How do you provide for service users straddled across 19 islands? Amy Taylor visited Orkney to find out
About 10 miles off northern Scotland, to the west of Norway and where the North Sea and the Atlantic meet, stands the archipelago of Orkney. Many have capitalised on the area’s remote nature throughout history.
In the 9th century the Vikings used the islands as a base to attack their own king and in the second world war the allies sent 2,000 Italian prisoners of war to its shores. Nowadays 19 of the 70 or so islands are home to about 20,000 people, a mix of native Orcadians and “ferry lowpers”, the term given to those who have come off the boat and stayed.
The island’s geography is unique, but it’s challenging to those delivering public services. For social care staff dealing with the most vulnerable members of the community, this is even more acute.
More than half of Orkney is made up of its “mainland”, which includes Kirkwall, the islands’ largest town, where the council’s social workers are based. There are regular boats and flights to most of the inhabited islands, but two are served by ferries only once a week and bad weather can suspend services.
“It’s not quite planes, trains and automobiles but it can be along those lines,” says Duncan MacAulay (pictured right), the council’s interim social services director.
MacAulay, formerly social services director at Edinburgh where he worked for 27 years, has been at Orkney since June and the time spent travelling has been quite a culture shock. He said that to reach island-based clients, social workers may have to use boats and taxis and stay overnight.
Alastair Muir, a senior practitioner with the children and families team, sees the travelling as a positive aspect of the job.
“I see that as a bonus, it’s another dimension of working on Orkney. I worked for many years in Aberdeen and I find this a more stimulating environment. If you compare the two, when I worked in Aberdeen I was travelling through traffic, here you look out at the breathtaking scenery and it gives you time to reflect.”
Rachel Cromarty, a care worker at a residential home on the island, says the perception that Orkney is totally isolated is incorrect. Flights to Aberdeen take just 30 minutes and there are regular boat services to mainland Scotland and Shetland. Like Muir, she sees the travelling involved to see clients as far preferable to navigating a busy city. “I have friends who live in London whose commute takes longer than it does [for me] to get to Edinburgh,” she says.
Along with its towering red sandstone coastlines, big skies and frequent rainbows Orkney has good schools and little crime. Muir feels he has the best of both worlds, an exceptional quality of life alongside a different role from that of Scotland’s other social workers.
Going it alone
Visiting a family to discuss concerns about their parenting while your colleagues remain on a separate island may seem a daunting task to some, but Muir revels in it. He explains how on some child protection inquiries social workers are accompanied to islands by police officers and on others teachers, headteachers and GPs involved with the family will make themselves available to support lone workers.
“You need to work within those restrictions and be creative,” he says. “It makes it more interesting. The headteacher at the child’s school will come to a meeting quickly and you just wouldn’t get that in a city because they don’t have the resources or the time. They are dealing with all the statutory casework while we do a lot of preventive work.”
Attached to Orkney’s mainland by the Churchill barricades, four massive concrete barriers put up by the war-time prime minister to prevent German U-boats reaching the islands, South Ronaldsay is a compact collection of slate grey houses standing on the water’s edge.
Today a Michelin-starred restaurant in a picturesque setting draws visitors to the town, but its name will jar with many in social care for different reasons.
In 1991 social workers and the police removed nine children from four families in dawn raids after social workers raised suspicions of satanic child abuse taking place. The case was later thrown out of court and the children returned after fierce campaigning by the local community.
While Cromarty and Muir are still asked about the case when they meet professionals from other places, it’s not raised by the islanders themselves. At the time of the case, other families in South Ronaldsay were receiving services and the negative publicity didn’t result in them turning away social services. According to Muir, this highlights one of the advantages of working on the islands – the small size of the islands’ population and strong communities allows social workers to get to know people well and gain their trust.
These factors can work the other way, with professionals sometimes finding it difficult to distance themselves from clients in their free time and facing walls of silence. But Muir says these are not big issues in Orkney.
“It’s less of a problem now because in the past 15-20 years there’s been a higher number of people coming [from the outside] to live in Orkney,” he says. “More people are willing to report concerns than five to 10 years ago. That suggests there’s a lot more trust in the community and confidence that we can deal with things.”
In terms of its geography and size Orkney could not be more different from MacAulay’s previous environment in Edinburgh. Despite this, he emphasises that the islands have similar social issues to the capital and the rest of the UK, but their rural nature adds an extra dimension.
“There are people who are vulnerable because they have health problems, learning difficulties and older people who need care in the community,” he says. “These are all faced by other authorities but we have a super added situation.”
Like other parts of the UK, one of the biggest challenges facing Orkney is its ageing population. For the islands the issue is even more pressing because they have one of the highest life expectancies in Scotland and the largest proportion of over-75s.
There are only two island-based facilities for older people, a very sheltered housing unit on Westray and another sheltered unit on Hoy. Most of the long-term residential facilities are on mainland Orkney.
The lack of island-based services makes the move to residential care more difficult, as people are moved further from their families. MacAulay says: “If you need to move from your own home to a residential establishment people face having to come off the island that they have probably been on all their lives.”
There is a facility in Kirkwall where care home visitors can stay. But Lucy Stansfield, service improvement manager for older people at the local authority, says there are few requests for this because most people will have family or friends whom they can call on – a reflection of the strong community ties in the area.
“It’s not often raised as an issue. People on the island come up with their own solutions,” she says.
The local authority is set to build two new residential units to tackle the issue. Long-term home care is another solution and islanders enter residential care once they have developed a higher rate of dependency than in other areas.
All of Orkney’s 18 qualified social workers have to take part in the out-of-hours rota and in emergencies a council or police “launch” (a boat) is available. Stansfield says this has never been used for an adult during her time at the council but has been used for child protection. Unlike the social workers, most of the area’s home carers are based on the islands where they work and they can be relied on in a crisis, she adds.
“The home carers are really good. In an emergency you just know you wouldn’t have difficulty getting somebody to help out.”
There is medical cover on each island and some community nurse teams are island-based. The council and NHS Orkney, Orkney’s NHS board, are also looking at developing a generic health and social care worker, at the level of an auxiliary nurse and social work assistant, to provide a more efficient service.
The merging of the two fields reflects a trend across the council. NHS Orkney and the local authority are considering creating a health and social care partnership. This would involve merging primary health services with children’s and adult’s social care, with a joint director of social care and health. If approved by councillors, the partnership could be launched next year.
In 2005 the Scottish government published its social work review, Changing Lives, looking at how to allow social workers to take more decisions and risks and offer a more personalised service.
Orkney’s size means personalisation holds particular challenges. Roderick McLeod, chair of the authority’s social work committee, says the financial gain that would otherwise be achieved by reducing council provision does not hold true in Orkney due to the small number of facilities. “If one person decides they would like to have their own care, rather than go to the day centre, there is no saving for the day centre,” he says.
Despite the potential difficulties, MacAulay says the council is committed to the Changing Lives agenda and it has completed a piece of work with consultancy Capgemini on implementing the plans.
Recruitment is an issue in social care and across the council. Orcadians acknowledge that island life isn’t for everybody but argue the area’s uniqueness should be its selling point. Yet Stansfield is clear that a career in social care on Orkney will not be an easy ride.
“There’s an assumption that it must be really easy being a social worker in an environment like this,” she says. “It’s a fantastic job, you are going to have plenty to do but you are going to have the same pressures as you would in any other area.”
- Interview with the social work Orkney10
- Do you fancy working somewhere as rural as Orkney? Go to CareSpace
Published in the 18 September issue of Community Care with the headline ‘Remote Control’