Last December, a social worker was brought in front of a panel of the Health and Care Professions Council’s (HCPC) conduct and competence committee accused of failing to make regular visits to some of the children on her caseload and to maintain adequate records. After hearing from the social worker and other witnesses, the panel acknowledged that she “clearly had a high workload”. It also said “some aspects” of her supervision “appeared to be lacking” and eventually concluded that she should be allowed to continue practising under certain prescribed conditions.
A few months earlier, in June 2013, another social worker stood before another of the HCPC’s panels, accused of failing to visit two vulnerable adults on her caseload within an acceptable timeframe, or offer them an appropriate level of support. Again, she raised the lack of support she had received from her manager and colleagues at the time as a mitigating factor. However, on this occasion, the panel took the view that she was trying to excuse her misconduct, and that in fact this suggested she had “limited insight” into her own failings. In the end, she was given a formal caution.
Of course, we cannot really compare these – or any – fitness to practise cases like for like. The women worked for different employers, one in children’s services and one in adults, and the allegations, context and aggravating factors in each case are unique.
Yet, as time goes on and the HCPC brings more and more judgements to bear on social workers in England, and as working conditions deteriorate in the face of budget cuts, cases such as these beg the question of whether the regulator is paying enough heed to the conditions in which many social workers are practising.
Before it closed in 2012, the General Social Care Council considered complaints against social workers in England using a conduct model, focused on whether the registrant’s behaviour or actions were a breach of its code. The HCPC, on the other hand, uses a fitness to practise model, which looks at whether someone’s ability to practise safely and effectively is impaired because of misconduct, a lack of competence or their health.
For a profession like social work, however, assessing competence is not a straightforward task. At a health select committee hearing last month, Liberal Democrat MP Andrew George challenged the HCPC on whether the fitness to practise of social workers could be assessed in the same way as biomedical scientists and other professions the HCPC regulates, “given the subjective nature of decisions regarding the welfare of children and vulnerable adults”.
HCPC chair Anna van der Gaag responded: “There are circumstances where there will be much clearer objective parameters around a judgement and others where the nature of the relationship, how it’s interpreted and understood, will be very difficult because there will be often very diametrically opposed views on that relationship, as is the case in social work practice – and we are very aware of that. But I think that’s also the case in other disciplines, perhaps not to the same extent, but certainly psychologists, occupational therapists, speech and arts therapists.“
Andrew George is not the only one to have raised concerns about this approach. In the letters page of the British Association of Social Workers’ (BASW) in-house magazine, Professional Social Work, this month, a member writes: “The HCPC does not seem to distinguish between ‘misconduct’ and ‘doing a poor job’. … In my experience, many under-performing social workers can turn their practice around with the right attitude and help – a misconduct panel is not the place for people whose confidence will already be at rock bottom.”
BASW and its trade union arm, the Social Workers Union (SWU), represent social workers at some conduct and fitness to practise hearings. Martin Weinbren, a SWU official who has been a qualified social worker for more than 30 years, says: “We will not defend bad practice; however, I would question whether the HCPC should be looking at technical social work decisions as an issue of conduct or competence, when in fact it’s an issue of professional judgement.
“Social work is not an absolute science. If you make a considered decision based on your professional experience, if it’s not an act of intentional misconduct, then it shouldn’t be framed in that context by the HCPC.”
A lot to learn about social work
At the health committee hearing, Van der Gaag pointed out that most of the cases that come before the HCPC’s fitness to practise panels involve allegations of misconduct or a combination of incompetence and misconduct. She said only 8% (of all substantive fitness to practise hearings, not just those involving social workers) were exclusively about technical incompetence. However, she admitted that the HCPC still had a lot of learning to do when it comes to regulating social work. “We will be doing an in-depth analysis of the cases as time goes on,” she told the committee.
It is perhaps unfortunate that social work regulation in England should switch to a model that assesses conduct and competence at a time of such severe cuts to budgets and services. In July 2012, just before the HCPC took over from the GSCC, a Community Care survey found half of social workers had seen a colleague quit over high caseloads in the preceding year. In June 2013, nearly a third of social workers responding to another survey said they were not currently receiving any supervision. In December 2013, nearly a third of social workers told us they had taken time off due to stress in the previous year. A whopping 78% of respondents said stress was affecting their ability to do their job properly.
Of the 94 substantive hearings (where a decision was made on the facts and sanction) held by the HCPC and involving social workers between 21 January 2013 and 30 January 2014, excluding those where the case was dismissed or adjourned, roughly one in 10 involved mention of poor or no supervision, 16% referred to workload pressures and 16% to issues with management.
Yet it seems these concerns are often dismissed. Weinbren says the HCPC’s indicative sanctions guidance does not allow for proper mitigation: “The HCPC wants to see evidence of reflection, remorse, reassurance and recognition of the seriousness of what you have done. The way out is not to say ‘I had a caseload of 65 children and was working seven days a week, 20 hours a day’. They don’t want to hear that.”
A level playing field
So Community Care asked the HCPC, how do you judge whether complaints about lack of supervision, poor management and/or high caseloads are valid excuses for individual failings? And how can you ensure social workers are not unfairly penalised for incompetence when they were working in near impossible conditions?
A spokesperson replied: “With regard to the accountability of managers and how this would relate to a fitness to practise case about a registrant, this would be considered within the context of the case and the scope of practise of the individual involved. We also actively engage with employers to ensure they understand the fitness to practise process. This includes a series of events for employers, as well as specific information and guidance in print and on our website.”
She added that there is always a social worker on the panel, who can provide insight into the working conditions of social workers. However, while in both of the cases described at the beginning of this article the registrant attended their hearing, over the course of last year only 40% of social workers turned up to their hearings, with or without a representative. That means it is more often than not left to the social worker on the panel – and the other two panel members – to make sure the context of cuts, high caseloads and stress is properly taken into account.
“It does depend on the panel,” confirms Weinbren. And, while he says the HCPC’s substantive hearings “by and large offer a level playing field”, he adds: “There are a couple of brilliant chairs and social workers on the panels and there are some for whom I don’t have quite as much respect. I have come across some who ask the most intelligent questions and some who don’t ask any.”