For this assignment, I will be looking in to three related themes in regards to multi – agency working; Social Policy, Culture and Diversity and Inter – professional Team Working, in order to critically discuss the influences of each of these themes in relation to a chosen character. I have chosen to focus my assignment on Amita.
Amita is identified as the mother within the case study, who is presented to have a diverse range of needs. Applying the three themes to the issues, will allow me to critically discuss the three themes. Whilst Social Policy is concerned, there may be a connection between policies and Amita’s housing troubles; Amita feels her housing is having a negative impact on her families wellbeing and therefore, there may be policies put in place to assist with this issue.
In regards to Culture and Diversity, Amita has expressed issues with her language as it has been suggested she has worries that her feelings will not be clearly expressed due to English not being her first language. With consideration for housing, Amita may not be aware of the help and support in her area, therefore she may feel slightly trapped.
In relation to Inter – Professional Team Working, Amita presents concerns with her mental wellbeing, as it is stated that she is increasingly tearful and low in mood. Amita has also expressed worries about her partner Jacob’s passive smoking as this could affect the development of their unborn child. These concerns are in partnership with issues in relation to Amita’s four-year-old daughter, Eva, having downs syndrome. With inter – professional team working in mind, these issues could be looked at in various ways, as some professionals would place a higher priority on one issue over another, therefore by working together, all the issues will be addressed, allowing Amita’s issues to potentially decrease.
In my assignment I will focus on Amita’s housing issues, alongside her low mood as I feel these two issues could be related.
In regards to Social Policy and housing, Amita is expressing struggles within her privately rented one-bedroom flat. According to a Government Policy, ‘Review of Property Conditions in the Private Rented Sector’, Landlords have a duty to ensure that the property meets a ‘good standard’ (https://www.gov.uk). However, questions may arise regarding what is meant by a ‘good’ standard of housing. There is no clear definition within the policy of what is meant by a ‘good standard,’ therefore how can one maintain it. This policy may affect Amita’s living condition due to the Landlord having no definitive standard for the provision of tenants that needs to be met. On the other hand, the policy sets out to ensure that all those accommodated in the privately rented sector have a decent standard of living, with an emphasis on help and support being available if they felt their property was not meeting these standards. In this case, it gives Amita the opportunity to turn to the Local Authority regarding her flat and the ‘poor repair’ of it. According to Section 11 of the Landlord and Tennant Act, 1985, the “Landlord is responsible for keeping in repair the structure and exterior” with the inclusion of “sanitation and space” (Dean, 2002, P:130). With reference to Amita, the one bedroom flat described within the case study, is lacking in these areas. This allows questions to arise about the Policy as the Landlord of Amita’s property is not providing the required appropriate ‘space’. Therefore, this Policy does not suffice in the case of Amita and her family as although the policy strives to be effective in providing tenants with a decent standard of living, it does not have the capacity to meet its aims.
Amita, along with her family, may have additional issues with the considerations of housing and overcrowded space. According to a recent Government policy paper (2008), “Living in overcrowded accommodation can, both directly and indirectly, have a devastating effect on families” (https://www.gov.uk). The paper states that all Local Authorities should have the ability to formulate action plans in order to tackle overcrowding. Amita is pregnant for the second time, meaning all four members of the family will be accommodated in a one-bedroom flat. This causes concerns as according to Reynolds, Robinson and Diaz (2004) “living in cramped conditions can have a detrimental affect” on health. Overcrowding can be a cause for concern due to relationships within the family being put at risk, whilst also having an effect on the spreading of illness to be more frequent. However, according to the definition of overcrowding, those with young persons under the age of 12 months, in this case, the unborn baby, are not viewed as members of the family. Amita’s daughter Eva, as she is only four, is considered to be half a person, therefore, there housing situation is not defined as overcrowded as they do not meet the statutory threshold (www.shelter.org.uk). This policy could be considered to exclude Amita and her needs as it allows issues to arise according to health; Amita and her family are not defined as overcrowded, however, -in reality, four persons living in a one bedded flat is considerably overcrowded. Reynolds, Robinson and Diaz have stated that for parents, the issue of overcrowding within a property can cause potential barriers in the provision of “positive opportunities for their children and a constant cause of anxiety and depression” (2004). This suggests that the small space that Amita and her family are living in, is having an inadequate effect on her health, implying the above policy is not effective due to the negative impact it can have upon a family and their health.
