Project: Trainee AMHPs
Faced with a shortage of AMHPs, Devon County Council and Devon Partnership NHS Trust has reengineered its approach to developing the next generation of AMHPs.
“Like a lot of areas AMHP numbers were dwindling here,” says Robert Lewis, practice manager for the Central AMHP Team at Devon Partnership NHS Trust.
“There was an ageing population of AMHPs and because of the challenges of the role it was difficult to make it attractive to people.”
Devon’s solution was to redesign the way it trained AMHPs to make it both a better experience for trainees and a more effective way of filling vacancies as they arose.
“We looked at the long-standing vacancies and said ‘why don’t we convert some of these into trainee posts so that people can come in on a social work grade,” says Lewis.
The result was that trainee AMHPs would get a proper job where they spent part of their time working as case-carrying social workers and two days a week within the AMHP service helping on assessments and learning the ropes.
When ready, the trainees then take the five month course to qualify as a AMHP and best interest assessor before returning to work as a AMHP.
The beauty of the approach, says Lewis, is the certainty, both for the trainee and the council. The council can succession plan more effectively and the trainee knows there is a job at the end and also gets the chance to learn about the role before taking the course itself.
“It also gives us a bit of flexibility and means we don’t have to rush people onto the course,” says Lewis.
“We have one very good candidate we’re holding back for the next course so they can get more experience within adult mental health. We want to create a learning environment for people that feels safe because a lot of AMHP practice feels unsafe due to the legal changes and other pressures.”
Rob Manchester is one of the first social workers to join Devon’s AMHP trainee scheme.
“I think it’s a really good set up,” he says. “I feel valued because there is a clear career progression in place. It makes you feel you’re really going somewhere within the organisation.”
Another benefit of the approach is that the trainees, while spread all over the county, get to know and support each other.
“One of the biggest problems with AMHP work is it can be very isolating because you are an independent practitioner within an organisation. In a heavily rural area like Devon you might be the only AMHP in the village, for the lack of a better phrase,” says Lewis.
“One thing I really like about the trainee AMHP approach is that it is making a group where people who are on the course or are about to or have recently qualified can share experiences with each other and identity themselves as a group.”
Project: Help to Live at Home
Wiltshire Council has been blazing a trail for a fresh approach to domiciliary care for the past four years with its Help to Live at Home programme.
The programme sets itself apart with its outcomes-based approach- four care providers are paid for delivering outcomes set out in support plans that are agreed with service users and cover both eligible and non-eligible needs.
“What traditionally would have happened is a social worker would do the assessment, write the care plan with the customer and that care plan was then commissioned from one of any number of providers,” says Dee Robinson, team manager for adult services in the North Wiltshire locality.
“Now what happens is we do the assessment with the customer and we discuss what outcomes they want, both eligible and non-eligible.
“We then send the assessment to the provider with those outcomes and the provider does the support plans, but often that could be jointly with social workers particularly when it’s a very complex situation.”
The greater focus on what the customer wants and willingness to cover non-eligible needs means people’s support plans are also more tailored to what service users want to achieve themselves.
“We are building on improvements, so even for somebody with a very significant physical disability we will look at even the tiniest things they want to achieve and are important to them,” says Robinson.
“So there might be lots of maintenance outcomes that are about trying to support somebody with the most difficult tasks. But if being able to wash their face themselves is important to them we build on that. That’s probably not something we did with the old care plans.”
The approach also frees up the county’s social workers to focus on social work rather than case management.
“Because of Help to Live at Home, social workers are no longer doing care management, they are doing social work, which is great because they intervene when social work is required for mental capacity, best interest and all the more complex things,” says Robinson.
“Social workers in Wiltshire are now are much more involved in doing pure social work.”
Project: Gloucester PODs
How child protection social work teams in Gloucester operate is about to change drastically thanks to a new two-year pilot about to be launched in Gloucestershire city.
“Historically the teams in the city are very busy and we’ve struggled to hold and keep staff because of the sheer nature of the work and because we’ve had high numbers of re-referrals,” says Vicki Butler, deputy director of safeguarding and care at the council.
Gloucestershire’s answer to this problem is a rethink of how social workers in the city are organised and work. Currently the city is divided into two teams – one covering the north, the other covering the south of the city.
But from this month that will change as social workers are rearranged into six PODs that cover smaller geographic areas in line with the different communities and neighbourhoods of the city.
Each POD will have a lead practitioner whose role mixes together that of a senior practitioner and deputy team manager, four social workers and an administrator that will work together on the cases in their area.
“So rather than social workers having 20 to 25 cases and then reporting to a managers who have to make decisions without knowing the families, the idea is that each POD will work with a set number of children in that area and there would be a sense of joint ownership in terms of the practice of those cases,” says Butler.
That, she says, will mean more observations, more joint working and joint reflection.
Crucially, the PODs will also have adult workers on the teams.
“We’ve been lucky enough to get funding for adult mental health, adult drug and alcohol and domestic abuse workers as well, which is exciting,” says Butler.
“The plan is the adult workers will work alongside the social workers and help with the assessments, it’s very much about getting that joint approach at the beginning to link up adults plans with children’s plans.”