Social Workers as Agents for Change for Adults with Learning Disabilities

“Social work is a practice-based profession and an academic discipline that promotes social change and development, social cohesion, and the empowerment and liberation of people.” International Federation of Social Work Definition of Social Work (IFSW, 2014).

http://ifsw.org/get-involved/global-definition-of-social-work/

Based on your interests or experience, choose a citizen group in need of care and support (for example, looked after children, young people in the youth justice system, people living with mental health issues, adults with learning disabilities, older people living with dementia etc.). Drawing on research studies and critical commentaries that explore the experiences and perspectives of this group, discuss how social workers can be effective agents of change for and with members of this group.

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55% of social care users state that services never support their independence (Grayston, 2014, p.31). Generalised, this statement indicates high dissatisfaction amongst adults with learning disabilities (ALD) and carers across Wales. Mencap (2017, para.1) defines a learning disability as a “reduced intellectual ability and difficulty with everyday activities.” In 2018, there were 13,843 ALD residing in Wales (Welsh Government, 2018). Social worker’s (SW) have a major role in supporting ALD. The International Federation of Social Work (ISFW) (2014, para.2) describes SW as ‘a practise-based profession and an academic discipline that promotes social change and development, social cohesion, and the empowerment and liberation of people.’ Morgan (2012) adds there is a direct link between governing law and competent social work; both grounded in human rights and mental capacity law, and underpinned by the social model of disability. From these statements it is assumed that SWs are positive agents of change for ALD but in practise this is not always the case. Sapey, (2004) cited in Smith (2004), argues there is an issue of care and control; where SWs are seen to be both agents of change and agents of oppression for ALD (Priestly 1999). This essay will critically analyse this view. The social work roles of empowerment, inclusion and co-production shall be explored through United Kingdom based research and contemporary Welsh law and policy.

The Oxford Dictionary (2018, para. 1.1) describes empowerment as “controlling one’s life and claiming one’s rights.” The Department of Health (2015) states SWs need to empower ALD to exercise choice and control; in turn enabling them to make own decisions and govern choices. The Mental Capacity Act 2005 sets out core principles of which empower ALD. Principles include the insurance of access to decision making information and that best interests are upheld. This can be aided by a mental capacity “independent advocate;” who empowers the voice of an ALD to maintain and hold control of lives where there is a lack of capacity (Carr and Goosey, 2017, p. 196).

However, an exploration into social work research shows that there isn’t always correlation between law and practise. Stancliffe & Parmenter (1999), found ALD are exposed to fewer choice-making experiences in modern society. Grayston’s (2014) study found that 28% of those studied felt that they did not have substantial choice, this in comparison to 41% who felt they had no choice in their care services. Braye and Brammer (2012) saw that this is due to a conflict between ensuring best interest and safeguarding of the ALD, and respecting individual choice. Here, best interests are often held at higher regard and results in a depletion of choice. A SW is governed by the Code of Professional Practise. Section 1, sub-code 1.2, states a SW must respect choices of individuals (Social Care Wales, 2018). This can be difficult for SWs as they have to separate their own personal and professional value base (Banks, 2012). Therefore, what they believe to be most important may not reflect in what the ALD believes. This can have an effect on whether SWs are agents of change.

A SW’s role is to break down barriers and tackle oppression. This can be done through the promotion of inclusion of ALD in social work practise (Beresford and Boxall, 2012). “SWs work alongside people with disabilities and families to realise social inclusion” (IFSW, 2012, para. 6) and challenge discrimination.Underpinned by social model of disability, the 1983 All Wales Mental Handicap Strategy enabled ALD to access additional support to maximise ability to make positive choices and gain social cohesion (Beyer, Todd & Felce, 1991). Section 120 of the Government of Wales Act 1998 (GWA) and Section 77 of the GWA 2006 work in agreement with the Equality Act 2010 (EA) as it explores “equality of opportunity” for all (p. 13). The EA created “protected characteristics” and creates a perfect “climate for taking forward issues of anti-discrimination and equality of opportunity” of ALD (Williams, 2012 PAGE). The Welsh Assembly Government (WAG) promotes “mainstream equality,” (Williams, 2010, p.119) where policy and practise are intertwined with equality and diversity. Wales has stepped away from English equality law and towards this innovative approach; all about human rights Romeo (2016) and intertwined with social justice.

