| THERE IS A CRISIS IN SOCIAL WORK & SOCIAL CARE OK - What is Social Care & Social Care work? Let's answer this question and, in the process, attempt to bring back greater Dignity and Status to this important area of community work; both for Practitioners and those they care for, or otherwise support, in the person's caring for themselves. The 'Empowerment' of users of our services is almost impossible without our own re-empowerment. Practitioners are often the role models and potential advocates for those they support. Idealistic? - No, I do it every day I go to work, so do others - TC. Lets first look at the 'contexts' of Social Care Work: Social Care has always been there, within the wider social work discipline. Many good social workers came out of the Care Worker and Unqualified Social Worker and Health Care positions. Many good nurses did also. It was a way into the professions for people who were not naturally, or particularly interested in the academic, intellectual, increasingly legalistic and pretentious side of Social Care (i.e. Social Work :-) ). The professional and public status of Care Workers has never been particularly good, but was seen (and treated), as having relatively lower status, once 'Generic' professional Social Work started up in earnest. There were few incentives for excellent Care Workers to remain within these key caring positions. They understandably migrated through the Social Work structure to find their appropriate and often deserved professional status, often displaced from the most effective, social-therapeutic, direct roles. In doing so, these critical, Personal Care Skills and High Level, Intuitive Social Skills, were constantly being lost to the Social Care workforce but Social Work gained some of its best practitioners as a consequence. To some degree, there were always others desperate to take their place. Unfortunately, the cyclic process continues and the Skills Resource, at the Social Care base, never really achieved any great stability. This, in turn, affected status, quality and conditions of these services, pushing more workers out to the 'higher order' professions, of Nursing, OT and Social Work, etc., or into other professions and commerce. The Haemorrhaging of Direct Care / Therapeutic and Specialist Social Work. In the early stages of this process, we attempted to keep these natural and well practiced competences (along with the developing & learned Social Work Skills) within the Direct Care institutions, i.e.; Residential, Day Care, Social Training Centres, Community Work and Domiciliary Services. The powers to be, at the time, largely lead by members of BASW (A self Preservation Organisation - committed to keep Social Work elitist and in the dark ages), gradually sought to differentiated social care from social work. These same self appointed, elite members have enforced this differentiation through the GSCC, making Social Care a poor brother (sister) rather than a vigorous partner. This is no accident. Such practitioners never liked to get their hands dirty, or take direct responsibility, but they do enjoy the power & control. They are in positions of power and control that have produced the largely ineffectual, inefficient, uneconomic services that the public and media rightly criticise (even if they don't fully appreciate and understand the purpose, or potential benefits of community care itself). These early, Direct Care, Social Work institutions were well motivated and quite healthy. Incoming Care Workers had a natural progression (with training) to become specialist Social Workers, with high level Social Work, teaching/Training and Social-therapeutic Skills. The status that this carried, improved the status of the institutions that they worked within. Clients were more empowered, because staff were more empowered to empower them. These institution still thrive in some UK inner-cities, in the United States and else where. UK Rural Areas are about 20-30 year behind and still talking 'ideas' that were implemented at least 20 years ago, else where. To give a clearer context for the gradual emasculation of Direct Care Social Work; BASW is a kind of 'Masons' of Social Work, many members are in powerful position in Social Care / Social Work institutions, influencing (rather badly) the development of the craft and the intellectual development of Social Work (including through the Universities). This is what I describe as the 'intellectualisation' of Social Work'. This is not to say there is anything wrong with intellectual understanding, 'as part of a complete professional skills package'. Social Care Workers have, consequently, again become the 'cheap' eyes, ears, arms and legs of increasingly detached Social Work and Health Care institutions. Before then they were social work. The quality, skills, competencies, insights and attitudes of (Social) Care Workers were always very varied. They were employed with the clear intention of providing personal care, often under close supervision and often with very little acknowledged practitioner discretion, being required to follow tight policy and practice guidelines. In 'fact', Care Worker's provided an insightful and skilled, 'monitoring' and 'intervention' of Risks and of developing crises. In 'fact', often without it being part of their explicit brief, they are undertaking important roles in the socialisation, befriending and motivation of clients. In 'fact' they undertake the most important aspects of 'social work' as a true skills set, within any meaningful definition of the term. They are, in practice 'Social Workers' at the sharp end of things, providing most of the important interventions, with inadequate support, pay, recognition, or appreciation. If those in positions of being concerned for professional reputations wish to 'protect' Social Work as a concept and as a professional practice, they had best re-incorporate Direct Care Social Work within the Social Work brief proper. In