Efficient Protocols for Principal Eigenvec- tor Computation over ...

University of Sheffield

MA in Social Work

Dissertation (SCS 6140)

Personalised
support systems
and disabled adults:
An analysis of the
financial barriers to
independent living



Author: Christopher Renshaw

Submitted: August 2007 Appendix 2
DEPARTMENT OF SOCIOLOGICAL STUDIES
SHEFFIELD UNIVERSITY

Research Ethics Review Checklist
This checklist should be used for all research projects. It should be accompanied
by a research proposal.

Name of student Chris Renshaw Email Sop05cpr@sheffield.ac.uk
Name of Kathy Boxall Kathy.boxall@sheffield.ac.u
supervisor k
Title of Dissertation: Personalised support systems and disabled adults: An analysis
of the financial barriers to independent living



Research checklist

(Please tick) YES NO
√
1. Does the study involve participants who are particularly vulnerable or
unable to give informed consent?
√
2. Will it be necessary for participants to take part in the study without
their knowledge/consent at the time?
√
3. Will the study involve discussion of topics, which the participants
might find sensitive (e.g. sexual activity, own drug use)?
√
4. Could the study induce psychological stress or anxiety or cause harm
or negative consequences beyond risks encountered in normal life?
√
5. Will the study involve prolonged or repetitive testing?
√
6. Will financial inducements (other than reasonable expenses and
compensation for time) be offered to participants?
√
7. Will the study involve recruitment of patients or staff through the
NHS? If it does you are alerted to the requirements for ethical
approval of NHS related research activities.
√
8. Does your research involve participants under the age of 18?

ii


IF YOU HAVE ANSWERED YES TO ANY OF THE ABOVE QUESTIONS, IN
THE BOX BELOW, PLEASE NOTE THE NUMBER AND PROVIDE FURTHER
INFORMATION ABOUT HOW YOU WILL MANAGE THIS ISSUE –
CONTINUING ON THE BACK IF NECESSARY












When reviewing the answers to these questions the ethics committee will be
concerned primarily with whether you have mounted an adequate defence of
how you intend to handle any ethical issue that arise.

Please note that it is your responsibility to follow the University’s Code of Practice
on Research Ethics http://www.shef.ac.uk/r/researchoffice/RO/ethics_policy.pdf
and the Code of Ethics for social work and social care research (see
Appendix 3). Data should also be handled in a manner compliant with the Data
Protection Act.

Please sign below to say that you have read the University Code of Practice and
the Code of Ethics for social work and social care research, and that the
information you have provided here is accurate. It is the responsibility of the
student to ensure that the research is carried out in an ethical way, and it is the
responsibility of the student to inform the supervisor of any changes that occur in
the research process. The supervisor’s signature indicates that the supervisor is
satisfied with the student’s response on this form.

STUDENT

SUPERVISOR

DATE
iii
NAME: Christopher Renshaw



YEAR OF SUBMISSION: 2007


TITLE

Personalised support systems and
disabled adults: An analysis of the
MASTER OF ARTS financial barriers to independent living
SOCIAL WORK

Abstract: Personalised support systems – care management, direct payments
and individual budgets – are designed to meet the needs of individual service
users. In recent years, government policy (PMSU, 2005) and legislation (DH,
2005; DH, 2006) has promoted the use of these systems with a growing
emphasis being placed on direct payments and individual budgets. Whilst this
development is encouraging, the government has failed to invest in the social
care system and expects, instead, that social services departments will make
“efficiency savings” and use the savings to develop personalised support
systems. Many disabled people claim that direct payments and individual
budgets enable them to live independently in the community. While there is much
evidence to support this, the extent to which independent living is achievable in
the current economic and financial climate is questionable.

The aim of this dissertation was to gain a greater understanding about the
financial barriers to independent living and to find out how the social work role in
relation to funding impacts upon social worker-service user relationships. In order
to do that, an extensive review was conducted of relevant literature. The findings
suggest that financial barriers hinder the ability of personalised support systems
to enable disabled adults to live independently, particularly in relation to rising
eligibility criteria, since many disabled adults only receive support if their needs
are “substantial” or “critical”. The findings also suggest that the role of social work
in relation to funding has a negative impact on social worker-service user
relationships.


Key Words: Personalised support systems; financial barriers; independent
living, cost efficiency; social work role.




iv
Table of Contents
Research Ethics Review Checklist ii
Abstract iv

One Introduction 1
The Social Model of Disability 2
Aims and Objectives 4
Dissertation Outline 5

Two Personalised Support Systems: History, ideology, social policy and
legislation 8
The Poor Law and institutionalisation 8
Welfare benefits and community support 9
De-institutionalisation 11
Disability activism and independent living 12
Community care and care management 14
The Independent Living Fund (ILF) 16
Direct Payments 18
In Control and Individual Budgets 21

Three Assessing the financial barriers to independent living 25
Efficiency savings 25
The impact of financial barriers on eligibility criteria 28
v
Assessing the cost efficiency of independent living 30
The “Disability Category”, capitalism and financial barriers 37

Four The social work role in relation to funding 41
What is social work? 41
The changing policy context 44
Care management, direct payments and the social work role
in relation to funding 46
Benefits 53
In Control and Individual Budgets – new funding systems and
roles 55
Service commissioning 56

Five Conclusion 61

Bibliography 6










vi
Chapter One
Introduction
In recent years, social care policy and practice has become more “personalised”
(PMSU, 2005; DH, 2005; DH, 2006). This means that services are increasingly
being designed around the needs of individuals rather than communities or
groups of service users. The Social Care Institute for Excellence (SCIE) uses the
following definitions for personalised support systems:
• “Care management – the development of individual care plans,
based on detailed assessments by budget-holding care managers,
taking full account of the service users’ wishes and needs.
• Direct payments – where people, after assessment, are given
money to pay for their own social care, along lines proposed by
them and discussed with their care manager.
• Individual budgets – a system which involves streamlined
assessment across a number of support funding streams, resulting
in the transparent allocation of resources to an individual, in cash or
in kind, to be spent in ways which suit them” (SCIE, 2007, p. 3).
Recent government policy (PMSU, 2005) and legislation (DH, 2005; DH, 2006)
acknowledges that traditional community care services have failed to meet the
needs of disabled people and has established that direct payments and individual
budgets are to be central components of social care provision in future. What the
government fails to either explicitly state or acknowledge is that, due to economic
pressures, it has not been able to provide social workers with sufficient financial
1
resources to promote independent living principles within the social work
environment (e.g. Priestley, 1999; Barnes and Mercer, 2006; CSCI, 2006; LGA,
2006; Wanless, 2006; Beresford, 2007; Ellis, 2007, Holloway and Lymberry,
2007).

The Social Model of Disability
Social policy and legislation often use medical or individual definitions of
impairment and disability. The International Classification of Impairments,
Disabilities and Handicaps (ICIDH), or similar definitions, have been used
extensively by the government and professionals working with disabled people.
The ICIDH defines impairment, disability and handicap as follows:
• “Impairment: Any loss or abnormality of psychological,
physiological or anatomical structure