In discussion with Peter Beresford - “The implications for adult social work in a social care context”

My focus in this discussion is on social work, particularly with adults, in relation to social care policy and practice. There is a tendency to treat social work in isolation as a profession in its own right, which of course it is. However, its key context tends to be the policy which is increasingly understood as social care and this can play a significant part in shaping social work's outcomes, purpose and ideological role.

Different societies, different countries in Europe have different approaches to supporting people's rights and needs where help is required as adults - the central formal purpose of social care policy - for example, as disabled, or older people, people with learning difficulties, or mental health problems and long term conditions. As these groups have been growing significantly in number and proportion of total populations through demographic change, which they have, both in the Global north and more generally, so the frequent shortcomings of such social care policy, which is intended to support people's social rather than specifically medical needs has become clearer. It is probably true to say of European countries and beyond that generally their provision for social care has tended to be inferior to their health care provision. It has become a neglected, less considered area often, yet given the population change I have already referred to, longer term social care needs are already at least as important as acute health care ones and seem to be gaining increased significance (Beresford and Slasberg, 2023; Humphries, 2022).

UK Social Care as a Case Study

Barriers to Person Centred Support

Not surprisingly we found lots of barriers. These included:

• The lack of a well-supported well trained workforce
• Low staffing levels
• Poor working conditions
• Over-reliance on family members for support
• Institutionalization in services
• Service users' restricted access to mainstream policies and services
• Lack of capacity building support for service users

This was a research and development project working in a number of sites and we had funding in the budget to support people address the difficulties they encountered. But there were two related and important ones, which such local input and support couldn't successfully deal with: culture and funding.

The Campaign for Real Care

A new user led campaign, the Campaign for Real Care in the UK has picked up on this. As they highlight in their Charter, the 2014 Care Act here identified 9 areas of wellbeing for people needing social care support:

• Personal and physical dignity
• Physical and mental health and emotional wellbeing
• Protection from abuse and neglect
• Having control of day to day life
• To participate in work education and recreation
• For social and economic wellbeing
• For domestic family and personal relationships
• To have suitable living accommodation
• To be able to make their contribution to society

Sadly, we can say that the UK system is failing to achieve this, and many other societies may also be falling short.

United Nations Convention

This also falls far short of an international standard set out by the United Nations Convention on the Rights of Persons with Disabilities, which covers the population who are meant to get support from social care.

The Charter of the Campaign for Real Care

Very conscious of this international convention, the Charter calls for the following (quoted):

The Charter would ensure proper delivery of the Care Act. It is not risk free, nor does it promise the earth. Beware organizations that do. But it does absolutely guarantee, from day one, the first two of the three elements essential for all to have the best wellbeing possible for them.

It guarantees:

1. All needs for the best possible wellbeing for all will be identified and costed
2. Because resources will be matched to authentic need - as defined by the person themselves - the available resources will secure the greatest level of wellbeing for the greatest number of people

And the pathway will be opened to achieving the third requirement - sufficiency of funding.

Conclusion

In conclusion, I believe establishing social care policy and practice within a framework of such principles offers the best chance of taking forward arrangements consistent with the rights and interests of both service users and professional social workers and social work.

References