23rd April 2015
For social work this puts personal and community well-being on the agenda, redefining need to accommodate self-perception of the mind and body. But what will this mean to statutory adult social work in the current climate defined by austerity?
Critics worry that it is a disguise for cost cutting with the emphasis being on personal and familial responsibility, while advocates hail it as a the opportunity for social work to shake off the constraints of care management and to return to ‘real’ social work founded on relationships and strength building.
Whatever the system of social work has operated over the years social workers have tried to work in a person centred way at the micro level, using professional discretion to achieve positive outcomes: after all most social work activity is about working with people by means of a positive relationship enabling them to achieve problem resolution.
So the emphasis on personal well-being is not entirely new to practitioners, however it does represent a shift in assessing eligibility for social work services.
Well-being is a subjective term with the potential for confusion despite the instruction offered in the Care Act and subsequent guidance. Self-assessment allows for the acknowledgement of all needs perceived by the individual, but eligibility for support services remains subject to the updated FACS criteria (a new nationwide one level threshold) with its application based on the interpretation of workers and budget holders.
The eligibility criteria are defined by government with its stated goals of prevention and the avoidance of ‘dependence’. Both of these goals make positive headlines; leading full and healthy lives after all is a universal aspiration.
However, I would argue that there are assumptions within this agenda which are perhaps less palatable. Specifically I contend that the notion of independence is problematic, and what is advocated in the Care Act is independence from state support relating to a Neo Liberal construction of individualism with the ideal relationship between citizen and the state focusing on security and welfare being merely a safety net.
My concern is that this has the potential to be divisive, separating those without established networks who are in need of on-going state support, the already marginalised, from others who can embrace the healthy nation concept, accessing facilities and services to enhance their well-being.
My research has been exploring sexual well-being which I define as ‘being at home’ physically and mentally with one’s sexual identity. I advocate that sexual well-being is a significant aspect of self-efficacy and a holistic assessment will take this into account, the Care Act accommodates this but meeting a need is a different matter.