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Personalisation and Social Care
Personalisation has been described as a “cornerstone of the modernisation of public services” (Department of Health, 2008: 4); however there has been much discussion as to how this impacts upon the protection of vulnerable adults. Thus, it seems as though the current practices employed by social workers will have to be adapted in order to integrate personalisation into their agenda’s. This is likely to prove extremely complex given the conflictions that are likely to arise. This study will thus discuss such difficulties in more detail.
The ways in which the personalisation agenda might impact on the protection of vulnerable adults will be critically discussed in order to consider the difficulties that are likely to be associated with personalisation. This will be done by firstly looking at social work practice implications, ethics and values. This will allow a determination to be made as to whether changes to such practices will need to be made. The effect personalisation has on anti-oppressive and anti-discriminatory practices will then be discussed followed by a review of the current HCPC standards, legislation policy and guidance. Once all of the applicable information has been gathered a conclusion will then be drawn.
Social Work Practice Implications, Ethics and Values
In improving social care standards in England, the Government published the personalisation agenda in their ‘Putting People First’ (Department of Health, 2007: 1) report. This is a shared commitment and vision that seeks to ensure all adults can have control over their own lives and thus live independently. This is likely to have a significant impact on the protection of vulnerable adults since the main objective of the report was to ensure vulnerable adults have the best quality of life. It was also made clear that the “quality of independent living is fundamental to a socially just society” (Department of Health, 2007: 2). A Local Authority circular; ‘Transforming Social Care’ (Department of Health, 2009: 4) strengthened this vision further by placing additional responsibilities on Local Authorities. Accordingly, it was noted in the circular that Local Authorities must take a more pro-active role when dealing with vulnerable adults and that they must make applicable steps towards re-shaping their adult social care services, which was also supported by the Secretary of State for Health (Lansley, 2010: 5).
In spite of such governments’ policies, it is questionable whether vulnerable adults will be better safeguarded since there appears to be “little guidance into how this agenda sits alongside that of personalisation in practice” (IPC, 2010: 3). In addition, it has been argued that both personalisation and the protection of vulnerable adults, although share the same end goals, their approaches actually conflict (Gray and Birrell, 2013: 207). Thus, personalisation is generally about enabling individuals to live their own lives, whilst the safeguarding of vulnerable adults is about ensuring the safety of such individuals by conforming to a set of policies and procedures that have been created specifically for this purpose. Arguably, by giving vulnerable adults the ability to control their own lives is likely to undermine the safeguarding principles that currently exist. This carries a significant risk since vulnerable adults may not actually have the ability to take control, and this may subsequently expose them to harm and impact the protection that they are to be afforded. Whilst personalisation encourages independence, safeguarding is about acting on behalf of vulnerable adults.
Personalisation and Anti-oppressive and Anti-discriminatory Practices
It remains to be seen how personalisation can be implemented, whilst ensuring that the protection of vulnerable adults is maintained, yet noted by Carr (2010: 2); “The goal is to get the balance right, moving away from being risk averse while still having appropriate regard for safeguarding issues.” It is questionable whether a balance is easy to achieve since personalisation is all about reducing the levels of control Local Authorities place upon vulnerable adults, yet higher levels of control are needed to protect such adults from harm. This can be extremely difficult for social workers who must employ anti-oppressive and anti-discriminatory practices by developing an understanding of structural inequalities so that they can be pro-active in their work with vulnerable adults (Hopton, 2012: 47). As personalisation is contrary to this, problems are likely to arise since social workers are required to “develop creative ways of working” by a “critical, politicised and geographical view of our culturally plural society” (Gardner, 2011: 30). This is much more difficult to achieve when adopting the personalisation agenda as social workers are required to take a step back and allow vulnerable adults to take control.
HCPC standards, legislation policy and guidance
The current HCPC standards that are required of social workers are also likely to conflict with the personalisation agenda since social workers are required to act in the best interests of their service users (HCPC, 2012: 3). Accordingly, enabling vulnerable adults to live independently may not be acting in their best interests as certain individuals will require constant supervision and will need the help and support from social workers. Hence, even if it appears as though a person is capable of taking control of their own life, this may not always be the case and so it is important that social workers continue to take a pro-active role in the lives of vulnerable adults. Thus, under the ‘No Secrets (Adult Protection)’ guidance managers with the responsibility of overseeing and supervising the investigation of, and response to, adult abuse are required to ensure that “all appropriate agencies are involved in the investigation and the provision of support, and that good standards of practices are maintained” (Department of Health, 2000: 16). However, personalisation is likely to have an impact on such responsibilities as it will require a change in the way welfare services are being delivered and the ways vulnerable adults are being supervised.
