Looking Back – 2009

I was wondering how to finish the year off and mark it. So I looked at last year’s posts for inspiration to see how I marked the end of the last year. I ran a couple of posts – one looking back on the year in my first ‘proper’ year of blogging and another post looking at changes that had taken place professionally over the previous year of 2008 and another one looking forward to 2009.

I thought this year, I’d combine them into the same post and then, over the weekend, that will leave me time for the ‘looking forward’ post.

So as far as the blog has gone, I have definitely picked up readers over the past year and thank all of you visiting for that! Without doubt I have had more external distractions this year, with my father’s health fading and his death in August, to starting with the fostering  and now, the placement of our third foster child – so I have allowed myself a little more leeway with ‘days off’ than I did in the first year.

I installed a couple of extra widgets to track visitors and Clustrmaps tell me that by far and away most visitors come to me from the UK – unsurprisingly – followed by the United States, then Canada, Australia and then India.

But visitors have called from Libya, Sudan and Moldava – I can’t help wondering if they found what they were looking for!

Unsurprisingly the ‘About me’ and ‘Contact me’ pages are the most popular – probably because they have been constants however the Gerry Robinson posts come up pretty close which, considering the recentness of their posting, shows how many people were affected by the programmes made and wanted to find out more. The effect of the mainstream media is unsurprising and undeniable.

A quick run down on some search terms is always good for a giggle although I can’t beat some of Mental Nurse’s efforts as my most popular search terms have been, after the name of the blog, ‘angry face’, ‘general social care council’ and ‘good mental health’. Fairly expected, I think.

As for the next year, I definitely intend to read and discover more blogs, even if it means cutting down my own output a little as that’s an area that I haven’t concentrated on as much this year. Ideally, I’d like to produce better quality postings, less frequently, if necessary but retain the mix between commentary on social work, mental health and anecdotes from my working life with the occasional foray into personal thoughts.

And professionally, looking at 2008, I was reflecting on the changes to the Mental Health Act and the introduction of the Deprivation of Liberties Safeguards.

This year, it seems to have been about the Social Work Taskforce and coming in right at the end, the New Horizons paper on the future of Mental Health services in the UK. I expect both of these documents to have a major impact on the next year, at least, in a very real and immediate way. We have already had documents sent round about changes planned across the Trust as a result of the New Horizons proposals. I expect many changes before the year is out.

As for the Taskforce report, my expectations are that the impetus to change will come more slowly but I am comforted by the results published and am hopeful that there will be a blossoming in the development of social work in the UK. Ever hopeful, of course but as I was saying to a colleague just yesterday, whether you are an optimist or a pessimist, is unlikely to change the outcome, but if you are optimistic, you might have a more enjoyable experience along the way!

We have a general election coming this year – and a likely change of government, with different agendas and priorities, all in the climate of public sector cuts which are already affecting services. Interesting times.

The personal hopes for last year involved me aiming to start the Practice Education branch of my Higher Specialist Award and indeed, I have started that  now.  I have initiated my first couple of Individual budgets and although I retain a healthy dose of scepticism, I am committed to making sure all the concerns I have are raised and in order to do so I have to embrace the changes so that I can speak from a position of knowledge rather than stand on the sidelines and complain about changes in general.

I have noticed in myself that I have become more confident in my work and practice. I think that is something that grows incrementally each year but this year I felt more confident. I think that is partly due to the management and colleagues around me and the ethos that exists in my team which is very supportive.

I also resolved to try and become more active in both UNISON and BASW. While UNISON has been jettisoned a little bit, I have been more involved in a number of ways with BASW and have enjoyed the process of becoming more engaged with the profession on a wider basis than my office or my local authority. It has been heartening to see BASW become more vocal and confident and I am interested to see where that path lies.

I know the decade ends in 2011, but for my purposes, I’ll use this as a chance to look back too – although briefly – because in 2000, I qualified as a social worker. I find myself 10 years down the line. Partly I’m surprised I lasted this long – many of my colleagues on that MA (as it was then!) course that I attended have moved into different careers or away from front line practice.

I have worked in Community Care Teams, moving into Mental Health in 2006, nonewithstanding the ‘lost’ years I spent in Italy doing nothing related to social work  but which remain possibly the best thing I ever did and instilled a wealth of experiences that have shaped who and where I am now. Professionally, I worked though more statutory focus on carers and direct payments through to the initiation of individual budgets and the personalisation agenda. The Delayed Discharge Act which saw local authorities being charged for hospital stays if they were unable to facilitate discharges and what seems sometimes like over speedy discharges from hospital. I wonder how far that line will run. It seems that all policies are pointing to more care in the home and away from institutions.

