Can Gerry Robinson Fix Dementia Care Homes – thoughts after the series.

Last week, I wrote about the programme in general and my thoughts after watching the first in the two-part series presented and put together by Gerry Robinson which explores care homes and how they can be improved.

In the meantime, the Guardian has published an article on their ‘Joe Public’ blog highlighting some of the negatives about the programme and its aim stating that, for all Gerry’s good intentions

the programme undermines itself through glib responses and cheap-shot TV documentary trickery. Gerry’s saintly interventions with residents are contrasted with portraits of indifferent, surly staff and a collage of shots of a favoured home suggests wildly unrealistic levels of staff and activities.

More seriously there is a disingenuous failure to acknowledge basic truths about the relationship between care costs and quality. The ambush and skewering of a breathtakingly stupid general nurse in temporary charge of a home and telegenic shots of the suffering there are frankly exploitative.

Perhaps I’m viewing it through different eyes and I can understand an accusion of exploitation. I recognised a reality in the programme that needs to be more widely seen. I don’t think all the staff, even those in some of the worse homes, were presented as surly or indifferent. I think what did come across that there is little funding in the sector and a drive for profits at the expense of good staffing ratios.

Partly, this is due to the costs of staffing and this was highlighted in the programmes. Private sector, profit-making companies have little incentive to up staff ratios if no demands are made of them.

The other element that was highlighted was the poor inspection regime – the best way to improve quality of care is to improve motivation and numbers of staff. Good quality staff are happy staff. Staff who are pushed to the limits cannot provide any quality interaction when they are running between one person and another attending solely to personal care with no time for the interactions to have much quality to them. Staff don’t want to work like that. They want to engage and have a job beyond washing and changing. Interaction makes a job more interesting and exciting.

Often it is about time – and time is precious. The relationship between care costs and quality IS crucial. If pressures are placed on the funding for residential care, quality will suffer. When local authorities are forced to drive down prices again and again, the quality will be felt in a real sense.

I can see how we, in the care sector, can draw up our shutters and talk about impossibilies. There is only a question of money. And that is the issue that needs to be addressed.

As long as the government talk about saving money by keeping people at home for longer, there has to be an understanding and acceptance that for some people with some needs, residential and nursing care is the answer and it can’t be ignored or pushed to the sidelines because more can and must be done to support those who are the among the most vulnerable and who do need 24 hour care environments. Sometimes costs can’t be cut.

Mischievous

So on the fostering front, girl has been with us for two and a half months now – more or less. We went to a local pantomime at the weekend and I’d forgotten how much fun it could be and had to explain away my somewhat hoarse voice when I got back to work (lots of shouting was obviously involved in panto visit!).

It is a bittersweet period. We’ve done the decorations and I have the Christmas presents (although they aren’t wrapped yet.. ). Obviously being away from  her family is very painful at this time of year.

For me, I wish I had more family around in a sense. My partner’s family is overseas and I don’t really have a big family around at any time. My siblings are in different cities and we don’t really do much of a Christmas (or Chanukah) – but one of my sisters is visiting this weekend with strict instructions about Christmas present to bring for girl. Really though, she isn’t difficult to buy for. She compiled a list for me and another one for her mum so we don’t ‘overlap’ and has a lot of broad interests that are ripe for present-buying!

As I explained to our Supervising Social Worker just last week, it’s a shame that all the ‘issues’ that have come up by having her around, have been completely related to the local authority rather than the child. We have had some difficulties with her social worker (who has only seen her once in the time she has been placed with us and that was for roughly five minutes.. ), we have had difficulties with contact workers and interpreters turning up (or rather, not turning up where they are supposed to be) and an almost complete lack of communication has resulted.

So girl has a day off school today –some kind of teacher training exercise. I am off at work but my partner is at home and social worker is visiting them both.

I have left a copy of ‘Communication in Social Work’ on the dining table. With instructions for it not to be ‘tidied away’. I doubt it will be noticed amid the other books scattered quite genuinely around the house  but still..

I wonder if it is a bit passive-aggressive but I am truly reading up on it in preparation for the arrival of a student in my agency..

The GJ judgement and DoLs

I’m coming back to Best Interests Assessments and DoLs for a while now so excuse my indulgence but it is something that has and is creeping back into my workload after a few ‘dormant’ months and a part of the reason has been the impact of the ‘GJ’ judgement which has been winging it’s way around various communication channels in our Trust.

