Commentary On Uk Social Work Reports August 2009

UK Social work task force and select committee training reports - 1

UK Social work task force and Select Committee training reports Malcolm Payne (various dates in August 2009 – collected posts at http://blogs.stchristophers.org.uk/) This week has seen both the interim report of the Social Work Task Force, the English investigation of the state of social work. this is another of those occasions when social work seems up against it, and the government feels the need to do something about it. The Report is on the internet at: http://publications.dcsf.gov.uk/eOrderingDownload/DCSF-00752-2009.pdf This week also the Children etc Select Committee of Parliament published a report on the training of children and families social workers, also on the inernet at: http://www.publications.parliament.uk/pa/cm200809/cmselect/cmchilsch/527/527i.pd f From their early consultation, they came up with six themes; these are the worries they are addressing, which I’ve edited slightly. 1…social workers feel they do not have enough time to devote directly to the people they want to help. They feel overstretched by staff shortages and tied up in bureaucracy. 2…social workers feel frustrated by some of the tools and support they are given to do their jobs. 3…new social workers are often not properly prepared for…the job and …the education system does not effectively support ongoing development and specialisation. 4…social workers do not feel that their profession speaks with a strong national voice or is well supported at national level. 5…[performance management] systems are not driving quality first and foremost. 6… social workers feel that their profession is undervalued, poorly understood and under continuous media attack, …making it hard for them to do their jobs and hard to attract people into the profession. Summing these up, the diagnosis is that there are not enough social workers, even if more money could be found to recruit more, the job is over-bureaucratised, which is mainly the fault of local government processes, central government’s target-setting culture and dreadful computer systems, they are ignored and when not ignored persecuted by people who don’t care about our citizens in trouble. Oh, and nobody speaks up for them and the education’s not up to much. Some of this is just the usual whinges, and as I’ve said before, some powerful people in society, and a lot of the press, think people shouldn’t need the tax-payers to pay for services to help the weak and inadequate do things that people should do for themselves. This is a standard political position, much like ‘the middle classes who’ve worked and saved all their lives should not have to pay for the inadequates who

haven’t saved up to pay for their own old people’s care’. In that way, it’s the same as last week’s issues. This stance neglects the reality that education and healthcare are big political priorities in most people’s minds and the relatively less significant need for social care does not get the political priority or the priority in most people’s minds, because most people hope not to need it. Middle class people can cope with a lot of the problems that social workers deal with in their own families because they have just about enough money to throw at it and enough human resources with the capacity to sort out many problems. But a lot of poorer people don’t have these financial or human resources and need help if things get too much. In an rather good statement in normal language about what social work is and does, the Task Force tells people why they might sometimes need a social worker: PUBLIC DESCRIPTION OF SOCIAL WORK Social work helps adults and children to be safe so they can cope and take control of their lives again. Social workers make life better for people in crisis who are struggling to cope, feel alone and cannot sort out their problems unaided. How social workers do this depends on the circumstances. Usually they work in partnership with the people they are supporting – check out what they need, find what will help them, build their confidence, and open doors to other services. Sometimes, in extreme situations such as where people are at risk of harm or in danger of hurting others, social workers have to take stronger action to protect them – and they have the legal powers and duties to do this. You may think you already do this for your friends and family but social workers have specialist training in fully analysing problems and unmet needs, in how people develop and relate to each other, in understanding the challenging circumstances some people face, and in how best to help them cope and make progress. They are qualified to tell when people are in danger of being harmed or harming others and know when and how to use their legal powers and responsibilities in these situations. You may think that you’ll never need a social worker but there is a wide range of situations where you or our family might need one, such as:  caring for family members;  having problems with family relationships and conflict;  struggling with the challenges of growing old;  suffering serious personal troubles and mental distress;  having drug and alcohol problems;  facing difficulties as a result of disability;  being isolated within the community; or

