I will also be discussing what Laws, Policies and Practices have been implemented to protect people with learning difficulties from oppression and discrimination and how effective these Laws have actually been in assisting people with Learning Difficulties to live the life they choose to live. During the late 19th century in particular, socially excluding people with learning disabilities was particularly inherent. At the time, those with mental deficiencies were regarded as degenerates, and would often be blamed for social problems such as crime and poverty.
This in turn led to the removal and institutionalisation of people thought to be feeble minded and those referred to as idiots. Wolf Wolfensberger first published his thoughts about normalisation in 1972, through his works The principle of Normalization in human service. Wolfensberger argued that many of the problems with the institutions arose from the way in which they were designed and run. The residents of these institutions were treated like numbers rather than individuals, losing their identity and also their dignity.
They were often regarded as primitive, uncontrollable and unable to be educated. The basic ideas and aims of the principles of normalisation have aimed to advocate community-based support for people with learning disabilities, whilst moving away from institutionalisation. But one of the most apparent obstacles in achieving this has been the attitude of those in the community towards people with learning disabilities. Up to this point Social workers were still using the tick box format when conducting assessments and the medical model of practice was used which resulted in oppression of the service user.
It was not until the NHS and community care Act and the community care (Direct Payments) Act was implemented in 1990s that the attitudes towards people with Learning Difficulties began to improve along with the balance in power between Social Workers and Service Users. Further implementations of legal frameworks, policies and practices such as Valuing People 2001 and the Mental Capacity Act have helped to improve Social Work practice and in turn protect the rights of vulnerable people whilst promoting Anti-Discriminator practice, Social role valorisation and normalisation.
Todays process of Social Work consists of five key stages. These are Assessment, Deciding on outcomes, Planning, Intervention and Evaluation. Inter professional working should be placed centrally throughout all stages of the social work process in order to achieve the best possible outcome for the service user. Once the service users initial assessment has been carried out, decisions can then be made regarding the individuals overall needs and also their eligibility to receive funding for care packages and/or direct payments.
Intervention can differ according to setting, but when looking at the intervention process for people with learning difficulties working in partnership and respecting the service users expertise is vital when putting agreed plans into action. This aspect of the intervention process can be linked to the exchange model as this approach promotes Anti Discriminatory Practice by empowering the service user to help make decisions about their future wellbeing.
It also meets the expectations of the service user that social workers are respecting their expertise. Milner and Obrien 2002) During the intervention process it is the duty of the care manager/social worker to ensure that services provided are meeting the required standards and that the care is co-ordinated successfully to prevent deterioration due to gaps or lapses in care. It is also the responsibility of the care manager to ensure that services users are not excluded from services or receiving care that is of poor quality by constantly checking for discrimination stereotypes and assumptions made during the social work process.
It is at this point that the intervention process can be linked with the objectives of Social role Valorisation; the objectives being to prevent people from attaining negative social roles and to promote positive valued roles in the first place. Work to reverse, or at least reduce the impact of existing negative roles and promote positive valued roles. The two key processes od social role valorisation are to enhance the social image of vulnerable people and to enhance their competencies.
Social workers are expected to monitor and review intervention lans on a regular basis. Because of this it is vital that these plans can be changed at any time to suit the needs of the individual. When changes are made it is important that other organisations involved are kept up to date with these changes to ensure that the plan remains co-ordinated and effective. Although this theory of intervention illustrates a person centred approach, there is evidence to suggest that people with learning difficulties are still being failed by society due to standardisation and computerisation which can also be known as the tick box format.
There are also many instances where there is an incorrect assessment of finances during the initial assessment process, due to the focus on resources available rather than needs. This can lead to the service user being denied access to services that they are entitled to. When looking at my case study Gemma, she has successfully been integrated into society after a comprehensive process of assessment, planning and intervention has been completed to form a person centred care package that suits her needs as an individual with profound and multiple learning difficulties, but also as a young woman who is a human being.
The implementation of policies such as Valuing People 2001 and Valuing People Now promotes personalisation within society and has given people with Learning Disabilities like Gemma the right to their own independence, choice and inclusion. Also to have the option of appointing an advocate. However, I cannot help but feel that her story of success was down to the sheer determination of her mother, who had to fight for her daughters individual needs to be met.
Social Workers and other multi professionals who were involved in assessment of Gemmas needs obviously felt that she would have benefited from institutionalisation, as it is stated that this was suggested as a future plan on numerous occasions. I cannot help but wonder whether this has been due to professionals focusing on Gemmas disability rather than focusing on her as a person. Valuing people 2001 states that the role of services is to help people no matter how complexed their disability, to live full and equal lives in their local communities.
Although the article states that ideas for Gemma to live as independently as possible were well received and finally implemented, It is also obvious that there have been constant struggles to obtain funding such as direct payments to accommodate Gemmas visions to live a normal life within her community. Following Wolfensbergers development of Social Role Valorisation, Obrien developed the five service accomplishments, which provided a practical framework to work towards Social Role Valorisation.
Obrien suggests Each accomplishment supports a vital dimension of human experience which common practice limits for people with severe Learning Disabilities. They challenge and strengthen the relationship between people with disabilities and other community members. (Obrien 1989) Recent articles published on the community care website have suggested that social workers themselves are witnessing the target-driven culture of bureaucracy within councils (just like Gemmas mum experienced ),and are aware that this has created numerous barriers to people with mental health problems gaining access to direct payments.
It has been reported that a Social Work Team Manager within Adults with Learning Disabilities actually left her role at Doncaster Council in 2010 because she had encountered these problems and felt that it hindered the intervention process. She has since started up her own Personalisation Forum Group to bring these service users together. The weekly meetings at a community centre now attract 30 regulars, providing support and regular socialising opportunities. I utilise my social work skills to help the group solve the problems that they face; this involves reducing dependency on professionals by highlighting peoples strengths, and encouraging them to think through solutions on their own and with other group members. People describe feeling part of something, like they have some power over their own future and many for the first time can see something positive, Hicks says.
Michelle Lefevre, senior lecturer in social work at the University of Sussex, says it is a sad indictment that Hicks felt she had to leave local authority social work to build such meaningful relationships with users. Not only is local government overly focused on administration rather than spending time with children and families, she says, but problems in social work degree programmes and supervision mean practitioners are not equipped to deal with the emotional dimensions of the job.
Overall it is very refreshing to read success stories like Gemmas as it seems that she is living her live as independently as possible, whilst being supported by a dedicated team of people who are constantly ensuring that she is receiving person centred care and that her wishes remain central. It is my only hope that in the future it will not require a loving parent to fight the rights of a service user and to overcome hurdle after hurdle to receive the funding and care package they are rightful entitled to, but that the service user will be granted access to the services and funding they are eligible for with ease.