the absence of that, the errors of Social Workers and poorly supported and inadequately recognised Care Workers, will reflect upon the institution of 'Social Work' and the status of its practitioners (as, in fact, it already does). The approaches being taken by GSCC and CSCI (rather than the Government policy itself) is often insidious, dishonest, contentious & detrimental to clients, families & communities we support. Motivations towards Social Care Work: The reason for taking up this kind of employment has varied from 'wanting to help and care', through 'making a living doing something useful', to 'earning some extra cash', to supplement family income. Another motivation is, perhaps, to obtain flexible hours work, in order to help bring up a child as a single parent. There are countless other good and a number of bad reasons, of course. This loose motivation for seeking these forms of employment was to be expected, most practitioners are young, or part time, or those seeking flexible hours: Given that the more recent Social Service objectives for Social Care, is mainly to provide supplementary, practical support to Clients, at the lowest possible costs, we can expect to attract a wide range of people, with differing motivations, levels of skill and varying care philosophies. This wide range of skill mix and attitudes, has its problems but there is also a significant benefit from this form of motivation, which I hope to illustrate later, contrasting it with more formal, 'training' approaches. In more recent years (in the UK), and particularly since the re-organisation of the Health Services, the 'slave wages' end of Health Care has been exported to the Social Services and its agencies, at least in terms of the funding obligation. The Social Care demands have significantly increased as a result. The social / community care funding has not kept pace. Neither has the status, or wages of Social Care & Health Care, Care & Support Workers. Add to this, the increasing demands arising from alcohol and drugs problems, family break up, survival in to disabled older age, and increased expectations for community care and support; the demand now outstrips the supply of good quality Care Workers. Put bluntly, and honestly, there are not enough willing, or able, to continue to work for the poor wages, the inferior conditions of service, with the relatively low status, even taking account of the contribution made through immigration. This is especially the case; given the potential for excellence and strategic importance of this Direct Care Social Work, to the dignity and safety of our various, increasing numbers, of service users. This is particularly important, now that these qualities are a legal requirement and an increasing expectation of our population. Where there is a statutory obligation (and it is right that there should be) then there has to be the statutory resources to meet that obligation (that is simple logic). This ultimately falls to the Direct Care Social Workers. Statutory obligations should be met out of the public purse - fact. You want something - you pay for it! That is a responsible attitude. If governments do not responsibly apply this principle they can not expect citizens to do so. The fair and honest way to distribute the burden of statutory obligations is through the tax burden. Get used to it people. If you can no longer hide your social problems away (you can not) and you can not stand watching vulnerable people struggle; pay the price for their dignity, they earned it already and it is now their rightful, legal entitlement. In summary; With the painfully slow implementation of Community Care, for each of the Client Groups in turn (it has taken 30 years), there has been a gradual and persistent, year-by-year increase in the requirement for 'Community' Care Workers, especially since the 1970's. The reasons for taking up this employment have not changed significantly. The career structure, status and promotional opportunities have actually diminished in many instances (relatively speaking). This demand will continue to grow, we know that. People, thankfully, still have a genuine desire to provide Care, there are just not enough of them available and willing to meet the demands & needs. The only way to attract more (and to retain them and their skills) is to make the salaries and conditions more attractive 'to remain in Direct Care Social Work'. The inherent skills in Care Work are more substantial and significant than first appreciated. They equate and measure up very well against the systems, 'techniques' and 'methods' of other, more specialist professions, given the trust and legitimate opportunities to express these skills in practice. I have demonstrated this in practice on frequent occasions. Career Opportunities in Social Care Work: Those 'higher status' Social Care jobs, like Care Managers, Home Managers and Shift / Care Leaders, now have less professional autonomy and often, lower wages and professional status, relative to equivalent social work structures. The Domiciliary / Home Care and Residential Care Home agencies are largely privately owned and operate with very limited funding for providing the demanded, consistent, high quality standard of services for the Statutory Sector. This affects Charitable and other None-Profit Organisations also. This re-organisation was a government strategy for cost savings, that demonstrably works against its legally defined objectives to increase and improve standards, in keeping with all the Human Rights legislation. Such contradictions are not uncommon but none-the-less make government, and Local Authorities & Health Trusts (who contract out these services to the private sector), culpable for the consequential deficit in the consistent provision of these services. Someone needs to sue a Local Authority for this shortfall. Things may then improve. There is an obligation on all Service Providers and Fund Providers, to