High Risk Service Users

Published Date: 02 Nov 2017

The Case Study

Introduction

I am a support worker/project worker in a supported housing unit in Nottingham, for thirteen female young people between the ages of 16 -25 years referred from Housing Aid. Their basic needs are addressed in an interview before referral. The service users are homeless with a possible background of domestic breakdown and some have come out of the care system.

After referral from Housing, an initial assessment of need is undertaken covering several needs: physical and emotional well-being and any medication or health concerns. The young person may smoke or even have drug or alcohol issues; these will be on the referral form. The young person's mental health will then be examined and there may be additional reports from social workers or schools. High risk service users, such as ex-offenders, can be referred, who may have involvement with probation workers.

Mary, a service user at the housing project I work in is 18 years old with Portuguese parents who are separated. Mary's father lives in the West Midlands and her mother lives in Nottingham. Mary initially lived with her mother and father and then decided to live with her father. On school holidays, Mary stayed with her mother. Mary was assaulted by her father at the early age of 10 years old when he hit her with a belt and a metal bar, which resulted in Mary, placed in care after the involvement of police and social services. Mary’s friend, who lives in Wales, is her closest contact but she does not see her regularly. She does have other friends; however, she avoids them because of their criminal behaviour (Appendix 1).

The needs of young women arriving at the project further assessed after signing a tenancy agreement for accommodation in the project. Each young woman has a self-contained flat within the project with a bedroom, kitchen and bathroom. Most accommodation costs meeting through housing benefits. If the young person is working they pay part of the service charge after assessment. Mary came to the UK with her family when she was young. They applied for British citizenship but did not pass it over to Mary. She previously had issues claiming housing benefit, but as she is an EU citizen, she is now eligible for housing benefit. (Appendix1)

The educational needs of the young person in numeracy and literacy are assessed, Personal and social development and health are also taking into account as is the young person's ability to budget their money. Without project intervention, many young people would be homeless and at great risk of exploitation and/or bad health. Young people find the experience of homelessness means it is very hard to reintegrate into society (depauluk, 2010).

Harrison et al (2010) states youth work is informed by a set of beliefs, which help young people to develop their own set of values. From a practitioner’s point of view it is important to work with a set of clear values encompassing trust, respect, clear boundaries must be established, and the young person’s cultural background should be respected. (Banks, 2001). Authoritarian language should be avoided, and service users treated with respect and their opinions valued. Schon (1991) noted that the young person is not likely to accept the practitioner's authority but will have disbelief in it. To earn the trust the practitioners must take a stand on where they are from and what they believe, value and seek to achieve (infed, 2004).

NAOMIE (Needs, Aims, Methodology Objectives, Implementation and Evaluation) is a practice model for planning, monitoring and evaluating youth work (Table 1). It is a framework used to identify the needs of the young people (Ingram et al, 2001). NAOMIE includes every stage a project needs to go through and breaks down the planning stage into smaller chunks. This tool worked well for Mary because it helped to identify her needs and give a breakdown and indicator on what course of action could be taken. NAOMIE identified some of the barriers in anti-discriminatory practice on working together on issues of inequality, discrimination and oppression (Thompson, 1994). Mary attended weekly support sessions, however, at the time of the first key session, Mary had missed four appointments at Access College, who raised concerns about her behaviour. I learnt Mary had doubts about being able to apply herself to her educational needs, which affected her Job Seekers Allowance (JSA). Her service charges paid by direct deductions from her benefits. Mary will need support in budgeting and has agreed to set up a budgeting plan with her next payment. I agreed to meet with her and identified motivational interviewing as the best method to move forward (Table 1).

