Choice, Control and Obfuscation – How the Personalisation Dream is Dying

In the bold move towards a transformation in adult social care, it feels from where I sit, that control has completely overtaken any pretence of ‘choice’ in the so-called move towards more idealised ‘person-centred’ care and support planning.

I hope I’ve been clear over the years in which I’ve expressed a remarkably consistent view that I love the idea of people being able to choose the support plan they like from a wide menu of options with ‘professionals’ taking less of a role.  I am a massive fan of direct payments. I want people to have more personalised care and more creative care. Desperately. The options just aren’t there yet for people who lack capacity and that is a terrible disservice and inequity that is being served throughout the care system.

Removing care planning from my role doesn’t concern me – unlike those people on the training courses who bang the drums blindly about how wonderful and bright it looks when we allow people to choice whatever they like to put together packages of care, I don’t want ‘retain control’, I truly don’t believe that I, as a professional ‘know better’,  but likewise I know that with the user group I work with, it is rare that I can just hand someone a support planning tool and a list of potential providers and tell them to ‘get on with it’.

That is as far from reality now as it was 20 years ago in my work. While I can say that everyone I care co-ordinate who has a ‘package of care’ is now officially on a ‘personal budget’ and some even have direct payments, it hasn’t really increased choice or control for any but a couple of those people.

If anyone for a moment wants to ponder the duplicitious nature of those in policy making ivory towers who dribble down policies which they want to couch in ‘soft’ language so they are difficult to challenge, one only has to read a fantastic piece of research conducted and published on The Small Places site.

It is worth reading through the piece in detail. Lucy, the author, made a number of requests to local authorities to ask about how their Resource Allocation Systems (the link between the ‘assessment’ and the ‘cash’ – basically) was calculated.  She seemed to come up against a wall of obfuscation but it’s worth looking at her research in detail.

This reluctance for me, seems to relate to the lack and reduction in spending on care and support – the key ‘missing piece’ as to why a council can ‘reassess’ someone as needing less ‘cash’ than they did last year with a more traditional care package.

My personal experience is that the council I work in (and this is similar to things I’ve heard from people in other councils) probably doesn’t want to share it’s RAS because it’s ashamed of the utter dog’s dinner that it’s made of it. It doesn’t ‘work’. It doesn’t make sense. It is frequently changed. There is more emphasis on physical health needs as opposed to mental health needs and while there can be manual adjustments, some of the figures that are ‘spat out’ just seem nigh on ridiculous (and that works for sometimes calculating care ‘too high’ as much as a figure which is ‘too low’).  It comes down to everything needing to be qualified and fitted onto a spreadsheet when actually the needs of two people who might fill out a self-assessment with the same ‘tick boxes’ might have very different needs in reality – no RAS can account for that. One person might under-score because they are embarrassed by the process and don’t want to admit to being incontinent on an initial visit from a social worker because they haven’t been able to tell anyone other than their GP – another person might be anxious and think they can manage less well than they can. Sometimes and this is what local authorities and health services seem to find hard to account for, you just have to treat people and their needs as individuals rather than the subject of outcome measures, tick box performance indicators or resource allocation systems.

Shouldn’t personalisation be about putting the user at the heart of the system? Every user should have a copy of the RAS and how the figure was determined. Which questions are weighted and which aren’t. Without that, there flow of money and the control rests solely with the local authority.

I’m fully against ‘traditional’ care packages. Having someone anonymous and constantly changing pop in for a 30 min welfare check once a day isn’t about improving the quality, control and choice in someone’s life, it’s about a local authority doing the absolute bare minimum that they can get away with to fulfil their statutory duties of care.

The lack of openness about the ways that the RAS shows the true colours of the reasons for these pushes towards the Eden of ‘Personalisation’.

While I have no doubt that for some people, as I keep saying, those with advocates, family or who are able to voice their own needs clearly, have and will continue to benefit enormously from having direct payments – it’s worth remembering that direct payments have been available and accessible for many years now.

Forcing everyone onto personal budgets has only discriminated against those with carers by reducing the amounts of money they are entitled to through the RAS (that’s my own experience of how our local RAS works) and has discriminated against those who lack capacity by promising all sorts of ‘creative’ ways of exploring third party management of support plans but without providing any real ways of accessing it (this is my current bugbear as I have been requesting assistance with this for months for service users I work with but have been told it is not possible for older adults yet as only those with learning disabilities have budgets large enough to make it cost effective – thereby clearing discriminating on the basis of age and type of disability).

I have changed from a fervent advocate of a system which was supposed to be so much better for everyone to a bitter opponent of a system which favours some kinds of disabilities over others, some kinds of service users over others, some kinds of carers (those who are willing to put a lot more time in to manage and support plan where necessary) than others and all to provide fewer services under the guise of choice.

No wonder Burstow is pushing everyone towards direct payments. He is pushing everyone towards a system which masks the way that payments are determined and discriminates openly against people who lack capacity or who have the ‘wrong’ kind of disability or family support.

Now we know that the local authorities can hide the way they make financial calculations, it becomes much more obvious to see behind the facade of the ‘Wonderful Wizard of Oz’ who promotes choice as the final goal to achieve at all costs.

I feel tricked and betrayed by the implementation of the personalisation agenda and the lack of any of the services around it to tackle directly with the problems at it’s heart.