record failures to adequately service the Needs and Risks to Client / Patients and to monitor Quality and Best Value criteria, laid down by Government. Many agencies consistently fail to do this competently. Many deficits, although locally recognised and spasmodically recorded, are inadequately collected and presented to the appropriate Government Agencies. The typical excuses used, for these known 'shortfalls' and deficits, can be demonstrated to be flawed. They are, in fact, largely a consequence of same poor executive management and inadequate resources to undertake all necessary tasks. The service is being provided on the cheap and there are consequences, including stress and distress (and associated ill health) on the part of workers and managers in these professions. There may be inadequate recourses available to executive & line managers, but to pretend the problems are due to individual 'competence' at the bottom end, is actually criminal. I have directly heard and experienced these statements. Again, someone should sue. Perhaps the pretence would then end. There is little sympathy, from many, concerning the funding position in the private sector, but it is the quality and choice of service to the 'Service User' and 'Carers' that is at stake. Even with the best will in the world, on the part of private, charitable, non-profit and voluntary organisations (all of which are retained to provide services to the statutory sector), it is generally recognised that there is inadequate funding to maintain consistently, good quality services. This is especially since the expectations and demands to meet Care Needs and Risks Management are increasing yearly, with the previously described governmental policy and legislative inducements. There are also the increasing costs of good, on-going training, adequate professional supervision, the staffing necessary for 'reserve staffing banks' and to provide the additional resources to meet the other costly, statutory and administrative demands placed upon these Agencies (and their staff). These demands are increasing and the responsibilities and culpabilities of Care Staff out-runs the professional status, conditions of service, quality of training and remunerations that they enjoy. The same can be said for the demands and obligations placed upon Professional Managers of these services. Lets be blunt here and use the language of frustrated Care Providers, individually and as Institutions. Pay people peanuts and treat them like crap and you are bound to pee off quite a few (I kept it polite in the end). The best often leave care work, some become 'jobs-worths', some become increasingly disillusioned and despondent. Others just play the game and get by. What you see is what you get, what you get is what you pay for (in the end). A few make the lives of others almost impossible! But more of that else where. Many Care Staff still eventually migrate towards Social Work, OT, Nursing and other Professions, or get out altogether. The good quality staff that do remain, and persist in spite of the unreasonable pressures, often risk their physical and mental health. The constant demands on time, energy, shift work and adaptation to increasing administrative commitments (in addition to the increasing levels of required care responsibilities) have their toll. Add to this the following, just as further stressing examples: - The persistent, dispassionate and often judgmental scrutiny (felt & actual), by CSCI, the crucial Vulnerable Adult investigations and other, allied Professional Groups, who are aware of the critical pressures on Homes and Services. CSCI is often naive in dealing with the fact that Client / Residents evolve, become more dependent, more disabled, develop mental illness and can become more challenging.
- The enforced movement clients, for the above reasons, works against the stated objectives of Community Care and of many Care Homes. Funds, other Community Resource Input and Specialist Professional Support are needed to meet 'Best Practice' objectives. Face the Facts, CSCI and Funding Agencies. (You are not engaging Monkeys, just paying for them).
- The contradictory demands of Fund Providers, Service Purchasers and Referring Agencies, Requiring Agencies and staff to meet increasing demands and challenging behaviour, at minimum costs, with minimal supportive input, while expecting this not to risk producing Vulnerable Adult and other Risk & Conflict situations.
- The secondary and rather diminished status of Care Work & Community Worker, within the GSCC, relative to that of Social Work (and Nursing). Maintaining this distorted differential and institutionalising it through an apparently legitimate and independent Professional Body. It may dishonestly help ensures low cost services. It also distorts the service provided, increases risks & diminishes the opportunity for professional growth in this sector.
- The inadequate institutional and academic appreciation of well practiced Intuitive Skills, highly tuned 'Critical' Physical & Social Care Skills and Adaptive & Social Skills, developed by way of life apprenticeships. There is (in keeping with many modern professions) a distorted focus of academically achieved intellectual skills and competence. Many modern problems in health and social care can be shown to be a direct result of this distortion.
- Being constantly measured by the worst examples of practice, as depicted in the media, without acknowledgement, from CSCI and Funding Bodies of the inadequate resources, or the inappropriateness of Competitive Tendering in gaining 'Best Value' for clients.
- Being at the bottom of the pecking order, yet knowing you are providing an equally important role to that of other professionals. In being in that position, and effectively maintained there, it artificially 'reduces' the credibility and status or complaints and recommendations, relative to other professionals and Agencies with (vested interests).
