are other areas of partnership working that could lead to several dilemmas. Glasby (2004) defines inter-professional working as two or more people from different professions communicating and co-operating to achieve a common goal. Adams et al (2006) highlights the importance of having a professional identity to partnership working. Adams et al (2006) suggests that a professional identity gives a person a set of values, expertise, role and responsibilities; for example, social workers side more with the social model and health more with the medical model. Partnership working can be complex and often brings people together who have different views on what is ‘right’ for a service user with different approaches (Gasper, 2010). Whittington (2003) suggests that if professionals can understand what they have in common, what they can contribute individually, what can be complementary and identify the possible tensions between them; it could improve the effectiveness of partnership working. By identifying these areas clients could benefit to better services.

Keeping (2006) highlights a general uncertainty from other professionals around what social workers actually do. Lack of knowledge of what each professional involved, can lead to stereotyping each worker (Lymbery, 2006). There is often no clarity around the roles of voluntary and service users in partnership working (Marks, 2007). This means that it is important for social workers and other professionals to remember what responsibilities lay with them and try to understand other professionals’ responsibilities to make partnership working more efficient.

Seden et al (2011) suggests that social workers are often caught between care and control, finding their way through complex relationships with service users, other professionals, peers and the public. Trust is an important factor when facilitating open discussion and successful role negation, both of which are important features of inter-professional working (Barrett and Keeping, 2005). Where professionals trust each other’s motives, competence and dependability they are more able to manage risky situations (Lawson, 2004). Trust is an important element of a successful collaborative working relationship.

Issues may arise within partnership working when there is a use of specialist language that not everyone understands (Maguire and Truscott, 2006). For example health professionals may have abbreviations that the social workers may not understand and vice versa. Communication across professions can be difficult, especially when they are not in the same location. Not being based in the same location can result in a breakdown and delays in services; this can be seen in hospital discharges for example (McCormack et al, 2008). There may be differences in status between professionals and this must be acknowledged to understand the impacts it can have on communication (Barrett and Keeping, 2005). Some practitioners perceive threats to their professional status, autonomy and control when asked to participate in more democratic decision making forums (Lloyd and Wait, 2006).

There may be issues around different resources available across different professionals. Resources can be split into three areas; money, information and time. Issues around money can be acknowledged in numerous areas. One is that there are different funding cycles, separate budgets and financial pressures (Frye and Webb, 2002). Also professionals may be reluctant in funding services if there are pressures on budgets (White and Harris, 2001). Information sharing can pose constraints for partnership working. For example in Health and Social Care there are different ICT systems in place, there is a need for a universal and shared systems between Health and Social Care to improve the exchange of information (WAG, 2003). There is also reluctance around sharing information with different professionals for fear of breeching confidentiality (WAG, 2003). Partnership working also needs a sufficient amount of dedicated time for it to be effective (Atkinson, 2007). Frost and Lloyd (2006) suggested that time is needed for relationships to develop and trust to be built. These are key components for agreements to be made around protocols and reflection upon new professional identities (Frost and Lloyd, 2006). Partnership working may involve travelling to meetings, some of which may be long distances; this requires a lot of time (Atkinson, 2007).

Currently my practice learning level three is based within the Adult Community Care Team (ACCT) which implements care plans for clients with presenting eligible needs. To ensure that clients’ needs are met there is a process which involves various professionals within the information gathering and care planning stages; for example social worker, health, brokerage, finance team and carer assessors. ACCT works daily with other professionals; some are within the same location such as occupational therapists and some are offsite, like doctors based in hospitals. There is a wide range or partnership working; some work more successfully than others. I have found those on site tend to be more successful as information exchange is more effective and there is a better understanding of each other’s roles.

One particular experience I would like to focus on is during one unified assessment (UA) when I worked collaboratively with an assessor nurse. Assessor nurses are based within the local health board in another location. The reason for our partnership working was to identify if this particular client was in need of a nursing home rather than a residential home. The expertise of the nurse was vital to complete the assessment. However there were some issues within this process. Firstly we have different ICT systems so we both have access to different information; Health could only see medical records whereas I could only see Social Service records. Having two separate ICT systems also made it difficult to complete the UA and there was a duplication of work. I had to use the Social Service UA documentation and the nursing assessor had to use the health UA documentation. If there was one ICT system only one UA form would have needed to be completed. This would have saved both of us having to complete two different lots of paperwork, which essentially had the same outcomes. There was another issue of understanding specialist language and abbreviations used within Health. I found myself regularly asking for clarification. There was also a reluctance to explore continuing health care from the assessor nurse even though there were triggers. This could be down to the sheer amount of time needed to complete the decision support tool and perhaps budget restraints. There are a few examples of good partnership working that I have experienced on placement but the majority had difficulty around budgets, communication, different ICT systems, difference in languages and a lack of understating other roles.

Overall this essay has highlighted the increasing focus on partnership working from a UK wide perspective and a Welsh specific context. Some policies reflect upon the issues mentioned within this essay. There appears to be a faster pace to improve partnership working within a policy context. For partnership working to be positive, there is a need for collaboration from professionals to overcome particular issues and great outcomes can be achieved.

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Introduction

In this unit we are asked to make a report regarding on the importance of effectively managing equality and diversity and dynamics of leading and managing equality and diversity. In order to achieve this, we are given 2 task to complete which includes the analysis of the legal requirements relating to equality within the chosen organisation; evaluation of the implications of guidance and codes of practice; analysis of policies and procedures that need that needs to be place to promote equality and diversity and the needs and expectations of stake holders in relation to the organisation’s policy on equality and diversity. The second task is about explaining the practical aspects of promoting equality and diversity within the organisation and to stakeholders and of addressing equality and diversity issues.

TASK 1

Through this paper I would try point out some aspects in understanding the importance of equality and diversity as core values in healthcare business organisation. What are the elements to be considered for effective organisational equality and diversity management? What does the organisation gain in the practice of equality and diversity? What must be done to ensure commitment in leading business organisational equality and diversity?

In the care home that I used to work, commitment to equality and diversity help us understand how we treat our customers or service users, the wider public we serve, and one another. And if our policies, processes and interactions based on equality and diversity are fair, inclusive, accessible and responsive we would know the procedure as regards dealing effectively with discriminatory issues. Generally, an excellent customer service and equals high standards on equality and diversity. It is then, useful to grasp the meaning of equality and diversity, some related terms such as code of practice, equality legislation. A better understanding of these terms will help the healthcare organisation commit to better practice of equality and diversity.

