By Stephanie Lister
Once registered and inside the Business Design Centre in London, the somewhat subdued queue of social workers, managers and students were invited to attend any of the over thirty different legal sessions, seminars and interactive zones. These covered topics as varied as ‘Coroners Court Mock Inquest’, ‘Engaging Safely and Effectively with Perpetrators of Domestic Abuse’ and ‘Immigration Law and the Children Act: What are the Social Workers’ Responsibilities?’. So much choice! In this blog, I share insights from the four sessions I attended.
The first seminar was ‘Getting it Right in Transitions: Goals and Aspirations’ – a topic close to my heart and an area I worked in for over twelve years. I was pleased to see the focus was on the young person and what’s important to them, such as finding and keeping a job, things to do in their spare time, living independently and staying safe and healthy. The discussions were grounded in the Care Act and adopted a strengths-based approach. Also covered was the need for joined up working with partners and supporting parents as their child moves into adulthood. Associated positive risk needs to be juxtaposed with ongoing vulnerability.
‘Navigating the boundary between the Mental Health Act (1983) and the Mental Capacity Act (2005)’ was the title of my second seminar. This was a legal learning session designed to broaden understanding of the scope of the two acts, the differences between them and how to decide which regime to follow in different scenarios. This was a relatively new topic for me, as I have limited experience working within the framework of the Mental Health Act, but some experience undertaking Mental Capacity Act assessments for young people over the age of sixteen. I found the topic both challenging and helpful. It reminded me of a previous case where the young person, diagnosed with high functioning Autistic Spectrum Disorder had found it increasingly difficult to self-regulate. This resulted in deteriorating mental health, increasing self-harm, isolation and risk to themselves and family. After much multidisciplinary debate regarding the needs and provision for this young person, a hospital place was found under the Mental Health Act. They made good recovery and were able to return to supported living in a specialist educational setting. Having a clearer understanding of the Mental Health Act would have helped me advocate more directly in this case.
Stand up for what you believe in, even if you stand alone
Seminar three was a refresher entitled ‘NHS Continuing Healthcare and the Legal Limits of Local Authority Responsibility’. Continuing healthcare assessments were a regular part of my working life. My role involved assisting and supporting young people and their parents/carers through the assessment process, balancing the tension between the Care Act 2014 sec 22(1) and the NHS Act, the various budget holders and the often-desperate needs of the family. This seminar highlighted again the need for clear understanding of what is a primary health need, how the characteristics of Intensity, Nature, Complexity and Unpredictability look across the domains of the assessment and how regional variations in assessment can lead to a ‘postcode lottery’ of funding being agreed. It raised the importance of accurate recording of evidence of risk, strengths and unmanaged needs within the framework of the domains outlined in the decision tool.
The final seminar of the day was one based in adult services, but which occurs in families I’ve worked with. The focus was ‘Trauma-Informed Practice with Adults who Self-Neglect or Hoard.’ The speaker, herself a survivor of trauma resulting in a form of hoarding, gave an insight into the effect of trauma on the brain, the way life events are then experienced through that lens or trigger and its effect on attachment. We were encouraged to recall three objects that were of sentimental value to us. We were then instructed to keep one, recycle one and throw one away. We then had to recognise the emotions and physical responses we felt. This simple activity was a helpful insight into the distress experienced by people when the outward signs are addressed, but not the healing of the trauma. A question was raised about how would a person’s executive function affect the outcome of, for example, a Mental Capacity Act assessment? as often those affected can ‘talk the talk’ i.e. tell the assessor the steps needed to carry out tasks, but are unable to ‘walk the walk’ i.e. actually carry out those tasks. It was suggested treatment pathways that can be helpful such talking therapies, Cognitive Behavioural Therapy (CBT) and Eye Movement Dual Task Therapy.
It was interesting to note that by the end of the day the attendees appeared more upbeat and re-energised and there was a definite buzz of enthusiasm. This was also something I noted in myself as although the day had been full on and exhausting, I felt a renewed sense of purpose and value.
About Stephanie Lister
Stephanie has nineteen years’ experience as a Nursery Nurse working with children, who have special educational need and/or a disability (SEND). With a desire to do more and advocate for individuals and families, Stephanie retrained in social work and subsequently dedicated twelve years to working in a local authority with a broad remit covering Children with Disabilities and Transitions into adulthood. Stephanie is a valued member of #TeamADL where she continues to advocate and find solutions in a social care context.
To find out more visit the #TeamADL website