Monthly Archives: January 2011
Over the week, I have a few posts planned about different aspects of the Mental Capacity Act 2005 – it’s partly because I’ve been asked questions specifically about it and partly because I, personally, find the area enormously interesting.
Working, as I do, primarily with older adults, means that I work with a lot of people with dementia of one form or another. Working with a lot of people with dementia means that the issue of capacity or lack of it is one that we deal with every day. While far from setting myself up as an ‘expert’, I thought it might be interesting – possibly helpful – if I shared some of the issues that have raised themselves in our own borough.
When the Mental Capacity Act 2005 ‘went live’ we had a lot of training about capacity, capacity assessments and the roles of IMCAs (Independent Mental Capacity Advocates).
In a sense though, the Mental Capacity Act just firmed up a lot of practice that had been happening within the sphere of ‘case law’ or ‘common law’.
One thing it does do though, is provide more protection and guidance for anyone who carries out an assessment of mental capacity – and make no mistake – anyone can carry out an assessment of mental capacity.
Today I want to look at the idea of ‘The Decision-Maker’ as it is one that still causes a great deal of angst in the office.
Who is the Decision-Maker?
The Decision-Maker is the person ‘on the ground’ so to speak if they suspect that the person lacks capacity and are there (figuratively as well as physically) when a decision needs to be made.
So the carer who goes in to someone’s house in the morning to someone who cannot make a decision about what is ‘weather appropriate’ clothing, might be the decision-maker in that case.
A husband might decide that it is best for his wife to have steak for dinner rather than chicken because steak was always her favourite. He is the decision maker.
These are the kind of snap decisions that might not immediately come across as being subject to an ‘assessment of capacity’ but many people – especially those involved in care – would take thousands of decisions in the ‘best interest’ every day.
Most commonly it will be family members or carers who make these decisions.
Sometimes, of course, it is the involved professional.
Last week, I was sent a letter from a GP asking for an assessment of capacity for an individual for whom I am the care coordinator because she was refusing to take her medication. Could tell him if she had the capacity to refuse medication?
I responded that I could not because the GP is the decision-maker.
(Of course, while happy to advise and support - the decision is not mine to make).
Another nurse in the team discussed with me a conversation he had had with a social worker in one of the community teams who had asked him to ‘make a decision’ about the type of care a particular resident was having at a nursing home.
The social worker is the decision maker. Sure, she can ask advice, that’s no bad thing. But she cannot delegate the decision making to my colleague.
A few months ago, we had a request from a social worker in another team to assess the capacity of someone who had dementia to make a will. The referral came to the team meeting and was summarily dismissed with a ‘the solicitor has to do that’ remark. It seemed counterintuitive at the time but the Code of Practice is very clear about this. (MCA COP 4.38 – 4.43)
The person making the assessment as to whether capacity exists has to be the person on the ground who is suggesting (or not) that action that is to be taken.
Those are some fairly straightforward examples. Sometimes it is a much more difficult place to be.
There is someone I’m working with at the moment who lives at home. There are proverbial risks hanging from every corner of the house. I can’t even begin to recount them! She has been agreed for residential care. She has family who take an interest who find they are constantly worrying about her and want her to move to a residential care home nearer to them although, they tell me with slight reservation, she always said she would rather die at home than go to a residential care home.
I’d like to devolve the responsibility of my decision to someone else. Really I would. I sometimes see my caseloads play out on the imaginary front pages of the Daily Mail or the Sun.
After completing my capacity assessment (I’ll come to the details of that tomorrow), I surmise that no, she does not have the capacity to make a decision about her needs regarding her residence.
That doesn’t mean that I then ship her off to a residential home even though she doesn’t want to go though.
My decision takes into account the risks and the strength of feeling that she wants to be at home and her utter and complete distress at mentioning residential care.
She remains in the community with increased support and every time I see her my heart is in my mouth.
I wish someone else would make the ‘decision’ but while other people can inform and support me with it – just as I said to the GP – it is my responsibility.