“Equality means fostering and promoting the right to be different, to be free from discrimination, and to have choice and dignity and to be valued as an individual, with a right to their own beliefs and values.” This works on the following premises that everyone must be treated fairly. Everyone has the right to have their individual needs be respected. Inequality happens and there must be an effort to deal with discriminatory issues. Employment and services must be available to all. Equality is about fair treatment. Rights, responsibility and anti-discrimination are important parts of equality. And knowledge of the legislative framework on equality will help those disadvantaged obtain opportunities for full participation in the society by imposing legal sanctions against malpractices of this principle.

“Diversity as a word means “varied and different” thus, ‘diversity’ is about more than equality. It is about valuing variety and individual differences. It is creating a culture, environment and practices which respect and value differences for the benefit of society, organisations and individuals.” Diversity acknowledges the fact that individuals and groups have varying backgrounds, perceptions, styles, values and beliefs. Where there are two people there is diversity, for everybody is different. It is a challenge for all of us to understand, value and respect such differences. Diversity is about respecting differences. It is the positive acceptance of the uniqueness and distinctness of each person. Thus, the care home created policies, procedures and practices where the diverse needs of diverse employees and service users are considered.

Equality and diversity are closely connected to one another. For equality means treating individuals in spite of differences. Diversity believes in the unique contribution of each individual and values differences. If we treat persons according to their different needs, we cannot be unfair to them or to others. Where equality and diversity is practiced, equality of opportunity for all is ensured where each individual has chance to attain his potential. Each person must be protected from prejudice and discrimination. Any experience of discrimination on the grounds of our age, race, gender, ability, sexual orientation, religion or belief must be challenged.

The Race Relations Act 1976 and the Disability Discrimination Act 1995 have been merged to become the Equality Act 2010 which has a more consistent approach to comply with the law. Equality 2010 protects individual from discrimination and promotes one’s right to equality such as:

Disability discrimination: Disabled people at work are protected from discrimination. This means that employers: must not treat a disabled person less favourably because of a reason relating to their disability, without a justifiable reason; are required to make reasonable adjustments to working conditions or the workplace where that would help to accommodate a particular disabled person.

In our work place, we have colleagues who have difficulty in writing (dyspraxia). But his skill was really a great help to the group. He was given extra work on the floor while his partner is the one who documented all the personal care that has been given to the service users. The colleagues and the manager are very supportive of him.

Equal pay: Employers must give men and women equal treatment in the termaˆˆand conditions of their employment contract if they areaˆˆemployed on: ‘like work’ – work that is the same or broadly similar; work rated as equivalent under a job evaluation study or; work found to be of equal value.

In the care home, equal pay was implemented fairly and it is in accordance to your qualifications and the job that you are into. If you work in the caring job, male and female are in the same rate, they only differs if they have more qualification than others like having degrees or NVQ’s.

Part-time employees: The Part-time Workers (Prevention of Less Favourable Treatment) Regulations 2000 aim to ensure that part-time workers are not treated less favourably than comparable full-timers. Principally, this means they should: receive the same rates of pay; not be excluded from training simply because they work part-time; receive holiday entitlement pro rate to comparable full-timers; have any career break schemes, contractual maternity leave and parental leave made available to them in the same way as for full-time workers and not be treated less favourably when selecting workers for redundancy. In this regard, our care home is following the said legal requirement for part-time employees; they are receiving same as what full time employee is having.

Race discrimination: The Equality Act 2010 makes it illegal to treat a person less favourably due to their colour, nationality and ethnic or national origins. Race discrimination covers all aspects of employment – from recruitment to pay, and training to the termination of a contract. The care home that I used to work is a type of organisation that is multicultural; the employees are from different countries and with different culture. But since we are respecting each other and working in one objective of the organisation, the said racial discrimination are being lessen though it is prohibited but sometimes it happens.

If conflicts about any of the rights occur, it is recommended always to resolve the issue to the employer (manager) first. Thus, our employer provide a contract employment for us employee where both parties may agree better terms than those required by legislation. The employer has the obligation to present to the employee a written statement of the main particulars of employment within two months of the beginning of employment. This must include, among other things, details of pay, hours, holidays, notice period and an additional note on disciplinary and grievance procedures.

Another way of resolving any grievance issue is through the help of an independent third party or mediator. Such mediation is a voluntary process whereby the mediator helps both sides to reach an agreement. Any agreement comes from those in dispute, not from the mediator. If an employee believes that an employment right has been denied or infringed, he can make a complaint to an employment tribunal.

It is, indeed important to have a comprehensive grasp of the existing legislative laws to be able to promote equality in the workforce and protect every employee from discrimination. An understanding of the legislative laws will also help in creating good quality guidance to equality and diversity organisational practice. Commitment to equality and diversity means the organization is willing to comply with legislative procedures. Legislative laws not only protect the individual employee but also different stakeholders and service users.

On the other hand, the implication of guidance and code of practice in relation to equality and diversity in healthcare business is to have abetter knowledge and understanding regarding this matter. First what is code of practice? Codes of Practice are golden rules for guidance on legislation which have significant effect on healthcare business. The Code is non-statutory and not legally binding. This means it cannot prevail over mandatory external requirements. Healthcare organisation must abide by this Code of Practice whenaˆˆproducing new guidance or revising existing guidance. This Code of Practice states in simple terms how to create good quality guidance. A good guidance must have a good understanding of the target audience which is diverse and knowing their needs. In our care home, they know the intended service users; the guidance will adapt the most appropriate format and language in preference to their needs. There must be input users and their representative groups like the relatives beforehand. Organising a stakeholder panel and asking advice from concerned representative groups can provide useful resources so that the guidance will be designed and communicated effectively. If the guidance is easy to understand and straightforward then it can be assured that it will be followed correctly. Guidance must be easily accessible to the service users. Guidance will ineffective if no-one reads it. And no matter how well designed a guidance is, each item of the guidance must be reviewed and improved. It must be opened for feedbacks from the service users. Guidance must carry a link where the user can state any inaccuracy about the guidance.

