We operate to a system of targets. That should be no great surprise. It is how ‘value’ is determined and efficiency is maintained. Social Work is, for the most part in the UK, funded from the public purse and it’s quite right that we should be subject to a checking and controlling system than ensures we give the taxpayers value for money.
But (you could see the ‘but’ coming, I suspect) the types of data that we are expected to collect can provide a false sense of security in the systems. Some of this has clicked with the press over the weekend. Targets were met in Haringey. That does not mean a quality of service is maintained.
I’m not against all targets, by the way. One which I think has improved the service is the one which is based on time from referral to contact. It means that noone can sit on a ‘waiting list’ not knowing what is happening to them. Even if it is just someone phoning to acknowledge receipt and give a contact telephone number until an assessment has been completed, at least that is better than hearing nothing.
Some though, are less than logical. There is a target relating to how many cases we close. By the way, I was taught never to refer to cases as case but as people. So while I’m writing that in my head, I’m thinking ‘people’ but it just doesn’t seem to flow as well!
Back to the case-closing (I couldn’t really write people-closing..). To me, it is one of the more difficult targets to get my head around. I’ll close when I need to – not based on targets or pressure. It’s probably one of the more damaging targets, I think.
Then we have targets set by the NHS Trust and targets set by the Local Authority. The Trust, for example, sets guidance that we should each care coordinate 25 people and that we should register at least five ‘contacts’ per week. The five contacts is usually very easily achieved. Sometimes I might do that in a day.
Their views of contacts aren’t necessarily my view of contacts though. Going to visit someone in their home, ok, that’s an easy one, of course that’s a contact.
Going to visit someone when they are at home and they aren’t in/don’t answer the door. That’s also a contact (actually that doesn’t happen to me too much).
Visiting a carer or any kind of carer support. That’s not a contact.
A telephone call that is over 10 minutes and has some kind of therapeutic value (self-judged) is a contact.
The team I recently left was the worse in the Trust for the contacts. Or the worst at actually entering them on the database……
I think the older adults teams suffer slightly by having the same targets as the other CMHTs though. Our care coordination requires a lot more care management (putting together and monitoring care packages as older people tend to be more likely to need physical help) and our service users never come to our office to see us.
We are out and about a lot more. I think, although this is gut instinct, that there is a lot more carer support work that possibly goes on in our teams. I know there are some weeks that I have done nothing else.
Then we have the Local Authority targets. I used to be really hot on these when I worked in a local authority office. Now.. possibly not so much. It is to make sure that reviews are regular and timely – but they also include things like monitoring work status without providing any way to put ‘retired’ on the forms they must have spent hours devising.
We have targets for carers support packages (actually providing services), direct payments and carers assessments. Apart from Direct Payments where the only situation where I was going to do this was in progress and was never seen through to completion due to other factors that changed the situation while I was working with it, I’ve been pretty good at the carers assessments and the carers services.
Not bad, actually, those targets. They remind us of the job we need to be doing.
But then there is the target that really rankles me. We have a target amount of Safeguarding Adult Investigations to complete. OK, it isn’t a high target but shouldn’t some things just be. . er.. done on the basis on which they are needed. Luckily, no manager I have ever worked with has ever done anything but be baffled by this as a target. It happens or it doesn’t.
The need to create a tick-box culture does more than anything else to remove the professionalism required.
Targets aren’t going anywhere. Some can encourage good working practice, even, but when they are imposed on a draconian basis, there is a danger that they will attract shoddy and half-hearted work on the basis of ‘completing a target’ or ticking a box. That is the real danger. So by all means, set targets – but make them realistic and relevant to individual services. What works for one agency or service may not work for another.