As the Care Bill returns to Parliament, Bernard Walker explains how The College of Social Work intends to press for changes to the legislation that will ensure social workers play a leading role in its implementation.
The government’s decision to put individual well-being at the heart of the Care Bill has the potential to be its most radical innovation. We believe that the well-being principle, if it is fully implemented as part of the legislation, can bring about a deep-seated change in community-based health and social care services and improve the lives of the people who use those services.
The bill also emphasises the importance of prevention, which must be at the heart of any health and social care system which promotes well being. It will take strong social work leadership to reshape health and social care so that it is less reliant on crisis-driven services and more focused on preventing and postponing the need for care and support in the first place.
If the aims of the Care Bill are to be realised, social workers must be fully recognised and valued by fellow professionals as making a specific contribution to the well-being of individuals and communities. They will have to be confident and assertive with their health colleagues, to overcome the exclusive “medical model” of the NHS and combine it more effectively with the social model of disability and need, public health planning and models of community development.
In order to exploit this leadership role to its full potential, the Care Bill must equip social workers to take it on. A service geared to prevention would invest in information and advice for service users; it would make sure that assessments of need were conducted by the experts best placed to help people remain active members of their communities for as long as possible; and it would ensure that service users were prevented from drifting unnecessarily into institutional and hospital care. Finally, it would give adult safeguarding the status and professionalism it requires if public expectations are to be met.
So we have a four-pronged strategy for amending the Care Bill:
- Information and advice: named social workers should always be available to local information and advice services because they have the knowledge and skills to identify present and foreseeable need, and ensure that early and appropriate arrangements are made to prevent an unnecessary deterioration in an individual’s condition.
- Assessment of need: registered social workers should be responsible for assessing people with complex needs to ensure that socially inclusive, community-oriented forms of care and support are put in place, focused on well-being.
- Safeguarding: social workers should always be appointed to supervise safeguarding enquiries on the basis that they are trained to prioritise community solutions rather than default to institutional care and have the professional relationships with service users most likely to bring about a person-centred response. We have also argued that the local authority representative on safeguarding adult boards should be social work-qualified and that safeguarding adult review teams should include a social worker with substantial experience of safeguarding work.
- Powers of access: our survey of College members last year showed strong support for a qualified power of access by a social worker to interview a vulnerable adult where this was being blocked by a third party. Such a power could only be granted by the courts, as is already the case in Scotland. The government decided against including this power in the Bill, but along with our partners in the voluntary sector we are urging the government to reverse this decision.
So far the government has been receptive to our lobbying on the Care Bill in the House of Lords, in large part thanks to the efforts of Baroness Greengross and Baroness Browning in tabling several of our amendments.
Health minister Earl Howe conceded that qualified staff had a role to play in relation to information and advice services, adding that statutory guidance should lay out expectations. He also agreed to review the assessment clauses of the Bill to ensure that people with complex needs are assessed by ‘appropriately qualified staff’. Baroness Northover, speaking for the government, acknowledged that local authority representatives on safeguarding boards must have the required skills and experience.
Clearly, though, there is more to do to ensure that the government gives social work specifically the place it deserves in this Care Bill. When the Bill returns to the Lords on Wednesday (October 9) for its final stages before going to the House of Commons, we will continue to press for an explicit commitment to social work and the essential role of social workers in taking forward reform that is genuinely underpinned by the well-being principle.
Bernard Walker is chair of the Adults’ Faculty at The College of Social Work