Coping without paperwork

The government has promised to sweep away the red tape clogging the care service, but some workers feel protected by paperwork, and face a change in the balance between deskwork and face-to-face visits.

An overload of paperwork has long been blamed for depriving social workers of the time and space to do their job.

Possibly the most popular thing the coalition government has so far done in social care is to ask Professor Eileen Munro to review child protection, with the aim of sweeping away as much bureaucracy as possible.

Munro is on record as saying that she feels a clean slate is necessary to really examine “why we record anything and what is the purpose of it”.

Such a potential change is breathtaking but, like the difficulties experienced by a long-term prisoner when released, it also raises the question of whether social workers will be able to cope without the paperwork. Quite a few influential voices within the sector have expressed worry that frontline workers will need retraining to ensure they have the skills to practice effectively.

The issue was highlighted recently in Channel 4’s documentary Dispatches: Undercover Social Worker, in which a children’s social worker said she actually preferred sitting at her desk filling in forms to going on home visits.

Professor Andrew Cooper, director of the Tavistock Clinic and the Centre for Social Work Practice, points out that avoidance of direct contact with service users is a problem in all emotionally demanding care settings.

“In psychiatric hospitals nurses often retreat behind the glass because it’s hard work to face patients and sometimes scary. Similarly, in social work, paper has become a kind of displacement for practitioners. It’s their version of hiding behind the glass.”

Munro agrees that the current system means social workers can use paperwork as a defence mechanism without being aware of doing so.

“To be honest I think some social workers may have been well trained but the job is so heavily bureaucratised that it’s deskilled them,” she says.

“The possibility of some practitioners needing to be retrained if the level of bureaucracy changes is a very real problem we have to take account of. To switch from filling in forms to spending time in family homes will be a big adjustment for some – they will need help in feeling confident and getting the skills to do it.”

Nushra Mansuri, joint manager for the British Association of Social Workers in England, says social workers have told her they are anxious about this kind of shift in the system.

“We had a series of meetings with BASW members last year regarding child protection work. Certainly some of the social workers there said they thought some practitioners would need to be retrained if paperwork was cut back substantially. The sector needs to recognise that if we are going to see this liberation for social workers, then high on the agenda has to be working directly with children.”

It is exactly the sort of area the new College of Social Work would be well-placed to deal with, she argues.

Cooper says the key issue is that social workers have been bogged down for so long they now lack the ability to think creatively.

“What you see in the sector is a lot of social workers unable to think outside the box,” he says. “They don’t seem to have any sense that they have lost contact with service users.”

He points out that while many complain about the current paperwork they also fail to be proactive about doing more face-to-face work with families when they can.

“Retraining is a longer-term solution – we’ve been losing this ability for a decade or more. So I think right now there needs to be a much stronger emphasis than there was in the Social Work Task Force report on refocusing the curriculum to look at reflective practice a lot harder.”

However, Colin Green, chair of the families, communities and young people policy committee at the Association of Directors of Children’s Services, takes a more relaxed view, saying reflective practice will come automatically when bureaucracy is cut down.

“The extra time that will result in not having to work that way will allow social workers to indulge in more reflection and development,” he says. “I don’t necessarily think it will require staff to be retrained. It’s about giving social workers the opportunity to spend time on reflection of a case with their peers and with supervisors and learning to operate in a different way as a result.”

Harry Ferguson, professor of social work at the University of Nottingham, agrees and claims that the vast majority of social workers already possess the skills they need.

“Of course the job is more bureaucratised and managed than it once was, but within that environment social workers still need to work with children and families. For all the sector’s imperfections, we do actually equip social workers to do face-to-face practice.”

Possible retraining needs

Spending time with the child: Nushra Mansuri argues social workers have been so stifled that they now look on spending time with children as a luxury rather than a necessity.

“Spending time with children is such an important part of the job, but it isn’t at all prescriptive because every child is different. You can’t take every child to McDonald’s – you need to think about the best way to work with this child, to relate to them. You need to think what environment is going to make them feel comfortable and animated, she says.

“I think that’s something that’s been taken away from the profession and it needs to be legitimised again through shifted focus and proper training. I’ve had social workers tell me they’re doing it on the quiet because the target-driven culture of their departments makes them feel guilty for every minute spent with a child. It’s extremely depressing.”

Risk assessment: Andrew Cooper says: “What social workers have lost is the capability to think about how to assess risk in a context where children remain at home and services are working to try to get the family to function differently.

“Getting parents to think about their family role differently and think about themselves differently is a very reflective process in which social workers have to carry a sense of risk with them at all times. They can’t displace it and think, ‘Oh well, I’ve completed all the right forms’. They have to consider the risk on a more continuing basis and that’s difficult work. They can’t panic or act prematurely and that takes confidence which I think a lot of social workers currently lack.”

Over prescribed practice: Colin Green says: “We need to consider what’s good about the current frameworks because there are good elements – at the moment they’re just over prescribed and buried in too much guidance.

“So, for example, assessments still need to be done in a timely manner; it’s a good idea to have a strategy meeting and a child protection conference because these are sound elements of practice and we will still need to do them. The hope is that these processes will no longer be so over-prescribed that they become an end in themselves.”

Related articles:

Eileen Munro must cut red tape, improve IT and build confidence

Sector experts urge Munro review to focus on workloads

Munro: Thresholds are wrong for children’s services

This article is published in the 5 August 2010 edition of Community Care magazine under the headline Coping Without Paperwork