Take part in the debate…

…and visit  which is mounting a green paper campaign in tandem with this series of articles, including an online discussion forum for all our readers to air their views on each week’s theme. We will compile your views into a report to be discussed at our green paper conference, Power to the People: Will the adult green paper deliver?, taking place in London on 27 June. New workforce roles raise many questions. Tell us what you think.

 

About the panel

Our panellists are drawn from the Inter-Agency Group on the green paper, a coalition set up to analyse the impact of government policy on adult social care.

 

John Dixon, Association of Directors of Social Services’ disabilities committee

“ The new roles referred to in the green paper are potentially confusing: care navigators, care brokers, along with the existing care managers. And who is best placed to carry out these tasks? A local authority social worker?  An independent? The service users themselves? We need to build on best practice in developing self-assessment and service users may need help to find their way around (from a “navigator”): here, knowledge of the system is the prerequisite and some service users may also prefer this person to be independent of the local authority.

There will always come a time when an assessment with significant funding implications needs to be matched with needs-based criteria and that is a role for a care manager.

But there is also a role for independent care brokerage. West Sussex buys only about one fifth of its formal care provision; the rest is paid by service users and their families. Often these decisions, with their life-changing consequences, are made with little or no advice. If those people were buying a financial product they might well go to a financial adviser. Why not go to a care adviser or broker for this even more important decision?

The green paper lays great stress on the need for a change of culture as well as improved leadership. But staff should find it gives them a chance to do what they came into the job for in the first place. The gatekeeping process removes social workers from personal contact with clients and submerges them with paperwork.

We’re running a project at our help desk in Chichester, returning control over workflows in referrals and intake to the social workers. Staff who were desk-bound are now able to go out and make personal assessment visits.

The results have been startling - the proportion of cases resolved satisfactorily at first contact jumped from 46 per cent to 82 per cent.”

 

 

Jeni Bremner, programme director, education and social policy, Local Government Association

“ The green paper must be seen alongside the children’s workforce strategy published by the Department for Education and Skills. A key role for both the new directors of children’s services and the directors of adult services is working together to plan and develop the workforce. Many of the skills are transferable between adults and children’s services.

And, as children are cared for by adults, child protection will remain an issue for adult services. Staff in both adult and children’s services will be working with families and communities and there are the issues of transition between services to support children and young people to services for adults.

Directors of adult and children’s services will also need real joint working arrangements with local health organisations as actions in one part of the system will have knock-on effects in other parts of the system.

At the centre of the green paper workforce agenda is social work. Care navigators, care brokers, person-centred planning facilitators and care managers are roles currently carried out by social workers. Social workers are at the heart of joining up care across different sectors and professional groups and we must continue the work to support and develop this essential profession.

The quality of our services is dependent on our workforce. Building its capacity will require real investment in training. In such a workforce intensive sector that will not be cheap. The current level of investment is welcome but without further sustained investment in training and development across the social care workforce, the green paper cannot be delivered.”

Jo Webber, policy manager, NHS Confederation

“ If care navigators and planning facilitators are to be introduced, isn’t there a danger that current working relationships between health and social care at operational level will be upset?

The challenge will be to manage this transition so that integrated care between the professionals working in health and social care sectors is maintained and enhanced.

Care navigation should be part of the skills of all primary care professionals. But perhaps this role has been lost as our services provide ever-increasing services within the same finite resources.

The navigator or manager of care for an individual person could be a community nurse or matron, a social worker, a health care assistant or care assistant - it is the role and the skill, not the title that is attached to it, that matters. And where will these new staff come from in a system that already struggles to attract recruits?

The status of the social care profession and staff morale needs to be addressed as a matter of urgency by the government - that’s the key to the current recruitment and retention challenge.

At the level of care worker and health care assistant there needs to be investment and development just as much as for the more senior grades.

