Ring for service

If you have ever dialled a number with a simple query, only to be
offered a range of irrelevant options by a recorded voice, you will
know how deeply frustrating a call centre can be.

Yet the government is pressing forward with the introduction of
call centres in the public sector in the name of efficiency. Its
spending review last month talked about “more convenient access to
services through more use of electronic delivery or innovative
delivery outlets such as one-stop shops”, while the accompanying
Gershon efficiency review mentioned increased automation of call
centres to make savings.

So call centres seem set to be the ‘next big thing’ for a variety
of council services. But while that might be fine for council tax
enquiries, isn’t social work something that needs to be done face
to face?

Not everyone thinks so. Call centres are already revolutionising
the way some social services departments handle enquiries and
incoming calls. Gershon himself flagged up an innovative scheme in
Liverpool as a good example of public sector efficiency. And
Westminster has also taken the call centre message to heart.

Liverpool’s dedicated social care call centre, Careline, has been
running for more than a year. It has two different phone numbers,
one for children’s services and one for adults’ services, and about
5,000 calls are taken each week. Careline forms part of Liverpool’s
overarching call centre – Liverpool Direct – which has one general
number for people to ring about any of the council’s
services.

Careline’s former project manager, Terry Hawkins, says: “Just over
a year ago there was a complex organisation of different
switchboard and telephone number arrangements for people to contact
social services. There was also a complicated array of face-to-face
reception points. Professionals and service users complained that
they didn’t know how or who to contact.”

The switchboard would often clog up and collapse, with only half
the calls received answered. Now nine out of 10 are picked up
within 20 seconds, says Hawkins.

Instead of connecting to a switchboard operator, callers now speak
to a customer adviser. These advisers are not social care
professionals – in fact, many will not have had any social care
experience before joining the service – but they are required to
undergo a four-week training programme delivered by social work
managers.

This training looks at what information advisers should take from a
caller and teaches them how to make a referral. It also covers
legislation, confidentiality and data protection. In addition to
specific modules on children and families, vulnerable adults and
mental health, the advisers must also attend the local child
protection training courses run by the area child protection
committee.

Crucially, advisers are told when they should refer, or even
transfer, a call on to a professionally qualified member of staff.
To help them, social workers sit alongside and can step in at any
point.

“The social workers are there to deal with more sensitive and
urgent matters. The customer adviser can turn to a social worker if
they feel it’s necessary. Child protection cases are always handed
over to a social worker,” says Hawkins.

In the children’s service there are six social workers and one team
manager – a ratio of just over one social work professional to
three advisers. All the child protection referrals have to be
scrutinised by the team manager within an hour, and non-child
protection cases within 12 hours.

The adult service has fewer social workers – just three and a team
manager, sitting with 15 customer advisers. The adult service also
includes two occupational therapists who can commission small items
of equipment.

Advisers can check the client index system to see whether an
individual is known to social services. If they are the call can be
transferred to the appropriate social worker in the field social
work team; if not, a referral can be sent online to the back
office.

Since the launch of Careline there has been a significant drop in
the number of referrals taken. Liverpool Council says 40 per cent –
2,546 – of all calls regarding children’s services that previously
would have resulted in a referral have had their needs met through
advice, information or signposting on to other agencies. This
compares well to the old model when nearly every enquiry resulted
in a referral.

Nicky Urding, a children and families team manager, says: “Before
Careline social workers took on referrals sometimes because of time
limits or because they didn’t know how else to log the information.
There was no system to take in enquiries and so they had to be put
down as referrals.”

Given that social workers in the field team are no longer required
to take referrals, it could be expected that they have more time to
go out on visits. But Urding says this has not happened because of
the lengthy government assessment framework – even though some of
the pressure has been alleviated. “The call centre has saved time.
There’s no way we would meet government timescales without it,” she
says.

The efficiency of Careline is the subject of an evaluation by
Lancaster University and Barnardo’s. Only after the results are
known will other councils be able to decide whether it is a good
idea to follow suit.

Although Westminster’s social services department has a three-star
rating, it had a poor record of directing people to the right
service, says Vivienne Lukey, deputy director of social and
community services, explaining the reason for setting up a call
centre. “If the police needed an appropriate adult in an emergency,
they didn’t know whether to start with mental health or learning
difficulties teams or whether to go to the north or south of the
borough. There wasn’t a central number they could ring where
someone could signpost them to the right department or find the
answer and get back to them.”

