LETTER OF THE WEEK (3 July 2008) Mike Bygate, social care manager, Merseyside
Group models of care must survive
In the spectrum of mental health provision, community-based social care services are relatively under-developed. There is a longstanding, settled direction in policy favouring a shift from hospital to community based services. Yet social care service providers currently feel very uncertain about the future owing to a combination of policy imperatives including competitive tendering and self-directed care.
In addition to admitted self-interest in wishing to continue in this sphere of work, I am much concerned about the drive against grouped patterns of community provision, and the assumed incompatibility of grouped and individual services on the part of some policymakers.
Writing as someone with lengthy experience in social work and social care management, and as a relative of a user of services, I am very much of the view that services such as grouped accommodation schemes and day centres are a vital part of a spectrum of provision and can be outward-looking and recognise individual differences.
They are popular with many, and serve a preventive function. Most importantly they help to relieve loneliness and isolation.
We should be adding to this part of community provision in addition to adopting new models of service. It is predictable that if intermediary community services of this kind are undermined by the current drive for highly individualised services, the drift for many will be back into NHS provisions or into social exclusion of a much less caring kind.
Buzz off, David Johnstone
As a carer and resident of Devon, I was interested to read David Johnstone’s article about personalisation (“Can you feel the buzz of care management transformation?”. The only “buzz” I can detect comes from the plethora of buzz words (Johnstone and the Jargonauts?), and perhaps the buzz, buzz, buzz of the busy line. As so many commercial firms and their customers have long since discovered, call centres are not the answer to customer care or satisfaction.
I find it ironic that as director of adult services, Johnstone has, for two years, steadfastly ignored a proposal from a large and committed action group to set up truly local and “personalised” services based around a small and highly rated care home.
Rather than work in partnership and support the energy and enthusiasm of the community, he is in the process of negotiating a deal with a national conglomerate which will close the care home and leave this small community with no local services. A buzz for you, David, but not for us.
John Burton, Devon
Surrey leaves staff in a quandary
Surrey Council is intending to use the transfer of undertakings (protection of employment) regulations (Tupe) mechanism to transfer all its mental health and substance misuse staff to the local NHS trust – Surrey and Borders (“Surrey Council mental health transfer sparks staff woes,” http://www.communitycare.co.uk/108549). This transfer will happen in October and will affect over 300 staff.
The concerns of staff are:
● We have no choice.
● The consultation period is a minimum of three months and it looks as if Surrey will not start to involve our union until July, leaving little time for staff who do not want to be subject to Tupe to find other local authority employment.
● We will lose our continuous employment if we move out of the trust back to a council.
● Our pension will not be equivalent to someone remaining in continuous local authority employment.
● Our union does not seem to be taking our concerns seriously.
Many of the staff are approved social workers who can easily find employment in neighbouring mental health services with better terms, leaving vacancies that might be hard to fill.
We understand that in other areas negotiations have been over a much longer period and resulted in a choice being offered between becoming a trust employee and remaining with the local authority but seconded. The deal that seems to be on the table for us gives us the worst of these options and no choice.
Name and address withheld
Users will need good insurance cover
Your report on the relationship between direct payments users and the personal assistants they employ (“When service users and personal care workers fall out,” highlighted several pressing issues. Unison’s Helga Pile rightly points to the fundamental relationship shift overnight a service user goes from passive receiver of services to active contractor of a service provider with the accompanying responsibilities.
You also note the scarcity of training available from local authorities to help users manage these new responsibilities. This is not surprising social services are simply not geared up to act as employment law specialists.
We addressed these concerns by providing users with round-the-clock access to specialist employment law advice plus cover for legal fees and tribunal awards as key benefits of a new policy.
Many local authorities have recognised the value of such enhanced insurance cover not least in encouraging take-up and minimising the risk of re-intervention by social workers to ensure needs are met following relationship breakdown. But a number of authorities are capping insurance costs. While I understand and sympathise with the immense budgetary pressures they face, the difference between the cost of the basic and enhanced cover is little more than a pound a week. It seems a small price to pay given the benefits to both user and local authority.
Moreover, in denying users the choice between basic and more reassuring enhanced cover is the whole ethos of independent living, which direct payments underpin, being undermined?
Elissa Foster, CEO, Fish Insurance
Help for new staff
I’m really pleased to see that there’s at last some recognition that social work graduates finish their courses feeling unprepared.
The main problem lies with practice placements. Given that many people joining social work are now younger and have no experience of work, it is especially important that they start work feeling confident and are given proper levels of support once they start their first job. I can see merits to the newly qualified social worker status but I hope it will be properly implemented.
Name and address withheld