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Uusitalo 1985 asserted that a commonly discussed point about state welfare is its ability to redistribute wealth. However, there are other commentators who do not agree with this assertion and feel that State Welfare (SW) has failed to redistribute wealth and create equality (Miller, 1994; Clegg, 2010; Osborne 2010; Grice, 2009). SW was instituted to, in a way, give basic human rights such as the right to education, health, social services, housing and social security. It was therefore imperative that all individuals had access to it and were treated equally by the system.

Thane (2010) asserts that although UK is perceived to be an accommodating society, inequity and prejudice has long existed in the country. Legislative Acts such as the Discrimination Act 1995, Equality Act 2010 and the UN Convention on Rights of Persons with Disabilities legally give disabled people civil rights, yet disabled people remain at a disadvantage. Massie (2007) claims that disabled people of working age are still living below the relative poverty level. This is affirmed by disabled activists such as Mike Oliver, Colin Barnes and others (Barnes, 1981; Oliver and Barnes 1991). It is alleged that SW has not only failed to ensure disabled people’s basic human rights but it has also infringed and diminished some of these rights.

This essay will examine the assertion, first by defining what State Welfare (SW) is. Second, it will briefly discuss the theory and history of SW in the United Kingdom and critically examine how SW has enabled disabled people to exercise their rights, especially in recent times, through Independent Living, Direct Payments and Basic Income. Third, it will examine the Human Rights Act 1998 and the UN Convention on Rights of Persons with Disabilities in the light of Human Rights principles. Fourth, it will explore how SW has infringed on the rights of individuals relative to education, housing, employment, health and social security. Last but in no means the least; it will highlight the role of professionals in perpetuating dependency, and discuss the role of the Disabled People’s movement in challenging SW provision and developing alternative policies and services to remove disabling barriers. It will conclude by drawing the arguments together relative to the question.

Definition of Welfare

Academicians, historians and social commentators have all attempted to define State Welfare (SW). Lowe (1993) however, purports that there is no formal definition of the term State Welfare. Wedderburn (1965) defines SW as a government obligation of some level which alters demand and supply to ensure fair income distribution. Lowe (2005) has also defined SW as not just a case of providing an isolated human service but a community where the state embraces accountability for the well-being of everybody. The Cambridge dictionary (2011) has described it as a form of tax collection that allows the state to provide basic human rights such as health, social security etcetera to those who require it.

Briggs (1961) contextualizes SW by arguing that the state uses its’ sovereignty to manipulate demand and supply for labour in three ways. The first is to make sure people receive a basic income regardless of the price of their labour or amount of their assets. The second is to minimise uncertainty by meeting people’s basic needs to alleviate social deprivation and the third is to give people access to good quality services regardless of their social standing. While Marshall (1950) purports that welfare rights and social citizenship are closely connected, rendering SW worthless without welfare rights. Esping-Anderson (1990) also points out that social citizenship is made up of the essential notion of SW.

Theories of State Welfare

State Welfare (SW) does not exist on its’ own, like any other system it is underpinned by various theories. O’Brien and Penna (1998) explain that theories are not intellectual concepts taken out of this world but ideas which give guidance and explains behaviour. SW in United Kingdom (UK) is underpinned by four main theories and they are as follow:

Liberalism

Liberalism takes the view that individuals should support themselves with the state interfering only when they are not able to do so. Gray (1989), a proponent of pluralist liberalism, maintains that there are different kinds of liberals. Firstly, there are those who take individualism to the extreme and rely on themselves alone, with the state intervening only when it comes to their freedom. Secondly, there are those who although are dedicated to their freedom, do not mind communal plans for socio-political progression. Finally, there are those who also see any state interference as evil. Liberals are said to have created the basics of SW (Clegg, 2011).

Marxism

Karl Marx and Friedrich Engels wrote their work during the 19th Century. Marxism concerns itself with materialism. Marx and Engels argued that the antagonism among social classes lead to social change, which finally culminates into capitalism: the common ‘evil’ predominant in today’s socio-economic structures. They see capitalism as ‘evil’ because they hold the opinion that it promotes oppression where the working class are exploited by the ruling class – bourgeoisie (Avineri, 1968 pg 3). The tradition of Marxism does not promote the view of SW as fundamentally the Marxist does not view welfare as the way forward for changing inequalities. (Esping-Anderson, 1998).

Neo-Liberalism

Neo-liberalism is an ideology that sustains an ethical and rational stand for capitalism. It associates itself with economics, social behaviour and social interactions (Thorsen and Lie, 2009). The Neo-liberalists promote the idea of cutting down state debts, reducing state support, changing tax legislation to widen the tax network, getting rid of pegged exchange rates, globalising markets to trade by limiting economic policies that restrict trading among countries, promoting privatisation, private ownership and supporting deregulation. Plant (2010) asserts that Neo-liberalism has produced an open market where the state has ultimate power.

Conservatism

Conservatism is a belief in organisations and traditions that have developed over the years and have shown to be on-going and stable. The term was devised after the 1833 Reform Act by the Tory Party when they changed their name to Conservative Party. The term has origins in Edmund Burke’s 1790 thinking on the French Revolution (Thompson, 2011). The ideology was based on preserving tradition such as the royal family, the church and social classes. Welfare is not paramount on the Conservative agenda as they believe in work, family and patriotism.

History of Welfare

Whelan (2007) states that welfare for the disadvantaged goes a long way back in British history, with individuals and charities such as churches running schools to educate children and charities meeting the housing needs of the working class. The idea behind these benevolent acts was to relieve the social conditions that industrialisation had created (Head, 2009). Poor Laws were one of the first legislations instituted in 1598 to assist the poor and the disabled in the UK by the Elizabethan government (Slack, 1990). The Victorian government continued to uphold these laws, but in the 1900s life became difficult for the working class such that it compelled the liberal government to introduce various reforms from 1906 to 1914.

Some historians’ claim, that state welfare (SW) developed from the 1601 Poor laws (Thane and Whiteside, 2009). Lowe (1993) asserts that the term SW was created in the 1930s, having first been used derogatorily in Germany to describe the Weimar Republic (Lowe, 1993; Gough, 2005). Weimer was a central city southwest of Germany and the first to be associated with SW (Harsch, 1999). In the UK in 1940, during the leadership of Winston Churchill, the conservative government became concerned about the Second World War returnee soldiers and their reliance on the state to earn meaningful living. In view of this, Sir William Beveridge was tasked with examining the already established National insurance schemes. He produced a report which was to establish SW. The key message in his report was the five ‘giant evils’ which were namely: Want (representing poverty); Disease (health), Ignorance (lack of education); Idleness (unemployment) and Squalor (housing) (Timmins, 2001).

The Beveridge report, 1942, brought changes to education that was laudable, such as promoting education for all (Batterson, 1999). This subsequently led to the enactment of The 1944 Education Act which was based on the Education Act 1870 that offered free education to all children in the country. Through the 1944 Education Act, the government intended to give children an equal chance in education by creating three types of schools: secondary modern, grammar and technical schools. Children were select into various school based on the individual ability (Batterson, 1999).

Beveridge’s report was influential and caused the government to start dealing with poverty and instituted constructive measures that resulted in introduction of universal benefits like The 1945 Family Allowance Act (Pleuger, No Date). This act allowed all families in Britain to receive weekly allowances for their children who were under 16 years, regardless of their financial or social status. Subsequently, other systems were introduced such as the National Insurance system that allowed contributing claimants to claim cash benefits from it. The National Assistance Act was next introduced in 1948 and it provided assistance to anybody who needed help or was not covered by other benefits. That same year the National Health Service (NHS) was also introduced and it provided universal health services. Mandated by the 1946 National Health Service Act, NHS operated on the following values: free care, free for all with clinical needs and not based on the ability to pay (BBC, 1998). However, this situation changed in 1951 when NHS started charging for dental treatment and prescriptions.

Beveridge’s report also touched on housing issues. There was shortage of houses after the World War II causing people to live in squalor, but between 1950 and 1955 the government tackled this problem by financing local authorities to build council houses for low income families (Burnett, 1987) The housing shortages compelled the government to take measures to alleviate severity by nationalising utility companies as part of the programme to control living expenses. Thirty years after Beveridge’s ‘From Cradle to Grave’ report, SW became a permanent part of British society. The economy however took a turn for the worse with high inflation and unemployment. People were ever more reliant on SW and there were calls for a change. (Devine, 2006)

Political power changed hands and Margaret Thatcher became Prime Minister in 1979. Mrs Thatcher was of the persuasion that individuals should take care of themselves instead of paying high taxes to support public services like the NHS. Hills (1998), maintains that the Thatcher government emphasised on four things: denationalizing, targeting, disparity and cutting public expenditure. Thatcherism as it was called introduced some far-reaching ideas that produced means testing, selective welfare and privatisation of public services (Glendinning, 1991 ; Hills, 1998). The ‘Right to Buy’ scheme, for instance, encouraged council tenants to buy their homes. All these policies reinforced belief in self-reliance rather than on state ‘hand outs’.

By 1997 Britain wanted a fresh pair of eyes after 18 years under the conservative government. Labour reinvented itself as New Labour with Tony Blair as Prime Minister. He introduced New Labour, announcing the discovery of the Third Way (Walker, 1998). New Labour believed that the route out of poverty was through work and therefore constructed SW on jobs for the ‘able’ and protection for those who were ‘unable’. Hills (1998, pg23) poses the question: ‘is New Labour any different?’ The answer is yes and no as New Labour was seen to have combined conservative ideas of cutting public spending married with a New Labour priority on education. New Labour presented a slightly modified SW as compared to the previous government, the Conservative. They did not however escape criticism, which led to their defeat in 2010.

A Coalition government has been formed and the conservatives and liberal democrats have put their heads together to lead Britain. Their aim is to reduce the state fiscal deficit by cutting public expenditure yet again. The theme for SW reform is making work pay (Turner, 2011). Disability Alliance (2010) has indicated that their organisation is worried about what the coalition reforms mean to disabled people. This is similar to the 1980s, where disabled people faced cuts in welfare benefits, restricted access to work and access to unemployment benefit taken away completely (Glendinning, 1991; Hills, 1998). The Coalition government refers to this change as a move to a ‘big society’ primarily aim to relinquish some of its responsibilities and to give individuals and communities control of services (Sutton, 2011). Reformist Frank Field supports this goal, maintaining that similar arrangements were in place during the 1800s (Sutton, 2011).

Human Rights

The right to health care, education, housing, income maintenance and social services are all fundamental human rights found in state welfare (SW). The United Nations define human rights as an individual constitutional right that should be enjoyed regardless of whom you are and where you are in this world. Each and every one is allowed to have access to these rights without prejudice (United Nations Human Rights, 2011). Amnesty International (2011) define human rights as rudimentary privileges which should be enjoyed by everybody irrespective of whom they are, where they come from, which skin colour they are, and irrespective of their gender, faith, linguistic background or standing. The British Institute of Human Rights (2006) posits that the fundamental human rights are fairness, equality, dignity and respect.

The term human rights was recently coined, but the concept has roots in medieval times. Ishay (2004) asserts that development of the human rights concept has many accounts. Some accounts have said Kings ruled their subjects in such degrading ways because they felt they had the God-given rights to do so. This led people to develop ‘man’ rights to combat the God given rights. Others indicate that the Quran, the Bible and eastern world teachings have all contributed to the development of human rights (Ishay, 2004). Subrahmanyam (2011) also purports that political struggles such as Liberalism, Marxism, Socialism, etc. have all contributed to creation of human rights.

After the genocide committed by Adolf Hitler and his government during World War II, the United Nations General Assembly created the Universal Declaration of Human Rights (UDHR) to prevent that kind of abuse from ever happening again. The UDHR document has become the backbone of many treaties and human rights laws all over the world (Bailey, 2011). Gleeson (2011) asserts that this document was used by the Council of Europe to implement the European Convention on Human Rights (ECHR) in 1953 to safeguard human rights and basic liberties in Europe.

The European Court of Human Rights was also implemented by this convention and anybody who feels their rights have been abused can take their case to this court. Britain joined the convention 1951 even though it was not until 2nd October 2000 before the convention became part of the laws in UK (Jepson, 2004). Another recent treaty is the UN Convention on the Rights of Persons with Disabilities (UNCRPD) which was signed by UK in 2008.

State Welfare enabling Disabled People to exercise their Rights

There have been many policies and laws for disabled people since the establishment of state welfare (SW) in 1945 which have enabled disabled people to exercise their rights. Bracking (1993) states that disabled people’s lives have been transformed since 1939, when disabled people started to speak for themselves. Thornes et al (2000) maintain that there have been four areas of care for disabled people since the establishment of SW. The provision of residential homes, National Health Service (NHS) care, educational services and income maintenance.

There have also been several laws that have assisted disabled people in exercising their rights. The Chronically Sick and Disabled Person’s Act 1970, for instance, was an important law which came to empower disabled people. Through this legislation councils gained authority to provide care, homes and support to people in the community. It also gave disabled people the same rights to leisure and academic services (BBC News, 2010). The Seebohm Report (1968) recommendations also led to the enactment of the Local Authority Act 1970 which gave local authorities the right to set up community care.

The Education Act 1944 recommended that disabled children should school alongside their non-disabled peers (Barnes, 1991). The Warnock Report influenced the 1981 Education Act by recommending that disabled children be educated with their non-disabled peers. The Special Educational Needs Act 2001 gave disabled children, parents and carers the right to be educated in mainstream schools if reasonable adjustment could be made. The Employment Act 1994 made working easier for disabled people even though the quota system did help employers to discriminate against disabled people (Barnes, 1991).

The 1948 National Assistance Act gave assistance and support to people in need and replaced the Poor Law. It also gave local authorities the duty to provide community care services for the sick, disabled, the aged and other people. The 1946 National Health Service provided advice, treatment and care to the nation free of charge (BBC News, 1998). The NHS and Community Care Act 1990 promoted community care which has benefited many disabled people.