I found a good summary of the GJ v Foundation Trust, PCT (Primary Care Trust) and Secretary of State for Health case in Family Law Week.

It clarifies a lot of the questions that existed about the ‘eligibility’ assessment part of procedure to determine the authorisation or otherwise of a ‘deprivation of liberty’ under the framework of the Mental Capacity Act as opposed to the Mental Health Act.

When assessing people who are being deprived of their liberty and who lack capacity, in a hospital setting, the eligibility assessment has always been crucial. The eligibility assessment disbars the authorisation if the patient would otherwise meet the criteria of an assessment under the Mental Health Act.

I am aware that this may seem a little dry to those coming in from the ‘outside’ but it is absolutely fundamental to the legislation and the legislative tools that we engage with.

The situation of GJ, as highlighted in the case law, relates to himself, as a 65 year old man suffering from Korsakoff’s syndrome and vascular dementia as well as diabetes. His partner had assisted him in managing his diabetes prior to her death however following this, he had suffered from two hypoglycaemic attacks with obvious consequences for his physical health.

The discussion in the judgement published by the Court seems to centre around the question as to whether the treatment in hospital is on physical health grounds in which case, it would seem that a DoLs authorisation may be appropriate however if there is any part of the treatment process which relates to a mental health need, then GJ would move into the ‘ineligible’

The judgement summarises that there are two strands to this case – namely whether GJ is being detained and treated in hospital and thus being deprived of his liberty on the basis of his physical treatment regime and the only reason for this detention was on the basis of his ‘package of physical treatment’. In which case, he would not be a ‘mental health patient’ and an authorisation could be granted to deprive him of his liberty to receive this treatment under the Mental Capacity Act.

However, if the mental disorder existing were to be treated in a hospital setting, that seems that the eligibility requirement for the Mental Capacity Act would be ‘failed’ and the Mental Health Act assumes it’s primacy in this situation.

The other crucial point that can be gleaned from the judgement is as follows

58. In my judgment, the MHA 1983 has primacy in the sense that the relevant decision makers under both the MHA 1983 and the MCA should approach the questions they have to answer relating to the application of the MHA 1983 on the basis of an assumption that an alternative solution is not available under the MCA.

59. As appears later, in my view this does not mean that the two regimes are necessarily always mutually exclusive. But it does mean, as mentioned earlier, that it is not lawful for the medical practitioners referred to in ss.2 and 3 of the MHA 1983, decision makers under the MCA, treating doctors, social workers or anyone else to proceed on the basis that they can pick and choose between the two statutory regimes as they think fit having regard to general considerations (e.g. the preservation or promotion of a therapeutic relationship with P) that they consider render one regime preferable to the other in the circumstances of the given case.

So the Deprivation of Liberty Safeguards cannot be used as an alternative to use of the Mental Health Act as the eligibility criteria still need to be met in order for the assessments to continue. I’ve underlined for greater emphasis as much for my own benefit as anyone elses’ as I know personally of consultants who have favoured referring patients for the DoLs framework rather than using the Mental Health Act as it seems ‘least restrictive’ (an argument that doesn’t really exist in my view as the effect, namely someone being in hospital against their volition is the same in both regimes and in fact, there is a much more robust appeals procedure available under the Mental Health Act).

I’m sure there are many more qualified to sift through the case law which is coming from the Court of Protection, than I but it is a relevant judgement that has a significant impact on my work as a Best Interests Assessor and as an AMHP, eligibility assessor under the DoLs framework.

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A day in the life.. of Approved Mental Health Professionals

Today,  Deborah Orr in the Guardian has an article published today detailing a day out that she has spent with some AMHPs in the Camden Duty Office. It’s an interesting insight into the day to day work in their office and certainly worth a glance to understand some of the processes that we work with as Approved Mental Health Professionals.  And the Importance of Pink Forms..

Can Gerry Robinson Fix Dementia Care Homes?

This evening, BBC2 are running the first of a series of two programmes about the state of dementia residential (and presumably nursing) care in the UK. Gerry Robinson, a successful businessman, who, in 2007 brought us ‘Can Gerry Robinson Fix the NHS?’ returns to focus his attention on what might be done to improve the care that is meted out to those who live in 24 hour dementia care.

I have to try and hold my cynical tongue from just crying out ‘money’ although it’s hard to escape from that as the premise. Staff in care homes are poorly paid and poorly rewarded as regards career development and I speak from personal experience as I worked in residential care for about seven years doing ‘hands on’ care and reached a point where I felt the only way to progress apart from through the management structure (which I really didn’t want to do) was to return to university and train as a social worker.