In terms of promoting equality and diversity, it is equally important to develop policies and procedures that will provide clear instructions and guidelines on what must be done in particular issues. Policies and procedures will ensure the well-being of all individuals in the workforce and everyone connected to the organisation by providing a framework of action. They help new members familiarise with the organisation’s working practices and provide them information on what is expected of them. Policies and procedures reflect the main priorities of the organisation which with good practice will ensure good quality service. Policies are also basis for making and monitoring changes in the procedures about moving towards equality and diversity. Equality and diversity policy must provide a framework where commitment to equality and valuing diversity in all aspects of the business organisation are clearly included. The policy must be easily accessible to all those involved in the organisation as regards equal opportunities and services and that the organisation is willing to protect the discriminated and the disadvantaged.

Further more, identifying the needs and the expectations of potential stakeholders will be affected positively or negatively by the implementation of such policy and it is vital. The policy in the care home provides overall mission statement standing for the importance of equality and diversity to our stakeholders. Such statement can be used in publicity, recruitment advertisements, offering quality services to clients. Strategy and action plan must give an outline about how to keep this public promise and how equality and diversity will be implemented. And for an effective policy, it must be developed in consultation all members in the organisation. Action plan must be specific, measurable, achievable, realistic and timed. This will include plans for training staff/management committee members and monitoring and evaluating.

In healthcare organisation that I used to work, delivering services must provide appropriate services that meet the needs of the different clients/service users. It is a legal requirement that reasonable adjustments are considered to enable disabled people to use the services offered. The front line workers aware of the diversity of the clients must use inclusive language and provide extra support to meet the needs of the clients. As example maybe offering an appointment with a deaf client by text rather than via phone call or in our care home we provide interpreters for those clients who do not speak English through the use of colleagues who can speak the same language or volunteers with language skills or making appropriate referrals to organisations that can better respond to the needs of the client. We make sure that the needs and preferences of our service users are being met. In so doing, we can achieve the expectations of the stakeholders in accordance to the organisation’s policy on equality and diversity.

TASK 2

Being aware of equality and diversity issues and knowing how to address them is important in ensuring commitment to equality and diversity. For example, in the healthcare sector, an ageing workforce can become a great challenge for employers especially when there is workforce turnover and skills shortage. Policies and procedures reflecting inclusive employment would regard a diverse workforce as an asset where person’s with life experiences can become part of the workforce. Experts have expressed the fact that those employers who value older workers’ skills and experience are better placed to emerge from the recession. Another issue is the religion and beliefs. It can be noted that employees are characterized by predominantly diverse religion and faiths. Religious faith and belief can be relevant to recruitment and retention strategies. However, applying a dress code for all employees can be a disadvantage for some people of particular beliefs. But since equality and diversity are being practice in the care home, they allow staff to wear there turbans for male and bandanas for female.

Discriminatory attitude resulting from stereotyping and prejudice would exclude individuals or groups from employment or services. Sometimes institutional discrimination occurs through policies and procedures which lead to disadvantage of a particular group. It is a legal requirement to have a process called Equality Impact Assessment whereby an organisation reviews one’s services, policies and procedures whether there is a negative impact on an employee or to service user.

Creating a culture committed to equality and diversity means that the everyday goals and behaviour of the organisation includes commitment to equality, human rights and inclusive working. In healthcare sector leadership and accountability is a key to creating a commitment to equality and diversity. Leadership must recognise all aspects of diversity: race, gender identity, disability, age, religion, sexual orientation, part-time workers and persons with alternative working patterns, persons with different educational and social backgrounds, and persons with caring responsibilities. Role modelling of inclusive behaviour in recruitment, development and promotion of staff and readiness to address responsibly discriminatory issues are significant aspects of good leadership committed to equality and diversity. There must be clear and transparent accountability for delivering equality and diversity. Senior leaders must be active equality and diversity champions who create change in culture and attitudes. They must help enhance and sustain equality and diversity in partnerships and collaborations with all stakeholders. They set vision and goals, strategies, daily interactions with trustees, staff, volunteers and service users showing that they value equality and diversity. They must have the capacity to listen and communicate openly with all employees with diverse needs. Effective communication is another important element to consider if the organisation would really promote equality and diversity. It is the capacity to listen and to share information. It is not enough to work efficiently for the organisation. The contribution of each one to further growth process and practice of the business organisation through one’s creativity, innovations and insights means would mean a need for good communication skills. The volume of information in today’s world can be overwhelming. It is important to discern appropriate information needed to understand the perspective of different stakeholders. Identifying/reviewing stakeholders’ expectations/needs and reconciling differences through networking would mean a high-level approach for communication. Methods of communication in a networked world have become challenging: training program on virtual negotiation; communication with increasingly diverse service users; good networking with different groups who promote values of equality and diversity; providing information in different formats. Developing an equality and diversity communication plan which is proactive and outward focused will be useful in promoting public understanding and awareness.

Practicing inclusion means embracing differences and creating an environment where each individual’s rights protected and potentials are valued and respected. This can help attract and retain staff and improve customer or service user satisfaction. It is providing relevant and appropriate access for the participation, development and advancement of all individuals and groups; removing or altering physical barriers so as to provide access to all; avoiding offensive language; improving access to service and workplace for example by changing working patterns or by providing mobile services for those socially isolated and tailoring services to the needs of the clients. Valuing inclusion means no one is discriminated or harassed but rather everyone is treated with respect and dignity. It means that all (e.g. from the senior management to the most junior staff) is involved in the process of creating the culture to commitment to equality and diversity. Everyone is engaged and feels that their insights and experiences are valued.

Reaching diverse group through constructive dialogue with stakeholders both internal (employees) and external (clients, finance sources, local government, NGO’s) can help build more harmonious working relationships. Engaging and allowing them to be partners can contribute to profitability, company image, expense management, and employee morale and customer loyalty. Another thing is through advertisement via internet or giving away pamphlets; when advertising one’s delivery of services, it must aim to be accessible to those in needs. Thus, it is important to think of ways how to reach the most disadvantaged people. This is one way of showing the organisation’s commitment to equality and diversity strategy. Written policies and procedures of the organisation must be easy to read and understand and available in relevant formats. This means avoiding jargon and abbreviation or any word graphics that could cause offence. Plain English Campaign’s website provides good guidance regarding this matter. Having a clear purpose and structure and using easy to read print like Arial or Verdana font with at least 12 point font size for all texts need to be considered, too. When there is a need to produce alternative materials for particularly disadvantaged persons within the target group, it is important to consider large print, Braille, audio cassette, in electronic format by email or CD, or in other languages. Through this we can cater all types of stakeholders who are in need.