The Community Care (Direct Payments) Act 1996, gave local social services the power to make cash payments, but were not effected until 2003, when it became mandatory to offer it to eligible people after assessment. This allows individuals to buy and manage their own care provision. Disabled people also have available to them the Access to Personal Files Act 1987, which gives them the freedom to access any notes or reports about them held by organisations. Access to Health Records 1986, part of the Data Protection Act, gives individuals the right to health records.

The Disability Discrimination Act 1995, which has been replaced in many respects by the Equality Act 2010, safeguards disabled people from being discriminated against in education, employment, access to goods and services, buying and renting. The Equality Duty 2006 demands that public bodies provide services that promote equality. Social security benefits have also become substantial from the humble Industrial Injuries Disablement Benefits and the War Injuries Disabilities Pension to Disability Living Allowance and Carers Allowance which supports extra cost incurred as a result of a person’s impairment. Long term sickness assistance like Income Related Employment and Support Allowance, Severe Disablement Allowance and Attendance Allowance are in place to support disabled people. Further support can be acquired through Working Tax Credit, Income Support, Pension Credit, Housing and Council Tax Benefit (DirectGov, 2011).

Self-directed care schemes like Direct Payments, Personal Budgets and Independent Living schemes also allow disabled people to access opportunities like their non-disabled peers (Barnes and Mercer 2006). Bracking (1993) affirms that Independent Living gives claimants the freedom to live on their own. Furthermore, it allows disabled people to make and be part of decision making processes. Disabled people are able to select and organise services for themselves and not rely on their local authority or other organisations to provide them. The Mobility and Blue Badge Scheme allows disabled people to buy or lease a car and give help with parking. Barnes (2004) purports that independent living can change the value of disabled people’s life.

State Welfare has diminished Rights

British Institute of Human Rights (2006) states that human rights are not simply concerned with legislation but impacts on services provided by the state like residential care, academic institutions, hospitals and support workers in disabled peoples home. Barnes and Oliver (1991) postulate that SW ‘cradle to grave’ promise of safeguarding its participant’s has not worked or else there would not be a demand for a disability discrimination law. The state has therefore not only been unsuccessful in securing disabled people’s fundamental rights, it has impinged and limited some of them. The Socialist (2010) highlights a recent case in which a disabled woman’s UN convention Rights and human rights have been ignored by being asked to wear incontinence pads instead of using a commode at night because of the cost of employing a carer. If the local authority wins this case it will have big implications for disabled people across the nation.

Federation of Disabled People (2011) purports that the Education Secretary, Michael Grove, was recently informed that not dialoguing over the idea of cutting school building schemes resulted in not considering equality concerns. Centre for Studies on Inclusive Education (CSIE) (No Date) propound that inclusive education is part of the international human rights law. Disabled people have been fighting for inclusive education since SW began and the 1944 Education Act was enacted Although it was stipulated in the Act that disabled children should be educated alongside their peers it never materialised. The Warnock Report in 1978 found that one in five children would need special educational support at one point or another during their school life. The report therefore recommended unit are created on school premises to accommodate such needs (Warnock Report, 1978).These recommendations influenced the 1981 Education Act which also asked for children to be ‘statemented’ before being placed in special schools. It furthermore, gave parents the right to appeal against their children special needs assessments. The 1981 Education Act also failed to establish inclusion, integration and accessibility breeching disabled people’s right to access educational institutions at any given time.

Rieser and Mason (1992) indicated that not much had been changed by the 1990s. Disabled children were still being educated with the medical view instead of a curriculum. This led to many completing their schooling without proper qualification (House of Commons, 1999). This breeched their right to obtain official recognition for a course they have completed. The 1993 Education Act tried to give parents more rights to appeal against decisions by the Local Education Authority (LEA) to send their child to special needs school. The Act also extended LEA’s time frames for assessing children with disability and encouraged inclusive education. Part of the subsequent 1996 Education Act identified and modified certain sections in the law allowing parents to choose if their children were to attend main stream schools.

The enactment of the Special Educational Needs and Disability Act 2001 brought disabled children close to inclusion. LEA were now under duty to provide mainstream education for children if that was the wish of their parents but this should not be to the detriment of non-disabled students (Vaughan, No Date). Disability and Equality Duty 2006 gave public services the duty to improve equality in all their services delivery. The most recent Equality Act 2010 also demands that all those providing services like education to provide fair and equal services to people.

The conceptualisation of moving towards an all inclusion option for education for people with disability has made in roads with the introduction of the Education Act (Virvan 1992). Policies and Green papers such as ‘Excellence for All Children: Meeting Special Educational Needs, 1997’ and the advancement of technology have not been able to address significantly the challenges that face disabled people in education. Johnson and Cohen (1984) suggest that challenges in the classroom, communication levels and total social inclusion are still not fully addressed leaving disabled people’s right to effective education breached.

The Office for National Statistics Labour Force Survey 2009 indicates that UK presently has 1.3 million disabled people ready and free to work. 50% of people with disability at employable age are actually employed as equated to 80% of people without disabilities. It is also noted that the type of disability also influences the figures significantly. For example, only 20% per cent of people with mental health difficulties are in work. About 23% have not got any educational credentials in comparison to nine per cent of people without disabilities. Non-disabled people get roughly ?12.30 in equation to ?11.08 that disabled people get (Shaw Trust 2011). These figures evidence the disadvantages disabled people face in employment.

Lindbeck (1996) states that Keynesian idea of full employment and Beveridge universal state welfare (SW) system stem from the same roots. In Britain for instance, the government’s committed to providing employment, universal state welfare and well-being to its citizens but disabled people had less chances of being in work than their non-disabled peers in the 1970’s. These figures improved in the 1980’s because a lot of non-disabled people were out of work. By the 1990’s things had become worse with 21% against 7% of non-disabled people were out of work. Fagin and Little (1984) assertion that people have dignity, sense of belonging and responsibility in working hold true. Most disabled people however, are stuck on state benefits because of unemployment and under employment situations. Where is their right to respect for their private and family life, home and correspondence if they cannot be involved in community life?

Barnes (1992) propounds that reasons given about difficulties that disabled people face in employment is out-dated and no longer acceptable. Although the 1944 Employment Act was designed to give disabled people opportunities in paid work the quota system undermined it. The Disability Discrimination Act and Equality Act 2010 were all designed to combat employer attitude and discrimination but there remain barriers like medical screening, age, education, experience, transportation, appearance and environmental factors that need to be addressed to allow the disabled person to participate actively in employment.

Berry (2010) advocates that the idea of state welfare (SW) was to eradicate divisions amongst people, but seems like the impact of the SW has made these divisions even more noticeable. He further asserts that the property division among property holders and renters is emphatic than ever. Equality Human Rights Commission EQHRC (2011) state that there are certain rights a person has in relation to housing and home ownership. One of them are to have and delight in the possession of property, but clearly owning your own home is something that most disabled people do not have the power to acquire. Derbyshire Coalition of Disabled People (DCODP) (1986) state every person has the authority to dwell in a home in any average place but critics have said this is not possible because there is lack of houses in UK more so accessible homes.

Although the 1970 Chronically Sick and Disabled Person Act requires local authorities to provide the housing needs of disabled people, most councils have sold their properties and have little stock left (BCODP, 1987). Some Local authorities have to work with other organisations to meet the housing needs of disabled people. Accommodation and supported housing are usually few and farther away from town centres, thus isolating disabled people and breaching their right to independent living. Disabled people also usually have to go through a medical assessment to get into social housing. This practice has been slammed by disabled commentators advocating that it is discriminatory (BCODP, 1987). The Housing Act 1988 did not include disabled people in purchasing council flats and houses in the 1980s. Peck (2011) submits that a lot of people with disabilities cannot get assistance to enable them avert being homeless. Those who do get housed sometimes face houses with adaptations that are not up to standard (Heywood, 2001).

State welfare (SW) amongst other things was to provide financial assistance that will relieve poverty and create social protection for all citizens. However, disabled people do not seem to have experienced this relief. Carvel (2005) asserts that three in ten disabled people who are employable are poor and this gap is widening regardless of what the state is doing to combat societal handicap. Smith (2008) advocates that the charity Leonard Cheshire Disability’s recent report reveals three million disabled people in UK in 2008 lived in relative poverty.

Palmer (No Date) states that about a third of people with disability falling between ages 25 and 65 onwards live in poor families, half of Non-disabled peoples figure. Disabled people are poor because they often do not work. Statistics indicated that about 60% of disabled people are not employable in contrast to 15% of non-disabled people (Palmer, No Date). A large percentage of disabled people are willing to work but cannot find employment. Disabled people often do not have the credentials required for working. 75% of people who are of employable age and on benefits are either ill or have a disability.

The 1988 disability survey conducted by the Office of National Statistics confirms this deprivation. The survey recognised that most disabled people rely on social security benefits, but the 1988 benefit reforms did not consider these findings and cut social security spending which in turn affected disabled people. DisabledGo (2010) advocate that Equality Human Rights Commission (EHRC) is apprehensive about the governments Work Capability Assessment test and the impact it is having on Employment Support Allowance claimants. Cooper (2010) asserts that the 2011 housing benefit reforms will make a lot of people homeless. The government’s plan to cut public spending and relieve itself of some its responsibilities will undermine schemes and programmes that support disabled people. This will inevitably corrode disabled peoples right.

The National Health Service posits that disabled people have intolerable challenges accessing their services (Department of Health, 1999) The National Health Service’s core value is to provide health care for all in UK but it is apparent this not the case. Wide spread discrimination has been reported by various organisations and the media. Brindle (2008) and Triggle (2007) submits that an official inquiry has found that NHS discriminates against people with learning difficulties. They further alleges that the main shortcoming of the NHS is the lack of knowledge in learning disability issues. Disability News Service (2009) state a recent report by Every Disabled Child Matters indicates that disabled children are being let down by the NHS despite having the resources to support them.

Aspis (2006) alleges that disabled people’s right to life is in today threatened, as medical staffs are allowed to make life and death decisions about disabled people without making clinical references. He further alleges that scientific experimentations like gene manipulation and pre-natal screening could wipe out disabled people in the not too distant future. F

The Services Available to Disabled Children
Introduction

Disability is all too often seen as a social problem i.e. it is seen either in terms of personal tragedy or of blame. Disability has been theorised in a number of different ways, most of which locate the problem in the individual rather than the broader social, political, and economic influences. This has implications not only for the location of the blame for social problems but also for the ways in which services for certain groups are delivered and accessed. All too often access to services is hindered for children with disabilities and the burden of care is left to the family (Moore, 2002). In many cases it would seem that if a child has a disability then this is seen as a matter of private concern for families. The present Government advocates a mixed economy of welfare where welfare is provided in part by the state and partly by private companies operating for profit. The shift from public to private has received much publicity and contributed to social problems and to social exclusion (Giddens, 2001).The mixed economy of care (largely as a result of the 1990 NHS and Community Care Act) has meant that access to care for children with disabilities has become problematic. Thus families who are already stretched both financially and emotionally face further stress as the result of being unable to access appropriate care and services for their child. This tends to support the view that having a child with a disability results in the family as a whole being disabled by the unjust society in which it is situated (Fazil et al, 2002)..

Within the human services great emphasis is placed on the rights of the service user, and this discourse is also evident in Government debates on social support and caring for people with disabilities. All too often however, this remains at the level of discourse and is not followed through when it comes to policy making. This assignment will therefore undertake a critical review of research into the services available to disabled children to assess whether the problem is as broad as some theorists would have us believe, and what might be done to alleviate the problems faced by families who have a child with a disability.

Research Question

What services are available to children with disabilities and what are the difficulties associated with accessing them.

Protocol

The area of interest is children with disabilities. The outcomes are what services are available and what if any difficulties might be associated with accessing those services.

Objectives
To carry out a critical review of literature to discover what services are available to children with disabilities.
To ascertain whether it might be argued that perceptions of disability might affect what services are on offer and how these might be accessed.
To assess whether parents receive accurate information from professionals
To make recommendations
Search Strategy

A broad search was undertaken of the following:

Disability and Society

Community Care

British journal of social work – Child: Care, health and development

www.doh.gov.uk/research

www.socresonline.org.uk

www.jrf.org.uk

www.leeds.ac.uk/disability-studies/archiveuk/archframe

A broad search of Taylor Francis journals and Google Scholar was also undertaken. Key word and key word phrases were, disability, family, service users, disabled children, disabled children and their access to services, access to services for disabled children, effects of disability on family life.

Part of the problem for disabled children and their families has been an over-reliance on the medical model of disability which locates the problem within the person. Inclusion discourses and debates about discrimination tend to suggest that this pathologising of children with disabilities is further extended to their families for example Bowler and Lister Brook (1997) when speaking of children with Downes Syndrome say that:

The identification of a genetic basis for Downes Syndrome led many researchers to explore the possibility that there might be behavioural phenotypes in addition to physical phenotypes that result from specific genetic abnormalities (Lister and Brook, 1997 p.13).

Clearly this is locating the problem within the child and does nothing to improve perceptions of either the disabled child or his/her family thus discriminating against the family as a unit. Most of the studies looked at in the following review, and the ones concentrated on in the analysis, report distorted perceptions of disabled children and their families. They also report that services for disabled children are not consistent nor easily accessible.

The key concepts that were present in the literature were an assumption that people have plenty of extended family support, use of formal and informal care arrangements, any difficulties in securing access to appropriate services, and the effects that having a child with disabilities has on families. Most of the research indicated that across the board service provision for children with disabilities was at best patchy and at worst lamentable and that it was this, along with perceptions of disabled children and their families that affected access to appropriate services.

The review begins with an indepth assessment of three studies in particular and then reviews the concepts generally.