I also  trained as one of the last ASWs (approved social workers) – in fact, I was the last ASW warranted in my borough – in July 2008 before moving straight into the ASW to AMHP (approved mental health professional) conversion training.

Without doubt that training has been the most significant to my professional development over the last decade. Seeing the beginning of the DoLs (Deprivation of Liberty Safeguards) process and the mess that seems to exist within what looks like frankly sloppy legislation and protocols and being able to recognise it as sloppy, will no doubt be one of the key parts of the legacies the decade leaves in my service area. The scope of the Mental Capacity Act still has a lot to encompass and needs a lot of padding out – probably by case law.

It’s easier to look forward one year than ten so I’ll duck out of decade predications until next year.. but as for the coming year, I’ll put something together over the next few days.

For now, there’s still another working day left of the year.. but Happy New Year to all and thanks again for visiting.

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Ginkgo fails

USA Today reports that a research project studying the effectiveness (or not) of Ginkgo Biloba – a ‘traditional remedy’ thought to aid memory has shown that it has made absolutely no difference in affecting the cognitive decline or otherwise in older people.

The plus side for those reliant on the herb is that at the very least, it was found to cause no harmful effects which I suppose is a definite positive for those who use it regularly (and I’ve come across a few on my travels over the years!).

It’s interesting that the study was funded by the ‘National Center for Complementary and Alternative Medicine’ oops!

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Although unsurprisingly

Douglas MacKay, vice president for scientific and regulatory affairs at the Council for Responsible Nutrition, a supplement industry trade group, disputes the study’s findings.

“There is a large body of previously published evidence, as well as ongoing trials, which suggest that ginkgo biloba is effective for helping to improve cognitive impairment in older adults,” he says.

Although it’s a case of ‘he would say that, wouldn’t he?’ I fear.

As the article from USA Today goes on to say

U.S. sales for ginkgo biloba were $99 million in 2008, down 8% from 2007 but still placing it the 8th most popular herb and botanical that the Nutrition Business Journal tracks.

And that’s an awful lot of money.

It’s not to say I’d be wishing it to fail. Believe me, I would love there to be something that would stem cognitive decline in any way, but I also think that selling false hopes is a cruel business and picks on our fears for profit.

Akmal Shaikh

Akmal Shaikh was killed this morning by the Chinese government. He was a convicted drug smuggler and China operates a system of capital punishment that decrees that such a crime should be punished by death.

His case has been raised partly due to circumstances which have led to his execution. Shaikh’s family have stated that he suffered from bipolar disorder and is said to have experienced some kinds of delusions which had led him to be ‘duped’ into carrying 4kg heroin with which he was found.  He wanted to make a record and save the world. He wanted to be a pop star.

Wanting to be a star is not necessarily any indication of mental instability but looking at some of the circumstances leading to his arrest as well as his belief systems, there does seem to be reasonable grounds for an assessment at least.

Reprieve, a charity working on his behalf as they do for other prisoners whose human rights are being violated, had been trying to arrange an independent medical assessment for Mr Skaikh over the past year – possibly longer – but were blocked by Chinese authorities.  They did, however, put together reams of evidence from experts, family members and people who had come into contact with Mr Skaikh in various capacities over the years to verify his delusional thoughts and mental ill-health – in fact, the Reprieve site, gives a robust summation of the circumstances leading to his conviction and ultimately his execution.

Various representations were made at various levels of the government however all amounted to little at the end and so Mr Skaikh died this morning.

Being firmly opposed to capital punishment on any level and for any offense, this again serves to compound my thoughts on the matter. Drug smuggling is wrong, of course it is. It should not go unpunished but these circumstances leave me with greater concern about the situations that exist around the world – not just for British citizens that we might hear about  but those who do not have the diplomatic force of overseas press (for what it’s worth) behind them.

Newspapers and various websites are filled with possible repercussions for diplomatic relations between Britain and China. I personally, don’t think there will be any longstanding repercussions there and time and circumstance will move on – but for Akmal Shaikh, it won’t.

Merry Christmas

Not really much to add except that I’m wishing everyone a happy, safe and peaceful Christmas time.

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And with that thought, I’m off to tend the turkey..

