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Understanding disabling barriers: a fruitful partnership between Disability Studies and social practices?
- Authors:
- WILLIAMS Val, et al
- Journal article citation:
- Disability and Society, 33(2), 2018, pp.157-174.
- Publisher:
- Taylor and Francis
Disabled people are regularly denied their human rights, since policies and laws are hard to translate literally into practice. This article aims to make connections between social practice theories and Disability Studies, in order to understand the problems faced by disabled people, using different methods to look in detail at how practices are shaped and how disabled people get excluded. Disabled people are active agents in making change, both informally on an everyday basis and through formal actions. Thus we also suggest that the insights of disabled people could bring a fresh perspective to social practice theories, by troubling the taken-for-granted in our everyday lives. (Publisher abstract)
Best interests decisions: professional practices in health and social care
- Authors:
- WILLIAMS Val, et al
- Journal article citation:
- Health and Social Care in the Community, 22(1), 2014, pp.78-86.
- Publisher:
- Wiley
This paper reports on data collected in 2011 from a national study about the operation of the best interests principle, a key feature of the Mental Capacity Act (MCA) 2005 for England and Wales. Four contrasting sample sites were selected, in which National Health Service trusts, social care and other organisations were recruited to participate. A multimethod design was followed, including an online survey with 385 participants, followed by qualitative research through a telephone survey of 68 participants, and face-to-face semi-structured interviews following up 25 best interests cases, with different perspectives on the process in 12 of those cases. This article reports the qualitative findings. The findings indicate that the MCA was successful in providing a structure for these practitioners, and that the five principles of the MCA were in general adhered to. A variety of perceived risks led to best interests processes being undertaken, and a typical scenario was for a period of hospitalisation or ill health to trigger a best interests decision process about a social care and or a life decision. The study supported previous research in finding the notion of capacity the most difficult aspect of the MCA, and it provides evidence of some specific capacity assessment practices, including problematic ones relating to ‘insight’. Best interests decisions were often made by consensus, with practitioners taking on different roles within the process. Meetings played a key part, but other ways of involving people lacking capacity and significant others were also important. It was recommended that the issues highlighted in this research could be clarified further in the Code of Practice, or within risk guidance. (Edited publisher abstract)
Best interests decisions study: lay summary
- Authors:
- WILLIAMS Val, et al
- Publisher:
- Mental Health Foundation
- Publication year:
- 2012
- Pagination:
- 10p.
- Place of publication:
- London
The Mental Capacity Act 2005 (MCA) sets out what should happen in England and Wales if someone is unable to make a particular decision themselves. The MCA says that a decision made for someone who lacks capacity must be made in their ‘best interests’. The person making that decision is often a health or social care worker, and they must follow the MCA Code of Practice. This study aimed to find out more about how best interests decisions are being made, how far the Code of Practice is followed, and how helpful it is in real life situations. Information was collected about 385 best interests decisions made in 4 areas of England through an online survey of professionals and workers involved in best interests decisions. Telephone interviews with 68 of the people who responded to the survey, and face-to-face interviews with 25 of these, gave a better understanding of what they had done and why. The findings cover the following areas: triggers for undertaking a best interests process; assessment of capacity; the process of making a best interests decision; including the person lacking capacity and others close to them; the role of Independent Mental Capacity Advocates (IMCAs); recording of best interests decisions and assessment of capacity; the basis of the decision; and outcomes. Recommendations are provided for policy, commissioning, professional education and training, practice management, and future research.
Making best interests decisions: people and processes
- Authors:
- WILLIAMS Val, et al
- Publisher:
- Mental Health Foundation
- Publication year:
- 2012
- Pagination:
- 157p.
- Place of publication:
- London
The Mental Capacity Act 2005 (MCA) sets out what should happen in England and Wales if someone is unable to make a particular decision themselves. The MCA says that a decision made for someone who lacks capacity must be made in their ‘best interests’. The person making that decision is often a health or social care worker, and they must follow the MCA Code of Practice. This study aimed to find out more about how best interests decisions are being made, how far the Code of Practice is followed, and how helpful it is in real life situations. Information was collected about 385 best interests decisions made in 4 areas of England through an online survey of professionals and workers involved in best interests decisions. Telephone interviews with 68 of the people who responded to the survey, and face-to-face interviews with 25 of these, gave a better understanding of what they had done and why. The findings cover the following areas: triggers for undertaking a best interests process; assessment of capacity; the process of making a best interests decision; including the person lacking capacity and others close to them; the role of Independent Mental Capacity Advocates (IMCAs); recording of best interests decisions and assessment of capacity; the basis of the decision; and outcomes. Recommendations are provided for policy, commissioning, professional education and training, practice management, and future research.
Making best interests decisions: people and processes: appendices A-F
- Authors:
- WILLIAMS Val, et al
- Publisher:
- Mental Health Foundation
- Publication year:
- 2012
- Pagination:
- 337p.