Other decisions I might have made have been with the input and support of an advocate (Independent Mental Capacity Act Advocate has a formal role – which again, I’ll come to later in the week) but they don’t make a decision for me. I am not bound by their advice (although I’ve never gone against it!) but at the end it is advice to help me make a decision – not make a decision for me.
To make a decision there has to be a reasonable belief that a person lacks capacity. There are some indicators about what form and what steps should be taken during this process but as a professional being asked to make decisions, the most important thing that has been drilled into me is to ensure that I record clearly the reasoning behind my assessment and my decision.
We have some very good forms (I don’t say that very often!) that we use when we are carrying out these Capacity Assessments which really take us through the process and the legal requirements on a step by step basis and form their own record and reasoning.
But I’ll come back to the process tomorrow.
In the meantime it is important to remember that the Mental Capacity Act is a document that protects the service user/patient/all of us.
Someone doesn’t lack capacity just because they don’t agree with the professional decisions made around and about them just as they don’t suddenly have capacity just because they agree to do what they are told.
Making decisions about other people’s live – especially very significant decisions – isn’t always a comfortable place to be – but the mantra of best interests needs to be playing in the background of our heads along with the very basic tenet of ‘what would this person want if they didn’t lack capacity?’.
The answer isn’t the same as ‘what would I want if I lacked capacity’ or ‘what would their family want for them?’ Sometimes it is but that isn’t necessarily the default position. Yes, of course family and friends must be consulted. As good a picture as possible must be created of that person’s life, aspirations and hopes. Often it is the same as the people around them who love them most.
It must though always be a very transparent decision that, if challenged, can be defended. To the Court of Protection if necessary although lets hope it never is!
It’s a lot of responsibility at times but legally it can’t be shirked.
I haven’t put together my social work links for the weekend yet because I was busying myself putting together this weeks
I hope to pump some more specific social work links over the weekend.
I’m also working on a few posts relating specifically to Capacity, the Mental Capacity Act and DoLs so if you have any questions – or want to prompt me in a particular direction – do ask – I can’t promise I’ll deliver though!
It may very well be a theme for next week though.
Posted in personal
A couple of weeks ago, I had one of those deeply depressing moments that will generally punctuate a career in social care.
I had to go and tell a woman, who cares for her mother with enormous patience and dignity, that we could not increase their personal budget although her mother’s care needs had grown.
I suppose I went to my manager in a relaxed almost casual way and explained how the needs of the older woman had changed and to ensure her well-being, she needed additional time.
I was told, with a degree of equal sadness and regret that there would be no increase. If we were to provide what I felt was a necessary increase in care, the time had to be taken from the the hours already allocated.
She did, to her credit, try to have a discussion about this with her own manager but there was no budging on budgets. Despite the change in various situations, there would be no extra money. In fact, she added, the plan really needed to be cut.
It had been my first personal budget implemented. The council, in an attempt to encourage and prod us to implement these personal budgets had promised us and by extension, the service users and carers we work with, that no-one would be disadvantaged by moving to a personal budget so even if the RAS (resource allocation system – the way that figures are attached to needs through the personal budgets system) did not ‘deliver’ enough money to provide an equivalent package of care that had been delivered under the ‘old’ system – it would not be reduced (and here’s the key) at least, not initially.
Now this particular service user and her daughter had what was a high package of care. It had costed much more than the ‘RAS’ had spat out.
After making the promises, after the move to personal budgets is no longer an optional roll out of volunteers – the cuts are coming. There is no longer the carrot to offer of ‘equivalent packages of care’ because we now offer everyone as a matter of course a personal budget and those who were not receiving them are being transferred over to the new system regardless – they don’t have to be self-managed, of course, but they have to exist.
So I visited the family and we looked at ways of shifting around hours.
The hours that were cut were the respite hours.
I suppose it was inevitable.
Family carers are invisible. The work they do is not costed. Of course the daughter was sacrificing her own needs for a few hours respite to her mother’s needs for additional personal care.