Families and Children with Disabilities

Fazil et al (2002) undertook a triangulated study (i.e. one that uses both qualitative and quantitative research methods) into the circumstances of twenty Pakistani and Bangladeshi families in the West Midlands who had at least one disabled child. The aim of the research was to try and understand whether and in what ways the discrimination that these families might face was compounded due to the fact that they had a child or children with disabilities. The researchers used a combination of structured questionnaires and semi-structured interviews to obtain their results. The research focused on parents’ experiences, their use of formal services, their material circumstances, and the ways in which having a child/children with disabilities affected their lives. A significant finding of this research was that while Government discourses centre on the integration of service provision in Birmingham (where these families live) there was:

The absence of systematic services which came across most strikingly (Fazil et al, 2002,p.251)

This view is supported by research undertaken by the Audit Commission (2003) whose findings suggested that across the country, rather than the integrated and joined up services that are promised, service provision was a lottery. How much service and what kind of services offered to disabled children and their families depended very much on which part of the country they lived in.

Clearly the move to make partnership working the norm does not always succeed. Molyneux (2001)^[1] maintains that this only works when certain guidelines are established at the outset. His research into successful inter-professional working established three areas that contributed to the success of such partnerships. Staff needed to be fully committed to what they were doing and personal qualities of adaptability, flexibility and a willingness to share with others were high on the agenda. Regular and positive communication between professionals was seen as endemic to good working relationships and service delivery. This communication was enhanced (in the study) by the instigation of weekly case conferences which allowed professionals to share knowledge and experiences (2001, p.3).

Dowling and Dolan (2001) undertook secondary analysis of a qualitative study using the social model of disability as an analytical frame. Disability is usually defined too ways, as a medical model where the problem is located in the person and the social model where the problem is located in society i.e. as a social problem. The researchers found that having a disabled child in a family could marginalize the whole family who then suffered from unequal opportunities and outcomes. Through their use of the social model of disability as an analytical framework the researchers found that these families often suffered financial hardship along with stress created by social barriers, prejudice and poor service provision.

Some studies tend to suggest that much of the care that is on offer is discriminatory – that is to say it takes the view that disabled children and their parents have a tendency to be over reliant on services. This article was a summary of the work undertaken in Leicester and it did not therefore, contain the views of parents and their children. Bush (2005) is a senior manager in children’s services and in his summary of what are called ‘inclusive’ services for disabled children he points out that the services are only on offer for a short while so as to discourage over-dependence on the service. This is not to say that some of the tasks undertaken by this partnership group are not beneficial, but there is no guarantee that any of the services would be ongoing.

Fazil et al (2002) focused on the problems faced by members of two specific ethnic groups, the study was included because it was felt that the problems and feelings expressed within the study were quite representative of the feelings and experiences of many parents who have a child or children with disabilities. Although the study was very small, consisting of only twenty people, the use of both qualitative and quantitative data gave the study a breadth that it might not otherwise have had. Certainly the implications of the study were that services are difficult to access and all too often professionals make assumptions about the level of care and support that parents are able to give – these assumptions were also made in relation family support systems that the respondents may have had. The research also found that lack of support and the continuing struggle to access services and make ends meet affected parents’ views of themselves and their abilities to cope.

Bryman (2004) has this to say about the use of both quantitative and qualitative methods

It implies that the results of an investigation employing a method associated with one research strategy are cross-checked against the results of using a method associated with the other research strategy (Bryman, 2004, p.454).

All in all the study was fairly well balanced, and did not for example, appear to exaggerate parent’s fears. The use of data triangulation tends to add weight to the findings of this particular study.

Dowling and Dolan’s (2001) study tends to support the findings of Fazil et al. There appears to be a common feeling that when families have a disabled child or children then they, along with their child, are marginalised. Such marginalisation leads to stress in families and problems in accessing care. In many cases professional assumptions about these families increase the stress involved in obtaining appropriate services and care. This in turn supports the findings of Gregory (1991) that perceptions of disability and the assumption of parental responsibility has a huge impact on family relationships and on respondents’ own views of themselves as parents.

Bush’s (2005) summary of a particular project in Leicester supports the idea that parent’s of disabled children are in some way responsible. The services in Leicester operate to help parents cope with their disabled child in the short term and then the onus is placed back on parents in the long term. The project aims to prevent what it terms as an over dependence on service provision. It seems to be the case that the feelings that the parents of disabled children have expressed in other studies are generated by the kind of services that treat parents as though they are trying to shirk their responsibilities to their children. This was a very short article that briefly described the services on offer, some of which would need to be continued even though they were only provided on a short term basis, for example physiotherapy. As the author of the article states:

Each intervention is administered with the intention of ensuring that the services are short-term and discourage dependency (Bush, 2005, p.128).

This may seem overly critical of the project because until its inception two years ago many of the services that it offers were not available at all in Leicester. The fact that even now they are only available in the short term tends to support the notion that access to services for disabled children is often problematic.

Access and Attitudes in Service Provision

Case (2001) found that parents of children with learning disabilities were often dissatisfied with the professionals with whom they came into contact and when services were provided they tended to be reactive to the problem rather than proactive in solving it. Perceptions of children with disabilities, and particularly learning disabilities are often devalued by society and this devaluation is evident in poor service provision (Chappell, 1997). King et al (1997) maintain that service provision often reflects how children with disabilities are perceived by medical and social work professionals rather than the needs of an individual child. This follows the view among many researchers that the medical model of disability is still at the forefront of most professionals’ minds.

The problem … is that medical people tend to see all difficulties solely from the perspective of proposed treatments for a ‘patient’, without recognising that the individual has to weigh up whether this treatment fits into the overall economy of their life. In the past especially, doctors have been too willing to suggest medical treatment and hospitalisation, even when this would not necessarily improve the quality of life for the person concerned. Indeed, questions about the quality of life have sometimes been portrayed as something of an intrusion upon the purely medical equation. (Brisenden, 1986:176).

The medical model leads to the treatment people with disabilities as passive objects of medical attention. This view is oppressive of people with disabilities and spreads to other social relationships, it sees disability as pathological i.e. rooted in a person’s biology, and thus unchanging. Contained within this model is the perception of people with disabilities as problematic. As an adjunct to this model, disability has been theorized as a personal tragedy, which means that individuals with a disability are seen as victims.

Treating children with disabilities as victims arguably leads to their becoming almost invisible in service provision. Goble (1999 cited in Case 2001)) maintains that the needs of disabled children and their families are often not addressed because issues that are important to service users, rather than service providers, are not really considered and are under researched. Hornby (1994 cited in Case 2001) has argued that professionals often neglect to provide parents with all the information that they should have when it comes to the needs of their child. If children with disabilities are to get the correct treatment and have access to appropriate services then the parents should be fully informed.

Clearly disabled children’s access to services is hampered by social perceptions and by the perceptions that professionals have. This has resulted not only in problems accessing services, but when services are accessed they are not always appropriate to a particular service user’s needs. Research tends to focus on perceptions of disability and the disadvantage that it brings but as yet there is little evidence of what disabled children and their families actually want from service providers.

Conclusion and Possible Policy Implications

The prevalence of the medical model of health and the ways in which families are kept under-informed regarding the disability of a family member, particularly a child, affects family relationships. It also affects the attitude that professionals may take to disabled children and their families. Gregory (1991) maintains that when a person is diagnosed as ‘disabled’ this affects the ways in which society and the family respond to and deal with that person. Families themselves can tend to see the disabled family member as ‘sick’ and different. Gregory (1991) found that having a disabled family member also affected the way in which mother’s viewed themselves because ideological images of motherhood focus on having an able child. Thus a woman may feel that she is somehow not a mother because of the ways in which society defines motherhood. While doctors may diagnose a physical or learning disability families are often left to cope without either sufficient information or professional help. In a number of cases families have reported that hospitals have refused to admit non-emergency cases unless a parent or carer remains on site to provide additional support (http://www.cafamily.org.uk/rda-uk.html). A shortage of nursing staff and the increasing tendency to perform surgery on a day care basis means that many families are left with extra caring responsibilities once they take the disabled child or adult home. (http://www.cafamily.org.uk/rda-uk.html).

In conclusion it would appear from the literature that service provision is sporadic and often not appropriate to the individual needs of disabled children and their families. It might be recommended that more research is needed into what users actually want from service providers and that perhaps as one study suggested users fare much better if they are assigned a single key worker who will liase with all service providers.

Bibliography

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Bryman, A 2004 Social Research Methods Oxford, Oxford University Press

Bush, C. 2005 “Inclusive services for disabled children” Practice Vol 17 (2) pp 127-130 Routledge

Case, S. 2001 “Learning to partner, disabling conflict:”Disability and Society Vol 16 (6) pp 837-854

Coffey, A and Atkinson, P (1996) Making sense of qualitative data, Sage, London

Dalley, G. 1988 Ideologies of caring: Rethinking Community and Collectivism London, Macmillan

Dowling, M and Dolan L. 2001 “Families with children with disabilities: Inequalities and the social model” Disability and Society Vol 16 (1) Jan 1st 2001 pp. 21-35

Fazil, Q. Bywaters, P. and Ali, Z. 2002 “Disadvantage and discrimination compounded: The experience of Pakistani and Bangladeshi parents with a disabled child in the UK” Disability and Society Vol 17 (3) May 1st 2002 pp. 237-253

Gough, D and Elkbourne, D 2002 “Systematic research synthesis to inform policy, practice and democratic debate” Social Policy and Society 1 (3) pp. 225-36

Gregory, S. 1991 “Challenging Motherhood: Mothers and their deaf children” in Phoenix, A and Lloyd E, eds. 1991 Motherhood: Meaning Practices and Ideology London, Sage

Macdonald, G 2003 Using Systematic Reviews to Improve Social Care London, Social Care Institute for Excellence

Millar, J 2000 Keeping Track of Welfare Reform York, York Publishing Services for the Joseph Rowntree foundation

Molyneux, J 2001 “Interprofessional team working: What makes teams work well?” Journal of Inter-professional Care 15 (1) 2001 p.1-7

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Oliver, M 1996 Social Work with Disabled People Basingstoke Macmillan.

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1

The Disabled American Veterans is an association sanctioned by the US Congress for military disabled veterans of the US Armed Forces that helps them and their families through different means. It as of now has more than 1.2 million individuals. Charity Navigator does not rate the DAV as it is a 501(c)(4) association. It does rate the Disabled American Veterans Service Charitable Trust.

Debilitated veterans in the US in the result of World War I ended up truly impeded, with minimal legislative backing. A number of these veterans were deaf, blind, or rationally sick when they came back from the front lines. A surprising 204,000 Americans in uniform were injured amid the war. The thought to structure the Disabled American Veterans emerged at a Christmas party in 1920 facilitated by Robert Marx, a U.S. Armed force Captain who had been harmed in November 1918. Despite the fact that it had been utilitarian for a few months at that point, the Disabled American Veterans of the World War was authoritatively made on September 25, 1921, at its first National Caucus, in Ohio. While visiting over the U.S. as a major aspect of the election battle of James M. Cox, Judge Marx promoted the new association, which immediately extended. It held its first national tradition in Detroit, Michigan on June 27, 1921, at which time Marx was selected the first national administrator.

In 1922, an auxiliary women’s organization was established. The DAVWW continued working through the Great Depression to secure the welfare of disabled veterans, despite the fact that their efforts were vexed by fundraising challenges and the desire of the public to put the World War behind them. In the midst of these agitated years, DAVWW was issued by Congress federal charter, on June 17, 1932. The demands of World War II required the pressing expansion of the organization, which officially transformed its name to Disabled American Veterans to recognize the impact of the new war. In 1941, DAV propelled a direct mail campaign, distributing miniature license plates which could be joined to a key ring with instructions that lost keys should be mailed to the DAVWW, who would return them to the owners.

In 1944, the DAV started offering a National Service Training Officer Program at US University in Washington, the first venture of training that finished with a two-year mentorship program. In 1945, the DAV extended the program and accumulated the assembling house, inevitably buying complete responsibility for program in 1950. The program demonstrated dependable and very effective, both in acquiring donations and utilizing veterans in production. By 1952, 350 individuals were utilized in the endeavor, which acquired over $2 million a year in donations. In the mean time, the quantity of disabled veterans had been expanded by the as yet progressing Korean War.

The DAV suffered a decrease in the later 1950s and into the 1960s, with lessening funds and leadership; however it energized around the veterans of the Vietnam War furthermore concentrated intensely on living up to expectations for detainees of war and lost in action. Vietnam veterans soon filled the decreased ranks of the National Officers Service. On Veterans Day, 1966, the DAV moved its central command to Cold Spring, Kentucky. The accompanying year, the IdentoTag program was ceased for giving location marks, with an appeal for gift, when changes in license plate rehearses made proceeding with the IdentoTag program impracticable.

The DAV experienced generous change in 1993, when inner contentions concerning the administration of the association prompted a watershed election that turned over the organization to new hands and the National Program was redesigned. In 1998, DAV National Wilson Arthur joined with Lois Pope and for Secretary for Veterans Affairs Jesse Brown to push for congressional approval of the American Veterans Disabled for Life Memorial. When fundraising was finished in 2010, the DAV and its offshoots had raised more than $10 million for the memorial. Dedication of the memorial is situated for October 5, 2014.

This mission of DAV association is to give free proficient aid to veterans and their families in getting advantages and administration earned through military administration by the Department of Veterans Affairs (VA) and different organizations of government. It likewise gives effort concerning its program administrations to the US individuals by and large, and to disabled veterans and their families particularly. Broadening DAV’s central goal of trust into groups where these veterans and their families survive a system of state-level offices and neighborhood sections; and giving a structure through which disabled veterans can express their empathy for their kindred veterans exhaustive a variety of volunteer projects.

The Disabled American Veterans Organization gives administration for nothing out of pocket through an across the country system of 88 DAV National Service Offices. The Disability Assistance Transition Program administration give free help to administration individuals at Intake Site areas at military establishments by Disabled American Veterans Transition Service Officers with treatment records, recording introductory cases for VA profits and meet with the U.S. Division of Defense, the U.S. Bureaus of Veterans Affairs and U.S. Division of Labor facilitators and different members in the move process from military life to regular citizen life.

Numerous outreach programs like DAV’s Mobile Service Office, Veterans Information Seminars, Homeless Veterans Initiative and Disaster relief grants. The Mobile Service Office Program is designed to bring assistance for disabled veterans and their families living in geographic provincial areas on veterans’ benefits, documenting claims and services closer to home by taking out long trips for veterans to the National Service Offices. This outreach project is design to instruct veterans, their families and survivors who are unconscious of veteran’s legislature benefits and programs, counseling and claims recording assistance service by DAV’s National Service Officers (NSO) at communities all through the nation.

