As council adult services departments wrestle with the challenge of implementing personalisation amid austerity, one dilemma they face is how to distribute work between social workers and less expensive staff with other, or no recognised, qualifications.
This issue came to the fore earlier this year when the Audit Commission urged councils to replace social workers with non-qualified staff in less complex assessments and reviews on the basis they could thereby save up to 2% of England’s adult services budget without hitting quality.
Though social work leaders questioned the commission’s contention that quality could be protected by cutting social workers, there is broader support for its view that less complex cases can be allocated to non-qualified staff to free up social workers for more complex cases.
More complex work for social workers
British Association of Social Workers professional officer Joe Godden says: “All things being equal, it does make sense for social workers to take on more complex, difficult legal cases, but with the proviso that they feel they have a lot to offer other staff on occasions where they are not necessarily understanding the complexities of things and where the ethos that comes from social work training is required.”
Achieving the correct mix that enables social workers to focus on the most complex cases is not straightforward for councils, however.
One suggestion is that they employ formal case-allocation tools to ensure work is assigned to the most suitable member of staff. Examples of these were highlighted in an advice note for adult services directors on the deployment of social workers issued by Skills for Care and the Association of Directors of Adult Social Services in July.
Case allocation tools
One of these “case vignettes on workload management” demonstrates how a council could allocate cases by applying scores against criteria on risk, breadth and depth of need, the service user’s ability to engage, resource availability, and contact time required.
Social worker Kelly Hierons, a member of and spokesperson for the College of Social Work, says case allocation within the older people’s mental health team in which she works is based on a “complexity matrix” alongside a consideration of employees’ current caseloads.
Her team is a mixture of professionally qualified workers, including occupational therapists and psychiatrists as well as social workers, and non-qualified staff. One of the general rules is that only qualified staff will take the lead in assessments, which mostly follow referrals from GPs, while non-qualified staff, who are known as facilitators, will undertake reviews of existing care arrangements.
Importance of social work training
Hierons, who previously worked in the team as a non-qualified member of staff, says facilitators are highly skilled in their own right, but she feels her social work training – she finished a masters course two years ago – helped her to “put flesh on the bones of why I do what I do”.
John Nawrockyi, secretary of the Association of Directors of Adult Social Services’ workforce development network, says the approach taken by different councils to case allocation will vary. He points out that there is no list of tasks reserved to qualified social workers in adults’ services, unlike children’s services, where section 47 child protection investigations are so reserved.
However, he believes it would be “very unwise” for councils to allocate tasks such as adult safeguarding assessments or Mental Capacity Act best interests decision-making to workers without social work qualifications.
“Councils could drive down costs by reducing the proportion of fully qualified staff but that could be costly in the long run,” he adds.
Case study: ‘Social workers can now focus on complex cases’
While the Audit Commission report envisages that local authorities consider a greater assessment and review role for non-professionally qualified workers, Stockport Council has taken the opposite approach in recent years. In 2008 it decided that all staff in its client group teams across adults’ services should be fully qualified, a change from the previous situation where a mix of social workers and non-qualified social services officers were used.
The latter were given the opportunity to train as social workers, funded by the council. Michelle Bennett, who has worked for the council for 23 years, was one of those to take up the offer, and is now a social worker in an older people’s team in east Stockport. She says her social work qualification – a degree from the Open University – has given her more professional credibility.
Terry Dafter, Stockport’s director of adult social care, says the move to greater personalisation of services “requires the appreciation and expertise social work brings not only of the person as an individual but the individual within their networks and community”. In addition, the values at the heart of personalisation are “core social work values”.
Importance of social work to health partnerships
As well as the move to personalisation, Stockport Council was establishing a section 75 partnership agreement with NHS Stockport at the time of the change, and Dafter says there was “an appreciation that the social care contribution to joint working would require qualified social workers to work alongside qualified health professionals”.
All initial public enquiries to Stockport adult social care go through the Stockport Direct Contact Centre, which also handles enquiries to a number of other council services, including highways, waste and recycling, and parks and recreation.
The adult social care enquiry team is staffed by eight referral and information officers. Their role was previously performed in several area social services offices by administrative staff, who were trained and transferred to the contact centre.
Training for non-qualified staff
As well as conventional call-handling and customer focus training, they take specific courses on topics including personalisation, safeguarding, dementia, carers, and equipment and adaptations. They are not expected to have advanced qualifications, but receive dedicated support from a social worker if required.
These officers make an initial assessment decision and establish the most suitable referral route based on a series of questions addressed to people making an enquiry.
“We rely on the judgment of referral and information officers,” says Paul Hayes, Stockport’s service manager for reablement and intermediate care. “It’s important there’s a dialogue between them and people making referrals, who can often disclose some very sensitive information, such as issues of abuse.”
People who only need basic information and advice are referred to third-sector partners, while cases clearly related to requests for equipment and adaptation services are passed to a dedicated team.
Referral to social workers
All other cases are referred for full assessments to the client group teams, now staffed entirely by social workers.
If the social worker decides that a person needs reablement, they will refer the case to the reablement service, which is largely staffed by workers without social work qualifications (though many have other health and social care training). The social worker who referred the case will pick it up again at the end of the reablement process to determine if the service user is eligible for any continuing social care.
The manager and assistant manager of Bennett’s team are responsible for screening referrals and allocating cases. These are assigned at the start of the week based on the expertise of workers and their availability, while urgent referrals made during the week are immediately allocated.
More time on complex work
Bennett says the remodelling of the teams and the changing nature of the role have given staff “more time to focus on more complex work”.
“Social workers are all very anxious about what might happen to the social work role,” says Bennett, “but if you embrace change and take up the opportunity to pass on your experience, you can influence things.
“The way I look at my role now is very different. Many years ago it was about going into a situation and looking at what people couldn’t do, rather than what they can do. Now I can focus on people’s strengths, aspirations and abilities and enable and support them to achieve those.”