Docking Benefits and Blaming the Poor

I know I covered this more generally on Monday in my rant about ‘benefits’ but it’s worth coming back to with the proposals explained in the Guardian

Magistrates and crown court judges could be asked to dock benefits from convicted criminals under preliminary proposals being drawn up by the government in response to the riots, the Guardian can reveal.

Ministers are looking hard at how benefits, or tax credits, could be taken away to show criminals that privileges provided by the state can be temporarily withdrawn.

Under the proposals anyone convicted of a crime could be punished once rather than potentially facing separate fines – first by a magistrates court and then a benefit office. By giving powers to the courts to strip benefits, the Department of Work and Pensions would not be required to intervene in the criminal justice system.

Yesterday, a little tardy, I know, I listened to the podcast of Pienaar’s Politics which I tend to really enjoy and I did except for the presence of Kelvin McKenzie and an odious interview with Iain Duncan-Smith in which he discussed this.

(Iain Duncan-Smith who, incidently, laughingly claimed at his constituency of Chingford and Woodford Green was ‘inner city’. Really? Waltham Forest is inner city? Really? Have I missed something? Anyway, back to the programme).

Let me explain why it is so odious if I need to.

Firstly there are the assumptions that all those who rioted are claiming benefits. Yes, I know there are links to poverty but will how will there be an equivalent punishment for someone who commits a crime and does not claim any money from the State. This is an intentional scapegoating and targeting of poverty.

The riots were awful but the causes run much much deeper and broader than ‘gangs’ and ‘benefit fraud’.

Duncan-Smith in a truly odious and preaching manner seemed to make links between ‘generations of joblessness’ and the feckless claimants. He emphasised his joy in ripping away support for those who received Invalidity Benefit and while me gave a cursory nod to those who might have caring roles – he mentioned them solely in terms of the money that they save the government.

How about truly visionary leaders that display integrity and leadership rather than those who pander solely to  the lowest common denominator of cheap ‘kicks’ at those who need to claim money for support and those who are not able to afford the lives they see the privileged lead.

This week we have seen our millionaire cabinet members talk about the ‘feral underclass’ (Kenneth Clarke who was one of the few Tories I had a smidgeon of respect for previously).  Really?

Yes, the people involved in the riots may well have been some of the poorest and most disengaged but that doesn’t mean the cause of the riots needs to look solely at those who were out on the streets looting. If it does, it allows the cosy middle classes to look on from the suburbs (or in IDS language ‘inner cities’) to preach from their own comfortable positions of superiority.

These riots, this inequity, it is the problem of ‘other people’.

Surely the riots, the way that culture has become so consumerist in its nature, the dishonesty and the lack of censorship of anything other than ‘getting away with it’ the lack of inherent understanding of right from wrong in any other terms – that is not a problem of the poor and it is not a problem which is solved by taking away ‘benefits’. That merely pushes all the problems of a society onto one particular class that will match with the photofit of ‘problems’ that rest most easily in the middle-class heads. By looking at analysis of ‘who rioted’ or rather ‘who was caught‘ and looking at lists from magistrate’s courts we provide a very narrow view of what was responsible in our society for creating a moment when people thought they could ‘get away with it’.  The riots were not about who was rioting. They were about what is and has been happening within our society from top to tail and by concentrating reasons and solutions on the lower end, we allow those more privileged  to get away with all kinds of poor behaviours and excuse the problems that their behaviours have caused which have led to such strong feelings of disillusionment.

Personally and I base this on no research base other than my gut feeling, I think the problem  and the problems in society must be examined in a much deeper and more fundamental way. In England, at least, we have seen successive scandals and betrayals from the finance services through the collapse and deceit in the banking system, the MPs fiddling expenses compulsively, the Press through the phone hacking scandals and the police for bribery.

While politicians lament of a world where people loot ‘because they can get away with it’ and only refrain from crime not because of an inherent ethical desire but because they will not be caught, it is impossible to separate those who loot shops from those who loot the public purse. Those who sit in their comfortable suburban (sorry, inner city) homes.

How can we, as a nation, allow our poorest people to be scapegoated by an establishment (financial/political and media) that has been equally deceitful but who will never feel ‘benefits’ being taken away because they are all wrapped up in each others’ collective pockets. They will never be evicted from their council houses because of the behaviour of their children because they are fortunate enough to own their own homes and they will never suffer from having child benefit withdrawn when their kids truant because they aren’t reliant on child benefit and their children have trust funds.

How can we allow this to be the voice of ‘reason’ in the country?

I truly can’t understand it but I know it makes me angry.

Medication and Care Homes

Today, the BBC is reporting on a research study from the University of London which finds that seven out of ten residents out of the 256 residents in 55 different care homes were subject to errors in their medication regime.