All this adds to the increasing frustration and personal toll in Social Care Work, and still they keep coming (although in diminishing numbers). Part of the negative inducement for care workers to stay is, ironically, the maintaining of this low status mask. In doing so, agencies neglectfully suppress the confidence of many of these workers, for substantial periods, ensuring they remain in post beyond their potential to progress to higher status employment. All this means that moral and motivations are relatively low, in response to the inadequate incentives. The usual, reasonable inducement to obtaining and retaining staff are all but absent, beyond the personal desire to provide a service and constantly prove themselves. This is not good enough and has been the cause of many of the problems that the agencies have exhibited from time to time. This problems are not limited to Social Care Workers and the Service Providing Agencies they work for. But; They are the least rewarded and lease supported individuals and organisations. Bottom of the pecking order, with the least status and resources. The greatest direct responsibilities and culpability and the least autonomy and authority. To continue in brief: Least Choice, Recognition, Status, Authority, Opportunity, Resources, Appreciation, Remuneration, . . . . . . . . . . . . . . . . . . Some things never change, but then, then there is an interesting parallel with the natural and skilful, caring commitment of Mothers, in ensuring the welfare of their children. This has only more recently become appreciated as a high level and important multi-tasking skill set. Unfortunately this was after most Mothers were induced (by deteriorating employment conditions) to go out to work to help support families (often undertaking social Care work, utilising these high level, critical skills). Life is full of such ironies, is it not? The Professional & Managerial Context of Social Care Work: Professional Social Work Training (this is for those who may wish to retain a potential to become Fund Holding Managers and Executives of Social Services and Health Trusts) could do well to concentrating on some basic Maths, the advancement of basic interpersonal & care skills and Guidence in modern 'motivational' management techniques (as practiced by companies like Intel and Microsoft). The Social Care sums do not add up to consistent good quality services and the disproportionate responsibilities in Social Care / Social Work relationships do not add up to responsible and accountable practice on the part of Social Care and Social Work Managers and Executives. This has always been the case for as long as I can remember in Social Work (some 30 years). Moreover, Line Managers and Executives recognise the shortfall and do not adequately, publically disclose them, or enable their ease of disclosure by Social Work professionals. This is an obligation under the Community Care and Health Services Acts. This obligation is both as part of the specific package of care being provided to individuals (Carer Plans), or in the general budgetary assessments of the funding requirements for Care Provision in general (The Audit Commission). As a consequence, the provision of Social Care still very much relies upon the good will of Social Care Workers and Health Care Support Workers, who are increasingly being asked to undertake Assessment, Medical and Risk Monitoring duties and extensive Incident Recording, as part of their daily work, in addition to their very much, full time direct care work. The cost savings are obvious but so too are the training, accountability, risk and culpability issues. So, What is Social Care and Social Care Work?: The best amongst the Care Workers (and they will just about recognise who they are) survive in a tension between doing what they believe is best for Clients and the frequently irrational implementation of institutional restrictions, geared mostly to 'protect the backs' and poorly argued budgets of Social and Health Care Funders. A further feature of these 'purchased' services is the substantial recording of largely inefficient and ineffective, statistically & legally required data, inefficiently justifying the service being purchased and the risks encountered. Who determines the Policy 'context' of these operations?: Professionals who decreasingly have direct contact with clients and Family Carers; Service Administrators working within a legal framework of restrictive practices, that ensure as little is spent (as credibly possible), on the direct services to Clients & Carers. These services being consciously delayed until needs & risks have reached a 'substantial, or critical' stage. Prevention is avoided as a saving. Someone can pay later, 'off my shift', paralleling political time frames. This, of course, ironically means spending increasing amounts of money (and time is money) on the assessment and review processes. A process now disproportionately focused on supposedly saving money and justifying actions, rather than ensuring the longer term cost benefits of maintenance, recovery, rehabilitation, and de-institutionalisation, of clients in their chosen Community, or Residential & Nursing Homes, which they are forced to accept because of limited choices (due to inadequate state funding support being made available from poorly argued and ineffectually justified budgets). Who are the Social Care Workers? Social Care workers are usually highly skilled, dedicated and motivated Practical Social Workers, capable of demonstrating natural skills in Counselling, Training, Advocating, Motivating, Health Monitoring, First Aid intervention, Medication Administration, Conflict Resolution and Humour; as well as the essential and competent physical & practical care and the effective mediation of physical & social risks to clients. These skills have often been honed in the process of caring for siblings, offspring and the disadvantaged members of their own families, or their own personal recoveries. These skills would often be supplemented through other, allied vocational practices and the application of good common sense arrangements (if left to be). Social Care Workers are often, either young, quick to learn, highly motivated, client focused, innovative and experienced junior family carers, with a keen interest in Care Work in some form, seeking enthusiastic, committed and positive encouragement, skills training and professional recognition (in life apprentices). Or, they are professionally dedicated, highly experienced, considerate