With regards to monitoring and reviewing equality and diversity strategy plan, policies and procedures, current equality and diversity training programs, informal or unwritten work practices and arrangement for consultation and participation. This is important to be able to make needed adjustments to the workforce and services. “Equality monitoring is the process of collecting, storing and analysing information about employeesaˆY and/or clientsaˆY gender, ethnicity, disability, age, religion, sexual orientation or social class. Monitoring such information allows organisations to ensure it is delivering its services and employment fairly, equally and appropriately to all groups.

To understand the demographic make-up of the workforce and the customers will help identify under-represented groups and find ways to respond to their needs. Reviewing policies will show if there is awareness and good practice on the commitment to equality, diversity and inclusion. Monitoring and reviewing are important processes to see if the organisation takes legal responsibilities promptly and seriously and proactively builds a culture of commitment to equality and diversity to all stakeholders. Reviewing staff performances through appraisal against organisational equality and diversity set of objectives and strategy on an annual basis. Monitoring and reviewing through staff surveys, employee networks and forums are some ways of involving and consulting the employees on some key issues affecting them as regards equality and diversity. This can also lead more comprehensive understanding of the needs and expectations of the staff.

Conclusion:

Leading an organisation committed to equality and diversity is a great challenge. Collaboration among all members in the workforce and even among the clients is necessary. Understanding equality legislation and putting them into easy to understand equality and diversity policies as well as strategies will ensure good practice. There is a need in creating different committees responsible for the different aspects of promoting equality and diversity.

Since equality issues are very much related with government legislation, it is imperative to update the knowledge of legislation against discrimination. However, Neil Thompson in his book People Skills (2002) affirms that legal compliance is not enough but rather developing a culture where people in the workforce are more aware of the significance of diversity and do take personal responsibility to develop this sensitivity. There is a risk of “alienating” people if one does not learn about others’ perspective and life experiences.

A co-recipient of the 1998 Nobel Peace Price with David Trimble, John Hume, says, “Difference is of the essence of humanity. Difference is an accident of birth and it should therefore never be the source of hatred or conflict. The answer to difference is to respect it. Therein lies a most fundamental principle of peace: respect for diversity.”

Managing organisational equality and diversity can be a very complex task but an effort to good practice is possible if all are motivated to be involved and engaged. This paper is limited in scope in many aspects for it does not document detail accounts of the necessary processes as regards specific aspects of equality and diversity. It is recommended that it is useful to create different committees in the organisation to work on an in-depth study of the different aspects of equality and its concrete application.

This essay will analyse how issues of ‘race’ and culture are pertinent to mental health problems and to service responses to minority communities. However, other risk or causal factors will be considered which are essential in fully understanding diagnosis, access to services and outcomes of mental health issues including poverty, racism and violence against women. It appears that a combination of cultural, structural and individualist factors are linked to mental health issues and it will be highlight why an over focus on ‘race’ and culture (without considering other factors) can be dangerous.

Although individual factors will not be discussed in this essay, their importance must be emphasised. Personal elements intersect with other factors (structural and cultural) contributing to mental health problems. Individual factors on their own therefore are not enough but need to be considered in combination with cultural and structural factors. This can be linked to Thompsons PCS Model which looks at Personal, Cultural and Structural issues in terms of anti oppressive practice (Thompson, 1997).

It cannot be ignored that issues of ‘race’ and culture are extremely relevant when considering mental health. However, this essay views race as “socially constructed, with little biological validity as a risk factor that fully explains inequalities in health” (Bhui et al, 2005, p.496). What is more feasible and supported in studies such as the EMPIRIC study, is that race is a factor which can be a sociological risk to individuals which can be referred to as racial discrimination having the potential to result in lower self esteem, fewer opportunities, and stress leading to mental health problems (Bhui et al, 2005). In the UK racial discrimination does not just refer to the term ‘race’ as skin colour but also incorporates cultural differences as well (Bhui et al, 2005). Therefore in this essay, when ‘race’ is referred to as leading to mental health problems; it will be in terms of the explanation put forward previously.

It appears that ‘race’ and culture impact on diagnosis, access to services and outcomes. However, this view is based on research obtained in a short amount of time – it was only in 1995 that observing different ethnic groups became obligatory in mental health services which are publically funded (Mind, 2012). However this view is disputed by Glove and Evison (2010) who argue that “differences in the pattern of mental health care received by minority ethnic groups in England have been noted since the 1960s and widely debated since the 1980s”. Irrespective of this dispute, both agree that research has identified differences between different ethnic groups in diagnosis, treatment and availability of services. A common identification in literature is that there are high rates of psychosis (for example schizophrenia) amongst African Caribbean men and apparently low rates of mental illness among South Asians (NCSR, 2002). Influential pieces of research identifying these differences include the Count Me In census which began in 2005 and was created in support of the Department of Health’s five year plan ‘Delivering Race and Equality in Mental Health Care’ (Mind, 2012). The ultimate aim was to reduce admission rates, detention and seclusion amongst black and minority ethnic groups (Mind, 2012). The census identifies that 22% of 30,500 individuals receiving in-patient care were from minority ethnic groups (CQC, 2010). It also highlights that black men are more likely to be detained under the Mental Health Act and that black and black/white mixed race men are three times more likely to be admitted to psychiatric wards and had the highest admission rate of all groups (Mind, 2012). CRITICISM The Fourth National Survey (FNS) of ethnic minorities supports this to an extent. It identifies higher rates of psychosis diagnosis amongst Black Caribbean’s compared to white people (Mind, 2012). However, these differences are lower than previous studies have suggested. Studies undertaken previously have suggested psychosis occurs mostly amongst black Caribbean men however this study suggests higher rates amongst black Caribbean women (Mind, 2012).

Despite these figures, findings have also suggested that Black African Caribbean and South Asian patients are less likely to have their mental health problems detected by a GP (The centre for Social Justice, 2011). Black men have been found to be more likely to be admitted to psychiatric units via the Criminal Justice System (CJS) (NMHDU, 2010). The Count Me in census highlighted that Black Caribbean, Black African and White/Black Caribbean mixed groups are between 40 and 60 per cent more likely to be admitted via the CJS (CQC, 2010). In contrast to this, findings from the census identify that admission rates among South Asian and Chinese groups have remained much lower (below average in many cases) (Care Quality Commission, 2011). This is interesting, as other research has indicated that some specific subgroups of South Asian women (ages 15-24) are at high risk of completed suicide (Raleigh, 1996). Therefore, why are they not getting the necessary support from mental health services?

