Human motivation and professional practice: of knights, knaves and social workers (original) (raw)
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Social Policy & Administration, 2001
This paper examines the motivations of a sample of fifty providers of residential care for older people in England in . The theoretical point of departure is the "knights and knaves" categorization suggested by Julian Le Grand. A cluster analysis of the expressed motivations of the providers of residential care suggests three types: empathizers, professionals and income prioritizers. These combine knightly and knavish motives in varying degrees. Le Grand's recommendation that strategic policy towards actors in welfare services should be robust about motives is endorsed. However, a third, "mercantile", aspect of motivation is revealed reflecting providers' needs to exercise control over, and experience ownership of, their enterprises. This should also be taken into account in the design of policy. Policy decisions that are insensitive to this aspect of motivation are likely to be misguided and flawed.
Public Policy and Administration, 2004
This article will present interim research findings from a Department of Health-funded three year-project on the regulation of adult social care in England. Regulation is a very significant form of managing public services in Britain, as central government increasingly relies upon regulatory agencies and mechanisms to measure and improve the performance of agencies delivering public services. The present Labour Government's modernisation strategy has strengthened the key role of state-sponsored regulation of public services, including social care. A key plank to its modernisation agenda facing public services, and underpinned by Third Way thinking, is a move towards partnerships and collaborative governance embracing public, private and voluntary sector bodies in the delivery of public services. In the case of adult social care, this push furthers moves towards a mixed economy of welfare, where ideological 'state-versus-market' arguments take backstage to managerialist discussions about 'what works'. Public service regulation represents a 'third way' between state and market provision of public services. Our preliminary research findings support the view that regulation of adult social care, though not new nor without its tensions, has been and is being transformed as New Labour's modernisation programme of reforming public services increasingly takes hold, and that the transformed adult social care regulatory regime is consistent and informed by Third Way thinking. This article will present interim research findings from a Department of Health-funded three year-project on the regulation of adult social care in England, which started late 2003. This project forms part of the wider research programme, `Modernising Adult Social Care', launched by the Department of Health. Our research project addresses the following two questions: • what are the processes of the regulation of adult social care as perceived by different stakeholders? • what impact does regulation have upon adult social care as perceived by different stakeholders? Key stakeholders within the regulatory regime surrounding adult social care include central government sponsors of regulatory agencies (eg Department of Health, HM Treasury), regulatory agencies (eg Commission for Social Care Inspection (CSCI), General Social Care Council (GSCC)), regulated agencies (eg local authority social services departments (SSDs), private and voluntary providers of adult social care), and users of adult social care services (and their informal, unpaid carers). The four principal vulnerable adult groups investigated are the frail elderly and those adults with learning difficulties, mental health issues and physical handicap.
Beyond Modernisation? Social Care and the Transformation of Welfare Governance
Journal of Social Policy, 2008
This article reflects on the process and outcomes of modernisation in adult social care in England and Wales, drawing particularly on the recently completed Modernising Adult Social Care (MASC) research programme commissioned by the Department of Health. We begin by exploring the contested status of ‘modernisation’ as a descriptor of reform. We then outline some of the distinctive features of adult social care services and suggest that these features introduce dynamics likely to shape both the experiences and outcomes of policy ambitions for modernisation. We then reflect on the evidence emerging from the MASC studies and develop a model for illuminating some of the dynamics of welfare governance. Finally, we highlight the emerging focus on individualisation and on user-directed and controlled services. We argue that the current focus of modernisation involves a reduced emphasis on structural and institutional approaches to change and an increased emphasis on changes in the behaviou...
Needs Assessment, Street-level Bureaucracy and the New Community Care
Social Policy & Administration, 1999
In the wake of the Seebohm reforms of the personal social services, a number of studies were carried out in the 1970s to explore the role of frontline professionals in identifying and meeting social need. A common ®nding was that social workers behaved like``street-level bureaucrats'', using their discretionary authority defensively to manage an otherwise overwhelming workload. In the 1990s, top-down assessment and care management systems were put in place as part of community care reforms. Their aim was to reduce the scope of professional discretion so as to standardize responses to need and control demand according to resources available. In this paper, the authors consider the success of new systems in controlling``bottom-up'' decision-making by drawing on a recent empirical study of needs assessment practice in three types of social work team. They point out that the assessment practice of those teams facing the highest bombardment rates was most obviously criteria-driven, reinforced by the use of new technology. Rather than creating informal stereotypes to manage demand, social workers could mobilize legitimate forms of rationing to protect their time and other resources. Yet the sense of professional identity, the level of frontline autonomy, and the ways in which this was exercised, varied across the different types of team. The authors conclude, therefore, that the scope of discretionary space available to frontline staff in social services departments, and the practices to which it gives rise, are empirical questions only adequately addressed by methodologies able to connect with``bottom-up'' decision-making.