 having practical problems with money or housing. Having this statement so well written is a real asset. Overwork is a frequently recurring issue in social work. We have never had the resources to recruit and train the number of social workers we were thought to need over decades. And every piece of research about social workers’ caseloads going back to the 1960s that I’ve ever seen has always shown a high proportion of time being spent on administrative tasks and between a fifth and, optimistically, a third of time being spent in direct contact with members of the public. This is true also of other professions: they all have their meetings, forms, records, letters, phone calls etc etc. When you’ve seen a ‘service user’ or someone else from what the Americans call the ‘client system’ (family and carers), you have to follow that up with the application on their behalf, the letters and phone calls to get what they need, coordinating things with other services and so on. We really need to distinguish between unnecessary bureaucracy and the indirect aspects of doing social work, which are a bit part of the whole. Then you need to look at the computer systems. It’s clear there are a lot of badly designed computer systems in social care, clunky, slow and inappropriate. Many computer systems have been set up to meet the management’s needs, not the social workers. When we set up an electronic records system here at St Christopher’s (we’ve just had the first anniversary), we spent ages consulting with all the different professional groups to make sure it met their needs, and had to do masses of training. But the most important point is that it created a different way of thinking about what you wrote, and more pithy and focused records, which is probably better than in the past. Something else I’ve learned through several decades of working with written and computer records is that you can’t use a record system to control people’s practice, they ignore it, get round it, twist it or slow up coping with it – sometimes all four. Instead, decide on how th practice is and can be realistically represented, and make it helpful. One of the things we did when we introduced our new system was to find ‘easy wins’ as our computer guy puts it, things that will be an immediate benefit to practitioners. But look at Twitter - follow me at: http://twitter.com/MalcolmPayne - It’s easy, and a good discipline) to put most things in 140 characters, and it shows how flexible and useable computer systems can be.

College of social work: what and why? What would a College of Social Work do? And what would it look like? The Social Work Task Force is recommending a leadership body for social work called the College of Social Work. Perhaps more realistically, the Children etc Parliamentary Select Committee on training children’s social workers is recommending reforming existing social care bodies to create a body like the Training and Development Agency for teachers, which has apparently in politicians eyes helped the image and standing of teaching, although most teachers I know haven’t noticed.

Why call it a college? In England, a college is a fairly low-level training institution, although the term has a history of being a community of scholars. You will see from my public gallery of photos that the university I work for in Poland calls a lot of its sections or buildings ‘collegium’. Perhaps we should be moving into Latin as the high-prestige title: Collegium Socialis Laboriae. A bit too redolent of new Labour, you might think? My photo gallery of Opole University at: http://picasaweb.google.co.uk/malcolmpayne080/OpoleUniversity?authkey=Gv1sRg CNGRuZ-R1tyQ9AE&fgl=true&pli=1# The aim seems to be to have a authoritative and independent voice for social work in public debate. This has been a constant gripe of social workers since it became clear in the 1970s that the British Association of Social Workers was not getting the level of support in numbers, money nor effort to represent social work fully. The directors’ associations have done this quite well on occasions, but when speaking they have to defend the services they work for, so it comes across as self-justificatory, and they tend to speak for greater resources for their service, which doesn’t sound good in a public debate. The problem, it seems to me, is that an independent level of authority to speak needs to come both from united professional support and from a widely recognised knowledge and skills base. So we would have to get people to join up, and we would have to collect up people who actually could speak lucidly and strongly, but most importantly with authority for social work. Where would such spokespeople come from? Why can’t we find such people now? Partly it is because social work is socially and politically divided and would find it hard to agree on what should be said; there would always be snipers from the sidelines. Partly it’s because not a lot of people want to be high-profile public voice. The main reason, I suspect is that there is no wide agreement that the public want a social work; most people think they do it themselves, and think badly of people who cannot cope with difficulties in their lives. The Task Force’s statement about what social work is in normal language recognises this by their sections starting: 'You may think you already do this for your friends and family but…and You may think that you’ll never need a social worker but… (p 10)'. Moreover, there is a political issue: people on the right are particularly committed to people helping themselves, and to the view that it is weedy and pathetic to need help, and right-wing newspapers and politicians promote this position. For similar reasons, they attack any services and anyone who does it, and anyone who has any sympathy for these ghastly people who cannot organize their lives properly. So social workers, who provide these services and seem to have sympathy for these ghastly people are always going to be the target of right-wing vilification; everyone can see that they need teachers, doctors and nurses at times, provided they’re not pathetically soft (‘…it never did me any harm…’ etc). People who stand on their own two feet all the time are not about to have any sympathy with weepers and wailers. Presumably the aim is to have some prestigious group like the Royal Society for scientists; you would want the letters after your name. We already have the Academy of Social Sciences, which academics can be nominated for. The problem is that this is

