Bank Holiday Thoughts

A small pause for reflection. Firstly to thank everyone who responded to the poll I put up last week and to those who left comments both publicly and who contacted me privately.

I was, to be honest, close to giving up altogether last week but I have paused, reflected and reconsidered.

I will attempt to write longer, more considered posts but a little less frequently – maybe with updates between 2 – 4 times a week rather than the daily updates I had initially planned when I started.

I have password-protected some posts – not because there is anything earth-shatteringly compelling – indeed, they are all posts that have been public at some point – if you have been following me, you aren’t losing anything by not having free and ready access to those posts.

The reason I password-protected them, is that I believe they do or could identify me more fully and I know for a fact now that my blog has been picked up and read by people who work in the same team as me (which is the actual reason for the crisis of confidence!). Please do feel free to contact me via the ‘contact form’ for the password if you are interested in any of them but don’t expect mind boggling revelations behind the password because really, there aren’t any!

But for the meantime, thank you to everyone who has read, written, commented and contacted me via email. It’s been a wonderful experience and journey.

I’m also in the process of setting up a completely unrelated private site. I like writing too much to stop completely. I won’t link it or direct people there as I actively want to be more open and less anonymous.

A friend told me last week, as I was talking that we shouldn’t put anything on the ‘internet’ that we wouldn’t be comfortable putting our name next to. I think they were referring more to Facebook update statuses! But although I will retain an anonymity, I want to bear that in mind as I write.

Could you do it?

‘The Social Work Challenge’ is a short ‘quiz’ to test social work skills and to try and highlight some of the complex decisions made by social workers in child protection.

It was sent to me and I think the intention was that I pass it on to publicise it and to help generate discussion and understanding of the role of the social worker. It’s certainly an interesting exercise!

It is part of a campaign being run jointly by the ADSW (Association of Directors of Social Work) and the SSSC (Scottish Social Services Counci)l.

It’s good they are being proactive in publicising and demonstrating the work of social workers. Now let’s see what the GSCC (General Social Care Council) in England can come up with!

In fact, the more I read about the campaign and the structure of social work in Scotland, I’m quite tempted to just relocate up there but that’s probably another story for another day!

If anyone feels like it, respond with how you got on – either here or directly on twitter to @socialworkscot (which is the twitter account of the Social Work Changes Lives Campaign!)   with the #socworkchallenge hashtag!

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Vacancy Rates

Community Care have published a special report into social work vacancy rates in the UK. The report finds that 1 in 10 social work posts in the UK are currently vacant according to information that they have put together following a Freedom of Information request.

There has been a big push towards social work recruitment over the last year, indeed, the article states that

In England, where the government has invested £11m in recruitment campaigns and at least £28m into the reform programme, vacancy rates have risen from 10.9% in 2009 to 11.3%.

I would expect it’s too early to see the benefits of these investments as a lot of the push was towards social work training so it may be interesting to see any changes in the amount of people applying to study social work degrees has changed but it’s still a very high rate.

The breakdown of figures shows that the highest vacancy rates are  in the East of England at 15.3%, running slightly ahead of London at 15%. The lowest vacancy rates are in Northern Ireland.

It’s interesting that Northern Ireland, Wales and Scotland have lower vacancy rates than England. England is less cohesive and there are more variable elements. The GSCC seems to have lost its way somewhat and there is less of a shared identity across the whole of England perhaps.

Social Work according to another article in Community Care, has a different status in Northern Ireland where it seems to be (or at least, that’s my inference from the article) more highly respected and sought after – meaning that universities can be more selective and that vacancies are more likely to be filled by competent applicants.

In Scotland, the example is given that the workforce may not be as mobile and that social workers are more likely to live and work in the same areas.

The problem is, well, one of the problems is that the higher the vacancy levels, the worst the strain is on the current workers and the more likely they are to burn out or leave – leading to the problem existing in a cyclical nature.

