Social Work and Moving On

soraya nulliah goodbye perfect

In a couple of weeks I will be leaving social work. Or will I? I am moving into a job where my social work qualification is not an essential requirement. I am moving away from ‘frontline’ practice in the way that I have always understood and defined it.

Being diligent, I remain registered as a social worker by the HCPC (Health and Care Professions Council) and there is no doubt, therefore, that I can continue to  legally be entitled to call myself a ‘social worker’ but the job I will be doing is not ‘social work’.

I am incredibly proud of being a social worker so it is a shift for me. Of course, as I will be remaining in the sector, my experience will be crucial in the new role but I will no longer be building that same types of relationships on a personal level that I do (or at least I hope to) now. I will be working in a different way.

The next few weeks, then, will be filled with reflections. I am saying a lot of ‘goodbyes’. I have been in my current post for many years and the current council for even longer. I am saying goodbye to the people who are on my ‘caseload’ – some of  whom will be reallocated and some of whom will be discharged from the service. I am trying to get everything done but I know the way life works isn’t about neat closures.

I’m also saying goodbye to a local area I have worked in for many many years. Familiar streets, blocks of flats, estates which have so many faces and memories entrenched in them. There are roads and buildings I can’t walk past without remembering some of the people that lived within them and gave them the flavour and character of a neighbourhood.

I think of some of the people I worked with who had no one else to remember them. Isolated, detached from families by distance, ill-health or circumstance. Then I think of the families I saw, the warmth and kindness and hope within some of the depths of poverty and the tragedies that life can fling at people without recourse to ‘fairness’ or ‘equity’.

I’ve had the honour to work with some immense people who have opened up to me and allowed me to share some of their most difficult moments and I have worked alongside people who have struggled so long and hard with such dignity or pain.

I have put in services and tried to offer suggestions but – increasingly, I have also removed and denied services to those whom I felt would have an improved quality of life if they were provided.

I’ve learnt a lot about the value of good health and knowing ones limits. I’ve learnt enough about the effects of alcohol to turn me near enough teetotal (not entirely mind!). I have learnt enough that even the best planning can’t protect one from accidents or fate.

Ill health affects across all social classes, cultures and belief systems. I have walked into houses which have made my jaw drop, some through opulence and some through squalor. I have tried not to judge but to listen and respond – sometimes it can be predominantly about listening and hearing.

I have had good and not so good managers and feel so fortunate in my current role to work in a very supportive team and organisation so it is with sadness that I see how the cuts over the past couple of years have ripped the heart out of a service and professionals who really were, even if it didn’t always look like it from the outside, trying to do their best.

‘Doing our best’ will not be sufficient anymore. While a government talks of parity of esteem between mental and physical health and further integration or establishing the ‘dementia challenge’ which focuses on better diagnosis, it’s important that we do not allow those who spread the cheap and hopeful words around freely to believe that parity of esteem will not cost. Establishing good and supportive dementia services which focus on what happens AFTER diagnosis will cost and that integration has to involve more change that asking everyone to sit in a room together and do team building exercises.

When I look at adult social work and mental health social work, the two areas I have worked in and I see how things have changed, it is not only this government I look at with despair, it is the previous government too.

Ed Balls played political games with social workers and bought into the Sun criticism in the wake of the tragic death of Peter Connolly. All main political parties have backed the privatisation of care services without building in sufficient protection and until the personalisation agenda actually offers the same benefits to someone with dementia without a supportive family as it does to an independent adult with a physical disability I will see that it is not yet a success.

So I’ve seen a lot of changes but not all bad. I see a great hope in the profession as we can work harder on developing an independent voice that doesn’t need a battling professional organisation which can’t stop its bickering and pettiness or a ‘Chief Social Worker’ chosen by civil servants with no knowledge of what the heart of social work is to ‘speak for us’.

Let us speak for ourselves and find more ways of doing so. Social Work is a profession to be proud of – we just need to make sure more people know about it – and we need to put some more fight into it. Fight politically, fight against cuts which affect those whom we work with, challenge within the organisations in which we work and remember that we need to create and build a profession to be proud of for ourselves – because no one else will.

Not a ‘media officer’

Not a soap opera

Not a fly on the wall documentary

Not a professional organisation

Not a ‘college’

Not a Trade Union

Not a government-appointed ‘chief’

We have to claim the profession back from the narrow definitions that successive governments seem to be forcing us into. Social Work happens outside local government – something I am about to have a far better understanding of.