an elite body: what effect is it going to have on standards over the general run? And most such bodies are basically academic groups; you get elected for academic achievement. Something like the Royal Society for Literature is broader, but again it is basically public achievement that is recognised. How would you set up a system to recognise practice achievement in a relatively private activity like social work? Ad remember that prestigious organizations have spend decades getting to the point, with a lot of criticism along the way. There is not going to be an instant result. Another thing to remember is that social work is a relatively small fairly low-paid profession – we’re not talking about the huge number of incredibly poorly paid, inadequately trained and supported care workers. There are not enough people in social work to sustain, financially and with personnel, the kind of bodies that huge numbers of teachers and nurses in their professions can justify. And although it occasionally hits the headlines, the quantity of its work doesn’t justify the cost of a huge infrastructure. To have public authority, such a College would actually have to do something. What would its role be? I guess it would have to look something like the old National Institute for Social Work, which the present government abandoned at the end of the 20th century. Its leadership generally never acquired a public face, but it was a nice billet for a research unit and for a few academics who had a period outside universities, mainly running courses and day conferences for managers. None of its leaders became professional leaders: they got on with getting the grants and doing the research or teaching the courses and pursuing their academic interests. Social care is not a big deal nationally, and people are not going to go to some small institute to achieve the kind of prestige and standing that will make them leaders of the profession. People with leadership potential want to be where the action is, not some quite academic backwater. Rather than a college of social work, what we need is to collect up a number of lucid telly performers who are already in senior public roles or who have specialist knowledge, train them to represent social work effectively and promote them to the media.

Social work education (pre and post registration) in the latest reports One of the things that connects last week’s two Reports on social work is a concern for education and training. The Select Committee Report, as usual, brings together rather well a range of views and issues, and so is a good summary of the state of the play. However, it is focused on education for children and families social workers, responding to the concern about children and families work after the various child protection anxieties of the past couple of years. Because of this and the fact that it is a DCMS committee, it tends to see children as the be-all and end-all of social work, when it is actually a small service, which does not spend as much or do as much work as adult services, which is by implication much less serious business. I think it is just as important to have good care services for vulnerable adults, older people, disabled people, people with learning disabilities and people with mental illnesses as it is to have good care services for children.

The Task Force people, as well as the usual lobbies on behalf of higher education and the employers are all heavily represented in the evidence and the commentary. However, the Task Force interim report is still at the tentative stage on education. One area it trolls through is whether there should be specialist social work courses; this is in tension with the wish to preserve a generic social work course. Generally, children’s social care employers are keener on a specialist qualifying course for their employees than anyone else, at least partly because they think that post-qualifying training for everyone who does child protection work is a financial impossibility, because most agencies cannot afford to release staff to attend. Many people who have done the existing training or the new post-qualifying programmes do it on their own time. But we need a generic course so that people are properly prepared for the basic job of social work. Many have not made a choice at the course stage about what they want to do. And if we stopped to look, we would find that a majority of the younger people on courses want to do children and families work. So who is asking how many people we need to do adults work? It’s a much bigger field and just as, if not more, difficult; someone needs to be thinking what we need there as well, and we need to press the Task Force to do that. The other thing is that everyone does children and families work and everyone does work with adults. Our social workers at St Christopher’s are mainly working with older people. But those older people have children and grandchildren; our young patients (that is, those in their forties and sometimes younger with major illnesses) often have children who are the responsibility of children and family departments. Strangely enough, although you wouldn't think it to read the effusions from the people solely focused on child protection, your parent dying tends to have an effect on the child and family. Our social workers have experience in both children and families work and adult services work, and people in adult services work often have dealings with children in the course of what they do. It is crucial that all social workers have a basic grounding in all aspects of work. I want no more local authority social workers ringing up surprised because a hospice deals with dying people. Then, in the same way that I think that all social workers with older people need to learn how to communicate in a really skilled way with older people and their families about their impending end of life, I agree that social workers working with children, among whom I count most of ours at St Christopher’s, need to have advanced training in communication with children. In exactly the same way, it has been agreed that all doctors need specialised training in giving patients ‘bad news’ (that is, ‘you’re going to die’). It is taken for granted that they won't get enough in their general medical courses, although of course many of them naturally have the skills and personality to do it well, even though they could use some extra tips and tricks. Both reports make the very valid connection between the qualifying or preregistration, course and post-qualifying education; we need to look at the whole process of lifelong professional education and experience in social work. I think everyone is agreed that there needs to be stronger post-registration specialist education for social workers. Working in a healthcare-connected organisation, I find the different attitude to lifelong education as compared with local government very striking. Local authorities just have no tradition of educating their staff. Nurses have