There doesn’t, from my brief glance, seem to be a definite trend as to whether the vacancies are in adult services or children services.

For example (using London as it is what I am familiar with)

Waltham Forest has vacancy levels at 47.8% in children services and 16% in adult services whereas Richmond Upon Thames has children vacancy rates at 26.1% and adult at 43.1%.

(come on Richmond, you must be able to do better than that !)

Those are just a few of the examples.

These figures don’t surprise me. We knew as much last year and this is not a situation which is going to solve itself within a year. The changes I, personally, have seen in the year – well, we’ve had people leaving our team whose posts are not going to be recruited to. Reconfigurations have meant that those posts have now ‘officially’ disappeared and therefore wouldn’t show up in any statistics on vacancy levels but they are vacancies because there are fewer people to do the same amount of work.

On a real level, that means quality slips, mistakes are made and increased pressure makes a less healthy and potentially more expensive (sick leave) workforce.

But this isn’t news to anyone. This is common sense.

Going back to the initial article and report there are a few things that worry me and I am speaking from my position as a social worker particularly in adult services.

Tim Loughton has written a piece for Community Care pledging to bring down vacancy rates in Childrens Social Work. He is the Parliamentary Under-Secretary of State for Children and Families. But – he has also been tasked with overseeing the social work reforms. Of course his priority will be seeing to the childrens’ services. That is where the political capital is to be gained.

Again, Community Care emphasises this explaining

English councils can now access a share of the £23m local social work improvement fund for children’s services promised in March.

Other programmes aimed at children’s services in England include the development of an advanced social work professional status, due to be launched by the Children’s Workforce Development Council next month. Keith Brumfitt, director of strategy at the CWDC described this as “a retention and reform measure to keep experienced people in frontline jobs so they can share their expertise”.

Where is the input regarding Adult Services – where in there any government minister showing an interest or pledging that social work in the adult sectors will be injected with cash or promoted or that our services are actually vitally important.

It shouldn’t need to be a competition but my worry remains that with the money and the focus on vacancies in childrens’ services, adult services which are suffering equally and more silently, will be slowly sucked dry of any expertise.

Community Care teams will be replaced by Support workers who validate self assessment questionnaires as they come in but the underlying principles, training and theoretical base is lost and Mental Health teams slowly replace social workers with ‘mental health practitioners who can come from a wide range of disciplines of which social work is one’.

Social Work has a lot going for it. It is a lot more than administration.

To me, this is the ultimate legacy of the NHS and Community Care Act and the advance of Care Management to the stage that there is no longer any need for a professional background to carry it out as it increasingly becomes more about ticking boxes.

Hope remains in the form of the Reform Board though and possibly developments attached to the establishment of the College of Social Work.

Things can only get better.

Consultations

The BBC report that Unison, a large public sector union (disclaimer – I’m a member), is challenging the government’s plans to ‘shake up the NHS’ as proposed by the ‘Equity and Excellence : Liberating the NHS’ White Paper that was much discussed a few weeks ago.

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Initially I scoffed at the thought that this challenge would be going anywhere, but I think they have a fair point.

Basically, the issue on which the challenge is being made is an interpretation of  what a ‘consultation’ involves.

The Constitution of the NHS states that the public, staff and unions have a right to be consulted over changes made within the NHS and on the other hand, the Chief Executive of the NHS has sent letters out to all NHS chief executives telling them to implement the changes immediately.

Do I think the challenge will make any difference whatsoever? No.

I’ve been involved in a few NHS consultations around service reconfigurations in the past as a ‘member of staff’ and to term them ‘consultations’ has almost been an insult to ones intelligence. They have never been anything other than paper exercises in which the ‘men in suits’ have produced shiny documents about changes they want to make and have made no attempt to listen or consult.

Oh, there might be a 2 hour meeting in a hospital at the other end of the borough of which you are given less than a weeks’ notice or a page or two on the website with no structured form but just a free form invitation to ‘respond’ but never has the result of the consultation been anything other than what was proposed from the outset.

