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Journal ArticleDOI

The morphogenesis of disability policies and the personalisation of social services. A case study from Italy

22 Jan 2018-International Review of Sociology (Routledge)-Vol. 28, Iss: 1, pp 86-109
TL;DR: In Europe, and particularly since the 2008 Financial Crisis, new demands for tailor-made services came from different actors and perspectives: user-led organizations, intellectuals, policy make... as discussed by the authors.
Abstract: Across Europe, and particularly since the 2008 Financial Crisis, new demands for tailor-made services came from different actors and perspectives: user-led organizations, intellectuals, policy make...

Summary (3 min read)

1. Introduction

  • The paper is structured in the following way.
  • In Section 2 the authors clarify the difference between personalized and individualized social services; then (Section 3), they argument their hypothesis, methodology and research outline; in Section 4 they present their research on Sardinia personalized plans.
  • In Section 6 the authors briefly comment on the results, pointing out the critical, controversial and contradictory aspects of Sardinian personalization policy.

2. The conceptual difference between personalization and individualization

  • (2) collaborate in designing and co-producing services.
  • Each and every solution has to be shared and decided together with case managers, personal advisers, users and others responsible for the service.
  • This concept of co-production goes back to Elinor Ostrom's work (a process by which 'inputs from individuals who are not "in" the same organisation are transformed into goods and services ' 1996, p. 1073) and it is connected to policies governance (as co-creation, codesign, co-planning, co-management and co-assessment Pestoff, Brandsen, & Verscheure, 2012) .
  • To conclude, in PSS persons are conceived as the medium of new social services.
  • As Sabel demonstrated, the new welfare regimes will be based on 'capacitating social services' (Sabel, Zeitlin, & Quack, 2017) .

3. Hypothesis, methodology and research outline

  • Methodologically, the authors use two different sociological approaches: Archer's morphogenetic theory 1 (1995) and Hedström's social mechanism theory (Hedström & Swedberg, 1998) .
  • The authors try to include within the morphogenetic approach the so-called 'Coleman boat' to show how changes over time at different policies layers, can influence personalization (or not) .
  • 'Basically, A's are extra-individual social factors that might be cited as causes of social phenomena and that might influence individuals' (Ylikoski, 2016, p. 5 ).

Morphogenesis of social policy administration Forms of governance Hp1

  • Interaction between social workers, users and their supportive networks.
  • Hp2 Individualised/Personalised social services Conditions for the implementation and delivery process properties of agents and their situations, like values, opportunities or interests (Node B) and to behavioural outcomes, like choices, behaviours, or actions (Node C).
  • 'It is the starting point of the analysis that employs the diagram.
  • The interviews with key informants have been divided into four parts: ( 1 Interviewing users, family members, and relevant social workers have carried out the analysis of personalized plans.
  • On average, each interview lasted 90 minutes.

5.1. The four phases of the process: situational, actional and transformational social mechanism

  • You don't care about all the personalized process.
  • It remains personalized, but about all the participatory process where the choice is made ….
  • You aim to have just a technical report that defines how high is your seriousness level and how much money and then they will explain you how to spend them ….
  • If they will arrive to these conclusions, the authors will say nooo!.

5.2. Interactions through personalized plans: 'misunderstanding' and coproduction

  • The other focus of their analysis concerns interactions taking place between users, their families, social workers, personal assistants and professionals.
  • These interactions are now very ambivalent: in a certain sense, plan designs and their implementation are fully delegated to users and families, but this 'devolution' gives rise to a reaction that, paradoxically, generates a more bureaucratic procedure.
  • This means that the collaboration between users, families and social workers collapses; but, at the same time, the absence and the breakdown of this institutional collaboration is balanced out on a different level: the design and implementation shift to users, families and their networks.
  • Social workers and public officers simply limit their role and action to validate autonomized personalized plans.

