There and Back Again

As I finished yesterday, I had left my first job and embarked on my little (well, it was two years) adventure and I decided to return to London and join the ranks of gainfully employed social workers again.

London Eye
I knew it was what I wanted to do. I had grown a little tired of living out of a suitcase/rucksack.  First thing I did was look for somewhere to live. I’d managed to secure room on a friend’s floor for the initial ‘return’ period.

I didn’t have too many boxes to tick regarding accommodation. I was looking for a shared flat ‘somewhere as central as possible’ because I didn’t know where I’d be working and of course, good transport links.

I registered with the social work agency I’d used before going. I needed to work as soon as possible so I thought I’d try and get an agency placement and could apply for permanent jobs in the meantime.

It wasn’t the flood of offers that I had been used to on graduation but a few noted signs of interest. I was concerned at how my two year break would look to employers. I didn’t have a massive range of experience but I got an interview and not only was it in an area ( adults services) that I was familiar with, it was also, by coincidence, in the same borough I had randomly chosen to live in. Walking distance – but just in case there was a useful bus and tube route I could hop on for speed.

I was nervous during the interview with the team manager while I was asked about a fairly standard scenario. I kept thinking about things I’d forgotten to say while I left and the manager didn’t exude any natural warmth, indeed, I could detect a hint of ambivalence at best.  At some points she almost seemed to snap at me. It was not one of those interviews you come out of with positive feelings.

Off I went on my day to day path to wait for the next calls. To my surprise though, they wanted to take me on as a ‘care manager/social worker’ in a much smaller adult services team than I had worked in previously.

I remember saying specifically in my interview that although I had a years’ experience, I had two years ‘out of the field’ and would need some support to get back into my stride. I didn’t want to be expected to pick up the baton immediately. I am glad I mentioned it but I realised in retrospect how hopelessly naive I was. Of course they nodded and smiled but they were paying high agency rates and I was given a caseload of things that had clearly been waiting for allocation for a while.

I was baffled by FACS (Fair Access to Care services) which seemed to have appeared while I had been gone. Direct Payments were beginning to permeate through the systems as had Carers Assessments although no one could really get any services from a Carers’ Assessment so it was just another piece of paper although I’ve tended to find the process of the assessment and discussion can be useful.  Charging was more widespread and the types of services offered where quite different from my previous place of employment.

Each desk had it’s own computer by this point and a new database system  had just been introduced – much to the chagrin of most of the staff.  All reports were expected to be typed up by now. I was also the only agency worker in the team which  had been so different from my previous job. Not only was I the only agency social worker but all the other social workers and care managers (qualified and not) had been there for a good few years. It wasn’t a transient kind of team. People rarely joined and always stayed. A good sign perhaps.

Saying that, they were the friendliest and most welcoming team that I’ve ever worked in and there was not a hint of any thought of me being ‘different’ because I worked through an agency. I was immediately taken under the wing of some of the more senior staff members who were the easiest people to ask questions of if a manager couldn’t be found.

And the rather ambivalent manager who seemed to scare me during the interview? She was one of the best managers I’ve ever had and then some more. She had a way about her of making people think she didn’t like them but when push came to shove, she would support her staff up to the hilt and seemed to rather savour arguments with more senior management. As I learnt, she had a fierce reputation throughout the borough but all the staff who worked for her were very protective of her. She spot-checked files when she was walking round the office to check notes were up to date and papers were filed in the right place.

She was also the manager who insisted we never refer to ‘cases’ and ‘files’ when talking about other human beings. Files were the physical paper documents, not the people and not the families. No-one was a ‘case’. They were individuals with hopes, dreams and aspirations. She was very strong on language and did not tolerate and thoughtlessness as she felt it reflected sloppy thinking.  Cases were not ‘difficult’  but rather ‘complex’. People are not ‘difficult’ just because they may not respond the ways we may want or expect to them. They take time or they have complex issues. I still refer to her use of language as a model to ways of thinking and interpreting things that I might find troubling about working in particular routine ways with particular people and families.

They say when you find a good manager, you hang around. Hang around I did.

I applied for the permanent job that my post was covering when I came up and am still working for the same borough although I moved into Mental Health services.

The manager I had, she retired a while back as have some of the people that shared the office with me, but others are around and we bump into each other from time to time.

They were difficult days and I struggled a lot at times, especially getting back some confidence in working in a field when I had been doing so many different things in the meantime but the time out of the country also taught me a lot about resourcefulness and self-belief.

