Fighting Monsters

I was asked over the weekend by someone who is just about to finish her Social Work degree and  if I would recommend she goes  for statutory or voluntary Social  Work when she qualifies.

I had no hesitation in recommending voluntary sector work in an unashamedly contradictory manner - having worked, myself, almost exclusively in the public sector. One of those classic ‘do as I say and don’t do as I do’ models!

I have very little experience in the voluntary sector - I worked in a voluntary organisation for a few years before I qualified - but that was in residential care so in quite a different capacity to what I imagine the role of a qualified social worker would be - and my second placement all those years ago when I was training was in a voluntary sector organisation but other than that, all my post-qualification experience has been in the statutory sector.

We were generally advised to ‘get some experience in the statutory sector’ before deciding. The difficulty is though is moving on from that ‘experience’.

Statutory work is for the most part going to be paid better than voluntary sector work. And once you take the penny from the paws of the State, its very very difficult to take a salary drop to go back to voluntary work. That’s what I found anyway..

My intention was, all those years ago, to go voluntary and stay voluntary - I think in some ways, some of the social justice and advocacy/support roles that I sought to implement as an idealistic student would  have been better served in the third sector.

But I’ve found it now, too difficult to go back.

Perhaps I justify it but saying that in this role, I can work from within on the change-process but I’m likely kidding myself. I barely have a voice in the organisation I work in, let alone in the wider sector.

Maybe one day..

I’d be interested in other peoples’ opinions though - what would your advice be to someone starting out on their first job post-qualification?

(and if the person who asked is still around - I’d also recommend checking out the Carespace Forum from Community Care…you can never have too much advice!).

*(Apologies to Robert Frost)

I wasn’t intending to follow up the post I wrote on Saturday but then, yesterday, I read that Social Workers are buckling under the stress burden according to The Guardian, and the coincidence seemed to be too ripe to pass up.

Anushka Astana writes

‘Research carried out by the Conservative party, using figures obtained under the Freedom of Information Act from local authorities across England, show that as many as 15,550 social workers took long-term sick leave. The rate is one of the highest for any profession and double that of teachers. Meanwhile, stress-related claims by social workers cost the taxpayer £13m last year.’

kelvin255 @ flickr

I can’t think of anyone in statutory social work (and I’d say I know a fair few!) who could be remotely surprised by these figures. Although not currently, I have worked in more than a few teams that have been decimated by stress-related sickness.

It’s all very well for this to be acknowledged by The Conservative Party but by noting that this is information has been made available under the Freedom of Information Act, this does, by its nature imply that this is nothing new to the Social Work departments in local government.

Our employers (and I’m speaking from the view of someone who has worked, since qualification anyway, in the statutory sector) know exactly how many of us they are driving into stress-related sickness.

We don’t need national politicians to tell us.

But they have consistently allowed this situation to continue.

Occasionally, in my experience, when the situation is too hard to avoid due to sheer numbers - it might be addressed but never in a very proactive way. Of course, I’m speaking from personal experience so there might be, and I’d expect it, some great teams out there somewhere that have excellent evidence-based practice in relation to stress management at work - but judging by the figures above, not enough of them!

There are, in my view, a couple of things that would help the situation. Personally, the one factor that causes me stress is management, expectations and target-driven work. Not that actual contact work, that is.

I am used to working with people in difficult situations, I am used to being verbally abused either directly by service users or by family/carers on a regular basis, I’m used, now, to having my physical appearance, dress-sense (or lack of it!) , race, class, weight, accent, religion and gender picked up on by people, my competence questioned, my intelligence (or rather, lack of it!) mocked. That is something I am well able to manage. I know it isn’t me, personally, that the attack is aimed at, but my role, my job, my organisation, the government policies, local and national and the completely uneven power dynamic in the relationship. Honestly, I can deal with that and manage it. It isn’t always easy but it definitely gets easier to detach from verbal abuse at work.

What really stresses me is the lack of support from management - lack of opportunities to ‘let go’ of some of the feelings that I have when I finish work at the end of the day. The loss of sight of the individual in the mass of figures and targets.

I don’t see people as targets. I would love not to meet the ‘adult abuse investigation’ targets because those targets are black and white on a balance sheet but they mean that someone, somewhere has been undergoing pain - and collating figures doesn’t always match up.