I still consider those years that I worked in that area to be a crucial part of the process of my professional and personal development. The fact that I worked on a day-to-day basis in a residential environment has given me a much wider understanding of the room for growth in that field and have informed my judgements when assessing the quality of care homes as I have had to do over the years in making placement decisions and reviews and taught more lessons that I can recount in making and establishing relationships and the importance of dignity.

But back to Gerry Robinson and ‘Dementia Care Homes’. Apart from the cynicism that only those open to change would be willing to ‘let him in’, I hope that the attention on this area of care will focus some more on what needs to be done to provide the excellent standards of care that we all should be clambering for.

It has been too easy for poor quality care to go unchecked and we can look to the CQC (Care Quality Commission) and its predecessor, the CSCI (Commission for Social Care Inspection) and their move towards ‘desk inspections’ and away from the system of announced and unannounced inspections as one reason for this. Another is that often ‘old age’ is an area that people want to forget. It happens to ‘other people’. The less we move older people, and unwell older people at that, the more that some people try to shrink away and pretend that it will be different for us or our families. The truth is, it isn’t. However loving and caring a family is, there are some people that will need more care than can be provided at home and these residential homes and the quality that they achieve (or don’t) should be a concern for us all.

I often thought that there was no reason, except money, of course, that residential care homes for older adults need to be accommodating so many people whereas those for younger adults with learning or physical disabilities can be run on a much less ‘instittutional’ basis as group homes. Where are the ‘group homes’ for older adults who demand the same quality of care?

We come back to a lack of money and investment and probably interest in the wider population. As long as less can be spent on care without it being seen as scandalous or some kind of electoral issue then it will be.

Again, going back to my experience, good care does not have to be expensive care. I have seen some excellent, forward-thinking homes that are no more expensive – but the massive difference is not so much physical environment as commitment and quality of staff. While some excellent staff are willing to work for mininum wages, the way to improve the quality of care would be to add more incentives to keep good staff – that doesn’t need to always be through higher pay although that wouldn’t go amiss,  but by a wider and broader valuing of those who work in residential care, better training and development opportunities,more flexible working practices and quality supervision.

I expect it to be an interesting programme and will try and summarise after I’ve seen it. Ultimately more attention paid to this issue can only be a good thing.

BBC 2 – 9pm – Tuesday 8th December + Tuesday 15 December

EDIT 10/12/09

I thought I’d add a few thoughts about the programme after having watched it. I was impressed by it to be honest and surprised in a way. Not by some of the attention to the care (or lack of it) that exists in the sector but at the real attempts to explore what works.  I am mostly glad that there is some focus on the quality of care delivered in these enterprises that are, for the most part, profit-making private ventures. Most interestingly. I thought, was the highlighted fact that for all the inspection regimes tick-boxes that can be completed, there is more to quality care than ensuring the boxes are ticked and really, it is about putting yourself into the thoughts and feelings of that person and not treating people as commodities or homogenic.

I was appalled by the first manager who appeared and had no training in dementia care and referred to the elderly residents as ‘little ones’ – I can’t remember the quote exactly. I know that we need to move away from language but I think it is indicative of an inner thought process that is both patronising and infantilising. What was really heartening was to see some care homes that did things well. For me, as mentioned above, I think one thing that was obvious was respect to care staff who are there on a day-in day-out basis and are responsible for the happiness of residents in a much more real basis than some of the managers and owners. Respect is not only about pay (although that helps!) but about training and ‘perks’ – one thing emphasised by the programme was that ‘free’ meals on duty were being denied care staff at little cost to the owners and was a considerable source of resentment to the staff. I can well-understand that having worked in that setting.

A part of me wanted to quit my job and buy a care home to implement some of the more progressive ways of working immediately to be honest. It should be a programme more widely watched by those involved in the sector and I’d urge any interested party to pick it up on the BBC iPlayer in the meantime.

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New Horizons in Mental Health

New Horizons, which is the 10 year plan for Mental Health strategies and plans is finally published today after a long gestation period of consultations. It is the successor to the National Service Framework for Mental Health which covered the periods between 1999 – 2009 so just about makes it out by the end of the year.

There has been much discussion about its contents, none of which are likely to be a surprise but it is hoped that the renewed focus can reinvigorate the service delivery although there is little appetite for new government strategies and ideas, this has been expected for a long while.

