Abstract
Over ten chapters, this book explores and critically evaluates the importance of the social work role within adult social care. An analysis set within the context of the changes in legislation and social policy during the 21st century, the development of the disability movement, the move from community care to the personalisation agenda, the recognition of the service user as the expert in their own needs and the advent of self-assessment.
In the introduction, the authors argue that, whilst the social work role with adults is at the core of community care, the growth of managerialism and the market agenda provide a threat. They suggest that the view of social work has become distorted; that the previously diverse role of providing emotional and therapeutic support combined with its radical, politicised and anti-establishment nature is not celebrated. Instead they argue that, with the advent of personalisation, the social work role has become limited and is now tasked with applying eligibility criteria to ration services, to act as gatekeepers to control costs and safeguarding.
To challenge this attack on its professional identify, social work will, the authors argue, need to looked at its flaws, which includes lapses into being paternalistic, a lack of alliance’s with service users and other agencies.
Lymbery and Postle argue that it is important to understand the historical context of policy in relation to adult social care. Outlining how, during the 1940s, health and social care were separated, leading, as Jane Lewis (2001, cited on p. 17) identified, to a ‘hidden policy conflict’ between the two organisations as to who was financially responsible for funding care. This fact was compounded by health being free and an ‘absolute’ right and social care being a ‘contingent’ right, (Slater, cited on p. 17) leading to a disproportionate amount of time spent arguing over funding, an argument that continues to this day, particularly in times of continued fiscal challenge.
Using a wide range of reports, Lymbery and Postle critically explore the development of community care policy, with the emphasis on a reduction in spending, the development of the private sector to provide choice, flexibility and empowerment for service users, the growth of managerialism and the development of care management.
The book then focuses on the implementation of personalisation, a new vision, aiming to enhance service users’ well-being by giving choice and control, with the advent of personal budgets, which developed as a direct result of service user pressure. However, the authors argue that as personalisation is still provided within the context of austerity measures, limited resources, finances, and managerial control, it is on the same trajectory as community care towards potential failure.
The authors contend that it is difficult to assess personalisation in terms of potential benefits for the service user. They believe it obstructs the social worker’s ability to be fully involved in its implementation, perceiving personalisation as ‘fundamentally flawed’ (p. 49), and does not represent a clear break from community care. In addition, they argue that the implementation of community care has led to the growth of managerialism, a market economy and a lack of confidence in the public sector. This provides ‘fertile ground’ (p. 95) for downgrading the social work profession to one where there is a lack of clarity of the role, where there is a requirement to meet management targets, the ability to replace social workers with unqualified personnel: factors contributing to the widespread de-professionalisation of the social work profession.
Chapter 8 offers a number of possible solutions to these problems by providing an interesting reflection on and application of social work values to the personalisation agenda. Lymbery and Postle discuss the importance of bringing together relationship-based practice and radical perspectives to actively engage with and support service users to fulfil their potential, arguing for a return to relationship-based practice. This chapter also highlights the importance of social workers re-engaging with the political agenda and fighting for social justice to re-address the inequalities that impact on service users and social workers alike.
To enable them to translate the abstract into practice, in Chapter 9, Lymbery and Postle discuss the importance of social workers practising in an ethical way, demonstrating how they envisage this by applying their ideas to a variety of case studies from a 21-year-old to an 84-year-old, which proves to be interesting and informative.
Lymbery and Postle’s writing style is easy to read and, with references back to ideas discussed in previous chapters, the book links the authors’ ideas to give an insightful overview of the development and perceived failure of community care and the subsequent development of personalisation, which they are concerned is on the same trajectory. This is a debate that will need to be considered in relation to the introduction of The Care Act, which continues the focus on personalisation, but with a focus on well-being and the prevention agenda.
The discussion is set within the context of social policy, the impact of austerity on the provision of services and the deprofessionalisation of social work. However, the book argues strongly for the importance of the social work role within adult services, which they believe requires social work education to focus on the following areas: the importance of the relational aspect of the role; the importance of social workers developing alliances with service users and organisations, and a focus on social work’s collective heritage. The book strongly advocates for social workers to regain their professional identity and to reconsider their orientation and role, thereby enabling them to better use their skills to advocate and support service users.