On Professional Conferences and Frontline Workers

The thought for this post came during a brief conversation with my sister yesterday. I was berating and ranting about how I have a feeling that ‘no-one ever listens to us’. The ‘us’ in question, just to give the conversation some context, was front-line, currently practising social workers.

The reason for my railing was the way that I have been following the National Children and Adult Services Conference 2010. Mostly my links have been maintained through a variety of Twitter feeds that I am following. Twitter is good for checking while sitting on buses or when you are hanging around because you’ve shown too little faith in London Transport and turned up 20 minutes early for an appointment.

The National Children and Adult Services Conference has had a lot of influential speakers – ministers, shadow ministers, heads of various services and quangos. I see (and maybe I’m wrong in this) no place for actual practitioners at events such as this. It costs £500 a throw and there’s no way on earth any local authority is going to let loose anyone who actually works in the frontline access conferences that have expenses such as those.

Instead, they create little silos of managers talking to policy-makers talking to consultants talking to reporters. About Social Care. About us. But not to us.

Yes, Hilton Dawson speaks, the Heads of the College of Social Work speak but where are the people who actually work in social care at the front-line? Not in the managers’ officers earning comfortable pay packets to commission utterly inappropriate services and push us into working in unintuitive ways. We have a lot of people in ‘social care’ who would wince at the actual day to day work.

A few years ago, when I was in a different team (I’m sure I’ve told this story before, so indulge me for a moment or two), one of the assistant directors in the borough was doing an ‘on the coal-face’ type exercise. For some reason, I can’t remember why, I was ‘volunteered’ by my manager to take him out with me on my visits. I think because she was fairly sure I wouldn’t say anything rude! The cases I had on the cards (already booked up by the time I knew he was coming) were bread and butter stuff. Very straightforward and non-complex pieces of work – one initial community care assessment and one review with a carer involved.

On the second visit, when we were speaking to the user and carer, I explained what services we could offer, he chipped in and was very sympathetic – he was (I say ‘was’ because he is in a different role now) a really pleasant guy – actually offering more than we would under our eligibility criteria because it ‘seemed rational’. Afterwards, I explained to him that we couldn’t offer the care that he had suggested because it was outside the budget allowed by the authority. This surprised him. He had an idea how rationing actually works on paper but when you are on the front line telling people that they can’t get a service that they desperately need. That was a ‘new’ experience for him. He saw the stress of the carer and wanted to help. Wanted the service to be available for them. It wasn’t though.

It’s what I do every day. I am the person who tells users and carers that their local day centre is closing down and the social contacts they have made will be dissipated as the council see it as ‘unimportant’. I tell the overstretched and undervalued carers that respite has been cut because eligibility criteria have changed.  I am the person who people complain to when they get the bills for their care services and explain how ineffective the agency care workers are. I am the person who sits with someone in tears as we try and battle through a Self Assessment Questionnaire which has no subtletly  and reads like another DLA form, putting a price and a cost on something as ethereal as disability – especially fluctuating disability. I am the person who tells people they can only access minimal services because the criteria of the council have changed.

Not Paul Burstow. Not Andrew Lansley. Not the people sitting in the room at the National Children and Adults Services Conference 2010.  They may be experts in organisations but they are not experts in practice. They do not speak for the social care sector, they speak for the managers of the social care sector.

Now my sister, who is a lot less hot-headed that I, gently reminded me that this is not something that is exclusive to the social care sector. This happens in all industries. Managers talk to managers.

I have to wonder where the expertise lies.

When I hear Paul Burstow make statements about personal budgets and everyone nodding along at how awful it is on the ‘front line’ without any of them ever having an experience of going into someone’s home and holding the hand of someone who is terrified by another form, another set of bureaucratic functions that seem to be further removed from the reality of needing care immediately.

When I hear Cynthia Bower, I wonder how she would feel sitting next to me this week as I attend yet another safeguarding meeting at one of the ‘supposed’ ‘Good’ residential homes that can’t even manage the very basics of care and have not had an actual inspection for a couple of years.

Yet, she is the ‘expert’ who is able to make all sorts of claims about improving services by taking away controls and checks. And the managers cheer because THEY don’t like being inspected.

Sure, I complain about performance indicators. A lot. The reason I complain about performance indicators is not because I don’t think we should have our work measured objectively. I do. I just think some of the PIs are utterly ridiculous and have no relation to the quality of work we undertake.

Back to the National Conference of Children and Adult Services. It’s fairly interesting some of the noises that have come out of the processes. I know there are practitioner events such as Community Care Live. Indeed, on 17th November there is a Children and Families Event – definitely worth attending if you are involved in that area of work and available.

