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With the continuously growing number of older population in the country and the life expectancy that keeps on increasing, the demand for the elderly care is also equally on the increase. Consequently the government are also putting in effort in order to continue improving the service provided for the elderly care such as the introduction of personalisation into the care service in the government policy in December 2007, when the Putting People First concordat was published. This is the reason why this assignment will be looking into this concept of personalisation in further depth along by looking at the strengths and limitations of implementing it into the social care.

CONTENT

The term personalisation as picked up by the Department of Health and is being used as a term to describe the series of reforms drawn out in the 2007 concordat Putting People First. In its formulations the policies have been set within the following framework of improving access to universal services, the prevention and early intervention, the increase of choice and control by the users and also growing social capital for the care (Department of Health, 2009). In addition to this, personalisation is about giving people more choice and control over their lives in all social care settings. It also means to recognise the user as a person with strengths and preferences and it starts with the user instead of the service (Social Care Institute for Excellence, 2012).

The reasons why personalisation is introduced in social care is because the government is against the ‘one size fits all’ concept in terms of providing care as it has been found to have not met most of the needs of the user especially with the fact that all users are different. The second reason is to finish up the The 1988 Griffiths Report on Community Care in which it advises that social services should become ‘brokers’ to a range of care and support providers. It also proposed that social workers should take on a ‘care management’ role.Thirdly is to combat the McDonaldisation in social care. This McDonaldisation thesis consists of five primary components of efficiency (minimising time in delivering care), calculability (trying to get user to believe that they are getting quality care for lesser money spent), predictability (where the care provided are highly routine and predictable), control (standardised and uniform care provider) and also, culture (as part of the standardised control). Finally, personalisation is implemented due to the convergence of disability movement and also the increasing neo-liberal marketisation. The disability movement as a part of service user movement and the social model of disability have been a really powerful driving forces in lobbying for government reforms. An evidence for this is the Community Care (Direct Payments) Act, 1996 where the direct payments have been made available to the disabled adults of working age in England and have since been extended to other groups (Carr, 2010). The popularity and success has stimulated much of the personalisation around service users and also the development of personal budgets (Glasby and Littlechild, 2009).

In November 2010, A vision for adult social care: capable communities and active citizens document was published, with personal budgets and personalisation, put central along with prevention, health and social care integration and the development of a plural and creative social care market to enable choice forming central aspects of the continuing social care reform. In this document too, it was made clear that personal budget alone does not in itself mean that services are automatically personalised. People should get personal choice and control over their services rather than the inflexible block contracts – from supported housing to personal care (Department of Health 2010). Glasby (2012) explained that the concept of personal budgets is rather than assessing the user’s needs and selecting services from fairly limited menu of options, personal budgets start by placing each individual into a cost band and being up front about the resources available. By knowing how much of money is available for them to spend on their needs then allows them and their circle of support to make decisions about how the money could best be spent (by direct services, direct payments, public services, the independent sector, paying family and friend or any of the combination).

Some of the strengths of using personalisation concept are the user’s outcomes can be improved and at the same time, costs can be reduced as people who control their own budgets are able to find smarter solutions for meeting their needs and can reduce their need for paid support. This is possible because the person is empowered to make the better, right kind of decisions, seize new opportunities and respond more quickly to their own problems. In the old welfare system the government pushes resources into those services that it believes people need. Users can only receive little benefit from these resources because it is unlikely that the services are perfectly tailored to meet their needs and there is no opportunity for the user to mobilise those resources to ‘pull in’ in other resources. However, when someone has a Personal Budget they are able to make quality, efficient use of those resources. Such as rather than paying ?10,000 per year at the day centre and the user will simply have to put up with whatever services offered there that they do not value. Instead, if the user is given a ?10,000 Personal Budget they then can actually spend some of their budget on those particular services they value, e.g. only coming into the centre on the ‘good days’. This process explains why people can get better lives with less money as the money that can be controlled works better with the new found freedom than the money that cannot be controlled (Duffy, 2010).

Other than offering better quality choices and empowering the service user, personalisation also is shown to be consistently cost effective of the public finance as found by Glasby and Littlechild (2002) that direct payments support are on average 30-40 per cent cheaper than the equivalent directly provided services. In addition to this, it was discovered that carers feel the relationship between them and the service user has improved due to them or their relatives being able to access the direct payments (Rethink Mental Illness, 2011). Finlayson (2002) also suggested that this positive relationship between the carer and service user is central to carer’s job motivation and satisfaction as in turn it will increase the quality of care provided. Another advantage of this concept as suggested by Zarb and Nadash (1994) is that the flexibility of the service is enhanced. The service provided is fitted around the user’s time on top of their different needs rather than fitted around the carer’s timetable.

Although according to the findings discussed earlier that expressed the positive outcomes of personalisation, there are few limitations associated into practicing it. The first one is that it is inappropriate to some users especially those who are mentally incapable and the elderly. It is found to be a daunting experience as they are suppose to manage their own financial arrangements directly which will also add extra burden and unwanted stress for them. On top of this, most of service users are also anxious by becoming employers and having to deal with responsibility particularly when they are unwell. This is especially with regard to assistance with the direct payment’s managing of the service user, either by family member, friend or support agency on the user’s behalf. In addition to this issue, the potential problem that could possibly happen regarding the vulnerable user is being exploited and potential for their money to be fraud (Leece and Bornat, 2006). On the other hand, as suggested by Glasby and Littlechild (2009) the local authorities have a key role in making their systems as simple as possible and also proportionate to the risk, along with the availability of independent support (such as peer support and support agency) and the advent of self-directed support to reduce potential hassle from this concept should any problem arise.

Another limitation of this concept is the community care assessments that are carried out sometimes underestimated the needs of user, especially those with mental illness as their needs are subjective (for instance, not so obvious on a good day) and therefore failed to be met. To make matter worse, these assessments are often not person-centred as it lacks of user’s involvement in decision making thus, they tend to be passive recipients and disempowered. This highlights the need of a better person-centred assessment by the professionals involved as the central element in the direct payments is ‘good assessment’. Hence, a better, different kind of relationship needs to be developed between the professional and the users as well as other approach to allocate the community care resources for this particular service user (Leece and Bornat, 2006).

Another problem is direct payments and personal budgets are identified as a threat to the professional expertise of the social workers, as well as the longer hours due to the flexibility needed. It was also suggested that at one critical point, services will not be able to be managed properly as more users are becoming employers thus, changing the ‘balance of the services'(Leece and Bornat, 2006). In contrast, direct payments and personal budgets are able to free social workers up to focus on people who are in greater need of support and thus, reconnect their value base and principles of profession (Glasby and Littlechild, 2009).

Furthermore, the monopoly of market with the increasing choice through the direct payments is seen to be a problem. This will someway force the existing providers to make more effort to be more appealing to the service users in order to avoid of going bust. Additionally the real goals of these providers are often doubted as whether they will put quality care over profit-making (Leece and Bornat, 2006). The argument against this is that with the presence of competition, the providers will struggle to increase their quality of care along with a better value in order to keep up with the other providers.

The strengths of the concept of personalisation as per discussed have found to be outweighed by the limitations that are associated to it. This is also proved to be the case as nearly all users is found to be satisfied with their experiences of using the direct payment as they found it to be more convenient and secure in the research carried out for the Department for Work and Pensions (2004). Out of the total participants, 75% reported to have found no disadvantages when using the direct payment.

CONCLUSION

The concept of personalisation has had a long history on why the government want to put it into practice as a way of reforming the social care particularly in the last few years when the direct payments and personal budgets were introduced. This was proved to be a huge success with majority of the users are extremely satisfied with how it has changed their lives in terms of empowering and giving them better quality of choices. Moreover, it was also found to be cost-effective and thus, able to save large amount of the public fund. However, as this concept was also subjected to few arguments against it, such as it not being able to cater certain types of user, there is also backup plan, support and effort made by the local authorities to minimise this. Moreover, the arguments that it threatens the social workers profession and the market balance are found to be ungrounded. Thus, the benefit of implementing personalisation in social care was found to overshadow the limitations as discussed earlier.

Problem Background

While reading the true story of Reggie Kelsey it appeared that there were many psychological, biological, and social aspects that lead to his final outcome, death by suicide. This paper will focus on the sociological aspect of what led Reggie to decline in society, was simply that Reggie aged out of foster care. Three and a half months after he aged out of foster care Reggie was found dead in Des Moines River. Foster care, though a temporary placement for youths, until they reach eighteen years old was the one conclusive factor that kept Reggie alive. Foster care, a social agency, was involved in providing social services that were to ultimately prepare Reggie for transition into dependency; these transactions should be viewed as a macro systems problem.

Reggie was pushed out into the world without possessing the skills that would have kept him alive because there was a time allotment on how long he could use the services of foster care. Though Reggie had a helping network it was weak, and he lacked several resources that would have kept him from being homeless and from death. Though youths who age out of foster care are seen as regular teens, most of them lack the stability of family, food, and shelter that a normal teenager would have. In stage five of Erikson’s psychosocial development, which involves the transition period from childhood to adolescence where they establish their identity; it is clear that Reggie’s inability to integrate his role into his new environment after aging out, suffered and left him uncertain about his identity. Aging out of foster care when not developmentally ready left Reggie without power, coping skills to adapt, structure, and strict supervision needed for survival, especially for a person with an IQ level that considered him to be mentally delayed.

Literature Review

Imagine one day having a strong, well connected supportive network that kept you living and the next day that system abandons you. According to Atkinson (2008) “approximately 20,000 youth age out of and exit foster care each year,” and the majority of them face challenges because they have been abandoned by the only support system they know (p. 187). Avery and Freundlich (2009) reported that many youth lack social support, economic resources, and independent living skills which cause them to be less inclined to become successful adults. Avery and Freundlich further noted that “foster care support, which provides housing, financial support, and a range of health, education and other needed services, typically ends when youth are developmentally unprepared to assume full adult roles and responsibilities” (p. 248). Youth like Reggie Kelsey who age out foster care because of some type of neglect or abuse are more likely to have problems “forming positive interpersonal relationships, reduced educational attainment, increased delinquent behavior, and engage in high-risk behavior” (Atkinson, 2008, p. 183). They simply find it difficult transitioning from one social environment to another, with significant problems impeding their way to becoming successful adults. When aging out of foster care, youth experience challenges such as homelessness, unemployment, and lack a support system. All the challenges from aging out of foster care generated Reggie’s symptoms that led him to become suicidal.

Atkinson (2008) explained that “maintaining successful housing presents a significant barrier for youths after emancipation from foster care” placing them on an often irreversible path to failure (p. 188). Since Reggie did not have stable housing when he aged out of foster care, he was not under a constant supervision that could have kept him alive. Being homeless is not an ideal situation for any persons, but for adolescents particularly it leads to having identity diffusion, where they suffer from a serious lack of direction and ability to make sound decision. “Chronic stress has been found to negatively impact learning, memory, and executive functioning” (Avery and Freundlich, 2009, p. 251). Homelessness can also viewed as great stressor and coupled with psychological variables are aspects that lead to suicide in adolescence.

Unemployment plagues youths that age out of foster care significantly to where they end up involved in criminal activity, in poverty, or on public assistance. Being unemployed can be a blow to an adolescence ego because they are not able to support themselves they result to criminal activity to take care of themselves, or feel like life is not worth living. Living more independently was the most common living situation for young people who remained in the foster care system after age eighteen years. According to Atkinson (2008) “Close to two-thirds of adults in their twenties receives economic support from their parents” (Atkinson, 2008, p. 193). In the case of Reggie, he had no support financial support from parents, he was on his own, and with little to no employment skills it would shows that the odds were truly stacked against him.

Avery and Freundlich believed “”independent living” is simply not a feasible option for the majority of youth in foster care who lack the social scaffolding of stable family and community networks” (p. 253). Reggie may have had a helping network that worked within the social service system but he lacked the connections that a state based system provides. In the absence of a distinct social network for foster youth aging out of care decisively infer unacceptable subsequent foster care outcomes. Youth that age out of foster care already feel sense of powerlessness, and hopelessness, and as they move towards independence they still need a social environment to fall back on; they can not do it all by themselves especially at eighteen.

Discussion 1- Ethics

Though aging out foster care youths when they are not independently developed violates several NASW codes of ethics, the two that principally led to Reggie’s demise are sections 1.14 and 1.16. In section 1.14 it states “when social workers act on behalf of clients who lack the capacity to make informed decisions, social workers should take reasonable steps to safeguard the interests and rights of those clients”. By aging out Reggie, who was mentally disabled, the foster care system took away his basic right to thrive. The process of aging out foster care youths who are unable to make sound decisions without providing extensive care after is unethical.

In section 1.16 it categorizes when it is acceptable to terminate services for a client. There is one significant factor that correlates to all youth aging out of foster care, and in this factor, b, it states that “social workers should take steps to avoid abandoning services, withdraw only under unusual circumstances, and carefully consider all factors making sure to minimize adverse effects”. With this statement it can be visualized that when deciding to age out a youth there is no consideration taken to counteract any of these factors. The fatal determinant that youth face when aged out is that the youth have to face several adverse factors.