and attentive Family / Social Carers with the ability to pass on skills to their younger and less experienced colleagues (Master Craftsperson's, having completed life apprenticeships). Using natural, competent, enhanced social skills; basic ergonomics, personal, domestic & nurturing skills; adapting these, utilising essential commonsense and gregarious communication, in collectively considering, interpreting and adjusting these skills to an individual's particular needs. These practitioners have, historically, been the subjects of research, by psychologists and others, who have, from this evidence of effective Social Care Practice, produced the 'clinical' approaches used by other, more intellectual and academically inclined professionals. They have the abilities and resolve to persist in their tasks, irrespective of the disrespect, prejudice and abuse frequently shown towards them; by their distressed clients; the more demanding and distressed client's family members and other frustrated professionals, involved in the discharging of complicated, often contradictory, professional duties. All sides have limited time, resources, autonomy and appreciation. Social Care workers have the least vocational rewards, beyond the satisfaction of doing a good and meaningful job. All in all, taking even the average amongst Social Care Workers, they produce exceptionally good results, given the lack of financial reward and relative lowly status, compared with Social Work and Nursing counterparts. In a world that is overly impressed by 'average' intellectual and academic prowess, the humble but highly skilled, largely self educated, creative, intuitive, adaptable and intelligent Social Care Worker achieves their status by trial and demonstrates their competence in relatively private humility. Social Care Worker Knowledge and Skills in Context: Social Care Work is not alone in this 'experiential' development and constant recreation of intuitive competence. Some of the most creative scientists, and the earliest advocates and practitioners of the welfare state, nursing, and medicine, practiced with little formal training and established highly effective theory, methods and practices, based on simple observations, from new perspectives, discarding the pretentious and frequently prejudiced, historical intellectualisations. These fundamental, direct perspective, from social and health care, now form the sound foundations for generic and specialist, modern social work and health care practice. They are increasingly forgotten as the bed-rock, of good, pragmatic practices in social care generally. They are also forgotten as the 'subjects' of research into the natural skills and practical features (later to become techniques) which have been transformed into more specialist, intensive psychological treatments (recently, the more intelligent practitioners have re-incorporate the equally important, high level social skills which originally accompanied them). The modern welfare state grew out of the initiatives of a few radical intellectuals and the 'model' practices of experienced & advanced Social Care Workers, recognising the wealth of natural skills that are available within the community. Community Care is the latest phase of that natural development. All-be-it slow to get up and running fully. The initial drive, in the field of learning difficulties did well, physical disability services progressed quite well, along with drugs and alcohol services. By the time it was necessary to address mental health and older age & dementia service, this original impetus was almost was lost. Again, Community Care was supposed to be a move away from the new dependency upon 'experts' and again, towards a greater empowerment of service users, family and community carers, supported to maintain themselves as independently as they can, with an improved quality of life that they deserve. All that is often missing, is the confidence to utilise the skills that are already there (within the support worker's repertoire) and the language needed in order to describe these skills to others. It is the most formally trained that run the greatest risk of becoming blinkered and complacent in their practices, and least able to think outside the box, when needed. This is the consequence (and always is) of the; one size fits all; cram it in and squeeze them out; follow the rules and do as you are told (policy directed); be seen 'to do' & regression to the mean (risk adverse), approaches to social welfare practices. Formal training, however useful and necessary it potentially is, also risks limiting thinking and removing professional initiative and natural adaptability to change and crisis. The actual content of this training is often good and diverse, but the legal frameworks and prescriptive nature of some of the legalistic, obligatory content; the institutional fear of risks of litigation and the prescriptive approaches to the adherence to the minimum levels of practice that this legislation describes, conspire to make these services barely competent for the purpose at times. Formal training, for all its modern emphasis on 'reflective' practice (the latest fashion) tends to make these underlying, 'given', skills into schemes that are more easily managed by service providers and service funders, through 'policy' directives. The professional ethics, initiatives, autonomy and accountability are largely forfeited. This is a feature of the modern practice to have Employer's interests reflected in the Vocational Courses, coupled with the modern tendency to exclude radical activities, creative processes and debate within vocational courses. This prescriptive form of training and management, can also divert us from the essential client focus, advocacy and re-empowerment. These kinds of qualities are being prostituted for the politically and socially engineered practice of creating what is becoming a social police force. Social workers are having to take radical stands against this tendency to mitigate this effect. Students are kept so busy on prescribed tasks that they do not have the time to be genuinely reflective on their own and the institution's practices. Sadly, Social Care Workers are being pressured in the same direction and it is against their natural and intuitive inclinations. Like all professionals they have to assert their good practices against the natural resistivity of the institutions and the negative effects of other colleague, who have already become disillusioned, or work in the