I was deeply disappointed, for example, that the Mental Health Foundation’s ‘research’ and work with people specifically with dementia only focussed on people who either had capacity or had family.  Their advice talks lovingly of setting up trust funds, appointing brokers – well, that is a fantasy rather than a reality and exists only on paper as a choice. They merely replicated a lot of work which was done when direct payments were rolled out around lack of take up for people with dementia and they hadn’t said anything new (I happened to write my dissertation about the lack of take up of direct payments for older adults so did actually do literature researches at the time..).

Anyway, I’m getting ahead of myself.

For now, I think it’s important that we who see through the cosy policy makers congratulating about a ‘job well done’ speak up and speak up loudly for those for whom the system is a further barrier for true individualised care because these self-same policy-makers see them as ‘too difficult’.

My title explains that the personalisation dream is dying but it isn’t dead yet. To be brought back to life, all those involved need to embrace the principles of honesty and openness and not blind themselves to their successes if they can’t see the continuing barriers.

Interviews and Ideas

Please forgive the blatant self-promotion in this post but it’s Friday and I’m feeling a like I have a bit of a cold coming so I’m less ‘perky’ than usual.

Dorlee from Social Work Career Development has published an interview which she did with me and it concentrates on what I do at work and some of the ways it differs from Social Work in the United States.  Excellent work, if I do say so myself – but joking apart, it is a good way for us to learn about social work in other countries.

Shirley Ayres has written a fantastic post for PSW, the BASW magazine (yes, I know.. ) and it includes some gems from myself. It’s a piece about social media use for social work specifically and is definitely worth a look.  The PDF is available here

As for my twittering on last week about wanting to work collaboratively on more online social work conferences/learning/interaction – well, it’s VERY rudimentary, but I’ve set up a ‘holding site’ here

Feel free to nose around as the whole point is to emphasise openness, conversation and working together on something that can be led by social work and improve social work without having a cost barrier to entry and that allows all who want to learn and contribute to do so. I’ve also added a very basic forum just to collect ideas.

I don’t have any great desire to ‘run’ this project and if anyone with greater technical skills wants to volunteer them then please please do but it’s a start and I hope someone will – even if it isn’t me – because I think something that adds value to our collective, international knowledge base and moves learning out of universities and into practice will be a real ‘hook’ in convincing more practicing social workers to engage with social media and new technologies.

Enough from me, the forum is here. Do join and share ideas.

(Don’t be scared that there isn’t much there yet.. everything needs to start somewhere!)

Why I’m wrong – A response from BASW

I am not going to add anything to this post. After I wrote a post explaining why I left BASW, I was sent this as a response and agreed to publish it.  I’ll leave the questions and comments for others and I have asked that someone from BASW respond to any questions or comments that arise from this post but obviously they are very busy so here’s their post. – cb

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I’m disappointed that you are leaving BASW and, as head of communications for the Association and editor of PSW, I’m equally disappointed about your assessment of this magazine.

BASW is fortunate that more members have been joining than leaving for some time now but retention is just as vital as recruitment so any loss is frustrating.

Most members leave because their circumstances have changed – they might have lost their job, left social work or retired. On those occasions when someone contacts us to cite a specific issue for why they no longer wish to remain a member, someone from within BASW will usually correspond with them to at least try to respond to their concerns. Whether it makes any difference isn’t really the point – the main thing is to secure a grasp of what we’re doing wrong and how to do it better.

Your departure, inevitably more vocal and more public, is no different except that it seems appropriate to respond equally publicly, given the platform you have employed to air your views.

You cite BASW’s launch of the Social Workers Union (SWU) as the reason for now deciding to leave the Association. Clearly, the odd gripe apart, you are happy with your union and with your local representative. Fine. Really, fine, BASW has no intention of encouraging social workers who are happy with their trade union to up-sticks and join SWU instead.

We hope members in this position will still reflect on the range of member benefits being part of BASW offers, and will want to be part of their professional association, but in no sense is it making a play to poach you and others like you from other unions.

There are two reasons why SWU can be a good thing for the social work profession generally without impacting on the social work membership levels of Unison or any other union.

Firstly, there are well over 40,000 social workers in the UK who are not a member of a trade union or a professional association, so have little of the security such membership affords a practitioner in need of support – from basic advice to prolonged representation. By no measure can this be a welcome fact.

To date, a standalone BASW, acting solely as a professional association and without a union arm, has not attracted these people into membership. Nor too has any trade union appealed sufficiently for them to consider subscribing. BASW’s launch of the Social Workers Union offers these people something else, another option which some of them, just some, might choose to take.

Secondly, and most pressingly, there is one significant factor in BASW deciding to establish SWU that shouldn’t be ignored. A number of local authorities were increasingly unwilling to allow our Advice & Representation officers to attend internal disciplinary or conduct hearings. Although in contravention of ACAS guidance, this was leaving some fee-paying BASW members without access to the sort of expert representation they were entitled to have.

The ACAS guidance, it would seem, is just that, and if you are not a trade union then you don’t have guaranteed access to represent members with employers in the way we would want. By launching SWU, for no extra cost to members, we ensure, among other things, proper protection for local authority staff. This has to be a good development for social workers.