The EMPIRIC study considers white people as a comparison with Bangladesh, Black Caribbean, Irish, Indian and Pakistani groups (Bhui et al, 2005). This study was undertaken in the community which is quite rare. It considers the impact of racial discrimination in the workplace (Bhui et al, 2005). The study identified that Black Caribbean people reported the highest amount of job denial and Pakistanis the highest level of insult (Bhui et al, 2005). Bangladeshi, White and Irish people were found to be less likely to report discrimination (Bhui et al, 2005). Discrimination in the workplace is common and is a risk factor for common mental disorders (Bhui et al, 2005). The differences between each group in terms of Common Mental Disorders (CMD) were small and there were some variations in terms of age and sex (Bhui et al, 2005). It found CMD were higher amongst Pakistani and Irish men ages 35-54 and higher rates amongst Indian and Pakistani women ages 55-74 (Weich et al, 2004). Common Mental Disorders were found to be lower in Bangladeshi women than white women which is interesting considering this group has the highest level of socio economic deprivation and the accepted link between poverty and mental health (Weich et al, 2004). There were no differences in rates between Black Caribbean and White people despite them suffering the most job denial and this identifies differences to findings from other key studies which often identify higher rates of mental illness amongst black men in particular (Weich et al, 2004). Therefore this suggests this group may be more resilient or Black Caribbean people with CMD may have been excluded from jobs (Bhui et al, 2005). The EMPIRIC study actually identifies that Black Caribbean women had more CMD than Black Caribbean men (Bhui et al, 2005) and as findings from FNS also suggest an area of concern for this group, it appears further research should be undertaken. There are some criticisms on this study being that what is perceived as racism does not always impact on current employment experiences (Bhui et al, 2005). It does not consider the fact that CMD may result in more people reporting racial discrimination (Bhui, 2005). More long term and qualitative studies may be beneficial in understanding the impact of racial discrimination (Bhui et al, 2005). However, studies undertaken late 1990s and early 2000 because there was a raise in concern regarding this issue (partially due tot the Rocky Bennett case) therefore the government commissioned this research due to these concerns. However, in recent years things have died down a bit therefore less research is being undertaken so knowledge is not developing and there is no funding available for researchers.

Despite this, research already carried out seems to follow suite in identifying differences in the diagnosis, treatment and outcomes of mental health for ethnic groups, however these differences are not always on par with each other and identify differences in themselves as already stated (McLean et al, 2003). It is important to understand why variations do exist between ethnic groups in terms of mental health which will be the focus of the rest of this essay.

It cannot be ignored that cultural factors undoubtedly play a role in the findings identified previously. Black and minority ethnic (BME) groups may speak in a way which is considered ‘different’ to white British individuals or they may have dissimilar mannerisms. As a result, this may be interpreted wrongly which could subsequently lead to an incorrect diagnosis of mental health issues (Singh, 2006). As stated “western psychiatrists are more likely to misinterpret behaviour and distress that is alien to them as psychosis” (Singh, 2006). Individuals may be labelled as “strange” or “unusual” because of cultural traits (Singh, 2006). Thus, this identifies that a lack of understanding of cultural differences may impact on interpretations. However, no matter what cultural training people obtain, interpretations of behaviour are always going to vary as cultures are complex and continuously adapting.

Another argument relating to ‘race’ and culture and its link with mental health is that some cultural groups may not react to western-type methods of dealing with mental illness. For example, in Western society, psychiatry is viewed as an objective discipline and therefore the individual receiving the support/therapy is separated from the therapist (Fernando, 2004). It is likely that the therapist will not know the individual and will rarely have any physical contact with them. As put forward “the therapist learns the treatment and applies it within the overall medical model of dealing with problems as individual illnesses, disorders or disturbances of what is assumed to be ‘normal’ mental functioning” (Fernando, 2004, p.121). This way of approaching mental health may be different to other cultures for example where more spiritual methods of healing may be used (Fernando, 2004). As a result, certain ethnic groups may not involve themselves in western methods for example going to see a General Practitioner (GP). Koffman et al (1997) found that in comparison to non-black groups, more black patients who had been admitted were not registered with a doctor. This may be a result of different cultural methods of healing in which western practices do not fit. However, culture should not be considered as stationary or immobile – it does and can adapt and change. It is important to recognise that different cultures can begin to interlink with each other as cultures may react to the environment they are in contact with (MDAA, 2012). This identifies how it can be dangerous to focus too much on culture which I will look into further on in the essay.

Language is a cultural factor which can impact on the right diagnosis and support for an individual: “both diagnosis and treatment are handicapped if there is no common language between doctor and patient” (Farooq and Fear, 2003, p.104). Even when an interpreter is involved, they may not be trained in psychiatry which can limit understanding and can have a negative impact on translation (Farooq and Fear, 2003). However, I would argue that at least if an interpreter is involved, they can bridge the language barrier to a significant extent. As argued “patients in mental health services will experience a better quality of care when accessing interpreters” (Costa, 2011). This is emphasised in the NICE Guidelines for GA, Schizophrenia, Depression and Dementia which puts forward that written material should be translated into different languages and interpreters should be used where appropriate (ref). A mental health professional that comes across a patient of a different culture, who speaks a different language, may not recognise the severity of their symptoms due to the cultural and language differences resulting in lack of support from services for example. Therefore if someone presents to their GP with symptoms these may be misinterpreted if an appropriate interpreter is not present. Therefore although many mental health settings may use interpreters regularly, others may not and the importance of this must be emphasised in order to work through issues of wrong diagnosis, treatment and outcomes of mental health.

Although ‘race’ and culture are evidently pertinent to mental health problems and service responses, it is necessary to consider other factors as “an emphasis on cultural issues can sanitize or mask other issues” (Chantler et al, 2002, p.649). It seems that mental health services are focusing on cultural differences and understanding cultural diversity in an attempt to overcome the differences in diagnosis and support for different ethnic groups. However, in their attempt to do this they may actually be ignoring other key issues thus potentially making the situation worse or at least maintaining it. Some argue that “there is an urgent need to develop cultural competence among nurses and other care workers if they are to meet the needs of the diverse populations they serve” (Papadopoulos, L and Tilki M and Lees S). However, professionals may not treat black people any differently just because they are trained to be culturally aware (Fernando, 2004). There are lots of references to cultural competence in the Department of Health and NHS. The government strategy No Health Without Mental Health which replaced New Horizons in 2011 seems to focus on culture but does not seem to acknowledge important links between race and mental health.