The summary of the report suggests that the reasons for this are

inadequate information, over-worked staff, poor teamwork and often complex courses of medication

I wonder how much of these issues could be addressed by better training and better staffing levels – the things that often can be the most costly.

I spent 7 years working in residential homes before I qualified (and while I was training). I know that however good the regulation is, there is always scope for errors and rushed jobs because unless CCTV cameras are placed in all areas, there is a lot of scope for people to work individually and to make mistakes – sometimes the mistakes are honest and due to wholly understandable issues, noone can legislate for human error, but sometimes they are due to tiredness due to packing in tons of overtime as the pay is so poor, sometimes because there is a lack of knowledge and system management to ensure that medication management is prioritised and sometimes it is down to staff just plain not caring enough to do a good job although that is by no means the only reason.

Looking at the errors picked up most frequently in this study, they are

wrong dosages, insufficient monitoring of residents after medication had been taken and people being given the drug at the wrong time

I’m not sure how wrong dosages can be explained away but I can understand insufficient monitoring and drugs given at the wrong times because those can often be matters of staffing levels, especially in some of the larger care homes. I worked in a small home where there were five residents and there were always between two and three members of staff on duty at any given time, so medication management could be individualised and monitored but in some of the care homes I visit now with up to 80 residents, the level of staffing may not allow for such individualised care. It isn’t right, but it is cheaper.

This is also an issue which is brought up by the changing and more complex needs of those who are needing residential and nursing care. Whereas in the past, the idea of a convalescent or rest home was more of a longer term stay issue, now it is only people who can no longer be supported at home due to complex needs that are accessing residential care, meaning that there are more extensive medication needs.

At least a report that highlights this can focus some more attention on the needs of those who do need residential care. Hopefully, it will concentrate the minds of those who commission services and provide placements as well.

Tories’ Insurance Plan

I like to follow the news and so, yesterday, when I heard about the plan proposed by the Shadow Chancellor, George Osborne to allow those approaching 65 to purchase a type of insurance policy for roughly £8000 to cover future cost of nursing or residential home fees, the idea actually baffled me.

image banalities at Flickr

Sure, it served it’s purpose and made lots of headlines about the stretched middle classes who resent that they have pay for services that they receive in later life, even if it means selling their own home to do so.  But the proposal made me wonder how much Osborne and the Conservative Party actually know about the current system and the changes that the ‘Putting People First’ agenda is pushing or whether (which I suspect is the answer) they are chasing cheap headlines.

I will be clear and say that as a home-owner, there is no way on earth I would recommend anyone taking out this insurance at 65. The likelihood of going into ‘care’ is minute. Some newspapers quoted the figure but the current policy is to (quite rightly) keep care in the home as much as is possible. Those who have underlying health conditions that might indicate a propensity to need this  type of care would be excluded from the ‘insurance scheme’.

I suppose I come from a position of seeing how much care costs to the local authorities who fund it and thinking that if someone can pay for their own care, there is no reason that they shouldn’t, however I know that is not the opinion of the majority of the Great British Public and it is politically expedient to provide a ‘solution’ to this issue for the voters.

As pointed out in the Independent, the option of taking insurance against long-term care already exists in the private sector insurance market so presenting this as a public policy also makes little sense.

As with all policies though, the devil is often in the detail rather than the grand posturing designed to capture the attention of the media – just as Labour’s ‘free care for those with highest needs’ did last week.

I am sceptical of both plans to be honest, especially as the consultation period is still open for the Green Paper on the funding of Adult Care. I will await the results of that consultation although it’s looking increasingly likely there will be a change of government next year so we might be back to the beginning again..

A future for adult social work?

Community Care carried out an investigation a couple of weeks ago which found that vacancy rates in adult and children and families’ teams were roughly equal therefore the news that the Migration Advisory Council have dropped specifically adult social work jobs from their list of ‘shortage professions’ while children and families jobs have remained may seem curious.

Further investigation though makes the move seem a little more nefarious.  The Guardian reports that

The decision to remove social workers involved in adult services from the official shortage list follows the introduction of new initiatives to increase the number of students on social work courses and to improve the retention of more experienced workers.

The decision to ban recruitment of international qualified social workers, however, will not apply to those involved in child and family services, where it is considered that a national shortage remains. The MAC’s report says recruitment difficulties in this area have been exacerbated by the negative media image of social workers responsible for children.

Understandable but it does beg a lot of questions. Are all the proposed new graduates expected to go into adult social work jobs? Or are there just going to be less qualified jobs to go round..

