On yer bike!

Housing is an issue that has been a consistent backdrop to all of the work that I’ve done since I began working in statutory social services.  There is a massive shortage of affordable housing. This leads to overcrowding, poor conditions and some heightened social problems.

I’d personally venture to make a link between the previous Conservative government’s Right to Buy scheme and the lack of public housing Especially in the areas where I live and work in London where the cost of housing has made millionaires of those who did access their ‘right to buy’ and thus deny future generations access to low cost local housing.

I also feel strongly because I have seen private landlords squeeze and squeeze those who are still renting privately – including many older people who still have the secured tenancies – as every kind of adaptation is denied as a means to get the ‘cheap’ tenants to leave a property whose market rent may be much higher. It seems particularly cynical when the properties were bought as investments with sitting tenants.

So now Mr Duncan-Smith is proposing a ‘get on your bike’ type policy of promoting workforce mobility and according to the Telegraph, speaks of people who are ‘trapped in estates where there is no work’ without the possibility to move due to not being able to lose their tenancies. His proposed scheme would allow these people to ‘go to the top of housing lists’.

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Forgive me if I chortle bitterly at this point. There’s no benefit in ‘going to the top’ of a list if the list is already full and there is no housing available.

Along with this, and perhaps to promote his programme of ‘mobility’ he also talks of “tons of elderly people” living in homes they cannot run as he announced plans to tackle under-occupancy in large council properties.

I have to wonder about firstly his choice of language when he speaks of ‘tons of elderly people’. Is it really a dignified way to refer to people who have worked out their whole lives and who wish to retire in the same houses that they have brought families up in?

Yes, there is an issue of under-occupancy but when the Tories are fighting for the rights of those who own their own homes to pass the properties through the inheritance systems to their own – hardly disadvantaged – offspring yet they would batten down the right to a security of tenure to those who haven’t had the opportunities to buy their own property and refer to ‘tons of elderly people’ creating a perception that it is the fault of these people that there is a shortage of public housing stock rather than a direct result of the policies of the Conservative Party in the 80s.

More broadly, my concerns about this way of thinking is one of placing the blame on those who cannot find work and penalising people depending on where they live in the country. There is a concern that there will be a shift away from some parts of the country and moving to somewhere in which there might be more vacancies might not be any more guarantee of employment.

Currently and for as long as I’ve been working in London, there have been programmes focusing on under-occupancy. These are based on volunteering to give up a larger property and often involve (or at least the schemes I’m familiar with) financial incentives. Duncan-Smith seems to therefore be promoting a more ‘stick’ than ‘carrot’ approach.

My moral difficulty with this lies around the multi-millionaire ‘ruling’ classes forcing decisions about housing and where to live on those who are living much closer to the poverty line and there is such a disconnect between the experiences of these politicians and their knowledge of what life is actually like where neither housing nor employment is secure.

The solution to the housing ‘problem’ is to shift more housing into public ownership and to put a halt on the right-to-buy schemes although already some brakes have been put on that programme.

I have no doubt that some of the tax credit system of welfare benefits seems to be grossly overcomplicated and not necessarily fair but there seems to be a wholly uncomfortable picking off by the government of the weakest and poorest members of society.

And it’s not a society I feel comfortable living in.

Random Round-up

As I’m still creaking back to normal, I have come across a number of articles that made me consider and ponder which I thought I’d share. It is a little hotch-potch of different things about a variety of subjects but that’s just the way my brain is working (or not!) at the moment.

There’s an interesting piece in the Los Angeles Times written by a doctor who has been diagnosed with Alzheimer’s. It’s a short piece with perceptive insights worth a look.

Martin Narey, the chief executive of Barnardo’s has again been saying that he believes more children should be taken into care earlier. I haven’t explored the details of his views in any great detail but it is always interesting to challenge confidently held orthodoxies once in a while.

I certainly think that providing additional support to 18 and on to 24 should be a minimum expectation for children in care .I also wonder at where the additional foster care placements are going to be coming from although it reads that Narey has more ideas about extending childrens’ homes.

The Guardian has a panel article written about perspectives in caring. It is worth reading through. It consists of six personal accounts and suggestions as to how things might be improved for carers.

It’s a well put-together piece and the conclusions are unsurprising namely that carers should be valued more in our society both financially and in relation to moral authority regarding their knowledge of the needs of the cared-for person.