Some of them I can understand more, like the targets for carers services - which have really been pushed and have been the source for more services to be put in but some of the exercises are just paper exercises and looking at how work you already do can be interpreted to meet the targets that have been put in place.

I’d like to see more humanity in the structure of social services management that accepts that workers have needs as well and that dealing with the situations that people find themselves in on a daily basis, can be draining on the workers as well - maybe not every day - but it isn’t a fair expectation that we should all take this home to our families.

The targets aren’t going to disappear - I’m under no illusion. It’s the means by which local authorities and Trusts are funded and judged. I am not entirely sure about the realistic nature of the figures expected and whether some more quality-based ‘figures’ can be added to the frame to make the work less pressured.

Some positive focuses and praise when things do work out as a result of work we put in. That would help too.

Caseload management and support - some kind of structure in the way that work is distributed more evenly. I can’t remember what our guidance is on caseloads at the moment - something like 25 I think. But having a system that just sees people has figures is ridiculous. I can spend an entire week working with just one or two people - and on the other hand see (or speak to) someone else once a month. It is not a comparison of like with like when you just have a figure. The tasks aren’t considered just the ‘caseload’.

Personally, I think more teamwork and joint working would improve the situation enormously or at least having a more formalised ‘buddy’ or ‘mentoring’ system where you can discuss issues with colleagues if you are not primarily office-based with the support and discussion around you.

The article goes on to say

‘The Conservatives are calling for a Chief Social Worker to represent the profession. They also want a high-profile advertising campaign stressing the importance of social work as a career.’

Well, I’m not sure what a Chief Social Worker would do to be honest but I would have thought that would be the purpose of British Association of Social Workers (BASW) in this. Surely they should have this purpose of representing the profession. I would imagine this so-called ‘Chief Social Worker’ would be someone who has moved through the management structures (probably by meeting targets!) that they would be so far removed from the front-line practitioner that it would serve no purpose anyway.

I’d rather see the change at a much lower level - as ultimately, I’ve become basically indifferent to the public perception of social workers. Sure, it would be nice if people actually knew what we did on a day to day level - if people actually did see the positive work that goes on, but few people go into social work with any illusions that at the end of the day, society will thank them for it!

I’d like to see the government, local and national, looking at the figures they are asking social workers to move towards and how realistic these figures and targets are.

I would like to see time built into these ’standards’ to allow for quality rather than quantity of work to be achieved. It is easy for the policy-makers and commissioners who have no idea of the actual work on the ground to huff and puff in their seminars (that are too expensive to be offered to ‘ordinary’ front line social workers) about meeting targets and raising quality - but until they engage the people who are going out and doing the work - and putting their own health at risk because they have been pushed to the point that the quantity of work being asked for is not able to be provided in a 39 hour week - the situation won’t be getting better.

It sometimes feels that at the end of the day, we are more or less expendable and a newly qualified social worker will be along to replace us one by one until they, in turn burn out.

I hope I’m wrong - but I have seen little evidence of action being taken to work on the causes of the stress for social workers. It can’t be a coincidence that so many of our number need to be actually signed off on long term sick leave.

‘One in five of the country’s 76,000 social workers has signed off work for 20 consecutive days or more in the past five years because of conditions such as stress or anxiety.’

One in five. Imagine one in five of the nation’s teachers, doctors, nurses being signed off, and you’d see some action.

How much of social work exists in the Care Management model? It’s a question I’ve been toying with for a fair amount of time - especially as most of my work, post-qualification anyway, has been situated very much within the care management model. Although now, I have a slightly different role within Mental Health services, the domain of care management even within a multi-disciplinary team is seen very much as that of the social worker and the place of both is something I have been considering over the past few weeks.

One of the CPNs in the team I work in (bless her) constantly talks about ‘doing social worker’s jobs for them’ or ‘using social work’ language. She’s a great nurse with very high standards and we get on well, but she doesn’t think much of ’social work’ in general (individuals notwithstanding!) and certainly not when she feels she is being asked to do this at the expense of therapeutic or clinical work.