In Reggie’s situation there could be minimal responsibility placed on him resulting in his final outcome, but only if someone was trying to advert attention from their unethical mistakes. In section 1.14 vehemently relates to Reggie and sets aside those minimal mistakes, because as a mentally disabled child he relied heavily on the states decisions to safeguard his life. In the end the state aged Reggie out at eighteen which is not unusual; this is not an age that necessarily attest to the fact that a person is ready for all that accompanies adulthood.

Discussion 2- Practice

A 2007 article in the journal, Child & Adolescent Social Work, examines the practice issues for teenagers aging out of foster care (Scannapieco, Connell-Carrick, & Painter, 2007). The foster youth stated, foster youth and sub-systems involved with foster youth after they age out discussed three very important practice themes that should be addressed. The first theme was to have a youth focused practice; here foster youth thought the change needed was that they wanted to be involved in the decision-making. They expressed how they thought it was disrespectful to them because they were not asked what they thought they were just told; unlike an adult who has the ultimate say in their own lives.

The next theme that youth expressed was a challenge was communication and collaboration. There is a break down in communication when it came to the sub-systems, with missing important information and lack of accurate knowledge about supports and services available. Everyone identified a solution of a need for one individual responsible for facilitating the coordination of planning amongst the sub-systems. The last important theme suggested was the need for more skill building opportunities. The youth focus group felt they were unprepared for independent living and what training they got they were unable to practice them before being aged out. They wanted better understanding of their own health and mental health needs, also advocacy for better educational setting.

Recommendations

There were many different actions the foster care system could have taken to prevent Reggie Kelsey’s outcome. The actions that would have helped Reggie even if they still aged him out would have been intense independent living training, strict follow up meetings with caseworker and a monitor, or buddy-system release could have been incorporated. For an adolescent like Reggie with a mild level of mental disability training is important; there needs to be practice of everyday situations so issues that arise are not uncommon to him. This action helps because if he gets into a situation that he has had training he will know the best option, but depending on the situation he could be overpowered or influenced by another component.

A second action of follow up meetings and a monitor could have helped because the caseworker could have been in tuned to the needs of Reggie. A weekly schedule, then bi-weekly, then monthly, up until he was stable would have been best. Also the monitor anklet, or bracelet would give the caseworker a constant notation of where Reggie was. This the best plan of action for a person like Reggie even though they may feel like they are on probation it keeps them under strict supervision and needs are easily accessed. The last option of a buddy-system where foster youth are age out in pairs is a good option, each person is has a peer to relate and talk with. This would be helpful though the two are in the same boat and neither is a professional, and one may abandon the other.

References
Atkinson, M. (2008). Aging out of foster care: Towards a universal safety net for former foster care youth. Harvard Civil Rights-Civil Liberties Law Review, 43(1), 183-212. doi: Article.
Avery, R. J., & Freundlich, M. (2009). You’re all grown up now: Termination of foster care support at age 18. Journal of Adolescence, 32(2), 247-257. doi: doi: DOI: 10.1016/j.adolescence.2008.03.009.
Code of Ethics (English and Spanish). (n.d.). . Retrieved November 2, 2009, from http://www.socialworkers.org/pubs/code/code.asp.
Scannapieco, M., Connell-Carrick, K., & Painter, K. (2007). In their own words: challenges facing youth aging out of foster care. Child & Adolescent Social Work Journal, 24(5), 423-435. doi: Article.

Mental health services have previously been heavily dominated by health service attitudes reinforced by medical models of explanation and beliefs, creating a division between the mentally ill and society. The dominance over biochemical approaches to mental health has so far presented little space for the expression of a more holistic alternative, (Tew, 2002).

Literature suggests that mental health services need to move beyond the bio chemical approach, which has created a division between the ‘normal’ and the ‘mentally ill’, by defining their ‘illness’ in terms of their ‘pathology’, (Bainbridge, 1999), into a practice which incorporates social work values underpinned by the social model of mental health.

‘2009 will be a significant year for mental health policy in England.’ (New Vision for Mental Health, 2008)

As the governments 10-year strategy for mental health, the ‘ National Service Framework’, is coming to an end significant policy changes are being made. Amendments which have been made to the Mental Health Act 1983 have radically changed mental health practice with changes in the roles and responsibilities of qualified mental health professionals, including introduction of two new roles: the responsible clinician (RC), formally the registered medical officer, (RMO) and approved mental health professional (AMHP), formally known as the Approved Social Worker (ASW). There has also been increased interest in social models and approaches to mental health, which is being supported through organisations such as, ‘The Social Perspectives Network’ (SPN), a network of people interested in how social factors contribute to people becoming distressed. (SPN, 2009).

With these changes in mind and plans for social care and health services to work together on a more integrated service delivery, the question is- where does this leave the role of social work practice in the future.

This literature review will focus on the changing approaches to mental health practice. Based on the literature provided it will examine why the medical model has dominated mental health practices in the past, and what the social model emphasises, focussing on psycho-social perspectives. It will place a critical perspective on the medical model and aim to show why increased emphasis on the social model may have encouraged a shift in policy and legislation, (amendments to the Mental Health Act 1983). It will also focus on how the social model can influence future social work practice.

‘Social work’s role in relation to psychiatry and the mental health system is particularly uncertain’. (Beresford, 2005).

As interventions within mental health are primarily medical model based, the role of social work within the multi disciplinary led service remains unclear. It has been noted that medical models have been the ‘driving force’, of policy and procedure within mental health. (Carpenter, 2002), and the dominant treatment paradigm in most mental health practices (Beecher, 2009). However in terms of social work, this model is detrimental to services users self worth and consequently conflicts with a number of social work values, (Carpenter, 2002).

The medical model is a perspective that is adopted by doctors and psychiatrists, suggesting that mental illness is rooted in our physiology and is treated as a ‘disease’ or ‘illness’, (Golightly, 2008) and although criticisms exist, it has been favoured by practitioners within the health care system, as a tool for aiding their practice (Boyle et al, 2006). It can be described as

‘The predominant Western approach to illness, the body being a complex mechanism, with illness understood in terms of causation and remediation, in contrast to holistic, and social models’, (Braye, 1992).

It is proposed by psychiatrists that ‘the ‘medical model’ is a process whereby, informed by the best available evidence, doctors advise on, coordinate or deliver interventions for health improvements’. (Shal and Mountain, 2007). This model characteristically seeks to identify the problem by a ‘diagnosis’ then prescribe medication as a form of treatment to ‘eradicate’ or ‘rehabilitate’ the problem, (Kihlstrom, 2002), however critics state that this ‘diagnosis’ results in the service user becoming an illness rather than an individual. (Deegan, 1996).

Supporters of a more holistic approach would argue that the medial model is guilty of being ‘too restricted’ and ‘problem focused’, it also maintains the depersonalisation of the individual with mental ‘illness’, and their families, (McLean, 1990). In addiction it is too simplistic in taking into account the many variables that are in a persons environment (Ashford, et al, 2006), (which may be a cause of their ‘diagnosis’) focusing too often on their symptoms and deficits, not recognising or engaging with the whole environment (Rapp, 1998). It also ignores the individual’s or families experiences, (Barker et al, 2001), which could also have an affect to their behaviour; it is guilty of not seeing the situation holistically. (Beresford, 2005).

Other evidence suggests that social causative factors, such as unemployment, unstable family circumstances, substance misuse and poor education are more likely to explain a persons behaviour rather than any medical diagnosis, (Taylor and Gunn, 1999).

Although it has been noted that the medical model has been the more favourable approach in reinforcing policy and service provision we cannot say that the medical model, on its own, is a sufficient basis to underpin policy and practice in mental health, (Carpenter, 2002). As also argued by Tew, (2002), research which has been based on longitudinal surveys shows that advances in medical treatments have resulted in inconsistent recovery rates-so we cannot say that the medical model is a sufficient tool to base practices on.

This raises the subject of the social model, how does this model differ, what does the model emphasise? The following literature will aim to identify the key principles in answer to these questions.

It has been established that the medical model sees the service user as an individual with a problem, rather than an individual within an environment, which holds causable factors. Literature suggests however that the social model takes a more ecological approach, (Littlejohn, 2004). So what is different about the social model and how can it change perceptions in psychiatry?

According to Ramon (2001) the social model fits well within the holistic approach of social work and is the underlying rationale for mental health social work. Tyrer and Steinberg (2003) express that,

All social models in psychiatry have the same fundamental premise. They regard the wider influence of social forces as more important than other influences as causes or precipitants of mental illness (Tyrer and Steinberg, 2003. p87).

The social model embraces the impact that social causative factors and psychological factors can have on a person’s life. (Duggan, 2002) especially the impact it can have on their health. It considers that individuals suffering from socio-economic disadvantages (such as social exclusion and poverty) can impact their health both physically and mentally, and are more likely to suffer as a result of this.

Duggan (2002) supports the social model and identifies clear key characteristics, which the social model emphasizes. The impact of social factors on individuals who are vulnerable and the importance of maintaining social networks and support systems. Unlike the medical model, the social model considers the inner and the outer worlds of individuals, emphasising empowerment and capacity building at individual and community level and places equal value on the expertise of service users, carers and the general public, (Tew, 2002). Duggan goes further and explains the model in more depth,

‘The model allows practitioners the chance to see mental distress as a reaction to a range of social circumstances (past and present) that may be experienced. In this sense, it may often link with issues of powerlessness and loss’, (Duggan, 2002).

Smith explains his view on the social model as apposed to the medical model and argues,

Behaviours defined as symptoms and disorders are best understood as creative responses to difficult personal and social histories, rooted in a person’s experience of oppression. (Smith, 1999. p.31).

The social model emphasises key characteristics, which can be identified in social work values, those of service user empowerment, self-determination and environment role in personal experience (Carpenter, 2002).

The general orientation of social work values are helpful in attaining a more holistic approach, in that they promote a more user-centred social work practice and combine a commitment to work with individuals and the environment which surrounds them, (Tew, 2002). Therefore the values that are at the heart of social work practice sit more comfortably with what the social model emphasises.

Both the medical and social models have been discussed, highlighting what each model emphasises, the literature has aimed to underline why a shift in policy and legislation may have taken place. The following literature will now look at the implications for social work.

Farone (2006) also argues that social work with its ecological perspective is well suited to address the complexities in mental health practice. So how can social work effectively intervene within mental health services?

In a study published by Rethink, (Martyn, 2002) involving 48 people with a schizophrenic diagnosis (a common mental disorder), they identified themes in support areas which service users perceived as being effective in their situations – access to paid and voluntary work, support with relationships with family and friends, counselling and psychotherapy and education on health living, a similar research also concluded these were important, see Macdonald and Sheldon, (1997).

These support areas embrace solutions beyond those recommended by medical diagnosis alone.

Employment plays a key role in tackling social exclusion (a common social cause of onset mental disorder) it also provides the service user in helping building self-esteem as well as increasing social capital and standard of living. (New Vision for Mental Health, 2008). Loss of employment can consequently have adverse effects potentially creating strain on mental health.

Literature suggests that the family is an important source of support for services users with mental illness, and social work should seek to maximize and sustain this support (Reinaires and Vieta, 2004). The social model does acknowledge that this imperative to any service users mental health as it is a central aspect of social inclusion and plays a critical part in recovery. Social work can in turn help seek and sustain employment (Beresford, 2005).

However as acknowledged by a leading mental health organisation,

‘Employment is an area where people with mental health problems experience extensive discrimination and disadvantage and be a source of damaging stress that causes mental ill health. (Mind, 2009).

This is an important factor which social work can effectively intervene with, to tackle discrimination and support service users through sustaining work placements, to remain included. Social inclusion remains a large factor in maintaining mental health as research suggests the social model can contribute to social workers challenging social exclusion (Tew, 2002). Huxley et al (2003) identified the difficulties services users face in sustaining and preserving social contacts and social networks, especially when suffering from mental disorders.

In addition Corry et al (2004) also found that people with mental health problems who live in more isolated rural areas with limited access to services are likely to find it more difficult to develop and preserve supportive social contacts and networks. Social work role then is support service users in accessing and day centres, and promote relationships between people who use services, encouraging group work, which can lead to challenging marginalisation and discrimination, and in turn educate the user.

A psychological factor underpinned by the social model that is overlooked by the medical model is the importance of family support, without this service the user could be at risk of mental health deterioration. (Huxley et al, 2005). Research suggests that maintaining network relationships between family and services can have significant impact on mental health. It is suggested that a social work role here would be to support the network relationships, (Germain and Gitterman, 1996). However as acknowledged by Jack (2000), relationships can be both supportive and stressful and therefore necessary to examine the nature of the relationships to understand whether they were liable to assist or weaken functioning.

Direct payments, personal budgets and individual budgets are at the centre of the government’s aim of personalising adult social care services around the needs of users. They involve direct cash payments given to service users to purchase care services, which they have been assessed as needing, and are intended to give users greater choice in their care. Direct payments allow the user to employ people or commission services for themselves and take on all the responsibilities of an employer. (Community Care, 2009)

However research conducted by the Health Care Commission (2007) reported that direct payments for people with mental health problems are under-used. Social work role here would be to advocate on behalf of the service user, working in partnership and facilitating empowerment to increase access to direct payments as suggested by Spandler and Vick, (2005) who conducted a study into the usage of Direct Payments.

The subject of social work with a mental health practice is a wide area of discussion. Unfortunately, the coverage of research studies evaluating social work contributions to mental health practice is erratic and many areas of practice remain under-researched.

