This is a set of slides used for a full days talk to social work students. It explores the moral purpose of social work, the meaning of social justice and citizenship and some of the practical and political issues confronting social workers today. The course includes an exercise encouraging people to see the disconnection between our own expectations the reality of social care systems. The course was developed by Dr Simon Duffy and has been run for several years at Huddersfield and Hertfordshire Universities.
1. The keys to citizenship:
theory & practice for
social workers
Curriculum of training for social work students by
Dr Simon Duffy of the Centre for Welfare Reform
2. “Know how to take things. Never
against the grain, though they’re
handed to you that way. There are
two sides to everything. If you grab
the blade, the best thing will do you
harm; the most harmful will defend
you if you seize it by the hilt.”
Baltasar Gracian
Gracian B (1991) The Art of Worldly Wisdom. New York, Doubleday.
3. These slides are used to help social work students reflect on their
work and its purpose - in theory and in practice. The central aim of
the training is to show that central purpose of good social work
should be to help people achieve full citizenship.
The training explores the tension between the theoretical goal of
social work and many of the system pressures that make it hard. In
addition the course offers lots of practical advice on helping people
achieve citizenship, using the keys to citizenship framework.
These materials have been used with social work students at
Hertfordshire and Huddersfield Universities. If you want to use or
adapt any of the materials then you are free to do so. Please just
acknowledge the source and respect copyright where it applies.
Introduction
4. Dr Simon Duffy
Simon is the founder and Director of the Centre for Welfare Reform. He speaks regularly on
television and radio about the welfare state and social policy. He is best known for inventing
personal budgets and for designing systems of self-directed support. He works as a consultant
and researcher with local social innovators and national governments.
Simon began work in the NHS and then went to work with Choice Support, where he led
innovative work in social care on individualised funding and brokerage. After being a Harkness
Fellow in 1994, Simon went on to found Inclusion Glasgow in 1996 and, following this, he helped
establish several new organisations in Scotland, including Partners for Inclusion and Altrum. He
also provided training in person-centred planning and supported living as a Director of Paradigm
Consultancy.
From 1999 he began to develop self-directed support, as a system to reform the organisation of
social care. He began work with North Lanarkshire Council and in 2003 he led the development of
individual budgets and self-directed support in England as CEO of In Control. This work led to
significant changes in social policy in England and Scotland, and in 2008 he was awarded RSA's
Prince Albert Medal, and in 2011 the SPA Award for outstanding contribution to social policy.
Simon has a doctorate in moral philosophy and has written extensively on moral, political and
social issues. Some of his key publications include Unlocking the Imagination (1996), Keys to
Citizenship (2003) Women at the Centre (2011) A Fair Income (2011) and Peer Power (2012) and
The Unmaking of Man (2013). Simon is also an Honorary Senior Research Fellow at the University
of Birmingham's Health Service Management Centre.
5. Course outline
1. Social work in practice - making sense of crazy systems
2. Disability and individual service design - an exercise
3. Key concepts in social work - philosophical explorations
4. Creativity in service design - keys to citizenship in practice
5. Policy and politics - thinking about the welfare state
7. Blatt B & Kaplan F (1974) Christmas
in Purgatory: A Photographic Essay
on Mental Retardation. Syracuse,
Human Policy Press.
8. It’s important to recognise that institutional
background to modern community care services.
Institutions developed out of the workhouses of
the nineteenth century. But they grew even more
rapidly during the twentieth century, in response to
the ‘eugenic panic’ which led to the segregation
and sterilisation of disabled people and people
with mental health problems.
The peak population of the institutions in the UK
was about 1970 and, unsurprisingly, early efforts to
provide ‘community care’ maintained many
institutional assumptions and practices.
You can read about one of these modern
institutions in No Going Back.
Keilty T & Woodley K (2013) No Going Back:
forgotten voices from Prudhoe Hospital. Sheffield,
The Centre for Welfare Reform.
http://bit.ly/nogoingback
9. The shift from institutional hospital, day centres
and residential care homes has been slow. In fact
often the services that replaced the institutions
were hardly less institutional than those they
replaced.