This is what the cuts mean to one family.
I had to tell them and negotiate with them about what to cut from their own package of care.
Not the Prime Minister. Not the Millionaires in the cabinet. Not any elected politician or Council Chief Executive. No councillor had to sit in that room with me and look the service user and carer in the face and ask them what they would prefer to give up from their package of care.
I’ve known this family for many years. I have a good understanding what is at stake for them and how much these cuts are hurting. I also know they won’t complain or grumble or shout from the rooftops.
They are not going to be going on any rallies or demonstrations against the cuts – not least because the respite hours have been cut.
We who can, have to demonstrate and shout and scream on their behalf.
And you know, as I know and I say this with a heavy heart – they’ll be much more of this to come.
- Greater ‘choice’ for social care (bbc.co.uk)
- Paul Burstow writes… Our vision for social care (libdemvoice.org)
- David Cameron accused of second betrayal over care for disabled children (telegraph.co.uk)
Posted in carer, carers, dementia, direct payments, elderly, health, local authority, mental health, old age, older people, personal, personal budget, politics, social care, social issues, social work, work
Tags: budget, caregiver, cuts, Disability, evil tories, family, individual budget, london, personal budget, personal care, personalisation, respite care, sds, self-directed support, social care, social work
It was a fairly standard visit as they go. I knew the block of flats. It was one of those seemingly ubiquitous 1950s high rise blocks that had been built in the shadow of the wartime bombings.
I knew that particular block though. You get this, when you’ve been working in an area for a fair amount of times – particular estates or blocks that will bring back a range of memories about the people you know who live behind the doors.
There had been a family there, in this block, with whom I’d worked for a couple of years until I was moved to a different patch and handed over with a fair bit of reluctance on both parts, to a colleague.
Now, the boundaries have been redrawn again and I found myself in exactly the same building – in the flat directly underneath the one in which I had spent so much time.
On my way in, I tried for the life of me to recall the name of the family that I’d been working with previously. It worried me that I had spent so long in the life of a family and I couldn’t remember their surnames (I remembered the first names fine, of course). I pondered about the nature of my job, flitting in and out of lives but the lives continue and have to deal with such anguish of illness and tragedy. I can walk away from it.
As I went towards the lift on my way out of the flat I had been visiting (I was on the 11th floor at this point, and while not adverse to staircases, I sometimes have limits), I saw the woman who I had visited so many times a few years previously, coming down the stairs.
I immediately remembered her surname. Thankfully. Maybe I just needed to connect the face with the name.
She did an almost double-take when she saw me and she greeted me warmly. She told me the rest of the story that I knew, partially, from my colleagues’ visits of her husband’s death.
She told me and I listened. We had, by this point, moved downstairs into a more sheltered area. She interspersed the story with tears. I listened more. We walked a little way together.
‘People tell me’ , she said ‘that I should be glad to have got my life back’.
She had been a devoted carer for her husband who had needed an incredible amount of care at home.
‘And that’s not how I feel’.
I nodded, and listened some more.
I gently reminded her how much she had done but mostly, I listened.
Throughout the conversation, there were tears running down her face. I offered her a tissue but she did not wipe away the tears. She just continued to talk.
As I was heading into a different direction, she touched my arm lightly and thanked me.
‘I can’t talk to anyone really about his death’, she said. I nodded. ‘I mean about the details – about what happened’.
‘I don’t want to upset my children, you see’, she said.
I nodded and explained that I felt glad that she had been able to share this with me.
As I headed up to the bus stop back to the office, I pondered the nature of random encounters and the importance of knowing and being attached to a particular community.
I was also pondering the way that we think and discuss death. I have worked for almost 10 years in older adults services. Death happens. It happens in many ways but it never stops being something of a shock. It never stops being the crucial key in the life of the family around that person.