In fact, I’d venture a guess that the cost of the consultations and the associated consultants/project managers are wasting resources when a decision has already been made.

The truth is that there is no core wish or desire to know what ‘people’ want – whether those people are staff or patients within the service. On the most recent occasion, we were told about the ‘consultation’ which apparently had been going on for months, about a week before it finished and it was a matter that intrinsically involved every one of us (I use us to mean employees in the team in which I work).

It’s easy to be cynical until I was reminded of the constitution’s statement that this is an obligation. I wonder that it has been so flippant in its implementation.

Good luck to Unison though – I don’t expect them to have any long term success. The changes are coming but there does need to be a lawful implementation of these changes and if they need to consult, we have a duty to respond.

The consultation document is here.

For the record, the ‘local HealthWatch’ referred to is described in the document as that body

‘which will act as local consumer champions across health and care. Local Involvement Networks (LINks) will become the local HealthWatch.

Like LINks, their services will continue to be contracted by local authorities and they will promote patient and public involvement and seek views on local health and social care services. We propose that local HealthWatch be given additional functions and funding, so that they become more like a “citizen’s advice bureau” for health and social care – the local consumer champion’

So I thought ‘I don’t know what ‘LINks’ are – I’ll look it up. LINks (which currently exist) are

Local Involvement Networks (LINks) are made up of individuals and community groups, such as faith groups and residents’ associations, working together to improve health and social care services.

There is a proposal that they will have a greater influence and maybe it’s a part of the ‘big society’ and ‘consulting’ process but I do wonder and worry as to whether specific interest groups can position themselves in these bodies. It was the ‘faith groups’ part that worried me to be honest. I have nothing against faith groups – some of my best friends are very religious (true!) but I don’t want them trying to monitor or make decisions about how health care is delivered in my local area, thank you very much. I may have to do more LINk investigation at a later date because, for now, I want to concentrate on the discussion document.

These are the questions asked in the document

The Government would welcome views on the following questions:

‘Q1 Should local HealthWatch have a formal role in seeking patients’ views
on whether local providers and commissioners of NHS services are
taking account of the NHS Constitution?

Q2 Should local HealthWatch take on the wider role outlined in paragraph
17, with responsibility for complaints advocacy and supporting
individuals to exercise choice and control?

Q3 What needs to be done to enable local authorities to be the most effective
commissioners of local HealthWatch?

Q4 What more, if anything, could and should the Department do to free up
the use of flexibilities to support integrated working?

Q5 What further freedoms and flexibilities would support and incentivise
integrated working?

Q6 Should the responsibility for local authorities to support joint working
on health and wellbeing be underpinned by statutory powers?

Q7 Do you agree with the proposal to create a statutory health and
wellbeing board or should it be left to local authorities to decide how to
take forward joint working arrangements

Q8 Do you agree that the proposed health and wellbeing board should have
the main functions described in paragraph 30?

Q9 Is there a need for further support to the proposed health and wellbeing
boards in carrying out aspects of these functions, for example
information on best practice in undertaking joint strategic needs
assessments?

Q10 If a health and wellbeing board was created, how do you see the
proposals fitting with the current duty to cooperate through children’s
trusts?

Q11 How should local health and wellbeing boards operate where there are
arrangements in place to work across local authority areas, for example
building on the work done in Greater Manchester or in London with the
link to the Mayor?

Q12 Do you agree with our proposals for membership requirements set out in
paragraph 38 – 41?

Q13 What support might commissioners and local authorities need to
empower them to resolve disputes locally, when they arise?

Q14 Do you agree that the scrutiny and referral function of the current
health OSC should be subsumed within the health and wellbeing board
(if boards are created)?

Q15 How best can we ensure that arrangements for scrutiny and referral
maximise local resolution of disputes and minimise escalation to the
national level?

Q16 What arrangements should the local authority put in place to ensure that
there is effective scrutiny of the health and wellbeing board’s functions?
To what extent should this be prescribed?