While some progress was made the following data,
which was gathered directly from social work
students in Lancashire shows that most of the
money spent on services has not promoted
community inclusion - but has sustained
segregation and exclusion.
10. Data gathered by social workers in
Lancashire County Council in 2002
11. Data gathered by social workers in
Lancashire County Council in 2002
12. Data gathered by social workers in
Lancashire County Council in 2002
13. Data gathered by social workers in
Lancashire County Council in 2002
14. We can see the distorting impact of
services on people who use services by
examining the peculiar distribution of
ordinary life chances. For example, instead
of ordinary housing options and home
ownership (how most people get a home)
people with learning disabilities are forced
to rely on either the family home or on
unusual housing options.
16. Even more concerning are the distorted
and lower level outcomes this creates for
people who use social care services.
For instance, the option that receives the
most funding (residential care) is the option
associated with the highest risk of abuse.
17.
18.
19.
20. If we start from an assumption of humility
but with a commitment to justice then
there are some assumptions that might
guide us in developing better systems.
21.
22. In reality our current systems of support for
disabled people, older people and people
with mental health or long-term health
conditions is highly complex and incoherent:
• It is delivered through 3 main systems
(DWP, NHS and Local Government);
• it is partly free and partly (severely) means-
tested;
• it is partly under the control of people and
partly highly controlled by bureaucratic
systems and regulation.
23.
24. Efforts to reform this system have included
the creation of the Independent Living Fund
(ILF), the creation of ‘direct payments’ and
the invention of self-directed support.
Self-directed support was an effort to shift
power and control to everyone using adult
social care.
This kind of reform is now being extended to
health, children’s services and education.
25. Alakeson V & Duffy S (2011) Health Efficiencies - the
possible impact of personalisation in healthcare.
Sheffield, The Centre for Welfare Reform.
26. Personal budgets are entitlements that can
be managed in a number of different ways
in order to shift control as close to the
person as possible.
27. Personal budget
Duffy S (2010) Personalisation in
Mental Health. Sheffield, The Centre
for Welfare Reform.
28. One of the striking outcomes of self-
directed support is that it seems to lead to
people beginning to use resources
differently - less on institutional care and
more on community life itself.
29. Pitts J, Soave V and Waters J (2009) Doing It Your Way: the story of self-directed
support in Worcestershire. London, In Control Publications.Hay M & Waters J
(2009) Steering My Own Course. In Control Publications, London.
30.
31.
32. What seems to be going on is that instead
of ‘pushing’ resources into often
inappropriate services self-directed
support and personal budgets allows
people to ‘pull’ resources together in order
to help people build better lives for
themselves and those they love.
33.
34. You can read more about self-directed support in
Travelling Hopefully:
Duffy S (2013) Travelling Hopefully - best practice
in self-directed support. Sheffield, The Centre for
Welfare Reform.
http://bit.ly/travhope
35. Naturally these changes inevitably has a
significant impact on social workers in local
government. Much depends on how self-
directed support is implemented and how
the social worker’s role is adapted to self-
directed support.
36. Architecture for Personalisation proposes a way
ensuring social workers are enabled to use all their
skills with people who really need their help, while
also empowering people, families or other
professionals to take on a bigger role where
appropriate.
http://bit.ly/architect-pers
37. How do social workers in adult social care
use their time?
Duffy S & Fulton K (2010) Architecture for Personalisation.
Sheffield, The Centre for Welfare Reform.
38. Mostly on assessment
and planning…
Duffy S & Fulton K (2010) Architecture for Personalisation.
Sheffield, The Centre for Welfare Reform.
39.
40. The new role for care managers or
social workers might be seen as a kind
of community broker.
http://bit.ly/a-new-script-film
41.
42. Of course new ideals like self-directed support or
personalisation are also full of problems. Poor
implementation, misuse and abuse are all likely
especially during a time of ‘austerity’ when
government is keen to cut funding for people
needing social care.
44. Another way of thinking about the
importance of inclusion and citizenship is
simply to think about our own situation and
what we would choose if we had a
disability.