When my student was on placement, two of the people who were allocated to her died. We reflected a lot about the nature of the job we have and what we do when that work comes to an end through a death. Sometimes it is difficult to have a discussion with family members after a death has taken place. It might feel awkward or intrusive. It depends a lot on the length of time you have known a family and the nature of the involvement – whether it has been welcomed or not.
Generally, I think back to my own experiences of my parents’ and grandparents’ deaths and try and pick up on the need to connect and acknowledge the life of someone rather than trying to brush what may be difficult conversations under the carpet.
Death is still a taboo. Especially to those who do not have personal experience of it. For me, I count my childhood and adulthood through the deaths of those whom I have been close to. That sounds dramatic but it builds a unique perspective. I spent much of my adolescence trying to think through issues surrounding death. Through the anger, the blame, the fear of ‘being left’, the confusion – what do you do WITHOUT that person who was the rock, however unwell, however much disease ravaged the body, the unresolved pieces that need to be fit together.
One thing that I have learnt, through personal experience and through professional experience is that it’s good to talk and conversely, it’s good to listen quietly and let the stories be told.
Sometimes when you face a bereavement some people, friends, family, for their own reasons (often fear), don’t want to listen – they express sympathy but they display discomfort. Sometimes people don’t want to hear about death.
Listening without comment, to the commentary about a person’s last moments isn’t always easy but it is undoubtedly important.
Yesterday Community Care had an article on their website talking about the need for social workers to have training around talking about death.
It struck me as a coincidence. As I talked about death. In a corner of a lobby of a high rise block of flats in central London. And I think it helped. I hope it did.
A week or so ago, Johann Hari, a journalist and columnist for the Independent, wrote an article about his grandmother and the poor to verging on abusive care pathway that she experienced through devastatingly shoddy system that was and is not fit for purpose.
Today he writes again for the Independent proposing a series of changes across the sector which would improve the quality of service delivery.
I have a massive amount of respect for Hari and he writes very eloquently and passionately. I desperately hope more people listen to him than have listened to us, within and engaged with the sector who have been shouting, Cassandra-like, for so long.
His proposals are quite straightforward.
- Support elderly people to stay in their own homes wherever possible
This concurs with the evidence produced yesterday by the Alzheimer’s Society in a report published yesterday ‘Support.Stay.Save’ which concludes that while care in the home (rather than premature residential home placement) is a favoured outcome – the quality and training of staff is a serious issue – however if this were challenged, promoted and improved, there would be an eventual saving in the costs of placement in residential care.
There is a whole range of services that make this possible – from Meals on Wheels to home helps who are there to help an old man to shower in the morning and get into bed at night. We should be stepping them up, to keep anybody who possibly can free and independent. Instead, we are ruthlessly stripping them away.
and it is this that breaks my heart. We are tightening criteria, raising the bar to access support and increasing the cost of these services to those who may be responsible for their own costs. Hot meals on wheels delivery is not a default position anymore – they’ve been replaced by a fortnightly delivery of frozen food. This is a saving on paper to the local government but in the longer term denying this additional personal contact of a regular face delivering hot meals, is a much larger cost.
Councils have tendered out for the services at the lowest baseline cost. Care staff are provided on minimum wage, with little, if any, training and barely any dignity in their employment conditions so no wonder that corners are and have been cut. We need to provide the best possible rather than the cheapest possible.
They are better off with their families – so offer the care home funds to them first
Again, a seemingly obvious point. Hari states that residential care can cost upwards of £450 pw. Why isn’t that same amount of money offered in the home? It makes perfect sense. It makes perfect logical sense. Of course, some people will always need the 24 hour care. To be honest, we tend to fund increasingly higher packages of care in the home and it isn’t unknown for similar levels to be provided. I have one service user who has a package of virtually double that in her home (as a personal budget) but am frequently told that that is an unusual case and it’s only possible because a family member takes on a significant amount of care.
Local authorities do need to get over their aversion to funding overnight care in the home though. That would immediately make this more possible. Personal budgets theoretically should allow this point to be immediately actionable. In practice, it is not easy to squeeze the funds out of the interminable RAS (Resource Allocation Systems).
