Making Adult Social Care Better 1

I think I’m fairly good at griping and raising ‘problems’. For the next week, I want to try and take a positive approach and look at solutions as well as problems.

A few conversations I’ve had over the past week have focused on what is wrong with adult social work and mental health social work at the moment but more importantly what can be done to make things better.

My frustration is that for all the discussions that take place in the sector, so few seem to focus on those of us who have worked and are working at the so-called ‘front-line’. A home carer knows about the ways that contracts have been managed and awarded at the lowest cost and they will be able to tell you with far more insight than any contracting manager about the effects of 15 minute ‘spot’ visits and the lack of dignity present in the care for older people. They would also be able to give you an amalgam of ideas which branch from consideration, knowledge and experience of a wide range of service users.

Are employed home care workers ever invited to discussion forums and debates about the future of care? No. But you know, maybe the feedback would be the most valuable.

On a more personal level it feels as if the conversations about service design and delivery take place around and above us – with us being the people at the front line of support. Yes, there are discussions  with service users and carers but how much effort is made to seek out opinions that do not fit in the model that the consultants want them to express? How many of the people who attend these meetings, discussions and debates become self-selecting.

If you create a service user group, for example, in a particular borough, it seems to me obvious that you are most likely to engage will be those whose voices are already heard through different means.

I like to set myself up as some kind of advocate in terms of having an understanding of the needs of people who don’t often have their voices heard in these kinds of meetings and debates because the discussions I have are mostly with people who are at their lowest ebbs on the scale of health and need.

For me, it is crucially important that these people are not left behind by commissioners and service design but my experience and understanding of the sector suggests that they are.

I don’t want to keep harking back to the roll out of personal budgets on the back of the model of direct payments but I will. The voices of those without support and without advocates are understandably quieter and the way that the services have been designed focuses quite rightly on choice but what is not present is a way for an equitable service to be delivered to those who aren’t for some reason able to express choice.

So things that can make things better

– Use of advocates in a more formalised manner throughout the system. Volunteer advocates have a role but I see more mileage in professional advocacy with extensive investment in non-directed advocacy as that is potentially where the greatest need lies. If I weren’t so tied to my job in terms of needing a salary to pay the bills, I would, at a flash, try to establish some kind of enterprise to focus specifically on support planning and advocacy for adults with dementias. I hope there is a role for independent social work in this area in the future – in the meantime, if anyone wants to jump on my idea and run with it, I am happily ‘open sourcing’ it.

– involving front line practitioners in conversations, debates and discussions with the local authorities relinquishing some of the reins of power in respect to conversation. Recognise our professional vigour and competence. We see people and have discussions with people that will never attend forums collectively. We can signpost and support commissioners and contracting officers but we are never asked and never given the time to think more creatively outside our little boxes of control. We have ideas and a happier, more connected workforce is an engaged and interested one.

– speak to home care workers too – those with agencies and where in-house services still exist, with them. They will have good ideas about the ways that their services are failing.

– home visits to facilitate discussions – why have all meetings in a central hall when it can be limiting regarding those who have greater physical and mental health needs.

Technology can facilitate greater conversation and communication with two-way flows but face to face discussion is still very important as technology and keyboards can alienate some people – perhaps exactly those people whom it is most important to connect with.

-Practitioners have to be more engaged with developments in the sector and unfortunately I don’t see BASW or the embryonic College of Social Work being particularly engaged with social workers. Why have social workers become so disengaged from professional organisations and unions? Is it to do with a fear of employers? I think some more group action could really build the strength of social work but it is hard to shrug off the feeling that we are a disengaged and disenfranchised profession that like to feel sorry for our collective selves and wallow in our diminished status. I think if we took a stronger political stance and stood up to our employers and their political agendas and displayed more independence of thought, we would be able to demand more respect.

I have decided that while I can moan and groan with the best of ‘em, coming together with ideas for improvement is by far the best way of making our voices heard.

Trade Unions and Strikes

I’ve written about my background and my somewhat ambivalent relationship with Unison in the past but today, as there is to be a widespread strike in the UK, I almost wish we had also been called out to strike alongside the teachers and the civil servants.
Marching through Piccadilly Circus

I’m very far from a ‘trigger happy’ union member. My default position has been to vote against any strikes called because I just want to get on with my job. Saying that, my attitude has changed over the last year or so since the election of this government and the dismantlement of the welfare state. The difference is that now, I’m angry.

Yes, I have a ‘public sector’ pension so the issue that today’s strike is about does affect me directly. I think the amount of jealousy and petty spirited hate that has been stirred up by the current government against public sector workers is distasteful in the extreme. We are portrayed as ‘fat cats’ milking the State while we depend on the poor private sector to prop us up. Oh, I might have a ‘get out’ because I could be regarded (although who knows on what definition that go) as a ‘front line worker’  but I don’t want to be patted on the head and distinguished from those who work incredibly hard to make sure that the work I do ‘at the front line’ can be carried out.