I was surprised/horrified by this report from a home carer quoted in the piece

Take this example: two ladies in my care are living together. Mother and daughter both have very different needs. The mother struggles to walk as her knee joint replacement has become septic and needs removing. The daughter has learning difficulties, asthma and is morbidly obese. Easily fixed? Sadly, no. The mother also suffers with severe dementia and refuses to have any personal care or treatment. She is legally responsible for her daughter, and also prevents her from having treatment.

Social services do not have the power to make both women wards of court. We, as carers do not have the authority to even call a GP to them, unless it is an emergency. My fear is that these ladies, who are already being terribly neglected, will come to serious harm, an occurrence which will force an enquiry. Why can’t this be stopped now? Because carers are gagged. We are advised by our agency to “cover our backs” and make notes of our tasks and concerns at each visit, which we do, diligently. These records are collected once every few months and immediately archived.

For me, capacity decisions cried out from this vignette. Do the women have capacity to make these decisions? In which case, no decisions can be made on their behalf as they are capacitious but if there is a question of the lack of capacity over the issues of health management or care, then this is exactly the situation that the Mental Capacity Act should be able to clarify through the use of the Court of Protection if necessary. The carers DO have the authority to call a GP if there is a lack of capacity or understanding of the need for medical attention. I truly hope that the legal position of these women is clarified and that the carer writing realises that she does indeed have the responsibility to call a GP if she feels a GP is needed and capacity is lacking.

I hope her agency are well aware of their own legal responsibilities.

Finally, an Irish MEP, Nessa Childers claims that Facebook is a public threat to the mental health of a generation. She states that

the social networking site is an addiction that caused people to “crossed the line from social networking to social dysfunction.

It’s easy to ridicule this kind of position due to a lack of understanding or intransigence about attitudes towards ‘new’ ways of connecting or networking. Personally, I see ‘facebook’ and ‘social networking’ as a tool to use rather than a use in itself and like everything, it is how we choose to use the tools rather than the tools in themselves.

Hopefully, I’ll be able to build up a bit more consistency in the posting as I still work towards recovery! Otherwise, it’s just a bit of pot luck in the meantime!

Into the Deep End

While I’m still recovering at home, my thoughts are turning over a number of things as they come up and I suspect while I am still off work, I’ll be considering some more ‘memory’ posts to keep me on top of things.

After I qualified, well, actually a couple of months before I qualified as a social worker, I lstarted looking for work. This was before the GSCC registration when a DipSW/Degree were enough to start working immediately as a qualified social worker.

Agencies were literally snapping off our hands to work for them. There was a massive shortage of social workers in every field, in every area. Many people were recruited directly out of college. I decided to sign up with a social work agency. Partly because I was very impatient to earn money after a couple of years of part-time working and partly because I was far from resolved as to which area of social work I wanted to move into and I felt the agency option might leave me some greater flexibility.

Perhaps times have changed now – this was almost exactly 10 years ago – but at that point, when I explained to the agency and subsequently in the interview, that I was a freshly qualified social worker equipped with a lot of experience of hands-on care in the voluntary sector and one statutory (first) placement there was an understanding that support would be given. There weren’t NQSW programmes but there was a desperate need for bodies at desks.

I went to work in an inner city borough in London – not the same one I work in now. Process of elimination will determine that there aren’t THAT many boroughs that count as ‘inner city London’ but I’ve now made my way through a few of them..

I was working in an older adults’ team. It was a large team and a large office. Fortunately, for me at least, there were some familiar faces as that borough has some sponsored students on the same MA course as I’d been on so went into the office already knowing a couple of people which definitely helped.

I was struck by the friendliness and the willingness to help. Yes, I was a brand new, young (relatively!) agency social worker but honestly, the team bent over backwards to assist and answer all the stupid and not-so-stupid questions I had.

I immediately was grabbed by the upping of pace between placement experiences and ‘qualified’ experiences but as regards to training and access to support, I might have been employed through an agency but there seemed no obvious difference with those who were directly employed. The caseloads were very high and the output was expected to be high. As I learnt later though, and in different teams, it could have been a lot worse. I only had my placement experience to compare it to though as all my pre-course experience had been as a hands-on carer/support worker in residential homes.

In retrospect, I realise I was very lucky to have had a good team around me. There were a lot of things I was worried about. Manning the duty phones filled me with dread, probably for the entire time I was there.

I’d like to say my manager was fair but he wasn’t desperately. While team members were friendly, competent and helpful, he seemed to have an over-fondness with appearing to be doing the ‘right’ things to his immediate managers. Since then, I’ve realised one of the most valuable assets of a good manager is to be able to fight for the things that they believe it and stand up what is ‘right’ even if it is not something that fits in with the ‘higher management’ model.

