Checking the health of social work departments

Employers in England are being urged to carry out “health checks” of social services departments, but will they deliver improvements on the frontline?

High vacancy rates, heavy caseloads, complex IT systems, stretched resources and compromised supervision do not make for a healthy working environment. With such problems all too familiar in many areas, social workers often struggle to provide the service that users need.

Clearly the Social Work Task Force has had much to contend with. In its final report, it set about addressing working conditions by recommending that employers “hold frank and open discussions with frontline practitioners and managers about the reality of the frontline, the burdens practitioners are carrying, and how they can improve services”.

Now, under the Social Work Reform Programme, employers in England are being asked to carry out “health checks” of their social work departments (see panel, below) by the end of 2010-11, to assess whether practitioners are receiving the support required to deliver high-quality services.

The results will feed into two of the taskforce’s 15 recommendations: the development of “clear, universal and binding standards for employers”, due to be rolled out in 2012 alongside a national standard for supervision.

The policies will be applied on a national level, but what makes frontline conditions “healthy” or “unhealthy” often depends on small things such as how much office space is available for confidential meetings with clients or lone working risk assessments, says Helga Pile, Unison’s national officer for social workers. “There is a feeling that management is focused on performance indicators and don’t want to make the effort to find out what it’s like for frontline staff. The health checks will give social workers the chance to bring it into the open.”

Elected members must know the outcome of these checks so that the onus to address any of the problems identified is put on those responsible for making the financial decisions, Pile adds.

“There’s a big gap about what may be known at an organisational level and what members know about what’s happening,” she says. “You are going to find there is a severe staff shortage and there’s going to be a fear in the financial climate that it can’t be met but you can’t justify sweeping it under the carpet.

“Take it to the elected members and, if they can’t fund it, they will have to go to central government. What you can’t do is carry on covering up the problems, otherwise things will go seriously wrong within the service. There’s some kind of national expectation around this which strengthens their hand to say we need this to address these problems.”

Unison is disappointed at the lack of powers to enforce the requirements on health checks and the national standards, and is still calling for the General Social Care Council’s code of practice for employers to become statutory, in line with the recommendation of Lord Laming’s 2009 child protection review.

Pile says: “There’s an imbalance between professional standards that social workers can be held to account for but there’s no way of holding an employer to account [even though] the two are linked.”

Although Unison and the British Association of Social Workers have called for the checks to be carried out within months, it’s more likely to take until the end of the year.

Dave Hill, the Association of Directors of Children’s Services’ representative on the Social Work Reform Board, says: “The end of May [ Unison’s suggested deadline] is extremely challenging and would turn it into a checklist exercise. If this is to be used as the basis of proper discussion between frontline workers up to and including the director of children’s services and councillors, it’s not about filling out a form and you’ve done it. It’s about the conversation that follows from doing that.”

Jo Cleary, co-chair of the Association of Directors of Adult Social Services’ workforce development policy network, says it has to be regarded as a work in progress. Adass has agreed that a local authority from each of its nine regions will try out health checks. The London Borough of Lambeth, where Cleary is executive director of adults and community services, is one. “We’re just taking stock now and then it’s about having that engagement with social workers.”

Cleary already has regular lunches with social workers and predicts that two of the most pressing and complex issues to come out of the checks will be workloads and supervision.

Overall, there is consensus that the checks will lead to improvements. However, the taskforce’s recommendation that the results of health checks are published is causing some apprehension. Hill says: “[Health checks need] proper discussion between social workers and managers and that’s difficult if everyone thinks everything will end up in the tabloids. It’s not meant to be some kind of name and shame [list] comparing authorities, it’s meant to be a tool for improving services and a transparent dialogue. If the checks become a public document available through a Freedom of Information request all it will encourage is people to be less transparent.”

For Fran Fuller, BASW UK’s acting chair, there has to be a reason for publishing: “There has to be legislation or policy behind it, otherwise, what’s the point? It could give you a league table of best local authorities to work for rather than raising standards. It has to be underpinned by a consequence [if employers fail to comply]. But the more transparent we can be with the public the better.”

How healthy is your workplace?

The initial framework in the final report of the Social Work Task Force, published in December 2009, highlights five key areas on which health checks should focus.

• Workload management: vacancy rates; average caseloads; supervision sessions.
• Case allocation: unallocated cases; peaks and troughs in workflow; delays in transfers of cases between teams.
• Having the right tools to do the job: access to IT equipment including internet; access to information resources; appropriate office space.
• A healthy workplace: monitoring of stress and sickness levels; frequency of team meetings; risk assessments to ensure staff are protected on the frontline.
• Effective service delivery: staff survey results; findings from compliments, comments and complaints; feedback from service users.

Case study

Hartlepool Council Adult’s Services: Supporting frontline staff earns department five ‘excellent’ outcomes

Hartlepool Council adults’ services received a glowing report from the Care Quality Commission last year, with five out of seven outcomes rated “excellent”. Part of this was down to its proactive approach to supporting frontline staff, according to John Lovatt, acting assistant director of operations for adult and community services.

Lovatt says the north east council is using the Social Work Task Force’s health check framework to build on work it has already done to improve support for frontline social workers. For example, in 2005 the council developed a management stress policy and made it mandatory training for managers, and in 2009 it conducted a staff survey on stress levels.

“Once the survey was done we commissioned an independent evaluation to look at the different forms of stress staff experienced and the effectiveness of the support mechanisms we have in place across adult social care,” says Lovatt.

Senior managers used early indications from the evaluation to identify areas for priority action, such as tackling high caseloads, which fed into their discussions about how to approach the workload health check.

This led to the creation in February this year of a “complex case reference group” for adult social care workers. Any member of staff faced with a challenging case can book an appointment with senior managers to discuss it. “We share accountability, as well as our knowledge and skills,” says Lovatt. “It’s important to have a mechanism in place where people can speak to someone, and not necessarily their line manager, very quickly.”

The health check will also help with funding decisions. As lead officer for business transformation and service delivery options, Lovatt is responsible for allocating resources in adult social care for 2011-12. “I’m going to use [the health check] as a tool to inform that decision-making,” he says.

The council has yet to decide how it will meet the recommendation for it to publish results of the health check, Lovatt says. “We need to have a look at it in more detail and talk to staff before we move it forward.”

This article is published in the 8 April 2010 edition of Community Care magazine under the headline Health and Efficiency