Halfway There? Policy, Politics and Outcomes in Community Care
Social Policy & Administration, 1996
The community care reforms which followed the 1989 White Paper "Caring for People" were apparently focused on addressing the needs o fpeople requiring long-term care, and on achieving improved outcomes and better quality of life. The agenda set out by the White Paper was for community care in the next decade and beyond. Half way through this decade, we question the extent to which the objectives of promoting choice and independence f o r users and carers have been achieved. The paper drams particularly on a programme of monitoring conducted jointly ly the ~u~e l d Institute for Health and the King's Fund, based on national and local focus groups meeting over a two-year period. It proposes a framework f o r evaluation which consists of four components: the dejinition of desired outcomes; specijication of service systems necessary to deliver such outcomes; promotion of access to services; and the development of supporting operational policies and resource allocation mechanisms. This framework offers a substantial step beyond much of the monitoring of the community care reforms which has taken place to date. This has assessed progress largely in terms of the establishment o f new systems andprocesses. We conclude that such changes were essential building blocks for delivering better-quality community care services, and in the short term it may have been legitimate to view their establishment as proxies for progress towards delivering user-centred services. However, monitoring and evaluation should now be increasingly oriented towards ensuring that these changes are in fact producing the desired service outputs and user outcomes. We propose that our framework offers one such way forward.
Aspirations and realities: community care at the crossroads*
Health & Social Care in the Community, 2007
The community care reforms in the United Kingdom were a response to a broadly based critique of the policy's failure. After an apparently successful first year's implementation, their robustness is increasingly under question. This paper reviews evidence about the early implementation of the reforms. While attention has focused on erecting a structure of systems and processes, the foundations of community care are in danger of being undermined by internal and external policy contradictions. The twin objectives of improved service access and expenditure control are already proving difficult to reconcile. In addition, radical changes in the delivery of acute services are creating additional pressures which the reforms were not designed to bear.
Governance of local care and social service
The introduction of the Dutch Social Support Act (in Dutch: Wmo) in 2007 symbolises a major welfare state reform in the Netherlands. It concerns the decentralisation of tasks and responsibilities with regard to social care and support. This reform is not only a matter of shifting tasks and responsibilities from central government to local government; the Wmo was also intended to cause a paradigm shift that should change the way in which clients, citizens, governments and providers act and think. The core of this paradigm is formed by the compensation principle which describes the replacement of citizens’ rights on care by an obligation for municipalities to compensate citizens. If the Wmo is however purely regarded as a decentralisation of tasks, its implementation may, three years after its introduction, be considered a success. After all, municipalities are making serious efforts to regulate home care and social support. Most crucially, however, is the question whether this actual...
Regulating Adult Social Care: Who Cares? And Who Knows They Care?
This paper will present interim research findings from a Department of Health-funded three year-project on the regulation of adult social care in England, which started late 2003. This project forms part of the wider research programme, `Modernising Adult Social Care', launched by the Department of Health. Our research project addresses the following two questions: • what are the processes of the regulation of adult social care as perceived by different stakeholders? • what impact does regulation have upon adult social care as perceived by different stakeholders? Key stakeholders within the regulatory regime surrounding adult social care include central government sponsors of regulatory agencies (eg Department of Health, HM Treasury), regulatory agencies (eg Commission for Social Care Inspection (CSCI), General Social Care Council (GSCC)), regulated agencies (eg local authority social services departments (SSDs), private and voluntary providers of adult social care), and users of adult social care services (and their informal, unpaid carers). The four principal vulnerable adult groups investigated are the frail elderly and those adults with learning difficulties, mental health issues and physical handicap. Our interdisciplinary research project employs a hybrid research strategy involving a mix of research methods: documentary analysis, individual and group semi-structured interviews, and survey-questionnaires. This strategy, including our research protocols, has been ethically approved by an NHS Multi-Centre Research Ethics Committee (MREC). The project is advised by two bodies-the Advisory Group of Experts (AGE) comprising key policy-makers and academics, and the Service Users and Carers Panel (SUCP) comprising service users and informal, unpaid carers (two of whom also serve on AGE).