My current role does give me more therapeutic leeway, although I am very much a product of the ‘care management system of social work’ as I trained when the NHS and Community Care Act (1990) was already very much entrenched in the systems. People spoke fondly and wistfully of ‘old style social work’ but beyond vague helping notions, it wasn’t something I could necessarily link immediately with the work I was being asked to do. After all, the idea of the new legislation was to be a provider and buyer of services that would give the end user a better quality and variety of care and would allow the care manager to manage on a strength-based model - that’s how it was sold to us when we were studying anyway…

When I was operating in an environment where I was primarily a care manager above and beyond all else, thought I felt that any individuality and professional competencies that I had worked to achieve were being sucked out of me almost before I’d started to work. All ideas of ‘buying services’ was throttled out of my by service level agreements and commissioners dictating which providers could meet the needs of the local authority in terms of pricing.

I was going into people’s houses, judging their needs against dry ‘Fair Access to Care‘ Standards - which were very tightly controlled by commissioning bodies.

stephmcg @ flickr

I was then matching those needs against a local authority list of times (I did actually have a physical list) - so 30 mins was allowed for a shower in the morning, 45 mins if breakfast was to be prepared as well - all mechanical, all prescribed. Anything above and beyond that time allowance would have to be justified in triplicate.

Paperwork completed, a few phone calls made and the package was in place.

No real need for any professional competence derived from graduate level study. Not really. Of course, the profession likes to make you think there is, the academics like to make you think there is. But I am confident that any non-qualified community care assistant could do an equal job , if not better job - especially after a few years. When the need for critical appraisal and considerate reflection is lost on a day to day level, the elements that identify the profession seem to fade.

Supervision was a list of what you had done that week/fortnight/month in terms of targets - and what you still had to achieve.

Of course, communication is necessary. You have to talk to people to make them feel better - to help garner information successfully but it’s hardly something that demands a rigorous academic approach and discipline.

This frustrated and continues to frustrate me.

Of course there is more complicated work coming in and there would be some marginal therapeutic work around, in some situations - but it is almost the mechanism that frustrates than the work. The de-skilling seemed to be more or less complete.

It felt like I was bestowing the beneficence of local government funding and for all the academic discussion of strengths-building and relationship-building - you’d likely only see someone a couple of times - to assess and then to review unless there were particular difficulties.

I remember once trying to explain to a woman that I visited why I couldn’t explain what Pension Credits she might be entitled to (I can just about manage Attendance Allowance or Disability Living Allowance - any other benefits remain a blur in my mind) and then, why I didn’t have access to any cash to give her (the social worker who had helped her when she was a foster parent had given her money directly so what kind of a social worker was I if I couldn’t provide cash?).

There was a hope that Direct Payments would go some way to solving this - but direct payments, while extremely liberating for some younger disabled adults, have proved harder to ’sell’ to older people and those in mental health services.

Namely, they are easier to sell to those who want to be sold to. When there is someone who needs more support in order to start having direct payments - the care manager isn’t, in my experience, given much leeway to have the time to explain, assist and support - well, certainly not in older person’s services where timescales are tight because of targets and turnaround is expected and pressured.

I can proudly say I was relatively successful in pushing direct payments out to older adults - more possibly than most in the team I worked in - because it was something I felt quite passionately about at the time. But even for me, operating in a target-driven system, it took time that I sometimes wasn’t allowed. All very well if the service-user is able to advocate for him or her self, contact the right people to assist with payroll and recruitment or has family around to help, but if they don’t - it’s a time issue for the care manager who is being pushed to targets, targets, targets.

Peter Beresford, writing in the Guardian, reviews a new book called The McDonalidization of Social Work by Donna Dustin. She writes (apparently because I haven’t read the book) of some of the effects of the care management that resulted from the 1990 NHS and Community Care Act.

The era of Personalisation is upon us which is apparently being welcomed as a move away from ‘care management’ and towards ‘individualised personal budgets’. The Care Manager is dead (so to speak) and long live the ‘traditional’ social worker. But I wonder how this accounts for social workers already burnt into the Care Management system who are too young to remember the glorious ‘old style social work’ era. What tools do they have to equip themselves with, years out of college but nested firmly in the bosom of the NHS and Community Care Act.

Social Work needs to reclaim some of the ground for itself in a target-orientated environment. If not, practitioners will become mechanic and complacent. Time needs to be given to workers to actively engage - but I can’t see the time ever being there as long as local authorities have tick-lists of ‘targets’ that need to be followed.