And let’s be very clear about which social workers. You describe BASW as ‘less relevant to me as a local authority social worker’ and ‘focused on either students and newly qualified social workers or independent social workers’. Yet SWU is, more than anything else, about ensuring we can support local authority social workers fully and properly in the increasing number of cases we are sadly being presented with where members are being poorly supported by employers.

You do allude to something very interesting though on the issue of how BASW represents local authority social workers and where we can do better. You suggest that the one thing you would really welcome is the chance for informal social networks – ‘safe’ places, physically and virtually, where like-minded people can discuss the future of social work. It’s a very strong concept and one BASW has recognised but could do far more in developing.

In this instance it is fair to say that we have gone much further down this road with independent members than local authority workers, as illustrated by the number of very successful independent groups holding regular meetings around the country. These aren’t controlled propaganda exercises – BASW staff usually only attend the first meeting to help get things off the ground – but informal meetings of independent social workers which BASW helps facilitate and that participants themselves then take forward.

We have staged a host of ‘tours’ within all UK countries over the past three years, many of which proved to be useful two-way discussion sessions, but facilitating networking groups within local authorities would be a good step for our members and should be explored further, and soon.

One of the most notable aspects of your blog, and the one I felt most keenly, was your assessment of PSW magazine. In particular, you referred to ‘pages and pages of propaganda’ and that there is ‘no space at all for any kind of dissenting or alternate views’. I will respond to this at some length but in brief I do not feel this is an accurate assessment of this magazine or BASW’s approach to dissent.

I have worked for a trade union where the members’ magazine became solely a propaganda device, where every editorial item was utterly patronising and where opportunities for dissent gradually dissolved to the extent it was untenable for me to remain with that organisation. I don’t miss it and I wouldn’t go back into that same environment or remain in an organisation that developed such a mindset. BASW is not that kind of organisation. Not even close.

Look at page 11 of this month’s PSW and you can see that one of the three letters is a direct attack on the magazine for publishing an article the correspondent loathed about lessons to be learnt from the Baby P case. I might disagree with the contributor but his was a valid member’s view which we published without hesitation.

Go back to March when we published a double page spread of comments posted by members online after BASW launched its own College of Social Work (as you will know, the name has since been dropped as BASW and the SCIE-sponsored College work to establish a single organisation for 2012) and you will see two sharply critical views and one far from convinced about the move. As a proportion of the 200 or so responses we received online this wasn’t just a fair reflection of dissent, it actually represented a higher proportion of opposing opinions than were actually posted.

Go back even further to the fall-out from BASW’s decision in early 2010 to hold a referendum of members on the kind of college members wanted to see. We carried letters from one BASW Council member who had resigned and another from a member at the end of his term, both of which were sharply critical of any move away from the SCIE college. No censorship, just publication.

It may surprise you but we actually don’t get a massive postbag of alienated members wishing to air their ire. Far more correspondents focus on something specific they have read, respond to requests for comment on a particular topical issue or, to my inevitable frustration, highlight minor errors of fact or grammar.

As for ‘reams of pages about how important BASW’ is, this is a tougher one because to some extent you have a point – we didn’t used to highlight the Association’s work that much in PSW at all. And people would complain that they didn’t know what BASW did.

People used to wonder why they were paying their membership fees if BASW wasn’t more publicly prominent, more vocal about the issues that mattered to them. BASW is definitely more assertive, more opinionated and, sometimes, more bolshy and for a lot of members that is a good thing.

Now, should that entail using the magazine for endless self promotion? No, in my view it should mean members get to read what BASW’s position is on key issues, whether on the riots in England, adult protection laws in Scotland, funding cuts in Northern Ireland or a consultation document on the future of social work in Wales.

As a monthly title PSW can’t present you, in print at least, with the very latest news, but it can reflect on the past month’s developments by offering the facts and adding a BASW view. This doesn’t change the facts but it does enable members to see what BASW is lobbying for, using the membership subscription fees they pay each year.

News is only a small part of the magazine though, so too is The Chief, where the chief executive is free to write what he wants to the BASW membership. Elsewhere you can read content including features, book reviews, advice columns and interviews, none of which offers a BASW view or seeks to evangelise.

Incidentally, though not without relevance, 345 members replied to a survey on our communications output in early summer and 92% said PSW was either a welcome or very welcome member benefit. It’s not scientific and there are plenty of members who haven’t expressed a view but it’s not a bad statistic considering it is an anonymous poll and I haven’t stood behind anyone’s back twisting their arms.

And just to go back to the issue of self promotion, only a couple of days ago, after reading your blog, I noticed a comment within a Guardian story about research it was co-sponsoring into the causes of the riots, in which the editor-in-chief waxed lyrical about the ‘great strides in the field of data journalism’ The Guardian was continuing to make. Possibly true but certainly self promotional.

BASW is an active, growing organisation that is constantly developing new services. We need to talk about this if we are to sustain our growth as, to borrow from your blog, there is ‘strength in numbers’ and the more members we have the more we can represent the interests of the social work profession – whether you are a student, local authority worker, independent or anyone else.

Joe Devo

………

As for those Annual General Meeting numbers you wanted. Around 230 people attended the Practice Symposium in the morning and 164 remained for the actual Annual General Meeting. Of these, 134 supported the launch of SWU, 21 opposed the motion and eight abstained. Proxy votes totaled just nine, with five opposed to the launch of SWU and four in favour.