Amita may face issues relating to their financial needs and housing. The case study states that Jacob works a lot of the time, perhaps suggesting they have a low income and are struggling to make ends meet. Moreover, Amita needs to be made aware of the financial support she is eligible for. The ‘Housing Benefits Local Housing Allowance’ that is used to work out benefits for those who privately rent property, states that the amount you get is dependent on ‘where you are living’, ‘the size of your household’, ‘your income’ and the ‘circumstances’ in which your living (https://www.gov.uk). This policy however, varies according to the Local Authority you are deemed to be under, as it is “administered by your local authority” (http://www.nhs.uk) therefore, the policy is not reflective over the whole of society. This implies it is a UN effective policy in the case of Amita, as it may be if she lived elsewhere, she would be liable for more than what she is receiving by where she is currently living. Another questionable aspect of this policy is how does it assess various people’s circumstances to decide how much housing benefit they are entitled to. With housing benefits policy in mind and the above policy on overcrowding, Amita’s family do not fit the definition of the defined overcrowding family, does this therefore mean her circumstances are not sufficient in meeting the threshold criteria for housing benefits. Due to other policies put in place, some unacceptable ‘circumstances’ are not presented as unacceptable as they do not meet the criteria for assistance. Therefore, assessing people in accordance to their ‘circumstances’ is a poor way of assessing their eligibility for housing benefits due to the effect of other policies on the threshold criteria and how they assess the situation within the home. Overall, the various policies surrounding housing all have an effect on one another, meaning that some lack in effectiveness due to another.
Interprofessional team working is the concept of a wide variety of different professional teams, that work alongside one another, in order to support and assist and help provide positive outcomes for a diverse range of individuals and families. Inter – professional work is important as it allows the different professional contexts to work together on a common ground, ensuring that intervention is effective (Beckett, Walker, 2011). (Inter professional team work) it is (therefore) vital when vulnerable people are concerned, as it allows an assorted range of views (on the situation) stemming) from the contrastive professionals involved, for the provision of further knowledge. According to Beckett and Walker (2011) “joint working is the best way of delivering coherent and effective care in health and social work practice” (p:131). This emphasizes the idea of effective inter professional working being a vital aspect of an individual case.
Belbin has composed a theory in regards to teamwork and the individual roles that each team needs in order to be successful (Belbin, 2004). There are nine specific team roles that vary dependent on an individual’s behaviour type, these nine team roles include ‘Resource Investigator, Team worker, Co-ordinator, Plant, Monitor Evaluator, Specialist, Shaper, Implementer and Complete Finisher’ (www.belbin.com). According to Belbin, “most people have two or more team roles.” A team should benefit if they have a mix of the team roles that Belbin has proposed.
With regards to Amita, there will be a number of professionals involved due to the poor repair of her one bed flat. According to Macintyre et al (2003 cited in Barnes M, Cullinane C, Scott S, Silvester H) factors associated with higher levels of anxiety and depression are dampness within a house that’s in a poor state of repair. Therefore, suggesting Amita’s housing issues are potentially leading her to what appears to be an anxious low mood. Moreover, this would initiate Occupational Therapists working alongside the Social Worker to resolve the housing issues that are causing this low mood. It has been found that ‘working age adults living in bad housing conditions are placed at greater risk of poorer general health and low mental wellbeing’ (Shelter, 2015), therefore implying that the state of Amita’s housing, may lead to her having poor general health thus including a GP in regards to her care and needs. If the poor state of Amita’s house is having a direct impact on her physical wellbeing, this may be the cause of concern in regards to her apparent pregnancy related pelvic girdle pain, thus meaning there was a substantial need for a physio therapist to be involved within her care.
In order to work effectively with Amita, it would be of great importance that all the professionals around her work together utilizing effective communication, but also including Amita in any plans they have, for example, initiating meetings whereby all the professionals could come together, with Amita to plan interventions and revise strategies in which they can all work together to gain positive outcomes for Amita. It would be vital that Amita’s voice is heard when it comes to decision making as Øvretveit, Mathias and Thompson, ‘patients, clients and carers’ are expected to have a ‘greater say in decisions’ (1997). As there could be a number of professionals working with Amita it may be of importance to make sure Amita is constantly kept aware of what is happening with the various professional groups as there may be a degree of overlap.
According to the ‘British Association of Social Workers’ Code of Ethics, it is of great importance that Social Workers, have the ability to “communicate effectively and work in partnership” (The Policy, Ethics and Human Right Committee, 2012) with not only various other agencies and organizations but also with individuals, families and communities, whilst also placing a degree of ‘value and respect on the contribution of colleagues from other disciplines.’ Therefore, in the light of Social Workers professional codes, both Amita and her family will work alongside the Social Workers to ensure their needs are met through allowing their voice to be heard and valuing and respecting any decisions or wants they may have. Additionally, the codes set out for Occupational Therapists are of a similar nature to that of Social Work, implying that when working alongside other professionals it is expected that you ‘respect the practices, responsibilities and roles of other people with whom you work’ (https://www.cot.co.uk/). Both professional codes insist on working together in partnership, therefore suggesting that Interprofessional working is a vital aspect of the profession.
However, barriers of Interprofessional team working can include the notion of communicating and how effective this is whilst put in to practice. According to Hammick, Freeth, Copperman and Goodsman ‘poor communication’ is an important factor effecting the barriers to good practice (2009) thus this could bring the professional team work to be jeopardized. It has also come to my attention that the Interprofessional teams surrounding Amita will have a differing way of utilizing language, according to Day (2013) ‘some professionals may utilize the same words, however they may have a different meaning’ implying that this could be a potential barrier to Interprofessional team working.