Hilton Dawson the new Chief Executive of BASW (British Association of Social Workers) writes in Community Care that

BASW regularly receives complaints from members in adult services who speak of major reductions in social work jobs and, significantly, of a devaluing and lack of understanding of the social work role. Social workers are beginning to feel excluded from personalisation. The unique and vital contribution that social workers can bring to this crucial agenda is being dismissed and ignored.

The Personalisation Agenda remains largely mysterious. There are a few pilots usually with capable adults who benefit massively from being able to design and determine their own packages of care and where the money should be spent but little of the literature (that I have come across – and I have looked) seems to approach those user groups that were and are poorly served by Direct Payments – namely older adults, adults who lack capacity and those with mental illnesses who have not benefited to the same extent as other groups. It makes the right noises though – user choice is, of course, an incredibly positive goal – more holistic, devolved power and services.

Although the aim of the NHS and Community Care Act was to create a role of ‘care managers’ who could help to pick and choose services from different providers and put together user-centred care packages in a holistic manner – and look where that ended? With councils bidding each other down to provide ever cheaper services from private companies who pay a minimum wage salary to inexperienced care staff to rush in and rush out of many homes and houses on tightly implemented limiting packages where there is no scope for any ‘leisure’ activities apart from local day centres – is that was what envisaged when it was laid before Parliament? I don’t want to be over-cynical but it’s hard not to be.

So where does that leave adult social work?

There is likely to be a continuing need in adult protection but the sizes of teams will not be equivalent. In mental health teams which move more progressively towards generic roles, Approved Social Workers have transmuted into Approved Mental Health Professionals – and although the place of a voice for the social model of mental health care remains more than necessary, there is a move towards job adverts more generically calling for ‘mental health professionals’ rather than Social Workers, or CPNs or Occupational Therapists.

There is no doubt in my mind that a signposting role has significant importance for older adults and some people, even those who might not fit into the criteria for a mental health team, do need more outreach work  but is that a place for statutory services?

Perhaps the future of adult social work is actually in the voluntary sector?

It isn’t surprising that protecting children is seen as more ‘urgent’ but really the levels of abuse of older adults is often overlooked – and although it shouldn’t be a case of ‘compare and contrast’ it is difficult to ignore the push to marginalise further vulnerable adults when honestly, abuse of a person is abuse of a person – cruelty is not dependent on age.

As care services become more tailored to the ‘30 min’ rush-in rush-out visits that rarely last 30 minutes there is a greater scope and need for a more cohesive protective and preventative service in a sector that has almost no lee-way to work on any preventative measures apart from for a very small group of people who might fit into specific criteria in a specific service.

All the focus and interest remains very much in the domain of those who work with children and understandably so – it is more emotive and of more immediate concern to the general public.

I wonder why it is so few people are actually concerned about the services or lack of them, provided for older adults. Personally, I think it’s because we don’t want to think about getting old – young people, children – they are ‘other people’ – older adults, they are our parents, and us – eventually. Sometimes we just don’t want to be reminded but one day we are going to have to be.

Ageism and Justice

Community Care reports on a proposal by the Crown Prosecution Service (CPS) to recommend more severe sentences to those who commit crimes against older people

The policy is the last to be published on six “equality strands” and brings victimisation due to ageism in line with crimes driven by racism, homophobia, religious hate, disability hate and domestic violence.

coach Royal Courts of Justice

To be honest, before severe sentences are considered, I’d like to see the CPS take more action about taking seriously crimes reported by elderly people so that -any- sentence is considered.

I can personally run through many examples of protective conferences and planning meetings I’ve been party to that have whimpered to unsatisfactory endings because witnesses/victims were deemed to be unreliable witnesses in a court setting or not able to testify in a court – situations where I honestly think video-links would have been extremely helpful.

The policies currently have no teeth and as a victim’s daughter told me just earlier this week ‘why should it be that it’s my mother that has to move away from her home because of my brother’s actions?’.

No answer – but the CPS won’t take any action because of the unreliability of evidence, an injunction requires a similar level of proof and we need to ensure safety as best we can and unfortunately that means a move of someone who would in any other circumstance, be able to stay in her own home.

These are the things that constantly frustrate working in adult protection. The mechanisms just don’t exist to put into place and sturdy protective actions if the witnesses are never deemed to be reliable due to cognitive impairments. While allowances can be made for young witnesses, they rarely are for older ones.

This article explains

The policy also describes how older people who are acting as witnesses can be subject to “special measures” such as being able to give evidence by video link. Older victims will also be offered specialist advocacy services.

Seems well overdue but I’ll try not to be ungracious about it and merely add the sooner the better..

Action on Elder Abuse responded to this by adding

“There is a growing body of evidence indicating the extent and complexity of elder abuse, and the argument is becoming increasingly compelling for there to be equal parity with child protection and domestic violence strategies.”

Couldn’t have put it better myself..