5.2.1. The interaction between social workers and users and families: a 'creative misunderstanding'

  • Interviewed social workers report that personalized plans are still able to meet families' requirement for care, but also report that support, monitoring and evaluation activities are not really carried out.
  • Co-production is thus suspended, and users and families have to manage their relationship with personal assistants autonomously.
  • In a sense, the process of co-production is creatively 'misunderstood' because care services become dependent on the family ability to operate on their own.
  • At the same time and paradoxically, users, their families and the chosen staff are included in the care system because they are necessary for the daily workability of the system.
  • Arbitrariness and freedom to design the plans autonomously are thus traded off for a restricted and limited co-production of services.

5.3. Interactions between users and personal assistants: three steps towards coproduction

  • It is exactly here that the authors can see the difference between personalization and standardized services: users and families are not seen as mere passive targets, but as real proposers, people with competencies and capacities useful to elaborate solutions.
  • In their actions they represent the precondition for the existence of personalized services.

'Interviewer:

  • That means that she has followed, understood and then she does it.
  • 2), 'the authors work on her skills and her desires' (story no. 4). Assistant's empathy and understanding are increased by two factors: the presence of a caring and collaborative family, and the possibility of a fruitful dialogue with other professionals (see Box 4 and 5) .
  • She can discuss frequently with other assistants, can rely on several professionals in order to design each specific plan and can learn how to support disabled people in a very personal way.
  • The authors worked on some useful activities but that F. might also like.

6. Conclusions

  • Here external forces have a significant influence.
  • In the logic of elimination (phase 4) the demand for cuts in social spending creates an austerity policy and consequently closes opportunities reducing the number of possible active actors.
  • In the morphostatic logic of protection (phase 1), the policy system is steered by agreements between regional policy makers and big for-profit providers, immunizing themselves from external events and from the entries of new possible actors.
  • Within the logic of correction (phase 3) unions, private in-home assistants and migrant caregivers emerge as leading actors.

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Content maybe subject to copyright    Report

This is an Accepted Manuscript of an article
published by Taylor & Francis in International
Review of Sociology Revue Internationale de
Sociologia on January 22
nd
2018, available online:
http://www.tandfonline.com/10.1080/03906701.201
7.1422887

The morphogenesis of disability policies and the personalisation of
social services. A case study from Italy.
Riccardo Prandini and Matteo Orlandini
University of Bologna, Nonantola, Mo, Italy
Abstract
Across Europe, and particularly since the 2008 Financial Crisis, new demands for tailor-made services
came from different actors and perspectives: user-led organizations, intellectuals, policy makers, social
workers, advocacy organizations, which call for a new way of programming, realizing and evaluating
social policies. Personalization became a relevant part of the so called ‘welfare innovation narrative’,
which concerns to name but a few English personalization agenda, Scottish self-directed support,
Finnish education system, Norwegian cash-for-care policies. Even the European Commission is
addressing new social services, reshaped through users’ capabilities. The aim of this paper is to critically
explain, through a case study focused on the Sardinian disability policy, how social policy’s
morphogenetic cycles influence the governance of personalized disability plans and, consequently, the
possibility of their implementation.
Keywords
Personalisation; disability policies; co-production; morphogenesis; governance; social services
1. Introduction
European Welfare states are facing a growing demand for personalized social services, due
to among many reasons the de-standardization and heterogeneity of individual needs
(Valkenburg, 2007) which give room to the dramatic rise of new (Taylor-Gooby, 2005) and
non-actuarial societal risks (Sabel, 2012): harms whose incidence is so unpredictable that
it is impossible for those at risk to create an insurance pool sufficient to indemnify those
who incur losses. These changes make unsuitable the one-size-fits-allservices designed
to serve the average clienttypical to traditional forms of welfare state (Rosanvallon, 2000).
Across Europe, and particularly since the 2008 Financial Crisis, new demands for tailor-
made services came from different actors and perspectives: user-led organizations,
intellectuals, policy makers, social workers, advocacy organizations, which call for a new
way of programming, realizing and evaluating social policies. Personalization became a
relevant part of the so called welfare innovation narrative (Needham, 2011), which
concerns to name but a few English personalization agenda (HM, 2007), Scottish
selfdirected support (Scottish Government, 2010), Finnish education system (FNBE, 2010),
Norwegian cash-for-care policies (Christensen, 2012). Even the European Commission
(2013) is addressing new social services, reshaped through userscapabilities.
Personalization has been basically conceived as: a very ambivalent reflexive narrative
(Needham & Glasby, 2014); something in flux, making it difficult to identify a stable core
(Needham, 2011, p. 157); being simultaneously liberal and conservative (Ferguson, 2007);
for independence/self-sufficiency and in favour of retrenchment (Power, 2014); for
citizenship rights protection and for families and communities activation (Glasby, Duffy,