It’s going to be a weird few weeks for me as I grapple with my own professional and personal identity. I rather feel I won’t give up the fight wherever I go – I hope not. There’s still a lot more to be done.

pic by soraya nulliah @ flickr

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Carers Week – More than Words

Building Blocks of Art
‘Carers Week’ begins today. While the ‘official theme’ of the week is ‘In Sickness and In Health’ with a focus on the health of carers, I would provide my own theme from my position of having worked in social care for a fair few years as ‘more than words’.

Carers’ need more than accolades in order to feel supported and be supported properly. We need to be able to provide resources and that needs money.

Over the last 15 or so years, there have been definite changes in the status of ‘carers’ in social care organisations.  We have rolled out ‘Carers Assessments’  and have been able to provide services for carers directly as a result of new legislation. While we  assess the needs of carers – what we don’t have and where the disconnect exists – is a duty to provide services and nor national criteria about where a service should be and must be delivered.

The problem I face all too often is revolves around carrying out Carers’ Assessments (of course there is a target for these) but not being able to actually provide anything as a result of them. To which the obvious question I am asked is ‘Why do them if they only provide information to the Local Authority?’.  My local authority, fortunately and for now, at least, is fairly generous with carer support and direct services but this is by no means universal.

Mother watches over

I have been fortunate to see and provide some excellent services through direct payments made to carers and in a lot of ways, the services I have been responsible for providing as direct payments to carers have been a lot  more successful than some of my experiences with direct payments more broadly. I am able to encourage assessments with the possibility of a direct service provision as a result but I know this is by no means universal.

Assessments in themselves can be useful if they are conducted well and sensitively. Sometimes allowing a carer to have the space to discuss their own needs and explain fully the care they are and do provide and the effects that this has on their own wellbeing/goals and lives can be valuable – however there comes a point when this has to be acknowledged in a more ‘real’ (and yes, that can mean costs) way than smiling and nodding. More than words.

I’ve also seen an increase in the ‘posting a carers assessment out’ style of assessing which can lose some of the subtleties gained in a conversation and a visit. Of course, not everyone wants an assessment because the language and the questions can be formalised and particularly we get the ‘I’m not a carer, I’m a spouse/child/parent’ response but I’d counter that’s something that can be addressed by a change in the way of ‘paper assessment’ and the language and discourse models that exist around social care. Why can’t we be more flexible regarding what an assessment actually is? Do we have to ask the questions on the form?

We give, others receive but that’s a tired model – particularly in relation to carers who give us, as a service and organisation – much much more than we can ever give them.

So why is it reduced to a paper assessment logged onto a computer database? Because that allows performance indicators to be met.

My ideal service would be more flexible about the ways that assessments are compiled and would allow much more for free text and less on box ticking. Box ticking can help some clarify but it by no means captures what role caring plays in all lives. ‘Caring’ is not uniform. There are a myriad of needs and a myriad of ways to both communicate this need and for support to be delivered – or there should be. If people want boxes to tick, by all means provide them but if they want open space to discuss or write or record what and how they feel about their role and what might help, then allow that too.

We also (in social care) need to work on our assumptions a lot. Families exist in different ways and have different histories. There may be many reasons that don’t need to be disclosed about caring may be more difficult in particular situations and assumptions can be very damaging.

The new Adult Social Care White Paper is imminent, apparently. There needs to be a commitment not just to assessments of carers but of delivery of services and support to carers. More than words.

While the government talks about ‘respite’ and the need for breaks, I’d argue that is essential but while the provision of services is being cut and there are fewer, more distant places to offer respite the realities will remain as far from the government planning as they are at present. Capital investment and investment in decent staffing in homes that offer respite consistently would help. Clear explanations about entitlements and potential costs would help. Services that speak to each other would help. Pooled budgets would help but the easy words come thick and fast. The solutions can’t be found by words alone.

The current system as it exists relies on carers significantly to ease the burden of cost of the social care system. This needs to be more transparent in terms of publishing details of how indicative personal budgets are arrived at and the amount that is ‘saved’ by a carer. If some of these ‘savings’ (not even a minute proportion – but some ) is ploughed back into effective and personalised support with professionals who are able to access and feedback good, local information and provide support and training to carers where they want it the savings over the long term would be much higher.

The cost of poor support for carers is much much higher than the cost of good support – but in these times of ‘belt-tightening’ it can be forgotten while we reach the goals of short term savings.

It’s a lesson that both the NHS and social care systems would be mindful to heed.

In order to support carers ‘In Sickness and In Health’ the government, the organisations such as the NHS and local authorities, employers and communities needs to provide ‘more than words’.

Images by W4nd3rl0st at Flickr and Sapphiren at Flickr