Social work is concerned with people and their environment and seeks to intervene to assist in dealing with complex problems and difficulties people face in their lives. It focused on assisting the individual to reach their full potential and engages in problem solving and social change (Graham, 2007, p. 8). Social work emerged in the industrialised countries during the late nineteenth century and played an important role in Victorian society. In 1869, the Charity Organisation Society (COS) in London came together to form a charitable good works to eliminate poverty by increasing co-operation with other charities and the Poor Law, to eliminate the unequal distribution of the poor relief. Women volunteered to give assist and advice to those in need. The Beveridge report which advocated for family allowances, free health and employment services, flat rate social insurance, served as a foundation and shaped social work role in the post-war Britain (Abel-Smith, 2007). In 1954, the first generic social work course was introduced at London School of Economics (Denney, 1998, p. 18).
This eassy discusses the political relevance of social work provision for adults with learning disabilities (LD) who live in the community. It will further examine the impact of discrimination and oppression on service users and need to promote anti-oppressive practice in social work for the benefit of those with (LD). Thereafter the eassy will explore the importance of service user participation and how it informs social work practice.
The White Paper, Valuing People, defines a learning disability as ‘a significantly reduced ability to understand new or complex information (impaired intelligence) with reduced ability to cope independently (impaired social functioning) which started before adulthood, with a lasting effect on development’. Department of Health, (DoH, 2001, p. 14), discussed in Galpin and Bates, (2009, p. 50). Social work services concerned with the disabled people developed in the health and the voluntary sectors (Graham, 2007, p.127).
Before the 1960s, disability was often invisible and has always been discussed in the context of medical model on which it concerned on the individuals’ disability. Social work practice with disability was mainly influenced by the medical model as it encouraged paternalism and dependency on State Welfare benefits (Oliver, 1996). However, the social model of disability was influenced by disability movements such as MENCAP and MIND organisations, who campaigned to bring awareness to the able-bodied professionals and policy makers to focus on the social environment and participation in the management of services for people with learning disability (Oliver, 1990). The social model has gain influence and been adopted as the best way to work with disabled people, because of it influence on social barriers and attitudes of the society (Graham, 2007).
People with (LD) did not have the opportunity to access mainstream resources in the society as they were either shut away in hospitals and large institutions, and often isolated from the society. However in the 1960’s the poor physical conditions and the misconduct of staff brought to the attention of political and public perception of long stay in hospitals and institutions (Shardlow and Nelson, 2005). The Community Care came about when the newly created National Health Service wanted to rid itself of the old workhouses. However, people who needed nursing care, had no where to go so a smaller units in the community was recommended. For people with (LD), the publication of the White Paper Better Services for the Mentally Handicapped in 1971 was a landmark change Social Policy. One of the main recommendations of the White Paper was the replacement of 27,000 of 52,100 hospital places in England and Wales with residential homes in the community (Stevens, 2004) discussed in (Galpin and Bates, 2009). The community Care served as the cheaper option to deliver a high quality of services for people with (LD). This made a way for them to move into the community, for example some owned their own tenancies, some in houses with twenty four hour staff support. This promoted choice and inclusion and enabled people with learning disability to live in the mainstream of life (Thomas and woods, 2003,).
The National Health Services and Community Care Act, (1990) and White Paper Caring for People (DoH, 1989) reduced the interference and dependency through managerialism, and introduced care managers into local authorities social work and social services departments. Their role was to take assessment of the individual disabled needs and then purchase social care packages for them. In this way, local authorities became enabling authorities rather than direct care providers for people with disability (Graham, 2007, p.127; Oliver and Sapey, 2006, p. 1).
People with (LD) are discriminated against in terms of disability and other social divisions and their environment. Most often when the above occurs, the resulting experience is generally one of oppression (Thompson, 2006).The Disability Discrimination Act, states that ‘disabled people should have fair access to the mainstream society in relation to employment, access to goods, facilities or services and renting or buying property (Graham, 2007, p.130). A number of organisational practices, society and professionals view impairments as personal tragedy. People with (LD) face discrimination when seeking for employment, as most jobs are tailored to suit the able-bodied. numerous employers do not make available resources to recruit disabled people, most often this throws them to dependant roles of policies, and restrict people with ( LD) living in the community to meet the demands of independent living (Booth, 2002). Lack of confidence, disempowerment and social exclusion also sets in and the end result is oppressive. Although Social workers, cannot single handledly change the attitudes of the society and employment limitations towards people with (LD), however ‘social workers can act as resource to be used by disabled people, rather than providers of care’ (French, 1994) to effectively be involved in promoting and supporting their rights and aspirations. Social work provision should enable disabled people to overcome the barriers by assisting service users with (LD) to seek employment, to receive welfare benefits due to them and gain access to adaptation, equipment and personal support to participate fully in the mainstream social and economic life (Barnes,1991). This will lead them to dependence, self-determination and inclusion (Shardlow and Nelson, 2005).