& Needham, 2011). In a nutshell, personalization is generally observed as a powerful
hybridization(Ferguson, 2012) between market consumerism and social rights discourse,
giving rise to a social policy mix constituted of counterposed values like deep citizenship
and consumerism, community support and individual choice (Mladenov, Owens, & Cribb,
2015). This ambiguity becomes a key element of its success because different actors and
services users perceive personalization differently, so that it can be extensively accepted
as an actual option by the political system (Beresford, 2014): personalization become
varieties of personalisationand it is framed differently in various national welfare regimes
(Christensen & Pilling, 2014; Needham & Dickinson, 2017).
Scientific literature and case studies have not yet fully explored the social mechanisms
that allow personalization to work properly (Reeve & Cooper, 2016). In particular, the
relation between personalization and its governance which is one of the cornerstones
leading to the discourse is poorly developed (Duffy, 2010). An adequate account on how
the personalization of social services has to be governed has not yet been elaborated.
The aim of this paper is to explain, through a case study focused on the Sardinian
disability policy, how social policys morphogenetic cycles (Archer, 1995) influence their
governance and, consequently, the possibility of implementing personalization.
The paper is structured in the following way. In Section 2 we clarify the difference
between personalized and individualized social services; then (Section 3), we argument
our hypothesis, methodology and research outline; in Section 4 we present our research on
Sardinia personalized plans. In Section 5 we try to identify the morphogenetic cycle
observed in the Sardinia case, to show how varieties of governance are linked to different
ways of personalization. In Section 6 we briefly comment on the results, pointing out the
critical, controversial and contradictory aspects of Sardinian personalization policy.
2. The conceptual difference between personalization and
individualization
For policy makers, personalization is a specific and innovative way of designing,
delivering, financing and evaluating social services (Glasby & Littlechild, 2009).
Personalized social services are targeted and tailored on individual needs and aspirations,
supporting and enabling citizens in realizing autonomously their life-projects (Duffy,
2008). Personalization means that social services should be de-standardized, adapted and
tailored to the individual characteristics and their circumstances in order to increase their
effectiveness(van Berkel & Valkenburg, 2007, p. 3).
Three drivers enhance personalization processes within social policies, especially as far
as social care is concerned. The first driver involves the historical breakdown of the
Principal-Agent model, which has been typical of welfare states after the Second World
War (Sabel, 2013). The second driver concerns the crisis of the compensatory social
insurance model of welfare, which has already been replaced by a social investment and
inclusive growth paradigm, triggered by a service-based welfare system (Hemerijck,
2012). The last driver pertains to co-production of services, which deeplyinclude specific
ways of articulating users needs.
(a) Postwar welfare states and their governance were characterized by the PrincipalAgent
(P/A) model. In a nutshell, Principal i.e. a national government appoints some

