The social work role – servant or master?
Can social work practice based on the social model of disability
successfully challenge the oppressive practice and disabling barriers experienced by people with learning disabilities? Hannah Morgan and Elaine James report on a study to test their belief that social work is about human rights and its role is one of servant, not master.
STUDY TITLE: NAMED SOCIAL WORKERS – BETTER SOCIAL WORK FOR PEOPLE WITH LEARNING DISABILITIES,
AUTISM AND/OR MENTAL HEALTH CONDITIONS
Aims: To find out whether social work practice based on the social model of disability can successfully challenge the oppressive practice and disabling barriers experienced by people with learning disabilities.
Methods: We held workshops and focus groups with self-advocates to understand more about what they want in their lives and how they think social workers can help them achieve this. We supported the senior leadership team in a local authority to implement value-based practice and trial the role of a named social worker for people with learning difficulties. This included participating in the national pilot workshops, sharing academic resources and research and acting as a critical friend in discussions about the purpose and scope of the social work role. We shared our findings with self-advocates and practitioners from across our region to learn how we can support better social work in different agencies and locations.
This work was supported by the Department of Health, Calderdale Council and City of Bradford Metropolitan District Council as part of the Named Social Worker pilot. The views expressed represent those of the authors only and not those of the funding agencies.
BACKGROUND
In 2015 the government published its response to the consultation ‘No voice unheard, no right ignored’ (ref?). The consultation was issued in recognition that the response to the Winterbourne View scandal and attempts to transform care for people with learning disabilities, autism or mental health conditions had been too slow. One of the proposals for action was to: ‘pilot access to a named social worker who will provide professional advice and support, be the primary point of contact for the service user and their family/carers wherever the person is being supported, and provide a professional voice across the system’
The Centre for Disability Research (CeDR) at Lancaster University in partnership with Calderdale Adult Social Care applied to take part in the original pilot. We were strongly influenced by the stories we heard from families like those of Steven Neary and Connor Sparrowhawk and from the 7 Days of Action campaign about routine abuse and neglect. These stories demonstrated a health care system that is frequently restrictive and controlling in the lives of people with learning disabilities, and particularly young people at times of transition crises. The key themes from these experiences are:
- People and families are not listened to and their views not taken into account when decisions are made about them
- The most restrictive option (often hospital admission) is routinely being taken by professionals.
This is especially worrying given the Care Act (2014) and the Mental Capacity Act (2005) have choice, control and a legal obligation to select the least restrictive option at their heart. This is supported by Court of Protection judgments like that issued by Justice Hedly (2) which stated that people with learning disabilities should not be dressed up in ‘forensic cotton wool’ but allowed ‘as far as possible to make the same mistakes that all other human beings are at liberty to make and not infrequently do’. Restrictive practices frequently breach people’s human rights, especially to a family life, and are at odds with Article 19 of the United Nations Convention on the Rights of People with Disabilities, concerning the right to ‘Independent living and being included in the community’.
We wanted the opportunity to test our belief that social work that is ‘all about human rights’ (as Lyn Romeo, the Chief Social Worker for Adults in England described it), and that sees its role as one of servant, not master (3) can be the professional challenge that protects and upholds the rights of people with learning disabilities in the health and social care system.
FINDINGS
The key finding so far is that the named social worker pilot has provided social workers with the time and space to showcase what better social work looks like – social work that resonates with their values of social justice, upholding human rights and working cooperatively with the people social work is there to serve. It has less to do with creating a new role, that of ‘named social worker’. By working with people with learning disabilities as equal partners, social workers are better able to support people to live independent lives in the community.
The first three Statutory Principles of the Mental Capacity Act
- Every adult has the right to make their own decisions unless it is proved otherwise.
- All practicable help must be given to support people to make their own decisions.
- People have the right to make decisions others may see as unwise. Everyone has their own values, beliefs and preferences which must be respected.
KEY MESSAGES
- Health and social care is too often restrictive and risk averse when making decisions about people with learning disabilities
- Social work should be based on the social model of disability and a commitment to uphold people’s human rights
- Knowledge and shared understandings of better social work practice is most effectively co-produced by self-advocates and social workers working together in respectful and reciprocal partnerships.
WHAT’S NEXT?
The Department of Health are funding a second phase of the pilot over the next six months (until March 2018). CeDR are now working with Bradford Adult Social Care to implement the approach. We are also working with Bradford Talking Media, who presented at our Better Social Work Conference. In this phase, there will be workshops linked to the first three principles of the Mental Capacity Act where self-advocates and social workers will co-design the knowledge and skills social workers need to support people with learning disabilities. We will create learning materials and pilot a continuing professional development (CPD) module for social workers. We are planning another Better Social Work Conference next summer to share our learning and hear back from self-advocates and practitioners in our region about what difference social work is making.
References
- Department of Health, Government response to ‘No voice unheard, no right ignored ’ – a consultation for people with learning disabilities, autism and mental health conditions’ (Cm 9142, 10/11/15)
- An NHS Trust v P. & Anon 2013.
- Munby, Lord Justice. 2011. Safeguarding and Dignity: When is Safeguarding Abuse: Keynote address by Lord Justice Munby to the Rotherham, Doncaster and South Humber Mental Health NHS Foundation Trust’s AMPH and Social Care Conference, Doncaster.
Further reading
James, E. Morgan, H and Mitchell, R. (2017) Named social workers – better social work for learning disabled people? Disability & Society 32 (10) pp 1650-1655 DOI: http://dx.doi.org/10.1080/09687599.2017.1340019 (open access)
Easy Read version produced by Rebecca Fish http://wp.lancs.ac.uk/cedr/2017/07/10/named-social-workers-better-social-work-for-learning-disabled-people/
National Named Social Worker Pilot website hosted by SCIE https://www.scie.org.uk/social-work/named-social-worker
Hannah Morgan is Senior Lecturer &
Elaine James is Honorary Researcher
Centre for Disability Research (CeDR), Lancaster University