Would we like more members to take part in the decision about the future of their organisation? Absolutely and we are trying to learn lessons from our attempts to promote the AGM in May. Several advertisements and e-bulletins actually attracted the biggest turn out at a BASW AGM in my time at the Association, around five years, but we must continue to try and up the numbers further as clearly those who attend the event are clearly a minority of our overall membership – though this isn’t particularly unusual for any union or association.

Considerable effort will be made to alert members to the next opportunity to shape the future of BASW on 1 November when an Additional General Meeting in Birmingham will be asked to determine whether BASW should transfer its assets into a new College of Social Work. This will commence in earnest once BASW Council meets on 21 September to consider the latest position ahead of the Additional General Meeting.

Why I Quit BASW (British Association of Social Workers)

I felt a tinge of sadness when I finally decided to quit BASW (British Association of Social Workers). I’ve been an advocate and member for a good few years and I have a great deal of respect for a lot of people who work there. I advised colleagues to join over the years amid general  waves of apathy. I wanted to ‘make a difference’. I wanted to contribute to the general good of the profession as a whole and I saw my membership and support as the best way.

I can understand some of their irritation with the way the College of Social Work  has been established but what I couldn’t understand and believe me, I tried to, via their own forums and press releases, to get to the heart of what their anger about was  about UNISON  (the trade union that linked with the College of Social Work) , with the College, with SCIE – who were charged with setting up the College on behalf of the governmentwas all about.

I know it was partly about control. BASW had initially thought to propose the idea of a ‘College of Social Work’ and probably felt that they should have been charged with running it. The problem was and remains that BASW members remain a minority of social workers. I remained a member though. I enjoyed being a part of the professional association. I thought that it added ‘something’ to my arsenal and allowed me, theoretically at least, to hold a stake in the present and future ‘state’ of social work in the UK.

However, for me, BASW seemed to become less relevant to me as a local authority social worker. They run events but they seemed to be focused on either students and newly qualified social workers or independent social workers (I’ve been told that this is a faulty perception but it’s the perception that I have regardless).

I looked at their magazine and I saw what appeared to be page after page of propaganda for their own campaign to disassociate from the ‘official’ SCIE led College of Social Work. There was no space at all for any kind of dissenting or alternate views.  It felt like some ‘official party’ magazine. Sure, there would be some interesting articles but it would be one or two amid the reams of pages about how important BASW was. This is a membership magazine going to people who are already members. The writing felt patronising in the extreme as if we were just being exposed to a propaganda machine and were incapable of independent thought.

I am a member of UNISON as well as BASW. I never saw the two as being mutually exclusive. I certainly haven’t had UNISON bad-mouthing my professional organisation in its literature but BASW seem to find the idea of UNISON so difficult that they have press release playing ‘number games’ with their figures – forgetting the obvious point that some people (like me) are members of both organisations so comparing numbers becomes less.. helpful.. when you consider that some are counted in both ‘fields’.

I think their move towards creating a Trade Union is wrong-footed. I was unable to attend their AGM and when I asked about proxy voting, I was told that they only count the postal votes if those present dissenting reach a certain threshold. With that I realised that my vote against the Union would be discounted as those who would attend would be much more likely to vote in favour. I felt genuinely disenfranchised because my vote would not be counted unless I was able to attend in person.

I am deeply disappointed by both BASW and the College and their lack of engagement and innovation as regards trying to find new ways to build social work links and make progress in an increasingly social world. The same people are being appointed to the same committees to discuss the same issues. It very much feels like that from my point of view.

I was willing to continue my membership to BASW through their gripes and through my increasing concerns with the way they were moving.

However when they pushed out to promote their new ‘Social Workers Union’, that’s when I decided to leave.

They seem to be pushing their union as ‘added value’ to their current members. It would add no value to me as I already have a Trade Union. In fact, in their membership booklet, it even says that they encourage social workers who join to also join a trade union – and so I did. I know my Shop Steward and I admire them greatly. We link very well with the Health members of Unison as a lot of the issues, for me at least, in a Community Mental Health Team, are very similar regarding employment issues.

I’ve had my gripes with UNISON in the past as well but knowing how the local authority is minded, I would rather ‘stick my oar in’ with my colleagues regardless of whether they are ‘social workers’ or not as opposed to being in a union which exists only to support social workers. Currently our jobs are at risk. UNISON is working very hard locally to establish links within the local council and NHS trust to consultation and they are created with being an established partner and union who has members across the council. With unions, however right or wrong it may be, I think there is strength in numbers and I dare not quit my union membership in these current times. If BASW are focussing on ‘being a union’ and I don’t want to be a member of ‘their’ union – why should I pay for it? Especially when I am content with the union representation I receive from UNISON?

I felt sad to pack in my BASW membership and may be back in the future if they steer towards a more conciliatory path. I would still recommend membership for students, I think, because the fees are lower and if they to incorporate the union membership it may well be a good ‘deal’ to assist through difficulties with placements. I would also recommend membership for Independent social Workers as they have good networks and frequent meetings and events for Independent Social Workers and have good insurance packages (so I’m told).

For me,  though, I need to see more and mostly I need to see more positivity. The organisation increasingly feels very defensive and negative and that makes me sad.

Ultimately what  I would like from a professional organisation/college is more local groups/social groups. Spaces both physically and virtually to discuss the future of social work and ‘safe’ places to bring together issues that affect social work as a whole. Not just a forum, online forums are ‘old hat’ but there are more ways to discuss and find space.