Make being a care worker a desirable profession
Today, our elderly are looked after by people who are paid the same amount as street-sweepers, and have the same level of training..
This breaks my heart. I spent 7 years working as a care assistant in a residential home. I applaud this point. There were times when I met with friends from university and I was almost sneered at because of my job. Actually, scratch that ‘almost’.
‘When are you going to get a ‘proper’ job?’ I was asked. Eventually the pressure of that pushed me into social work. I am glad I did it but it is hard to understand where the sneering came from. Sure, money is an aspect of it but it’s wider than that. Sometimes the management seems to join in with this scornful and hierarchical approach to care workers – it’s important to remember that if a manager is not going to treat staff well and with respect you can be sure that residents will not be treated well either.
Increasing not only pay but conditions of service – decent holiday pay, sick pay and training – would make a difference. I’d like to see more of a line of career progression as well.
Retrospectively, I look back with a massive amount of fondness to those days. I was lucky to work in good homes where I was instilled with a good work ethic and values that supported resident’s rights. I know how easy it is as a worker to ‘go native’ within an organisation and agency if the work ethic and values are not good. It leads to spirals of dispirited behaviour.
I wish every social worker had had the experiences I had in hands-on care work. It was invaluable and it shapes a lot of my actions and values today. I doubt many do or will in the future. That’s more the shame.
Now, I am so proud that I was a care assistant in a residential care home. I wish I had been at the time.
Make every home publish its staff-to-residents ratio
Theoretically this should be possible. It should be easy to access. It makes a big difference. When relatives go to visit care homes I advise them to ask about this and perhaps ask the member of staff showing them round how long they’ve been there and what the staff turnover is.
Clarity would be a fantastic and simple indication of whether a care home runs on bare minimum or below minimum staffing ratios. Unfortunately the CQC doesn’t really help much here.
Every parent knows how many pupils there are per teacher in their child’s school. Nobody knows how many carers there are per resident in their granny’s home. I asked at every home I considered: nobody would tell me. But this can make the difference between a good home and a terrible one.
I’m surprised that no home could tell him when directly asked. Maybe because sickness is not taken into account – some homes seem to constantly run below the CQC required level due to ‘unexpected sickness’. The CQC could monitor this with spot inspections. It doesn’t. Or only when things are literally falling apart. It makes me angry.
Impose minimum nutritional standards for the food
This makes sense again and a menu list can’t always indicate what the quality will be like. However, unlike Hari, I have seen homes that have delivered well on this front. I am sure I’ve been to many many more over the years though.
The ‘Scores on the Doors’ system of food hygiene ratings has been extended to residential and nursing homes so perhaps that is a start.
Well, the best start is for the person responsible to think ‘would I want to eat this every day’. No-one should be serving food they would not want to eat themselves.
Change the attitude
This is a broad brush that Hari paints. The example he gives is a regimented imposition of bed times and morning times. There is something of the way that care homes are organised that sometimes some of the personal touches and individuality can be lost. This does differ in different care homes and there are as many attitudes as there are people. The key though is to emphasise individuality in choices and not to impose on others.
For me, it’s a matter both of training and staffing levels. Treat every resident as you would want a close family member of yours to be treated. It’s a very simple tenet and an easy one to remember. The difficulty is that not enough people will practice that way and so staff as well as residents are in danger of becoming institutionalised.
Stop the mass prescription of anti-psychotics to rebelling residents
This is self-explanatory really and to be fair (as Hari notes) it is one point that progress is definitely being made on. It is far less common now than it has been in the past. Quite rightly. Anti-psychotics can be dangerous for people with dementia.
Restore proper inspections of care homes
For me, this is a massive key to the whole process. The CQC needs to take responsibility for the decline in the standards and to restore spot unannounced inspections, day and night, weekend and weekday to EVERY SINGLE residential and nursing home in the country.
It is wholly unacceptable that there is a reliance on cheaper ‘paper’ inspections or ‘desk-based’ inspections and it is wholly attributable to staff being laid off by the CQC.