Another major barrier that people with (LD) faces is stereotypes and negative attitudes from the society. I recall an incident during a four day holiday to Norfolk with adult with learning disability. It was a warm day so we decided to go swimming. We got to the pool and some of the holiday makers protested that service users should not enter because they might spit or urinate inside the water. The team explained that they have same rights as everyone to use the facilities. After much discussion the manager was informed and allowed us into the pool. It was very intimidating. This attitude often leads to social exclusion for service users with (LD) which often results in oppression. Even though presently there are a lot of special facilities that are in place for people with (LD), there is still stigma attached to them by organisations and accessibility to some buildings is still limited.
The introduction of the Community Care (Direct Payments, Acts, 1996) has been a significant step forward in assisting people with (LD) to achieve independent living. The Act requires the local authority to offer the payment to the individual who are eligible, enabling them to live a quality and have control over their own independence and have self determination. The policy also supports social living for people with learning disability (Hasler, 2004) discussed in (Graham 2007). People with (LD) may have their payment made to a trust fund or families to manage for them.
The Concept of Normalisation has been a great tool for people with (LD). Normalisation originated from Scandinavia and practiced in America and later came to Britain (Denney, 1998, p.88). Though time has moved, normalisation still provides insight in a variety of services development. The concept emphasise the importance of people with learning disability to live and have the same rights and social roles as the able-bodied to live within society and be part of it (Thomas and Wood, 2003). The work of John O’Brien (1987) set out ‘five accomplishments’ target to serve as a guideline for community services development and support in other to realise the principles of normalisation. The accomplishments are; community presence, choice, competence, (giving disabled people the opportunity to develop a range of skills), respect and community participation (Sharldow and Nelson, 2005, p.64).
The Valuing People White Paper, published in 2001, came as a major breakthrough for people with (LD) after thirty years of segregation. The Paper is to promote rights, independence, choice, inclusion and modernising day services now and the future for people with learning disability (Community Care Magazine, 2008,). Some local councils has come a long way to put services and support for people with (LD) such as short breaks, daytime opportunities, supported living services and adult placements. The young adult receives advice on education, healthy lifestyles and sexual relationships (www.kent.gov.uk).
From experience, service users participation promotes inclusion, enhances respect and empowerment. Learning disability ranges from mild to profound, some do have sensory and physical impairments, speech and communication impairments, and others do have challenging behaviours which sometimes affect service users with learning disability involvement in decision making (Parrott, 1999). Social work practioners may use other tools of communication to involve them in decision making. This will enable them to contribute towards their care needs and encourage them in choosing appropriate service provision through advocacy. This will challenge people with (LD) to become independent and take active part in the mainstream community (Sharldlow and Nelson, 2005).
Person-centred planning (PCP) is one of the ways forward in involving service users with (LD). A process of ‘continual listening and learning: focused on what is important to someone now, and for the future; and acting upon this in alliance with their family and friends’ (Sanderson, 2000, p.2) quoted from (Galpin, and Bates, 2009, p. 67). The listening aspect is a good social work practice and care management skill to understand the individual’s with learning disabilities choices and abilities. PCP assist social work practioners to work in such a way that, they see the individual with learning disability in context of family and community connections, friendships, their race, ethnicity and religion, gender and sexuality, their previous experiences and other factors that makes them who they are
(Galpin and Bates, 2009; Sharldlow and Nelson, 2005).
This essay has highlighted the significance areas of the historical and political context of social work provision, and it has spearheaded a reform in social work practice. It has evaluated the different ways in tackling social exclusion and suggested avenues that can be explored to promote inclusion for people with (LD). The eassy has also examined the impact of oppression on service users, and how oppressive practice has hindered professional relationship with service users, and in this context people living with learning disabilities. Drawing from analysis on various literatures, it appears that there is a gap for social work professionals to identify any development delays in promoting