Direct Payments, Exploitation and Fairer Charges
As personalisation allows the individual to have a greater choice, the government will have less control over individual budgets. Accordingly, those in need of care will thus have a choice whether to accept direct payments in order to purchase their own social care services or allow local authorities to arrange their care (MNDA, 2010: 2). Whilst it has been said that this new approach helps those in need of care to attain a program suited to their individual needs (Age UK, 2013: 1), this can actually have dangerous consequences. This is because the service user may be at risk of abuse and exploitation by family members and unscrupulous carers (8). However, provided that this risk can be managed appropriately it has been said that the personalisation agenda may actually provide individuals with a fairer charging system (Duffy, 2011: 4). However, this will not be the case for everyone and whilst some individuals may end up with a better deal, others may be expected to meet the costs of their care themselves. Arguably, whilst this system is workable in meeting the needs of certain individuals, it may actually penalise others. In addition, as put by (The Policy Press, 2011: 96) “it increases the costs of disability, encourages institutionalisation and works against independent living and person-centred support.” This is not what was intended by the establishment of the personalisation agenda and unless these inherent risks can be managed, it is likely that vulnerable adults will suffer.
Overall, it is evident that the personalisation agenda is likely to have a significant impact upon the ways in which vulnerable adults are likely to be protected in the future. This is because, the main objectives of personalisation are to enable vulnerable adults to take control of their own lives and live independently. This agenda, nevertheless, conflicts with the current practices that are being adopted by social workers in protecting vulnerable adults and as a result of this many changes are likely to be required. Whilst it is clear that a balance needs to be struck, it is likely that this will prove extremely complex when trying to put this into practice. Yet, it remains to be seen, if any, what measure will be taken by social workers in ensuring that the personalisation agenda is being employed, whilst at the same time maintaining the protection of vulnerable adults.
Age UK. (2013) Personal Budgets – More control over Your Care, [Online], Available: http://www.ageuk.org.uk/home-and-care/help-at-home/self-directed-support/ [13 January 2014].
Carr, S. (2010) ‘SCIE Report: Enabling risk, ensuring safety: Self-directed support and personal budgets’ Enabling Risk and Personal Budgets, Social Care Institute for Excellence.
Department of Health. (2000) ‘No Secrets: Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse’ Home Office.
Department of Health. (2007) ‘Putting People First; A shared vision and commitment to the transformation of Adult Social Care’ HM Government. [Online], Available: http://www.cpa.org.uk/cpa/putting_people_first.pdf [10 January 2014].
Department of Health (2009) ‘Transforming Adult Social Care’ Local Authority Circular.
Duffy, S. (2011) A Fair Society and the Limits of Personalisation. Sheffield: Centre for Welfare Reform.
Gardner, A. (2011) Personalisation in Social Work, SAGE, Social Science.
Gray, A. M. and Birrell, D. (2013) Transforming Adult Social Care, The Policy Press.
HCPC. (2012) ‘Standards of Conduct, Performance and Ethics’ Health & Care Professions Council, Your duties as a registrant, [Online], Available: http://www.hpc-uk.org/assets/documents/10003B6EStandardsofconduct,performanceandethics.pdf [10 January 2014].
Hopton. J. (2012) ‘Anti-discriminatory practice and anti-oppressive practice; A radical humanist psychology perspective’ Critical Social Policy, volume 17, no. 52.
IPC. (2010) ‘Safeguarding vulnerable adults through better commissioning’ A Discussion Paper for Commissioners of Adult Social Care, Institute of Public Care.
Lansley, A. (2010) ‘Speech to the 5th International Carers Conference’ The Royal Armouries, Leeds.
MNDA. (2010) Direct Payments and Personalisation, Information Sheet No 22B, [Online], Available: http://www.mndassociation.org/Resources/MNDA/Life%20with%20MND/Information%20sheet%2022B%20-%20Direct%20payments%20and%20personalisation.pdf [13 January 2014].
The Policy Press. (2011) Supporting People: Towards a Person-centred Approach, Social Science.