The following slides represent the results of
multiple uses of the following simple
exercise.
45. 1. Who will help represent you?
2. What will you do with your life?
3. Who will support you?
4. Where will you live?
5. How much will your support cost?
You have had a serious
car accident. It has left
you with significant physical
disabilities, including some
brain damage. You will
need help with many daily
activities and help to make
some decisions.
Work in pairs
and discuss
You are still the same
person, with all the same
interests and preferences
and you still have all the
relationships you had
before.
53. It is striking that whereas most of us will
choose options that enable us to have
independence, be close to family and
friends and have a fulfilling and active life,
these are all areas where the health and
social care system struggles.
55. The following slides explore some of the
ideas that are important to social work
from a philosophical perspective.
56. • What’s wrong with the Professional Gift
Model?
• What does personalisation really
mean?
• What’s the difference between
personal or individual budgets?
• Why invent self-directed support?
• What is citizenship and Independent
Living?
• Why we need rights as well as needs?
• What are the keys to citizenship?
• What is social work?
Exploring the
meaning of key
words and
concepts.
58. Ursula Le Guin
Honour can exist anywhere, love can exist
anywhere, but justice can exist only among
people who found their relationships upon it.
59. John Rawls
All social values - liberty and opportunity,
income and wealth, and the bases of self-
respect - are to be distributed equally unless
an unequal distribution of any, or all, of these
values is to everyone's advantage.
60. Equality of income is
important, but it is even
more important that we
treat each other as
equals: whatever our
differences.
62. At the age of 23 I visited
an institution. The
experience was life
changing. I wondered:
• What a dreadful
place!
• What amazing people!
• How come I’ve never
met anyone with a
disability before now?
63. The long history of
institutionalisation,
abuse and the
Holocaust reveals that
we are capable of great
evil, especially when:
• We are frightened
• We find a scapegoat
• We dehumanise our
intended victim.
67. Sometimes we just replaced the institution with
another institution, but without the park.
68. Services come as a ‘professional gift’ which the
person cannot shape or control.
69. Maimonides
There are eight levels in charity, each level
surpassing the other. The highest level beyond
which there is none is a person who supports a
Jew who has fallen into poverty [by] giving him
a present or a loan, entering into partnership
with him, or finding him work so that his hand
shall be fortified so that he will not have to ask
others [for alms]. Concerning this [Leviticus
25:35] states “You shall support him, the
stranger, the resident, and he shall live among
you.” Implied is that you should support him
before he falls and becomes needy.
70. The power and control
given to those who help can
become toxic.
The challenge for our
society is to find out how to
support each other without
degrading each other.
73. Real and valuable
innovations emerge as
people, inspired by
values and visions, craft
thoughtful solutions for
real problems.
74.
75. Self-directed support and
individual (or personal)
budgets was an effort to
shift the whole system
towards the citizenship
model by converting
services into entitlements.
76.
77. In reality the shift towards
‘personalisation’ has been
undermined by its ambiguity
and by the lack of real
power or effective legal
rights for disabled people.
79. We are different and we are
equal. And our differences
are good - in fact they are
essential for a decent
society. So why do we find
it so hard to reconcile
difference and equality?
80. “How could men be
equal in the eyes of
God and yet unequal
in the eyes of the
Psychologist?”
Michael Young in
The Rise of the
Meritocracy [a satire]
81. Robert Nozick, Anarchy State and Utopia
The most promising ways for a society to avoid
widespread differences in self-esteem would be to
have no common weighting of dimensions; instead it
would have a diversity of different lists of dimensions
and weightings. This would enhance each person’s
chance of finding dimensions that some others also
think important, along which he does reasonably well,
and so to make a non-idiosyncratic favourable
estimate of himself.
82.
83. We do not have to acquire humility.
There is humility in us.
Only we humiliate ourselves
before false gods.
Simone Weil
84. Citizenship is not about having
some common property like a
certain kind of brain or a
passport. Citizenship is the way
in which we come together to
make sure that we all belong
and know we belong.
