Social workers should be freed from bureaucratic assessment procedures to spend more time with adult service users to drive personalisation, a six-month inquiry by sector experts published today has found.
Practitioners carrying out assessments are spending less than one-third of their time with service users because of an over-emphasis on administration, the report by the Westminster Social Care Commission said.
The commission was set up by Westminster Council to examine how it could meet the challenge of serving an ageing population amid significant spending cuts. The seven-strong commission was chaired by former Age Concern director general Baroness Greengross and included English Community Care Association chief executive Martin Green. Its 40 recommendations have national implications.
The inquiry called for an urgent review of community care assessments, saying that practitioners often had to produce lengthy assessment reports on service users who had “fairly simple or conventional requirements”, something it said was common throughout the country.
It also said care managers should focus on assessments rather than care planning, which should be left largely to service users and care providers. “Overly-prescriptive assessments take longer to conduct, crowd out innovation and act as a disincentive for personalisation,” it said.
Commissioner Ian Buchan, a former social worker who is now director of care services at charity Independent Age, said its conclusions were directed at central government as well as the council: “We need to look at the paperwork and bureaucracy around assessment [nationally] because there’s a lot of qualified social work time going into it, and you want to put that expertise into client contact.”
Westminster’s spending on adult social care is expected to be cut by almost 10% from 2010-11 to 2012-13, and the report raised concerns about the impact of severe cuts. It warned the council against cutting “arbitrary amounts” from users’ care packages, which could lead to a failure to comply with statutory duties or an escalation in users’ needs that would increase long-term costs.
It said the council’s decision to raise its eligibility threshold from moderate to substantial was “essential given the current financial context”, but it needed to be accompanied by investment in prevention to ensure people with moderate needs did not deteriorate.
However, it warned that councils faced barriers to investing in preventive services to generate long-term savings because of “inflexible” local government finance rules that required them to balance their budgets every year. It said this had “particularly devastating” effects on adult care at a time of cuts.
“It can mean the closure of valuable facilities and the loss of experienced staff to balance a budget in one year despite a potentially more promising financial position in the following years,” the report found.
The commission urged Westminster to seek talks with ministers to explain the damage caused by these rules in a effort to get them changed.
With councils expected to come under a duty to eliminate age discrimination in services next year, the commission found a disparity in the proportion of Supporting People resources spent on older people as opposed to younger client groups and called on Westminster to review whether provision was fair.
The report said the government’s NHS reforms, which would see the local primary care trust replaced by GP consortia, posed a challenge to existing joint commissioning arrangements for health and social care in the borough.
It called for a single commissioning function to be set up across consortia and the council, led by the local authority, as this would be “beneficial for all the major social care groups”.
The commission also endorsed Westminster’s plans to merge functions with Kensington and Chelsea and Hammersmith and Fulham councils, including by establishing a joint directorate for adult care, on the basis that this would “make the most effective use of limited resources”. This is despite concerns being raised by other social care experts that cuts in management capacity across the three boroughs would reduce their ability to drive through more fundamental changes to services to achieve more sustainable savings.
Adult social workers to be ‘freed from council control’The impact of personalisation on adults’ social workers