There remains a gap in the research capturing the perceptions of service users from marginalized groups, in particular views of women with severe mental disorders or those from linguistic minorities. It is important that social work develops a greater understanding within these fields to understand their situations holistically and in turn result in better access to services, which fundamentally underpins the social model of practice. With the growing interest of the social model within mental health to actively ensure the best service delivery these issues of equality and diversity need to be analysed.

There also remained a gap in research of service users with dual diagnosis, with the majority of the research having been undertaken in the United States. It should be stressed that due to medical research overshadowing social research in dual diagnosis and with a growing amount of service users falling within this area, more research is needed from a social care perspective.

There is also the growing concern as the integration of health and social care services evolves in the mental health; social workers role will become even more vague. Social work practitioners feel that their values, based on a social model, will be controlled by health professions values, which in turn will adopt a more medical model perspective. This concern has become more apparent with the replacement of the ASW by the AMHP.

Due to this replacement, and the loss of a professional group, which had a clear identity, the replacement, AMHPs will need support to remain independent and develop a common approach, which underpins the social model of practice. As the AMHP’s could potentially be from a health care background, it is the social workers role to ensure this overlap with other professions, continues to focus on the service user as an ‘individual’, based on the social model of mental disorder, as appose to a ‘anti social’ medical based model.

INTRODUCTION

Social work practice enables disadvantaged people to develop their full potential and enrich their lives. It is complex and challenging profession. Social workers deal with a variety of clients from different ethnicity, age, gender, disability and social inequalities. Use of theories in social work practice gives it a strong knowledge base. They provide a way of thinking and knowing.

In this essay I will discuss the inter-relationship between theory and social work practice and theoretical paradigms in social work. It will then explain how theories shape social work practice and vice versa.

INTER-RELATIONSHIP BETWEEN THEORY AND PRACTICE

Theories always help to improve the social functioning of individuals by helping social worker and clients to understand conflicting thoughts and feelings. They also help social worker to maintain a focus on interplay between the person and their environment. There are many theories from psychology, biology, sociology and economics that provide strong knowledge base to the social work practice. These theories are related to human development, personality, family system, socialization and organizational functioning. Depending upon specific issue social workers can apply relevant theories to practice.

Theory and practice work alongside each other in social work practice. Theories explain certain behaviours and guides through ways of changing troublesome behaviour. There are many theories that can be used by a social worker in practice. The theory used by social worker in relevant situation should provide social worker with a framework to understand and explain client’s behaviour, generalize client’s problematic areas, identify knowledge gaps and intervene. Theories help social workers to understand individuals and make sense of the situation by having a set of guidelines.

It is important to choose relevant theory as it directly influences on social workers approach to clinical practice. Theories work as lenses for social workers to describe and understand client and their world and facilitate insight to bring positive change (Walsh, 2010).

Clinical social work practice is defined as social work theory and method to resolve and prevent families, individuals, groups focusing on psychosocial challenges. Practice is based on human development theories and focused on inequalities faced by vulnerable clients (Walsh, 2010).

A social worker with a strong theoretical background is able to practice in a distress, relaxed, confident and competent manner. There are many theories that give a variety of interesting.

THEORETICAL PARADIGM

Theoretical paradigm is an image of society based on fundamental assumptions and guides sociological thinking and research. A social worker is a helper or a change agent employed to bring changes for betterment of an individual, families group or communities. They are expected to be knowledgeable and skilled in doing so (Zastrow, 2010). To make any decisions or to take any actions the social worker requires professional knowledge. Social work is practised in relevance to theories and perspective model. Social workers own experiences, personal and professional, values and believes contribute to identifying situations, analysing them using relevant theory and making decisions in practice.

Decision making in social work practice is based on social workers perspective model or theory .Perspective is a broad way of viewing human behaviour in relevance to its interaction with environment, strengths, weakness, values and believes .It is a holistic view of individual’s behaviour . In order to be able to make any decisions they need to identify cause, analyse them to find solutions to the situations and decide.

The Ecosystem perspective has been in practice since 1970s in social work. It recognises the relationship between environment and individual. In social work practice it helps acknowledge the influence of environmental and situational on disadvantage individual families or groups. The strength based practice emphasis on individual’s self-determination. Regardless of individual’s environment they have certain strengths, wisdom and knowledge. This approach is client focused and for a social worker to become aware of them, they need to show client that they are genuinely interested in helping and bringing a change. Social workers belief in clients and their strengths can explore solutions and resources (Poulin, 2009)

Social work practice is identified by two broad theories, Explanatory theory and Interventive theory. Explanatory theory explains factors that shape human behaviours and Interventive theory facilitates changes in human behaviours .Theories provide a generalised idea to understand human behaviours in different circumstance and facilitate change (Lehmann and Coady, 2001).

There are many theories available for social workers to refer to in practice. In certain situations some theories are more applicable and appropriate then others.

Psychodynamic theory views root cause of most problems faced by individual as unpleasant, frightening and painful experience as a child .The goal of this theory is to acknowledge unconscious mind and make it conscious. It helps client’s to interpret and develop an insight to their past influencing their present .Whereas the cognitive behavioural theories views maladaptive behaviours to be learned .Problematic behaviours and thoughts are learned in past and can be changed through positive reinforcement and behavioural-cognitive therapies. Humanistic theory views problematic behaviours as a result of losing their touch with aspects of their experiences. Social worker needs to get these clients to awake themselves to their painful realities and bring new meaning to their life (Lehman and Coady, 2001).

Perspectives, models and theories guide social workers to practice efficiently and bring changes .Theories give direction and purpose to the social work practice.

HOW THEORY SHAPES PRACTICE, AND PRACTICE SHAPES THEORY

Social work aims to improve societal conditions and functioning .They work in a dynamic work environment which is constantly changing and challenging. They need to acquire a framework to understand a context, its complexities and be able to provide solutions (Greene and Greene, 2008).Theories provides objectives to social worker in enabling people to make their social circumstances better. Theory informs day to day practice and help social workers see familiar patterns and regularities in practice. There are many theories that explains human behaviours and factors influencing it differently (Howe,2009). Some theories such as psychodynamic theory views human behaviours as product of unconscious minds experiences in childhood whereas on the other hand behavioural theory disregards notions of unconscious mind and views human behaviour as a collection of actions that brought favourable consequences and were repeated.

A social work theory explains human behaviours objectively but human beings are self-defining as well as socially defined. Theories in social work practice are just like maps suggesting routes to destination but which route is most appropriate and how to get to the destination comes down to social worker and his/her practice skills.

Social workers have ethical and professional responsibility to assist disadvantaged individuals, groups or families in the best way possible. They observe asses, interact and intervene with individuals and their environment. Social worker’s practice wisdom plays an important role in practice along with theoretical knowledge (Teater, 2010).

The wellness model given by Mason Durie views four dimensions that should be considered while working with Maori clients- the spiritual, emotional, physical and extended family dimension. When working with Maori client’s social workers approach should be in relevance to the four dimensions and appropriate theoretical framework is applied (Working with Maori, nd).

Social workers asses evaluate and reflect on their own practice and the use of theories to determine appropriateness and effectiveness of various theories (Teater, 2010). Critical reflection in social work practice helps workers develop self-awareness and evaluate their own practice professional and personally, it facilitates high standard of practice yielding favourable outcomes (Maidment and Egan, 2009).

Social work is practice is based on systematic and evidence based knowledge from researches and by reflecting on one’s own practice.

Different theories inform practice and are developed further and changed depending on practice outcome. Practitioners use a variety of theoretical perspective relevant to clients or practice by blending several theoretical approaches (Maidment and Egan, 2009). Relation between theory and practice is considered to be reflexive .Theories play a significant role in social work practice but at the same time social work practice is not a slave to theory (Maidment and Egan, 2009).Theories shape practise and practice shapes theory.

CONCLUSION:

Social work is a profession that works for betterment of society. It promotes wellbeing by empowering clients, families or groups. They recognise the complexity of interaction and influence on human beings and their environment. It is practiced on knowledge base provided by various psychology theories on human behaviour. Theories provide explanation on certain behaviours and guides on intervention to resolve problematic behaviour. Social workers deal with clients, families or groups from a diverse backgrounds and social inequalities. Their practice is based on generalised framework of understanding human behaviour given by various theories and social work practice models. Social work practice and theories work alongside each other and are inseparable and neither does one dominant other.

REFRENCE LIST

Greene, R., & Greene, R.R. (2008). Human behaviour theory and social work practice (3rd ed.). New Jersey, USA: Transaction publishers

Howe, D. (2009). A brief introduction to social work theory. England, UK: Palgrave Macmillan.

Lehmann, P., & Coady, N. (2001.). Theoretical Perspective for direct social work practice. New York, USA: Springer publishing

Maidment, J., & Egan, R. (2009). Practice skills in social work and welfare (2nd ed.). Crows Nest, NSW: Allen & Unwin

Poulin, J. (2009.). Strengths based Generalist practice a collaborative approach (3rd ed.). Belmont, USA: Marcus Boggs.

Teater, B. (2010). An introduction to applying social work theories and methods. New York, USA: McGraw Hill

Walsh, J. (2010). Direct social work practice (2nd ed.). Virginia, USA: Marcus Boggs

Working with Maori. (nd). Child youth and family. Retrieved from: http://www.practicecentre.cyf.govt.nz/knowledge-base-practice-frameworks/care-and-protection/resources/working-with-maori.html

Zastrow, C. (2010). The practice of social work a comprehensive worktext (9th ed.). Belmont, USA: Brooks/ Cole.

The aim of this essay is to discuss the role of the social worker addressing social exclusion and discrimination along with the impact it has on individuals, groups and communities. I will also discuss my understanding of anti-oppressive practice and ethical issues within the Welsh context, and the issues social workers will face daily throughout their profession.

To allow a social worker to carry out their roles and responsibilities they will need to understand the meaning of social work itself,

‘Social work is the purposeful and ethical application of personal skills in interpersonal relationships directed towards enhancing the personal and social functioning of an individual, family, group or neighbourhood, which necessarily involves using evidence obtained from practice to help create a social environment conducive to the wellbeing of all’ (Pierson 2010 p494/495).

A social worker needs to have knowledge and multiple skills to carry out their complex roles within society. One of those areas social workers will face within their professional role is social exclusion and discrimination. Social exclusion happens to a minority of people in society and those who suffer from social exclusion have different life experience and opportunities from other people.

‘Pierson (2002,p18) defines social exclusion as a process that deprives individuals and families, groups and neighbourhoods of the resources required for participation in the social, economic and political activity of society as a whole’.

There are many contributing factors that can cause someone to face social exclusion or discrimination, social workers will need have an understanding of people’s life experiences, using a holistic approach, be able to listen, communicate with all service users in an appropriate manner and work in partnership with service users so they do not discriminate. Social workers also need to be mindful that Wales is now a multi-ethnic society and will be challenged with ethical issues and their dilemmas, such as languages, religion and other areas. According to the Welsh statistics 2009 Wales have a population of 2,875,700 of which 29.800 are mixed race, 52,700 are Asian or Asian British, 18.600 are Black or Black British and 22,600 are of other ethnic groups (http://www.statswales.wales.gov.uk/TableViewer/tableView.aspx accessed 26th October 2012).

Those that are most at risk of social exclusion are children, older people, disabled, and unemployed, but the most significant factors are poverty and low income.

‘Those living in poverty are vulnerable in a number of different ways. We know that they are more at risk of poor health and poor educational attainment, have lower skills and aspirations, and are more likely to be low paid, unemployed and welfare-dependent’ (Huw Lewis AM 2010 p2).

Poverty is seen in different approaches, absolute, relative and consensual.

Thornes, P (2007 p77) defines absolute poverty as not having the very basic means to live adequately. Relative poverty as a measurement of poverty based on working out the income needed to attain the accepted standard of living in a society and consensual poverty as whether or not people can afford a series of items which most people, when questioned regards as necessities’.

‘Between 2005-2008 an average of 32% of children in Wales was living in relatively low-income households. There has been a general downward trend, but the two most recent figures show an increase on the previous years’.

Social workers will need to have an understanding of the impacts that social exclusion and discrimination can have upon a service user and their families. For this to happen social workers will need to be able to identify areas that cause social exclusion, be able to investigate and what actions will need to be taken to address it. The Welsh Government have put in place a number of policies, strategies and initiatives to fight against poverty and social exclusion which have impacted on those that live in Wales. These include Child Poverty Strategy for Wales, Flying start, Child tax credits, Winter fuel allowances, plus many more.

‘Over the past ten years in Wales, overall poverty has fallen by three percentage points, compared with two percentage points for the UK as a whole. However, the extent of poverty for all groups in Wales (apart from older people) is slightly higher than for the UK as a whole.’ (Huw Lewis AM, 2010).

Since social exclusion is a process we must be mindful that there could be hidden barriers involved which in turn will affect others areas of their lives, it will be like a domino effect. So in order for social workers to address social exclusion they need to have a holistic view of the service users, and consider any hidden barriers this will enable them to have an overall view of how the service user has lived up to date, what potentially triggered social exclusion and how to redress the situation. To enable good practice the social worker should be working in partnership with the service user where a trusting relationship can be built. Both sides will need to listen and engage with each other so needs can be identified and addressed, whist doing so social workers needs to be empowering the service user and practise in an anti-discriminatory way. Once the needs have been identified the social worker needs to understand how the impacts can affect the service users, their families and their lives. ‘Social welfare practitioners have a key role to play in terms of working directly with children, young people and families to help them improve their circumstances and mitigate the worst excesses of poverty and social exclusion.’ (Williams 2011).