The Disabled American Veterans Homeless Veterans Initiative is supported by the DAV’s Charitable Service Trust and the Columbia Trust, This activity promotes the advancement of supportive housing and necessary services to assist homeless veterans get to be gainful, self-sufficient members of society. DAV Disaster relief grants may be issued with the end goal of giving: nourishment, attire, and transitory shelter or to acquire relief from damage, illness, or personal loss resulting from regular or national disasters that are not secured by insurance or other disaster relief agencies. Since the DAV disaster relief grants program commencement in 1968, $8.7 million has been disbursed to veterans that suffered losses amid characteristic disasters.

References:

STEVE WILSON, Have a financial plan before transitioning, 2015

Wilborn, Thom ,“Architect of Modern DAV Retires”, May 2, 2013.

Orkin, Lisa Emmanuel, “Disabled Veterans Memorial has DC Groundbreaking, 2010.

The aspect of social work practice I feel most difficult to perform is the gerontological social work. This paper would firstly describe the context of social work practice with old people. After that, I would exam the reasons preventing me from effectively conducting helping process by evaluating my attitudes, emotions and experiences as well as by reviewing professional literature on social work practice with old people. In the end, I will shape a personal plan on how to address this weakness in the future.

Keywords: social work practice, aged, difficult aspect

Reflection Paper on Difficult Part of Social Work Practice

There is a universal folk saying that everyone wishes to live a good long life, but no one wishes for old age. Although in virtually every helping process attempt, social workers bring their own emotional or cognitive influences to intervention, I feel especially difficult to perform in the interventions dealing with older adults.

Describing the context of social work practice with old people

With the development of medical and health care and with the baby boomer generation’s entering into their old years, the aging of population in the twenty-first century has become increasingly concerned by more and more people. In responding to the drastic transformation of social institutions such as elderly social service and health-care system, the social work practice with old people turns out into one of the most popular social work aspect today.

Apart from the well-known nursing homes and hospital, there are other settings for gerontological social work as well. Geriatric care management, community social service agencies, adult day health care, legal services??home health-care agencies , macro settings for gerontological social workers and community planning also play their active roles in serving the older adult in a variety of ways.

The gerontologiacal social work, which needs high level of self-awareness, commitment and professional skills, is somehow a complex mission for us to carry. Many social workers admit that social work practice with old people is both challenged and exciting for the reason that, at one hand, it reminds of feelings about death, aging of our family and one’s own attitudes toward helping the disadvantaged and vulnerable old adults; on the other hand, it also presents joys and delightful pictures and makes us think more about ourselves.

Root of difficulty
Review own personal factors

Among all the factors that influence my ability to perform this particular area, the subtle effects of my social and personal massages and the counter-transference feelings of old people would be matters of cardinal significance. Furthermore, I also affected by my characteristics and cognition to certain kind of old people.

Stereotypes. When I was a child I always heard people saying that old people are vulnerable and need help, and older adults are less valuable as human beings because they have to rely on their children. At home, I was asked to behave properly and not offend grandparents; otherwise I would get scolds and punishment. While at school, I was required to help older people for that they have trouble getting around. These stereotypes toward elderly are usually negative for me and imply an attitude or unintentional message that old people are hard to take care of, stubborn, old-fashioned and unpleasant.

Consequently, I always feel that I cannot handle the relationship with older people well and they will not like me. I feel uncomfortable in front of many of my eldership because I do not know how to keep conversations going with my poor eloquence and interpersonal skills. Even though I understand ageism is a destructive social justification when I grow older, I still cannot change the comments I once made on aging and I am a little bit afraid of old people to some extent.

Personal emotion factors. I am by nature a sentimental and emotional person from an early age. My grandma passed away when I was in primary school. She left me even before seeing my admission into university and engagement with my fiance. I always think that if she could see these, she would be very pleased and also, I would be the most delight person in the world. She always lived a difficult life when she was young and did not enjoy much in her late years. Sometimes all my family members would feel guilty for missing the chance to treat her well before she left us.

As a consequence, when facing the dying older people, especially female elderly suffered from chronic disease or cancer, I inevitably feel urgent to ‘save’ them and so scared to face the truth that they will eventually die someday. I doubt myself about what I can do for them and I am so scared that they will leave me before I can do anything right or helpful. In fact, that is one of the most difficult challenges in social work practice for me.

Real understanding of old people. As a social worker, I appreciate that getting old does not inevitably mean the loss of intelligence, memory and cognitive functioning. I also understand that developing a level of understanding is necessary from a social worker standpoint, and it helps me to anticipate client needs and perform an ongoing self-critique in order to improve and grow my helping process. However, many times I feel I am not able to truly understand them and consider things from their perspective of views as I never experienced true aging. Many decisions I made somehow reflect my own perception of the situation such as to decide whether an old adult should stay in own home or hospital, or to conclude that an older person is showing poor judgment about financial decisions. Furthermore, it would be even harder to perform my role as a social worker when a balance between the opinions of the older adult himself, his family and the social worker need to be achieved. This obstacle prevents me from behaving more successfully at building a sustainable relationship with elderly clients and I simply do the work and move on.

When everything needs more time and patience. With the tight time schedule and many objectives to be accomplish, sometimes a social worker needs to be in a hurry to push on the intervention process. And some other times even if I have explained many times, it is still necessary to have extended periods describing complicated appointments to older clients. I always tend to speed it up although in that case, in order to attain my goal I should slow down to give them more time to think about the process. Lack of patience would be another problem preventing me from effectively working with elderly or even almost every aspect of social work practice.

Reviewing the professional literature

Many social workers admit that, even though both meaningful and satisfactory, working with elderly people can need a high level of self-awareness and self-discipline. The truth that everyone must eventually face the developmental stage of aging and death for themselves and their families may contribute to the anxiety and complexity of the helping process, as social work practice in the aspects of domestic violence or drug abuse may not personally affect worker. This can impact workers with older clients on both a conscious and subconscious level.

Ageism and Death Anxiety. In most cultures around the world, particularly the Chinese culture, people feel uncomfortable when deal with death or anything related to death. From an early age, children are asked to avoid to talking death and dying, and to replace the word death with phrases such as “passed on,” or “gone on to another world”. Therefore, the social workers dealt with older people may require more self-control and comfort on the acknowledging the real pain caused by the loss of human life of family and friends.

The anxiety of aging and dying process on one’s own work, combined with generally indisposed experiences about the proximity of death surrounding older adults, bring about some social workers’ avoiding work with the aging. According to the Hong Kong Social Workers Registration Broad’s data gathered from its members about their areas of practice, despite older adults make up about 12.8 percent of Hong Kong population, less than 6 percent of social worker identify gerontological social work as their field of practice, which compared to nearly 30 percent for mental health.

Countertransference. The reactions, real, and unreal, to a certain individual can occur irrespective of origin and can be based on one’s own past or present experiences or characteristics. Counter transference can be described as social worker’s reactions involve feelings, wishes, and unconscious defensive patterns onto the client. In the professional relationship with old people, a social worker may place negative feelings or dislikes of older persons onto the client, which restrict his willingness (no matter consciously or unconsciously) to continue investigating and result in impatience or intolerance of the aging. On the other side, old clients who evoke images from one’s past such as parents, grandparents or other elderly family members can make process even more arduous to advance as a result of ‘destructive’ sympathy and the ‘need to save an older person’.

The Independence/ dependence fight. Old people want to maintain their independence to make decisions while the social worker commits to promote self-determination and dignity of the individual. But things are not that simple. When an elderly claims for increasingly supporting service and experiences growing difficulties to maintain independence on his own, it will be confrontational to live up to the elderly expectations.

McInnis-Dittrich (2008) states ‘A worker can appreciate the desperate efforts on the part of an older adult to stay in his or her own home. Yet when an older adult is struggling with stairs or a deteriorating neighborhood, and difficulties in completing the simple activities of daily living challenge the feasibility of that effort, professional and personal dilemmas abound.’ This is a good example to understand that sustaining independence in the gerontological social work is a critical goal which has no simple good answer.

Private functions become public business. Discussing the topic such as an old woman’s bladder and bowel functions or an older man’s maintaining an erection or urinating with clients may cause awkward and uncomfortable resistance when social workers and other helping professional get involved. Therefore, sometimes it is important to be sensitive to the deeply personal nature when social workers try to acquire necessary comprehension of an older adult’s health conditions. A better understanding of interpersonal skills and psychosocial adjustment to aging would be helpful and essential.

Personal plan to address this weakness
Overcome stereotype influence

First of all, I hope that from now on I will pay more attention to those featuring active, healthy, productive, and successful older persons so that I will develop a balanced understanding about aging and elderly. Aging is not painful and debilitating. Many wise, gracious, and humorous elderly have made admirable contribution to the world and have shown remarkable strength to achieve a positive as well as enthusiastic life.

Secondly, another important thing for me is to keep the lines of communication open with older adults. If I can open my heart to communicate, they will share more with me. The stronger relationship between us will help me cope better with the stereotype challenges.

Last but not least, in my future helping process I will often ask myself: ‘does it reinforce stereotypes again?’ I should start from every thing in daily life to alter the attitude that hinders my ability to face the normal changes of aging. Make a change in attitude is not easy, but I will try my best to drive myself on the right direction.

Awareness and Introspection

Awareness of the emotional influence is the first and the essential key to solve my problem. How well do I manage my own anxiety with this client’s situations should be my first concern. I will always remind myself that do not be affected by my experience and differentiate my experience of losing a family member from the intervention my client. That will help me to distinguish between the older people’s need and my own need and, to remain focused on the clients’ need.

Furthermore, I could seek help from colleagues and supervisors as well. By discussing the situations with them, I can expose and explore my own feelings and get advices in order to effectively facilitate help process.

To truly understand elderly

Above all, I will try to get in touch more with old people to truly feel their emotional and cognitive problems, as well as to open my heart and listen to them. Maybe I can join them more in their music, art activities in communities. Aging does not necessarily mean the loss of memory and cognitive capacities, and I will try to explain the information in a variety of ways so that we can build understanding relationship.

Moreover, reading more books about the psychological problems of the elderly would be really useful to analyze their psychological changes and behavior patterns. Equipped with a better look at the findings from professional social workers, I will more effectively comprehend the aging process the distinguishing features of elderly.

Finally, I should learn from experienced social workers to get more suggestions when I feel difficult to continue. For one thing, they can improve my ways of carrying intervention by pointing out my mistakes. For another, they can help me understand and get the most from their strength and weakness by providing convenient and professional advice.

When the National Health Services (NHS) was founded in 1948, one of the principles was to provide complete services to all and free at the time of need in UK (nursing times.net 2009). Access to healthcare services is based on clinical needs of an individual and not the ability to pay the services. This means everyone has the rights of accessing to health and social care, although it is still a major problem for low social group and ethnic minority who are facing personal, socio economic, cultural and problems happening as results of the structure of health and social care processes (POSTNOTE 2007).

In this essay, a case study will be used to demonstrate a patient with learning disability who faces various problems during his access to health and social care services and factors that contributed to these problems. Also it will focus on how nurses could support these individuals to make decisions about their care. The meaning of learning disability will be explained. The assignment will also look at major cultural and social economic influencing the health and health choices of individuals. Also it will analyze the differences between health education and health promotion and with their importance in individual in accessing health and social care. The challenges inherent in meeting the needs of people of varying abilities and social backgrounds will be look at as well as the factors that trigger the accessing of multi-professional health and social service. The essay will also discuss the understanding of the legislation related to the provision of health and social care, as a nurse why are we needed to be aware of the inequalities in provision. A name mentioned in the case study has been changed in order to comply with the code of NMC (2008) and consent was obtained from the patient and the name Anil will be used in stead.

Anil is a boy of eighteen years old who came to UK from South East Asia seven years ago. He lives with his parents in the housing estate of East London where majority are ethnic from South Asia. His father who earns minimum wages works in a food factory in six days a week, speaks English and his mother is a fulltime housewife and does not speak English, only Hindu.

Anil was born with Asperger syndrome, a lifelong disability that affects how a person makes sense of the world, processes information and relates to other people. People with Asperger can find difficult to communicate and interacts with other (NAS 2010). Anil had never been to hospital in India and he was treated by traditional healers. He only started seeks medical assistance when he moved to UK. Anil physical condition has deteriorated recently. He does not eat well; look tired, sometimes suffered headache and finding difficult in sleeping. Since he came to UK, he had been to school for three years only and he never had friends. He does not mix well with other people and his parents do not bother about this. At times he lets himself become a little neglected.

Anil represents a small and vulnerable group in a society who find difficulty in accessing and using health and social care because of the greater health care needs they have than general population. Motor and sensory disabilities, Epilepsy, hypertension and Alzheimer’s disease are some of the conditions that are common in this group (NURSING STANDARD 2010). The MENCAP report (DEATH IN DEFFERENCES 2007) states that people with learning disability are being treated wrongly in all part of healthcare provision and they are not equally valued in the health services. The government also revealed that people with learning disabilities are poorer particularly uptake of invitations on primary care and hospital provisions such as access screening services (ALD 200/01). Because of their greater needs of healthcare, they are more prone to a wide variety of additional physical and mental health problems as it shows to Anil. According to Tudor- Hart (cited in Hart 1985) there is an increasing in evidence of an ‘inverse care law’ where those who needs are greatest get the least.

