My practice

Taking a service away from a client is never easy but we can take steps to make the news easier to bear, says Sarah Baalham

Ted Roberts* is 56. He lives in a small village in Suffolk in the house he was born in. For most of his life Ted lived with his mother and grandmother, who “looked after” him. About four years ago, both women died within a short space of time. Ted had never been in contact with care services but his GP described him as having epilepsy and “considerable intellectual impairment”.

Ted received home care to help him become more independent and cope with living alone. A review last year assessed Ted as no longer eligible for daily visits. His social worker knew that he would not be happy as he had become somewhat dependent on the carers.

With hindsight it is clear that working differently with Ted might have meant changes could have been made gradually, and we wouldn’t have found ourselves in the situation of needing to reduce his home care significantly all at once. However, there are ways of delivering “bad news” which can ease the process.

Consult all relevant people and consider all relevant information when reassessing a service user’s needs. Does the current service need to stop or can it be changed?
Know your facts. Be prepared to explain, for example, Fair Access eligibility criteria. Take time to understand resource issues so that your explanation is more than “we don’t have the money”.
Make sure you are acting lawfully in what you say and do. It is not generally lawful to reduce or remove a person’s service without a reassessment of their needs or for purely financial reasons.
Be honest. Explain clearly to people what you are proposing and why. If your assessment shows that a service is not needed because the person is capable of doing the task independently, say so.
Most people would rather hear bad news face to face than on the phone or by letter, although you should also give your decision in writing.
Regular reviews enable you to gradually adjust a service rather than suddenly change it.
Tell service users what they can do if they are unhappy with your decision, and how to complain if they wish to.
Refer them to their MP or councillor.
A welfare rights check can maximise a person’s income and may enable them to purchase services privately.

Being the bearer of bad news is never easy. With increasing demands and limited resources, social care staff may be unable to offer all the services they would want. However, it is still possible to remain true to our values even while telling people news they may not want to hear.

*Not his real name

Sarah Baalham is customer care manager, Suffolk Council