We would like to see better cross-agency shared training, both before and after registration, and we would also like to see the government actively investigating the possibility of shared registration. This could lead to better integration and movement of staff across care boundaries so that we can break out of our individual silos, not develop a new one with more jargon-laden titles. ”

 

Heléna Herklots, head of policy, Age Concern England

“ There are more than one million people working in social care and more than half work in the private sector. A trained and supported workforce, with appropriate recognition and status, is crucial for getting the right services and outcomes for social care users.

The green paper puts forward a number of suggestions of key roles to help and support users. These include care navigators, person-centred planning facilitators and care brokers. These roles reflect both the aspirations of the green paper - to give users more choice and control and the support to exercise this; and the implicit acknowledgement that the social care system is so complex that it is almost impossible to navigate it successfully on one’s own. So, care navigators could have an important role to play. But the green paper has missed an opportunity to look at simplifying the system for those who use it and those who work in it.

The green paper also ducks the issue of funding, which has a direct bearing on the social care workforce. Without adequate funding for social care the well documented workforce problems - recruitment difficulties, high vacancy rates and retention problems - are going to continue. And an ageing society makes it increasingly important to recruit, retain and support older workers.

Volunteers get a mention but their vital role in social care, and their importance for its future success, is underplayed. Carers are also acknowledged but the green paper should place more emphasis on their support, including making training much more widely available. Finally, the need for the workforce, in whatever sector or role, to work across boundaries and work effectively with different disciplines must be further encouraged and supported.”

Angela Greatley, chief executive, Sainsbury Centre for Mental Health

“ The challenge of creating a new social care workforce is similar to that facing the NHS. Efforts to boost the NHS mental health workforce have concentrated on recruitment and retention, tackling some growing problems with an ageing staff profile. These are problems for social care too. What is clear is that doing more of the same in either health or social care will not fill the growing gap. We need a new kind of recruit.

The green paper is strong in identifying leadership and the need to stimulate the voluntary, community and private sectors. It is also strong in identifying the potential for community support and volunteering alongside the more specialised social and healthcare sectors.

But both health and social care are still a long way from knowing how they are going to attract recruits from outside the traditional professional routes and from a wider range of cultures and backgrounds and provide them with the knowledge and skills to do the job. Whatever approach they take, the two sectors have to work together to avoid robbing Peter to pay Paul by competing for a diminishing pool of recruits.

We also need to avoid re-inventing wheels. Mental health has some long - and not altogether successful - experience of roles like that of the proposed care navigator and of advocates. It will be a challenge to get people to do advocacy well and for navigators to be more than care managers for mainstream services. Many staff have these responsibilities as part of their work currently. They need acknowledgement of this role and support to develop it. A new profession is not what is required.”

 

Independent View

Ray Jones, director of adult and community services, Wiltshire Council and deputy chair, British Association of Social Workers

“ A vote of confidence for social care workers and social workers - that’s my reading of the green paper.

For social workers in particular there are many positive statements about how we have, and can, contribute to assisting people to live independently, with more choice and control, and where they continue to play an active role in their communities.

The traditions of social work include a concern for social justice, seeing people’s strengths and capacity as well as their difficulties, helping people to determine their own solutions to problems and not running away from the distress that people may be experiencing.

As well as assisting people to shape their own pathways in a complex world (the “care navigator” role), the quality of the relationship between the social worker and disabled and older person is also given prominence, with specific therapeutic interventions being within the competence base to be used when necessary.

This is a chance for social workers to gain the professional recognition they deserve…let’s take it.”

Training and learning

Questions about this article to guide discussion in teams are at www.communitycare.co.uk/prtl Individuals learning from the discussion can be registered on a free, password-protected training log held on the site. This is a service from Community Care for all GSCC-registered professionals.

Abstract

In this article, leading professionals from the social care sector look at the green paper’s proposals for the workforce. New job roles, such as care navigators and care brokers, are examined, along with more traditional concerns about recruitment and retention and the training of the social care workforce.