People can become socially excluded and discriminated against through poverty, isolation, lack of life opportunities, lack of education, availability of resources such as health and public transport, employment, living environment, demography, social participation and economic resources. The effects upon a service user and their families can be devastating, it can lead to service users losing their dignity which can then lead to low self-esteem and lack of confidence. People can then feel powerless, and that their voice is not being heard and become disempowered. People who are in poverty are in a cycle of deprivation and once in this cycle find it very hard to get out of because of the domino effect. They may be in poverty due to low income or unemployment. Unemployment is a major risk factor for low income in Wales, that risk rising from 5% for a full-working family to over 60% for a workless one. Even when another adult in the family remains in work, the family’s risk of low income still rises to 25%. (www.jrf.org.uk/publications/monitoring-poverty-wales-2009 accessed 27th October 2012). Children who live within these household will also suffer the impacts of social exclusion and discrimination which have become a great concern for Governments.

‘Research confirms the negative outcomes for children associated with poverty, including poor health, low self-esteem, poor educational achievement and homelessness. Outcomes associated with child poverty are mortality, accidents mental illness, suicide, child abuse, teenage pregnancy, homelessness, low educational attainment, smoking and morbidity’ (Bradshore and Mayhem, 2005).

People who are unemployed also face the stigma of society, being classed as lazy and scroungers, so in turn are being discriminated against. We should be mindful that there are people who are claiming benefits due to ill health, being a lone parent with no social network available, been made redundant or the fact is there simply isn’t any jobs available. Although the Government have implemented initiatives such as Free swimming, free Breakfast Clubs Schemes Free School Lunch (eligibility criteria must be met) in a number of schools, Genesis Wales and Child Poverty Expert Groups. There are people also being excluded due to the area in which they live, especially if in rural areas where the transport is less scarce, health provision is harder to access and resources are less available.

‘Poor public transport networks in rural areas results in higher levels of car ownership. Consequently, poorer households are likely to spend a higher proportion of their income on transport than urban counterparts, and access to private transport remain a problem for many people’. (Williams, 2011).

Older people can become excluded due to isolation which could have a knock on effect to loneliness or health issues such as depression, they may not have family around or been moved into a residential home. Activities such as day centres or community activities may be hard to access or lack of transportation maybe an issue. Low income is rising in older people, despite initiatives such as Winter Fuel Allowances, concessions on TV Licences and public transport and Pension Credit ‘according to figures from the Department for Work and Pensions (DWP), 26 per cent of people of pensionable ages in Wales were on low income households in 1996/97 compared to 18 per cent in 2008/09’ (Francis, 2010 p59). Poor housing also causes social exclusion for people in society as its impact can have an impact on someone’s life. ‘living in poor quality housing impacts significantly on quality of life, e.g. by contributing to poor physical and mental health, increasing spent on keeping warm ect’.(Stirling, 2010). Overcrowding, inadequate heating, dampness within the home can also cause health issues for service users. Debt/credit also plays a big part in social exclusion, anyone who is in poverty will be faced with financial problems and again like a domino effect people borrow from one to pay another. And those who borrow are likely to borrow off high interest rate lenders because they have not got a good credit score, which in turn gets them deeper into debt and more difficult to get out of. Those who have a disability also face exclusion and high risk of poverty, they are discriminated against through lack of employment, shops, building, schools and transport still have restricted access,

Part of a social workers role is use an anti-oppressive and anti-discriminatory approach when working with service users, this means considering their experiences, who the service users are as a person, such as their gender, if they have a disability, their race, and values. The way we communicate with service users is vital, engaging and working in partnership. We must focus on people’s strengths as well as weaknesses and empower service users to have choices, knowledge and encourage decision making whenever appropriate.

‘The more people become involved in determining their own destiny, the higher will be their self-esteem. They grow in confidence. And when group members learn that knowledge is power, they demand to know, to be kept informed, to be given information’ (Howe, 2009 p149).

To work in an anti-oppressive way we must work in an ethical way, we must respect and value service users whilst ensuring we protect the vulnerable. As social workers we should be treating each service user as an individual with individual personal and social needs working in an empowering way so they can develop their own potentials. Social workers must be open and honest with service users to gain trust and relationships, this will enable both parties to work in partnership. Social workers will come across barriers they must be competent in overcoming, for example, language, we must allow any service user to use their preferred language, and this could be Welsh or any other language. If you cannot speak the language yourself then find an alternative way to communicate such as through a translator. Other barriers may include demography, available resources, religion…………..

From all the above information we can see social exclusion, discrimination and poverty can play a part in many lives of people living in Wales. Even though Welsh Government has implemented policies and initiatives to eradicate these issues, people in Wales are still suffering the effects and impacts

. ‘Despite both the UK and Welsh governments’ commitments to the eradication of child poverty and support for this aim across all political parties and a range of policies and programmes to achieve this goal, statistically, child poverty in Wales remains stubbornly high. In order to meet the Welsh Government’s target or eradicating child poverty by 2020, the rate of child poverty in Wales would have to fall four times as fast over the next 10 years as it has over the last 10 (New Policy Institute, 2011).(Williams, 2010).

Overall I personally don’t think we can eliminate social exclusion and discrimination because whatever Governments gives, they always take back in other areas. Here is just one example, ‘LOW income families in Wales face losing an average ?74 a year in support to pay their council tax bills, a study warned yesterday. Cuts of 10% will be passed on to claimants when the UK Government transfers responsibility for council tax benefit to the Welsh Government from 2013. The support is more widely claimed than any other means-tested benefit with 328,000 recipients in Wales. The move will slash the benefit by more than ?24m across Wales’. (www.dailypost.co.uk/news/north-wales-news/2012/06/22/low-income-families-in-wales-face-74-council-tax-benefit-cut-says-report-55578-31235972/ acessed 27th October 2012). I also feel society can play a big part to exclusion, many are still ignorant to diversity and can, directly and indirectly, discriminate certain groups of society.

References

Howe, D. (2009) A Brief Introduction to Social Work Theory, Basingstoke: Palgrave

Lewis, H, (2010) Poverty and Social Exclusion in Wales, Blaenau Gwent, Bevenfoundation

Pierson, J and Thomas, M. (2010) Dictionary of Social Work, Berkshire: Open University Press McGraw-Hill

Walker, H. (2008) Studying for Your Social Degree, Exeter: Learning Matters

Williams, C. (2011) Social Policy for Social Welfare Practice in a Devolved Wales (2e). Birmingham: BASW British Association of Social Workers LTD

(www.dailypost.co.uk/news/north-wales-news/2012/06/22/low-income-families-in-wales-face-74-council-tax-benefit-cut-says-report-55578-31235972/ accessed 27th October 2012).

(www.jrf.org.uk/publications/monitoring-poverty-wales-2009 accessed 27th October 2012).

(www.statswales.wales.gov.uk/TableViewer/document.aspx?ReportId=14038#_5._Income_Poverty

Discuss the social construction of older age and how this should then contribute to anti-discriminatory social work practice How has older age been socially and historically constructed? The biological perspective of ageing believes that the process of aging is a biological fact which is universal and affects all people. It takes the view that aging is a fundamental, progressive process which continuous throughout life (Lymbery, M 2005). The biological approach believes that as a person ages there is a decline in function as cells degenerate. Therefore, this approach views age as connected to a state of dependency and weakness with no possibility for improvement (Crawford, K and J, Walker 2004). However, in contrast there are other perspectives which take into account other elements such as the social construction of old age. For example, the introduction of retirement meant that clear boundaries were created which defined the point at which a person enters older age. Also, other developments in the welfare system such as the provision of pensions, have further defined the concept of old age. Therefore, the end of employment and the start of retirement can be seen as a major influence in the way older age has been socially constructed (Lymbery M 2005).

Crawford and Walker (2004) believe that the way in which older age has been historically constructed impacts upon the current view and treatment of older people in today’s society. They note that during the Middle Ages, older people were cared for by either charities or religious institutions. The Poor Law Act, introduced in 1601, transferred the responsibility of the care of older people within the family, to care within the community. This meant that older people were now cared for by their local parish, as families were unable to support them due to the financial risks of agricultural based society.

Workhouses were then introduced for individuals who were seen as needy and unproductive members of society. This included groups such as older people, the sick and those who were disabled. As there were no welfare system in existence, this meant that older people had to reside in workhouses as they had no other means of support. As the demand for care rose, the Poor Lawn Amendment Act in 1834 was introduced in attempt to cut costs by eliminating outdoor relief, this meant that older people were no longer able to receive support in their own homes and those in need of welfare were institutionalised in workhouse. This resulted in older people being viewed as a burden on society as they no longer had power, choice or control over they way they lived their lives (Crawford, K and J, Walker 2004).

According to Phillipson (1998), the concept of old age being a separate group within society only surfaced during the end of the nineteenth century. As highlighted by Slater (1930 cited Phillipson, C. 1998) up until this period both the welfare provision for the sick, and the welfare provision for the elderly, were classified in the same way with no distinction between the two groups. Slater believes that it was at this point that societies found it necessary to end sickness benefit when an individual reaches 65, and to replace this with old age pension.

The Old Age Pension Act was introduced in 1908 and provided all citizens who were over the age of seventy with up to five shillings a week if their income was under ten shillings a year. However, although this provided support for older people, the view held by society was to remain in work until they were unable to do so due to physical difficulties. Therefore, this resulted in older people who did not work being viewed in a negative way, as they were looked upon as ‘useless’ due to the belief that they were either too stupid or too weak to work (Crawford, K and J, Walker 2004).

It was during the twentieth century when older people began to be seen as different in they way they experienced and held an inferior status within society. It was found that through this period in time, one in five people who had reached the age of seventy were very poor and were a recipient of state welfare, and the likelihood rose significantly for those who were seventy-five, to a chance of one in three. This meant that circumstances such as being in poverty and experiencing marginalisation were seen as inevitable as an individual entered later adulthood, which provided the basis for which the concept of older age was constructed.

What are the consequences for people in terms of social disadvantage?

Older people face social disadvantage in many ways, such as infantilisation. This refers to a process in which adults are treated as though they were a child. This is a form of oppression as it demeans older people by assuming that they are fundamentally different from other adults and are therefore less worthy of respect (Thompson, S 2005). For example, the desexualisation of older age plays a key role in infantilisation. This is because old age is seen as a second stage of childhood, with an inappropriate link with sexuality, which further reaffirms the idea that older people are not adults. However, as sex is seen as an action of the healthy, this also reinforces the idea that older people are unwell, dependent and frail and further excludes them from sexuality. This illustrates they way in which older people are seen to be in need of support and reliant on others, similar to the conventions of childhood (Gott, M 2005). Also, by referring to older people by names such as ‘dearie’, it can be degrading as the person using the term automatically assumes that the individual does not mind being referred to in this way, which can be seen as disrespectful and inconsiderate of their feelings. (Thompson, S 2005)

Marginalisation is also another way through which older people face social disadvantage. Marginalisation is a form of social exclusion, and is used to describe the way in which people are pushed to the margins of society, which then prevents them from taking part in activities (Thompson, S 2005). When referring to older people, this is the process where older people are excluded from society due to preconceived ideas that they have no use, and are therefore a burden to society (Thompson, N 2006). There are many ways in which older people can experience marginalisation within society. For example, Thompson (2005) highlights the lack of suitable transport for many elderly people. This can mean that they are isolated from the rest of the community as the public transport is either inaccessible or unsuitable. This shows how older people can be marginalised due to factors they are unable to control, such structural problems within society.

Dehumanisation is also another factor of social disadvantage in older people. This is because it gives older people a label of being ‘elderly’, to which the individual is then viewed in terms of this label and not as a person with unique thoughts, emotions and needs. Dehumanisation can have adverse consequences as it fails to identify that each person is different, which can cause discrimination and oppression due to its impersonal and stereotypical viewpoint

Abuse of older people is a further way in which people of an older age may face disadvantages in society. Abuse in elderly people can be physical, psychological, sexual, emotional or financial. The underlying factor in this type of abuse is the exploitation of a comparatively vulnerable group within society. The people who carry out this abuse believe that older people within society are inferior with no requirement for respect (Thompson, S 2005). The ‘No Secrets’ document (DoH 2000 cited in Crawford, K and J, Walker 2004) was created as guidance on how to implement and adhere to procedures to help protect vulnerable adults from abuse, and also clarify definitions, which would enable authorities to carry out good practice. According to Hothersall and Mass-Lowit (2010), older people who are isolated, reliant on others, have poor health, or who are considered disabled are more likely to be abused. They believe this abuse can take place in any environment, such as hospitals, residential homes or even the individuals own home.

What multiple disadvantages can impact on people’s lives?