Of Snowiness

Really it was a fairly busy day yesterday. The person I had been scheduled to visit and had completely expected to be out when I called was actually in. Of course, he wouldn’t let me in but we managed a fairly useful chat through the front door and kitchen window. He had some choice words about ‘social workers’ but although I had clearly introduced myself (when he levered the front door open to see my face) he seemed quite happy to continue shouting in my direction for a while. At least we’ve tracked him down and he has agreed to further visits – hopefully beyond the front door but I’m happy to work it either way!

I also popped in to another visit that I had scheduled where there were some unexpected local difficulties with various care package issues over the Christmas holidays and a carer who had had some personal difficulties and I wanted to check that everything was in place and working as best it could.

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It started snowing when I made my way back to the office. By the time I arrived I resembled a snowman – completely covered in a sheet of white. And cold.

We joked amongst ourselves about having difficulties getting home but relying on the Transport for London website, I happily assured everyone that there were no problems on public transport. When one of the  less optimistic nurses muttered about having to spend the night in the office if it snowed too much, I happily said that if that were the case, I would walk home –it’s only 5 miles after all (I checked the distances on Google!).

As the snow began to fall more heavily and was obviously settling, we were told to leave early if necessary. That was at 4.30pm. Oh, how I cursed my previous jauntiness. One traffic jam, one broken bus, a long walk, a tube journey and another walk later, I arrived home just about 7.45pm.

The worst part was definitely trying to walk on what quickly became sheet ice.

The most inappropriately funny part was when the bus driver told us to stop moving around on the bus in case it started sliding downhill.

The stupidest part was that I didn’t just get the underground to start with and that I even made an attempt on the bus.

But you live and learn.

Towards Christmas

Certainly it’s been picking up this week in terms of the rush – and compounded by more than the usual number of people off work at any given period, mean that it’s likely to be a busy week.

I am used to working over the Christmas period – I can’t remember the last time I had the Christmas period off work and in some ways, my work can serve to compound the fortunate state that I find myself in general in my life and situation. As for this week itself, today I have to do and visit someone who is very unlikely to be in when I visit – it might seem unnecessary but it is a part of a concerted attempt to ‘make contact’ – probably in the precursor to other methods of outreach being attempted although to be honest, between the team, we’ve tried most things.

Last week, I had a call at the tail end of the week from a carer who is the daughter of a woman that I work with to tell me a close family member had died very unexpectedly. I assured that I would pop in this week. And there are a couple of pre-Christmas visits to people I am more concerned about – who have had particularly difficult years and might need some extra support and assistance through the so-called ‘festive’ period. I don’t say that as a cynic but simply that, in my experience, it can be one of the more miserable times of the year for those who are alone or without family.

I try to spend the week between Christmas and the New Year in the office and ‘dealing with emergencies’. I have scheduled a couple of visits for those I am most concerned about but generally, it can be a good time to catch up on paperwork when the office is quieter than usual.

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For me, I rather like Christmas. Girl wanted a traditional English Christmas. So I bought a Turkey.. for the three of us. I was intending to buy a Turkey Crown at the very most, just on a quantity scale and fear for the amount of food involved but she sounded heartbroken and REALLY wanted a leg of Turkey. I bought the smallest turkey I could find but I still worry about quite the amount of leftovers that it’ll be generated. I am trying to make it as traditional a Christmas as possible although ironically we never really did Christmas much in our house. We have some assorted presents under the tree but have had, unsurprisingly, a tearful weekend with thoughts of being away from family at Christmas time and a time that is emphasised as being for families to be together.

My friends and family have been good about including her in our present-giving and card-giving rounds. Especially grateful as I’ve been a little lax with presents this year!

Apart from Christmas, there’s the thought that my dad would have been 70 on Wednesday. Each of these ‘moments’ without him – my first birthday, his first birthday, Christmas/Festivals … they bring it home. If they weren’t so hard on the annual leave, I would have taken the day off to be honest because I doubt my mind will be particularly well-focussed but I have endeavoured to arrange some of my last ‘pre-Christmas’ visits for that day so I’m unlikely to hit the office (so to speak) very much.

But at least I have four days off over the weekend.

Are Social Work Lecturers out of touch?

This is a question which was raised by the Social Work Taskforce report and challenged by said lecturers in a Community Care article after the report suggested that there is an element of being ‘out of touch with current practice’.

When I was studying, and I’m going back roughly 10 years, there was a feeling that some – and by no means all – of the lecturers were trying to take a side-step away from direct practide as a concerted effort to free themselves from some of the day to day practide.

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Some unrealistic models were employed and the way we were taught certain issues did not relate to what we were learning from our placements.