to get higher degrees for promotion to many senior posts, and nurse consultants do PhDs as part of the requirements for their job. Doctors take it for granted and their employers pay for fairly extensive and expensive courses. But the work they do is no less dangerous or important in its way than that of many social workers. My daughter is a newish social worker, with about five years experience and a social work masters, has recently gone to a new CAMHS job and was immediately sent on a young people’s mental health masters. This is how it should be for any specialised job, and I think there can be no doubt that child protection is increasingly a specialised job. The time is long gone when it was a routine regular part of every junior generic local authority social worker's job. Local government really does have to pay for this, and it should be encouraging all its social work staff, including those with adults, to develop post-qualification education. But my experience of some local authorities when I was dealing with them as a head of a university department was that they actively obstructed staff who wanted to go on advanced courses. They claimed this was because they were so hard-pressed that they coundn't spare them, but I suspect that it was because the managers thought that all education was a holiday camp, a luxury that they shouldn't have to pay for, and moreover it gave them ideas and evidence to disagree with the stupidities of local authority bureaucracies. When are we going to evaluate agencies by the proportion of social work staff at every level that have achieved advanced qualifications in the work that they are doing? When are the post-registration training and learning requirements of the GSCC going to have real teeth instead of the milk-and-water current arrengements?

Palliative care social work demonstrates the richness of all social work If I look for coverage of palliative care and pallcare social work in the documents on social work from the Task Force and the DCSF Select Committee, this would be a very short post. Instead, I ask what we might say about their absence from consideration. One point is that, although I know from personal contacts that palliative care social workers are sometimes hard to find for hospices and pallcare teams across the country, I also know there have been some ace appointments of really fine staff in recent months too, not least here at St Christopher’s. So perhaps pallcare is not in the crisis of job vacancies and work pressure that local authority social work experiences. It has always been the case that people have often started their careers in general social work, built up a good range of experience quickly in busy general departments, found out what really interests them in their career and then moved towards a specialist area that really allowed them to develop their skills and their contribution. The accusation then is sometimes that they are moving out of the kitchen into the sunny uplands of less pressure. On the other hand, I do not know a lot of social workers who think pallcare social work is a doddle; interesting, yes, satisfying, yes, but also dealing with difficult human issues at a time of real crisis in people’s lives which all of us at some time in our lives do not want to face. No, a lot of students and colleagues say, I think I’ll stay with the care management or child protection. Also, social work’s way of applying general principles in all settings means that you don’t get stuck. One of our medical consultants said to me enviously a little while ago how lucky social workers are to be able to move between specialties, taking a high

level of skill with them, and learning new information about their new area. I’m a little cautious about this. Talking to a very experienced social worker about some research on groupwork that I’ve been doing recently, it was clear that some of the findings about issues discussed by bereaved carers in the groups reflected her experience over twenty years, but had clearly been new to the groupworker, who has moved medical specialties. So you have to look at the specialised areas, in this case responses to bereavement, and identify where the specialised knowledge is, and what is more general that can be transferred. So the failure of these reports to think about social work’s small-scale specialties and the knowledge that is required for them is one important weakness in these reports; they need to look at the interaction between general and specialist and see where they can foster each other's progress. It’s understandable that the government is looking at the big services that it is responsible for itself. But thinking about the profession as a whole, it has a duty also to think about how it can build, retain and train for the myriad of specialist areas in social work. And there is a payback, too. The building of specialist knowledge and skills feeds back into the regard for social work in the community, and the store of skills in the profession. Several of our really good pallcare social workers have moved back into child protection, adult services, mental health or general hospital social work in recent years. It renews their interest and commitment to work in a new area and they will take their resilience in helping with powerful human emotions and knowledge of dying and bereavement into those areas too. We are always pleased to employ a mix of people from children and families, mental health and adult services work coming in the other direction, because it enriches the services we offer, too. What the social work specialities also show, and pallcare social work is a prime example, is that imaginative human helping is entirely possible, valid and worthwhile as part of our services. All social work does not have to be bureaucratic and rulebound. Let a little imagination in and official social work can be human helping too. One of the weaknesses of the statement about social work written for the general public in the Task Force document is that it focuses very much on the individualised, concrete, risk averse things that you can say social workers provide and, in the cause of public understanding, does not convey the richness that social work may contain. Pallcare social workers, and many others working in specialist areas, can claim to be demonstrating that richness every day. Malcolm Payne