Agents i.e. local public authorities to implement previously defined collective
goals. In other words, general programmes and reforms elaborated by the Principal
are translated, through a bureaucratic chain of command, into specific actions and
policies by the Agents. Literature revealed many structural, non-contingent reasons
for the failure of the P/A model: (1) the Principal should know what he wantsex ante,
but actually this is not usually possible, since contingencies pervade the whole
process; (2) the Principal is supposed to be able to identify all tasks of Agents: as a
matter of fact, it rather coordinates many Agents, whose interaction gives rise to new
emerging problems (and subsequent new tasks); (3) the distinction between means
(enforced by the Agents: policy implementation) and ends (enacted by the Principal:
policy making) is no longer clear, neither materially, nor socially and temporally; (4)
social issues are always contextual and mutable so that it is no longer possible to
design long-term and one size fits allsocial services; (5) goods and services are often
de facto co-produced with users-customers-citizens: therefore, the distinction between
active-agents-professionals and passive-ignorant-citizens is unbearable; (6) it is not
useful to adopt simple rules because if they are too general, an interpretation is needed,
which generates conflicts that cannot be solved hierarchically; (7) Principals and
Agents are increasingly conceived as search networks, which horizontally
collaborate to solve part of the problem they face; (8) those Agents who should
implement Principal decisions often aim to protect their own interests and not the
Principal one; (9) recruitment procedures are less and less suitable for selecting the
bestopportunities (under which respect Agent) and some rules (i.e. the lowest price)
are often useless for the purposes of servicesimplementation.
(b) The second driver concerns a conceptual change, pointing at the emergence of the
socalled new social risks. These new risks are increasingly complex and
unpredictable (Taylor-Gooby, 2005). Old welfare risks were coupled with standard
insurance calculated on an actuarial basis, with a focus on a typical male citizen, full-
time employed, holding a steady job position that was maintained throughout the
entire career; job interruption was mainly contingent upon sickness or unemployment
(which were correlated to predictable economic cycles). These risks have completely
changed. To differentiate people included or excluded from the labour market has
become more difficult because of the proliferation and fragmentation of new
employment contracts. Moreover, categories of people previously excluded from the
labour market e.g. women, disabled people, single mothers, elderly have become
more and more included, while, on the other side, other categories who were included
e.g. young people have gradually been more and more excluded (Annesley, 2007).
Old welfare systems were also founded on a tacit intergenerational solidarity pact
involving working and retired people , which operated with a passive financial
redistribution mechanism. On the contrary, nowadays, risks that need to be insured
against are less and less estimable on an actuarial basis (Luhmann, 2013). Such risks
are so unpredictable that it is impossible both to say who, whenand how much
should be paid, and to generate an amount of insurance sufficient to really compensate
those who suffer a loss. This new welfare constellation drives towards the notion of
social investment where costs are conceived as tools for creation of human, social and
economic capital. Instead of passive financial compensations (i.e. old-fashioned social
assistance), now capacitation and active policies are new keywords. Since risks

aggregation fails, new social services are needed to help individuals and families to
self-insure against risks, making them able to develop, throughout their life course,
skills and capabilities to tackle ever changing problems (Crosby & Duffy, 2008).
(c) The third driver is connected with the importance to capacitate people by means
ofsocial services, thus transforming their abilities into positive resources. In order to
generate a cohesive and dynamic society, welfare systems have to organize
personalized services so that the increased human and social capital can tackle
dependence trap and social isolation (Castel, 1995; Ehrenberg, 2009). The efficiency
of personalized services depends on userscollaboration and response: users have to
personally engage in order to thrive. Activating peoples potentialities is a condition
of possibility to discover and meet unmet needs: our hypothesis is that this process
can take place only through a personalized services co-production.
These three drivers permitted and enhanced a new culture of personalization within
social policies. Though within the concept of personalization are conflated two very
different ways of thinking and designing social services. Given this conflation we need to
distinguish personalization from individualization to frame our research project. These are
two very different logics of delivering social services, usually conflated in literature.
We define individualized social service (ISS) as a top-down example of policy making,
aimed at offering a standardized and specified provision of social services, which could be
better defined as customization of services. Goods and services are pre-arranged and
planned by professional experts and policy-makers: the whole range of customized
services is available in a packageready to be delivered. In many situations this more
individual approach is combined with a primarily top-down approach, in which the
political process has already defined the problems that have to be solved and the ways in
which this should be done(Valkenburg, 2007, p. 38). In ISS the designer defines the
clients needs and decides how to deal with their context, shaping a diverse but
standardized caseload. That is why the clients are not real co-producers: they can only
decide how to utilize the resources previously arranged by services designers.
Individualization as a set menu service can reach remarkable levels of precision,
differentiation and tailoring, but it cannot develop real processes of co-design and co-
production because the client, by definition, is limited to a passive role. They are a target
defined by an expert systemwhich holds the powers and knowledge to decide what is
the caseand who is in charge. The client is made passive because they have no real power
to co-produce/deliver/evaluate what they need: because service users and carers were
excluded from directly contributing to the original policy problem formulation, they could
not influence the proposed solutions(Carr, 2014, p. 30).
We can give some examples based on English personal budget and self-directed support
scheme, exactly to underline the case for individualization without personalization.
Slasberg and Beresford pointed out how need assessment, that formerly was divided into
a need evaluation (with the client) and a decision concerning which needs to meet, has
become a single process: the imperative for Councils became to constrain assessments to
affordable need only. Thus needwas always seen through the prism of resources(2015,
p. 480). The person-centred approach has turned into a resource-driven approach. Series
(2014) with Clemence (Series & Clemence, 2013) showed the failure based on RAS

