Glendinning Caroline, Mitchell Wendy, Brooks Jenni
Social Policy Research Unit, University of York, York, UK.
Health Soc Care Community. 2015 Jan;23(1):23-32. doi: 10.1111/hsc.12123. Epub 2014 Oct 21.
Carers play an ambiguous role within the personalisation paradigm currently shaping adult social care practice in England. Although carers have rights to assessments and support in their own right, these rights sit uneasily alongside the practices of assessment, support planning and personal budget (PB) allocation for older and disabled people. This paper reports how 14 dyads of older and learning disabled people with cognitive and/or communication impairments and their carers viewed the roles - desired and actual - played by carers in PBs. Interviews with carers and with older and disabled people were conducted during 2012 as part of a wider study into carers' roles in assessment, support planning and managing PBs. The interviews complemented a survey of reported practice in two English regions - interviews with adult social care services senior managers and focus groups with front-line care managers. Talking Mats(©) were used to support interviews with some service users. Interviews were transcribed and data analysed using the Framework approach. The interviews indicated that carers played important roles in service users' assessments and support planning, but were less likely to report receiving assessments or support of their own. While carers had the potential to benefit from PBs and support arrangements for service users, this did not reflect practice that aimed to enhance choice and control for carers. The paper draws on Twigg's typology of service conceptualisations of family carers and concludes that, despite the important social rights won by carers in England, current practice continues to regard carers primarily as a resource or a co-worker, rather than a co-client.
在当前塑造英格兰成人社会护理实践的个性化范式中，护理人员扮演着模糊的角色。尽管护理人员本身有权接受评估和获得支持，但这些权利与针对老年人和残疾人的评估、支持计划及个人预算（PB）分配的实践并不协调。本文报告了14对患有认知和/或沟通障碍的老年人及学习障碍者与其护理人员如何看待护理人员在个人预算方面所扮演的期望角色和实际角色。作为一项关于护理人员在评估、支持计划和管理个人预算中角色的更广泛研究的一部分，于2012年对护理人员以及老年人和残疾人进行了访谈。这些访谈补充了对英格兰两个地区报告实践的调查——对成人社会护理服务高级管理人员的访谈以及与一线护理管理人员的焦点小组访谈。使用“谈话垫”（©）来支持对一些服务使用者的访谈。访谈进行了转录，并采用框架法对数据进行了分析。访谈表明，护理人员在服务使用者的评估和支持计划中发挥着重要作用，但他们自己接受评估或获得支持的情况却较少被报告。虽然护理人员有可能从个人预算和服务使用者的支持安排中受益，但这并未反映出旨在增强护理人员选择权和控制权的实践。本文借鉴了特威格关于家庭护理人员服务概念化的类型学，并得出结论，尽管护理人员在英格兰赢得了重要的社会权利，但当前的实践仍然主要将护理人员视为一种资源或同事，而非共同客户。