I think regional groups would definitely help build connections and membership.

I know there are good people in BASW and that they want the best for the profession but I couldn’t justify continuing to pay over £200 per year alongside my union membership as they move in a path I no longer agree with and in tough financial times, you have to ask ‘Is it worth it?’.

Personally, I felt it wasn’t.

My hope is that there is a move towards more collaboration with the College of Social Work but that those within the College will push away some of the apparently self-obsessed cobwebs from BASWs eyes and create and evolve an institution that can really work for Social Work rather that what appears to be their own ends because unfortunately that’s sometimes how it feels from the ‘front line’.

Committees arguing for their own continued existence. I’m sad to say that but that’s how I feel.

Just one aside, when playing their numbers games and trying to ‘outmanoeuvre’ Unison in claiming to have more ‘Social Work’ members, I commented that I would like to know two things

How many members attended the BASW AGM?

How many people voted in favour of the move towards a Trade Union (numbers not percentages)?

I haven’t been given these figures but if there is anyone from BASW reading, I’d really like to know.

I’m not saying at all that I’ve left forever. I really hope I will be back at some point but I have to see more effort and will towards promoting the profession rather than BASW itself.

Weekly Social Work Links 30

As the days become more distinctly autumnal, I’m sharing some interesting links I’ve come across over the last week. As always feel free to share any other links you find that are related or interesting in the comments section.

I’m always wanting to find new blogs that are related to social work internationally so if you find one I haven’t noticed again, please leave a link!

Firstly, another plug for This Week in Mentalists – a now-traditional weekly round up of mental health related posts from which I stole my inspiration for these round up posts. Essential weekly reading for me and for all those who have an interest in mental health.

Indeed, it was through This Week in Mentalists that I came across the wonderful new blog ‘Veruca Salt’ who works in a CAMHS (Children and Adolescent Mental Health Service) Team and in which she discusses anger management. Rang a lot of bells with me. I really look forward to following her blog which she suggests in her byline, will share ‘views on children and adolescent mental health’.

Keep writing, Veruca, I think this one will be a corker!

I also came across this post on Blogher which is written by someone who worked as a social worker. The title says it all really ‘The Problem with handing out the Happy Pills’. She raises some excellent and thoughtful points about medication.

Social Work Soldier – another new blog I’ve recently found, shares her thoughts on her first weeks in a new job.

While Social Worker Mom looks for a new job.

And as the author of From Media to Social Work gets ready to embark on her course, she shares her thoughts of the shadowing experiences she has had over the summer.

The Masked AMHP shares part one of his ‘genesis’ story or how he got into social work. It’s a fantastic post!

On a related subject the Social Work Career Development shares some motivational quotes and asks for more examples from readers.

Social Worker in the South meanwhile shares a moving story which indicates the importance of this line of work.

and Going Mental explains that sometimes ‘the system’ works.

On Eyes Open Wider, meanwhile, some reflection and thoughts on what the innate sadness in some of the work that is done.

The Modern Social Worker shares a post about Eugenics, Race and a woman’s right to choose. Perhaps particularly timely as the abortion debate ranks up here in the UK.

SocialJerk has some fine posts as always including this one about the paranoias that exist about adults working with children and some of the absurdities that have arisen around these paranoias.

Community Care’s Social Work Blog has a post about a ‘game’ developed by the University of Kent to assist in training around child protection practice through the use of scenarios (I haven’t actually tried the game but would be interested to hear from anyone who has)

Nechakogal’s blog shares some relevant (and freely accessible) research on different subjects,  which is worth checking out. I’m a great fan of open access for research and papers.

How Not to Do Social Work shares his variation on ‘What I did in my Summer Holidays’ post with typical thoughtfulness.

One a completely different note, A Social Worker’s View draws our attention to Ovarian Cancer Awareness Month.

And The New Social Worker Online Blog considers the impact on endometriosis.

The Social Work Tech Blog has a fantastically detailed ‘how to’ post about using technology to ‘observe’ sessions and to learn from them.

Finally congratulations to Gamer Therapists who has published a book on Video Games and Psychotherapy.

Online Learning and Social Work – A proposal

I’m on a theme at the moment so run with me. I have through various conversations that I’ve hooked into among Occupational Therapists come across this programme OT4OT (Online Technology for Occupational Therapists)

 

connectlrmeli @ Flickr

It is a proposed, international educational programme using occupational therapists internationally to provide and support web-based learning or as they call it a ‘virtual exchange schedule’ to promote learning and understanding and uses of technology to grow international knowledge about occupational therapy internationally.

It’s a fantastic model but I’m desperately jealous. Where is the social work equivalent? How about an international ‘virtual exchange schedule’ of free programming that social workers internationally can both contribute to and participate in? Why do we leave these things to those who organise and charge fees which are too large for individual interested practitioners to attend?

I’d love to find out more about this model and see if there’s a way of pursuing a similar experience in social work internationally but I’d need people to come on board. Is there anyone firstly who would contribute their expertise to run virtual sessions or discussion groups throughout a ‘day’. Any social work departments willing to help with technology aspects and providing an educational ‘oversight’ to the quality of submissions? The idea would be for an international event to broaden international experiences of social work. I think it could be a fantastic resource and opportunity.