It is thought that the report will focus on prevention and  with that in mind, the Guardian reported yesterday that additional funds will be available for funding research in the fields of mental health – in fact, a tripling of funds from £50m to £150m per year.

The other focus is on wellbeing and general mental and physical wellbeing being a way to prevent mental ill health developing further. This may mean more focus on tackling mental health at earlier stages through ‘talking therapies’, indeed, the BBC reports

The 10-year strategy is expected to call for better identification of those most at risk and wider access to psychological therapies for patients.

I don’t really expect any additional surprises alongside what we already know from the public consultation documents but it does represent an important move in the focus of mental health services over the next decade.

Calm before the Storm

For some reason, that I wish I could capture in a bottle and keep, I woke up in a particularly good mood yesterday. I made a more conscious effort than normal to try and preserve my good humour and positivity throughout the day.

It started with supervision – my first supervision with a new supervisor. There are some things I had dwelling at the back of my mind but it was generally very positive. Currently, and I know this is something of a jinx, things are relatively stable in my caseload. I’ve spent the week doing some catch-up and checking all my risk assessments and CPA reviews (Care Programme Approach) are up to date – something that usually waits for the quieter periods.

I have one or two situations that are ‘pending’. Two people in hospital, one of whom, on discharge, will require a lot of support. While ‘ready’ for discharge there are issues relating to housing which may be resolved at any point and as soon as they are, I can see an extremely busy period ahead – I expect it will coincide with the Christmas period….

Talking of the Christmas period, that also tends to lend itself to an upturn in the work. It is not always a happy period for people who do not have families or do not have families nearby, particularly, remembrances of happier Christmases past can be haunting and cruel.  It’s hard to escape from the expectations of a ‘happy Christmas’ when you have noone around you to share the season with. Sometimes, the ‘group-think’ expectation that we will all be sharing festivities with loving families around us can add additional pressures.

I’m thinking of a couple of people I work with who have had particularly painful years involving bereavements. I’m working all the way through Christmas this year (apart from the bank holidays) but then, I’ve always done that. I can’t remember the last time I had the period off between Christmas and the New Year.

Being brought up in a secular Jewish home, we used to have presents at Chanukah instead of Christmas (12th – 19th December this year) but it was slightly different as we got little presents (and I mean little – some chocolate coins or something like some new colouring pencils) each night. But certainly in our household, the gift-giving was for children  – adults didn’t get presents from adults and children didn’t give presents to each other – it was about adults giving presents to children.  Of course, it has meshed more with Christmas as there is a cultural expectation of presents.

This year will be different for a number of reasons. My dad’s death earlier in the year, of course, breaks that link with my childhood. My siblings live in different cities. They hopefully will be some overlap but it doesn’t happen on Christmas day.

We also have a child with us this year and whereas we, on our own might bypass some of the grander traditions and watch some television – this year we are going more ‘traditional’ Christmas (and I’ll add whereas I’m, at least, culturally Jewish, my partner is Roman Catholic (non-practising) so the traditions do have some place in the household at large!).

So all in all, I can understand a lot of the pain Christmas time brings for those I work with. The separations and bereavements and longing for holiday seasons past when the family might have been together, as well as seeing the pain through the eyes of a child who is away from her family at this period where so much cultural focus is on ‘together’ time.

But for now, I’m rather enjoying the calm before the storm.

Inspections

The big news today seems to the publication of the annual performance assessments from the CQC (Care Quality Commission). The results can be read in two ways as is evident from the headlines resulting from this publication – from Community Care’s ‘Councils improve for the seventh year running in adult care’ headline to the Guardian’s ‘Nearly 4,000 adult services criticised over level of care provided’

The obvious conclusion being, things are still pretty awful but not as awful as they were..

Obviously there is a need for inspections and reports, otherwise we would be completely clueless about what is going on within services however I am far from alone in my lack of faith in the rating systems, certainly those that I have had most experience with in residential services.

Meanwhile, as services generally improve across the board, eight councils were particularly ‘named and shamed’ as they were told to improve services, namely

Bromley, Cornwall, Peterborough, Poole, Solihull, South Tyneside, Southwark, and Surrey and particularly, according to the Guardian, Peterborough and Poole, were designated as “poor” in terms of the dignity and respect shown to individuals dependent on their care.

All eight councils will be subject to further scrutiny by the CQC.