I learnt about living in a different environment and culture and ‘being a foreigner’. I learnt another language. I learnt that there is a difference between solitude and loneliness and that being comfortable with yourself is inherently important. I saw amazing things, went to amazing places, met some amazing people and did amazing things.
Big Ben

Then I came home

To Say Goodbye

The best kind of ‘goodbyes’ are the planned ones. We can discuss with someone a couple of visits before their discharge from the service about how they might be supported on discharge and we have already, by this stage, put into place all the available means of support through both formal and informal means.

As we say goodbye, a recovered well-supported person waves us out of the door with a heartfelt thank you.

That’s a decent goodbye.

It doesn’t always happen like that. Sometimes people are desperately worried about being discharged from the service and you leave with either spoken or unspoken hostility.

‘How could they leave me like this?’ ‘I can’t manage without them’ – but you do and they can.

Sometimes it is after a review in a residential placement and you might leave someone in the hands of others to provide the care.  The nature of those goodbyes change depending on the restfulness and peace of the service user you leave behind.

A colleague of mine commented how sometimes you feel that you almost become a part of the lives of the people you work with, especially when you work with them for a few years, and then you flit out like a shadow and barely exchange more than a nod and a smile when you pass the street. If you pass in the street.

Sometimes you don’t get to say goodbye at all.

Sometimes death causes a one-sided goodbye.

Sometimes all you have to reconcile yourself is the missed call on your mobile from a service user who tried to contact you the day they died. And you didn’t answer. Not through ill-will or callousness  but through the general pace of work undertaken.

I wonder if he was trying to say goodbye to me. I’ll never know but I’ll imagine he was.

That’s what we do as humans. We ascribe our own personal perceptions of feelings to other people. And sometimes to animals. We can imagine everyone thinks in the same way as us. It can help though.

You see, we do flit in and out of peoples’ lives. But they also flit in and out of ours. Some more than others of course.

Each has a lesson to teach, a life lived. Opportunities taken, grasped and lost.

Each life was filled with hopes, dreams and aspirations. Sometimes things worked out and sometimes they didn’t.

This is the importance of reflection at every stage of this work. It contextualises events, lifes, people. We extrapolate out the lessons learnt for the next time and the things we could have done differently. Like pick up the telephone calls as they come in.

Sometimes you get a sense of when a life is nearly completion but sometimes it hits like a bolt out of the blue.

Sometimes you just wish it could have ended with a goodbye.

That’s when you realise the luxury that there is, on both sides, in a well-managed and well-scheduled goodbye.

You value them all the more.

The Past is Another Locality..

The RedBalloon office - an example of an open ...

Image via Wikipedia

I’ve mentioned this before, but I have worked in a couple of different teams within the same borough. Through fair means or foul, yesterday, I ended up in the office where I used to work before I moved to my current team, roughly five years ago.

I was there for a meeting in one of the side rooms but decided to wander into the open plan area (after making my way through much better security than there had been when I worked there!). Fortunately, someone ‘official’ recognised me and ushered me in.

The room had changed. They have  moved to ‘smart working’ with laptops and hot desking. They have little lockers with their names on, reminiscent of school – as the lack of personal desk space means that things can’t be, as they were, left on desks.

Some of the faces have changed as new people have arrived and older ones have left. Retired or ‘reconfigured’ to different teams.

But there were enough familiar faces for me to find a warm welcome. It had been a good team to work in.

I commented on the desks and the laptops and I was met with some level of surprise that ‘hot desking’ hasn’t yet made it to our offices.

‘No’, I said ‘we still have our own desks’.

I was met with wistful sighs of memories long past.

As I said it, I could feel the preciousness of those words – and acknowledged, internally at least, how rare they  must sound to this team.

We passed some general conversation about respective families before inevitably asking about work.

‘How are things going here?’ I asked tentatively.

A few nervous laughs and rolling of eyes.

‘Busy – but that’s pretty much a default decision’.

I decided to grasp the proverbial nettle.

‘How about.. the cuts?.. are they affecting you guys.. are there any jobs going?’.

I still work for the local authority but feel a sense of detachment as I am seconded into the NHS – so I don’t always get the same information as those directly working in the local authority might get. I was really eager to find out some more information.

‘Think so’. ‘Yeah’. There were despondent nods and acknowledgments all around. ‘There’s no money left in next year’s budget, let alone this years’.