The administrative support, the IT support, the care workers (as we still have an in-house service) the emergency alarm cord operators, the library staff, the receptionists, the training department, the HR team and the accountants.

I want to know who these ‘paper pushers’ are supposed to be as most of the paper pushing happens in the executive offices or in the Houses of Parliament.

Over the last year, when we have had endless consultations about the cuts that are coming in our services and the changes that are coming to our jobs, I have seen the real value of union membership. As a member of Unison, I have attended regular meetings in our service and have gleaned a lot more information about the process than I would otherwise have had. We have been involved because the council has needed to involve us and yes, some of the shop stewards can be a bit bolshy, but that has been a very necessary characteristic in their dealing with the council.

I do wonder if BASW’s idea of a Union of Social Workers would have the same fire and resources to fight so strongly on our behalf as local authority employees. At the moment, I am very happy with Unison and the way they have supported and informed us through these difficult times.

As for today, good luck to those on strike. The issue they strike about today is also my issue but my anger is much broader than the pension issue – it is the destruction of support in society and the way that those who have least as being asked to pay.

I have learnt more in the last year about the importance of union  membership than I had in the previous ten. I don’t expect to ever follow blindly but I do value my membership much much more in these uncertain times.

Lansley, Nurses, Social Workers and Colleges

Yesterday, as a part of Lansley’s so-called ‘listening’ exercise, he found himself at the conference of the Royal College of Nursing (RCN) as they voted in favour of a  motion of no confidence in him personally by a fairly substantial 99%.  Rather marvellously when you take into account the 13 abstentions, only 6 nurses voted against the motion of no confidence. As was mentioned on Twitter yesterday, it seemed to be a miracle that 6 were to be found.

You’d have thought that that was quite a strong message for Listening Lansley to have paid heed to but no, he wanted to give a perception of listening (as if the vote of no confidence wasn’t a strong enough message!).

He asked for 60 specially chosen RCN representatives to talk to him while he ‘listened’ for 90 minutes in a room to which press were not allowed.

Well, nothing wrong with listening of course. I shouldn’t scoff but I can’t help it amid Lansley’s gruff and graceless apologies. Why? Because the listening should have been done before the plans were announced. The listening should be done with a whole wide range of people who have an interest in the health service.

He has got it wrong  but he doesn’t seem to want to listen as much as try and persuade and regroup around his message of privatisation.

The message from the Royal College of Nursing was strong, and powerful and it has caught the news media. People listen to nurses when they say things are wrong.

But we can’t forget how wrong the government got when they brought these proposals to Parliament in the first place. What does it say about a government that has to do its consulting AFTER it has taken a Bill to Parliament that has been so strongly attacked on all sides by public and professional opinion. It doesn’t exactly make one comfortable that we are ‘in safe hands’ as they like to promise at election time.  Maybe it’s because all the consultations they did before the Bill was presented were with private companies and party donors.

This is a government which is struggling under the surface and has been caught out already on many occasions by acting without any idea of what the plans that they propose actually signify. It is when they try messing around with the health service that people sit up and shout back but what about the other measures that they have proposed like the changes in the welfare benefit systems which seem force degrading and inappropriate ‘tests’ to claimants to jump through hoops to get the money they ‘deserve’.  This is what we need to speak up against as well.

And one of my sadder moments yesterday, when I thought about the impact of the nurses and the fact that they are at least being listened to for press purposes, is how we, in social work, have been poorly served by the organisations that supposedly represent our interests.

We should look at the RCN and what they have done and the effect a vote of confidence had on the ridiculousness of Lansley’s ‘listening’ exercise when with an almost unanimous voice they have humiliated him. Where is the nearest equivalent social work voice?

Community Care reports that the Chief Executive claiming that ‘he simply doesn’t believe’  Unison’s figures of having 40,000 social work members.

Honestly, is that the best he can do in rousing his members? Is that the best we can do as social workers when we should be at the heart of opposing the government agenda to heap the cuts on those who have the least? We just get into squabbles between Unison and BASW about who has the most social work members? Who is going to ‘lead’ the College of Social Work? Are we going to have a ‘Chief Social Worker’? Surely better to have a broad members organisation that can speak for all social workers rather than split members into different ‘camps’.  As for me, I’m a member of Unison AND a member of BASW. Generally, I’ve seen value in both.  It isn’t about a competition about who has more members and some people like me would be counted twice in the figures.