In my previous job we had a target to meet about adult protection investigations. If not enough people needed protection within a quarter, that was another target failed! There is nothing needs-led in the system of targets. It is completely service-led.

And I can’t be convinced by personalisation until I have seen concrete proof of its benefit to older people who are not able to speak or shout loudly about their needs. Within the pilot studies, I’d like to know how people with dementia are going to have their needs met or if personalisation is again, like direct payments, going to be a buzz word about individuals and choice - depending very much on who the individuals are and how much choice they are able to make without professional support.

I first saw on the news over the weekend about the report produced by the Institute for Public Policy Research related to  Personalised Budgets for Carers and it baffled me a little bit.

Don’t get me wrong, I completely think that carers need, deserve and are entitled to a lot more support than is available presently.

The Carers Allowance is, quite frankly, an insult to those who put in so many hours and whose lives are changed by the amount of care that is put in (as well as, on a less emotive level, the amount of money that is saved by both the NHS and Social Services). Also (for what its worth) it’s linked to Disability Living Allowance/Attendance Allowance and is means-tested. All of which contribute to its inefficiency.

But the call for personalised budgets seems to be, as far as I can garner, more or less the same as Direct Payments for Carers - which is explained much better on the Worcestershire County Council site (thank you, Worcestershire - and no, I don’t work there - actually, I don’t think I’ve ever been there!) as follows

‘Support for Carers

A Direct Payment can be provided to enable family and informal carers to purchase the services they are assessed as needing as carers to support them and to maintain their own health and well-being.

A Carers Assessment and Support Plan should be completed to identify the impact of caring on the person’s life along with the support they require to continue caring or to take a break from their caring role.

Carers are able to use Direct Payments to purchase support in any variety of ways including:

• Short breaks for themselves and/or the people they care for;
• Personal assistance within the home;
• Sitting services;
• Social, education and leisure activities;
• Transport costs;
• Equipment
• Relaxation, stress management and holistic therapies.

Some of the intended outcomes of using Direct Payments for carers are:

• Promoting social inclusion through greater opportunities for carers to actively participate in family and community life;
• Greater opportunities for the personal development of carers;
• Promotion of the carer’s health, well-being and coping skills;
• More responsive, timely and consistent methods of providing support, with greater opportunities for creativity;
• Values the essential contribution carers make to family life and the wider community.

Under the service, young people, aged 16-to17-years, are also eligible to receive Direct Payments to support them in their role as young carers and to minimise any difficulties or isolation they may experience in undertaking their caring responsibilities’.

psd @ flickr

I have to say I like the direct payment scheme as it works for carers because it is incredibly flexible. Indeed, I’d say it is the easiest way to provide direct support to carers and in the most visible way - so I’ve got a fair amount of experience using it.

In a lot of ways, it is a lot more flexible than the direct payments provided for service users because it can be used for ‘anything that would support the carer’ - so gym membership, travel costs, parking costs, washing machines - there is the ability to be much more creative. ‘

And it exists now - today and has been used with frequency.

So that’s why I didn’t really understand the call by the IPPR for personalised budgets with no comment about what is actually happening in social services departments to support carers today. Maybe they are calling for more money to be a part of the personalised budgets (a good thing) or more control (although the control can be basically in the hands of the carer themselves), more exposure to issues that matter to carers or less scrutiny from local authorities who provide the funding.

I suppose I’ll have to actually read the whole report rather than just the reporting of it!

I noticed that Sophie Moullin from the IPPR wrote about this in the Guardian and from what she says, I can’t see any difference in the new system she proposes to what is actually, legislatively in place at the moment.

I am absolutely in favour of anything that will help though and if the proposed system will ringfence more money or provide more exposure or utilisation of services then I’m the first person to applaud it.

But to promote the new system which has a lot of links with Carers’ Direct Payments without discussing the failings of that particular system and to look at the issue as if this system didn’t exist, seems not to be giving a true picture of the situation as it is today. Perhaps more needs to actually be done to increase awareness of the system as it exists today and promote use and access to it.

Yesterday I was called to an ‘emergency’. Well, as I don’t operate strictly in a crisis setting, it was more to act as a gatekeeper to the ‘real’ emergency services.

In essence, did Mr A need to come into hospital?  It wasn’t a formal assessment - more like  a pre-assessment and an attempt  to establish levels of risk.

