Rashmi BeckerChallenging the Commodification of Care as a Means for Improving the Wellbeing of Men and Women With Learning Disabilities

In the wake of a number of high profile failings in social care, most notably the abuse of people with severe learning disabilities at Winterbourne View in 2011, there has been widespread recognition of the need to address the lack of care and compassion afforded to society’s most vulnerable. The Cavendish Review highlighted the disconnect between services providing care, and earlier this year the National Audit Office reported the government’s failure to deliver on its promise to move people with a learning disability out of hospitals and into more appropriate settings.
There is plenty of anecdotal evidence demonstrating improvements in quality of life when people are enabled to have choice and control in their lives, underpinned by the concept of ‘personalisation’, which was first developed in ‘Putting People First’ in 2007. However, rather than seeing the widespread adoption of the personalisation agenda, the economic crisis in 2008 only exacerbated the ‘one size fits all’ approach with local authorities and the NHS remaining firmly in control and focused on implementing government savings. In this context, ‘care’ is essential a commodity purchased by commissioners, and results in service users experiencing ‘support’ as a transaction – potentially devoid of any meaningful interaction.
Nonetheless, compassion and quality remain at the forefront of government policy, as for example, in the introduction of the Care Act, CQC regulatory framework and the Care Certificate designed to improve the recruitment of support workers. There is however, an absence of any in depth analysis or understanding of the role of relationships between client and support worker – in improving the wellbeing of people with learning disabilities. Yet, I have seen how critical these relationships are during my employment in the sector, and wish to investigate this further.
For the past three years I have worked with national learning disability charities where I have been fully immersed in the challenges facing many vulnerable people and the people supporting them, as they try to navigate the complex social care system, the continuous squeeze on resources and increased bureaucracy accompanying new legislation and regulations. Yet I have also continued to be inspired by the passion and commitment in many support staff to make a difference for the people they support.

On a personal level, I recently became guardian to my older brother who has autism and lives in a supported housing development. Having to oversee his wellbeing and working with his support team has further developed my drive to make a real contribution to improving the quality of life of people with a learning disability and autism.

In the charities I have worked for, the interpersonal aspect of support and its impact on the quality of life of the people being supported is striking. The role of relationships in social care is not contentious but neither is it treated as a priority. From commissioning, to inspections, to delivery, the pressures remain on price and at its worst, ‘care’ is a tick box exercise.

There is a huge gap and opportunity to evidence the real impact of relationships in supporting people with a learning disability and my professional and personal experience has led me to be in a position to make a difference.

Rashmi Becker

Email: rc207@cam.ac.uk

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