By Joe Warner
When The College of Social Work wanted someone to join next week’s Community Care Live debate on targets, I felt compelled to throw my calculator into the ring.
My interest in data and statistics goes back to my undergraduate days in the sociology department at Warwick University, where I became both perplexed and fascinated by the use and misuse of statistics to explain complex social phenomena.
I probably should have left it there, but several years after becoming a social worker I took on the management of the performance section in a social services department.
At the time, the complexity of performance indicators and their definitions struck me as both futile and time consuming.
When asked to improve performance on a particular indicator, I would spend six months auditing data, clarifying definitions, refining processes and hounding social workers to comply.
The measured performance did move from the bottom to the top quartile, but nothing had changed for the people it was supposed to help improve the lives of.
And then the government changed the definition.
The new lexicon of performance talks about outcomes rather than targets or outputs, but outcomes are even more complex to measure and achieve.
The Adult Social Care Outcome Framework is 47 pages long and comes with a 64-page handbook of definitions but what does it mean for social work and the people who rely on social care?
It means we need an army of technocrats to decipher, collect, collate and report on it.
It is inevitable that different areas measure different things, making comparison and improvement difficult, and – worst of all – we cannot see the person for the data.
The framework is effectively meaningless to those who actually deliver the services and, instead of informing and helping practice, it is more likely to dominate and demoralise practitioners.
This framework, along with other frameworks for the NHS and public health, are meant to facilitate integration and preventative approaches, but the biggest driver of integration is budget cuts and the issue is further compounded by high thresholds and charging for social care.
The recent debate around self-directed support, prompted by the Slasberg et al paper, highlighted significant methodological flaws in measuring the impact of a policy designed to improve outcomes through empowering individuals to take control of their own support.
The authors also claim that the policy resulted in a significant reduction in social work productivity and the creation of a large, costly bureaucracy.
People are complicated and you cannot replace social work judgement with a tool like a Resource Allocation System.
There is no substitute for an interactive understanding of an individual’s strengths, potential resources and their needs.
The Resource Allocation System shows how a seemingly simple solution to a complex issue results in an over-engineering failure.
Simon Duffy, the director of the Centre for Welfare Reform, has described the system as a ‘disaster area’ that is needlessly complicated and applied ‘unthinkingly without reference to social work values and human rights’.
What we need is a simpler system that is meaningful to frontline workers; one that removes the inherent tensions around charging and what is or isn’t health or social care.
We need a system based on trust and respect between professionals and partners within an integrated approach.
Joe Warner is a member of The College of Social Work’s adults faculty steering group.