Things are a bit fraught

Social work is a psychologically dangerous occupation. Stress
levels are often high, leading to exhaustion, burnout, depression
and mental illness. It has often been viewed as an occupational
hazard, something that comes with the territory.

A Community Care study of more than 500 social workers with
depression earlier this year found that almost three-quarters said
that their depression had started after entering social
work.¹ Eighty per cent
identified their job as a cause.

Employers can no longer afford to ignore the consequences. Last
month, the Audit Commission published a report on the factors
behind the accelerating recruitment and retention crisis in the
public sector. It confirmed what many have suspected for a long
time: stress is the number one reason people decide to leave their
jobs.²

Even when people don’t make the decision to quit, sometimes it is
made for them. The Institute for Public Policy Research (IPPR)
suggests that a decade ago, muscular, skeletal or cardiovascular
problems were most commonly cited as reasons for not being able to
work. Now, mental health issues, often linked to workplace stress,
dominate.

Is working in social care particularly stressful? “Yes,” says Terry
Dadswell, who runs the British Association of Social Workers’
advice and representation service. “Staff in social care are more
susceptible because it’s such a grinding business. They deal with
misery, illness and poverty all the time. They see people who are
desperate, violent or abusive. It’s a very fraught job.”

But these pressures have always existed. The difference now is the
environment within which people have to deal with the inherent
stress of the job. Teams are understaffed and overworked, regularly
pilloried in the media and treated with hostility by the public.
They don’t have the resources to do their jobs properly, and
dedicated staff feel they have to drive themselves harder and
harder to ensure that clients don’t suffer as a consequence.

As Owen Davies, Unison’s senior national officer for local
government, puts it: “It is partly about increasing pressure, but
it’s also about the way public sector workers are seen as lazy and
feckless. People can take a bit of stress if they feel what they do
is valued and respected.”

The effects that stress and any resulting mental ill-health have on
teams are not good. Team members go off sick or simply resign,
leaving remaining team members with additional burdens. Or stressed
employees manage to keep going, barely keeping their head above
water, but performing poorly and possibly putting clients at risk.

In this context it seems a little ironic that, amid the plethora of
public sector performance targets and indicators, there isn’t a
single one asking how an organisation looks after its staff.

Mike Leadbetter, outgoing president of the Association of Directors
of Social Services, acknowledges that these are vital issues for
employers. He says: “For staff to focus on the needs of service
users, their employer has to focus on their needs.” As a result of
this recognition, Essex introduced revised grievance procedures,
new whistleblowing policies, and made available two counsellors to
whom staff can (and do) self-refer. There are now also more
opportunities for secondment, and the option to take a year’s
career break to work overseas.

More importantly, says Leadbetter, managers have to be willing and
able to act when they feel something is wrong. “It’s absolutely
pivotal that you have a robust supervision policy which means
managers can say to someone ‘I don’t think you are well, we’re
going to stop this session, and I want you to go home and see your
GP’.”

Employers also have a legal responsibility, under employment
legislation, to protect employees from the damaging effects of
stress. According to Simon Foster, principal solicitor at mental
health charity Mind, “The main one, under employment legislation,
is to ensure there is a ‘safe system of work’ in place, which means
that if someone is being made ill by work the employer must deal
with it. It is the same as the duty to deal with a dodgy electrical
cable – employers have to take steps to deal with the stress people
are under if it’s making them ill.”

But the options are limited for employers faced with staff who can
no longer do their original job. According to Dadswell: “In offices
where all the fat has been trimmed away, it’s proving very
difficult to find people other jobs that they can do – particularly
in small teams. We’re now seeing something called a ‘capability
dismissal’ where no other job can be found for someone. And even if
another job is found it’s very dubious whether you’d get the same
level of salary for very long.”

But there are other options. Cary Cooper is Bupa professor of
organisational psychology and health at Manchester School of
Management, and a stress expert. He says there are two issues: “The
first is about how we give people the skills to manage their
stress. There are lots of things that people do badly that add to
their stress – they don’t manage their time, they don’t prioritise
their workload. That can be improved with appropriate
training.

“The second is about structural issues. This includes bad managers,
not enough support, uncontrolled workloads, or bad relationships
between work colleagues. Individuals don’t have any power over
these factors. In my experience there are more bad managers in the
public sector, perhaps because there’s less good management
training.

“Organisations should undertake stress audits. There are lots of
tools to do that, but essentially, someone independent and
impartial from outside the organisation comes in to diagnose the
problems, and a working party consisting of managers, front-line
staff and unions is responsible for taking the findings of that
diagnosis and acting fully on them, without leaving out the
difficult or inconvenient bits.”

Cooper has little time for the idea that public sector staff simply
whinge more than those in the private sector. “There is a reality
to the complaints made by social workers – they are under stress,
they are overworked, their pay rates are terrible compared with the
private sector. There’s a support issue too, because local
authorities have become too mean and too lean. But they have better
support from their unions, which means their ability to pursue
their grievances is greater.”

But Cooper adds: “Whatever the reasons people give and the truth
behind them, as an employer, if you have a lot of people who simply
don’t want to come to work, shouldn’t that trouble you? Employers
should look at the bigger picture and ask themselves, why is it
that so many people don’t want to come to work?”

For anyone facing the decision to quit or go under, the newly
launched General Social Care Council code of practice for social
work employees and employers includes a number of relevant clauses.
These include a duty to report and to deal with “dangerous or
discriminatory practice”, and a responsibility to “respond
appropriately to social care workers who do not feel able to carry
out their duties”. Another demands that employers, while ensuring
that the care and safety of service users is the first priority,
must ensure that social care staff affected by ill-health are
supported and their workloads subject to clear limits.

Perhaps these government-supported codes will give employers the
leverage they need to demand resources necessary to care for and
support their staff.

¹

“Down on record”

² Audit Commission,
Recruitment and Retention, 2002, from www.audit-commission.gov.uk/