The geographic area I covered was one of immense and obvious poverty. The high rise blocks rose as trees do in thick conifer forests. Sometimes there would be glimpses of true loveliness when reaching the top of a high rise and looking out at the view of the entire city as it pans out below you. Then there was the abject despair of the broken lifts and the graffiti in the stairwells. Graffiti would be the best of it. The vomit, the bloodstains, the urine and faeces – human and animal. But there were also some of the most beautifully kept houses I’d seen as well. Sometimes, in some areas, the stairwells became places to congregate and trade all manner of illegal goods and substances with the residue very obvious – discarded needles, used condoms. There seemed to be little dignity in the external presentation of some of the estates which often contrasted acutely with the dignity retained within the flats that I visited.

I have always been fascinated by stories and peoples’ stories. By trudging the streets (I don’t drive and mostly walked from visit to visit), I would pick up the history of the city and the neighbourhood, the familiar noises and smells. People would tell me their own and their families’ histories. There would be the histories of families who had been living in the same areas of the same city for generations and the recent arrivals from other parts of London, other parts of the UK and other parts of the world – each with a story about how they had arrived at the place they were.

One of the things that struck me was the way that all these stories intermingle in the same communities, sometimes crossing and sometimes taking themselves on different strands.

I had been leaving in various shared houses in various parts of town myself and the opening up to the true meaning of community was something that had been fairly new to me. I heard stories that I would never have been privy to in any other circumstance and the streets, as I trudged through them, took on different colours and hues. I knew, through my discussions and conversations which shops had been there for decades and which had been new arrivals. I knew where the old Bingo Hall and the old Dance Hall had been. I knew where the different community groups met and what support they provided for ‘their own’ and how to tap into these resources.

Covering duty scared me at first as I was unsure what I might come to expect and thought I was expected to ‘know everything’. Fortunately, I had many experienced people around me who didn’t mind my constant questions too much.

I remember when the first service user that I had been working for a while, died. I had been trying to arrange a residential placement for her. I had been coordinating with family members and had been to see a number of homes. We organised the move and within two days, she had died. I remember the abject sadness that welled over me. I pondered the influence of the move and the way it had happened. How anything might have changed. Discussions with more experienced colleagues helped me to think through the matters logically and I know, particularly now, working with older adults, you do see death up close, but it is still something that touches one profoundly, especially when you have spent time building a relationship with the service user and the family.

Things worked differently then as well. Care management as a model which had developed from the NHS and Community Care Act 1990 and was still at it’s earlier stages – services hadn’t necessarily been pushed to large block contractors at the same levels as they were subsequently. FACS hadn’t been introduced and each authority had their own guidelines. When I drew up care packages, I would have to cost each one on a different form before submitting it. Computers were still shared and forms could be handwritten. It seems so archaic in a lot of ways.

Some ‘new’ databases were just being rolled out but few people used them, certainly not as many as the managers wanted. There was some resistance to change.

I learnt a massive amount there though and took some very strong lessons with me. I made a lot of mistakes but fortunately none with grave implications. I learnt to love working with older adults and relishing the richness that a long experience of life can bring and what can be shared as a result. I saw my share of loneliness and heartbreak but also the joy of kindness and community that is brought to other lives.

It was a good place to start.

Initial Budget Thoughts

Osborne delivered the so-called ‘Austerity Budget’ yesterday. Cuts we were expecting and cuts is what we got although, and there is nothing original in me saying this, the ‘We’re all in the together’ mantra does ring a little hollow when it’s delivered by a multi-millionaire.

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I’d recommend Aethelread’s thoughts on the Budget as well. He has a well-considered piece (and I agree with a lot of what he wrote as well!).

I’ll run over my first thoughts on a few of the areas announced.

VAT Increase to 20%. Both unsurprising and disappointing. VAT is recognised as being the most regressive tax – yes, there are exempted items but that’s hardly an argument in favour of the increase. It is impossible to argue anything other than the fact that those with the lowest incomes will suffer the most from this increase. Yes, it will bring the money in for the government but it hardly rings of the ‘fairness’ that the so-called ‘new’ politics has lauded.