I have my sources (actually a couple of very good friends of mine whom I worked alongside in those days when we were all care assistants in the same residential home!) who work within the CQC and they have been given much larger caseloads and have less time to do more inspections.
Inspections need to put the providers on the spot and really and truly inspect. They need to check that what homes write about staffing ratios is really what is happening on the ground. We rely on them. They do not deliver.
As Hari says
In 2005, there were 50,000 physical inspections of care homes. This year, there will be a quarter of that number. David Cameron has called for “light touch regulation” of this sector, so homes are increasingly being asked to engage in “self-assessment”. That means they will be asked to fill in a few forms.
This, more than anything, makes me furiously angry. Light touch regulation DOES NOT WORK. It leads to increased abuse. I can give so many personal examples that I have witnessed. I will try to keep shouting until the system changes.
I wrote about this last November and have no doubt I’ll be writing about it again. And again. And I’ll mention again because I think there’s a relevance that the Chief Executive of CQC is Cynthia Bower who was Chief Executive of NHS West Midlands when Stafford Hospital was delivering contemptible and appalling care. Hardly a CV that instills much confidence.
Make sure care homes that are shut down stay shut down
This raises the issue that care homes can fail and then just re-register and open under a new name which should be wholly unacceptable.
Again, I wrote about this last November when Private Eye and Compassion in Care were trying to gain more information about care homes that were closed down.
Impose serious criminal consequences for elder abuse
There is a new law of wilful abuse of those who lack mental capacity which was introduced in the Mental Capacity Act 2005 but I agree with Hari in that the legislative framework for adult safeguarding needs to be as strong as it is for safeguarding children. Our hands are tied and the punishments do not fit the crimes.
It’s an excellent piece by Hari and I wholeheartedly applaud it. I hope more people will listen but we have to keep shouting as loudly as we can to improve the quality and attention of care for those who lack capacity and for all people who rely on others for support.
We all need to shout. Not just those of us who are directly affected or who have parents or grandparents who might be affected (as we all may be eventually) but anyone who cares about living in a civilised society as well.
Perhaps its endemic of a society that wants to push the uncomfortable realities of ageing ‘under the proverbial carpet’ that has led to institutional abuse but our humanity is lost if we don’t stand up against it.
This is not a party political issue as significant damage was done under the last government but this government can’t get away with it either.
And thanks to Hari for raising these issues among a wider readership. I wish so deeply within my heart that this piece shocked me. Unfortunately, after many years working in the care sector, I’m sad to say it doesn’t.
- Johann Hari: My grandmother deserved a better ending than this (independent.co.uk)
- The plan to solve our care home crisis (independent.co.uk)
- Letters: Caring for the elderly (independent.co.uk)
I’ve been spending a lot of time recently thinking about the effects of some of the actions I take, particularly placing some of my work within an ethical and philosophical framework.
Yesterday, I caught ‘Justice : A Citizen’s Guide to the 21st Century’ on BBC4.
It is an absolute joy of a programme and I’d say that it has helped me reframe some of the questions that come to me on a day to day basis.
Michael Sandal, a professor in political philosophy at Harvard University, presents some of the key tenets of some prominent philosophers, Bentham, Kant, Aristotle for example and puts some of the challenges that they presented in their writings but in a modern context.
Philosophy and ethics, as Sandal states at the beginning, does not take place in a lecture hall vacuum of reading dusty texts but it takes place every day with every decision we make.
These tenets of ethics and philosophy affect every decision I make both in a professional and personal basis. When I make decisions about how to spend my time and whether to spend longer at one visit to be later for another. To the decisions relating to compulsory admission to hospital and decisions about ‘best interests’ and where the line for capacity and individual freedoms are drawn – these are all decisions that come to me daily.
As Sandal takes us to different places to discuss some of the concepts that were expounded by these philosophers.
It led me to question myself (almost socratically!)
Do I make the right decisions? Are there right decisions?