It is well known that there is a significant link between poverty and mental health (Chantler, 2011). It appears that mental health social work is beginning to revolve around the bio medical model therefore social factors such as poverty are not focused on as much as they should (Chantler, 2011). It has been identified that social exclusion can often be a result of poverty as a lack of financial means results in the poorer sectors of society being unable to involve themselves in societal activities thus resulting in exclusion (Gilchrist and Kyprianou, 2011). Social exclusion/isolation can impact on mental health therefore poverty can be viewed as a risk factor for mental health problems (Chantler, 2011). Being in the lowest social class is often linked with poverty and this is something which spans across different ethnicities and cultures. Therefore white, working class members of society may experience mental health issues which are instigated as a result of poverty thus race and culture cannot be viewed as the only factors impacting on mental health – other factors which can also impact on white sectors must be recognised.

However, black and minority ethnic groups may find it more difficult to move into higher classes as a result of issues such as racism and discrimination thus may remain in low socioeconomic circumstances. This highlights a link between poverty and ethnicity and emphasises the concern that peoples race and culture may result in them being forced into situations which could increase their likelihood of mental distress. It appears that there are two main ways racism can impact on individual’s health: the immediate psychological and physical impact and the result of which different races and cultures are not valued within society resulting in social exclusion and disadvantage (Karlsen and Nazroo, 2000). As argued “racism, whether openly hostile or lurking in institutional cultures and practices, limits the opportunities and life choices individuals make” (Gilchrist and Kyprianou, 2011, p.7). Therefore, certain people of certain races or cultures may feel more comfortable remaining in communities together due to racist discrimination or prejudice and as a result may not seek new life opportunities thus potentially remaining in poor socioeconomic circumstances as a result of this forced exclusion (Gilchrist and Kyprianou, 2011). Similarly, discrimination and racism may result in less support within education arenas and less opportunities to excel within employment circles (Gilchrist and Kyprianou, 2011). It has been recognised that unemployment has an impact on mental health (Meltzer et al, 1995). Findings from the Fourth National Survey identify that four fifths of Pakistani and Bangladesh respondents, two-fifths of Indian and Caribbean respondents and one third of Chinese had incomes lower than half the decided national average – recognised as poverty (Karlsen and Nazroo, 2000). This compares to one in four white respondents. Thus, this may be the impact of racism, discrimination and disadvantage (Karlsen and Nazroo, 2000) Therefore there seems to be a vicious cycle whereby BME groups feel the impact of structural oppressions resulting in fewer opportunities to break away from factors which can lead to an increased risk of mental health problems, such as poverty. Therefore, arguably social exclusion, poverty and class could be reasons why there are higher levels of mental illness in some subcultures of South Asian women for example (Karlsen and Nazroo, 2000). The fact that communities ‘stick’ together may result in further antagonism and segregation thus resulting in inappropriate support for mental health problems as ‘outsiders’ may not want to intrude in these cultures – they may take the attitude ‘leave them to it’ which can be very dangerous. Therefore a combination of factors including class and poverty can emphasise mental health issues.

It seems that the role of racism as a risk factor for mental health is being ignored or at least undermined by the coalition government. Although the No Health Without Mental Health strategy acknowledges the need to consider causal factors for mental health, it appears to neglect to discuss the pertinent issue of racism/institutional racism which can be viewed as a downfall in response (Watson, 2011). Therefore, it neglects significant links between race and mental health. This is emphasised in its ‘a call to action’ document, which does not include any BME organisations (Vernon, 2011).

Stereotyping of different groups refers to the discrimination of groups based on views they are certain way. So, South Asian groups may be viewed as having lots of family support and not believing in mental illness. This can be dangerous as it may result in services neglecting to offer support to certain races or cultures. Therefore, it appears that some mental health professionals may inherit views regarding racial stereotypes (Fernando, 2004). Another common racist stereotype is that black men are dangerous which again impacts on diagnosis and treatment. A well known example is that of Rocky Bennett. He was killed in 2004 in a medium secure psychiatric unit after being restrained by up to five nurses and an independent inquiry into this accepted that it was a result of institutional racism (Athwal, 2004). This is not a lone incident and has been recognised as an issue across mental health services. A concern which is shared by many including Richard Stone (a member of the Bennett inquriy panel) and Errol Francis (a campaigner on black mental health) is that cultural/racial awareness training will not reduce institutional abuse, it must be acknowledged and then the behaviour of the professionals and workers needs to change (Athwal, 2004). Once understood and acknowledged, progress can be made to tackle and understand causes (McKenzie, 2007). McKenzie (2007) put forward concern that the importance of Delivering Race Equality would be undermined, which seems to have been the case in No Health without Mental Health as it does not seem to recognise the importance of racism as a risk factor for mental health and the impact it has on service responses (Watson, 2011). Watson (2011) argues that “the impression given is that we are moving to a post-racial big society where ‘state multiculturalism’ is expunged from British values and public consciousness…” Thus the link is being undermined and if this is the case it is unlikely changes will be made.

Chantler et al (2002) undertook a ten month qualitative study with a group of South Asian women who are survivors of self harm or attempted suicide. It seems that survivor’s highlighted issues causing mental distress including immigration status, poverty, and domestic violence in their accounts however an over focus on cultural sensitivity by professionals and policy makers means that these factors often goes unrecognised (Chantler et al, 2002). Also, important to note is that there does not seem to be much research into the fact that if people are seeking asylum, there is a possibility that their mental health needs may be higher as a result of their experiences prior to migration (Chantler, 2011). As a result of lack of recognition, inappropriate or a lack of support was offered by services. The researchers found that the survivors who had been seeking asylum mentioned policies such as the ‘one year rule’ as causing them distress and oppression as it meant they were trapped (often in an abusive relationship) for a long period of time without a chance of escape (Chantler et al, 2001). As stated, “current immigration legislation strips South Asian women of the legal and personal support available to white British female citizens” (Chantler et al, 2002). The survivors identified that they felt these policies ensured that all power was given to the man (Chantler et al, 2002). Policies implemented trying to overcome problems in services by employing South Asian workers needs to be looked into (Chantler et al, 2002). It seems that policy makers used cultural clashes as explanations as to why issues such as domestic violence, immigration issues and poverty were not highlighted (Chantler et al, 2002). Thus in models of mental health, factors such as immigration are neglected. Services claimed to be unable to meet their needs due to cultural conflict (Chantler et al, 2002).