Ethnicity within older age can be seen as a significant influence on the life a person leads. This is because there is a belief that older people, who are of an ethnic minority background, face a ‘double jeopardy’ in society, as they are oppressed by both age and their ethnicity (Thompson, S 2005). Ray, Bernard and Phillips (2009) argue that services are institutionally racist. This is because they tend to be directed towards the majority population, which can mean that people are doubly disadvantaged. This can occur as they are not recognised within the service, and instead they are they are overlooked and treated as though they are invisible. Thompson (2005) states that the common feature of racism and ageism is that they are often susceptible to dehumanisation. This is because it is easy to categorise people as ‘elderly’ or ‘Asian’, however, in reality, these terms incorporate a vast amount of people into one group who experience different religion, culture and way of life. This leaves little manoeuvre for individuality and therefore these categories should be avoided, as the person is then seen in terms of this labels and not as a unique individual. Consequently, social work should seek to recognise the barriers which face ethnic minorities who are of an older age, and attempt to work with them to overcome their disadvantage (Phillips, J, M, Ray and M, Marshall. 2006).

Gender can also be seen as a key issue which can further disadvantage older people within society. Phillips, Ray and Marshall (2006) support the idea of a ‘feminisation of aging’, as older age is now seen as a predominantly female world due to the fact that women live longer than men. This can mean that women are widowed for a greater time than men, which can lead to women having to enter residential care due to being unable to support their own needs without the help of their partner (Arber and Ginn, 1991, cited in Phillips, J, M, Ray and M, Marshall 2006). Women are also seen as less likely to have private pensions compared to men, which means that they are forced to depend upon state pension (Hunt, S 2005). This can be increasingly difficult for women living alone as it becomes the only source of household income which can leave them deprived and subjected to poverty (Phillips, J.M, Ray and M, Marshall 2006). Gender stereotypes within older age can also cause detrimental effects. Women can be seen to be oppressed due to pressure to conform to gender roles, such as to be caring and supportive, which can mean that they are undervalued as it is seen as ‘normal’ and not something which needs to be commended. However, the caring role when displayed in men receives a higher status, as it is not seen to be a typical responsibility of mans stereotypical gender role, therefore they receive greater praise and support in fulfilling the role (Rose , H and E, Bruce, cited in Thompson 2005). It is important to note that not all gender related disadvantages in older age are associated with women, as men also experience undesirable situations. For example, the male gender role is surrounded by the belief that they are the dominant, providing and protective sex. However, this expectation may come under threat in older age as work is replaced by retirement and their health declines. This can then lead to lower self-esteem as they experience a loss of role within society (Thompson, S 2005).

Multiple oppression can also be experienced in regard to ageism and economic disadvantage. Social class can be an important factor within old age, as those who belong to a lower class are significantly more likely to have a lower income and to live in poverty. Being in poverty affects a vast amount of older people, and can have negative consequences as a sufficient income is a required to be able to meet a persons fundamental needs (Crawford K, and J, Walker 2001). According to Thompson (2005) if an older person has a low socio-economic status within society then they are more likely to suffer from a state of poor health. Crawford and Walker (2001) point out that this may be due to being unable to afford to heat their home or to buy nutritional food, which increases the risk of contracting an illness as well as being able to properly recover. Also, they believe that other socio-economic factors act in a way in which reinforces multiple oppression. For example, older people may be afraid to seek medical help when it is needed due to a fear of disapproval from people of a higher and professional status, such as doctors. This can mean that an older person tolerates their condition for a longer period of time, during which it could cause their health to deteriorate. Phillips, Ray and Marshall (2006) believe that it is becoming increasingly important in modern day society to contribute to an occupational pension. This is because there is a growing inequality between older people who rely on a public pension and those with the benefit of private pension schemes. Consequently, as state pensions are low, they have to be supplemented by means-tested top up benefits in an attempt to enable older people to remain above the poverty line.

What do social workers need to think about when working with these service users with particular reference to anti-discriminatory practice

One crucial factor in which social workers need to think about when working with older people is to avoid ageist assumptions. For example, Thompson (2006) proposes that older people are often subjects of sympathy as they stereotyped as being lonely. However, it is important to realise that people of all ages can be lonely, it is not something reserved for the elderly. Also, many older people have good social relations, and although they live alone, this does not mean they are lonely. Therefore, within social work practice, each case needs to be assessed individually to avoid stereotypical assumptions about older age.

Another aspect which social workers need to think about when working with service users is to challenge the concept of ageism. This is because there are many negative stereotypes surrounding old age, which can be seen by the disproportionate media coverage when an older person is abused and dies, and when the same happens to a child. This means, that to actively challenge the concept of aging a social worker needs to perform roles such as assessing the strengths of an older person and what they are able to do, rather than focusing on their problems and inabilities. As well as other positive functions such as advocating on the behalf of the service user, to enable them to gain access to services to improve their standard of living. This will allow the service user to overcome the discrimination and oppression which they may face (Phillips, J. M, Ray and M, Marshall 2006)

To conduct good social work practice when working with older people there should be support for the service user, individual personal care tailored to their needs, and also physical assistance, especially when offering help to those who have long term illness or disabilities. There are also other factors which constitute good social work practice such as values, skills and knowledge which enable social workers to carry out anti-discriminatory practice. A value base is needed to recognise the common issues amongst older people when trying to protect their independence. Skills are needed such as being able to empower people to remain in control of their lives, to advocate on behalf of the service user, to manage risk, and to be able to communicate effectively with both the service user and their carer. And also a knowledge base, that is derived from evidence based practice, policies and similar past experiences (Ray, M. M, Bernard and J, Phillips 2009)

An important factor that social workers need to consider when working with older people is the language that is used. This is because terms such as ‘the elderly’ can be seen as demeaning as they have negative connotations which can be seen as disrespectful. Also referring to service users as ‘old dears’ or similar names, although it is not meant to be intentionally offensive it can be seen as patronising. This can then mean that the person feels inferior due to the lack of respect shown through the language used towards them and make them feel as though they are not being taken seriously. Therefore, the language used to refer to older people needs to be carefully considered to try fight ageism, rather than reinforce it. (Thompson, N 2006)

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“We know far more about how to prevent the primary occurrence of maltreatment than how to respond effectively once maltreatment has occurred” (Munro, 2010, p. 22)

Preventing harm is beneficial, therefore, to social work with the Smart family, children Zac, Karly and Tierney; their Mum, Sam; Paul, father of the girls; and Mike, father of Zac. Focus on harm prevention, however, can create defensive practice, considering only safeguarding welfare and not its promotion (Tunstill et al., 2010). Critical exploration of both safeguarding and promoting of these childrens’ welfare, therefore, forms the basis of this essay, considering the application of ‘child in need’ and ‘significant harm’ to the complexity of lives depicted. Critical evaluation of skills and methods required in assessing rights and needs of these children, will then be explored, followed by steps which could be taken to safeguard and promote their welfare. Relevant research informing my thinking provides an evidence base for substantiating arguments made. Conclusions drawn, however, are done so in recognition that actual practice would benefit from engagement with this family in assessing, planning and intervening.

The Children Act (1989) [CA] places a duty on the local authority to promote the welfare of children, provide services to those in need and safeguard childrens’ welfare by investigating, and taking action, in situations concerning significant harm, which I consider to be relevant as a social worker in a case involving concerns regarding the welfare of three children. Furthermore, as a number of professionals are involved in working with the Smart family, the importance of multi-agency co-operation in safeguarding and promoting their welfare, emphasised in Working Together (DCSF, 2010) beneficial to engagement with this family, as is the policies’ detail regarding the implementation of Children Act principles. Significant factors impacting the work undertaken with this family, however, are also determined, in my view, by local authority policy and bureaucratic process, interpreting how legislation and national policies are implemented with individual families. Differential rates of court order applications, for example have been found in demographically similar local authorities (Dickens et al., 2007), suggesting work with this family to be impacted not just through law and policy creation but also their implementation at a local level (Marinetto, 2011).

Analysing concepts of child in need and significant harm relation to this case, however, also require consideration of critically applying a researched evidence base to information gathered about the family. Nutritional deficiencies, for example, resulting from sporadic meal provision, a concern Sam’s health visitor raised, can be detrimental to all areas of child health and development (Kursmark and Weitzman, 2009), suggesting the Smart children may not achieve a reasonable standard of health and development (s.17, CA). The persistent failure to provide adequate food constitutes neglect (DCSF, 2010) suggesting the presence of significant harm, relating to health and developmental impairments (s.31, CA). Significant harm, however, must be attributable to the care given by parents not being what it is reasonable for them to give (ibid.). Regarding food provision therefore, I would argue, contexts of poverty require consideration, affecting 27% of children currently living in the UK (Adams et al., 2012). Sam and Paul’s financial situation, therefore, might dictate how possible it is for them provide regular meals, causing the children to need services which promote their welfare (s.17, CA). Without this context, however, the children may be suffering significant harm, through their parents unreasonably denying them regular meals (s.31, CA).

Food insecurity has also been associated with externalising behaviours (Belsky, et al., 2010), highlighted in Zac’s aggression at school. Furthermore, regular meals have been linked with educational achievement (Roustit et al., 2010), suggesting Zac’s current cognitive difficulties, reading 4 years below his actual age, may be attributable to a lack of food. Whilst Zac’s educational development suggests his being a child in need, relevance of significant harm is less clear, in that without assessing causes of cognitive delay, the contribution of food provision to such difficulties cannot be ascertained and, as such, the extent to which parental care is insufficient. Zac’s current delay may also be associated with poor attendance at primary school, which is linked with poor attainment (Sheppard, 2009) and behavioural difficulties (Carroll, 2011). Furtermore, Karly’s attendance at primary school is also poor, which if not addressed may lead to similar developmental impairments, relating to concepts of child in need.

Inconsistent food provision may also be impacting Tierney’s development, who at 18 months is not walking and appears to have delayed speech, developmental concerns consistent with concepts of child in need. Whilst specialist assessments may indicate medical contributions, nutritional deficiency impacts physiological and cognitive development, required in language development (Rosales et al., 2009) and learning to walk (Hanson et al., 2011). Parental neglect has also been linked to language delay (Vernon-Feagans et al., 2012) and lack of routine and poor living conditions, both identified as problematic for the Smart family, are prevalent in cases of neglect (Long et al., 2012). As such, Tierney’s home environment may be contributing to her language delay. At 18 months, however, speech development is varied and what appears to be delay, may not be indicative of problematic language development (Graham, 2011), suggesting, in my view, that the extent of current concerns, in isolation are insufficient to constitute ‘significant’ harm.

Lack of routine and boundaries, might also be related to Zac being found by the police, unsupervised in the city centre, at 10pm, suggesting neglectful parenting, through a lack of adequate supervision (DCSF, 2010), or parental control (s. 31, CA). Sleep deprivation has been linked to poor attention and impulsivity (Beebe, 2011), noted as concerns for Zac, as such current routines, or lack thereof, limiting the security of sufficient sleep, may be impacting his ability to maintain a reasonable standard of development (s.17, CA). Establishing the presence of routine, or degree of supervision, is not possible on the basis of a singular event and as such the relevance of significance harm in relation to these factors is difficult to ascertain with additional information, making it a key consideration within assessment.

Lack of family routine and predictability could also be contributing to Zac’s behaviour at school (Deater- Deckard et al., 2009), and further exacerbated if concerns regarding domestic violence between Paul and Sam are found to be accurate (Moylan et al., 2010). Living in contexts of violence increases risk to children of physical and emotional abuse (Montgomery, 2009) and can affect secure attachment development (Levendosky et al., 2011), which I consider noteworthy as Tierney is at a key age for this, requiring sensitive and responsive care givers (Beijersbergen, et al., 2012) and Zac’s early attachment relationships are likely to have been disrupted by frequent foster care placements (Leve et al., 2012). In light of this, should domestic violence be evident, significant harm may be relevant and irrespective of its presence, current conflicts and instability in the family home, are likely to be impacting the childrens’ emotional development, suggesting their being children in need (Cummings and Schatz, 2012).

Significant harm often results from the long-standing impact of an accumulation of factors, rather than requiring a singular traumatic event (DCSF, 2010). Assessment, therefore, requires skilled critical reflection upon the inter-relatedness and cumulative effect of factors, both detrimental and protective (Rose and Barnes, 2008). In isolation, for example, there may be no evidence that Sam is currently misusing any substances. Associations exist, however, between substance misuse and domestic violence (Gilbert et al., 2012) and with chaotic lifestyles (Straussner, 2011), both possible concerns for Sam. Considering their cumulative effect, therefore, the likelihood of substance use still being problematic could increase, subsequently heightening, in light of its impact on child welfare, risk of significant harm (Traube, 2012). Ecological approaches, therefore, which consider the relationships between various parts of a system, can create a context for managing the complex interconnectedness of relationships, helping to avoid minimisation occuring when problems are viewed in isolation (MacKenzie et al., 2011).

The complex interplay of factors affecting the Smart children, I would suggest, requires a thorough knowledge of the family’s case file, including events which previously escalated risk of harm or promoted the childrens’ welfare, providing insight into current circumstances. Chronologies and genograms can provide visual aids in analysing such events and relationships and their impact upon one-another. Genograms can also beneficially be constructed in collaboration with families, highlighting unknown relationships and exploring conflictual ones.

