Social workers have a big role to play in adult care but should no longer be deployed in roles where their skills are not required. That was the message from Association of Directors of Adult Social Services president Sarah Pickup in an interview to mark her accession to the role today.
As director of adult services in Hertfordshire, Pickup has overseen a reduction in social workers and other staff in older people’s and disability teams as the council’s success in helping people regain independence has translated into lower caseloads. She told Community Care that the funding situation meant councils would have to make reductions across staff groups, including social workers, though the proportion of qualified professionals employed by adults’ services would vary from place to place.
But she added: “There’s absolutely a place for social work particularly in that work with personal budgets for the highest needs. If you think about the learning disability challenges we face in terms of getting people out of high dependency settings into the community. This requires social work skills.”
“Equally, there are other tasks where we don’t need qualified social workers to go and sort out simple pieces of equipment,” Pickup said. “There’s a place for all the different professions. And there’s a place for people who are trained but not social work qualified.”
Pickup said councils needed to ensure they invested sufficiently in information, advice, prevention and reablement to limit the numbers needing ongoing care and support, as Hertfordshire had done. Not only was this an economic imperative, she said, but a moral duty, in so far as it promoted independence for people. “We’ve got a health and social care system that spends its money in the wrong places,” she said. “We will always spend the majority of our money in social care at the higher end. But we must always spend enough on prevention information advice to stop people who don’t need to end up at the higher end from ending up there.”
She called on the government to promote this approach in its forthcoming White Paper on social care. While all councils had made some progress in this area, even the best could do better, particularly in working with the NHS to deliver prevention and reablement, she said. Pickup added that the government’s NHS reforms provided opportunities for closer integration as long as GPs took genuine control over health commissioning. This is because GP commissioners would see the logic of investing in preventive social care to reduce hospital admissions, as this would reduce the bills they paid to acute trusts.
She said levering in funding from the NHS for social care could be the best bet for solving the sector’s funding crisis. “If we can prove that social care generally prevents hospital admissions [this could happen],” she said. The government is due to respond to the Dilnot commission’s proposal of a £35,000 cap on lifetime care costs, in a funding reform progress report that will be published alongside the White Paper. But Pickup stressed the Dilnot plan would “not bring more money into the system”; rather it would provide insurance for self-funders against catastrophic care costs and the prospect of selling their homes.
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