Protected: Getting back to work

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Unproductive

The Guardian reports that there has been a dip in public sector productivity in 2008. The worst offenders are those in Adult Social Care. Oops. It makes interesting reading though when you consider what is classed as ‘productivity’.

The productivity measure used by the ONS sets outputs of public services, such as NHS operations and GCSE grades, against inputs of labour, materials and capital assets.

I expect these are those wonderful performance indicator types that we are measured on. With operations and exam grades positive results might be better determinable but if you think about social care, let’s think what kinds of things might count as productivity?

It can’t be hours of care provided as we are consistently encouraged to cut down care and tighten criteria.

Anyway, hours provided is not a factor in itself of success or failure. Even hours provided against hours provided to the same person last year as if there has been an increase it could be wholly unrelated to the effective of any service provided (through there being a deterioration in health, for example) and if there has been an increase – well, increased cost is hardly likely to be seen as an indicator of good performance.

We are marked on the  number of carers’ assessments but to be honest, carers’ assessments are mandatory anyway, so we should be doing them for everyone who has an informal carer, so working on the basis that everyone is availed of their mandatory right to receive an assessment, there is no way to ‘increase’ these. You have one, if you are a carer, or, if you don’t have a carer, no-one has one. I can’t see how these can be increased apart from by stretching the definition of ‘informal’ carer or as a previous manager once told us, to carry out carers assessments ‘on paper’ even if the carers’ themselves had refused them in order to meet the numbers (we didn’t do this and I’m not sure if she was being entirely serious when she suggested it!).

Another criteria we are measured on is Safeguarding Alerts and Investigations. Again, this is a mandatory social work function. If there is a concern, an alert/investigation is completed. You can’t really massage the figures in any way because you HAVE to do the work – the only way productivity could increase is for there to be more abuse recognised and alerted…  Maybe the lack of safeguarding alerts could be a seen as a good thing and a sign of high levels of care rather than a bad thing and an unproductive office – this is bearing in mind that a lot of safeguarding issues arise from care given in a formal capacity – residential care homes and paid carers.

We factor in timeliness in completing assessments and responding to referrals. This is all well and good and better than people waiting for months. But if the quality of service better as a direct result or is moving a limited staff team from otherwise important work to take a low level referral an effective use of time.

I would question how many of the people in the ONS (Office of National Statistics) have ever had a hands-on role working in adult social care to be able to understand the way that quality and quantity of work can be judged.

It’s a great headline though – look at those inefficient workers in adult social care – they aren’t as good as other sectors in maintaining ‘productivity’. I would say that outcome measures are currently not making any allowance for quality of care and the shame is that it is on the basis of reports such as this that jobs will be lost and services cut – and more staff time will be spent on administrative tasks which ensure that ‘outcome measures’ are favourably determined as opposed to devoting time (and money) to fighting for a high quality of care and service delivery.

The role of a social worker

Often it takes an ‘outsider’ to see it clearly but this post from Stuart Sorensen says it far better than I could .

I would only add that professional courage is developed from confident practitioners. Confident practitioners – namely those who are able to advocate for the service users they work with, are able challenge their management and procedures and not just ‘tow the party line’.

This is something that is developed through  good supervision and support from more experienced social workers and a healthy dose of challenging some of the more commonly held paradigms in the sector, even if it doesn’t make a friend of the ‘management’ who prefer things to be clearly defined and cost effective.

Social Work cannot always be clearly defined and cost effective for as long as it claims to be a value-based profession. A social worker who is a ‘yes-man’ is the most dangerous and ineffective type.

I hope that is something that the Social Work Reform Board/College or whoever will be responsible for social work training and professional standards in the future pay heed to.

The Generation Game

Yesterday, I watched ‘The Generation Game’ on BBC1. It irritated me. The programme seemed geared very much to a comfortable middle class scared of losing their right to their parent’s properties. There was no ‘cutting edge’ in the debate. It was geared towards a particular audience that doesn’t link in with a large swathe of people that I might come across on a day to day basis. Remember, the poor woman who had to sell her mother’s house that she knows she and her brothers and sisters would have inherited, chose a care home which was not on the list approved by the local authority and cost £900 per week. Who exactly does she think should pay the £900 per week? Also, if all care home places were funded that would leave a massive gap in funding and at least the way of ensuring that people who can pay, do, means that more of those who cannot pay can receive services and no, this are not people who have ‘frittered their lives away’ and not paid attention to saving – but people who might have have different circumstances and situations that might have arisen or who have had lower paid jobs. It is not as simple as drawing a line and saying ‘everyone should save’. Not everyone can.

I’m not saying the current system is fair. It needs to change. But the picture painted in the first part of the programme was unrealistic and actually false in some parts.

Where the programme failed was to actually look at support for those who don’t have resources to fall back on.

Yes, the extra-care sheltered scheme was fine but if they were like the schemes in our local authority, they don’t like to take people who have anything verging on what might be considered a ‘mental health’ diagnosis (and yes, that does include dementia – ironically). I have a lot to say about extra-care sheltered schemes in general and should probably leave that for a post in itself…

I wonder if I’m the only person that thinks paying for care needed in life from ones’ estate is actually quite a good idea and has no ethical issues with a ‘death tax’.

Last night’s TV

There were a couple of TV programmes of interest on last night. One was on ITV, called ‘Behind Closed Doors’ and was about childrens’ social services in Birmingham. I didn’t watch it because.. er.. we were watching Beethoven… you never grow too old for cute animal films!   Living the Social Work Dream writes up a brief account of her impressions and it seems like a sympathetic view.

The other programme, which I did watch was ‘Undercover Boss’ on Channel 4 about Kevan Collins, the Chief Executive of Tower Hamlets. I  was curious to see what the perceptions of services on the ground would be from a local authority Chief Executive. I thought it was an interesting programme and quite enjoyed it. Of course, I’d have loved to have seen him in a social work office but the scope of the work of the council is so broad that it would take an 8 hour programme to cover all the different departments. The one thing that struck me at the beginning, where the filmed the Council Executive meeting (I assume) was how the ‘suits’ seemed all so worthy and nodded away when they talked about the usefulness of getting ‘front line’ workers to give input as they knew what was going on ‘on the ground’. I wonder it takes a television programme to emphasis this. I think they would all do well to ‘get their hands dirty’ to some extent and to actually listen to some of the ideas that would filter up.

Collins spent some time with the meals on wheels service. As I mentioned to my partner, Tower Hamlets is lucky to an extent as my local authority don’t deliver hot meals anymore and all the services have been contracted out. It was painful to watch how much that simple human contact can deliver to a person living alone at home who might not have the personal care needs to warrant a care package, and yet it is denied due to the costs of meal delivery systems. I hope it means that Tower Hamlets retains and promotes this service.  He certainly came out of the programme positively and I hope it was more than a just-for-the-cameras interest he was showing and will continue to show in the services in that Borough.

I jalso wanted to highlight this post from a US social worker who came to London with her college to learn about social services in the UK. She visited Waltham Forest and gave an interesting view ‘from the outside’. One of the things I have enjoyed most about the blogging experience is learning more about comparative systems of social work, particularly in the US, It makes a fascinating read to see how a British Social Work team is viewed and is something quite different from the usual navel-gazing that we occupy ourselves with!