It seems that this is still the case to a certain extent. Perhaps it is a feeling, from the ‘front-line’ that it is a ‘easy way out’ to revert to reams of research about issues that barely relate to some of the day to day practicalities and situations that are dealt with.

I know that my ex-university has made a step of taking on part-time lecturers who work in direct practice in the ‘other part’ of their jobs. I know because I’ve come across a few with their ‘social work practitioner’ hats on and we have chatted about their lecturing roles. It seems like a good way to inject some verve into the university teaching structures. From what I hear too, other universities are picking this model up which seems a little of the ‘best of both worlds’.

Sometimes from the front-line, it can seem as if some people are just too keen to get away from direct client experience as soon as they can – whether this is by taking a managerial post or by hiding behind the robes of academia.

I have always worked along the principle that I would not ask someone to do something that I am not willing to do for myself. It’s one of those lessons I picked up by doing the hands-on care work in a residential care home. I had more respect for those lecturers who have been through the mill and ‘served their time’ in social work teams for more than a couple of years, regardless of their current practice.

I don’t think direct and relevant practice experience is necessary in all modules or study areas. There are some parts of social work that don’t change and some that require a more academic base but I think a better course would have input from practitioners, even if it is on a visiting basis.

Social work as an academic discipline is very different from history, politics or philosophy. The motivation to study and to affect change in society is a key influencer in the development of the profession as a whole. I wonder if sometimes desk-based research can be seen as divorced from practice and that is why there is this divide.

Perhaps more integration of research into practice would be a way for front-line practitioners to see the benefits of engaging with university Social Work departments. For all I see it, and this is with a desire to engage as much as possible, any conferences, papers and research is delivered within and among the academic communities with little thought to how it might be disseminated outwards to the local authority offices and departments staffed with overworked, stressed workers who barely have a chance to read directly relevant proposals (New Horizons – which I have been carrying around in  my bag for a few days in an attempt to find some time to read!) let alone to take measure of the ‘research’ that takes place in these institutions.

That is why the lecturers can seem have a stymied view of practice.. it can seem a little like looking up into an ivory tower where knowledge shifts around from institution to institution in an attempt to inflate their egos and research budgets but if nothing filters down to direct practice, what is the worth in a discipline like Social Work.

Can Gerry Robinson Fix Dementia Care Homes – thoughts after the series.

Last week, I wrote about the programme in general and my thoughts after watching the first in the two-part series presented and put together by Gerry Robinson which explores care homes and how they can be improved.

In the meantime, the Guardian has published an article on their ‘Joe Public’ blog highlighting some of the negatives about the programme and its aim stating that, for all Gerry’s good intentions

the programme undermines itself through glib responses and cheap-shot TV documentary trickery. Gerry’s saintly interventions with residents are contrasted with portraits of indifferent, surly staff and a collage of shots of a favoured home suggests wildly unrealistic levels of staff and activities.

More seriously there is a disingenuous failure to acknowledge basic truths about the relationship between care costs and quality. The ambush and skewering of a breathtakingly stupid general nurse in temporary charge of a home and telegenic shots of the suffering there are frankly exploitative.

Perhaps I’m viewing it through different eyes and I can understand an accusion of exploitation. I recognised a reality in the programme that needs to be more widely seen. I don’t think all the staff, even those in some of the worse homes, were presented as surly or indifferent. I think what did come across that there is little funding in the sector and a drive for profits at the expense of good staffing ratios.

Partly, this is due to the costs of staffing and this was highlighted in the programmes. Private sector, profit-making companies have little incentive to up staff ratios if no demands are made of them.

The other element that was highlighted was the poor inspection regime – the best way to improve quality of care is to improve motivation and numbers of staff. Good quality staff are happy staff. Staff who are pushed to the limits cannot provide any quality interaction when they are running between one person and another attending solely to personal care with no time for the interactions to have much quality to them. Staff don’t want to work like that. They want to engage and have a job beyond washing and changing. Interaction makes a job more interesting and exciting.

Often it is about time – and time is precious. The relationship between care costs and quality IS crucial. If pressures are placed on the funding for residential care, quality will suffer. When local authorities are forced to drive down prices again and again, the quality will be felt in a real sense.

I can see how we, in the care sector, can draw up our shutters and talk about impossibilies. There is only a question of money. And that is the issue that needs to be addressed.

As long as the government talk about saving money by keeping people at home for longer, there has to be an understanding and acceptance that for some people with some needs, residential and nursing care is the answer and it can’t be ignored or pushed to the sidelines because more can and must be done to support those who are the among the most vulnerable and who do need 24 hour care environments. Sometimes costs can’t be cut.

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