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Within my group in the Partnerships 2 module, I have gained a lot of knowledge regarding team work and Interprofessional working. I have learnt that it is of such importance that we communicate on a regular basis and share our ideas as each profession has something different to bring to the team that another profession may not have an understanding of. For example, with poorly repaired housing, it was unidentified to other professionals in the group that the effects of a poorly repaired house could have such diverse impacts on an individual’s health and wellbeing and that therefore, the housing may have amounted to Amita’s other struggles. It also highlighted the importance of acknowledging different professional’s opinions and ensuring they were listen to and respected, whilst also placing some value on them. With Interprofessional team working, Partnerships 2 has taught me that not everyone in the team is willing to put in the same amount of work as others, or at least not share as much as the other members of the group has; it is important that these professionals are aware of how this can have an effect within the professional group and the impact it can have on the client, thus allowing Interprofessional team work to continue with no issues.
According to Leininger (1978 cited in Holland and Hogg 2010 P:4), culture is associated with the “learned and transmitted knowledge” about a certain culture with regard to its “values, beliefs, rules of behaviour and lifestyle” that enables guidance for those in this culture to follow.
Papadopoulos, along with Tilki and Taylor (1998) published a model to develop an understanding of cultural competence. According to Papadopoulos (2006 P:10), ‘cultural competence’ is having the “capacity to provide effective healthcare taking in to consideration people’s cultural beliefs, behaviours and needs.” The model goes through four stages ‘Cultural Awareness, Cultural Knowledge, Cultural Sensitivity and Cultural Competence.’ The achievement of cultural competence is subject to the application of the previous awareness, knowledge and sensitivity, therefore coming together to enable professionals to work in a cross cultural way with clients.
With reference to Amita, and Papadopoulos’ model, the professionals working around her must ensure that they have an awareness of their own culture, but also the diverse nature of different cultures to enable them to access a cultural knowledge base whereby they can establish similarities and differences between cultures. According to Obrey (2011) professionals must ensure they have the ability to provide care for individuals without “stereotyping, discriminating or making assumptions.” This leads professionals to have a degree of cultural sensitivity, whereby they can apply it to the given client to ensure they are working in a way that does not go against ones’ culture. Obrey states that “being sensitive is essential” therefore professionals in health and social care must ensure they have the ability to communicate with the client in a fashion that is appropriate to their culture.
This allows acceptance and therefore transfers to the next stage of the model to enable cultural competence. The achievement of this stage of the model requires the “application of previously gained awareness, knowledge and sensitivity” (Papadopoulos 2006 P:18). It has been stated that it in “addition to understanding the culture of clients” it is also of great importance that there is an understanding of the culture of the providers of care and their organisations (Ludwig – Beymer cited in Andrews and Boyle, 2012 P:211) suggesting that it is vital to gain awareness and knowledge regarding someone’s cultural, but also ensuring that the organisations working with Amita are culturally competent in that they can provide cross cultural care and have an “awareness of many cultures” (Hogg and Holland, 2010 P:63). Thus ensuring cultural competence is met.
In order for professionals to be culturally sensitive, they must have the ability to demonstrate a knowledge base for all cultures they work alongside thus allowing negative stereotyping to be avoided and therefore work will be completed on an individual basis down to individual and cultural needs. With reference to Amita’s housing situation, it is important that professionals make it clear what services are available in Amita’s area for her to access. This is due to Amita moving to the England 6 years ago, suggesting that England may have a very diverse way of working in comparison to Amita’s last area of living. Thus it is of great importance to treat the client as a “cultural individual” (Leininger, 1978, cited in Holland and Hogg 2010 P:61) as all people’s needs are of a diverse nature.
Other cultural issues Amita is likely to face include a significant language barrier. According to Giger and Davidhizar (cited in Holland and Hogg 2010 P: 69) there must be an awareness of how individuals, although speaking the same language, “may differ in communication” due to “cultural orientation” Amita has expressed that English is not her first language and therefore, it is vital that the professionals working with Amita take this in to account and make sure that they have an understanding of what Amita is expressing, rather than making assumptions based on what she says. Communication with someone whose first language is not that of English may prove difficult as there may be some forms of misunderstandings. To make communication effective, it is dependent on how the messages are received and how they are conveyed to the other person (Seden, 2005). Therefore, as a professional acting in a culturally competent way, professionals must ensure what they are saying to clients, is being received as they wish it to be. In regards to housing, there is a professional band system in which people are placed on, dependant on their needs for housing (https://www.gov.uk/). Amita may have a social awareness of these bands, however, may not have a full understanding due to her language difficulties. Thus meaning Amita may feel incapable of getting help in regards to what band herself and her family should be in, or feeling she is not eligible for help. This expresses the needs for clear and exceptional communication between professionals and clients and cultural competence.
According to Robinson (2008) foreign national’s eligibility of social housing is “limited by statutory regulations.” Robinson has stated that most foreign national’s must be registered in work, which Amita is not, therefore allocation of social housing is restricted for her and her family. If Amita is aware of this issue, she will may feel that service provision for different cultures in England is not sufficient and therefore may chose not to seek help in regards to housing. This is where the need for cultural competence is important as professionals will be able to assist Amita in seeking help in housing.