I nodded

‘People are leaving and not being replaced – that’s mostly how we see it – but we are being asked to do more. There are rumours about people being asked to leave but we haven’t heard anything concrete yet’

They told me about services that were closing – day centres, sheltered housing losing the on-site wardens, posts being amalgamated.

The  morale was notably low. It had been a happy team, full of chatter and jokes. I like where I work now. I like the work I do now. But that old team had been and is the friendliest I had ever worked in, as a member of staff.

It was flat and clinical now. People didn’t have the same opportunity to build relationships with colleagues. There were no students (a couple of the social workers there, at least, are practice teachers and a few more on top would be workplace supervisors). Usually, when I have been there there were always at least a couple of students around, this time of year.

I asked.

‘Nah, we haven’t taken any students in this team this year. We just don’t know what’s happening in the service. There are more meetings planned but it isn’t fair for a student to be learning in this environment at the moment’.

I was given the names of a couple of people who had left or were about to.

It was the team I remembered but it was a shell of what it had been. The spirit had more or less been sucked out of it as we are increasingly turned into mechanised automatons drowning under paperwork in what had been heralded as a system of paperless offices.

I think I might have seen the future.

It wasn’t working.

It was inputting.

 

Office Jokes

Just a quick post about today’s Daily Mail headline which made me laugh aloud – literally.

The Mail bemoans the ‘Death of the Office Joke’ due to the so-called ‘draconian new equality laws’ that came into force yesterday.

News for the Daily Mail – and this might surprise them.

Jokes don’t have to relate to someone’s race, or ability/disability. It is actually possible to have perfectly entertaining office banter and have a wonderful work environment where someone or their religion/race/culture  isn’t actually belittled.

Is that REALLY so hard to believe?

Perhaps I’m ‘shielded’ due to the area I work in. Perhaps. Although, going back a few years, I was subject to some ‘comments’ that made me feel incredibly uncomfortable.

It was back in a different office. I was a fairly newly arrived agency member of staff in a new team. I’d been friendly enough but not gone into massive details about my familial or cultural background – just because it isn’t usually the first conversation I have with people as a matter of course.

And one of the other social workers came into the office after going to see an elderly Jewish woman. I think we can all see where this might be going….

She proceeded, with some vitriol actually, to explain exactly what her thoughts and perceptions of Jews were. I suppose some of the comments might have been construed as ‘jokes’.

I was surprised at how much I was taken aback.

Firstly, this was a way of talking that came from an individual for which I had a great deal of professional respect, who often discussed informally how oppressive the structures we work with could be. She was one of the first to stand up and challenge any potential inequity that came into sight. But she still felt she could comfortable have this conversation in this office.

Secondly,  I did take it personally. That surprised me. Of course she didn’t know I was Jewish but I can’t help it. Even though I strictly place myself in the ‘secular’ camp . it is an attack on a culture with which I identify myself. Sometimes I might laugh it off, with service users I have dodged the specific issues and moved to a more general challenge, but I wasn’t expecting it from colleagues in a social work setting.

Thirdly, no-one else challenged her. I thought about this. Maybe I was being over-sensitive. Maybe no-one else saw it as derogatory, or maybe I was more sensitive because identification.

I tried to challenge in a jokey way, you know, the ‘come on.. that’s just a stereotype’ and it was laughed off and forgotten.

Forgotten by everyone else except me.

We got on with the work but even years later I recall the way it made me feel.

A lot of people in a lot of environments have to deal with a lot worse – but no-one should have to go to work and feel that a part of their lives that may be a very fundamental part of their identity is fair game to be ridiculed in a work environment.

So I say, thank you to Harriet Harman, thank you for this excellent legislation.  Lots of jokes can be made that don’t offend or upset anyone.

Sometimes legislation follows public attitudes and sometimes it has to lead it.

Risk, Capacity and Ethics

I know it gets a bit boring saying it but these last few weeks have been  busy. Ironically, bearing in mind what I have said about caseloads, the ramp-up in the disproportionate time available versus things to do ratio has been related to just one of my cases.

For obvious reasons, at this point, I can’t disclose too  many details but it will certainly be one of the ‘classic’ case studies that just about hits on all areas of practice including a hefty chunk of ‘ethical practice’ and what that may or may not mean.

