World Social Work Day

Happy World Social Work Day! A day to celebrate the joy of social work – I had an idea for a post planned but couldn’t let this occasion pass so my thoughts about the letter received by every registered social worker in the UK on Friday will have to hold for another day – oh the suspense!

Hilton Dawson, the incoming Chief Executive of the British Association of Social Workers, a former MP, writes a piece in the Guardian celebrating Social Work with much more eloquence than I would be able to muster pre-work but without doubt it convinced me that today should be for positive thoughts.

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I have said it before and I will again, just for effect – I’m incredibly proud to be a social worker. I might not shout out too loudly about in when out and about in public because I quite like my nose the shape it is already thank you very much, but when I look more globally at the work that is done and the work that I have been able to do, I’m very very proud.

It isn’t always easy – in fact, it rarely is. If it were easy, it would be boring. I have an opportunity and a window to walk with people through some of their most difficult moments and to convince, cajole and encourage them through it. Sometimes we make it out the other side, sometimes we don’t but at least by ensuring that there is a place to turn to, a number to ring, an ear to listen – it can make sense of some of the more troubling shots that fate plays with us.

Sometimes it isn’t about walking through scenarios with people, sometimes it is about making decisions for them or bursting into their flats with platoons of police officers to cuff them and assess their mental health. No, it isn’t fun. No, it isn’t rewarding. But thinking of the longer term – being years rather than weeks or months – it is something that is measured in degrees of the whole. Sometimes the decisions we make aren’t the ‘right’ ones. We work with risk. But we cannot afford to be afraid of risk.

I feel honoured to have the opportunity to share peoples’ lives. I see some of the pain that lingers behind the twitching net curtains. But I also see some of the hidden joys – some of the unexpected recoveries.

I qualified as a social worker in 2000. With about two years out where I had nothing whatsoever to do with anything related to social work, I have been working for almost 7 years in the post of a qualified social worker.

The most valuable things I have learned?

Clearly humility. You gain nothing by status and no-one goes into social work for the status, obviously. You cannot assume you know anyone better than the client and/or the carer who lives in that situation. Respect is a two-way street – you cannot and should never expect it unless you willingly give it. That obviously holds for users of services but it needs to hold equally for other professionals, care staff everyone with whom you have contact.

Advocacy – we learnt about the importance of advocacy and particularly self-advocacy as I was training. I have found myself most effective when I advocate for myself as well. We can dictate to our own managers what expectations should be made of us. What expectations we have for support and supervision. If we can’t advocate for ourselves we cannot effectively advocate for others.

Social justice underpins social work. When you are sitting under mounds of papers that need to be filed in front of a computer with a database programme that needs to be compiled, it is good to throw a thought back as to why the job is important and continues to be so important. We can’t escape the paper work or the database systems. We probably can’t truly learn to love them either. Unless we actively engage with those who are responsible for making these systems – at a national rather than local level – we can’t expect change.

And so I’m back to the letter we all received from Alan Johnson and Ed Balls – the content being too predictable, it did end with an invitation to discuss and engage with the Social Work Taskforce – with those who are deciding the future of social work in the UK (and an agony aunt from The Sun). I engaged. In pretty strong language – but not offensive language, I hasten to add.

I would encourage others who received their letters to engage – and if the requested conference date is full (as the one I wanted to go to is) – write directly because they do leave an email address (and I, for one, even got a fairly speedy response!).  It will not take long and it is important that we re-grasp the profession for what it is and not for what the media creates it to be.

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Dementia Strategies and Memory Clinics

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The National Dementia Strategy for England was launched yesterday with an impressive sounding 5 year plan to increase support people who are diagnosed with dementia and take through the different aspects that need to be worked on – from early diagnosis through to raising public awareness and raising standards in nursing homes by improving training for social care workers throughout the sector.

Some of the attention has fallen on the recommendation to set up ‘Memory Clinics’ around the country to support Alzheimer’s sufferers and carers of people with Alzheimer’s. I am not sure how much additional money is being provided.

A part of the reconfiguration of services in my own service was to allow for the setting up of a Memory Clinic. Four area CMHTs were merged into two plus a Memory Clinic. It was a what the management delightfully refer to as a ‘zero cost’ change – meaning that no additional money or posts were made available.

Of course, our new memory clinic hasn’t been running too long and setting up a service from stratch is never an easy prospect but there are a few elements that have concerned me.

Firstly – and this is a personal gripe so bear with me – the team is staffed by CPNs exclusively. Not that they aren’t wonderful, of course but there was no role for any social work input and that was a very deliberate move.

Our Memory Service is about diagnosis and then referral to adult social work departments if any kind of additional care is needed. I did suggest at the time that even having an unqualified social worker in post who could set up minor care packages at the very least, might make a more seamless service but this was seen as contrary to the ‘point’ of a memory clinic. It has a purely medical  model.

The CMHTs will take on people who have particularly complex needs or who have not been engaging with services as they always did but the staff have been moved out of the CMHTs to work in the memory clinic so we are even harder pressed.

Of course it is still early days. I am sure for some people it is a much better service. It means we, as a CMHT, are able to refer more people back to the Adult Community Care. That is seen as a bonus. I don’t think it is though. I came into my job from the Adult Community Care Team. I know that they have much higher caseloads than we do. They simply do not have the time to provide the same level of support that we can. Anyway, as I said, that’s a personal gripe with the way that our service was set up.

According to the BBC, Alan Johnson, the Secretary of State for Health, states  that

The clinics would be “one-stop shops”, offering expert assessment, support, information and advice to those with memory problems and their carers.

The clinics could be housed in hospitals, GP surgeries or in the high street, and patients could refer themselves, he added.

