Community Care asked social workers, managers, service users and academics from across the UK to talk about their experiences of social care and devolution.
The map below shows our interviewees – click on the icons to find out what they said. Beneath, Josephine Hocking draws together some of the issues that emerged from the interviews.
View Whose grass is greenest? in a larger map
The effects of devolution in the UK, where all three devolved governments have different responsibilities and powers, means that the four countries’ approaches are diverging. Although in England, Scotland and Wales local authorities are responsible for social care, there are different systems.
Most areas in England have had separate children’s and adults’ services since the Children Act 2004, though there has been a move from several councils to reverse this, with mixed success. In Wales departments have remained unified while in Scotland some councils have split their social work services between adults and children. Scottish local authorities are responsible for social work services and there is a mix of generic (Dundee) and separate (Edinburgh) children’s and adults services.
Northern Ireland has the most distinct set up with councils having no responsibility for social care. Instead, on 1 April the four health and social services boards merged into one health and social care board responsible for commissioning, with five health and social care trusts responsible for provision.
Responsibility for social services in England is split between the Department of Health and the Department for Children, Schools and Families. In Wales social care falls under the Welsh Assembly Government’s health and social services department. Wales has a relatively small population of three million, covering a large geographical area. Since devolution the Welsh assembly has been keen to develop its own specific policies relevant to its needs. It has a minister for health and social services and a deputy minister with a specific social services portfolio.
The Scottish Parliament is responsible for primary legislation and social care is a fully devolved service. Responsibility for social care in Scotland is split between the Health and Wellbeing department (adults) and the Education and Lifelong Learning department (children). In Northern Ireland it comes under the Assembly and rests with the Department of Health, Social Services and Public Safety.
All UK social workers must be registered to practise with the appropriate registration body. Because social workers make up just 5% of the social care workforce in England, the General Social Care Council has argued that registration needs to be extended to all social care staff. However, the push to expand it has been sluggish throughout the UK, particularly so in England.
April’s adult workforce strategy for England announced that voluntary registration for England’s 500,000 domiciliary care workers is finally due in 2010 and will later become compulsory. Meanwhile, registration of residential staff is promised by the government but no date for implementing this has yet been confirmed.
England is lagging behind its neighbours in this respect. Residential child care staff in Wales are already required to register with the Care Council for Wales, the country’s GSCC equivalent. In Scotland, residential child care workers must be registered with the Scottish Social Services Council by 30 September. A timetable to register residential and day care staff at all levels in children’s and adults’ services by 2015 has been published by the Scottish government. The Northern Ireland Social Care Council is also registering its workforce in phases, but in this instance it is being carried out according to job role and location.
The GSCC has a purely regulatory function and workforce development is the responsibility of two other bodies – the Children’s Workforce Development Council and Skills for Care. The Care Council for Wales, the Scottish Social Services Council and the Northern Ireland Social Care Council all handle workforce development as well as regulation.
In England the Association of Directors of Social Services became redundant when the Children Act 2004 created separate children’s and adults’ services, and the Association of Directors of Children’s Services and the Association of Directors of Adult Social Services emerged. The Association of Directors of Social Work in Scotland and the Association of Directors for Social Services Cymru has both adults’ and children’s services members, mirroring the fact that social services departments in the two countries have remained generic.
Children’s social care in England is inspected and regulated by Ofsted, while for adults’ services the Care Quality Commission takes on this role. Because Ofsted’s origins lie in regulating schools there were widespread fears about a lack of social care expertise within the inspectorate, and with recent cases such as Baby P these don’t appear to have abated.
The Care and Social Services Inspectorate Wales regulates all social care. Reforms aimed at improving inspection and focusing more on service users’ experiences were implemented in April. Local authorities are required to produce an annual improvement plan for social services, and will receive announced and unannounced visits each year.
In Scotland, the Social Work Inspection Agency inspects all social work services provided by or on behalf of local authorities and the Scottish education inspectorate takes part in joint inspections of children’s services. There are plans for a single inspectorate and regulator north of the border for all social care by 2011. Care services for children and adults in Scotland are currently regulated by the Scottish Commission for the Regulation of Care.
