Category Archives: Workforce

This Week’s Star Prize – a named worker!

Warning – certificate 35+ (this post contains entertainment references only understood by those of 35 years and over)

I will always remember an ex-manager’s lament that social workers were not getting to see people who needed care or support early enough, and therefore missing opportunities for, in particular, safeguarding prevention.  I remember thinking that I could probably purchase a range of illegal services/substances/items much more easily than getting through to a social worker, in a council. Their phone numbers and contact details have become a closely guarded secret, to for helen 1which one can only win access, after winding one’s way through the Crystal Maze and scrabbling around for enough golden tickets in the Crystal Dome.

 

Think about the average journey a person makes before they ever get a sniff of someone who will provide them with an in-depth and holistic assessment. Most of the time a GP will give out the leaflet with information about their local contact centre for social services. Thereon in, they are thrown into a Labyrinth of services, people, teams – and all without even catching sight of David Bowie in obscenely ill-fitting spandex.

The Care Act recognises that people don’t know what they need to know, in terms of their journey through the confusing system that is social care. Good information and advice will be a welcome relief for helen 2for those who are understandably perplexed about heading towards teams whose names have no meaning in the real world: ABC team, A&R teams, ART workers, CC teams, Zone teams, SPOCs, ICT, numerous HUBs and my favourite of all: ‘The proof of concept team’ – hurrah for that one being the most inexplicable.

The Care Act retains the low bar from the old legal framework for accessing an assessment of need: “Local authorities must undertake an assessment for any adult with an appearance of need for care and support, regardless of whether or not the local authority thinks the individual has eligible needs or of their financial situation” (para 6.13 of the Guidance). So, people in contact centres in Local Authorities need to understand this to ensure they are not inadvertently turning people away without offering an assessment – or something else that should come before even that part of the process, such as advocacy or prevention/reduction suggestions.

According to the Guidance, an assessment begins as soon as a Local Authority starts to gather information about a person – therefore once someone in a contact centre begins to discuss and record potential needs, the assessment clock has started ticking. It isn’t actually ticking towards anything, though, because there are no timescales for completion of assessment written into the Care Act.  However, there are a range of other issues that need to be considered at first contact, including pausing the assessment, and knowing you are doing this in order for a round of prevention to be accessed.

The duty to provide advocacy for those who might have substantial difficulty being involved might be triggered for the purposes of assessment, which might begin at first contact, which means contact centre workers need a working knowledge of the test to ascertain the level of difficulty in being involved. This is not to be confused with the test for capacity – which in itself means workers need to know the difference. The Care Act recognises this complexity: Local authorities must ensure that their staff are sufficiently trained and equipped to make the appropriate judgements needed to steer individuals seeking support towards information and advice, preventative services or a more detailed care and support assessment, or all of these. They must also be able to identify a person who may lack mental capacity and to act accordingly (Para 6.25)

Carers now need to be viewed in the same vein as people who need services, and that is both a change of mind-set and cultural shift within many Local Authorities. First contact workers need to understand the issues regarding whether they are offering Carers’ Assessments or Carers’ preventative services, as Belinda discusses here.

First Contact is a complex area, and one which tended in recent years to be staffed by people lessfor helen 3 qualified than those at the end of a very…long…line. Before one can get the golden contact number of an actual social work team, let alone an actual named worker (wowzers!) the journey through this vortex is governed by the triage work within first contact centres – as with most triage, it’s not best done with a script, because it involves making complex judgements, which need to be addressed in a legally compliant and knowledgeable manner.

This area of first contact is both a skilled and sensitive role. Oh how I remember when local teams used to have direct contact with members of the public – straightaway, no less! We were in touch with families and GPs, we could see issues coming from a distance in order to react and actually do some prevention! Pull up a beanbag and make yourself comfy whilst I regale you with tales of how much better it all was…a few years ago.

The Guidance continues to speak to first contact workers: Staff who are involved in this first contact must have the appropriate training and should have the benefit of access to professional support from social workers, occupational therapists and other relevant experts as appropriate, to support the identification of any underlying conditions or to ensure that complex needs are identified early and that people are signposted appropriately. (Para 6.27)

for helen 4Maybe this means that people WILL get access, quickly, to someone who at least has had some support from someone qualified and legally astute?  Perhaps once again, workers in local teams will regain a sense of the community they work within, a sense of the community so many of us crave within our working and personal lives.

And maybe, it will be a little easier to win the golden ticket – the one with the phone number of a team whose name isn’t akin to a Krypton Factor challenge, on the back. And of course, this week’s star prize – a named worker!

for helen 5

null

Continue reading »

Professional control and person centred practice – the elephant in the Care Act?

In the last few months I have stood in many training rooms and talked, walked, carried and cajoled about 1000 of our sector’s professionals through the Care Act – its complexities, its opportunities, its conundrums and its laughs. Ok. I’m lying about the last bit.

At times, I have felt like an anthropological observer, watching David Attenborough style at the fascinating combinations of reactions to the biggest shake up in social care for years ranging from mistrust and disbelief to relief and even exuberance.