An opportunity for ‘people like me’ who are not linked directly to universities to run ‘events’ online, it could also be an opportunity for those who teach to share some of their information globally and gain experience and exposure of running online events.

I need to do a bit of work behind the scenes regarding technical aspects and how that  might work but I don’t think it needs to be complicated.

Anyone interested? I can put together some kind of mailing list or group on Google to discuss further. I just want to know if I’m shooting into the wind or not!   I’ll do a bit of investigating regarding hosting and technological needs over the weekend and will write up posts as I find out information. I think it could be something really exciting.

(just as an aside – wouldn’t it be a wonderful world if this was something our ‘College of Social Work’ or BASW were to put together without nudging – that’s the kind of innovation and progressive thinking I’d like to see from a professional association rather than messing around and replicating unions that already exist).

Consultations

I was interested in this article on Community Care website yesterday that more than half local authorities did not comply with the twelve week period for consultation when setting their adult social care budgets for 2011-12.

I had to stop and think whether the authority I work for did this. I think they did. I have vague recollections of something like a consultation being circulated but we’ve been subject to a number of different consultations for a whole variety of things and I’ve lost track of which were for what.

CWGL @ Flickr

I’ve probably been directly party to more consultations over the past 18 months than I have at any other point in my career and to say I’m disillusioned is an understatement.

Consultations, in my experience, are never about actually consulting. They are about presenting decisions that have been made in smoky rooms, behind closed doors as a fait accompli.

These ‘management consultants’ who are engaged at high cost to produce these consultations only do so to meet statutory guidelines about what ‘consultations’ should be but I’ve been party to consultations which seem to arrive during the Christmas period, at Easter, over the summer holidays – whatever time seems to be the least convenient to actually gain the opinions of those directly affected and in whatever way seems to stymy any kind of criticism the most.

Do I sound cynical? Well, maybe just a teeny bit. It’s because we’ve been blasted by some massive changes presented through consultations-that-are-not-real-consultations and I’m bitter. I’m very bitter.

One of the major issues I’ve noted is the short periods of time between the ends of the consultations and the publishing of proposals as if, by magic, all the submissions could be judged within a week.. oh, not many responses? Well, that’s awfully convenient.

I’ve seen documents accompanying the consultations which don’t even try to disguise what the final outcome to the so-called consultation will be.

I have no doubt whatsoever in  my mind that consultation is about the most misused term in local government and the NHS that I have ever come across and that’s saying a lot.

Large organisations don’t want to consult. Or rather, they want to consult with their own consultants. They want to consult with the same group of people whom they can explain and describe to at detail. Thinking about creativity, if there was a real desire to consult about changes rather than impose them, the organisations should be forced to use more creative means to garner responses. Questionnaires don’t always work. Public meetings attract the same time-rich people who will always attend. What is done in a consultation to seek out those who are least likely to respond? Is three months really sufficient time for this?

As I said, I’m a cynic. I can’t see the work ‘consultation’ without laughing cynically and reading the end of the document to see what is proposed and what will, no doubt happen.

I’d love more openness in the process of putting together proposals and garnering ideas rather than being given consultation documents which appear to be vastly resourced ‘fait accompli’ type documents justifying why ‘we’ are changing what ‘we’ are changing.

Does anyone have any positive experiences of consultations? I’d really be interested in hearing.

Panels

Since I’ve been employed as a social worker one of the constants in my working week has been the presence and existence of ‘panels’ in many different forms. There was a brief stage when we were told not to refer to them as ‘panels’ but rather meetings but it’s all the same thing at least, in the setting in which I’ve been working. They are groups of managers and professionals of a variety of provenances making funding decisions on behalf of the local authority or health service.  Of course sometimes they say it is about joint decision making (which is why the word ‘panel’ is frowned upon now) but that’s really a facade. I make recommendations but I have little authority over funding decisions.

Different local authorities often have different mechanisms so my explanations of the panels that I might attend come with the proviso that things are arranged and organised in a variety of ways.

We have panels which primarily make decisions about packages of care that exceed a particular baseline cost. That baseline has changed a variety of times but generally managers in each team are given a certain ‘threshold’ to which they can approve funding requests but above that and any application for funding for residential or nursing respite or long term care have to navigate a ‘panel’.

We have separate panels for high cost personal budget packages which would be provided for care at home and those which approve residential and nursing care/respite and continuing health care (which authorise applications for long term payment for care by the NHS )

Going to panel generally involves the transfer of reams of paperwork. I’d probably say it’s the most obvious way though that I provide the function of advocating for a particular service user or family member when I ‘present’ the situation to those who make the ultimate funding decisions.

Contrary to what some people might think, I have absolutely no vested interest in the local authority or NHS ‘saving’ money by not agreeing to a particular package – indeed, I won’t tend to bring something to the panel if I don’t wholeheartedly agree with it myself. I am a great advocate of money being spent where it is needed.  I have a general wish to see public money well-spent of course and I understand the need to ration resources but if I bring something to the panel and authorise an assessment, it is because I believe that that is what is needed according to my professional  judgement and as far as that’s concerned, balancing the rest of the local authority’s budget is not an issue I consider (which is obviously why these panels exist!).