Citations
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11 Apr 2015

48 citations

Journal ArticleDOI

23 citations

Posted Content
TL;DR: The third edition of the leading textbook on personalization in social welfare payment systems in the United Kingdom brings the analysis up to date, taking into account the major changes enacted by the Coalition Government since 2009 and pointing the way to the likely future, when all social welfare payments and support will be delivered directly, via a personal budget as discussed by the authors.
Abstract: This third edition of the leading textbook on personalization in social welfare payment systems in the United Kingdom brings the analysis wholly up to date, taking into account the major changes enacted by the Coalition Government since 2009 and pointing the way to the likely future, when all social welfare payments and support will be delivered directly, via a personal budget. This close examination of the theory and practice will be essential to scholars, policy makers, and practitioners.

11 citations

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"The morphogenesis of disability pol..." refers background in this paper

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Frequently Asked Questions (14)
Q1. What are the contributions in this paper?

The aim of this paper is to critically explain, through a case study focused on the Sardinian disability policy, how social policy ’ s morphogenetic cycles influence the governance of personalized disability plans and, consequently, the possibility of their implementation. 

(A) Already in 2002, 266 municipalities, 70.5% of the municipalities of Sardinia, had presented at least one personalized plan in favour of residents with severe disabilities. 

User led organizations supported families in designing their own plans, sustaining the relationship with social workers and personal assistants, influencing mass media conceived as a sounding board for requesting support to personalized plans. 

The authors define individualized social service (ISS) as a top-down example of policy making, aimed at offering a standardized and specified provision of social services, which could be better defined as ‘customization’ of services. 

Social workers have been asked to focus on their job, and personalization and co-designing strategies activated with users and family members. 

Introduction European Welfare states are facing a growing demand for personalized social services, due to – among many reasons – the de-standardization and heterogeneity of individual needs (Valkenburg, 2007) which give room to the dramatic rise of new (Taylor-Gooby, 2005) and non-actuarial societal risks (Sabel, 2012): harms whose incidence is so unpredictable that it is impossible for those at risk to create an insurance pool sufficient to indemnify those who incur losses. 

Userled organizations and unions defended the amount of social expenditure reserved for disability and long-term care because it gave them power to negotiate. 

User-led organizations were pushed to accentuate their defensive and advocacy role to the detriment of their previous proactive and supportive role. 

An assistant can work with a child in a family from 6 to 10 hours maximum per week, but for the rest of the hours the parents and other figures around the family have to take care of them. 

A new form of opportunistic behaviour is now developing, especially in some areas of Sardinia, where the pressure to have a household income in order to participate in consumption is very strong. 

Without co-design and co-production of services, i.e. the inclusion and activation of users and clients into the service, personalization became mere (standardized) individualization. 

(Interview no. 9)(D) The care system changed in many ways: the funding strategy moved from a mutual public-private arrangement, to direct families’ reimbursements (according to eligible costs of personalized plans); the topic of social policies changed as well, from standard treatments based on experts’ knowledge to care services chosen and controlled by users. 

Governance is more pluralistic when it is open to the largest number of actors: users and their families, users’ associations, for-profit or non-profit service providers, public administrations. 

In identifying the development of the policy governance and its street-level functioning, the authors have observed a morphogenetic cycle composed by four different phases (Table 4): (1) the period since the Regional enforcement of the law 1682/98 (before 2000); (2) the period covering the start-up and the institutionalization of services (between 2000 and4.