Good preparation can also support the ability to form trusting relationships quickly, in communicating care for, and competence working with, families, which I would suggest, is key in creating relationally-interactive assessments, founded on principles of empathy, respect and transparency (Healy and Darlington, 2009). Creating contexts where collaborative exploration of assessment can occur, in my view should also be valued, accumulating everyone’s views, children, parents and professionals, on problems and strengths within the family and involving them in shaping the purpose and direction of assessment (Gallagher et al., 2011). Collaboration, however, is a two-way process and should also involve being clear about concerns and regularly discussing how the childrens’ welfare is currently being safeguarded and promoted (O’Leary et al., 2012).

Families may be understandably reluctant to engage in such relationships, however, perceiving assessment to involve ‘experts’ defining parenting competency and judging them as adequate or not (Buckley et al., 2010). Exploring the presence of domestic violence with Sam, for example, may differ if she views my role as collaborating with her to implement plans which make things better for her family, than if she views my role as assessing risk to the children and her inadequacy in protecting them from harm. Effective communication, a warm, empathetic approach and persistence may therefore be required, in challenging this perception and undertaking assessment in a way which seeks genuine collaboration, rather than tokenism (Platt, 2012).

Pauls’ inconsistency within the family home and the absence of information regarding Mike’s current involvement in Zac’s life, may lead me to give less significance to their engagement in the assessment process, placing expectations to provide good enough parenting, solely upon Sam (Brown et al., 2009). Irrespective of Paul and Mike’s legal parental responsibility, however, determined by their names being on birth certificates (s.2, CA), they play an important role in the lives of their children, affecting welfare and development through presence and absence (Coakley, 2013). As such I consider it important to assess the role that these fathers currently play in family life, the involvement they would like to have and risks and strengths associated with such involvement (Maxwell et al., 2012).

Observations, in my view, are also a key element of assessment, both of relational interactions and of living environment (Urwin and Sternberg, 2012). They have the potential, however, to be intrusive, unrepresentative of actual care and undermining of collaboration with parents. Clear understanding, therefore, by all involved, of their nature and purpose should be facilitated (Welbourne, 2012). Whilst multiple observations may create a more holistic picture of family life, reducing the impact of observer effects (Gambrill, 2012), in reality, quantity may be determined by time scales. This creates opportunity, however, in my view, for collaborative assessment, discussing with Paul and Sam how interactions may have occurred differently, had I not been there, indicating insight into, and valuing their expertise in, good enough parenting.

Children have a right to have their views heard and taken seriously (UNCRC, 1989) and as such, I would argue, should be actively involved in the whole assessment process, making adaptations, in light of their developmental capabilities, to enable engagement. Clear and simple language is required in explaining the purpose of assessment, as is gaining feedback confirming understanding and exploring their views on the best ways to undertake them (Petrie, 2011). Practical activities, in light of Zac’s educational difficulties, could better enable his engagement, such as photographing important things in his life, opening up discussions around strengths, worries, wishes and feelings (Pimlott-Wilson, 2012). Karly, being younger, could engage through play activities, using toys and imaginary play to express feelings about current situations, without having to talk directly about them (Landreth, 2012). Tierney, I would suggest, is harder to engage directly in assessment due to her communicative abilities. Behavioural communication, however, I would suggest can reveal a great deal and I would suggest that skilled awareness of this would be relevant to all three children (Handley and Doyle, 2012). Consideration should not only be given regarding how to incorporate their views in plans made, but how, when made, such plans are communicated sensitively, clearly and honestly to all three children, giving consideration to their developmental capabilities (Polkki et al., 2012).

Assessment is an on-going process and should not, in my view, be seen simply as a predecessor to intervention (Brandon et al., 2009). In light of this, it is possible to begin considering steps which can be taken to safeguard and promote the welfare of these children, whilst recognising the uncertainty which accompanies the continuous changes prevalent within family life and therefore the need for dynamic plans which can adapt to accommodate these (Welbourne, 2012).

Providing it is safe to do so, children should be supported to grow up within their own family (CA, 1989). Steps taken, therefore, to safeguard and promote the welfare of Zac, Karly and Tierney should seek to uphold this right. Consideration, however, must also be given to their health and development and whether remaining within the family is likely to, or resulting in, significant harm (s.31, ibid.). Even where legal steps are being considered, however, I would argue that the continuation of collaborative relationships with parents should still be sought, as greater engagement is likely to be seen if plans are constructed in partnership with parents (Gallagher et al., 2011).

It may be that the welfare of all three children can be safeguarded and promoted by Zac temporarily living away from the family home, allowing Sam to focus on the care of Karly and Tierney, as she has demonstrated capacity, in the past, to parent younger children given sufficient support. In light of this, however, it is important that such steps are not taken because Zac is seen to be a problem but because it would be more beneficial for him than maintaining the status quo. Greater paternal contact, may be one such benefit achieved, by exploring the possibility of Zac living with his Dad under a residence order (s.8, CA). With the information currently provided, however, the suitability of such a placement needs careful consideration, including Mike’s capacity to parent, giving particular regard to his previous substance misuse and its impact on his care of Zac. If this is not possible, it may be that Zac has strong positive relationships with Paul’s extended family, whom he could live with, as kinship care has been found to have positive impacts on identity formation, stability of placement and behavioural and mental health outcomes (O’Brien, 2012).

Accommodating Zac outside of the family home, however, does not mean his welfare will necessarily be holistically promoted. His emotional and behavioural development may be indicative of attachment difficulties (Fearon et al., 2010) and a mentoring scheme, which have been found to support positive emotional development in boys displaying aggressive behaviours (Younger and Warrington, 2009), may be of benefit to Zac. Educational concerns have also been highlighted for Zac and although a more stable, home environment may support his educational development (Turley et al., 2010), sufficient impairment may have already occurred to warrant specialised support. Whilst Zac’s school may be better positioned to facilitate this, I would suggest it to be a key part of plans for promoting his welfare.

Sam’s capacity to parent, even two children, may also be significantly impacted by domestic violence (Levendosky et al., 2011). If following assessment, it is found to be present, the risk of harm to children living in contexts of violence (Stanley, 2011), could create the need for care order applications (s.31, CA) or voluntary foster care (s.20, ibid.), in respect of Karly and Tierney. If Sam is willing to engage with support, however, she could be supported to live independently, with her two children. Significant risk of violence continues, however, when domestically violent relationships end, requiring additional steps to protect Sam and her children, from continued risk of violence (Stanley et al., 2012). Enabling safe and productive contact, between Paul and his children, would also need consideration, including the girls wishes and feelings regarding this (Featherstone and Fraser, 2012). If both Paul and Sam, however, admit to the violence, engage with support and commit to removing it from their relationship, it may be that they can remain living as one family unit, although careful consideration is required as to how such commitments can be monitored and what domestic violence support is available for the whole family (Stanley, 2011). Irrespective of the presence of violence, however, Paul’s inconsistent living arrangements, combined with regular arguments, create conflict and instability which could impact emotionally upon the girls (Davies et al., 2012) and therefore steps are required to safeguard and promote their emotional welfare, exploring options of permanency for Paul and therapeutic family work being undertaken, finding less confrontational resolutions to disagreements (Cummings and Schatz, 2012).

Lack of routine, in my view, is impacting multiple areas of the childrens’ welfare, including school attendance and meal provision. Colourful charts laying out daily routines, such as meals, school, play, bathing and bedtimes, created in collaboration with the family, could reinforce the childrens’ basic needs, act as a visual reminder for maintaining routine, make tasks seem more manageable and create reassurance for the girls around their needs being met (Rees, 2011). Such a tool can support measurable outcomes, with home visits occuring at key times, to monitor progress and provide support where it is needed. For such interventions to be effective, however, the continued development of collaborative, trusting and supportive relationships is required, whilst being clear about the necessity of the childrens’ needs being met (Darlington et al., 2010).

Tierney’s welfare, in particular, could be promoted through using a local childrens’ centre, supporting language development, mobility, attachment relationships and providing parenting support (Sheppard, 2012). Whilst attendance cannot be compulsory, Sam has engaged with support in the past and, I would suggest, collaborative planning will increase the chances of her engaging again (Gladstone et al., 2012). Social workers, however, have supported this family over many years and although engagement is not described, deterioration in the childrens’ development has continued. Presuming that my interventions, therefore, will necessarily have a greater impact is uncritical and as such I would argue the importance of clarity, openness and honesty regarding expectations upon Sam and Paul and that if they are unable to safeguard and promote their childrens’ welfare, with support, care order options will be pursued, which could result in the children being adopted.

Concluding this case study, I would suggest is a complex task, particularly as assessment and welfare planning are part of a continuous process and therefore natural conclusions do not necessarily occur. Both concepts of significant harm and child in need, I would argue, to some extent have been shown to be relevant to the Smart children and that interventions to promote health and development are required. Whilst a range of assessment skills and methods have been explored, implementing these in practice is more complex than conveying them within an argument and, I would suggest, is largely dependent upon the quality of working relationships with family members (Platt, 2012). Analysing this case study has demonstrated to me the uncertainty which pervades safeguarding and promoting welfare within social work (Ferguson, 2010), the need to make purposeful space for assessing strengths and protective factors (Roose et al., 2012) and the complexity of striving for holistic analysis of inter-related presenting factors , whilst recognising that uncertainty will remain in the ever-changing reality of lives (Saltiel, 2013). Despite this, however, social work requires a degree of decisiveness, in collaboration with family and discussion with managers, as safeguarding and promoting the welfare of these children necessitates competent and effective assessment, planning and intervention (Munro, 2010).

The purpose of this essay clarifies ethics and values and how fundamental they are within social work practice. How relevant they are in modern day practice in addition raises concerns regards to professionals and personal values and ethics. Highlights serious case reviews and how they link into legislation and policies, and the difficulties with anti- oppression and anti- discrimination in relation to welfare benefit cuts and the economic climate. This assay highlights the BASW and HPCC code of ethics

Macmillan (2010) what are ethics? Ethics are somebodies beliefs, principles and morals that are important to them and propose a set of standards and values Oko 2010)) values are the theory and how you value what is good and influence our decision Ethics are the principle in which way we act.

Theory behind

Professional ethics are led by set of guidelines and processes that adhere to standards of code and ethics are implemented. Maynard A Becket (2005) believes Values are used in many forms, for example it could be financially personal or cultural in relation to faith and other religions. Values determined what we view as high priority and remain significant to your beliefs

G. Reamer (2006) suggest Social work values and ethics have developed significantly over the past few decades, acknowledging the importance of professional and personal values and ethics in relation to practice. During the 1960 values and ethic became core values of social work with growing interest towards diverse and complex issues. The National Association of Social Workers implementing a code of ethics.1970 saw a dramatic change in other professions such as nurse’s health and criminal justice on applying ethics to practice. Joyce E (2009) attitudes towards contemporary psychoanalysts practice and social work have changed in relation to ethics and value, an appreciation of cultural heritage are taken on board and therapy has been brought into the 21st century. Improvements in working together with social work have been accomplished.

Banks S ( also believes ethics’ and values have developed considerably and gain greater recognition with a global interest from various countries adopting the idea with new countries accepting social work has a profession however some countries are a little slower in moving forward but nevertheless taking on board and introducing ethics and values to practice. There is more opportunity than before to access literature and books in regards to ethics and values which makes it more obtainable, however equally feels there doesn’t appear to be a great deal of information regarding ethics in relation to politics and anti-oppressive social work even though they are very much attached.

.Domineli L(2002).Anti-oppression can be seen in many forms and links into social work practice and values and ethics. Policies and legislation usually play a big part in welfare reforms for example cutting down on benefits and welfare system; this clearly impacts on the poor marginalizing social exclusion. Individuals can often feel that they are a burden on society, especially people who are in receipt of benefits. The government can use destructive language aimed at the unemployed as well as influential through the media or public speeches their portrayed as “scroungers” and unworthy to society. This form of oppression needs to be addressed and challenged. Social workers are expected to stand up for human rights and promote equality.Gray.M,at et l (2012) believes Social workers are led by legislation and political dilemmas . Legislation and welfare reforms have impacted on public spending cuts which are taking place by the coalition government. Inequality happens when the government makes cuts to the youth services, and various other organizations and local communities, it divides the poor from rich and wealthy, this could be seen as injustice, grounds for oppression between individuals and social groups.

Social worker will need the skill and knowledge to underpin the vital importance of identifying their personal values from professional values in order to avoid poor practice and mistreatment. Forming opinions and concluding judgments based on your own assumptions and personal beliefs subsequently understanding values and ethics is imperative. According to Benchin, A., Brown,(2000) Values are encompassed in our daily life and a set of beliefs that originate from different background with expectations and ideas formed from the person’s perspective, this can impact on the way we react or behave to various situation therefore, recognizing personal beliefs and remaining open minded and respecting people as individuals will help develop your practice and achieve a better outcome for the service user. However Macmillan (2010) believes in relation to practicality social workers struggle over moral dilemmas all the time and are led by regulation, making decision can be exceptionally difficult Maynard, A Beckett.,(2005) believes Indeed at times it may be difficult not to be subjective and base your own beliefs and values on decision making, as this is what makes us what we are. As a professional you may have suffered a similar problem to the service user, this could influence your decision in deciding what is best for the service user therefore affect your practice blurring the boundaries. In this particular case the social worker may fail to overlook the service user’s needs. There is no room for judgmental practice in social work. Social workers should be professional and remain impartial to determine what’s ethically right. It is important to disregard your own values and beliefs to enable social worker to practice appropriately nonetheless when it comes to the service user needs other factors should to be taken on board in the terms of their ethnicity as the service user may have afro hair or religious beliefs therefore the social worker has to respect the individual.