Needs assessment

How you know the work is needed and not duplicating other work

Aims

The overarching point of the project/session

Objectives

Sub goals – steps on the way to achieving the aim

Methodology

The way you will deliver the work or engage young people

Implementation

Doing it

Evaluation

Reviewing it

Table 1 NAOMIE PLANNING MODEL (REF)

The theoretical underpinning of the intervention informed by Thompson (1997) looks at the person holistically with the PCS Model (1997). Society can and does often oppress young people through institutions which support cultural norms and personal beliefs. These institutions can label young people and hinder their development and progress. Thompson (1997) PCS model underpins the referrals and being a support worker. I can support Mary with learning tools that challenge oppression, such as the language I use in my person-centred approach (Table 2). By engaging using wider policy objectives it is a person-centred base. Young people will sometimes openly discuss within a safe environment amongst their peers and focus on building one's confidence. To get reassurance within a group, as well as maintaining the learner's concentration is vital for the young person to get away from the labelling of institutions they may have come from (Thompson, 1997).

As a support worker, I identified links within the project to refer to external agencies, such as social services and welfare agencies. I informed from staff that her key worker had contacted the Department for Work and Pensions (DWP) about her JSA payments stopping due to poor attendance at college. An important skill for this type of intervention is listening or active listening. Verbal and non-verbal skills needed in order to establish rapport and good a relationship between worker and service user. A person-centred approach using listening skills and asking questions helps the service users clarify their own thoughts(REF) In terms of theory, I used communication skills with empathy by getting to know Mary’s situation, I asked open questions such as "How is your day going?" I offered refreshments, which are an informal way to build a rapport and relationship (Egan, 2002). I developed the relationship with Mary through on-going one-to-one support. I used these interventions to develop an open method of expression, which can stimulate a young person's ability to connect with the environment around them and nurture positive aspiration, confidence and resilience to manage challenging life circumstances.

According to Thompson’s PCS model (1997), Personal means the individual; as a young person 18 years old placed in care after police and social services involvement. Culturally, Mary came to the UK from Portugal with her uncommunicative family, and left school with low attainment and poor attendance. Within the housing project, Mary developed relationships with other young people and made music for enjoyment; within the community she is sharing her thoughts and feelings with different groups. Mary has friends whom she avoids now as they are getting into criminal behaviour. In relation to Structural, Mary now has a network of divisions such as Connexions, Social Services, Health, and Local Authority. Mary referred to floating support has continuing support from social services. Mary has a leaving care worker, called Susie who visits her from time to time (Appendix.1)

http://youthworkcentral.tripod.com/PCS.gif

Table 2 Anti-oppressive model: Thompson (1997) PCS Model

In terms of Mary's experience at the project she has been mainly served well. Prevention needs to take place in the context of person-centred support and personalisation, with individuals empowered to make choices and supported to manage risks. As a support worker I reviewed the service user with other members of the staff. We reflected together with the service user using motivational skills. Secondly, I identify what a young person wants and what is possible. Finally, to action the intervention is to plan and choose the right intervention to support the young person in activities to achieve goals about building resilience. The limitations to the intervention and the positive aspects to the intervention I used Motivational interviewing skills and Thompson PCS Model with the service user by negotiating a plan one to one for change. In terms of anti-oppressive practices Mary has had a positive experience by going through the project. I have identified the theory to help me understand the individual or the situation she is experiencing. This has shown a positive and effective outcome for her to be considering she is no longer in the same location as her cultural background. Mary was born in Portugal and is an EU citizen, however, she experienced problems when claiming benefits such as job seekers allowance (JSA) but is eligible for housing (Apendix.1).

This legislation which forms social policy is outworked through the project's policies and procedures as an intervention, working with homeless or temporarily housed service-users and has a range of problems and challenges. The challenges facing young people by 2020 will require fundamental changes to the UK housing system. Young people are particularly vulnerable in a badly functioning housing system due to their lack of resources and opportunities ( jrf, 2012).

The Supporting People programme (SP) been central to the development and provision of quality accommodation based homelessness services (homeless, 2012).