I, of course, checked my own council and the reports are positive, I’m glad to say, but that pretty much goes along with my experiences to be honest.  I think there are improvements to be made, particularly regarding commissioning of services which I think has some appalling gaps and the direct payments/individual budgets services which have been poor in take up or promotion to older people with  higher level care packages, but hopefully, the roll out of the personalisation agenda will increase these levels. These weren’t factors picked up through the inspection however.

The process of inspection is under the microscope for a number of reasons currently and there seems to be an increasing lack of faith in public sector inspection processes, from OFSTED and the quality of their inspections to the NHS rating system. Inspections should focus on qualitative more than quantitive data.

But although criticism is necessary to evaluate the outcomes for those people who are reliant on care services, if there has been a general improvement across the board, that should be welcomed.

-

On a more heartening matter, the IPC (International Paralympic Committee) ruled that athletes with intellectual difficulties (or learning disabilities as we would refer to them in the UK) have been re-included into the Paralympic Games. This is slightly old news as it broke last week but I missed it at the time and as an issue that I always felt strongly about, it comes as very welcome news.

I hope very much to be able to support these paralympic athletes when they come to London in 2012!

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Report Reporting

So the Task Force report yesterday was pretty much as predicted. Personally, I think a lot of the contents are very welcome with the main concern being the lack of money to implement them – but I’m willing to engage positively with the process of change in the hope that some of the issues that we have been complaining about in social care will change – it’s that old chestnut – the triumph of hope over expectation but leave me in my ‘happy place’ however briefly!

I thought it was interesting to consider how some of the press reported on the publication of the Task Force report which in it’s full glory can be found here. I was about to print it out at work to read later when I realised it was 71   pages and thought that was a bit much -  more trees saved.

The Independent focuses on the tagline of ‘better pay’ for social workers but no money to fund it – which is the crux of the problem really.  Similarly, the Times also looks at the ‘elephant in the room’ – namely funding for the additional money that might be spent to implement the recommended changes.  The comments though are a little disheartening. There seems to be a perception that anyone with a bit of ‘common sense’ and ‘life experience’ can be an effective social worker. I think there is so little understanding of the importance of training that it is almost frightening.

The Daily Mail meanwhile go for a whiny

‘Social Workers to be given pay RISES in the wake of the Baby P scandal’ which is a disgustingly ignorant headline. Their capitals by the way. It is a plain misrepresentation which panders to their insufferable readers. The comments are enough to make my stomach churn. I would love that reporter to come to my office to see the work we do on a day to day basis.

The Sun’s agony aunt, Deirdre Sanders who actually sat on the Taskforce tells her readers

‘How we can stop another Baby P’

She seems to put things in patronisingly simplistic terms but it gets the general message across although I think that relating all the changes to a single child’s tragic death is not entirely a fair explanation of the scope of the work done. There is a generalised thought lingering in my mind that there should be a wider understanding of what we do as social workers in adult and mental health services rather than the focus solely on child protection issues as the Task Force was to concentrate on social work as a profession rather than one aspect of it.

Meanwhile on the safer arms of the pages of the Guardian, there are a number of articles addressing different parts of the report.  From the details of the report to opinions by Peter Beresford who discusses the long term commitment needed across the political board for the reform process to Ray Jones who writes in praise of the taskforce – although not without a well-aimed kick towards Ed Balls (and quite rightly in my opinion) who

followed through on the tabloid-generated victimisation of social work and social workers by himself vilifying those who gave their professional lives to protecting children. Not surprisingly there were then major problems in recruiting and retaining social workers, and the workloads for those who stayed increased. Who wants a job where, when a tragedy occurs and the going gets really tough, you and your family are hounded by the paparazzi and hung out to dry by politicians?

I was applauding in my chair as I read that!

Community Care, a magazine aimed specifically at those in the social care sector in the UK, unsurprisingly has a lot more in-depth coverage – from their own discussion of the main components to reactions from ADASS (Association of Directors of Adult Social Services) and ADCS (Association of Directors of Childrens Services) which understanding question where the money is going to come from to their own views (via the Group Editor, Bronagh Miskelly’s blog).

Personally, I think the issues around training and recruitment are far more important than the pay issue but I accept it’s because I’m not unhappy with my salary – although more is always good..

One of my favourite (and I mean that in an ironic way) quotes comes from the Independent piece where Tim Loughton, the Conservative shadow children’s minister says

“The task force makes some sensible suggestions for improving social work and child protection, many of which we proposed some time ago.

“Ultimately the success of these proposals must be judged on whether they improve conditions on the front line. This Government has strangled social work with 12 years of bureaucracy – it is important that it now acts to improve the situation.”