Human Right Committee January (2012) BASW believe British Association of social work is fundamental document that highlights the code of practice and strongly advises how social workers should practice. It refers to ethics and values as the main topic and hugely emphasizes the necessities for social work to represent the codes of practice. Due to the nature of the social work role it raises concerns regarding ethical issues that may well occur for a social worker, the code of ethics and values clearly states the importance of implementing ethics and values as a fundamental part of social work in order to promote and empower service user’s nevertheless social workers have a duty of care and in some circumstances have no choice but to restrict someone’s freedom. Social workers are also faced with inadequate resources which impact on their duties .Higman, P (2006) it may be argued that the BASW is a set of standards in relation to confidentiality nevertheless conflicting as remaining completely confidential can be difficult for instance there is easy access through the internet and admission to statuary meetings. It is almost impossible to remain confidential due the nature of working in partnership and multiagency teams. Information sharing is important when legal obligations are in place in the terms of safe guarding issues nonetheless service user should to be informed at all times.

According to Health Care Professionals council (2012) HCPC is very prescriptive generic document in which it regulates Social workers and health profession; it has the same guidelines as BASW regards to ethics and values in addition it provides guidance on how social worker should behave appropriately and questions professional conduct outside of work which suggests integrity as large part to play in all aspect of a social works life. Macmillan p (2010) believes Social workers struggle with moral dilemmas all the time with in their career, making decisions that are led by regulations and putting it into practice can be extremely difficult.

Pattison,Roisin pill.(2004) states social worker should be accountable for their actions in many cases social workers have overacted and placed children in care without any evidence unfortunately failed to this in the Victoria cimbers case. Victoria died a tragic death in the hands of her great aunt Marie Kouao and partner Carl manning this, was damming report led by Lord Lamming. Victoria was let down by the police, several local authorities and health professionals. Ethics and values are apparent throughout Victoria case, assumptions were made towards Victoria’s ethnicity and cultural heritage highlights the dangers of overriding personal views and religious beliefs. The department of Health Lord lamming Report p116 within the report concluded a catalogue of errors. Social workers complained of lack of supervision and during supervision the social worker alleged the manager discussed her own personal problems and talk about “god “unfolding her religious beliefs which irritated the social worker therefore found it incredibly difficult to discuss important and difficult cases often failing to complete supervision consequently prioritizing personal and religious beliefs. supervision is imperative to social work.

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Childhood is idealised as a garden, protected by walls and hedges, where nature flourished at its perfect best. It is often envied and honoured. However, in reality most children are often neglected, abused and exploited. An overview of the reported cases suggests that a major part of reported child maltreatment was sexual abuse. As many as one out of every four children will be the victims of some kind of abuse.

Child Pornography and child sexual abuse are two of the most disturbing issues in the world today. This paper aims to show the ongoing debate on whether consumers of child pornography pose a risk for hands on child sex abuse offences. It provides an overview of existing research studies and their approaches concerning the linkages between child pornography and child sex abuse. In this paper I will be including arguments for and against this relationship by various authors, statistics reports and surveys to reach a conclusion. This paper also aims to talk about how the legal system attempts to control child pornography through actual legislation and a graded selection policy.

INTRODUCTION

Child pornography is a complex topic for which the standards applied are subjective and dependent upon moral, cultural, sexual and religious beliefs. Legal definitions of both “child” and “child pornography” differ globally. However, the United Nations Conventions on the Rights of Child, which has now been adapted by 191 member states, provides a universal definition of the child as any person under the age of eighteen years. It should be noted that each country’s legal definition of “child” may be different but the term “child pornography” will refer to a “sexually explicit reproduction of a child’s image”. According to the Interpol Specialist Group on Crimes against Children, “Child pornography is created as a consequence of the sexual exploitation or abuse of a child. It can be defined as any means of depicting or promoting the sexual exploitation of a child, including written or oral material, which focuses on the child’s sexual behaviour or genitals. The Council of Europe defines child pornography as material that visually depicts a minor engaged in sexually explicit conduct. The ECPAT’s definition closely mirrors Interpol’s which states the visual depiction of a child engaged in explicit sexual activity, real or stimulated, or the lewd exhibition of genitals intended for the sexual gratification of the user, and involves the production, distribution and/or use of such material. It can be seen that each definitions given by the above bodies speak of visual images or depictions, or representation of sexual activity involving the “child” or “minor” defined in Article 1 of UN Convention Rights of a Child. Each of the definition emphasises the sexual nature of the representation and seeks to distinguish child pornography from, wholly innocent images of children, for example in a family setting or on the beach, where they could be fully or partially undressed, which are appropriate to the wider lawful activity shown in the depiction.

The official definition of child sexual abuse is “forcing or enticing a child or young person to take part in sexual activities including prostitution, whether or not the child is aware of what is happening”. The activities may involve physical contact, including penetrative or non-penetrative acts. They may also include non-contact activities, such as involving children in looking at, or, in the production of, pornographic material or watching sexual activities, or encouraging children to behave in sexually inappropriate ways. Persons who exploit children sexually, in the view of ECPAT, fall into two categories. “Preferential child sex abuser” and the “situational child sex abuser” where abusers in the first category suffer from psychological disorder and the latter are experimenting with new forms of sexual contact. In the paper prepared by Julia O’Connell Davidson for the World Congress against the Commercial Sexual Exploitation of Children, she describes both of these categories. According to her, the term paedophile refers to an adult who has a personality disorder which involves a specific and focussed sexual interest in pre-pubescent children. The ‘preferential child sex abusers’ are abusers who are usually, but not always, men, and their victims may be either male or female children. Psychiatry views their taste for immature and powerless sexual partners as the manifestation of a personality disorder.

The ‘situational child sex abusers’ are men and women who sexually exploit children, not because they have sexual interest in children per se, but because they are morally/sexually indiscriminate and want to experiment.These abusers do not consciously seek out children as sexual partners, but use them when such children are available. Generally child pornography will be possessed, made and distributed by the paedophile or preferential sex abuser. However, it would appear from a number of arrests that child pornography can be accessed with ease on the internet. Its anonymity has meant that ‘situational child sex abusers’ are also using this medium.

Identifying Victims and Offenders

In most countries, street children, poor children, juveniles from broken homes, and disabled minors are especially vulnerable to sexual exploitation and to being seduced or coerced into the production of pornographic material. While impossible to obtain accurate data, the perusal of the child pornography readily available on the international market indicates that a significant number of children are being sexually exploited through this medium. According to the Home Office Statistical bulletin more than one third (36%) of all rapes recorded by the police are committed against children under 16 years of age. Another study which examined police data on rapes committed against children found that children under the age of 12 were the most likely of all those age 16 and under to have reported being raped by someone they knew well. According to the NSPCC statistics, there is a predominance of girl victims than boy victims. For example, in England and Wales there were 6,587 offences of sexual abuse on a female child under 16 and 2,821 offences of sexual abuse on a male child. Another Home Office report shows that 60-70% of sex offenders against children target girls only, about 20-30% target boys only, and about 10% children of either sex.

In the context of sexual exploitation of children, ‘sex exploiters’ can be defined as “those who take unfair advantage of some imbalance of power between themselves and a person under the age of 18 in order to sexually use them for either profit or personal pleasure”. Child exploiters and pornographers often seek occupations that bring them into habitual contact with children. Paedophiles constitute a significant sector of the offenders. Some of these paedophiles are attracted to children of the same sex, but the majority are heterosexuals. It should be noted that not all paedophiles are child molesters and that many child molesters are not paedophiles. In 2005/06 the average number of registered sex offenders was 58 per 100,000 of the population in England and Wales. An estimated 110,000 people have been convicted of sexual offences against children in England and Wales. 90% of the child victims know their offender, with almost half of the offenders being a family member. Although higher proportion of the offenders is males, the number of female offenders is also a key concern. Researchers from the Lucy Faithfull Foundation, a child protection charity that deals with British female sex offenders, said its studies confirmed that a “fair proportion” of child abusers were women. The sexual exploitation of children can happen anywhere – in schools, homes, workplaces, in communities and even own computers, and anyone can be an exploiter – a teacher, relative, religious leader, employer, aid worker, peer or pornographer. A study which examined police data on rapes committed against children found that children under the age of 12 were the most likely of all those aged 16 and under to have reported being raped by someone they knew well. Children between 13 and 15 years of age were the most likely to have reported being raped by an “acquaintance”. Since the advent of the internet and mobile telephone services linked with download and exchanging capabilities, the production and sale of child pornography has also became a profitable business. The men who sexually violate or photograph children being violated in order to sell the images are child sex exploiters. So are those who operate the websites that are the shop fronts for the illicit trade in child abuse images. When someone pays to look at child pornography, they are not just looking, they are exploiting. They are part of the chain of exploitation and in most countries, are pursued by the law as child sex offenders.

Arguments

This research assignment is aimed to answer the question of whether there is a link between child pornography and child sex abuse. This is a very controversial area, with experts differing over any casual link. Some experts argue that there is a link between the two as watching child porn increases the risk of offending, and some argue that it reduces the risk of offending. The main reason for this debate is that it is virtually impossible to conduct research in the laboratory using standard specific methods which yield statistically reliable results. The constraints of ethical research, false reporting, interviewer distortion and a whole host of other problems contribute to the difficulty of acquiring scientific results. Many researchers have come to the conclusion that there is no sound scientific basis for the conclusion that exposure to child pornography increases the likelihood of sexual abuse of children. Others have suggested that there is a consistent correlation between the use of pornography and sexual aggression. This debate will be considered in two sections, the arguments supporting that there is a link and the arguments against the link followed with a conclusion.

Arguments supporting the link between child pornography and child sex abuse

A common theme within the existing discourses surrounding child pornography is that such an activity represents a threat because it is invariable existing sexual abusers of children who possess and use child pornography as an incitement to commit child sexual abuse. It is also frequently argued that possession and use of child pornography present a real threat to children

Introduction

According to Hardcastle, Powers and Wenocur (2004), “Community practice is the application of practice skills to alter the behavioural patterns of community groups, organisations, and institutions or people’s relationships and interactions with these entities”. Drawing from this simple definition of community practice, the report focuses on the work I carried out as an Applied Community studies student working with homeless people at the Salvation Army (SA) hostel in Coventry where I completed 140 hours of practice learning as an Assistant Project Worker. For personal reflection and intellectual development the report evaluates the themes around homelessness (causes and bio-psycho-social impacts of homelessness). The theories, legislation and policy underpinning work with homeless people is discussed, and for argument`s sake, the effectiveness of intervention methods is critically analysed while particular emphasis on factors contributing to inequalities in health and social care such as ageism, gender discrimination, race and ethnicity and social exclusion to promote an anti-oppressive and anti-discriminatory practice (Dominelli 2002 and 2008). An evaluation of my learning outcomes will be made, and the report will argue that relying on funding from the local government affects the administration and provision of welfare services at the centre, which in most cases creates ethical dilemmas for Project Workers. Further, the report will argue that complying with the local authority on who to give help makes the Salvation Army to depart from its core values based on Christian principles: feeding the hungry, clothing the naked, and giving shelter to the homeless (Walker, 2001) among others Christian values, for example, its work with asylum seekers. The report also recognises that lack of continuity in the community affects casework with individuals. The essay concludes by identifying areas of good practice.

description of SA and work carried out

The Salvation Army was founded in 1865 by William and Catherine Booth to help people identified as socially undesirables (Prostitutes, criminals, drug addicts) to embrace Christianity (Murdoch, 1996; Walker, 2001). To date, the Salvation Army has centres worldwide and provides social aid to people in need, including disaster relief (Chronicle of Philanthropy 30 October 2008). It runs youth programmes and provides accommodation to homeless people but on a temporary basis. In Africa the Salvation Army works with refugees and displaced people among other community works. It operates as a non government organisation agency that provides relief to people in need. Social support intervention is guided by the Salvation Army’s 11 Christian doctrines, or soldiers’ covenant, as an army against social ills. According to the Chronicle of Philanthropy (30 October 2008: 10) the Salvation Army was the largest charity in the USA giving away more than $2 billion in social aid in 2007.

The Salvation Army hostel (Coventry) provides accommodation to 80 residents, mostly men (75 rooms are reserved for men with only five reserved for women). The implications of this gender variation will be discussed later. In addition, it takes only homeless people between the ages of 18 and 65, and this concept will also be discussed later in relation to ageism. In addition, the centre does not provide accommodation to people who have no access to public funds, such as asylum seekers, and there are no facilities for homeless families, although the Salvation Army in Leamington has only one family unit. Again, this will be discussed in relation to society stereotyping single people, especially men, as more likely to become homeless. The centre also runs a resource centre which help service users to bid for houses on Coventry Home finder, and job search. In addition, the centre also hold cooking courses to promote healthy eating and budget meals among residents, and used sport (football) to encourage healthy living interaction through sport, and clients participated in football once every week.