Perhaps it is the system that needs to be changed?
How does the state serve the citizen, or perhaps it is the citizen that serves the state – and if so, is there any problem with that?
Does the state protect us? What do we offer to the state in response?
Has the nature of the ‘Social Contract’ Changed?
Mainly there is a question of individual and collective rights.
I love the ideas of creating a context to promote a better way of politics working that moves away from the individual but doesn’t dismiss the individual rights.
It is an excellent programme which I can’t recommend highly enough that left me massive room for reflection. It presents what can appear to be somewhat ethereal concepts as they have become and places them on a practical level. Not just on the nature of my work and my place as a ‘cog in the machine’ but the nature of modern politics and the ethical base and role of politicians.
We can’t rely on politicians to be the vanguard and determiners of what a society should be like but take a role as citizens in creating a world and society in which we want to live, taking action, if necessary to make changes.
I try not to lose the connection with my background as a philosophy graduate but this programme re-instilled and reinvigorated some of my love for debate about ethics (ethics was always one of my favourite courses).
It is part of a season on BBC 4 about ‘Justice’. I didn’t catch the debate about Justice and the Big Society which was on over the weekend, but I hope to catch it on the iPlayer. There a lot of really interesting programmes coming up. As for this programme, I’d recommend it highly.
Just a very quick post.
1. Excellent post by Malcolm Payne which gives a bit of background to the BASW College v SCIE College rift. Payne adds a great deal of information to the board and everyone should read this post!
2. When I was scrimmaging around for information this morning, I came across a Conference being run by the GSCC for registered social workers and social work students.
It’s a free event (but you have to have a GSCC registration) run in both Leeds (4/3/11) and London (18/3/11) called
‘Building a stronger profession in challenging times’. There are a variety of workshops and I thought it sounded fascinating.
(I’ve applied for the London course but haven’t had confirmation yet!)
I’m almost weary of this story before I start to write it to be honest. Unfortunately the story is ripe for pickings, I can’t really help but go with it.
A bit of background. (note : this is my understanding and perception of what has and is happening – if I’m wrong on the details, please correct me because I haven’t trawled through documents.. it’s just as it looks from a humble practitioner’s viewpoint).
BASW (British Association of Social Workers) has long been the professional organisation for social workers in the UK (the clue is in the name). BASW does not have a large membership. It seems to have a smaller group of mostly retired, independent or management members – lacking in front-line staff. I am a member of BASW. I have been an on-off member since being a student but I’m probably in my longest continuous stretch of membership at the moment.
They publish the British Journal of Social Work, they have an advice and representation service, they have a regular magazine but they fell short of being a trade union.
One of the things they were pressuring the government through the Social Work Taskforce was the establishment of a ‘College of Social Work’. Fine, good. Whatever. Sounded nice but I wasn’t entirely sure how it would make things different and make things better for me.
The Taskforce ran with this idea and proposed this. Negotiations began. SCIE (Social Care Institute for Excellence) was left in charge of the process and given significant amounts of money to set up a College of Social Work – but crucially, just for England rather than for the UK.
BASW seemed to feel increasingly marginalised by this process as they were only one of many partners rather than the lead partner that they had envisaged being.
There’s a lot at stake for BASW.
The College went along its merry path with BASW increasingly becoming irritated by it’s lack of leadership of the process.
Consultations took place. And then the ‘arrangement’ with Unison was made by the College. That seemed to kick off the main source of trouble.
Personally, it seems that the College development had a choice of convergence with BASW or with Unison and they picked Unison – one of the largest public sector trade unions. Unison though could deliver more members than BASW and the trade union element was one thing that the SCIE College could offer that BASW couldn’t.
BASW probably quite rightly fearing for its own existence, decided to establish herself as a ‘College of Social Work’. As of Friday, BASW is now called -
BASW – The College of Social Work
The SCIE-inspired College meanwhile sent out calls for social workers to join their own organisation in advance of it becoming an official college.
Here’s the rub.