- Place of publication:
- London
The Mental Capacity Act 2005 (MCA) sets out what should happen in England and Wales if someone is unable to make a particular decision themself. The MCA says that a decision made for someone who lacks capacity must be made in their ‘best interests’. The person making that decision is often a health or social care worker, and they must follow the MCA Code of Practice. A study aimed to find out more about how best interests decisions are being made, how far the Code of Practice is followed, and how helpful it is in real life situations. Information was collected about 385 best interests decisions made in 4 areas of England through an online survey of professionals and workers involved in best interests decisions. Telephone interviews with 68 of the people who responded to the survey, and face-to-face interviews with 25 of these, gave a better understanding of what they had done and why. A description of the study and its findings are published in the report ‘Making Best Interests Decisions: People and Processes’. This document contains the appendices to this report and provides further details on the experimental methods and analysis. The appendices cover: the online survey; the telephone survey; interviews; people with dementia; Deprivation of Liberty Safeguards; and the issues discussed in the focus group.
Money, rights and risks: a scoping review of financial issues for people with learning disabilities in the UK
- Authors:
- WILLIAMS Val, et al
- Publisher:
- Friends Provident Foundation
- Publication year:
- 2007
- Pagination:
- 53p., bibliog.
- Place of publication:
- Dorking
This report reviews financial issues for people with learning disabilities and their families, across the UK. It draws on a wide range of recent and ongoing research in the field of learning disability, as well as three focus groups for 25 people with learning disabilities in different areas of the country and ten individual interviews. There is also some reflection about the issues for financial providers, based on a small sample of interviews, and the report ends with recommendations for practice and further research. Key findings show that many people with learning disabilities had little control of their own resources. They were mostly given ‘pocket money’, which they spent on small non-essential items. People had few opportunities to improve their financial knowledge. Personal incomes were low, and some had taken on credit that they did not understand, and could not afford. The report concludes that those with learning disabilities need planned financial support packages when they move into independent living. They also need safeguards, to ensure minimal financial risk. Family carers and support staff need advice, information and training in offering financial support
Skills for support: personal assistants and people with learning disabilities
- Authors:
- WILLIAMS Val, et al
- Journal article citation:
- British Journal of Learning Disabilities, 38(1), March 2010, pp.59-67.
- Publisher:
- Wiley
For people with learning disabilities to have control over their lives, the quality of their support staff matters. This paper reports on an inclusive research study, which used video analysis to study the communication skills of personal assistants (PAs) who worked with people with learning disabilities. The findings reveal some of the fine detail in the strategies these PAs used, to show respect, support choices, and give advice. They were able to step back, to listen and observe the person with learning disabilities, and to use good, open body language. They also gave people time, built up a close relationship based on shared interests and activities, and they talked with people in a friendly, adult way. It is difficult to support people to manage their lives, and team work is important. People with learning disabilities also have to play their role in the relationship. This research produced training materials that will help people with learning disabilities to train and support their own PAs.
'Listen to what I want': the potential impact of the Mental Capacity Act (2005) on major life decisions by people with learning disabilities: report for the Social Care Institute for Excellence
- Authors:
- WILLIAMS Val, et al
- Publisher:
- Norah Fry Research Centre
- Publication year:
- 2008
- Pagination:
- 71p., bibliog.
- Place of publication:
- Bristol
Report of a study of major decisions in the lives of 20 people with learning disabilities, from their point of view. The overall purpose was to learn more about the potential impact of the Mental Capacity Act (MCA) with people with learning disabilities. The report includes three tools for practice that were developed and tested with people with learning disabilities, their supporters and managers.
What good support is all about
- Authors:
- WILLIAMS Val, et al
- Journal article citation:
- Learning Disability Today, November 2009, pp.36-39.
- Publisher:
- Pavilion
- Place of publication:
- Hove
'Skills for Support' was a research study conducted between 2005 and 2007 to find out what people with learning disabilities want from their personal assistants or other one-to-one supporters. The research methods used included surveys, individual and group interviews and video sessions of people with learning disabilities interacting with their personal assistants. This article focuses on the final video stage of the project and its practical findings. Five of the key outcomes identified were showing respect, giving choices, being friendly, giving good advice and supporting people to speak up. A resource pack was produced which includes a DVD of extracts from the videos to illustrate the five key themes.
Nice job if you can get it: work and people with learning difficulties
- Authors:
- WILLIAMS Val, et al
- Publisher:
- Norah Fry Research Centre
- Publication year:
- 2004
- Pagination:
- 39p.
- Place of publication:
- Bristol
This report is about employment opportunities and day centres and jobs for people with learning disabilities. It examines the policy background, and the motivation and barriers to work experienced by people with learning disabilities. Suggestions for enhanced advocacy and user led decision making are included.