Similarly with the Continuing Health Care Panels  I cannot conceive of a situation where I would bring someone to that panel if I didn’t absolutely want and believe that they should get that funding.  If I attend and collate a report it is because I and the multi-disciplinary team behind the report, believe in it.  I absolutely want people to get what they are entitled to and have no ‘secret instructions’ to try and deny the funding. The rules though are not altogether clear but it suits the funding parties and the governments to keep the rules complicated and unclear. There’s a lot of money at stake.

The panels are open to service users and carers but for me, personally, it’s very rare that service users or carers attend with me.

I have more often  had family members attend Continuing Health Care Panels with me and found it is a much better way of working as it allows a lot more transparency and removes one of those bars between me trying to put the words of others in my mouth.

By now, I know the people who sit on the panels and they know me. That’s a massive advantage in being able to persuade and cajole. It makes me realise how useful it is to have built up links and a reputation among the more senior management. I like to think that a trust develops.

Panels used to scare me because I’d be questioned, often in detail about the proposals that would have a substantial monetary implication for the local authority. My paperwork and assessments are examined in great detail and a level of scrutiny applied. Now that I’m more confident, I tend to take pride in presenting my reports and welcome the questioning as I know what to prepare, what to highlight and what to expect.

I’ve had panels where paperwork alone is assessed and where we are not required to attend in person.  I prefer being there ‘in person’ especially when there are any question marks that I feel I can clarify.

One of my favourite tasks in my work is feeling that I am genuinely able to advocate and navigate a person or family through the muddy mired waters of local authority funding streams and decisions. I wouldn’t say I enjoy the panel process although there is a satisfaction in having something approved especially if it is something you feel might be hanging in the balance, but I don’t dread them as much as I used to.

As for now though, it’s just another part of the process of seeing a paper ‘plan’ through to fruition.  I know they work differently in different areas – indeed, I’ve seen them in different forms in the local authorities I’d work for – but that’s how they work – whether they are called meetings or panels, the effect is the same.

And that’s the explanation of what the panels are – the other side of each discussion I have and each decision that is made by the faceless ‘management’ that I sit in front are that they are desperately important decisions to each person who is reliant on the authorisation of that funding to allow them to life their lives more fully, to allow their family to have access to respite services. My job as I see it, is to bring the paperwork and paper assessments ‘to life’. I am not only writing about a person on a pro forma, but I’m able to flesh out the requested questions and documents with a person, with a family, with relationships.

That’s why I don’t mind attending  these panels as much as  I used to. I’m not frightened of them anymore. I see them as an opportunity to take a crucially important role in someone’s life and to speak for them and not  just about them.

Technology, Social Media and Social Services – Finding new ways to ‘help’

Image via Wikipedia

I have some across lots of discussions and debates about ways of using social media and new technologies and interactions to ‘help’ social services become more effective. Most of it seems to revolve around building online directories and databases of micro providers and services that are available which build on so-called community capacity to improve the way that personal budgets can or might work.

At the risk of sounding overly cynical there is nothing ‘innovative’ in my mind about building a directory of services.  To me, this is not a particularly innovative way to use ‘technology’ in social services.  It taking a very obvious and well-trodden route to using new technologies. Providing directories while being useful to a certain group of people again exacerbates the isolation of those who are not party to or able to use them.  Being innovative isn’t always necessary to be helpful but it is very important that new ideas are focussed so we don’t just end up with increasingly specialised, localised directories that might have more ‘interactive’ features and feedback, look more ‘user led’ and compatible with the buzz words of social media but in the end they are brushing the surface of possibilities.

It feels more and more as if that there is a growing division between the ‘haves’ and ‘have nots’ as far as personal budgets have been extended and does absolutely nothing to address or use technologies to address those who reside continually in the ‘have not’ section.

While at work, we labour with database systems that have clearly been developed through conversations between commissioners and software companies without any recourse to frontline practitioners, nice new provider directories are being tinkered around with while the fundamental foundations of the systems we work with remain resolutely inaccessible.

I’ve had a few ideas myself and whilst I lack the technological expertise to see any of these ideas to fruition, this is a kind of ‘wish list’ of the sorts of things I’d like to see.  I’m under no illusion that these are ‘new’ ideas. I am sure similar things already exist in some form but they are things I’d like to see pan out in the longer run. Things I’d like to use at work.

I’d like to see more creativity in the use of technologies to assist with decision making for adults who have some kind of cognitive deficit. I’m a great fan of the ‘tablet’ and ‘touch screen’ model as I think it is intuitively an easier interface to understand.  When I see people instinctively reach out to touch the screen of my Kindle (which isn’t touchscreen!) I realise that we are becoming conditioned to seek the easiest input methods which are about touching a screen and speaking into a microphone and perhaps writing on a tablet. Now, voice recognition has improved, I’m yet to come across very successful handwriting recognition (possibly because I have scrawly almost illegible handwriting) but there is potential there. In the meantime, pictures and touchscreens seem like a good way to go.

Using pictures/sounds/music it can draw on multi-media ‘shows’ and explanations of different options – moving beyond the ‘written word’. Providing documentation in aural form or in pictorial/moving form rather than reams of leaflets. Having recordings of familiar voices or pictures of familiar faces might help to reassure. I’m a great fan of telecare in general with the proviso of always being mindful that the human contact is not replaced but in days where human contact is sparsely provisioned anyway, it may be something that can be experimented with.