There is no independent inspectorate for social care in Northern Ireland, it is the responsibility of the Office of Social Services at the Department of Health, Social Services and Public Safety.
Post-Baby P and with the emergence of the personalisation agenda, a greater emphasis is being put on safeguarding in both children’s and adults’ services. In Wales, the CSSI finished inspecting all 22 local authorities on safeguarding arrangements in children’s services in May and a similar audit of adults’ services is expected to start in the summer. The Welsh assembly government and Scottish government are both reviewing child protection guidance, prompted by the Baby P case.
One of the biggest differences between Scotland and the other three countries relates to youth justice. The Scottish children’s hearings system deals with offenders up to the age of 16 and with children where there are welfare concerns. It is designed to make the system of youth justice more welfare-focused than adversarial and punitive.
Plans to modernise the children’s hearings system were announced by the Scottish government in May. The new children’s hearings tribunal will oversee Scotland’s 32 children’s panels. The idea is to provide more consistent standards and better support for young people. The other three countries have youth courts instead, and arguably, a more punitive approach.
Moving on to adults, although direct payments are available in all four countries, the personalisation agenda seems to be bigger in England. The implementation of personalisation in Scotland has a bigger focus on safeguarding than elsewhere. For example, councils can withdraw direct payments from service users if they do not carry out a Disclosure Scotland criminal records check on a personal assistant, contrary to the approach in England.
Also, Scotland – unlike the rest of the UK- has legislation covering adult protection, the Adult Support and Protection Act (Scotland) 2007. Among its more controversial measures are provisions for alleged victims to be removed or alleged perpetrators to be banned from their homes if abuse is suspected, even if the alleged victim is opposed to such action.
Free personal care
When it comes to free personal care, Scotland pioneered the way in 2002. This means that everyone over 65 receiving home care or residential care receives £153 a week to go towards their personal care. This will not necessarily meet the full fees and the system has been criticised for being inadequately funded and for councils using waiting lists to ration access.
Only Northern Ireland followed Scotland’s lead when its assembly voted for free personal care in 2007. However, health minister Michael McGimpsey recently said he couldn’t introduce it due to lack of funds, although he emphasised his personal commitment to the plan and promised to keep the matter under review. In England a handful of local authorities, including the Isle of Wight, provide free personal care to some over-80s. All four countries provide free nursing care to care home residents.
There are obvious differences across the countries when it comes to mental health legislation. The Mental Health (Care and Treatment) Act (Scotland) 2003 is seen as a more progressive measure than the Mental Health Act 2007, which applies to England and Wales. So, under the Scottish act, no one can be treated compulsorily unless their decision-making is judged to be impaired, unlike in England and Wales.
In Northern Ireland the final report by the five-year Bamford review into mental health and learning disability services was published in 2007. It made 600 recommendations and set out to modernise services over the next 15 years. New mental capacity legislation and the modernisation of existing mental health legislation are expected to become law by April 2011.
State of social work
All four countries are either reviewing the state of social work or have already done so. In England, the Social Work Task Force has been set up to deliver a cross-government social work reform programme to improve frontline practice and management. It will sit within the framework of the 2020 children and young people’s workforce strategy and the adult social care workforce strategy.
In Northern Ireland, efficiency reforms aimed at putting more money into frontline services and trimming bureaucracy are now being implemented, as the Health and Social Care Reform Act 2009.
In 2007 the Welsh assembly published Fulfilled Lives, Supportive Communities, a 10-year strategy outlining policy direction for social services. And earlier this month the Welsh government announced it is setting up a task group to examine ways of improving social workers’ status and their recruitment and retention.
As many argue that Scotland is the most progressive of the four countries, it comes as no surprise that it kicked off this line of work in 2005 with its 21st Century Review of social work. This called for the creation of para-professionals, more responsibility for frontline staff and a training shake-up.
However, according to Hilton Dawson, chief executive of the British Association of Social Workers, the Welsh task group could put Wales ahead of the rest of the UK in terms of supporting social work.
Interviews from Scotland
Interviews from England
Interviews from Northern Ireland
Interviews from Wales