All but one of the survivors in the study had suffered domestic violence identifying the link between domestic violence, immigration status and suicide/self harm (Chantler, 2001). It is worth noting that refugees and asylum seekers may have experienced traumatic events before arriving in the UK such as war and poverty therefore they may have higher mental health needs because of their experiences – this is not covered much in research and is something which may be beneficial in our understanding.

Burman et al (2005) focuses primarily on domestic violence services with regards to African, African-Caribbean, South Asian, Jewish and Irish women, it became evident that culture was seen to be more important than dealing with domestic violence issues. Thus a focus on culture can be seen as an obstruction to offering the appropriate support (Burman, 2005). The study also identifies how other issues such as immigration policies prevent asylum seeking women from being able to leave abusive relationships therefore this needs to considered more (Burman, 2005). “racialised dimensions of such policies heightens their exclusionary effects”. The outcome of these findings suggests that there needs to be new ways of supporting women from minoritised groups suffering domestic violence (Burman, 2005). Criticisms of study?

It seems that in favour of culture, gender issues such as violence against women are often ignored in relation to minority ethnicities (Chantler, 2002). Would this be the case if it were white women? What is interesting is that violence against women is considered a gender issue in relation to white women but is seen as a cultural issue in relation to South Asian women (Chantler et al, 2002). This is something which needs to be recognised and changed. Cultural factors need to be acknowledged to a degree and particularly in certain circumstances for example honour based violence, however it needs to be recognised that culture and race are not always at the forefront of issues. It is important to move away from a complete focus culture in many instances, and consider gender issues as well. Segregating women from minority groups from white women with regards to violence can lead to lack of support thus potentially resulting in self harm/attempted suicide amongst other issues, as a result of the mental distress. The research undertaken by Chantler et al (2001) and Burman (2005) highlight this.

Conclusion:

As a social worker it is important to recognise cultural differences and be open about culture so that interventions are not so difficult however, although being culturally aware is useful, it is impossible to recognise all factors as cultural as there are numerous different cultures which are constantly adapting. Also, as this essay has identified, an over focus on culture can be dangerous. It is important to be conscious of other risk/causal factors of mental health such as violence against women, class and immigration status. It is essential label or stereotype someone based on their race or culture but rather engage, empower and empathise with service users. As Chantlers’ 2001 study identified, regardless of a service users race or culture, they often just want someone to listen to them. Do not always presume it is about culture as policy has tended to do in recent years. It seems that a combination of structural, cultural and individual factors including gender, poverty and culture will enable a greater understanding of diagnosis, treatment and outcomes of mental health. Considering one without the other will limit understanding. Therefore, knowledge needs to be more nuanced. I am not undermining the importance of race and culture in relation to mental health and service responses, as I have acknowledged its importance in this essay. However, do not neglect other equally important factors.

Also gender issues need to be considered for example domestic violence. Why is domestic violence considered cultural only when related to certain ethnicities e.g south Asian women??

SOME violence crimes are specific to certain cultures for example honour based violence, trafficking (UMHDU, 2010)

However, all ethnicities within the uk experience gender based violence not just certain ethnic groups and evidence suggests that violence and abuse cause mental health issues (UMHDU, 2010). However it is sometimes only seen as a gender issue when it is white women suffering abuse. Seen as a cultural issue when minority ethnic group.

Maybe it isn’t a cultural issue but a gender issue??

Research by Chantler et al – many women from different ethnicities don’t mention culture/race in their study – just mention abuse therefore maybe just need to consider this???

Outline the key areas of knowledge, skills and values required to carry out an effective and anti-oppressive social work assessment. Illustrate your answer from ‘one’ of the following areas of professional practice: Mental Health

The key areas of knowledge, skills and values which are required to carry out an effective and anti-oppressive social work assessment within the are mental heath have been set out within the various theories of social work assessment and involve engagement, effective communication skills, good inter-personal skills, non judgemental viewpoints, planning skills, confidence, experience, knowledge of the service user’s case history and an informed approach to assessment of users (Williams, (2002) 1) (Cambridgeshire and Peterborough Mental Health Partnership NHS Trust (2006) 14). This list is by no means exhaustive and it certainly is the case that there are some skills which merely require common sense and a pragmatic approach to the practice of social work assessment (Cree, V. (2003) 40) (Payne, M. and Shardlow, S. (2001) Ch. 1). From the writer’s perspective, specifically within the area of mental health, these skills arguably need to be more attuned in the social worker who wishes to carry out effective and anti-oppressive social work assessment. The social worker within the area of mental health will also require a firm knowledge base of the ways in which mental illness may manifest itself, and therefore the social worker will be able to identify the symptoms of common mental illnesses such as depression, bi-polar disorder, schizophrenia and others more readily and accurately. In this sense a combination of a good knowledge of the theory and practice of mental health social work will be essential tools for the social worker who wishes to be able to carry out effective and anti-oppressive social work assessment.

An effective and anti-oppressive social work assessment in the area of mental heath is a complex process which requires an understanding of the complex socio-legal environment that the social worker often operates within (Beckett and Maynard (2005) 46). This means that the social worker will need to be familiar with the various regulatory and legal frameworks within which they must operate (Higham (2006) Ch 1) (Beckett, C. (2006) Ch. 1) (Davies, M. (2000) 1-20). The social work care ethos is also increasingly making the role of the social worker more onerous and this viewpoint is supported by the presence of more prescriptive practice guidance in the area (Beckett, C. (2006) 4) (General Social Care Council (2006) 1). The Department of Health has issued specific policy guidance in the area and in particular the policy guidance which is of relevance here is that which relates to vulnerable adults and the mentally ill. The General Social Care Council, which was set up in 2001^[1], has issued guidance and codes of conduct for social workers outlining these frameworks and the context in which they should be adhered to, and this is particularly highlighted by the General Social Care Council themselves through their website (http://www.gscc.org.uk). Other bodies such as the Social Care Institute for Excellence have conducted sociological research which has shaped these contexts and frameworks. Within the sphere of mental health care assessment, the Social Institute for Excellence has issued guidance on how the needs of mentally ill older people should be assessed and they have given the following advice about mental health care assessment: ‘Everyone has mental health needs, though only some people are diagnosed as having a mental illness….older people are more likely to experience events that affect emotional well-being, such as bereavement or disability….Health and social care professionals should carry out an assessment of the needs of…people they are working with, which means talking…about…health and any illnesses or disabilities…finding out…any problems…. (www.scie.org.uk)’.