Learning Disability is a life long condition which has a significantly reduced ability to understand new or complex information and it is vary from one person to another. The World Health Organization (WHO) defines learning disability as impairment of the body function which limits the activity of an individual in performing a task or action (WHO 2010)

According to Thomas and Woods in their book ‘Working with people with learning disabilities 11(2003), a learning disability is a terminology used to label people with lower level of intellectual that is lower than the average to normal people in the society. The term itself was widely accepted in England following a speech in 1996 to MENCAP by Stephen Dorrell, the then secretary for Health. From time to time the title and labels have changed and this has been driven by several influences. The term used to cover children with specific learning problems that may arises from a number of different things like emotional problems, medical problems and language impairment (BILD 2004). In the past, many people with learning disability were lived in institutions and have been labeled differently by their generations. Many different forms of terms have been used before. Terminology such as menace, sub- human organism, unspeakable objects of dread, holy innocent, diseased organism, eternal child and many more (WOLFENSBERGER,1972). There are about 1.5 million people with learning disability in UK who require different levels of support (MENCAP). It has been identified that approximately 26.5% of people who have learning disability as being associated with genetic factors (Craft et al 1985).

Learning Disabilities is caused by problems during brain development before, during and after birth (RCSLT 2009). There are different types of learning disabilities some of which are Asperger syndrome (a specific type of Autism) which affect a person the way interact to the world, reading disabilities, writing disabilities, non verbal learning disabilities (NVLD) and many more (ALD 2000-2010), reading disability (dyslexia), speech and listening disability, and auditory processing disorder. It is often detected in early childhood.

In UK there are laws and policies which describe how the needs of people with learning disabilities should be met. The purpose of these laws and policies is to improve quality of life and based on empowerment, making choices and decision, having the same opportunity and rights as other people and social inclusion. Policy such as` valuing people’ which explain how the government will provide same opportunity and choice for people with learning disabilities and their families to live full and independent lives as part of their local communities and to ensure they gain maximum life chance benefit ( DOH 2010).

The Disability Discrimination Act 1995 which is a piece of legislation promotes the rights of people with learning disabilities to access healthcare and other care services. Healthcare providers must respect, support them and their families and conforms to professional standard (NHS 2006). It is the NHS duty to make sure they provide an equal service that can be easily accessed by anyone according to this Act.

Most of the people with learning disabilities have sensory and physical impairment that make it hard to make their choices and to understand by others. A piece of legislation which protects them in England is Mental Capacity Act 2005 which is empowers and protects vulnerable people who are not able to make their own decision. People with learning disability will still have the right to give their consent for daily living and accessing the services despite of having significantly reduced ability to understand new learning skills (NURSING STANDARD 2010). If the person lack a capacity of giving or refusing consent, it is still possible for care providers to provide care and treatments for the best interest of the person (DOH 2003). A survey showed that nearly 62%of all people with learning disabilities depend on their parents and other caregivers (EMERSON et al 2005).

However, healthcare providers have a duty to understand and recognize the needs of a person with learning disabilities and make sure their needs are met. It is a nursing role to work in partnership with the clients to overcome barriers by identifying what management and decision to represent the person mostly professionally although clients and their cares may make their own decision.

People with learning disabilities in lower social classes are particularly disadvantage relative to the higher social classes in accessing healthcare services because of physical, social, psychological and economic barriers that limit their full participation in society. Acheson (1998) identified the links between inequalities and poor health. He noted that health inequalities were widening with the poorest in society being more affected than those who are well off. The post code lottery which depends on where you might live is a big issue in NHS. The availability of better treatment, drugs and waiting time in a deprived area where people depend on state healthcare provisions will carry on experience poor access to services and treatment than those who have the power of buying services in private services (GUARDIAN 2000).

People from ethnic backgrounds experience healthcare service differently due to their lack of knowledge which can be limited by the ability to communicate in English. They may find challenge to enter healthcare services because it may require, for example making a telephone call, appointment, coping with a queuing system and complex procedures ( NHS 2006). Different in culture’s attitude and stigma between where they came from and UK can impact Anil’s health. It is believed that South Asian parents don’t have positive attitudes towards disabilities because religious and superstitious beliefs (ROYAL COLLEGE OF PSYCHIATRIC 2003). Anil’s parents might not take his problem seriously because of their background and social stigma of having a child with disability (AUTISM-INDIA 2008).

According to the report of Department of Health (2009) a review in development in tackling health inequalities of Acheson, recommended the improvement of living standards of people with lower income than average. Among the people in this group are people living in a deprived area and depend on social housing. Also people with learning disability may fail to get the necessary services because of lack of understanding about health issues articulating their needs based on their poor experiences of education system (Mathews 1996).

Research carried out by Cartwright & O’brien1976 found that General Practitioners spend far less time with their patients from lower classes ( cited in Hart 1985,p59). The situation may be more complex for service users who have little or no verbal communication and those with learning disability. A learning disability person may be unable to identify and describe the signs and symptoms requiring accurate medical attention. The information may not be presented in accessible format and the staffs may ask questions which can not understand (NURSING STANDARD 2010).

Unavailability of an experience interpreter in the healthcare settings can be barrier. It can affect the sensitivity of patient’s values and attitudes. To use a professional interpreter can reassure patients to communicate and feel freer when describing their religious beliefs and unsatisfactory environment conditions but to healthcare professionals may feel disempowerment and may depend on interpreters in order to carry out their roles (ROYAL COLLEGE OF PSYCHTRIC 2003).

Sometimes physical access may be an issue for people with learning disability; they find their appointment times are often too short to understand the system because of their difficulties and transport needs to access healthcare facilities are more distant. Practitioners may be given job in deprived areas with all facility available but they may be in the risks of vandalism, theft and anti social behavior (Thomson J et al 2003 p59).

The aims of the government today in UK is convince individuals to be more involved in their health. But the problems with availability of health promotion services and involvements are some of concern due to the restructuring of health and social care for people with learning disabilities has been accelerated by NHS and community care Act (DOH 1990, Emerson Et al 1996 chap 11). For example, most of the health promotion discussion and activities to accessing suitable primary healthcare is focus on medical involvements such as immunization (Stanley et al 1998 p71). Some of this medical approach can lead to reinforced dependency for people with learning disabilities. Those with severe learning disabilities, their needs are becoming known to service providers through secondary and tertiary care after being referred by primary care. Among health promotion is prevention which is focusing on decrease of risk occurrence of diseases, disabilities and handicap. These activities occur in health care settings. Primary prevention is to prevent from risk factors such as obesity through education, exercise and diet. Primary prevention produces information on various health issues in pictorial and easily understandable format such as cancer. On secondary prevention, it involves identifies early signs of diseases occurring such as cancer screening and tertiary prevention is involves reducing the impact of the disease and promoting quality of life through active rehabilitation (Thomson et al 2003).

Anil’s state of confusion may be caused a number of factors which might need further investigation. It is the duty of his General Practitioner (primary prevention) to refer him to hospital (secondary prevention) for investigation. A consultant may decide whether Anil has physical or mental illness.

To deal with and removing barriers such as difficulty with interpersonal communication, health promotion will need to promote inclusion and reduce inequalities in service provision (Thomson et al 2003 p129). World Health Organization (2010) has made it clear that health promotion is the process of enabling individual to improve and increase control of their health. Many primary healthcare professional do not have skills to overcome this problem as results those people who have learning disabilities are less likely to receive lifestyle advice than those who do not have learning disabilities (Fitzsimmons & Barr 1997). Learning disability nurses have a variety of skills in communication and observations which could be useful to teach other healthcare professionals in health and social care settings (Thomson et al 2003 p131)

Health education as a part of health promotion is defined as a planned communication activities designed to attract well being and ill health in individuals and group through influencing the knowledge, belief, attitudes and behavior of those in power of the community at large (Tannahill 1985p167-8). For people with learning disabilities, health education might promote social inclusion through decreasing negative stereotyping by valuing and respecting their needs. On a more individual level, people who receive health education messages have a choice to decide whether to follow or not the message given (Thomson J et al 2003).

Building partnerships between nurses, careers, other professional and people with learning disabilities is essential in order to promote and educating health by identifying their physical and mental health condition (DOH 1995). A partnership is not only the way to bring up to date statutory services but also is about developing and acknowledging the collective responsibility for the health and wellbeing of the community which they belong (Thomson J et al 2003, p102).

Having the opportunity to make choice about their healthcare is critical to their sense of inclusion in society. It is also a key factor in allowing individual like Anil to feel in control of his life. The NMC (National Midwifery Council) code of 2008sets out number of responsibilities on nurses to promote choice and respect the decisions of those they care. Nurses need to help them making their choice by making some simple adaptations. The first step can be taking a little more time to explain something and giving the person with learning disability more time to understand what is being said (NURSING STANDARDS 2010, P53).

Other approach could be the involvement of relative or paid career not to make choice on behalf of the person with learning disability but to use their knowledge of the person to help the care professional interpret or to explain treatment options. In all this processes, nurses need to ensure that they obtain consent before they begin assessment and treatment. Any decision to be taken by the staff must be in the interests of the person and must regard to his or her human rights.

To conclude, the essay has set out key difficulties experienced by people with learning disabilities in accessing healthcare services and the gap between rich and poor who are accessing healthcare appear to be widening. People who have learning disabilities are generally underestimated and find themselves failure to succeed their expectation. They experience more health problems than any other group in a society but use healthcare services less than the general population (RODGER 1996). Inequalities in health for people with learning disabilities must be dealt with by healthcare providers in health care provision with the aim of closing the division between the general public experiences and this group. By using good quality of health care and respecting people’s rights to access, and making reasonable adjustment, the lives of people with learning disabilities can be changed. Healthcare providers have a duty to ensure that people with learning disabilities are offered regular checking and are included in health screening program.

This essay discusses on the different types of discrimination and the different coping strategies or behaviours used. The Oxford Dictionary defined discrimination as the unwarranted or hurtful treatment of different groups of people, especially on the grounds of gender, race or age. Coping is defined as a change in cognitive and behaviour to evade harmful event. Discrimination affects an individual physically, mentally and emotionally. Studies have shown that discrimination can lead to depression. However, there have been various coping behaviours that have been identified to help victims of discrimination. Further studies need to be conducted to address other types of discriminations such as old age, disabled, workplace and others.

Keywords: Racial Discrimination, Gender Discrimination, Coping Behaviours

Discrimination and Coping

Discrimination has been present for hundreds and hundreds of years. Discrimination is defined as the unwarranted or hurtful treatment of different groups of people, especially on the basis of gender, race or age by the Oxford Dictionary. Acts of discrimination can be witnessed through many historical events such as the Holocaust, where the Jews were discriminated and murdered because the German’s believed that they were superior. Not only that but, the blacks were also a target of discriminatory acts during the Civil War where they were forced to become slaves. However, there are various ways to cope with discrimination. Coping is defined as a change in cognitive and behaviour to evade harmful events (Rantanen, Mauno, Kinnunen & Rantanen, 2011). There are many causes of discrimination.

In the western world, history is marked by BC and AD, however there was a third category which is 9/11. 9/11 marked a very tragic day in the history of United States as that was the day when the al-Qaeda launched an attack on the United States by hijacking planes and crashing them into the World Trade Center and The Pentagon. Post 9/11 witnessed a rapid increase and all time high report of discrimination, hate crimes and religion profiling (Ahluwalia & Pellettiere, 2010). Many Sikhs became the target of prejudicial and discriminatory act as they resembled the appearance of the terrorist whom wore turbans. Turbans are worn by the Sikh as a sign of faith. Therefore the Sikhs became the target of racial discrimination due to the media constantly and continuously portraying images of suspected terrorist wearing turbans. (Ahluwalia & Pellettiere, 2010).

Not only that, but it was mandatory that baptized Sikhs carry a kirpan. Kirpans are dagger liked shaped and is a symbol of peace and truth. There were such cases where the Sikhs residing in United States were sacked, downgraded, placed under probation and even came across false criminal charges due to them carrying the kirpan (Ahluwalia & Pellettiere, 2010). Due such unexpected events occurring, the Sikhs were forced to go against all their believes in order to lead a risk-free life. No stones were left unturned post 9/11 as the innocent Sikh children experienced the backlash of this event. Majority of the Sikh students in New York testified to being abused at schools due to their religion and country of origin (Ahluwalia & Pellettiere, 2010).

The September 11 attacks did not only impact the lives of the Sikhs in the United States in a negative way, but also the Muslims. A good number of atrocities took place on the streets, in convenience stores, petrol stations, educational institutions and at mosques (Abu-Raiya, Pargament & Mahoney, 2011). Many Muslims reported that they stayed indoors as they feared that they would be a victim of hate crime. Not only that, but many Muslims were concerned about their future in the country (Abu-Raiya et al., 2011).

Due to the sudden change in their environment, the Sikhs and Muslims had to find various coping methods to overcome these negative outcomes. Various research discovered that the Sikh would seek out assistance from their family, community and faith before pursuing mental health facilities (Ahluwalia & Pellettiere, 2010). The pious Sikhs seek assistance from their holy scripture the Guru Granth Sahib. This holy scripture taught them to oppress the feeling of being a victim and take control of the situation when undergoing superficial suffering such as discrimination and biasness. On the other hand, there were many Sikh men who decided that they could no longer handle the constant abuse and discrimination and made drastic changes against their culture such as cutting their hair and choosing to not wear turbans.

Similar to the Sikhs, the Muslims depended extensively on coping method related to religion such as reciting scriptures, praying and forgiveness. Research evidence found that religious behaviour increased post 9/11 attacks. There were two patterns in regard to religious coping; one pattern was positive religious coping methods and another was negative religious coping methods (Abu-Raiya et al., 2011). Researchers concluded that positive religious coping resulted in posttraumatic development whereas negative religious coping resulted in loneliness and mental instability (Abu-Raiya et al., 2011)

Asian Americans were also a target of discriminatory act pre 9/11. From way back then when Asians first stepped foot in America till now they have been faced with racism and discrimination. One might consider that discrimination against Asian-Americans might reduce as their population gets larger, however, that is not accurate. Asian-Americans are faced with discrimination on a day-to-day basis right from discriminatory terms to physical abuse (Yoo & Lee, 2005). Research validates that ethnic identity operates as a vital psychological asset that allows ethnic and racial minorities to fight against racial discrimination (Yoo & Lee, 2005). Therefore, we can see that having a strong ethnic identity and believe in one’s culture can help an individual overcome discrimination.