SP programme launched under the Labour Government in April 2003. The programme provided support through the Housing Benefit system, aimed to supporting vulnerable people to live independently (gov, uk, 2012). Homelessness Act (2002) gives housing authorities the power to carry out homelessness and has published a homelessness strategy based on the results of the review (gov,uk, 2012). The homelessness strategy is linked with other strategies and programmes that address the causes of homelessness. For example, health, education and employment, whose activities may help to prevent homelessness. The young people who referred from housing aid considered having a priority need for housing under homelessness (Nottingham city, 2012).

In order to improve interventions, investing in multi-agency working partnerships could provide more resources such as funding for young people provision, community care grant provision when a young person is moving on. Early intervention and targeted support is dependent, on the possibility of being able to recognise the young people who do not reach their potential and therefore the results is low academic and personal outcomes. Recently it has been identified that it is essential to recognise the risk factors involved in locating the risk factors for target groups (education.gov.uk, 2010). Early assessment of the risk levels involved in early intervention in order to target the most vulnerable are not simple and can be challenging (Nottingham city .gov.uk, 2010). Such as, young people need additional help in relation to their health, education, care and behaviour. Also it is recognise that practitioners should understand the necessity for risk assessment in order to gain an overall picture of the areas of the young person’s life that can make them vulnerable resulting in poor outcomes. However, assessment can result in increased resilience young people often turn their past life experiences from the home or in care is an opportunity for practitioners to support them (REF). A complete need assessment is important to identify risk factors and assess which of them can be effectively to identify a young person’s immediate needs and the required interventions/programmes. Rutter et al., 1998; Newman and Blackburn, 2002)explain that it includes the development of self-care skills , such as personal hygiene, health, sexual health, practical skills and interpersonal skills. For xample.

References

Rogers, C.R. (1951) Client Centred Therapy. Boston, MA: Houghton Mifflin.

Schön, D. A. (1991) The Reflective Turn: Case Studies In and On Educational Practice, New York: Teachers Press, Columbia University.

Thompson, N. (1997) Anti-discriminatory Practice (2nd Ed), Basingstoke: Macmillan

'

The Skilled Helper - a problem management approach to helping' by Gerard Egan. Brooks Cole, 6"' edition 1998

The National Youth Agency Research Programme Series Staying Safe: The implications for youth work of Every Child Matters

http://www.crsp.ac.uk/downloads/publications/alans_publications/staying_safe.pdf accessed 12/02/13

Joseph Rowntree research

http://www.depauluk.org/_uploads/documents/jospeh-rowntree-research.pdf accessed 12/02/13

Infed.org.uk

http://www.infed.org/thinkers/et-rogers.htm accessed 12/02/13

Joseph Rowntree research

(http://www.jrf.org.uk/sites/files/jrf/young-people-housing-options-summary.pdf accessed 12/02/13

Homeless.org.uk

http://homeless.org.uk/supporting-people#.URn8IqWHzSg accessed 12/02/13

Homelessness Code of Guidance for Local Authorities

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/7841/152056.pdf accessed 12/02/13

Nottingham City Council

http://www.nottinghamcity.gov.uk/index accessed 12/02/13

Department for Communities and local Authorities

https://www.gov.uk/government/policies/providing-housing-support-for-older-and-vulnerable-people/supporting-pages/local-councils-housing-support accessed 12/02/13

Intervening to improve outcomes for vulnerable young people: a ...

www.education.gov.uk/publications/.../DFE-RR078.pdf accessed 20/2/13

Early Intervention: Securing good outcomes for all children and young people

http://www.nottinghamcity.gov.uk/CHttpHandler.ashx?id=18568&p=0 accessed 20/2/13

www.gov.uk,2012)

Egan, G. (2010) The Skilled Helper: A Systematic Approach to Effective Helping, 9th edition.

Rogers, C.R. (1951) Client Centred Therapy. Boston, MA: Houghton Mifflin.

Appendices

The Naomie Planning Model (Table 1)

Anti-oppressive model: Thompson PCS Model (Table 2)

Case study (Appendix .1)