This above mentioned guidance has made the position of social worker more complicated. This rationale particularly applies to the area of mental health, because the skills needed to deal effectively in this area require an ability to relate to people across a whole spectrum of ages. In this sense, anti-oppressive and effective social work assessment is key. However, what are the ingredients of an effective and anti-oppressive social work assessment? Perhaps this is a question which invites an extremely broad response, which is open to subjective interpretation. Nevertheless, it is possible to argue that planning and effective assessment are two of the most important competencies when it comes to social work assessment. This is the case, perhaps primarily because the law requires the social worker to be aware of the legal duties which they owe to mentally ill and other patients (General Social Care Council (2006) 1).

However, the assessment of mentally ill patients is often associated with a minefield of difficulties. One piece of legislation which is relevant in this regard is the Mental Health Act 1983 which is often instrumental to social workers in their efforts to deliver appropriate care within the area of mental health. However, this piece of legislation places legal responsibilities upon social workers as well as other social care professionals who deliver frontline services to mentally ill people. It is a controversial piece of legislation and it is also regularly invoked by professionals within the field of social care. This makes the responsibilities which are owed by social workers to their service users even more crucial, and it makes good values such as understanding, non-judgemental behaviour and views and honesty even more important within the sector of social work assessments.

It is the case that many controversial issues come to light when the Mental Health Act is invoked in the interests of a mentally ill user who lacks the mental capacity to care for themselves. Firstly, there is the issue of deprivation of liberty by virtue of the Mental Health Act, and a social worker will often be asked for their opinion in the execution of the provisions of the Mental Heath Act, or they will be required to support service providers such as doctors who may not know a patient as well as the social worker does. This legislation allows for a mentally ill person to be ‘sectioned’ and brought to an institution against their will in order to receive treatment for mental health problems. In this particular regard, the principles of effective and anti-oppressive social work assessment are very important, not least because the input of social workers will often be considered key where a doctor or other senior health care professionals will be required to invoke powers under the Mental Health legislation.

A mentally ill person often may not appreciate what care is best for them, and interventions are often necessary to deliver the care that is required. However, this power of intervention can be abused, misused and conversely it may negligently not be invoked when it should have been. This is where effective communication and interpersonal skills are pivotal to the social worker who wishes to carry out an effective assessment. The powers which may be affected under the Mental Health Act require the support of two of more health care professionals, one of whom must usually be a doctor. This means that the social work must be capable of communicating their opinions on the most sensible intervention, the service user’s history and background, to the various actors who will be involved in the process whereby the need of a mentally ill person will be assessed (Scottish Executive (2006) Section 1.3) (Hill, M. (1991) Ch. I) (Philpot, T. (1998) 1-10). Communicating their opinions may not always be a direct process, which is why social workers are often required by law to keep adequate records and case histories of their contact with vulnerable people in their capacity as social workers, so that information can be communicated to other professional actors who need to rely upon it through record keeping.

On another level and in terms of communication and interpersonal skills, the social worker must also be able to communicate with the service user themselves. This is particularly difficult for the social worker, as they will often be the first individual who will be informed that a mentally ill service user is perhaps in need of the intervention of social care providers. In this context, and from the personal point of view of the writer, planning the interaction between social worker and service user through reading the background and case history of the person involved, if this information is available will be pivotal. This process is all the more difficult as the service user may lack any communication, and or inter personal skills. Mental illness is often a very absorbing process, and the service user may also be frightened or delusional, and consequently not capable of effective or any communication. Therefore the social worker’s communication and inter personal skills are often tested immeasurably within the context of a mental health care assessment, and are crucial tools if assessment is to be carried out effectively and anti-oppressively.

The interpersonal and communication skills which are needed must also be non judgemental, and this is very important if an anti oppressive assessment is to be carried out. The social worker must be prepared to distance themselves personally from the situation, and not to take any unwarranted criticism from the service user with mental health too personally. The person will inevitably feel very threatened by interventions from outside agencies and actors, and this will often lead to an angry reaction from the service user involved. It must also be remembered that communication between social worker and user may not always be through language, and therefore a calm outlook on life, as well as confidence and experience are also key factors which must be considered by the social worker who wishes to carry out appropriate assessments. These factors will often be picked up on, even sub consciously by the mentally ill service user, who may feel more threatened if they feel that the person who approaches them to assess their needs is not entirely confident of their own abilities.

In conclusion therefore, there are many skills which are critical when the needs of a mentally ill person are to be assessed and these may often be described in terms of knowledge, skills and values. This essay has argued that out of all the competencies that a social worker must have, communication skills, interpersonal skills, record-keeping and planning are arguably the most important. Sound values and skills such as administrative and managerial skills are also pivotal, but this essay has argued that without good communication skills, in particular a social worker’s ability to carry out effective and anti-oppressive assessments will be compromised.

Bibliography
Books

Beckett, C. and Maynard, A. (2005) Values and Ethics in Social Work. Publisher: Sage Publications. Place of Publication: UK.

Beckett, C. (2006) Essential Theory for Social Work Practice. Publisher: Sage Publications. Place of Publications: UK.

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Hill, M. (1991) Social Work and the European Community: Social Policy and Practice Contexts. Publisher: Kingsley Publishers. Place of Publication: UK.

Payne, M. and Shardlow, S. (2001) Social Work in the British Isles. Publisher: Kingsley Publishers. Place of Publication: UK.

Philpot, T. (1998) Caring and Coping: Guide to Social Services. Publisher. Routledge. Place of Publication: UK.

Articles

Cambridgeshire and Peterborough Mental Health Partnership NHS Trust (2006) Strategy for Social Work and Social Care. Publisher: Cambridgeshire and Peterborough Mental Health Partnership NHS Trust. Place of Publication: UK.

General Social Care Council (2006) GSCC Welcomes Healthcare Professional Regulation Reviews. Publisher: General Social Care Council. Place of Publication: UK.

General Social Care Council (2006). Social Worker Cautioned Following Hearing in London. Publisher: General Social Care Council. Place of Publication: UK.

Scottish Executive (2006) The Need for Social Work Intervention. Publisher: Scottish Executive. Place of Publication: UK.

Williams, C. (2002) A Rationale for an Anti-Racist Entry Point to Anti-Oppressive Social Work in Mental Health Services Critical Social Work, 2002 Vol. 3, 1.

Websites

http://www.scie.org.uk/news/mediareleases/2006/200406.asp

http://www.gscc.org.uk/Good+practice+and+conduct/