I worked as an Assistant Project Worker in a team of 20 staff that included 10 project workers. My job included attending referral meetings, carrying out risk assessments and identifying reasons for homelessness, profiling where a key worker asks the homeless person a series of questions in line with the National Monitoring and Evaluation Services (NMES). My duties also involved helping the service users to bid for houses, signposting them to the Job centre, organising cooking and football events.

Critical analysis of relevant theory to practice.

The report now analyses the discourse of homelessness in view of the bio-psycho-social needs of homeless people. Maslow (1954) identified seven basic human needs, of which shelter is among them (Taylor, 2010). In England, homelessness is a major issue, and between January and March 2003 there were 31 470 households identified and accepted as homeless by the Local Authority homeless (Wright et al 2003). According to Wright et al (2003), people who are homeless usually have socio, medical and psychological needs, and are stereotyped as anti-social, violent, migrants, and undeserving. Further, they also face isolation, lack of choice, and stigmatisation (Homeless Network 1999 Report). They are also likely to be discriminated and socially excluded because of their ethnicity, gender, race and age (Wright et al 2003).

Power and Hunter (2001) concur with this assertion and argue that some of the homeless people’s most immediate challenges include nutritional deficiencies, cold weather, poor personal hygiene and drug and alcohol misuse. In addition they have higher incidents of morbidity and mortality (Wright el al 2003). Some of their medical needs/problems include “a chronic history of severe alcohol dependence, with gastrointestinal, neurological, cardiovascular or metabolic complications” (Wright et al, 2003 pg 9). They also have higher incidents of depression and risk of suicide (ibid). For effective intervention with homeless people to promote their health and well-being, staff at the Salvation Army works jointly with health partners (GPs), housing departments, non-statutory organisation and social services departments.

Most people who use the services (homeless) at the Salvation Army hostel are single white men, ex-convicts, drug and alcohol misuse, and refugees. Underlying bio-psycho-social issues included HIV, substance misuse, isolation, and unemployment. An understanding of these underlying needs was important during a risk assessment so that they could be identified and appropriate intervention provided, for example, where homelessness was caused by unemployment, the person would be sign-posted to the Job Centre, or assisted to fill in job application forms. Getting a job would empower the person to become financially independent and offer a more permanent solution to a recurring problem. Similarly, people who lost their houses due to drug and alcohol misuse would be referred to other agencies such as Recovery Partnership for rehabilitation (solution focussed intervention).

The SA worked with the Coventry City Council, who referred homeless people to the centre. The Local Authority pays ?147 per week towards the accommodation of the homeless person, while the person is required to pay ?10. The City Council is also the major funder for the agency, a concept which eroded its independence and community standing as a Christian based sanctuary for the homeless regardless of creed, race (based on verses from the Bible). As a result asylum seekers who had no recourse to public funds were denied services. This experience highlights some of the challenges faced by community workers in their quest to promote social justice, which is defined as “the embodiment of fairness, equity, and equality in the distribution of societal resources” (Flyn, 1990). This makes their role controversial as they become border guards (Ravi Kohli, 2006), and gatekeepers of resources (Limbery, 2005). The project workers also works hand in hand with GPs, the Job Centre, drug and alcohol rehabilitation centres, Community Psychiatrists and independent and local housing agencies. This requires good team working skills, and I will comment on the development of my team-working skills later in this report.

Working with homeless people for statutory organisations is underpinned by legislation such as the Housing Act 1996, and the 1985 Housing Act. Local authorities have a duty under Section 183 of the Housing Act 1996 to provide or prevent homelessness. They have to make inquiries (Part 7 of the 1996 Act) where someone is likely to become homeless within 28 days. In addition, someone is prevented from becoming homeless if there is a casework intervention that will provide the person or family with accommodation sustainable for at least six months (Communities and Local Government Recording Homeless prevention and Relief E10 of the P1E Quarterly Returns, 2009). The Local authorities can work with partner organisations to help prevent homelessness, although these partner organisations have no duty to prevent homelessness. A partner organisation is “any organisation which is assisting the local authority in tackling and preventing homelessness” (ibid: 12). It may be funded by the Local Authority to help in preventing and tackling homelessness. In addition it can also be any organisation where the Local Authorities can refer people for assistance to prevent homelessness; and these include voluntary organisations and independent organisations for housing advice under s.179(1) of the 1996 Act. The Salvation Army is one of the voluntary organisations (faith based) that provide temporary accommodation to prevent homelessness.

The Green Paper Independence, Well-being and Choice: Our Vision for the Future of Social Care for Adults in England (DoH, 2005) and the White Paper Caring for People (DoH, 1989) recognise assessments as key to any methods of intervention and good care for people. Assessments were carried out to identify the causes of homelessness, the person’s history, entitlement to services, needs (medical, social and psychological), while a risk assessment was carried in all assessments in order to protect the service user from risk of self harm (suicide, intravenous drug use, substance misuse, financial abuse etc). According to Parker and Bradley (2006:11), a risk assessment is “the likelihood of certain outcomes, whether positive or negative, occurring under certain circumstances or dependent on decisions made”. It was important to carry out a risk assessment to establish the likelihood of people repeatedly becoming homeless, as some would return within three months to the centre. As such, a risk assessment sought to establish the best method of dealing with the presenting situation to reduce repeat homelessness, and where homelessness was attributed to drug and alcohol misuse, gambling, etc, the likelihood of that happening again was assessed before appropriate intervention methods were implemented. However, Webber (2009) argue that risk assessment in social work (and this can also be applied to community work) is laden with assumptions while lacking scientific thoroughness which can lead to rationing and excluding some service users. In particular I found that in some cases risk assessment led to the exclusion of some service users whose homelessness was seen as voluntary. One can argue that is being judgemental and not in-line with an anti-oppressive and anti-discriminatory practice (Dominelli 2006). However, in the same breath as risk assessment led to exclusion of service users, it also helped to identify those at risk of harm (physical and emotional) as a result of homelessness.

After identifying risks, an assessment of needs was also carried out to identify the needs of the person, such as shelter (which would be the reason for coming to the centre), financial needs and those who were eligible to receive social security benefits would be referred to the Job Centre and/or Social Services department for housing benefit. In addition, those who were homeless because of debt would be referred to national debt agencies to device ways of alleviating the debt. Others would have lost their jobs, which led to repossession of houses or eviction. Those with medical needs were referred to specialist services. In summary, I found the role of carrying risk assessments and assessments of needs very educative while I also applied theory into practice while I assumed a managerial role (commissioning services and signposting). In addition, liaising with other agencies improved my communication skills, advocacy skills and negotiating skills, all skills which are vital to effective community practice.

Skills required by community workers include community organisation, administration, social planning, social action and social development so that citizens can become active in their own environments (Hardcastle et al 2004). The model of intervention used with homelessness is that of empowering individuals to become self reliant and self sufficient. Social planning involved liaising with other external agencies such as the Coventry City Council, Refuge Centre, Job Centre and Social Services to help clients to get houses, social security benefits, as well as to help clients get jobs. My duties of coordinating services and signposting service users to these external agencies were part of social planning, organisation and action.

One of the most intervention methods used at the centre is crisis intervention. According to Jackson-Cherry and Erford (2010), a crisis intervention involves providing emergency psycho-social care to assist individuals in crises situation to restore a balance to their bio-psycho-social functioning. Similarly, Wilson et al (2008) define a crisis as a breakdown or disruption in a person’s usual pattern of, or normal functioning. Homelessness and losing a tenancy in most cases is a result of long-term crises, and individuals respond to crises by striving to maintain their equilibrium through using their coping mechanisms (Jackson-Cherry and Erford, 2010). In addition crises can arise where problems persist and the precipitating events are threatening, and usual coping mechanisms fail to work (Wilson et al 2008). An analysis of some of the people who came to use the centre showed that they were going through crises such as financial, debt, unemployment, domestic violence, which affected usual coping mechanisms in others. In addition, losing a house can also lead to a crisis and affect the individual’s coping mechanism. In a situation of homelessness caused by a crisis, or leading to a crisis, the role of a community worker is to solve the immediate crisis by offering shelter while looking for long term solutions (Wilson et al, 2008), which in turn leads to solution focussed intervention discussed below. Crisis intervention involves carrying out an assessment to identify needs, make referrals and implement a treatment plan or solution (Roberts, 2005). However, as already argued above, not all cases presented as crises were offered appropriate intervention, such as the case with asylum seekers, families, and people below the ages of 18 and above the age of 65, who were referred to other agencies.

In addition to crisis intervention, solution focussed intervention method was also used at the Salvation Army hostel. Solution focussed intervention is change oriented, and encourages service users to find solutions to their problems (Wilson et al 2008). Solution focussed works by placing the responsibility on the service user (empowerment), providing them with tools to identify the extent of their crises, and where they are in the crisis. Gamble (1995) cited by Hardcastle et al (2004) argued that community practice involves using “empowerment-based interventions to strengthen participation in democratic processes, assist groups and communities in advocating for their basic needs and organising for social justice”. Bidding for accommodation, job search, referring service users with drug and alcohol problems to Recovery Partnership were some of the solution focussed methods of intervention provided on the model of empowerment. In addition to finding solutions as a tool for problem solving, the Salvation Army also uses person-centred intervention method which sees the client as unique thereby requiring unique intervention. Person centred care (PCC), was developed from Carl Rogers’ person centred counselling (Nay and Garratt 2004). It promotes building relationships between client and professionals, which is empowering as it seeks to put the individual at the centre of their care (Wilson et al, 2008; Nay and Garratt, 2004). The project workers at the Salvation Army recognise that homeless people are individual people with different needs, and not a homogeneous community, hence support is tailored to meet individual needs.

The report critically analysed the main functions of the Salvation Army hostel for the homeless. As a student I felt that although the faith-based centre is doing its best to help homeless people, the SA has diverted from its original ethos of helping people in need regardless of race and creed, and this was notable especially with the way asylum seekers are turned away because of their immigration statuses. The role of the Church and philanthropists in helping the need and the poor has its roots before the Reformation, when welfare assistance to the needy was provided by the Church, based on the seven corporal works of mercy (the thirsty must be given drink, the hungry to be fed, the naked to be clothed, the sick visited, the prisoners visited etc) (www.victorianweb.org); through to the Elizabethan Poor Laws (1601), when the church provided relief to people through its parishes (Payne 2002). However, because the Salvation Army gets most of its funding from the Local government, this limits what it can do as a church.

Implications for practice.

In relation to providing shelter to people between the ages of 18 to 65, one can argue that this is ageism (Dominelli 2006) because it assumes that people below 18 and over the age of 65 cannot become homeless. Ageism does not promote anti-discriminatory practice, and it is also oppressive (Dominellie 2006). In contrast The Employment Equality (Repeal of Retirement Age Provisions) Regulations 2011 abolishes the retirement age of 65 years, which means that the government recognises that people can still be active after 65 years of age. The centre also views homelessness from a gender point of view by allocating 75 of the rooms to men and leaving only five to women. This is based on the assumption that men are more likely to lose their homes especially through domestic violence (perpetrators of domestic violence) yet there is increasing evidence suggesting that there are also male victims of domestic violence (Shupe et al, 1987) . In addition to homelessness, single women are also likely to lose their homes for the same reasons that men lose their homes (such as unemployment, drug and alcohol misuse, gambling etc).

The report highlighted that there is no family unit at the Salvation Army in Coventry, while Leamington has only one family unit. Under the current economic climate, many families are losing homes due to repossession of houses and unemployment.

As such it is also possible to have families becoming homeless. During my placement I witnessed whole families being turned away because of lack of facilities to accommodate families. One can also argue that by not having family units, the system views single people as more likely to become homeless. This issue of separating families was also practiced during the Poor Laws Amendment 1834, when families were separated in workhouses to ‘punish’ the undeserving poor.

For continuity of care the Salvation Army must continue to work in partnership with GPs, Community Psychiatrists and other health professionals during the recovery pathway so that people do not relapse when they return to the community. In terms of workloads, the project workers were allocated at least 10 service users each. In relation to time, comprehensive assessment to identify risks and needs, this workload was viewed by most workers as unmanageable, especially when allocated to service users with complex needs (accommodation, medical, drug and alcohol misuse, access to benefits etc). This also reduced the time of building rapport with clients (Trevithick 2000 and 2005) for effective intervention methods.

The placement provided me with a forum to apply theory to practice, including relevant theoretical intervention methods, understanding policy and legislation, as well as exposing me to the challenges faced by community workers when they work with people towards individual and community development strategies. I also gained an insight into social and health inequalities leading to homelessness and how these impact on people’s lives. My communication and interviewing skills were also enhanced (Trevithick, 2000 and 2005) as I spoke to different service users and professionals. Working with external agencies improved my team working skills (ibid). Values of a community worker include ability to empathise, to work in a non-judgemental manner, to be patient as well as to promote empowerment through social justice.

Conclusion

The conclusions to be drawn from the above report and analysis of the role of the Salvation Army with homeless people in Coventry are that the church and the voluntary sector play a significant role in the provision of welfare to citizens. However, there is also need to reform some of the Salvation Army’s policies to address issues of ageism, gender, challenge oppression especially with asylum seekers, and become inclusive to women and families who become homeless. Recruitment of volunteers can also be encouraged to reduce workloads. While the methods of intervention may be appropriate, however, assessments are not needs led but resource led, which makes it difficult for project workers to fulfil their roles to promote social justice.