Why not a YouTube type video to explain how services can be chosen instead of reams of ‘easy read’ leaflets which really aren’t remotely ‘easy read’. Instead of flooding people with lists of providers (which, while good for some ignores those who are restricted in terms of capacity and carers to choose ‘freely’ the types of services they garner) why not explain and expound in different ways the ways that services can work?

Why not explain providers in terms of what they can actually provide and what purpose they serve rather than creating directories that are meant for people with a good understanding of what they want and need?

I was in a day centre last week and there was a seemingly unused Wii. I wonder if he Kinect might be a better project to develop some type of interactive play, exercise and work as it doesn’t need a controller at all and uses the more innovative way of body movement.  Using participatory games with larger screens in company can provide different stimuli. I know why games developers  haven’t tackled directly the ‘older’ market with games that might otherwise reside in memories but why not repackage old school yard games and board games with Kinects and iPads? It may be a good way to introduce the use of these new technologies in a ‘friendly’ manner which may then see them used in other wider ways – such as directories or personalised information sources. Using YouTube video channels for personally designed ‘reminiscence’ therapies could personalise the delivery of memories and digitise memory boxes where items are not there to build up the frames of someone’s life and people aren’t there to fill in the gaps.

There are many ‘dating site’ type services that match people and organisations. Volunteers to voluntary groups etc. How about a type of match between schools and residential homes? I know it’s something that’s sometimes done locally where I work and having spoken to both providers and some of the kids who go in, they seem to enjoy it and it can change and break expectations – each of the other.  I

We talk of social media a lot and often it is used to provide ‘recommendations’ to particular services through these databases. Perhaps more user and carer led general recommendations can be collated. Crowd source an ‘introduction’ to social services provisions by those currently using the service.

Ask ‘what do you wish you’d known?’ ‘what do you wish someone had told you?’ and while taking out all the obviously libellous stuff, a local authority must be brave enough to leave in the criticisms. We learn through complains and criticisms and it can take a lot of guts (or anger) to make a complaint or to criticism and that MUST be respected by the service and the individuals at fault and used as a means of improvement.

I don’t want to see local authorities ‘whitewash’ problems in order to gain sparkling OFSTED or CQC inspections. It sullies the whole process and makes the inspections worthless. Regulation should be less authoritarian and more about actually making improvements and making things better for the end user – not about allowing local authorities to produce the ‘right’ results while poor practice is brushed away from the sight of the inspectors.

But back to my point about using social media to crowdsource – it is important that social media ALONE is not used as an ‘answer’. Crowd sourcing must be honest but it must also be broader than putting out an ‘internet consultation’ and having a Twitter account or blog. There must be pounding of the streets too to engage those who are not able to use digital means to put their points across. There should be knocking at doors and face to face discussions – not leaflets, not inaccessible (for some) groups.

Talking about crowdsourcing though, there’s a much better and perhaps more obvious way it can be used and certainly isn’t being used at the moment and that’s to engage other social workers and professionals into putting together more information and useful methods of practice for ourselves. Sure, it needs time but we remain reliant on organisations to provide ‘guidance’ such as SCIE (who do provide fantastic resources) and BASW and the College of Social Work but why none of these organisations who purport to exist to help social work and social care practice actually engage more directly and use social media and open access blogs/discussion groups/forums/micro blogging etc to engage with currently practicing social workers is completely beyond me.

I’ve become very interested in open access education and resources and feel there is great scope for professional engagement and information to build its own resources and information together with users and carers, together with other professionals but there has to be a push for social workers to see the benefit of sharing and finding appropriate ways to share the information that we learn every day.

I have other ideas which will come in different posts  but I’d be interested in hearing other peoples’ ideas for uses of ‘technology’ in the very broadest sense and how they can develop to help the broadest range of people we see in social services – particularly those who are less able to look information up in various fancy online directories.

Weekly Social Work Links 29

After my absence last week, I’m back with some of the links I’ve come across that I’ve found useful over the last week (or two because I’m covering some of the posts I missed during my weekend away!) which relate in some way to social work – some more than others!

Enjoy and as usual, please feel free to add your own links in the comments section.

A Deck of Many Things has a great piece about multiculturalism.

Chris Mills highlights the rise in care applications in England and Wales.

The Masked AMHP has a fantastic post about what happens in CMHT (Community Mental Health Team) assessment. Highly recommended (as always with his posts!)

In a very specific post, Jamie Middleton explains about contingency plans for a ‘flu epidemic in compulsory mental health services in England and Wales. 

How not to do Social Work writes about ‘Good Enough’ parenting.

Social Worker Mom worries about becoming a ‘Mean Girl’ (can’t imagine that myself!)

And SocialJerk writes about ‘ghettos’.

Classroom to Capitol has a post about being unreasonable

Diary of a Social Worker has a post about eligibility criteria for his service and those who don’t meet it.

On another tack, Mike at Gamer Therapist explains why he says no to some referrals.

Social Work Career Development has a post about Gestalt Therapy and Dream Analysis (and being particularly unknowledgeable about both, it was certainly educational for me!).

Aunt Bertha writes about the importance of gathering data. A quick example of the importance of evidence bases to service commission and provision!

I know there are some fantastic posts that I’ve missed out but hopefully I’ll be able to pick up more next week.

To all in England and Wales, enjoy the holiday weekend