This is a situation where I have worked from the basis of an assumption of capacity in regards to decisions being made, of course, in line with the context of the Mental Capacity Act. My judgement is not necessarily in line with other professionals and observers but ultimately, I am the ‘decision-maker’.

So, capacity is established. Even that is not clear-cut as I believe the individual has fluctuating capacity – as is not uncommon but the periods of lucidity allow the assumption to be made at those points.

And one of those ‘unwise’ decisions is being made. An unwise decision, we are told according to the Mental Capacity Act is central to our essence and choice as human beings with capacity and the making of an ‘unwise decision’ does not mean that someone does not have capacity.

So this is the perfectly acceptable and legally sound basis for the decision-making that I have taken.

We are given various examples of ‘unwise’ decisions on all the training we attend about the Mental Capacity Act. Often there is an element of humour in the training, you know, a man who might decide to spend his fortune on fast cars at the age of eighty rather than leave his money to his children and this is not a matter of capacity just because it is  not a ‘sensible’ decision. We all as an essence of our humanity take risks and make decisions that others might find ‘not very sensible’ but that doesn’t mean that we lack capacity.

It is a very important tenet.

The difficulty comes when firstly, there is not a necessarily clear-cut consensus that yes, this person is making a capacitous but unwise decision and secondly when there are risks attached.

Risk assessment is by it’s nature a tricky line to step. That’s the problem – if we knew all the facts, it would be simple.

I have been picking up lots of nervousness about this particular case because I think there was an expectation that the capacity assessment would go the other way – but the Act is clear about starting from an assumption of capacity.

I have spent an inordinate amount of non-work time worrying about the implications of the decisions being made. I went into work early one day after one of the ‘major’ decisions have been taken because this situation had been dwelling on my mind and I wanted to talk to someone about it.

I found my manager (who is always in early!) and ground her ear down a little about it. She was very good and patient with me as I explained my difficulties in separating the logical part of my brain where I am absolutely confident my practice is sound and I have acted in the way that is both in the best interests and respectful of the wishes of the service user – from the emotional part of my brain where I just want to be able to help more than we, as a service can offer or deliver in its current form.

I chuckled as I asked her, kind of jokingly, if she’d back me up in front of the GSCC if things didn’t go as we hope they will. She, of course, told me to stop being silly and that had I done anything more restrictive or authoritarian than she would have been truly upset with me. But in a way, that’s the ‘easy’ route – that’s the ‘safe’ route. When we talk about risk management and risk aversion, I can see the benefits and as a professional who does wield power to make decisions about peoples’ lives – that power unnerves me. I can see how easy it is to err on the side of caution.

A part of it is that I feel that although I can be clear that personally, I am taking the path which I am strong about, I feel that the service as a whole is not providing exactly what this person wants and needs and should have – because the needs are quite specialised and specific.

This should be exactly where ‘individual budgets’ can come into their own but the processes don’t always allow for people who are outside the ‘norm’. This is very far from a straightforward – ‘give a man a budget and let him plan’ that neatly fits the agenda of the individual budget. As I have discovered – although it isn’t really discovery as I knew this all along – it is hard to do anything quickly when you are wading through a swathe of largely unnecessary forms. It is hard to present some truly innovative systems and proposals when the system only permits choice to a certain degree.

As a practice assessor/teacher in the workplace, my last student often asked me about ‘ethical dilemmas’ as it was one of their competencies. I jokingly said that ethical dilemmas were a key part of the job as anything involving control had to be and when we cease seeing our power and influence as a part of that ‘ethics’ dichotomy, we take for granted the decisions we make and the power we have – we become dangerous practitioners.

We had a module on ‘ethics’ as a part of my Masters in Social Work but I also have a BA in Philosophy. I used to laugh about it and often do still. You know, the jokes about unemployed philosophy graduates and all that. To be honest, often they are fair.

But more than ever I am glad of the firm grounding I when I studied Philosophy as an undergraduate. Ethics – studied in far greater depth over the years of the initial degree, which seemed such a inately impractical course has bloomed into life.

Logic with it’s quasi-mathematical formulae has led me and directed my thinking in ways that I might not have been equipped to do otherwise.

I wonder, if, in retrospect, the first degree in Philosophy has aided my self-reflection and my skills as a social worker.

I remember when I applied for the Masters and the preference was for social sciences and I worried that people who had studied Social Policy would be better considered.

Now, I think Philosophy was the best grounding I could possibly have had. After all, doesn’t applied philosophy just about cover everything we do?

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.