Q17 What action needs to be taken to ensure that no-one is disadvantaged by
the proposals, and how do you think they can promote equality of
opportunity and outcome for all patients, the public and, where
appropriate, staff?

Q18 Do you have any other comments on this document?’

I may spend some time now reading the document and formulating a response – at least to those questions that I have an interest in – particularly Q17, I think. I’ll probably print the responses. The problem with consultations is that they can be done with little fuss or fanfare and the legal obligation is fulfilled. Often the decisions have been made in advance and would be best made as a group response rather than individuals responsing – indeed, some organisations make a business of it – but if it is a way of having voices heard at least, even if they don’t end up going anywhere, it is a chance that someone might stop and think about some of the implications.

What would you like to see here?

I’m having some thoughts and second-thoughts about where I want to go with this blog. I have been concerned to be honest, that I’ve been putting in too much of the personal stuff and have actually adjusted some of my posts to ‘password protected’. This is likely to be a temporary measure while I have a think… but in the meantime, I want to ask you what direction you would like me to go in.

Thanks!

Facebook and Kindle

I have set up a Facebook page for the blog. It took me so long because I was trying to work out privacy settings and some such and created a ‘new persona’ in order to set the page up – but it’s there and as soon as I work out how to put a widget in the side bar, I’ll link it there.

It’s linked to my twitter account and I hope to use it mostly as a depositary of interesting links as I come across them but I can’t promise it will be wildly active (that’s why I never went into Sales!).

I also (ok, this was a bit of a vanity exercise, I admit) have the blog published on the kindle. So you know, if you really really want to and you have a kindle (which you probably won’t as the UK ones aren’t released for a couple of weeks) you can go and subscribe there!

And if anyone out there has their own blog and wants to publish it on the Kindle format – go here.

It took  me a while to find the link but I’m happy to share!

Bel Mooney, Disability and Sex

There is something of a theme for the week and while I wanted to move onto other subjects and events, I was unfortunate enough, in my daily trawl of news websites to come across this ignorant abomination of a ‘column’ by Bel Mooney in, yes, you guessed it, the Daily Mail.

There is so much in it that angered me starting with the headline

The madness of offering the mentally disabled sex with prostitutes at taxpayers’ expense’.

What decade does she exist in that she thinks that ‘works’ as a headline. ‘The mentally disabled’ – thereby she says all she needs about her own attitudes and prejudices, immediately stripping any humanity from those who have learning disabilities of a wide range and using their disabilities as their defining point and mark.

Also this ‘taxpayers’ expense’ lark – I wish there were a greater understanding of the role of Personal Budgets for this reason alone. Everything is at the taxpayers’ expense. Trident is at the taxpayers expense. Soldiers in Afghanistan is at the taxpayers expense. Being a taxpayer gives me the right to decide on some of the things for which public funds may be used at elections but we all pay tax. You know, Bel, it may surprise you but even disabled people pay tax.

Phew.

It gets worse of course as she brings up the chestnut of ‘human rights’ and smirks and sniggers at the woolly do-gooders, in the persona of course of the man’s social worker’ who obviously have little understanding. I wish she would attend one of my AMHP (Approved Mental Health Professional) or BIA (Best Interests Assessor) Forums. She would be hard pressed to find a less woolly bunch of people who are incredibly keyed in to legal minutiae and who tear apart case law savagely piece by piece. Compassion and wooliness do not have to co-exist.

Then she goes on to show a widespread ignorance of the Putting People First agenda which she might well have typed into Google but she might need to use more robust research tools than Wikipedia to have any kind of authority.

She writes

The 21-year- old’s trip to the Dutch brothel, where he hopes to lose his virginity, will be funded through a £520million scheme introduced by the last government called Putting People First: Transforming Adult Social Care.