The SCIE College says it will offer as membership services
- a magazine
- peer reviewed journal
- professional indemnity insurance and public liability insurance
- representation and employment advice via Unison
- tools and resources to use in practice
- attendance at annual conferences
- special awards
- special interest groups, forums, communities of interest
It goes on and on.
The difficulty comes when you realise that this is exactly what BASW offers apart from backing of Unison.
In response, BASW has claimed it is going to develop it’s own trade union branch just for social workers.
The difficulty is that there are over 100,000 social workers or social work students currently registered by the GSCC and BASW has 13,000 members.
The GSCC only registers people in England. BASW membership covers the UK.
Can we see a problem here? Basically the SCIE College claims that BASW doesn’t have a mandate to have the prime mover role in its version of a college and BASW retorts, well, it’s better than anyone else has.
Except Unison – who may well have a higher number of social workers as members.
That’s a slightly shady argument though. Firstly, I’m a member of both Unison and BASW. I see them as having wholly different goals.
Anyway, BASW have now renamed themselves ‘BASW – The College of Social Work’. They have registered the name ‘The College of Social Work’ and seem to be insisting that the SCIE College refrain from using that term.
There have been many exchanges of letters that very few people will actually read.
The perception of disruptiveness whether right or wrong is likely to harm BASW.
I’m not an active member. I don’t have time to be but I didn’t see this coming. I received a letter through the post on Saturday about it. It didn’t inspire me very much to keep fighting the fight.
At the moment, this ‘fight’ seems somewhat distant to me. I can understand that BASW feels excluded and is fighting for its life. I wouldn’t want to see it go – there are good people there - but it really should have been fighting this fight for decades. If it had a larger membership and had inaugurated a trade union branch ten years ago without being under the threat of extinction, it would have been in a much stronger place now.
Perhaps it is the fault of the profession of social workers for not standing up for ourselves enough.
These bodies, these organisations mill around us and claim to be speaking for us but we have so little time to speak for ourselves that we allow them to be filled with the same faces and the same almost-professional committee members and board members.
The problem with BASW that I saw is that its’ vision of social workers was set very much by ‘old schoolers’. People who practised decades ago and moved into management, independent practice or the academia – thus having time to devote to committees and policy development – leaving the front line behind them.
There needed to be more support in those first few years of post-qualification working. Something that those of us who are hardly the best-paid professionals in the world, would look at and say ‘that’s value for money’, ‘that organisation knows what it’s like FOR ME’ – not just for my manager or for my wildly experienced colleague but for me as I enter this minefield of a profession.
I can’t see that the SCIE college will be any different. They haven’t made much of an effort with the interim board members. Where are the real issues that are facing us as the profession (in adult services) slips away and has slipped away?
Where was BASW 5 and 10 years ago when we should have been challenging the orthodoxy that has led to this current malaise?
I have been impressed by the drive of BASW since Dawson took over as Chief Executive, to be honest, but it may well be too little too late as BASW is judged on past performance and current membership.
As for me, my heart says I don’t want BASW to die a death. I have a positive feeling towards the organisation. I know they want and mean well. I like the idea of a UK-wide College.
But the government has pumped money into the SCIE College. I’m also a member of Unison which has sided with the SCIE version. It may also become an issue of money. I pay a lot to be a member of BASW and Unison. My gut feeling is to prefer a social work specific trade union as I don’t feel particularly well-served by Unison but Unison does have a lot of fingers in a lot of pies. It is hard to imagine not having the backing of a strong union.
I just wanted everyone to get on but at the moment, this seems like a bit of a mess and I think I’ll just be sticking my head in the sand and will let them battle it out. We’ll see what emerges from the dust.
I say that with a very heavy heart. Problem with social workers, they are too busy working to get involved in conflicts outside the workplace and it doesn’t really do us any favours at all.
- BASW vs College of Social Work (fightingmonsters.wordpress.com)
- Social workers to get new professional body – or maybe two (guardian.co.uk)