Occasionally I have been a lone messenger dodging the bullets of cynicism and frustration. But more often these are balanced by moments of absolute gold, and I am a delighted observer watching confident, competent professionals beam as they see the opportunities in hand to return to a way of working that is most commonly referred to as “back to our roots”.

What has struck me is that our concept of professionalism in front line workers has been on something of a journey over the last 10-15 years, and for the Care Act to deliver on even some of its promises, we need to boldly re-define what we mean by professionalism under the Act and how it sits with person centred practice.

Person centred practice in its most basic form prioritises the interests of a person over those of the system or service. You can be person led, or you can be service led, resulting in what works for the person or what works for the service, respectively. But can you be both?

Within the statutory guidance, you can’t swing a cat without hitting a strongly worded reminder of the importance of working in a person centred way. As someone who has spent the last 20 years hurling myself against the system in an attempt to make space for person centred approaches, this emphasis is welcome. In fact, I’d be lying if I didn’t confess that upon reading the draft guidance last year, I even welled up a little bit. What can I say? I’m a sentimental type.

But such a focus throws up some interesting dilemmas. A common response in the training room is to ask “but what if the person wants something we just can’t do, or they want something that in our professional judgement would not meet the needs we have identified? How is saying No, person centred?”

Another is “How can we call this person centred, when all the decisions are made by the professional?”

All 3 stages of the core process (assessment, eligibility decision and planning) are required to be delivered in a person centred way:

6.1 …The assessment is one of the key interactions between a local authority and an individual, whether an adult needing care or a carer. The process must be person-centred throughout, involving the person and supporting them to have choice and control.

10.2. …There should be a default assumption that the person, with support if necessary, will play a strong pro-active role in planning if they choose to. Indeed, it should be made clear that the plan ‘belongs’ to the person it is intended for, with the local authority role to ensure the production and sign-off of the plan to ensure that it is appropriate to meet the identified needs.

In terms of eligibility, needs can only be found eligible if they have a consequential significant impact on the wellbeing of the person – a step that puts the uniqueness of each person’s situation at the heart of the new eligibility process – but one that is already being lost as I see assessment practice prioritising the (arguably more tangible) identification of an inability in 2 or more outcome areas, but not the consequential significant impact on one or more of the wellbeing domains (the more “person centred bit”).

We have been describing this in training as the requirement for the professional to make an objective decision, but based on essentially a subjectively-led process. It’s important not to dodge the elephant in the room – the process is littered by wholly professionally controlled decisions.

However, our new defining difference is that the process which the professional is required to follow in order to make that decision has to be person led. It is professionally controlled, but person led. If a professional ends up before a judge presenting evidence that their decision was a sound one, that evidence will need to be of a person centred process.

Potentially, a person led process and professional control, could be uncomfortable bedfellows, and I anticipate some howling examples of getting it wrong. But it could also be a heady combination creating the perfect conditions for adults with needs and carers to actually get support that makes sense to them in their own particular life with the expert guidance and advice from the professional. It requires professionals to focus more on facilitation and enablement rather than the cul-de-sac of narrow FACS banding and subsequent conventional service provisions.

It may be a bit of an elephant – but by seeing it, naming it, and exploring it with professionals, adults with needs and carers, it could be the kind of elephant that we actually end up wanting in our front room.

The Care Act – Another New Dawn?

As a Social Worker who once felt inspired and excited when ‘self-directed support’ was implemented, I have grappled with feelings of disappointment and genuine sadness at what I felt to be the demise of a real opportunity.

I was a relatively new social worker when SDS was first mooted around 9 years ago. I was whole-heartedly engaged with making it work and became immersed in promoting and celebrating the ‘personalisation agenda’.

I then began to watch, with dismay, as the ideology and philosophy of this was gradually dismantled. It felt like all that was left of this amazing opportunity was the RAS (Resource Allocation System). I have nothing against the concept of the RAS in itself but what saddened me was the way it had turned into something solely being used to monitor and control spending. It grew into a monster through no fault of its own. I understand the very real and difficult job of managing a short supply of money, but my perception was that this was being muddied with the RAS and the philosophy of SDS and I found that difficult to watch.

I began to drift towards the cynicism that so many within social work begin to feel. I admit to having a healthy dose of cynicism and a potentially unhealthy dose of sarcastic humour, but this other feeling was something I didn’t enjoy and I didn’t want it to overtake my passion for social justice and equality; the very reasons why I went into social work in the first place.

When I became aware of the impending Care Act, I decided to take any opportunity to understand this new legislation. I started to read around it, tried to keep up to date with people who tweet and blog about social care law, as well as gaining as much information from training. I have an increasing belief that understanding the law is the way for people to appreciate what their rights are. I see law and social work as natural partners; it is the opportunity for social workers to have half a chance of ensuring people get what they need.  It also provides practitioners with an understanding of what Local Authorities don’t need to provide, which in itself is far more liberating than having a funding panel telling you!

As my understanding of the Care Act has deepened I again find myself inspired and excited about what this means for the culture of social care and social work. In so many ways, my lack of legal knowledge made the policies around personalisation seem weak. But if I had been equipped with the knowledge that I have now, even in respect to the laws that have now been repealed, I wouldn’t have felt so helpless.