Capital Gains Tax increase I think this could and should have gone further and it demonstrates the lack of influence of the Lib Dems in the so-called ‘coalition’. The increase only affects those who have earnings and income over the higher threshold of £37,400. There is no doubt that the growth in the buy-to-let sector and people wanting to ‘make a killing’ in property led in part to the housing boom that saw prices skyrocket. It seems that those who pay CGT have somehow been subjected to less ‘pain’ than those who generally pay income taxes. Again, it has a vaguely regressive feel to it.

Personal allowance raised This is one of the few pieces of good news that I have seen emerge from the Budget.  It will directly help low earners and bring more people on low incomes out of the taxation regime.

Council Tax frozen This seems like good news but actually it worries me profoundly. My council froze taxes last year and local government is increasingly having more pressures places on it for funding. We are going to see a LOT of pain in local services as a result of this as the money just isn’t there. Savings can be made. Savings will continue to be made. Lets just hope they are made on cutting down on consultancy posts and biscuits in meetings rather than actual services and withdrawing posts in front line teams.

DLA medical assessments Currently DLA forms are horrific. They require a ‘professional’ as a ‘reference’ – GP, Consultant, Social Worker, CPN, OT. I’m not sure what will be achieved by demanding independent medicals apart from a further stigmatising of people who have disabilities and a creation of a great new trade for independent assessors. There seems to be a wish to appeal to the ‘Daily Mail’ contingent who directly relate ‘receiving benefits’ to ‘scroungers’ which provides an oppressive and discriminatory narrative to discussions about assistance for those who have disabilities. DLA in particular is a benefit to recognise the increased costs related directly to having a disability. I truly can’t see a purpose for these assessments except to plant a seed in the ‘general public’s’ collective mind that a lot of people who shouldn’t be receiving the benefit are. My experience is far more in Attendance Allowance (which is a similar benefit at a lower level provided to those over 65)  and to be honest, it is FAR more likely that people who are eligible do not claim than vice versa.

Child Benefit This has been frozen for three years. I can’t understand why it is not means-tested. Anyone who complains that it would be ‘too difficult’ to means-test, I’d argue that the government seems to find ways and means to introduce potentially costly measures such as ‘independent assessors’ for DLA then it can work out a way to means-test child benefit and direct it to those who have the greatest need.

Child Tax Credits Households with incomes over £40,000 will see eligibility for child tax credits fall. I haven’t really paid a great deal of attention to tax credits as, honestly, they seem incredibly complicated to me but I think that £40,000 bar sounds reasonable if cuts have to be made.

Housing Benefits Upper limits introduced to Housing Benefits paid. As someone who lives in London where the housing costs are the highest in the country, I can see these limits leading to an increased ghettoisation of families away from certain parts of the city. One of the joys for me about living in London is the way that there is a juxtaposition of rich and poor in many areas and that may well be a thing of the past. Of course receiving £104,000 in housing benefits in a year seems ridiculous but I suspect that is the exception that turns up on the front page of the The Sun or The Mail rather than the rule. The problem is that in some parts of the country, housing is very expensive. The answer in my very simplistic mind is that more social housing be built and maintained in the public sector as I am not sure I feel comfortable about the buy-to-let landlords growing rich on the back of LHA but no matter, there’s no way that’s going to happen.

All benefits to be cut Linking all benefits to the Consumer Price Index as opposed to the Retail Price Index will see an effective cut across the board to all welfare payments. We’re all in this together, right?

Public Sector Pay Frozen This is one of the ones that hits me directly. I can’t say I’m surprised. I am glad that the lower paid public sector employees have been exempted. To be honest, I can absorb a pay freeze adequately. It doesn’t fill me with joy but it’s better than tying my pay to the Consumer Price Index.

In general, I am left with an uncomfortable feeling that some of those least able to pay might be suffering the most  (VAT) and the way that DLA has been targeted seems to show very little understanding of the needs of those with disabilities other than a wish to appeal to a rabble-rousing press fixated on ‘benefits scrounging’.

But to roll out a well-used cliche, the proof of the pudding is in the eating. We’ll see. I have no doubt whatsoever there will be more cuts coming soon.

and I’ll raise a glass of cider to that!

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Cutting the Fat

Yes, it’s Budget Day today but I felt the analysis is better suited to a discussion after the announcements have been made rather than trying to second-guess them although we can say without any doubt that cuts are the order of the day.

On the barest of connections (cutting excesses – yes, I know it’s a VERY tenuous link!), I was interested in this story in the Guardian today , which reports on a study from NICE (National Institute of Clinical Excellence) which attacks the food industry for some of the contents of processed foods and how it affects general health of the population as well as suggesting some actions that should be taken.