Mr A was homeless. Not ’street’ homeless but as near as possible to that as could be. He had been evicted from one hostel following allegedly ‘disturbing’ behaviour. He had been moved by the Housing Department of different council to another hostel  in our area where he had been for a few days, and was due to move to a more permanent place (a bedsit) but it was again in a different local authority.

The housing officer was concerned about him. She was concerned about how he would manage in a more independent setting as he felt that the hostels had been providing more informal support. So she called us to see if Mr A needed to come into hospital.

Mr A appeared unwell. It would, of course, be wrong as well as unlawful to use the Mental Health Act to solve housing issues. Mr A was unwell enough to need support though.

He was agitated but I’d also be agitated if I had strange people trooping in to see me when I didn’t know where I was going to be spending the night. There was no way he could be said to lack capacity, at least from the history and interaction that I had access to.

So what to do?

I told the housing officer that we couldn’t refer for a compulsory admission as Mr A did not warrant it. Yes, he probably needed to see a doctor and could definitely benefit, possibly most of all, from some kind of care coordination, someone to help him and guide him to tie some of the pieces of his life together, possibly some medication - but not compulsory admission to hospital.

But I felt a bit empty on my way home. It’s likely that Mr A moved to a different area overnight. I don’t know if he would have got into the taxi to take him or not (he was fairly adamant that he wouldn’t when I left), but I think it’s one of those situations that might be on its way to deteriorate.

The housing officer will contact us later to tell us where he is, and we can contact the local team there to try and ask them to make contact. I think its unlikely that he’ll want anyone related to Mental Health to go and see him. Already when I told him (and it was the first thing I did ) that I work in a Mental Health team he became visibly more anxious (again, understandably - he has had a string of compulsory hospital stays in the past).

I have a feeling things will get worse for him before they can get better - and that is frustrating.

Sometimes, I just want to -do- something,  but have to walk away. I think those are always the hardest situations and those are the people that sometimes I think about when I’m going to sleep at night.

I know I shouldn’t. I’ve been given and have given out the advice a million times about not taking work home with you - but I suppose there must be a way to stop thinking without stopping caring.

I seem to have had something of a ‘home’ themed week in one way or the other, so thought I’d round it off with a few thoughts about more general housing.

In one of the previous teams I worked in, we had a basic line that a lot of the situations and difficulties that were challenging to service users were created either directly or indirectly by poor housing. Mostly the reasons being

• Inaccessibility (physical disability and a flight of stairs without a lift in the property)

• Overcrowding (at least two people sleeping in every room including communal areas - I have seen a family of five in a one bedroom flat with a cat - on one occasion)

• Hoarding (this isn’t just a few newspapers from last week lying around - this is rooms not being able to be entered for the amount that is in them - rotting in some of the more extreme cases)

• Poor state of repair - bare floorboards, damp, holes in plaster in the walls, broken boilers

• High rise blocks with lifts that are continually broken

• Neighbours

And it is hard not to think in political terms about the effect that right to buy scheme and the loss of large swathes of housing stock with the inability to reinvest has had a massive effect on some communities but the way that some housing has been maintained is also shocking.

Some of my biggest battles to date have been with housing officers and departments, trying to hound them into carrying out repairs usually.

Last year I had a particularly frustrating time, working with an elderly man with dementia who lived on his own on a second floor flat. After numerous, increasingly urgent telephone calls to the local housing department, he actually had water pour through his ceiling one day and moved temporarily to a local sheltered housing unit (at the cost to social services rather than housing, of course) in order for work to be carried out.

Cut to a lot of angry telephone calls and the work was completed with redecoration, new boiler etc.

He moved back and was delighted with the newly decorated flat. But I was left, once more, scarred by a battle for resources that are very scarce and the knowledge that not everyone is able to argue their way to a decent basic service.

One of the things that always makes me smile a little (on the inside, of course, and always in an ironic rather than comical way) is when people ask for support for a housing application - only because I know how little difference it makes in effect. Although the move in some London boroughs (it might be the same nationally, but I only know about London!) to online bidding for properties can really disadvantage some people who need to move the most.