Sorry, but a Conservative shadow minister saying the government has strangled social work with bureaucracy? Shows very little understanding of the last Conservative administration… and the one before that, and the one before that.

I am no fan of the government and couldn’t despite Balls any more than I do at the moment but the Conservatives are hardly speaking from a position of authority after seeing what they did with and to the profession.

But in general, I am left with a warm buzz of excitement that changes might be implemented to benefit the profession and most importantly those who use the services provided by social workers in the future.

Social Work Taskforce Reports

The final report of the Social Work Taskforce, set up to look at the profession as a whole, is published today. There are not going to be any surprises as there has been an interim report already and much discussion of its contents.

The Guardian reports more details about it and it seems to be a very positive move forward for the much maligned profession that has too often been a government pawn. Switched and swapped and chopped and changed to meet the needs of the policies of the political mood of the day, however, I  expect a lot of public sector workers can say the same.

Back to the report itself though, again, Firstly, there is the introduction of a ‘licence to practice’. I haven’t seen too much of the detail about what this might involve along with the registration that already exists but it would mean a year in practice for newly qualified social workers before they achieve this ‘licence’ – presumably involving some kind of ongoing assessment to ensure that a sufficient standard is met. I’ve made my point many times on this matter. I think it is wholly positive as to rely on universities to produce fully-qualified and ‘ready to practice’ social workers has been a consistent failing of the current system. It also  puts social work more in line with other professions such as teaching and strengthens the quality of the profession as a whole.

Again, going back to the Guardian article, there will be no cap on caseloads but the introduction of some kind of monitoring system so that caseload numbers are managed. Personally, I think the ‘overworked’ issue isn’t simply a matter of numbers. If there is no effective caseload-weighting, the numbers make no sense. I’ve held caseloads of over 40 and caseloads in their teens – one might  not necessarily make me less overworked than the other if the complexities are not equivalent. Everyone working in the area will know that one extremely active case can be as busy as 10 bubbling along smoothly cases and so the numbers game doesn’t really work.

It seems that the emphasis on pay reform is being devolved to local authorities to work out career structure and link pay to training and career development. Although I’m relatively content with my pay, I accept I get paid more than the majority of social workers at my grade (non-management, non-senior) due to the London weighting and the higher pay that is usually commandeered in the Capital (because costs of living are higher – not for any more special or exclusive reasons) and the AMHP supplement – however the pay is a constant issue and whether we like it or not, just because it is a so-called ‘caring’ profession, does not mean that we should have to accept lower pay on that basis. There is an more interesting argument to be had about the traditional ‘female’ professions having lower pay on the basis of responsibility but this probably isn’t the place for it. Suffice to say if pay is to be addressed, that can only be a good thing.

As the article says

Employers will have to work with unions to reform social workers’ pay so that it reflects their career development and progression. Ministers will say that if this does not happen locally the government may introduce a national pay review body along the lines of those already in place for nurses, teachers and the prison service.

There is some mention of a practice-based Masters qualification. I hope that some consideration of the mash that is the current post-qualification framework is taken. It is easier to tie the post-qualification framework to academic qualifications perhaps but there are already routes to Masters’ level courses through practice-based qualifications. More streamlining perhaps and more flexibility. I never really liked that I had to make a choice between Adults and Mental Health as they run two different paths through the post-qualification system. The Foundation Trust have necessitated that I take a ‘Mental Health’ pathway when some aspects of the ‘Adult’ pathway such as ‘Personalisation’ and ‘Safeguarding Adults’ would be equally useful. I would prefer that we weren’t necessarily pigeon-holed. I do need more details on that aspect though.

The other issue brought up is the institution of a National College of Social Work. I know this has received some attention and Balls announced it at the weekend. Personally, I’d like to know what the remit is and how the interplay with BASW and the GSCC will ride with it. If the fees to be registered are to increase as the GSCC demands independence, and the College of whatever form it takes, will, no doubt, demand a fee payment as well as payments to BASW and a Trade Union (I know these are strictly speaking optional but I don’t see them as a choice!) we could be bombarded with costs to practice.

I’m sure there will be provision made for this and I like the idea of the National College but I would  like more detailed information about what it is. I expect that might come out as the day progresses.

So generally, it is hard to think of anything negative to say about the Taskforce report – not that I was looking for negativity of course. It seems a fairly broad, positive move to refocus social work. I think there is a lot more work to be done however, including at a ground level.