Another study investigated the relationship between racial discrimination stress and depressive symptoms and various coping strategies. Research suggested that the understanding of the intricacy in the involvement between perceived discrimination and health can be broadened by combining other factors into the model (Wei, Heppner, Ku, Liao, 2010). Racism and discrimination can negatively have an impact on the psychological health of their victims. Asian Americans very often encounter prejudicial insults, intentionally and unintentionally ( Alvarez & Juang, 2010). Continuous exposure to such insults and actions can take a toll on a person. It was reported that continuous taunting were positively correlated with depression ( Alvarez & Juang, 2010).

The level of coping with discrimination can be influenced by several extrinsic factors such as how frequent the discrimination occurs, the period discrimination occurs and the various types of coping behaviours either before or after the event. Research evidence also presented a previous study that was conducted by Noh and colleagues (1999, 2003) whom investigated both the individualistic coping behaviour of the Western culture (active coping) and the collectivistic coping behaviour of the Eastern culture (forbearance coping) (Wei et al., 2010). Noh and Kaspar (2003) identified that active coping helped decrease the perceived racial discrimination on depression for Korean Canadian immigrants. It can be concluded that Asian Americans should learn to practice active coping strategies by viewing the stressor in a positive way that will help develop their mental health.

Approach-type coping is another coping strategy that can be utilized to overcome the after effects of discrimination. This is then categorized into three common forms which are social support seeking, cognitive restructuring and problem solving.Social support seeking is defined participating in behaviour directed at gaining emotional support from others (Yoo & Lee, 2005). For example, an individual should open up about how they are feeling instead of oppressing everything inside. Another type of coping strategy is cognitive restructuring. Cognitive restructuring is defined as tactics that alter the significance of the harmful event and make an effort to perceive it in a positive way (Yoo & Lee, 2005). For example, an individual should view a discriminatory act as motivating and not de-motivating. Not only that, but problem solving is another coping strategy that is defined as participating in behaviour oriented at solving an issue (Yoo & Lee, 2005).

Similar to other studies, families play a very crucial role in helping victims of discrimination cope with their lives. Asian Americans have a tendency to cope with racial discrimination by communicating and socializing with their family members (Wei et al., 2010). Many cultures have faith in their religion and often turn to spiritual coping. However, it was discovered that Asian Americans did not patronize their religion and spirituality and reported it to be not constructive in coping with discrimination (Wei et al., 2010). This could be due to Asian Americans feeling more comfortable and protected with verbal support as compared to spiritual and mental support.

Other studies reported different types of coping behaviour. One study extensively classified coping as either problem focused or emotion focused. Problem-focused coping would require a confrontation with the offender whereas, emotion-focused coping would require pursuing social support (Alvarez & Juang, 2010).

Workplace sexual harassment is also a form of discrimination. Woman are more prone to this type of discrimination as they are often seen as the weaker half. Sexual harassment has been proved to negatively affect workers psychological and physical health. Not only that, but it has been identified that sexual harassment ended with female workers undergoing deterioration in their physical and emotional well-being ( Schneider, Swan & Fitzgerald, 1997).

Female workers often turn to various coping strategies to cope with workplace discrimination. Research implies that women do not use direct coping strategies such as confronting the harasser. Not only that, but it is proven that female students who undergo workplace discrimination often change plans, change workplace in order to avoid being further discriminated (Schneider et al., 1997)

Another discrimination that should be addressed other than racial discrimination is sexual discrimination. The current era has a predisposed thought that same-sex couples are very distinct from heterosexual couples. To the contrary, the faithful relationships of same-sex couples are recognized by same or parallel characteristics of heterosexual couples. However, many same-sex couples are distinguished by stigma and are confronted with discriminatory acts countless times (Rotosky, Riggle, Gray & Hatton, 2007).

Many individuals are not able to accept the fact that the number of same-sex couples is growing and it will soon become a common thing around the world. Just because two people of the same gender love each other does not make them any less of a human. In spite of this, same-sex couples undergo tremendous amount of discrimination from their family and religion. Religious and legal institutions have discriminated same-sex couples by saying that they are going to burn in hell because of their intimate relationship. These institutions that are the basics of every culture does not want to recognize that two people of the same gender can have an intimate bond (Rotosky et al., 2007).

When the discrimination against same-sex couples started becoming more and more prolific, it took a toll on them. These couples found it difficult to carry on with their everyday lives as their community and people around them made them feel like they were a cursed human-being. These couples had to gradually find ways to cope with this growing problem. The first step to coping for various couples was self-acceptance, by accepting themselves as sexual minority and seeing their relationship in a positive way. Another step was by originating a support systems made up of family members, friends and other same-sex couples (Rotosky et al., 2007).

The studies aforementioned discuss racial discrimination and sexual discrimination and the various coping strategies to cope with it. In order to improve the understanding of discrimination and it’s detrimental effect on an individual’s health, further studies needs to be conducted. Not only that, but other types of discrimination such as discrimination against the old age, discrimination against the disabled, workplace discrimination and others should be addressed.

Clear and effective communication between partners is central to working with children and young people, it allows partners to put the needs and requirements of the children first enabling them to achieve the best possible outcomes for the children and their family. Good communication between partners allows trust to be built between everyone and enables everybody concerned to share their views and have them considered and valued. Having clear and effective communication between partners helps with the collection and sharing of relevant information between all parties involved regarding the child, which may also contain sensitive information. Clear and effective communication also ensures that everyone is working towards the same aims helping to prevent any misunderstandings between partners, with one of the aims being working together to meet the emotional, health and educational needs of the children. It will also help with the process of collecting and maintaining information/records about the children providing an understanding of the children’s needs and requirements which then allows partners to provide the correct activities for individual children and maintain a safe learning environment for the children and young people. Regarding the importance of effective communication between parents/carers, clear and effective communication encourages the parent, carer or legal guardian to seek advice when needed and to use services provided which is the key to establishing and maintaining working relationships. Clear lines of communication also allow the parent/carer to discuss issues more freely and resolve problems with ease between partners if they feel there is foundation of trust built and good communication.

The policies and procedures in the work setting for information sharing are as follows,

Information regarding the children must remain confidential

Information must be stored/recorded as stated (Data Protection Act 1998)

Confidentiality & Respecting Confidentiality

Establishments storing records on a PC must be registered on the Data Protection Register

The Data Protection Act 1998 gives individuals the rights to view all information stored regarding themselves.

Staff must be familiar and conform to the guidelines

Confidential matters should not be discussed with colleagues unless necessary

Information regarding the children, establishment and staff should not be shared with third parties unless it regards to safeguarding

Confidential information must be handled with care & stored securely

Never leave sensitive paperwork/files unattended or where individuals who do not need to know will have access to them

All records must be stored safely and password protected ensuring restricted access only

Confidentiality within a setting is vital; breach of confidentiality is only acceptable when it is on a need-to-know basis. For example particular personal information may have to be shared with members of staff that specialize and deal with a child’s health, welfare or well being. Working within this type of environment means particular information has to be gathered and recorded regarding the children and stored securely, this information includes:

Names
Addresses & Contact Numbers
Medical History Records
Dietary Requirements/Nutritional Restrictions
Family Changes
Progress Reports
Child’s GP & Dentist Details
Emergency Contact Details
Special Educational Needs SEN

Sharing any of the above information is in fact a breach of confidentiality and should only be shared on a need-to-know basis, breaching confidentiality can cause great upset for a lot of individuals, loose trust and cause damage to working relationships. Breaching confidentiality within a childcare setting should only be done so in extreme circumstances, for example bullying, suspected child abuse and a medical emergency concerning the child.

Within a childcare setting there is a responsibility to ensure that all information/records are correct, kept up to date and confidential, following the settings policies and guidelines and passed onto relevant staff members only. Information and details provided by the parents/carers is given in trust and concerns the child and their family. This information should only be shared between individuals who are directly involved with the child, for example a named carer or member of staff who works directly with the child.

As a practitioner you may find yourself in a position where you want or need to share information but have been asked not to disclose any information. It may even be due to a matter of safeguarding a child within your care who you feel is at risk, putting you in a difficult position where you must break the confidence discussing it with your line manager.

When you are in the position of having to share information and maintain confidentiality, conflicts or dilemmas may surface.

For example you may find yourself being given confidential information by a parent who has trusted and confided in you as a practitioner discussing with you personal family issues, providing you with information regarding her husband leaving her and filing for divorce resulting in her feeling that she cannot manage and is also struggling to manage but requests that no one else is to be told this information. But as a practitioner being given this type of information gives an automatic concern for the child or young person’s welfare. This then may result in causing conflict or dilemma because you were placed in a position of trust and confidentiality by the parent who confided in you and specifically asked you not to tell anyone else but you are also in a position where you must consider the welfare of the child or young person and speak to your line manager, the manager has to know this information in order to care for the child effectively bearing in mind the Children Act 1989 – The welfare of the child is paramount. But it is important that the parent(s) is informed that you are going to tell your line manager this information.

Conflicts or dilemmas may also arise if a concern has been made about a child by for example a practitioner, key worker or manager directly to the child’s parents. The parents may in fact feel there is no reason for concern or that there is nothing wrong and therefore request that there is no further action to be taken or required and that no confidential information is to be shared with any other outside agencies. Putting the person with concern in a difficult position as this concern regards the welfare of the child or young person involved.

You may also find conflicts or dilemmas arising in relation to sharing information with partners and maintaining confidentiality in situations such as having concerns regarding a child’s welfare because for example you have observed frequent bruising and the child is now refusing to get changed for P.E and appears nervous and jumpy. You want to share this information but it would be inappropriate to ask permission from the child’s parents as this could possibly put the child at further risk of harm. Finding yourself in a very difficult position where you want to share information with a senior member of staff e.g. Line Manager or possibly with outside agencies.

It is important to record information clearly, accurately, legibly and concisely, meeting legal requirements to ensure any decisions or actions that have been put into place for a child or young person are not forgotten or lost and to ensure that written records are not misspelt, are containing incomplete sentences and long confusing paragraphs making it more time consuming for an individual to find the information they are want. This also allows everyone involved regarding a child or young person to receive the most accurate and up to date information and records when required and will enable individuals to refer back to the information for future reference and for the monitoring of children and young people’s behaviour patterns, giving an insight on whether the child’s behaviour has improved or gotten worse over time. It will also prevent any misunderstandings with any future reference at a later date and prevent any complications reading back on the written records. It is also important because all written records need to be up to date, dated and signed to meet the legal requirements of the Data Protection Act 1998. All settings handling personal and sensitive information/records have a number of legal obligations to protect this information under the Data Protection Act 1998. Information must also be recorded clearly, accurately, legibly and concisely, meeting legal requirements for self protection reasons to ensure that there is documented evidence in the case of something happening, which will abide by the procedures and policies put in place within your setting.

Communications and records are recorded and securely stored meeting data protection requirements by carefully carrying out the following:

All written records must be stored carefully

All records must be adequate, sufficient and relevant

Paper records should be kept stored in a locked filing cabinet

Electronic records must be (password protected)

Invoices, bills and money details are to be stored in locked files (password protected) on the computer.

Personal details about each child are to be kept within locked files and password protected documents on the computer.

All records must be maintained, kept up to date and accurate

Records and recording must comply with the Data Protection Act 1998

Personal information must be kept securely & only used for the purposes it was originally stated for.

Records must be kept safe and secure away from any unauthorized access.

Within the setting the following actions are taken to record and store information securely meeting data protection requirements

Invoices, bills, money details – Are stored in locked files (password protected) on the computer which are only accessible to the manager.

Outside agencies – If there has been a meeting of any kind with an outside agency regarding a child or young person within the setting a detailed and clear report must be typed up and a copy of the report distributed to only the relevant concerning parties involved with the child or young person.

Personal details about each child – Each child within the setting has their own individual file containing personal and sensitive information from things such as letters to parents/carers to special dietary requirements. These files are securely locked away within a filing cabinet where they must be kept and used only for the purposes originally stated. They are not to be shared with anyone other than the parents unless they have given permission to do so.

Child protection records – When making a child protection record an appropriate form is to be completed recording the concerns. The written record should consist of relevant details and accurate information. These sensitive records are then locked away and strictly controlled where only limited staff can have access, they are not to be kept on file for any longer than a 6 year period.

Child development records – Child development records are made by observing a child or young person on a daily basis and filling out an observation form and keeping a “daily diary” sometimes including photographs. These records are only shared with the child’s family and contain sensitive & confidential information which is then kept stored individually and securely.

All young children within a setting have their development monitored and recorded on day-to-day basis but if a member of staff believes there is reason for concern or a parent/carer shares concerns regarding their child’s development a meeting will be arranged where the concerns can be shared, the child’s development record reviewed and where information can be gathered on the child’s home life. If the conclusion is that the child in fact requires additional help and support with their development then the manager within the setting will complete the appropriate forms, which will then be sent to the corresponding agency(s) that will make contact with the parents/carers. For example a child who has been assessed as having a speech impediment would be referred to a speech and language team/therapist that will then assess the child and establish a programme that would then be put in place for them which would then be implemented by the teachers and TA’s within a school setting. They may also arrange one to one sessions for the child with the consent of the parents/carers and will assess the child to help recognize the cause of the speech problem or delay.

Referrals are made to ensure that a child or young person is receiving the best possible outcome and start in life. Referrals are usually made by practitioners who observe and make recordings of the child’s development and may pick up on any additional support needed, problems or difficulties the child may be experiencing. It is important to indentify a child or young person’s needs as early as possible to ensure that the child’s needs are assessed quickly and that they are referred to the appropriate setting or agency.

Referrals are made for many different reasons such as concerns regarding a child’s safety and welfare or well being etc. When a referral is required for a child who is in need it should ideally be accompanied by the consent of the child’s parents/carers. If a child or young person is suffering significant harm or abuse then social services will be involved in their case, in some cases depending on the severity of the harm the police may be involved. Other children may suffer from different problems such as emotional and/or learning difficulties. For example a child who has been assessed as having separation anxiety and sensory issues may be referred to CAMHS where they will under go different investigations and have an occupational therapy assessment and may be seen by a child psychologist. Or a child may be displaying signs of behaviour problems and thought to be displaying signs and symptoms of ADHD such as inattention during class time. And therefore may be referred for an ADHD assessment after under going a CAF assessment. They may then be referred to a hospital and consultant where further testing may take place to find out the outcome.