I tried to support a family with three generations living in the same household where two of those generations were affected by serious mental illness to get another property so the daughter and her children could move out. To say banging head again a brick wall would be an understatement because with all the best will in the world, if the homes aren’t there, they aren’t there.

There just isn’t enough accommodation for people to live in dignified and healthy conditions and poor housing can trigger so many social difficulties at the very least.

I read this story this morning about a woman who smuggled a baby into the country in order to secure council accommodation and it was just indicative to me of a system that has been pushed beyond its limits and people willing to do quite literally anything to get a place to live.

And with the demand rising and supply falling it doesn’t look like there will be a happy ending and just a means for discontent, anger and alienation to grow. This can, of course, be manipulated for political gain and I think the whitewashing and simplistic ’single mothers, immigrants etc’ get all the housing, is a means to divide and rule by the right wing press and political establishment.

Everyone would benefit from better quality housing and trying to create an us-and-them culture, apart from not being entirely accurate, doesn’t help anyone.

I know a lot of attempts have been made, certainly where I work, for more links between housing and social services departments but there is still a long way to go on that, because there is a culture of shifting bucks between one and the other that I have seen. But I honestly can’t see the problem of stock being solved in a hurry.

Brown announced that he was starting a six month consultation to make decisions about reforms to the ’social care’ system and in particular, its funding.

The Wanless Social Care Review was produced back in 2006 and it examined ways of paying for long term care in the face of an aging population. So it seems we are back again at the same place discussing the same issues although perhaps, a little more loudly, especially as a Green Paper on Social Care funding was initially announced back in October 2007 but it looks like the announcement today is in advance of another Green Paper on a similar subject.

A lot of eyes are turning to now to Scotland, naturally, with her much-lauded free personal care however, although it makes a wonderful headline policy, it isn’t without its problems.

There is always a cost attached to every service. I think expectation of free social care is a thing of the past or an unrealistic goal to work towards, however admirable it may be. Wanless recommended a free minimum level of care for all and the argument has a lot of merit. It could be topped up of course, but there should always be a means tested element because some people do have more money than others and it would allow the possibility of a better quality of care to be spread more widely.

Perhaps some more flexibility - such as would be afforded through personalisation would be one answer although this care would still need to be paid for.

The division between free health care and paid-for social care also seems to have blurred somewhere along the way, especially as it is clear that providing social care at an earlier stage can prevent higher costs in health care (through hospital stays) at a later stage.

As long as the budgets are separate there will be the pushing and shoving between the two posts as to who can make the other ’service’ pay which really does noone any favours.

As far as I can determine, more money will need to be put into the system of care to improve it but that seems to be the result that noone wants to consider as the additional money is just not there.

It will certainly be an interesting process to follow and to participate in.

The Guardian published an article this week about the germination of a New Deal for Carers and the results of the consultations that they ran over a period of a couple of months.

I hadn’t known this had been going on so thought I’d look at some of the interim findings regarding the challenges faced by carers.

1. Poor Information. There seemed to be a kind of dichotomy between people being bombarded with not-necessarily-relevant information (I presume, bundles of pre-printed leaflets and telephone numbers) and not being given enough or feeling that they had to ask specific questions in order to get the ‘results’.
2. Postcode Lottery - Without centrally provided or determined resources (and even with - to a certain extent) services will always have a different kind of provision in different areas. I’ve also found it can change very much from worker to worker - not necessarily the actual provision but the quality of service definitely. I know some people are more forthright in offering Carers Assessments than others (who might carry out their statutory duties by offering them but sometimes without explanations of their benefits).
3. Inconsistencies of Care. I think this is an issue across the board and not restricted to carers solely. The report offers the existence of a body similar to CSCI to monitor care workers but as most agencies are inspected by them anyway, I’m not sure that would make a difference.
4. Cohesion between services. Carers have a perception that ’services are centred around the needs of professionals’. Services are not necessarily well-coordinated. I wonder who the professionals are that are creating this perception of inflexibility and inertia. I think carers services (particularly with carers direct payments) have a lot of scope to be extremely creative but it takes time - like everything. Services really do need to set priorities.
5. Delay in the provision of services. This, I’ve seen, and been a part of many times. Sometimes the wheels can and should move into place earlier. Everytime something is attempted that is a bit ‘different’ or more personalised, it seems to take longer to set up or to get approval for. There is no logical reason that this should happen.
6. Bureaucracy. It’s everywhere and is inescapable. Forms and pieces of paper flow like a stream from every source. I think, in a way, targets are not as helpful as management imagine them to be.
7. Recognition of carer status. I think clearly this is something that potentially can change immediately and should be happening for the most part, in that carers’ are the experts on care for the cared for person and should be approached as such by professionals. It doesn’t always happen but it is something that can definitely be provided more concretely.
8. Attitudes of others. This is linked, I think, to the recognition of status. Sometimes it is ignorance that makes people dismissive of carers or just the knowledge that the familial ties make it more awkward to ask directly for help.
9. Lack of opportunities. An understanding employer can make a big difference but only to a point. I think there needs to be more motivation - forcible if necessary, which will point people in the ‘right’ direction.
10. Financial impact. Carers Allowance is laughable and an embarrassment to the government in my opinion. I am almost ashamed to mention it except that I believe it is an absolute entitlement. There are so many completely illogical aspects of the benefit system that seem to work against some sections of people but the treatment of carers is one of the most glaring omissions.