85. Aristotle explains that
a community is not
made out of equals,
but on the contrary of
people who are
different and unequal.
The community
comes into being
through equalising,
'isathenai.' [Nich.
Ethics 1133 a 14]
Hannah Arendt
86.
87. We create equality
between us by creating a
universal framework of
rights, duties and
freedoms. But citizenship
demands more than just
‘equal rights’.
88. We must create practical
solutions to support and
enhance citizenship for all:
1. Planning
2. Decision-making
3. Money
4. Housing
5. Help
6. Community
7. Relationships
96. We are beginning a
new phase of thinking
and action, one which
demands:
1. A focus on real and
effective legal rights
2. Less jargon and more
common sense
3. Organised political
power to challenge
and direct.
97. Although we keep ‘taking the institution with
us’ we can still make progress. The final stage
means tackling the institutions of the mind - our
prejudices.
98. Not only must we close
down the community
institutions we must
also start to reduce the
problems built into our
welfare system.
102. Citizenship can sound very
grand, but it’s a simple idea:
We’re all equal
We’re all different
& the best society is one
where we all work together to
respect and value everyone
Duffy S (2006) Keys to Citizenship: A guide to getting good support for people with learning
disabilities, second revised edition. Sheffield, The Centre for Welfare Reform
103. Citizenship is also very
practical
Everyone can be a citizen
Everyone can contribute
& the best support
strengthens
citizenship for all
Duffy S (2006) Keys to Citizenship: A guide to getting good support for people with learning
disabilities, second revised edition. Sheffield, The Centre for Welfare Reform
104. 1. Purpose
• Citizen’s have a sense of
purpose - a meaningful life
• People’s sense of meaning
has many sources
• We must listen and look for
meaning in the right places
• We each have purpose - we
just don’t always know it
110. 2. Freedom
• People have a right to be free
• But we need relationships with
others to be free
• We need to provide help with
information, communication
and good representation
• A man in a desert is not free -
he’s just alone
111.
112.
113.
114.
115. 3. Money
• People need the resources
necessary to be citizens
• The chance to earn and save
• Money for services is really
the person’s entitlement
• People only do things for us
for love or money - why not
have both?
121. 4. Home
• People need a home of their
own
• That means living with the
people we want to
• Safe, secure and private
• Going into a home - means
losing your home
122.
123.
124. Then the old Vainamoinen put this into words:
“Strange food goes down the wrong way
even in good lodging;
in his land a man's better at home loftier.
If only sweet God would grant
the kind creator allow
me to come to my own lands
the lands where I used to live!
Better in your own country
even water off your sole
than in a foreign country
honey from a golden bowl.”
From the Finnish epic poem: The Kalevala
125. 5. Help
• Citizens need help - its not
independence that build
community but dependence
• But help must be good help
• Supporters need to
understand what good help
demands
• If you need nobody you're no
use to anybody
126.
127.
128. Personalised support
Fitzpatrick J (2010) Personalised Support: How to
provide high quality support to people with complex and
challenging needs - learning form Partners for Inclusion.
Sheffield, The Centre for Welfare Reform.
130. Choice Support & Southwark
Council achieved over a 5 year
period a saving of 30% in the cost
cutting up the block contract into
personal budgets and treating each
person as an individual, using
technology and cutting central and
salary costs.
131. Ellis R, Sines D & Hogard E (2014) Better Lives.
Sheffield, The Centre for Welfare Reform.
132. Ellis R, Sines D & Hogard E (2014) Better Lives.
Sheffield, The Centre for Welfare Reform.
133. Ellis R, Sines D & Hogard E (2014) Better Lives.
Sheffield, The Centre for Welfare Reform.
134. Ellis R, Sines D & Hogard E (2014) Better Lives.
Sheffield, The Centre for Welfare Reform.
135. Ellis R, Sines D & Hogard E (2014) Better Lives.
Sheffield, The Centre for Welfare Reform.
136. Ellis R, Sines D & Hogard E (2014) Better Lives.
Sheffield, The Centre for Welfare Reform.