I know the different conferences are aimed at different groups. It would be interesting to know if they say the same things.

My father was involved in the disability advocacy movement as a disabled man. He expressed heartily the need for user involvement in the development of services (quite rightly!). Similarly, we in the profession need to advocate for our own professional roles in relation to our managers.

My message, and I’m channelling him now is ‘speak to us and not for us’.

One day, I’d like to see the same people attending events like Community Care Live as attend the National Conference of Children and Adult Services.

A future for adult social work?

Community Care carried out an investigation a couple of weeks ago which found that vacancy rates in adult and children and families’ teams were roughly equal therefore the news that the Migration Advisory Council have dropped specifically adult social work jobs from their list of ‘shortage professions’ while children and families jobs have remained may seem curious.

Further investigation though makes the move seem a little more nefarious.  The Guardian reports that

The decision to remove social workers involved in adult services from the official shortage list follows the introduction of new initiatives to increase the number of students on social work courses and to improve the retention of more experienced workers.

The decision to ban recruitment of international qualified social workers, however, will not apply to those involved in child and family services, where it is considered that a national shortage remains. The MAC’s report says recruitment difficulties in this area have been exacerbated by the negative media image of social workers responsible for children.

Understandable but it does beg a lot of questions. Are all the proposed new graduates expected to go into adult social work jobs? Or are there just going to be less qualified jobs to go round..

Hilton Dawson the new Chief Executive of BASW (British Association of Social Workers) writes in Community Care that

BASW regularly receives complaints from members in adult services who speak of major reductions in social work jobs and, significantly, of a devaluing and lack of understanding of the social work role. Social workers are beginning to feel excluded from personalisation. The unique and vital contribution that social workers can bring to this crucial agenda is being dismissed and ignored.

The Personalisation Agenda remains largely mysterious. There are a few pilots usually with capable adults who benefit massively from being able to design and determine their own packages of care and where the money should be spent but little of the literature (that I have come across – and I have looked) seems to approach those user groups that were and are poorly served by Direct Payments – namely older adults, adults who lack capacity and those with mental illnesses who have not benefited to the same extent as other groups. It makes the right noises though – user choice is, of course, an incredibly positive goal – more holistic, devolved power and services.

Although the aim of the NHS and Community Care Act was to create a role of ‘care managers’ who could help to pick and choose services from different providers and put together user-centred care packages in a holistic manner – and look where that ended? With councils bidding each other down to provide ever cheaper services from private companies who pay a minimum wage salary to inexperienced care staff to rush in and rush out of many homes and houses on tightly implemented limiting packages where there is no scope for any ‘leisure’ activities apart from local day centres – is that was what envisaged when it was laid before Parliament? I don’t want to be over-cynical but it’s hard not to be.

So where does that leave adult social work?

There is likely to be a continuing need in adult protection but the sizes of teams will not be equivalent. In mental health teams which move more progressively towards generic roles, Approved Social Workers have transmuted into Approved Mental Health Professionals – and although the place of a voice for the social model of mental health care remains more than necessary, there is a move towards job adverts more generically calling for ‘mental health professionals’ rather than Social Workers, or CPNs or Occupational Therapists.

There is no doubt in my mind that a signposting role has significant importance for older adults and some people, even those who might not fit into the criteria for a mental health team, do need more outreach work  but is that a place for statutory services?

Perhaps the future of adult social work is actually in the voluntary sector?

It isn’t surprising that protecting children is seen as more ‘urgent’ but really the levels of abuse of older adults is often overlooked – and although it shouldn’t be a case of ‘compare and contrast’ it is difficult to ignore the push to marginalise further vulnerable adults when honestly, abuse of a person is abuse of a person – cruelty is not dependent on age.

As care services become more tailored to the ‘30 min’ rush-in rush-out visits that rarely last 30 minutes there is a greater scope and need for a more cohesive protective and preventative service in a sector that has almost no lee-way to work on any preventative measures apart from for a very small group of people who might fit into specific criteria in a specific service.

All the focus and interest remains very much in the domain of those who work with children and understandably so – it is more emotive and of more immediate concern to the general public.

I wonder why it is so few people are actually concerned about the services or lack of them, provided for older adults. Personally, I think it’s because we don’t want to think about getting old – young people, children – they are ‘other people’ – older adults, they are our parents, and us – eventually. Sometimes we just don’t want to be reminded but one day we are going to have to be.

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.

image

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.

image