When a child is thought to be in need of additional help or support then a common framework is put into place known as CAF, CAF firstly provides a checklist to ensure that the child’s needs are being met and are up to the standard requirements. If the child’s needs meet the CAF standards required according to the checklist then a meeting would be held where the child’s needs would be accessed and possible support would be discussed within the group, giving the practitioner the opportunity to share their assessments, plans and recommendations for support. It is important to provide a precise, accurate and factual view on the child’s specific needs and requirements including both their strengths and weaknesses. A decision should then be made after the meeting on whether further support is required and a CAF may only then be completed once you have made an agreement with your manager and the child’s parents/carers on whether the child requires additional help and support which is not provided within the setting. During the CAF procedure the agreement will contain permission to share the findings of the CAF assessment with other agencies as sometimes outside agencies may need to be brought into the equation for the benefit of the child and their needs. You must have the parent’s permission for the competition of the CAF process when it is concerning a child and they should be kept well informed but a young person is required to give permission themselves. On competition of the assessment a plan must be built addressing the child’s needs, this should consist of short and achievable goals for the child and should include how these targets can be achieved. Plans must be reviewed and updated on a regular occurrence and referrals must involve the parents/carers and a senior member of staff.

Through attending the course of “Knowing ourselves, knowing our world”, I have increased self- awareness. Every week, I keep learning more and more about myself. Self awareness, according to Wong (2003), means recognition of our personality, strengths and weaknesses and likes and dislikes. Developing self-awareness can help us to recognize when we are stressed or under pressure. Self awareness also promotes effective communication and interpersonal relations, and also for developing empathy for others.

After I have gone to the camp, I learn to face something I used to evade. I was raised up by my aunt when I was young. I always feel difficult to live in the love between my own parents and my aunt. These persecute me for long. All these years, I have never told the others about the above thoughts. I just want to escape from these things. However, I feel so pleased that I have finally let my thoughts released out when I told my classmates in the camp. I used to evade the problem of “how to balance the relationships between my parents and my aunts and uncle”. Learning to increase self- awareness, Rothman (1999) suggests that it brings increased openness to other ways of thinking and a greater insight into other kinds of life experience. I will not escape from tackling the relationships and I can know more about my deep self. This enables me to understand my clients when they have something used to evade. I can then guide my clients to release their feelings and increase openness.

It does help me to be more aware of myself by knowing how my past experiences influence my personal values. Having an uncle who experience three marriages because of having other relationships outside of his marriage (with women from the mainland China), I personally dislike women who are come from mainland China, come to Hong Kong to marry a man and to grab our resources. I dislike like them as I think that they always intervene in their marriage. However, this hatred towards new immigrants makes me unable to make appropriate decision when a client who is a new immigrant seeks help from me. Furthermore, Biestek (1961) suggests that the relationship between the social worker and the client has been called the soul of casework. With such a bias, I may have personal value judgment and uncontrolled emotional attitudes toward the clients. As a result, it may be difficult for me to develop close relationship with the client. However, now I know and realize that my past family experiences are affecting my values and thoughts, Rothman (1999) suggested that it assists the worker to work with clients, and to control and minimize the influences of personal attitudes and beliefs that may be harmful and prejudicial toward clients.

According to Rothman (1999), as an adult, one has his own viewpoint towards something. The most concerned part in self-awareness is about the unaware perceptions, especially those negative feelings towards the others, such as biases, prejudices or stereotypes. According to Rothman (1999), they are hidden inside and covered by “acceptable” excuses and rationale. Take several minorities for an example, general people usually have some negative personal feelings and comments towards the disabled, homosexuals, prostitutes, the street sleepers and so on. Unaware perceptions may be expressed in conversations, acts or behavior since they are hidden in the subconscious. Having these unaware perceptions, as a social worker, I may unconsciously say some words which hurt clients’ feelings and make them become defensive and do not trust in me. Thus making it hard to develop good relationship with the client and hard to have intervention processes.

Besides, sharing my own feelings and opinions among peers can also help to make up my own viewpoint towards the population. I can know more about the peers’ attitudes and how the others react towards some issue by listening and sharing among a group of peers. By exchanging opinions in an overview, I can learn to think more comprehensively and to view an issue with different perspective. By gaining opinions and experiences from the others, I may then gradually change my former views towards an issue.

When it comes to the social work profession, it is common to have values or attitude conflicts with certain aspects. Self-awareness promotes several essential traits, such as openness, acceptance, willingness, trust, knowledge, interest and courage towards the clients (Rothman, 1999). When social worker can have comprehensive thoughts and view towards an issue, it can enable social worker to have a better understanding on the perceptions of the clients. Even the opinions of clients is different from the social worker’s personal view, the social worker can give clients an appropriate advice without any bias and would be more comfortable and easy to deal with the circumstances with their attitudes, values and beliefs (Rothman, 1999).. Social workers’ role is to stands right on the clients’ situations to provide services for them according to their wishes and needs. Self-awareness enables social workers to assist clients in a suitable and appropriate way.

According to Segal E.A, part of self awareness is understanding one’s down personal problems and biases, and addressing them so that they do not interfere in work with others. As a social worker (in the future), self awareness enables me to know myself and be aware of their own values, assumptions, beliefs, strengths, and weakness, so that I am able to help the clients effectively. Rothman (1999) suggests that increased awareness brings increased openness to other ways of thinking and a greater insight into other kinds of life experience. So, keeping my mind open, as a social worker (in the future), I can then listen to client’s sharing patiently, even when clients have other point of view different from mine, I can have an appropriate response and advice.

Self awareness promotes effective communication and interpersonal relations, and so as developing empathy for others. These are all elements which enable social workers to provide skillful service and positive attitude to clients. Increasing self awareness do helps me with my professional development.

DEVELOPING RURAL AREAS

Contents

Introduction.

Literature review

Current efforts to address this problem locally

Plan

References

Introduction.

Rural social work is poised to face many challenges that make it difficult for a social worker to provide services to a needy person in the community. Oppression by the society and also other social classes in the society has caused the poor to be looked down upon in the society and thus becoming hard to get the best social services.

In most of the cases that have been happening the women has seen a vast range of problems socially in the rural areas. Women and children have hence become the part of the population facing a lot of social problems. (Teasley, Archuleta & Miller, 2014).

The issue of a bad economy state has also been an obstacle to the providence of proper social services to the community. When inflation hits a country, it makes it hard and difficult for the rural community to survive with the raising prices of commodities.

Lack of support from the authorities has also caused a lot of poor service development for the needy in the rural areas. Therefore it has been seen in many cases that the policies put into place do not really favor the rural communities. Taking for instance the policies to do with medical services, high medical services hit the poor in the society and hence lives get lost every now and then.

For a good providence of social services to the rural community, resources have to be there. Lack of these resources render the social workers unable to access the areas with specific needs.an example of services that can be required is transport facilities for the social worker. If transport channels become a challenge for the social worker, it becomes hard for him/her to reach a good number of the rural population. (Witkin, 2014).

Literature review

Social working practice dates back to the ancient times where the church used to provide charity services to the community even before organizations dealing with social workers were formed. Social work was linked with the idea of charity work and by 580AD the church had already started charity work in the world and it was circulating food stuffs to the needy in the society.in the middle ages, the church become influential to the most parts of Europe and with time the practice of charity work become charity work in the 17^th century. (Vanagas & A?iA?ikienA-, 2015). Social work become a profession as well as people could now train to become social workers and serve the community.in the 19^th century it became a profession in the united states as a movement began in the states and England. In this case a system was established in which the poor were sorted into different categories as idle poor, bodied poor and impotent poor.in this particular century, revolution especially in the industrial sector took place. (McPherson & Cheatham, (2015). Therefore, technology and other scientific innovations came in to place and therefore a rural urban migration took place in those days in the western world. With this happening, social problems took course in the urban areas and therefore a missionary came into place to publicize and spread the Pentecost denominations ad therefore missioners attempted to come up with solutions for these problems in the urban areas because the cities were affected by prostitution, poverty and diseases. Therefore the church started activities like prayers and evangelism as it was releasing relief food to the poor in these areas. One of the people of steered up social work in the United States was Jane Adams who founded the US settlement house movement. Many schools to train people about social work came in to place at around 1915. This took place at the national conference of charities and corrections. After this, social work became a profession. (Parrish & Oxhandler, 2015).

Current efforts to address this problem locally

Organizations have come up now days with different strategies to deal with the problem of social work degradation. Rural development is the first step that the authorities are working on to ensure that the rural community is reached through good roads and electrification. Infrastructure development is a key thing that the government and the authorities need to develop in the rural areas. Some of the rural areas have already seen some of these development. (Mazza, 2015).

Another measure that is taken to address such problem is formation of organization to handle charity work and deal with the social work that is available in the rural areas. The organizations are governmental and some non-governmental organization. The non-governmental organizations dealing with social work are many in number and this has enabled the government to step up also and start other programs on the same. (Richards-Schuster, Ruffolo & Nicoll, 2015). Social work organizations have been organizing visits to the rural areas where the elderly and those with special needs have seen help in many areas. Some of these areas include their health, financial assistance. This program has been carried mainly by the non-governmental organizations. Due to this, the government has also borrowed this idea and emerged with a strategy to start up a development fund for the elderly and the needy in the society as part of the social work development. With such efforts in place, the work of the social worker is boosted and he/she can gain the morale to do such work. The recognition that there are people in the society with special needs is what has been steering up charity work by companies and institutions through different sponsorships. (Suk bong, Ullah & Won Jun, 2015).

Plan

Networking with other agencies is a consideration to take in order to be able to get sponsors for resources. This is because resources are an important factor to consider in order to be able to reach people from different parts of the society.

Resources like enough money is a key factor to consider in order to be able to meet the people’s needs in the society.as social workers strive to meet the needs of the rural society, it’s better for necessary resources to be provided in order to have a good strategy for the development of the rural areas.

The population census of a particular place can be taken and the number of people known. The population status should be taken and this knowledge should be made aware to the social workers because it will be at the end helpful to them. If the population of the rural society is known, the allocation of resources by the agencies will be easy and hence the needs of the people will be met. (Pitt-Catsouphes & Cosner Berzin, 2015).

Infrastructure development will always depend on the features of the place in which the target project is set to take place. The less the place is accessible the more it becomes difficult to channel transport pass ways and also electrification. The resources must be in line with the peoples preferences so that much money is not spend on trying to fund a project that is not feasible. The feasibility of the projects that help social work to gain an improvement is dependent on the adaptability of the place to welcome new ideas in the society which are helpful. Sometimes political issues can really hinder development of projects in the society and hence make potential investors and other helpful agencies to shun away from helping the society.

When the needs of the people in the society have been accessed, a plan to meet these people periodically is put into place. For instance allocation of funds can be implemented in a way that every year at a particular period amount of money is allocated to these particular people maybe the elderly with particular needs. (Clarke & Wydall, 2015).

Apart from the providence of money, the agencies and the organizations can plan to give out other tangible commodities which can be helpful to the needy. Stuff like food and clothing can be an alternative to meet these people’s needs.

At times we find some parts of the world affected and to be precise the rural society being struck by natural calamities. Places that are affected by calamities like earthquakes and flood get dented by misfortunes follow the people afterword. In this situation, social working can become very hard to conduct when there’s no proper channel to conduct them. Resources such as choppers to aid in the rescue of the survivors of such a calamity can be a challenge to acquire especially when the social workers are not registered with a particular organization to work as a team.

Apart from all these, social workers can take their job with a passion and with this strive and get trainings which will be helpful to them as they provide services to the rural community. (Sullivan, Ryser & Halseth, 2014).

Training can be facilitated by the governing authority where the curriculum can be incorporated in the education system to make the present scholars equipped with these knowledge.

Such training will be helpful for any social worker in the case of outbreaks of disasters like diseases and other calamities.in general terms the necessary thing to do in order to encourage the social work in the rural areas is to provide the social workers with the maximum corporation and support they need in order for them to gain that morale to serve the people. (Force-Emery Mackie, 2013).

References

Force-Emery Mackie, P. (2013). Hiring Social Work Faculty: An Analysis of Employment Announcements With Special Focus on Rural and Urban Differences and 2008 EPAS Implications. Journal Of Social Work Education, 49(4), 733-747. doi:10.1080/10437797.2013.812906

Sullivan, L., Ryser, L., & Halseth, G. (2014). Recognizing Change, Recognizing Rural: The New Rural Economy and Towards a New Model of Rural Service. Journal Of Rural & Community Development, 9(4), 219-245.