I appreciate it will take time for culture to change. I know that for advocacy to have any real impact the people who do it need be to legally literate and there needs to be enough of them. I know that in order to be truly preventative we need to tackle the culture of only being able to firefight and manage crises. I know there needs to be a change in how we view the importance of carers’ assessments, as this is where prevention starts. I know we need to put our most qualified and experienced workers right at the first point of contact, rather than at the end of a convoluted pathway. I know money is tight and spending is going to be reined in even more. All these topics are for consideration in subsequent blogs.

However, amongst all these tricky issues there is the glint of what could be possible. It’s there, in actual law; true personalisation, real involvement for the people we support, and an end to fitting people into the same old services.

The Care Act could be the way we change things for the better. But only if we open our minds and dare to be hopeful, all over again.

Is the closure of The College of Social Work an omen of doom?

‘We are recommending the establishment of an independent national college of social work. This will articulate and promote the interests of good social work. It will give the profession itself, strong independent leadership; a clear voice in public debate, policy development and policy delivery and strong ownership of the standards to be upheld.’ – The final report of the Social Work Task Force 2009.

I remember – not so long after I first read of this aspiration – it was announced that The College of Social Work (TCSW) was to be born.  I had just embarked on my journey as a Practice Educator. I admit that I did indulge in some fanciful visions of me lecturing at an actual University, dedicated solely to the education of all social worker wannabes in the UK.

This university would develop a workforce of staff which would strive towards and assist with maintaining the key values of Social Work; and I saw myself working there. For the first time we, as a collective group of people who held a “professional” qualification would get the recognition that our counterparts in health and law enjoy getting. Maybe we would even manage to get the same 10% discount which is offered across the country to employees of the NHS, police and fire service, as our actual worth may be finally recognised. Clearly, it never got to the point of an actual university opening its doors, nor was it ever intended to be that sort of a college! But what did it actually achieve?

I can really only go by my own experience of TCSW for the purposes of this post and I would say that aside from co-producing the Professional Capabilities Framework (PCF), which I have found very useful, I don’t really think it achieved much. To answer my own question “Is the closure of The College of Social Work an omen of doom?” I would have to be saying, no it is not. Had this been the only virtual source of support for social care staff then my answer would certainly be different; however, if I ever needed to research anything for my daily practice, this was not in the first ten places that I would have ever gone for answers.

With regard to the process for the implementation of the Care Act 2014, does my answer change?

The Guidance now states that “Local authorities must ensure that assessors are appropriately trained and competent whenever they carry out an assessment. This means ensuring that assessors undergo regular, up-to-date training on an ongoing basis” (emphasis* added from guidance paragraph 6.86). This is not a ‘should’ – or a ‘may’ – it’s a must, which means that the local authority cannot pick and chose if it provides training to enable continuous professional development of its assessment / care planning work force – they need to know the law, the regulations and the guidance, and if they don’t get retrained in that material every year, what does that mean for councils’ governance?

I don’t know how TCSW was funded, but I expect that it could have been saved, and the failure to do so is what should be explained. The closure of an institute, whose mission was to “act as the source and guardian of the highest possible professional standards at every level …” at a time when legislation is enforcing the necessity for ongoing professional development, indicates a lack of regard for the profession, by the government.

However, I don’t ever recall TCSW providing me with an education which would ensure that I remained competent to carry out assessments.

The PCF framework provides excellent benchmarking tools for assessment of competence but in my opinion TCSW never went further than this.  At the point of the press release about its closure, beyond the Professional Capabilities Framework, which gave a ‘flow chart’ as to where I would progress throughout my career, there was never any substance as to how I could progress – a road map or blue print for Continuous Professional Development (CPD) was not something that I ever got from TCSW.  And the curriculum validation standards for the qualifying degree for entry into the profession were not reviewed for the Care Act until this year, whereas it has been on the statute book since 2014. I think the Health and Care Professions Council offers more in terms of being a “source and guardian of the highest possible professional standards”.

So I do not think the closure of TCSW is an omen of doom. It is sad that it has happened at a time when the Care Act attempts to re-inject a bit of professionalism back in to the role of Social Workers but there are a lot of on-line resources that offer a place to gather for social care professionals who want to indulge in a little feather ruffling and debate.

When I reflect on what TCSW actually achieved for me, well, it’s my opinion that it was not that much. It did provide very cheap professional indemnity insurance and was useful during the transition between different occupational standards which had to be met by my students. Aside from this, well, I am struggling to think of anything.

Jo Cleary, chair of The College, is quoted by Community Care to say “This is a very dark day for social work and for the people that social workers support” but is it really? It is a very dark day for social work when central government trails further cuts to already starving social care budgets but I can’t think that the closure of the College, by comparison, will really have much impact on the profession of Social Work.

So, for now, it might be time to hang my imaginary Hogwarts social work professor’s cape back up, in my imaginary professor’s wardrobe. I’m thinking that the better thing to do from now on might be to promote legal literacy as my personal Patronus, instead of looking to institutions to light the way.