Policy to practice: a critical analysis of the ‘valuing people’ strategy

This qualitative investigation set out to analyse the impact of ‘Valuing People: A New Strategy for Learning Disability for the 21st Century’ (DH, 2001) on the lives of people with profound intellectual and multiple impairments (PIMD) and their family carers. Data was drawn from three distinct sources. The investigation began with a critical discourse analysis of Valuing People (VP). The findings informed the development of a semi-structured interview schedule for use with family carers caring for an adult with PIMD. It was deemed important to the study to include an individual with PIMD in as meaningful manner as possible. Therefore, following careful ethical deliberations, filmed excerpts of a woman with PIMD engaged in aspects of her daily routine, representing the main themes of VP, were used to elicit focus group discussions with paid care workers in different parts of London. The findings from the different data sources were triangulated, highlighting how a focus on a social model of disability in VP excluded those with PIMD. This neglect was confirmed and elaborated by the family carers and also the paid care workers. The findings further highlighted deficiencies in the volume and nature of provision of appropriately skilled staff, the availability of specialist services and residential respite for families. There was also a general feeling that things had not improved and much concern about the future. The film elicitations demonstrated the use of VP language among care workers but with little understanding of the concepts of rights, independence, choice and inclusion. By situating this hermeneutic exploration within a critical approach, the main findings have demonstrated the manner in which people with PIMD are marginalised within the policy, rather than having their differences recognized and ultimately their needs met.