field wholly for the wrong reasons. Worse than 'regression to the mean' practices, are those that are developed with selfish interests, or to promote professional self-interests in the main (power games). This may sound quite damning, but reflects my own and others observations over the last 30 years or so. Social Care Workers and Community Support workers, are the feeder streams for good, practical, social and community health care practices generally. Some of the best Social Work and Nursing practitioners came through this route, along with many Care Managers and Senior Social Work Managers. I was privileged to manage and advocate their training to these ends, as well as towards, occupational therapy, counselling and psycho-therapy. Sadly, as is frequently stated, power does corrupt and achieving higher status can make some practitioners complacent, arrogant, condescending, judgmental and prescriptive, often 'in the nicest possible way'. This is observable in all professions, right to the top. It is in the nature of things and it is largely for this reason, that we need to protect the natural skills, client focused, increasingly empowering practices of Social Care Workers. Their practical and direct relationship is more readily and highly respected by clients, than the professional status of the likes of Social Work and District Nursing. Fundamental Social Care practices can almost be naively successful in establishing the kinds of working relationships that clients feel comfortable with. These are the same, wide ranging, natural skills that early nurses and GP's used to gain the trust and confidence of patients and get them to co-operate with sometimes fearful treatments. These same skills are the seed bed of the best of tomorrows most effective practices. By comparison, by becoming aligned with 'decisions' for inadequate funding and with working practices that are are increasingly alienating and disempowering, the more intellectual, prescriptive practitioners are often rejected by clients. Client's show greater favour and cooperation towards people who retain their humanity and are more closely associated with the Client's practical, intellectual, emotional realities, circumstances and thinking. Some Social Workers retain these qualities, if their knowledge and skills came through an 'experiential' route. Although this used to be the position enjoyed by GP's and District Nurses. It has rarely been the case with Professional Social Work, which now generates fear of restrictions upon personal action, in some form, or other. Ask any member of the public and they will give you accounts of children being taken into care and receiving worse care and abuse than from the families the were removed from. The few extreme cases where they were reported to have 'got it right' do not compensate for the many times workers over-reacted, or took an overly judgmental, overbearing, or defensive approach. Harsh, but a common outcome that is fostered by media reactions to inept, over reactive, or under-reactive social work and health care practices, especially during emergencies. The consequential defensive reactions of social work managers makes them risk adverse and more inclined to over-react to mundane, as well as emergency situations. Some keep their heads and common sense but they are tarnished by the rest. Social workers and Psychiatrist used to play 'Good Cop, Bad Cop' roles in mental health. Social Workers used to played the Good Cops. In recent years I have found myself begging Psychiatrists to play this role, when it was appropriate. Roles have reversed and that is all that is needed saying in this respect. It is now the intention to promote Nursing Practitioners to take on the Mental Health Act responsibilities, along with Social Workers. Lets hope it is Community orientated Nurse that elect to take on this responsibility. I suggest that Social Care Workers never elect to obtain Mental Health Act powers, once their true competence and natural skills are identified as the most successful of approaches towards clients. I jest, of course - Mental Health Act powers will probably not be necessary in such instances !!! These commentaries are generalisations, of course, and there are brilliant practitioners in all fields and at all levels of practice. It is my experience that it is the best of these that tend to get the most 'stick' and end up taking on the greatest stresses. My critical analysis does, however, illustrate some basic historical and current truths. There are still bad practices, prejudiced perspectives, corrupt and lazy intentions, dishonesty and misrepresentation amongst the more powerful groups of Social Practitioners and Managers. The brief that the General Social Care Council (GSCC) have given themselves does not address the underlying problems in social work and social care. The protection of 'Title' does not protect clients. On the contrary; it is other independent, formal and informal agencies and the radical elements within social care, that protects client's interests, by ensuring that the Service Users are empowered to stand up for themselves with confidence and supported to 'self advocate'. The GSCC, as was feared, is little more that a 'Trades Protection' organisation, much like the 'Plumber's Association'. The declared 'Code of Ethics', which they have so proudly and expensively produced, has been wholly plagiarised from Radical Social work elements and has been almost indelibly and intuitively tattooed on the minds of pro-active Social Workers and Care Workers for over 30 years. GSCC? CHEATS, one and all :-). Any Comments:: Email: Terry@visitweb.org There are some links on the right that may be helpful: | Any Comments?: Email: Terry@visitweb.org Are you stuck in Overwhelm? All too often we 'put up with' and 'slog it out' when work gets too demanding. That is; when the work goes into 'overload, or, as the American's like to call it; a state of 'Overwhelm' (as distinct from the more pathetic state of 'Being Overwhelmed', where we can be identified as culpable in some ridiculous managerial way). It is usually in our nature, as professionals, to strive to meet our critical, 'person centred' obligations and objectives. These are not just those responsibilities as they are interpreted and laid down in Policy & Practice Guidelines (as our bosses would like us to accept. These, additional 'felt' and 'actual' obligation, include the Ethical and associated Legal obligations and the natural sense of responsibility we feel towards those we have