The original 2007 document (written in the usual tedious socio-speak jargon) sets out Labour’s ‘ambition to put people first through a radical reform of public services, enabling people to live their own lives as they wish… and promote their own individual needs for independence, wellbeing and dignity’.

If she had done a little more research, for example, she’d have discovered that the precursor to the Putting People First agenda was the Direct Payments legislation which was implemented and championed by the previous Conversative Government who were all in favour and pushed through the 1996 Community Care (Direct Payments) Act. The Putting People First agenda was an attempt role out the steps taken in Major’s administration to a wider ‘audience’ and in fact, if anything, broadened the scope of the direct payments system. So blaming the Labour Government doesn’t quite work here.

This is NO TAXPAYERS MONEY – This is NOT A STATE ‘HANDOUT’ – this is money which is provided to meet social care needs and would have been spent – possibly at higher levels in any case. The idea is to save the taxpayer money – believe it or not – by achieving better outcomes to the service users and more choice.

So her next point that she

can’t help wondering about the ‘human rights’ of all the sad, shy people who write to my Saturday advice column, desperate for love and – yes – sex.

No one will give them a handout to buy what they cannot find in the usual way. No one considers it their ‘right’ to have a holiday paid for from the public purse just because they’ve got mental problems – as so many have. There’s no lobby for the lonely.

Now, I’m sure most Daily Mail readers can sympathise with the ‘sad, shy people’. But there’s a big difference – they do not have disabilities that preclude them from making the same choices and they would not be entitled to any services under the increasingly strict ‘Fair Access to Care Criteria’.

And this ‘right to have a holiday paid for from the public purse just because they’ve got mental problems’ – she fails to ‘get’ the CRITERIA part of the conditions. The money is not given because ‘they’ve got mental problems’  but because they have an illness or disability that severely restricts them in many ways and these are not ‘holidays’ – often the holidays replace respite breaks which would otherwise have been in residential care homes in the UK. Does she think her ‘sad, shy people’ would REALLY be eligible for residential care services?

She picks up nicely and ties this all in with the demonisation of social workers which is such a strong theme of the hateful Daily Mail – because y’know, all these ‘madcap’ schemes are dreamt up in social services offices. It’s all the fault of those woolly social workers.

She highlights that

The assessment is carried out by a social worker, of course, and the payment is given in addition to benefits.

And it seems that many councils, through their social workers, are using the Putting People First money to fund visits to prostitutes and lap-dancing clubs, sex courses, subscriptions to internet dating sites and holidays in places such as Tunisia.

How many times does she want to emphasise that this is all the fault of social workers? Not enough, it seems. And seriously, where is the evidence for ‘many councils’. She has come up with one case example and if she’s going to use the example of the holiday to Tunisia, I’d fight to the death that it is a much better and cheaper use of public money than a week in a residential respite home in Bognor Regis. Surely the right wing understand the beauty of CHOICE – that is why the programmes were brought in in the first place.

She goes on to tell a couple of stories of people she has known who had disabilities and had relationships and good for them. Seriously.

Personally, although I feel fairly neutral about using money from Personal Budgets to pay for sex services, the matter is that this is a question of choice from people who have the capacity to make these decisions but need assistance in the arrangements of these services.

I have personally recommended various internet sites to help people make social connections – not for sex or even for love but through common interests and yes, one of the Personal Budgets I set up included a laptop and broadband subscription. I know, it’s nothing racy but it has improved the quality of someone’s life more than an afternoon a week at a day centre would have.

I would place more value on a loving mutual relationship than casual sex but that’s my own decision and perception – maybe disabled and not disabled would make other decisions and the idea is that decision remains with the service user and not the social worker and that is the key misunderstanding and ignorance of Mooney. She thinks that somehow this money is ‘controlled’ by her, as a taxpayer and that the social worker makes decisions on behalf of the user.

There are stringent requirements and they are met. No more money is spent than would otherwise have been and why should we set stricter moral bounds to people with disabilities than those who are able-boded and able to make choices for themselves.