Step forward, Vertex. A subsidiary of water company United
Utilities, Vertex specialises in customer care management. Under
its contract with Westminster, Vertex operates several customer
service centres – they do not use the term call centres – for 80
services in the borough.

The pilot customer service centre for social and community services
started in September 2003. Under the pilot, the centre deals with
five services: the substance misuse team; the children and families
department; the older people’s and disability team; the director’s
secretariat; and the complaints department.

There is a specific number for each of the five services. They run
9am to 5pm, after which calls divert to the emergency duty team. In
the week ending 25 July, 1,058 calls were taken and 86.2 per cent
spoke to an adviser immediately.

Five specially trained Vertex call operatives take the initial
call. Their job is to forward the call to information access
officers within the correct team. Part of the training involves
learning how to deal with the type of calls that come through to a
social services department – callers can be distressed, elderly,
abusive, or calls can be about child protection concerns.

The operatives are linked to the service’s database and can see
whether a caseworker is assigned to the caller. If they are, but
cannot be contacted, the can be reached by e-mail. If there is no
caseworker involved, operatives pass the call to the information
access officers.

“The benefits for our service users is that they have a more
simplified way of contacting us,” says Lukey.

The call operatives are just that: no more and no less. “We want to
keep the responsibility for the allocation of work and screening
people in and out of a service with the professionals,” says Lukey.

Tanvir Rehman, team manager for the social and community services
customer service centre, says: “It means we filter out the calls so
that the information access officers receive only the relevant
calls. It takes the pressure off social workers and admin staff so
they are not dealing with wrong calls or trying to work out who to
refer the call to. It frees them up to do the jobs they are paid to
do.”

Lukey says: “We used to get an awful lot of inappropriate calls
that should have gone to a different department. This problem is
resolved straight off as operatives can divert the calls.”

Andy Jones, team manager in the children and families department’s
duty and assessment service, says the system has reduced the number
of irrelevant calls by about one third.

“We would often get calls about planning permission,” he says.
“From a manager’s point of view it means you can focus staff time
and skills on the appropriate work they are meant to do.

“The more calls you have coming in, the easier it is to lose the
more important ones. And the more bits of paper you have, the
easier it is to lose the important bits. It cuts the calls coming
in and notes about irrelevant enquiries, making the system
safer.”

Implementing the system in Westminster has been helped by the fact
that the call operatives are based in the social services’ head
office. This allows managers such as Jones to listen in to how they
answered initial enquiries and give feedback and lets the
operatives consult social work staff.

Jones says: “If you do it properly, which I think we are, the
pay-offs are large. Social workers are doing social work, admin
staff doing admin. And we don’t get calls about other client groups
– or planning permission.”

But despite the largely positive feelings of those working within
and alongside them, there are concerns about the direction social
services are heading in.

Janet Foulds, chair of the standards and ethics board at the
British Association of Social Workers, says: “My worry is that we
are at risk of missing things. A social work service should have a
social work response. Sometimes that’s about knowing how to talk to
people who are distressed, how to ask the right questions and how
to analyse the information you are given.

“We could end up having social work decisions made by people who
are not trained to make them.”

Andrew Cozens, president of the Association of Directors of Social
Services, shares some of her concern. “It is important that the
staff are clear about the circumstances in which they must
immediately pass on the referral. The staff should have access to a
database so that they can check to see whether it’s an open or
known case.”

When older people approach social services they may not know what
help is available so may not make all their needs clear, says
Stephen Lowe, social care policy officer at Age Concern England.
“The person dealing with the enquiry needs to make sure that they
pick up any need for assessment, otherwise this type of service may
result in people being screened out.”

On a positive note, he adds: “This type of service could play an
important role by giving people a single source of information
about a range of local services, such as health, housing and the
voluntary sector, as well as social care.”

Alan Coombe, principal policy officer at Barnardo’s, is also
optimistic. “Call centres are a good idea so long as staff are
adequately trained and make efficient assessments of the calls they
receive. Call centres are no substitute for face-to-face contact,
but if staff are trained properly there is no reason why they
shouldn’t make a useful contribution.”