I’m not sure that our service has reached the ‘patients referring themselves’ part yet. We get most referrals  as always from GPs. These referrals still need to come in and when you work in a particular locality you get to know the various GPs and to be honest, almost all of them are great and refer if they have any doubts or concerns.

It still needs someone to actually make that trip to the GP in the first place though – whether an individual themselves – or a family member.

I can’t be the only person this has happened to but twice in the last couple of months I have made referrals myself to my own team when I have visited a couple at home and while visiting Mrs X have noticed that Mr X seems to be having memory problems. Of course the families involved have noticed but sometimes diagnosis is a scary prospect – even when, in reality, it is just a confirmation of something that everyone knew.

With all my cynicism though, more money is now going to be pumped into dementia services which is no bad thing as long as it is targeted money. If I were able to distribute it myself, I’d put much more into carers’ support, carers’ services and carers’ allowances.

So much of a patient’s quality of life depends on informal care networks. It is important that professional networks are available and most importantly are responsive but sometimes, providing actual cash to carers is much more important.

I would say some of the more valuable work I do is with carers and supporting them, at least psychologically, through some of the paths of dementia and the expectations of what may lie ahead when it reaches that point and gently nudging them to  make plans, make arrangements and preparations so that when the time comes at least they do not feel completely isolated or alone.

I see that the strategy is going to pilot a new role of ‘Dementia Advisor’. This, I think, seems to fall into this role but it can’t be a time-limited one. Someone does not need a dementia advisor solely at the point of diagnosis but it is important that there is a consistent through the process of deterioration and change. The strategy mentions that these advisors will be a place to turn for support for the person with dementia and their carer throughout. I assume additional funding will be available for these workers.

Some more and important positives of the strategy though is the recommendation for better dementia awareness and care in general hospitals. Having a team in a hospital that will advise and support patients who have dementia and improved training in care homes who are managing patients with dementia. It is hard to think that this can be a bad thing.

And there is also more money (if I have understood correctly) being put into research. Which can never be a bad thing.

Raised awareness of dementia, it’s broad reach and the implications and paths of care are all very positive. Some of the details – well, I’ll reserve judgement.

Just a reminder too, in the UK anyway, that tonight on BBC2 there is ‘Living with Alzheimer’s’ at 9pm –

Determined to prevent it if he possibly can, Terry Pratchett takes a personal journey through the science and the reality of what it’s like to be diagnosed with Alzheimer’s.

This two part documentary follows Terry’s race to find a cure as he endeavours to find ways of slowing, mitigating or even reversing its course.

I, unfortunately, won’t be watching – well, not live anyway. The snow flurry has blown my TV aeriel down  (which, if any of you knew me, you’d know how distressing this is as I’d say ‘TV watching’ is one of my prime hobbies (!)). At least I will be able to catch it on the iPlayer though .

Follow The Sun

Yesterday the make up of the shiny new government Task Force on Social Work was announced. This is a focus group who are to be involved in the ‘root and branch’ review of front-line practice of the Social Work profession as a whole in the UK.

The ‘team’ has been put together by the Secretary of State for Children, Schools and Families – Ed Balls and the Secretary of State for Health, Alan Johnson and are due to report back to the government this summer.

That doesn’t leave them a lot of time. Of course, I am sure there can be a million different views about the rightness or wrongness of the composition of this committee. Social Work runs across childrens’ and adult services. Social Work covers a wide gamut of interests and experiences. It is difficult for a committee which is small enough to function effectively to be large enough to address the differing aspects of the profession so the hope is that those groups not having a place specifically on the task force will be considered and represented by those who do have a voice.

The task force (I don’t know, that just brings back memories of the Falklands Invasion to me) has the usual members, some front line workers, some academics, some chief executives – but there is one member whose presence really is staggering.

Deirdre Sanders, the agony aunt of The Sun – remember, the same tabloid newspaper that carried out a vitriolic witch-hunt against individual social workers and organised a petition against them – has a place on this Task Force.

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I’m sure Deirdre is a wonderful human being. She writes very sensible letters in the newspaper (so I’m told). Am I the only one to be staggered that the social work profession has to engage journalists to discuss the future of their profession though at this level? Sure, if it were a task force on the ‘perception of social work’ or ‘improving the way that social work is reported’ she would be a valuable member of the team –  but honestly, a committee which is tasked with making changes to the social work profession?

It feels a bit like Ed Balls playing (again) a public opinion game with a profession that has had too much political interference for its own good.

Emma Maier considered this at The Social Work Blog and looks at both the positives of Deirdre’s appointment, namely that

giving The Sun the inside track on the taskforce could be a clever because it is always more difficult to slate something you are involved in. Having the popular press on side would help convey some of the important messages to come out of the taskforce. And the rest of the taskforce seems to offer a good spread of stakeholders from children’s and adults’ services.

It is something I hadn’t considered initially but then, why should a team of professionals who are conducting a serious review of the needs of social work in the 21st century have to get ‘popular press’ onside. Why should we, as social workers, need to work hard to involve tabloid journalists in our professional goals and developments. We should look at how social workers can work most effectively and beneficially for the public good and for the individual users of services rather than pandering to public agendas created by popular journalism.

Can we imagine a task force of any other professional group involving an ‘agony aunt’? OK, excepting a task force of journalists.. I guess that would work.. User involvement is represented quite rightly on the task force so why appoint a paid employee of the Sun newspaper. Will her presence, as I’m sure she is extremely articulate and able, overpower and detract from the serious discussions that need to take place about social work. Is this a true and honest attempt to improve and create a fundamentally workable system or is it a publicity stunt by Ed Balls. Again. Who seems to like using social workers are political footballs.

As for me, I feel honestly, insulted that my profession cannot be given the respect should command by the government.

I await the report in the summer with interest and no little trepidation.