Clarke, A., & Wydall, S. (2015). From ‘Rights to Action’: practitioners’ perceptions of the needs of children experiencing domestic violence. Child & Family Social Work, 20(2), 181-190. doi:10.1111/cfs.12066

Pitt-Catsouphes, M., & Cosner Berzin, S. (2015). Teaching Note—Incorporating Social Innovation Content Into Macro Social Work Education. Journal Of Social Work Education, 51(2), 407-416. doi:10.1080/10437797.2015.1012947

Suk bong, C., Ullah, S. E., & Won Jun, K. (2015). Ethical leadership and followers’ attitudes toward corporate social responsibility: the role of perceived ethical work climate. Social Behavior & Personality: An International Journal, 43(3), 353-365. doi:10.2224/sbp.2015.43.3.353

Richards-Schuster, K., Ruffolo, M. C., & Nicoll, K. L. (2015). Integrating Social Work Into Undergraduate Education Through a Community Action and Social Change Multidisciplinary Minor. Journal Of Social Work Education, 51(2), 329-342. doi:10.1080/10437797.2015.101293

Mazza, E. (2015). Experiences of Social Work Educators Working With Students With Psychiatric Disabilities or Emotional Problems. Journal Of Social Work Education, 51(2), 359-378. doi:10.1080/10437797.2015.1012935

Parrish, D. E., & Oxhandler, H. K. (2015). Social Work Field Instructors’ Views and Implementation of Evidence-Based Practice. Journal Of Social Work Education, 51(2), 270-286. doi:10.1080/10437797.2015.1012943

Vanagas, R., & A?iA?ikienA-, J. (2015). THE PECULIARITIES OF SOCIAL SERVICE ORGANIZATIONS DEVELOPMENT. International Journal Of Academic Research, 7(1), 24-30. doi:10.7813/2075-4124.2015/7-1/B.4

McPherson, J., & Cheatham, L. P. (2015). One Million Bones: Measuring the Effect of Human Rights Participation in the Social Work Classroom. Journal Of Social Work Education, 51(1), 47-57. doi:10.1080/10437797.2015.977130

Teasley, M. L., Archuleta, A., & Miller, C. (2014). Perceived Levels of Cultural Competence for School Social Workers: A Follow-Up Study. Journal Of Social Work Education, 50(4), 694-711. doi:10.1080/10437797.2014.947903

Witkin, S. L. (2014). Change and Deeper Change: Transforming Social Work Education. Journal Of Social Work Education, 50(4), 587-598. doi:10.1080/10437797.2014.947897

Critical Perspective on Diversity
Introduction

Mandy, a 44-year-old female with moderate learning difficulty, epilepsy, and with a congenital deformity of her limbs has restricted mobility, and limited manual dexterity. Mandy’s condition has caused her to be cared for by her parents since she was born, with the exception of two incidents. Mandy’s father was well informed, he managed to obtain for Mandy full benefit entitlement as well as a substantial payment from the independent living fund before he passed away. Mandy’s mother is the primary caregiver, and the funds that her father set into place before he died pays for her share of living expenses, food, medication, and related allowable expenses. Additionally, the money that Mandy receives permits her to have a carer visit the home for two hours, five days a week, to assist in helping Mandy’s mother. The carer assists in helping to move and wash Mandy as well as dress her and other tasks as a result of the advancing age of Mandy’s mother, whose health is deteriorating.

The loss of her mother’s husband has left her in a state of long term grieving, for which she has been taking anti-depressants as well as anti-inflammatory drugs. Mandy’s mother has always been there for her, but she is approaching 60 years of age. Over the years, Mandy’s mother has become rather rigid in her beliefs concerning what Mandy can as well as cannot do. Mandy attends a respite care unit at a long stay hospital and has informed her key worker she wants to leave home as things there have become tense and Mandy does not get along with her mother presently as she did in the past, owing to her new condition.

Mandy’s respite care is a short term break for patients from their caregivers as well as vice versa, whereby in Mandy’s situation, she is away from home as opposed to someone coming to the house (Rett Syndrome Association, 2006). Respite care is an official program that is a part of the ‘National Strategy for Carers’ that specifically is designed to provide carers with a break from devoting their time to the individual they look after, which is seen as an important component in maintaining a healthy relationship between the caregiver and the patient (Department of Health, 2007a). Prime Minister Tony Blair, in a forward to the ‘National Strategy for Carers’ document stated “The national strategy for carers – the first ever by a Government in Britain – sets out what we have been doing, and what we are going to do. It offers practical help in ways which are needed, and which will work. Carers will have better information. They will be better supported. They will be cared for better themselves” (Department of Health, 2007a). And while Mandy’s mother performs her care giving activities out of love for her daughter, the implication is clear. The publication for the government informs us that the important service rendered by carers is performed primarily by paid caregivers, representing three-fifths of the total number of people that are looking after an individual with a disability (Department of Health, 2007a).

The publication states that women are more likely to be carers than males, and that throughout the United Kingdom there are over 855,000 individuals that care for someone over 50 hours a week, with over 5.7 million, representing one out of every six households (Department of Health, 2007a). In Mandy’s mother’s case, it represents just the ten-hour break she gets on a weekly basis. Respite care is one of the initiatives under the program-implemented buy the government to provide assistance to carers. As mentioned, Mandy has told her key worker that she would like to leave home. Because Mandy attends a respite care unit, there are no cost implications as it is a part of the national program under the National Strategy for Carers (Department of Health, 2007).

Mandy’s disability allowance, as is the case with all social care allotments, requires residency in the United Kingdom, as per the following requirements 1). That the applicant must normally be a resident in Great Britain, 2). The applicant must not be subject to immigration control, 3). The applicant must be in Great Britain when making the claim, and lastly 4). That the applicant must have been in Great Britain, the Isle of Man, and either Jersey and or Guernsey for at least 26 weeks of the last 52 weeks (Directgov, 2007a). As Mandy qualifies and has qualified under the preceding, her desire to change her circumstances from home assisted living to a long stay hospital requires a local council assessment (Directgov, 2007b). The preceding is a part of the regulations and requirements in order for the local council to assess as well as work at the support the patient needs for such a change. As Mandy is learning impaired, and her mother has stated that she is the one who decides what Mandy can or cannot do, Mandy will be filing for the change in carers without the aid of her parent. The learning disability impairment makes the preceding a difficult proposition for Mandy to take on herself, thus she will need help. Her key worker at the respite care unit has offered to help Mandy and thus in order to do so, needs to contact the disabilities teams social worker that is assigned to Mandy’s case, or simply the disabilities team itself, as well as the ‘Valuing People Support Team’ (Care Services Improvement Partnership, 2007a).

The Valuing People Support Team was established by the government to address an unintended yet real concerns and problems faced by people with learning disabilities attempting to either be their own voice, or to be heard in the social care system regarding their own personal desires and wishes (Department of Health, 2007b). Prime Minister Tony Blair aptly sums up the purpose of the Valuing People Support Team in stating that People with learning disabilities can find “… themselves pushed to the margins of our society …” as a result of unintentional circumstances in being able to find “… the right care, health services, education …” and other aspects (Department of Health, 2007b). He continued that “At best they feel obstacles are constantly put in their way by society” (Department of Health, 2007b). The foregoing is easy to understand when one realizes that an individual with a learning disability has problems in not only finding out things to help themselves, they have problems in completing the paperwork and other facets of the system that has been put there to help them, but in many instances in the past did not as a result of the gap between their learning disabilities and communicating their needs to the system without the help of family members or other parties who either might not desire them to take such an action or simply do not have the time to assist them in wading through the process (Department of Health, 2007b).

The Department of Health describes people with learning disabilities as being the most vulnerable as well as socially excluded individuals in the British society (Department of Health, 2007b). In terms of social services, as well as other branches of governmental aid, individuals with learning disabilities faced, in the past, poorly coordinated services, poor planning, and most importantly they had little choice and or “… control over many aspects of their lives” (Department of Health, 2007b). The publications continues that day services, the contact point for people with learning disabilities, were “… not tailored to the needs and abilities of the individual”, the last point being ‘abilities’ as the operative word in this instance. People with learning disabilities may be able, over a period of time, or instantly, to verbalise their wants, needs and desires, however, under a system with so many departments and layers, getting in touch with the right department represented a problem. Under the Valuing People Support Team they have a governmental agency that is their road map as well as navigator and operative arm to help them through the system as quickly as possible to the services they needs and or desire.

If one thinks about it, the Valuing People Support Team also serves another highly important service, one of being in the position of patients accessing the system. Through a governmental agency helping people to use the system their experiences will provide a wealth of feedback from cases via which to monitor the effectiveness of the entire spectrum of services offered and provided by the government in this area, and make recommendation that have power. This inside system handling of the problems of users of services through its cases is the ideal manner by which to not only put the system on its toes, it represents the perfect feed back mechanism via which to implement improvements and change.

In Mandy’s case, this means the first break from one of her parents in her entire life. A prospect, if one is to put themselves in her shoes, that must seem quite intimidating and fearful, in that she has to put her trust in what can be termed as strangers to treat her as family and see to her best interests as her father did. The Valuing People Support Team operates under four key principles, which are 1), Rights, 2). Independence, 3). Choice, and 4). Inclusion as its operational foundation Department of Health, 2007b). Applying these to Mandy’s situation enables one to see the fit and vision of the preceding. The idea is to provide them with choices, thus giving them control over their lives as opposed to being immersed in a society whereby their prospect of finding the appropriate services and or information is left to a ‘well-informed carer’ such as Mandy’s father who waded through all of the necessary steps and information gathering processes to obtain the full benefit for his daughter. In terms of where Mandy is today, in desiring to take control over her life, she needs that same type of assistance, something that was difficult to find.

In order to accomplish the objective of providing individuals with learning disabilities with the options to access the system in the manner in which it is intended to work, the Valuing People Support Team was established to function as a ‘well-informed carer’. In the instance of Mandy, the Valuing People Support Team white paper set forth that it understands and has been established to help learning disabled individuals to access housing and other services that fit their needs. In this instance it entails the shift of Mandy from home care assisted living to hospital stay assisted living. Acting in a real sense as her advocate, the Valuing People Support is there to walk Mandy through the maze of social services to aid her in the achievement of her objective. As per its web site, under the Care Services Improvement Partnership, the Valuing People Support Team is there to work with 1), Learning Disability Partnership Boards, 2), Local people and organizations, and 3), Government Departments (Care Services Improvement Partnership, 2007a). The ‘Team’ 1) offers support as well as advice to people who want to and or are seeking to change services, 2) help people to get together for the purposes of talking and sharing ideas, 3) to listen to what people are saying, and 4) to feed this information back to the government to enable them to have the direct information from the users of the system so that things can be changed and improved for the better (Care Services Improvement Partnership, 2007a).

In Mandy’s instance, the Valuing People Support Team as an advocacy department that has been specifically set up for patients with problems like herself (Care Services Improvement Partnership, 2007b).

Advocacy

The preceding represents the solution to Mandy’s problem, an advocate to listen to her concerns, counsel her as to her options, obtain agreement from Mandy as to the direction she would thus like to take knowing and understanding her options, and then to take the appropriate action based upon the foregoing. The advocacy services segment of the Valuing People Support Team offers the following services 1) self advocacy to enable individuals to speak up for themselves, 2) citizen advocacy whereby people can get to know an individual that has a learning disability and thus be able to get their wishes understood as well as heard, and 3) a short term issue based or crisis advocacy whereby a person is usually paid to speak up for someone regarding a particular issue and or when that person is in a crisis (Care Services Improvement Partnership, 2007b). The Advocacy Toolkit was set up to aid individuals in waking through what this service offers and how it can help. In Mandy’s instance, she received the help of her key worker at the respite care unit to get her to the Valuing People Support Team, which is the same course of action that would have been taken by the disabilities team.

The disabilities team would have also been able to aid and assist Mandy in the getting to her destination. These teams, disabilities, represent service groups in the individual councils that are positioned within the individual authorities, whose service parameters are limited, however, they are there to assist. A typical disabilities team web site indicates its purpose as being a point of contact regarding disabilities issues that affects young people from partner organizations and other agencies (connexions, 2007). It is in place to offer and provide specialist services to young people between the ages of 13 and 25 who have a statement of special education need. They function as well as offer a limited and lower level specialist service in the pattern of the Valuing People Support Team that is on a lower level, yet in the same vein. Specifically they offer 1) support as well as guidance to personal advisers concerning individual cases, 2) training to personal advisors concerning disability issues, 3) a direct service for young people that have complex needs, 4) an innovative working arrangement with partner organizations to help young people identify need as well as secure funding, 5) independent advice, along with guidance and information regarding local as well as national special needs provisions, 6) working with individuals as well as groups as advocates and brokers, 7) and provide access to other personal advisors whereby they can help to fulfill requirements as well as guidance as set by the government concerning young people that have a learning disability and or any other type of disability (connexions, 2007).

The disabilities team would have not been able to assist Mandy in obtaining her objective of changing her carer, as a result of her age, but could have referred her to the Valuing People Support Team in order for Mandy to complete the process. Advocacy, as stated by Valuing People is that the government’s purpose and aim in putting this service into place was to provide a range of independent advocacy services in each area that permits people with learning disabilities to be able to choose the service(s) that best meet and fulfill their needs. The independent nature of the advocacy services represents one of, if not its most important features and facets as it ensures impartiality on the part of the patient (Care Services Improvement Partnership, 2007b).

In addition to advocacy services, the Valuing People Support Team handles many, many other services, including arrangement to place someone at an appropriate residence. Specifically, the Valuing People Support Team states that a long stay hospital does not represent a good place for people with learning disabilities to live in (Care Services Improvement Partnership, 2007c). This option for Mandy is closed as all learning disability patients at long stay hospitals were moved as of March 2006 (Care Services Improvement Partnership, 2007c). Thus, the Valuing People Support Team will need to work with Mandy to hear her needs, wants and desires and advise her on her options. Mandy could not be in better hands than these, as they oversee the full range of services that are available within the health care and social services system. The fact that the Valuing People Support Team oversees the full range of services under the health and social care makes it invaluable to patients as well as those seeking help for the first time. It represents a resource that aids all of the departments in getting the person to the right area quickly and avoid moving people around form service to service, and or having them call, hunt and become frustrated in obtaining the assistance and help that they need. .

Conclusion

Mandy’s situation is in no way unique! There are others that have either similar and or drastically different problems who need empowerment in order to avail themselves of assistance and help when either in trouble or seeking the right governmental services for their condition. The existence of the Valuing People Support Team would be helpful for an immigrant without papers under hospital care in finding out exactly what their options are in terms of support, aid and immigration as a result of a recent event that ended them in that position.

Specifically, the case of a gentleman named Boris who arrived in England twenty years ago and never secured his papers. Having had a reversal in circumstances, Boris has been living illegally in England and would up in a hospital as a result of kidney failure. His circumstance in living in an unheated room at the rear of a commercial establishment was unsuitable for return to after his hospital incident that requires follow up care. And as a result of his status, housing options were not open. The Valuing People Support Team represents a resource to aid Boris and the hospital to help this individual.

The Valuing People Support Team represents an important governmental resource to aid the citizens of the United Kingdom in wading through he huge maze of services regulations and requirements that is the system of health and social services care. It is helping Mandy and countless others, and will be of aid to Boris as well

Bibliography

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