More than anything we can see the importance of having a strong, national voice as a profession and as representatives of a social care sector that is being and has been ravaged by repeated governments. Perhaps a broader College of Social Care might not  have been a bad idea.

The stronger the body the louder the voice.

Of course, that isn’t going to happen. It looks like we will be left with a College that few social workers who are on the front line will be interested in because we don’t have time for the politics within the profession. We have too much to do and need to focus on the politics of the country before everything that we know and love about this society is lost.  So while the College or Colleges (depending) spend all their time and money rewriting competencies or capabilities or capacities again and again and again ad infinitum – some of us will just be getting on with doing the actual work.

But the shame of it is that a College of Social Work/Social Care could perhaps have been a voice to shout against the Welfare Benefit Bill and the ridiculous tests that are put in place to make decisions as to ‘eligibility’  in the same way that the nurses are a voice to shout against the health and (oh the irony) social care bill.

We should be more like the nurses. We need to be if we are to survive and have relevancy.  We need to be listened to as well.  But in order to be listened to, we need to build support up amongst ourselves rather than squabble like schoolchildren. That is the pity.

BASW vs College of Social Work

It was with more than a little weariness that I read in Community Care that BASW (British Association of Social Workers) may be about to launch their own ‘rival’ College of Social Work having been in dispute and frozen out of the ‘official’ discussions with the embryonic ‘College of Social Work’.

My first response was sheer exasperation. I’m a member of BASW. I pay a not insignificant amount of money to them annually for that privilege and I have a generally warm feeling towards them (I wouldn’t be a member otherwise!). I don’t see them as an alternative to a union although I would actually prefer it if they were. I like the idea of a more specialist union but I’m also a member of Unison, the public sector trade union and I also pay them a not insignificant amount of money for the privilege.

A little disclosure before I continue. I’m a little miffed with Unison currently. I know their reps must be incredibly busy as jobs are going and people are being asked to take salary cuts but I’ve been trying to contact my branch officers for weeks about something at work that affects a few people – phone calls, messages, emails and haven’t even had the courtesy of a response. I must have paid them thousands of pounds over the years, have never asked for any assistance before and honestly, on the scale of things, this is a fairly minor matter and have been wholly and completely ignored. Harumph to Unison but you know, I’ll of course, keep paying. And paying.

But back to BASW and the College. BASW it seems are being steamrollered by the College and are trying to put up a fight in the form of an ‘alternate college’ plan.  It is ironic seeing as BASW were so forceful in pushing for the existence of a College of Social Work in the first place.

BASW, it seems are unhappy with the deal that has been made between the College and Unison –

Under the deal, Unison will provide employee representation services to college members and the college will provide professional advice services to social workers who are Unison members.

First, I welcomed this potential merger but I do see an issue if BASW are going to be frozen out of the process.

As a lay-person, I see the potential role for a College of Social Work to be almost an exact equivalent of the services that BASW provides apart from having a statutory footing and the addition of trade union functions via Unison. It seems more than a little uncouth to push BASW out of the process.

I know that BASW don’t have a large membership base. It can seem almost cliquey at times but as a newly qualified social worker with limited money, if I had to choose between union membership and the membership of a professional body, I would go with the union membership every time just as a means of self-preservation.

That is what BASW have to face up to.

The problem is that they seem to have taken some kind of decision to split off from the process of establishing the College of Social Work. Whether they are right or wrong (and I don’t necessarily think they are wrong) there is a big problem of perception about being seen as ‘disruptive’ to the process. I can see how they might feel betrayed by the process of these different interest groups vying to positions of power. Retrospectively, I think they should have been given the lead role in the establishment of a College rather than SCIE (Social Care Institute of Excellence) but that’s all in the past now.

I say this with a heavy heart, but I’m not sure BASW can exist as an independent ‘College’ and I am not convinced that their branching off will be successful in the long run. I would have prefered a BASW-led college but I think we are now too far down the ‘other’ path.

My ‘perfect’ solution would have been some kind of mass consolidation of BASW, the College and Unison (or trade union functions by another means) but that looks nigh on impossible now.

The problem is that there are few enough social workers who are engaged with the process of actively wanting to be involved in these organisations as it is.  All these bickerings will no doubt put many people off membership of ANY of the organisations. You don’t want to ‘pick the wrong one’.

These rumblings leave a nasty taste in ones mouth and may be a disincentive for people in the social work profession to become involved.

Which will lead to the same people who like ‘being on committees’ and being at the head of things – mostly managers who can give themselves time off work for these things or retired/independent members – to run the same organisations and to claim to be speaking for ‘front line social workers’ when, in fact, none of them do because the ethereal ‘front line social workers’ are way too busy working to be bothering themselves with who represents them!