137. 6. Life
• Life is made by living
• Work, play, volunteering and
having fun
• Life happens in community
• But it really matters that you
are in the right community for
you
138.
139.
140.
141.
142. The lame rides a horse
the maimed drives the herd
the deaf is brave in battle.
A man is better
blind than buried.
A dead man is deft at nothing.
A Viking Poem from the Havamal
143. 7. Love
• We all need love - life without
love is hell
• Love comes in many forms
• We need to understand how to
nurture and encourage love
• Love is what creates
citizenship and new citizens
149. In order to create there
must be a dynamic force,
and what force is more
potent than love?
Igor Stravinsky
150.
151. 1.Get good at listening for direction
2.Build relationships that liberate
3.Get clear about entitlements
4.Respect and deepen roots
5.Be flexible - in the extreme
6.Get stuck into community
7.Look out for love
152. fruitful questions flow from an understanding of your purpose
there is no tool for creativity other than your whole humanity
153. A good exercise for social
workers…
Are you asking the right questions?
Will your questions open the doors to
creativity, capacity and citizenship.
155. The following slides explore the political
and social context for social work today.
We are now living through one of the most
troubling periods for social justice in the
post-war period.
It is increasingly common to see disabled
people or those in poverty stigmatised.
156.
157.
158.
159.
160.
161.
162. The welfare state, developed in 1945, has
often been designed in ways that don’t
seem to work well for the people who
need it most.
163.
164. Duffy S & Hyde C
(2011) Women at the
Centre. Sheffield, The
Centre for Welfare
Reform.
165. 44 women with complex needs
Duffy S & Hyde C
(2011) Women at the
Centre. Sheffield, The
Centre for Welfare
Reform.
166. Managing a serious health condition 64%
Finding a safer place to live 27%
Living with childhood abuse 51%
Didn’t finish their education 76%
Recent experience of domestic violence 85%
Fractured family (for those with young families) 66%
Children have experienced abuse (for those with children) 55%
Living with a severe level of mental illness 55%
Living with some mental illness 91%
History of drug or alcohol misuse 52%
Victim of crime 41%
Perpetrator of crimes 39%
Worried by debt or lack of money 65%
Of 44 women working with WomenCentre:
167. Service label N Urgent problem N Real need N
Victim of
domestic violence
55 Debt 50 Better self-esteem 64
Mentally Ill 39 Housing 48
To overcome past
trauma
54
Criminal 35 Benefits 46
To manage
current trauma
51
Poor Mother 33 Health 37
To stop being
bullied
50
Misuses Alcohol 24 Rent 32 Guidance 50
Uses Drugs 22
Criminal Justice
Advocate
24 Relationship skills 45
Violent 19 Dentistry 8 Mothering skills 26
Chronic Health
Condition
16 Others 3 Others 1
170. We need to
redesign the
welfare system
so that it
supports and
sustains
citizenship,
family and
community for
everyone.
171. Social workers are key
agents of positive change.
But they will need to
develop their role in the
coming phase of
development.
172. Simone Weil
Christ does not call his benefactors loving or charitable. He calls them
just. The Gospel makes no distinction between the love of our
neighbour and justice. In the eyes of the Greeks also a respect for Zeus
the suppliant was the first duty of justice. We have invented the
distinction between justice and charity. It is easy to understand why.
Our notion of justice dispenses him who possesses from the obligation
of giving. If he gives, all the same, he thinks he has a right to be
pleased with himself. He thinks he has done good work. As for him who
receives, it depends on the way he interprets this notion whether he is
dispensed from all gratitude, or whether it obliges him to offer servile
thanks.
Only the absolute identification of justice and love makes the co-
existence possible of compassion and gratitude on the one hand, and
on the other, of respect for the dignity of affliction in the afflicted - a
respect felt by the sufferer himself and the others.
174. Justice lives in poverty.
She survives. She measures
What is necessary.
She honours what ought to be honoured.
She seeks out clean hearts, clean hands.
She knows what wealth and power
Grind to dust between them. She knows
Goodness and the laws of heaven.
Aeschylus