The suggestions included banning trans-fats, bringing in tighter controls on fast food outlets which are placed close to school and ensuring that lower fat, lower salt are cheaper than unhealthier options.

The government is quoted as saying that it is an individual decision as to food consumption which is a fair point however the choices are very often stifled by cost. It is cheaper to eat processed foods. Not everyone has the same opportunity of access to some of the cheaper supermarkets and suppliers. As long as the programme of rolling out free school meals has been stalled, there is a public health issue regarding the types of foods that are available.

Public policy seems, in my mind, to have always been doing pretty badly on preventative work, possibly because there are less tangible measurable ‘targets’ to achieve by someone not getting diabetes in the first place or never taking up smoking or not falling because they were provided with strong support or not accessing mental health services because lower level supports were available.

I’m not necessarily ‘anti-targets’ but  having worked within systems where targets are paramount and linked extrinsically to funding, some are positively ridiculous and not even remotely connected to standards and levels of care.

The obsession with targets though has added extra layers of bureaucracy and certainly in social work, which, to be frank, is the area in which my knowledge base generally lies, has taken away some professional competency and expertise away from the day to day job in the interests of meeting, sometimes spurious targets.

But back to the NICE report – it makes sense. It’s something that has been known in public health circles for a while but processed is cheaper and that’s the real issue that needs to be tackled. If the government are happy to tax alcohol and cigarettes on the basis of the more general costs attached to providing healthcare for those who choose in this way, then why not subsidise and promote healthy food choices and tax higher fat foods…

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As they say, food for thought.

Cuts

Some of the coalition’s plans to cut the national budget deficit are beginning to take shape and we are beginning to see where the ‘pain’ will be felt. As I have previously remarked, the atmosphere within the service where I work anyway, has most definitely been one of austerity in the face of further reconfiguration mainly seen through a recruitment freeze and the dismissal of all agency staff.

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On a broader scale though, there were a couple of announcements made yesterday that caught my attention. The one that will have the most significant implications on adult social care funding in the short term was the news via Community Care, that the ILF (Independent Living Fund) is closing to all new applicants for this year and bearing in mind the financial year starts in April and we’ve only made it to June..

In my current job I don’t work much with the ILF as it is another service that is restricted to working age adults, assuming that those who are over 65 no longer have the same desires and aspirations towards ‘independent living’ but that’s probably another story for another day, in a previous job working with adults with physical disabilities I did a lot of work with the ILF.

It is a centrally funded scheme aimed at those who have the highest level needs. It provided a lot of the groundwork for Direct Payments historically as the money was awarded to adults with disabilities to buy their own care directly and employ PAs (Personal Assistants) and become a front-runner for the services and ways that direct payments and now personal budgets have been managed. To summarise what is a fairly complicated system, the local authorities have to provide a certain level of assistance for the individual to be eligible and then the ILF matches the funds that the local authority provides.

The implications of the withdrawal of support from the ILF are that the greater burden of funding the highest level care packages will fall directly on the local authorities and there may be a restriction in the funding that might be reserved for less critical needs such as social stimulation and accessing community facilities.

The intention of the ILF is to enable more people to stay out of residential care. Of course as a result fo the changing social structure and services, the amounts of residential care homes do not exist (quite rightly) at the same levels but a need is a need and if central government won’t fund it, it looks like an increasingly stretched local government will have to, probably at a lower level.

Of the other cuts that have been announced, the one that saddens me personally is the cut to access to free swimming for under 16s and over 60s because this is something I see with my own eyes. We go swimming every week with my foster child and while paying would be fine for us, we can easily afford it, some of her friends can’t and their parents are only able to allow them to join us because it is free but when they swim together, the barriers come down a little.

I have mentioned it before and again that I live in one of the poorest areas of the city, just this week, a 15 year old  kid was stabbed not 200 yards from our front door.

It may well be the case that a lot of the people benefiting would be able to pay anyway but I wish there would be a consideration of some kinds of means-testing, perhaps accessing free school meals as a pre-condition or highlighting some swimming pools in particular ‘deprived areas’, I don’t know but I see with my eyes a lot of the good that the policy has achieved and am saddened by it’s demise.

The local sports centre is a stone’s throw away and on Saturdays and Sundays it is full of kids of all ages enjoying the pool. I have a horrible feeling that this will change a lot after the withdrawal of this funding and there will be a lot less wholesome places for the kids to go to enjoy themselves.

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