Productivity in Social Care
Increasingly, disabled people are being offered enablement and re-enablement services, the aim is to enable the disabled person to regain or gain their functional independence, skills to undertake activities of daily living within a specified period of time. One well-known disabled activist said that the energy involved in getting dressed without support would not be a good use of his time and even to the economy. This disability advisor highlighted that he is much more productive undertaking paid work rather than being unemployed and spending time getting dressed without assistance. Even for disabled people not participating in paid work, if their time is preoccupied with undertaking daily activities without social care assistance then they have less time to take part in community based activities or being a consumer.
From social care management perspective, productivity is measured on maximised number of clients can be seen in minimum amount of time. To achieve this aim, support staff are required to complete specific tasks such as lifting and hoisting, bathing and using specific aids when working with clients in a prescribed and standardized manner. However, such practices can be harmful if an individual’s preferences and needs are not considered especially when procedures have not been tested with disabled person’s actual impairment or health condition in mind. Furthermore, disabled individuals are experts of their conditions and management of their care; they know what does and does not work and what to do or not to do in avoiding harm and injury that will promote their wellbeing and productivity.
Apart from the standardisation of tasks and time restrictions placed on support with tasks, there appears to be a move towards increasing support staff’s work load in order to maximise productivity and cost efficiencies. Increasingly support workers are being expected to perform tasks that would fall under the remit of professionally trained practitioners such as nurses, psychologists and physiotherapists and speech and language therapists. Sometimes, such professions will have specialisms in working with specific groups of disabled individuals. Unlike trained practitioners with many years of training and opportunities to adapt their practice during classroom exercises and on-the-job training to work with individuals under supervision, this would not be the case for support workers. Such an approach both denies a specific type and level of expertise some disabled individuals require which cannot be mastered in hours or days of practice by support workers often paid not much more than the minimum wage. Paradoxically, disabled individuals can become less productive if they are not benefiting from the right level of input needed to help them have fulfilling lives. For instance a disabled person’s communication will be more effective if SALT have regular input in devising programmes to enhance language ability and update communication aids software. Another example is when a disabled person with learning difficulties ability to walk independently affects their ability to explore and learn about their world through tactic means can be negatively impacted upon when support staff does not have specialist physiotherapy expertise in developing and implementing programmes for disabled individuals with specific needs such as those with neurological conditions.
Technology is becoming commonplace in deploying staff when they are actually needed for providing assistance with the aim of using social care budgets in a more effective manner. For instance telecare technology is used to provide disabled individuals with assistance when required such as attending to a fall without being in their own home. When services are arranged off-site, disabled individuals are more likely unconsciously to consider whether their requests for assistance is serious enough – i.e. can I wait until my daughter or son arrives to help me after a fall. When technological based services are used, disabled individuals may consider others frailty above their own needs for support assistance.
Global Positioning Systems (GPS) technologies can be used to monitor, track and locate a disabled person outside their own home. Further sensors can be used to detect if the person has left their home, similar to a tagging system for prisoners without the need for full time staff. Such monitoring equipment used as a social care intervention becomes no more than keeping someone safe and imprisoned within one’s own home which often leads to loneliness. Thus social care becomes risk adverse rather than risk promotion by providing disabled people with opportunities to go out in the community and lead productive lives.
Productivity in social care appears to be related to cost savings without considering impact upon disabled peoples wellbeing and living fulfilled and productive lives.