This combination can be seen as positive as governing law acts as an enabler of SWs to be agents of change for ALD. However, it has been documented by Sims & Cabrita Gulyurtlu (2014), that there is minimal research exploring the effect of personalisation on ALD. Oliver (1992) agrees with this view adding that research becomes invalid without the inclusion of ALD points of view. Often there is an assumption of capacity and carers or higher professionals take president in decision making (Ferguson, Jarrett & Terras, 2011). This lack of representation can lead to a barrier to SWs ability to be agents of change for ALD as policy and law in underpinned by research about ALD rather than inclusive of ALD (Department of Health, 2015). Jordan and Parkinson (2004), agree and found that SWs create inequalities through the support economics and governmental system.It is questioned whether SWs are really agents of change. Sapey (2002, p. 188-189) cited in Adams, Dominelli and Payne (2009) states that there are “structural, institutional, cultural, professional and personal barriers” to learning disability support.

Organisational care systems are seen to be fixed; this in turn creating a negative attitude barrier for ALD, who consequentially can become excluded based solely on impairment (West & Parent, 1992). Research finds that individuals seek to be included in their care services and that when they are excluded it can lead to a decrease in self-determination (Department of Health, 2015). SWs need to promote and support independence, choice and self-determination to ensure that they are included in society. Sims and Cabrita Gulyurtlu (2013) state that this increase in independence and involvement will create self- sufficiency. Leece and Peace (2010) discuss that autonomy as being individual, therefore is crucial for SWs to include ALD in care service decisions. Munby (2011) cited in James, Morgan and Mitchell (2017) state that a SW’s role is to be a servant and not a master of vulnerable individuals and carers.

Wales has taken a radical approach to combatting the exclusion of ALD’s voice from care service decisions. Published by the Welsh Assembly in 2007 the Learning Disability Strategic Action Plan (Welsh Government, 2017m para.1) was set up to ensure co-production in ALD support. This was followed by the Social Services and Well-Being (Wales) Act 2014 (SSWBA) which promotes co-production through a strengths approach where power is distributed equally and is mutual.Olsen and Carter (2016) believe that co-production works to break down the barrier produced by society and stress the importance of involvement of ALD in their own care services. It creates a platform of “‘real’ engagement” (Kight and Pettigrew, 2007, p.35) Grayston (2014) adding that ALD want a joint service, in which their voices and choices are held at high regard when making life decisions. Grayston (2014) found the 49% of individuals thought that co-production exists with consistent staff and this is important in the promotion of choice and control. Van Schronjenston Cantaman de Vak (2005) adds that if the individual does not know the people in the care services that they are more likely to put their barriers up. Therefore, it is crucial for SWs to ensure there is consistent partnership in care services. Co-production will lead to a more fulfilled services to meet needs (Olsen and Carter) and allows SWs to be agents of change for ALD.

Additionally, here it can be added that SWs ability to promote change has been affected by austerity (Taylor-Gooby and Stoker, 2011) which has led to issues of budgets and increase demand of services. Phillips and Morgan (2014) found that co-production has had a substantial impact upon the health and social services in Wales, one being a decrease in demand and in costs of services.

To conclude, it is evident that SWs are crucial within care services for ALD. But to deduce whether SWs are agents of change is difficult. Cree (2003, p.3) states “it is almost impossible to find a simple definition of social work with which everyone is likely to agree;” this due the conflict between what it is ought to be and what it is.This is because of the multiple societal barriers that social work practise faces; the examples used here were SW’s value base, governmental and organisational oppression, and lack of personalised research; of which there are many more. These factors impact whether SWs can be agents of change or consequentially become agents of oppression. The Welsh government worked to counteract this with the introduction of SSWBA, where a co-productive environment should facilitate SW’s ability to be agents of change for ALD through partnership working. Social workers should strive to remove barriers and work with “principles of social justice, human rights, collective responsibility and respect for diversities” in the hope of being an agent of change (ISFW, 2014, para.2).

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