been given some professional responsibility for; To ensure their security and personal wellbeing, appropriate to our defined roles. (See Note 'a' below) Clients come first and meeting the other demands of the Institution, even the 'unreasonable' ones, is part of the package which allows us to continue to meet Client needs. Where resources are adequate (if not perfect), this is usually possible without too much distress. It is worth noting, at this point, for reasons that will become evident later: Previous competent practice, without undue stress, is evidence of general employment competence. Areas of shortfall may have been identified and agreed, but our general practice is pretty well established as acceptable, within the first 3 - 6 months of employment. Unless formally determined as not the case. Now; there are times when there is an obligation to comment on how client's needs and risks are being compromised. This can be for various reasons. Ethical and Legal guidelines will largely determine when this is the case and Policy will help us identify when these situations have become critical. One of these times can be when your own and your colleagues, physical, psychological and emotional health is being affected by the workloads, frequent changes, harassment and other unacceptable conditions and factors of the employment. If practitioners are unacceptably stressed, to the point where functioning is inhibited, or if they are disempowered to the point that they are unable to fulfil their professional obligations, then clients can be put at unacceptable risk. It can be difficult, if you are also having personal difficulties (not unusual with work stresses), to identify what problems are due to personal life issues and which are due to unreasonable workloads. Which comes first is not critical, what is critical is to identify the excessive demands on workload at that time. Such circumstances have to be considered by responsible managers / employers. It is often useful to identify, where you can, when exceptional &/or unreasonable demands first started to be made on workloads. That noted, excessive & disabling demands and conditions should be reported through the established process within the organisation. It is important to do this early and to do so politely, without specific accusations. Lay down the facts and communicate them by Memo or eMail (cc them appropriately). Include the essential point of concern and support these with enough factual detail as to substantiate and discriminate between your various concerns. In the past, in many organisations, it may have been possible to have frank and open discussions about these employment workload issues. That time is now largely gone, but test it out. Cover yourself by ensuring that Managers, at each appropriate level, become aware of your growing concerns. Discuss these developing problems with Colleagues and get their perspectives also. Record incidents that arise from the ensuing pressures & distractions and report these to Managers. Keep everyone informed of the increasing risks to Clients, Carers, Self & Colleagues. This is as much a part of Health & Safety, as it is a requirement of professional ethics and good employee relations. Institutions and their Managers are under considerable pressure, financial, legal & administrative. They are unable to meet all the professional and institutional obligations with the resources that they have at their disposal. Some of these factors are beyond their control and some are due to the poor management of resources that they do have available. Manager, like ourselves, become defensive when they feel criticised, or accused. Often these deficits and contradictory requirements are beyond a Manager's control. This is an issue that may have to be taken higher, at a later stage. It is too easy for Employers to displace responsibilities onto us, using references to existing, often extensive, Policy Directives. It is not uncommon for the problems to be identify as shortfalls due to our inefficiencies & our neglect in following Policies. Managers are human and can do this in error, or as a prejudiced reactions to the induced work stresses of their own. Some are just bullies! Employers are now more inclined to seek to demonstrate general, or professional incompetence, once the persistent effects of these shortfalls have bitten into our confidence. Try not to let things get this far. Record and politely broadcast your concerns describe the impact of these on Clients, yourself & Colleagues. (See Note 'b' below) Your immediate Manager may be very reasonable, recognise the 'overwhelm' of workload and appreciate the unreasonable demands this places on upon you. It may even be possible to separate out and identify the contribution made by workload and personal issues. Some are competent to do this fairly. Often both are closely linked and the tendency is for the work to interfere in personal life. A good manager will adjust, or compromise the workload as best they can, to relieve the stresses, whatever the causes. If this problem is affecting other colleagues, this can become increasingly difficult, as it can place additional burdens upon them. Whether the problem can be resolved, or not (short term, or long term), it is important to record and report the difficulties and risks it produces, for your own and your clients safety and security. As the risks escalate, keep recording and politely informing Managers, escalating the level progressively. If you feel that there has also been a temporary impact on your 'competence', ensure that this effect is registered as consequential of unreasonable workload stresses. Accept any reasonable support to rectify and resolve these effects. No Blame, No Shame - live to the principle, even if others don't seem to have the courage. At some stage, where the deficits in resources are recognised as having a general effect, Senior Line Managers are usually called in. Their task is then to adjust team workloads, perhaps by temporarily restrictions on intake or, provide supplementary support for a time. They will also usually inform referring agencies of the crisis. If you take this gentle, determined approach you are likely to get your clients needs and risks addressed. Your own issues, and possibly those of colleagues should at least be partially met also. Such an approach generates trust in most instances, but there are never any guarantees. If your gentle approach fails to gain the respect of Managers it is important that you take a more formal