So out of these, some things that I think can change immediately

• - Professional attitudes to carers as experts

• - Information being personalised rather than just pushing leaflets and telephone numbers to people

• - Promoting more flexible means of providing support (Carer’s Direct Payments, Holiday Funds).

• - Building work with carers into the ‘targets’. Currently, where I work any time spent on carer support isn’t ‘logged’ as work completed. It sounds idiotic but each ‘piece of work’ is monitored so if carer support work isn’t monitored, it is definitely not prioritised.

Future possibilities:

• - Benefit reform - it has to come. It is a pathetic excuse for a benefit that benefits very few and many many more should be entitled to more money.

• - Carer Key Worker - not necessarily the same worker who is allocated to the person being cared for. Sometimes needs can overlap when they need to be separated.

• - One point of contact - for professionals as well as carers! Sometimes it can be incredibly difficult to set up what should be a basic service because of additional hoops to jump through.

• - Acknowledgement, support and assistance for carers who might be marginalised by mainstream support services. Support must be provided on an outreach basis as I know many carers who are more or less restricted to their own home. Sometimes some of the ethos of assertive outreach can be applied to carers who might be ashamed or embarrassed to ask for help.

• - Clearer expectations on a national level. There will always be some differences in provision between local authorities but there must be a minimum standard expected.

There is another reorganisation in progress at work. I’ve managed to put it to the back of my mind for as long as I’ve been concentrating on the ASW training but that doesn’t mean things have been standing still. I wonder if there is any theory of perpetual motion that relates to social services departments or to local government in general that means if nothing changes for about two years, the whole service explodes!

In my first ‘real’ social work job after I qualified, I worked in a large open plan office with lots of ‘more experienced’ (read : older ) social workers and social work assistants. This, of course, led to any number of tidbits of information being passed on to the new girl! I remember being told that there would always be a reorganisation either in place or in consultation or being reviewed. Always.

I laughed a little at the time. It seemed to be one of those truisms that is flung around about working in the public sector (as before qualifying I had worked exclusively in the voluntary sector) but it certainly has a ring of truth to it in retrospect. There does seem to be a continuous process of change and reorganisation. Sometimes it has an obvious purpose - for example, when there is a change in central policy that ordains it - but sometimes there just doesn’t.

Of course, standing still or resting on ones laurels can never be a good thing and a part of the process of social work is looking constantly for better practice and ways of working but the amount of reorganisations which seem to involve going back to how things were previously seem to be unnatural and mostly, one can’t help wondering if the amount of man (person?) hours that are devoted to reorganisations and consultations couldn’t be better spent.

The current process of consultation has been going on for over a year. We’ve had about three or four afternoon discussion sessions which involve everyone sitting around listening to the managers discuss what they think should happen and everyone else either nodding sleepily through the provided cake and biscuits or scowling with worry as they count, in their heads, the amount of work they could be doing if they weren’t in the meeting.

There would be more incentive to be actively involved if there wasn’t the overall impression that any decisions that needed to be made had already been made at the time that we meet.

Currently, the proposals involve shifting four local teams into two larger teams. While we have been assured that there will be no change in the number of workers or the professional mix. I think it’s pretty obvious that there will be one or two edgy managers around the place for the next few months..