line. This should remain polite and factual, well documented, argued and evidenced. It should carefully follow procedures and you are advised to get professional support from solicitors and unions, etc. For more details on dealing with employment issues, Workplace Bullying, Abuse and Dignity at Work issues, please refer to our other sections, follow our links and seek wide ranging advice from a number of quarters. Note 'a' Incumbent Ethical & Legal Responsibilities: These are Ethical and Legal obligation that Employers have to be aware of and accept into our on-going practice, when they choose to employ us. These do not need specifically stating, because they are an integral part of our registered, professional status, or otherwise legal requirement, place upon us in our employment, to disclose vulnerability and risks to clients / patients. These professional obligations and responsibilities are lodged with the GSCC, RCN, CSCI, GMC, other 'professional' registration bodies; incorporated into 'Codes of Practice'. In addition, there are more general professional / statutory organisations which state general professional duties and specific Legal & Ethical responsibilities, in more special circumstances. This does not mean that we are obliged to take these responsibilities directly on-board ourselves, but it does mean that we are required to take actions to ensure that the risks and needs are met adequately, by referring your professional concerns into the system appropriately. It is also reasonable that you seek to be informed what general actions are being taken to reduce the risks, and the approximate timescale involved. These broader ethical and legal responsibilities are not limited to those who are 'allocated' to us but also to anyone else we meet professionally, during the course of our work, and in many instances, that we become aware of in our more private lives. This is particularly the case with 'Children at Risk' and risks to 'Vulnerable Adults'. It is not enough that you are suspicious, or have an opinion, you have to be able to qualify and evidence your concerns. This said, the legislation and guidelines governing these issues is complex and beyond simple memorising. It is good professional practice to report all evidenced concerns that put clients and members of the community at risk. The Law is there as a safety net. It is not intended to replace good citizenship, excellent professional practice, or sound common sense. This is a mistake that Managers, as well as Professional, often make. Note 'b' Interlude:
I met my first distressing incident where a local authority worker had been targeted in this way, when I was about 10 year old.
I listen to the story he told my mother and was shocked at the level of his distress he expressed. He was clearly an intelligent and dedicated worker and gave his credible account well.
He described how he had identified irregularities in the practices in his Local Authority department. I won't go into details but he explained the progressive impact on the security of his position and the consequent affect on his general health.
This experience had a lasting effect upon my awareness of seriously bad management and institutional practices. I have never forgotten and have helped others in similar, bullying, incompetent management situations. Additional Commentary:
I have been around a lot and met some of the best Practitioners & Managers. I have also met some of the worst.
The best were variously qualified and unqualified Social Workers and Care Workers (along with other professional groups of course).
The worst were usually qualified - fact. They felt they had least to loose for being inept, judgmental & variously incompetent, I suppose.
Some of the very best were unqualified when I first met them. Some, like myself, either remained so, or had this thrust upon them :-). Here are a few stories of dedicated Social Work and Social Care practice. In good practice, it is almost impossible to distinguish between the two camps. We are none of us Radical, too proud to be associated with each other.  In the stages of preparation
Any Comments?: Email: Terry@visitweb.org NOTE: This Document is still at some stage of development. You are invited to respond and comment on its content and its logic. If you return to the document at a future date, you will be able to see its continued development, hopefully reflecting your own and others commentary. I thank you, in advance, for any contribution that you make. Please also feel free to visit and contribute, in any valid way, to these and other social issues, through our Forums. There is also a Chat Room and protected Chat Space for more serious group discussions and individual counselling. Please feel free o use this space for your legitimate activities. Copyright: Although you will see very few reference to other formal writings in this document, I acknowledge general recognition to the discussions and debates that I have had with students, practitioners and clients over the years. Most of the ideas and theory has evolved through this rather pragmatic process (operational research), rather than any formal reading. If any content of this document describes concepts, theory, or ideas that have been established else where, (prior to my writing, either here or else where - in part or in full), I acknowledge their entitlement to claim them as their intellectual property for financial purposes, if they can evidence this. I also reserve the right to retain them as my intellectual property, with due recognition to those who have made direct contributions, including other writers, should I identify such a past influences. Other than this, I invite you to share and copy any content, to the benefit of intellectual debate and the benefit of individuals and groups, without restriction, other than it be used for constructive purpose, in the wider context of my writing. Should you wish to use any material presented here 'as is', I ask that you then make reference to myself and the web site. The 'Reading Date' would be a useful 'publishing date' for the Current Edition. 1980 is the core publishing date for most of the basic ideas and theory (unless stated otherwise). This 'Reading Date' may be an important part of this 'reference', as the document (by its 'internet fluid' nature) will be constantly changing and this may affect meaning and interpretation, for those following up on such a reference at a later date. Thank you for your cooperation. TRC. eMail: terry.couchman@visitweb.org |
