The rise of non-qualified social care staff under personalisation

Are concerns over use of non-social work staff to assess potential service users the complaint of a profession under threat or genuine worries? Mithran Samuel reports

Last month, College of Social Work chairs Maurice Bates and Corinne May-Chahal accused councils of using personalisation as “cover for replacing social workers with a fancy array of job titles” that are cheaper to employ.

Those fancy job titles – self-directed support facilitator and contact assessment worker, for instance – are the property of non-social work-qualified staff involved in assessing and advising potential users.

Community Care’s personalisation survey has identified just how significant a role they play; 42% of respondents said most initial assessments were carried out by non-social work staff, compared with 46% who cited social workers.

For some respondents this shift, which has seen social workers concentrate more on safeguarding and complex cases, has been for the worse.

One said that social workers were “struggling to clear out the mess that the semi-skilled workers are creating”.

Another said diverting work to non-qualified staff would “have an impact on the quality of services and information that service users and their carers are receiving, particularly pertaining to legislation”.

But is this simply the cry of a profession under threat that wrongly downgrades the work of non-social work staff?

That personalisation has initiated significant workforce change within councils is beyond doubt. Most authorities had undertaken “a major workforce restructuring” that included a review of social workers’ role, found a 2010 report by the Putting People First Consortium, the local government coalition responsible for supporting personalisation’s delivery in England until this April.

The increasing role of non-social work staff has taken two forms, as Thurrock Council’s case illustrates (see case study).

First, councils have created roles to provide the first point of contact for service users, offering information, advice and, where possible, low-level assessments, often over the telephone. Staff filling these positions will often have administrative backgrounds.

Second, councils have expanded and reshaped the assessment roles of social work assistants, who have traditionally supported social workers in care management, often giving them new job titles.

Median pay for social workers in England and Wales last year was £30,400, compared with about £22,200 for social work assistants, according to the Local Government Group, and few disagree that finance has, at least in part, motivated these restructures. Even before the coalition’s cuts kicked in last month, councils were grappling with mounting demand for care.

“Local policy will be driven by several factors, including cost, and it tends to be cost that’s at the top of the list,” says Vic Citarella, director of care consultancy CPEA.

However, the increased role of non-social work staff arguably befits personalisation. If users are taking more of a role in assessing themselves there may be less need for professional input. If intervening earlier with people to divert them from the care system is a key objective, then providing the requisite advice, signposting and initial assessment need not require a social worker. Councils such as Thurrock believe they are serving more people and making better use of social workers’ skills by concentrating their time on more complex cases and safeguarding.

But there is no consensus as to what the role of the social worker should be in assessments. Jo Cleary, College of Social Work interim board member and Lambeth Council’s executive director of adults’ and community services, says she sees social work skills as crucial in intervening early with people with lower-level needs.

“My view is that social workers need to be at the beginning of the process [with all users] but that is not necessarily a view shared by every director,” she says.

Reflecting this, Lambeth is piloting an independent social work practice targeted at users who do not meet eligibility thresholds.

More clarity on how social workers should be deployed is planned. The Association of Directors of Adult Social Services produced an advice note on this last year, and is preparing detailed guidance.

But there are also concerns over the extent to which non-social work staff are appropriately qualified or trained.

Citarella says appropriate qualifications are available as part of the Qualifications and Credit Framework overseen by Skills for Care; rather the problem is take-up “because they don’t have to have them”.

However, there are also calls for a more formal training structure. “It’s very variable; there’s a bag of qualifications,” says Shereen Hussein, senior research fellow at King’s College London’s Social Care Workforce Research Unit, who says courses for non-social work roles often do not provide the critical thinking learned on the degree.

Cleary agrees. “It’s something we need to look at,” she says. “I don’t want people to feel devalued. [But] there’s a different world that we are trying to create [through personalisation] and it’s not a form-filling world. It’s about a different contract with the citizen.”

Case study: Thurrock Council

“It enables social workers to spend much more time with clients because they are not getting bogged down with pendant alarm assessments,” says James Thomas, a support planner at Thurrock Council.

Thomas is speaking about his former role as a community solutions worker, a telephone-based post created as part of a wholesale restructure driven by personalisation in 2009.

Previously, all assessments were carried out face-to-face, mostly by qualified practitioners or social work assistants training to be social workers.

Now, all calls come into the community solutions team: those with basic needs receive advice and information on local services; those with complex needs or safeguarding concerns are referred to locality teams for face-to-face assessment; and those in the middle receive their assessment and support plan there and then.

This can lead to them receiving meals on wheels, telecare or even home care.

Many community solutions workers have an administrative background. Training involves shadowing social workers on assessments and learning about self-directed support and safeguarding. Thomas did not undertake an assessment for a month after taking up the post.

Training in telephone skills and listening is also vital to encourage people to talk about their needs. Thomas recalls a case where this was important: “A person rang up asking for day care and I talked to them about their hobbies and encouraged them to join the local sailing club.”

Thurrock’s head of transformation and independence, Les Billingham, says staff are “really good at understanding when there’s a degree of complexity they can’t handle”.

And if they have doubts, they consult the community solutions team’s deputy manager and manager, both qualified social workers.

The support planner role was also created under the restructuring, to carry out less complex face-to-face assessments in the locality. Thomas says social workers are appreciative of this role for taking on “less strenuous cases”, enabling them to spend more time with clients in complex situations.

Thurrock believes it is able to serve more people than before as a result of the restructure.

Billingham adds: “It’s proven that it’s not necessary to have a qualified person to provide support and advice; and it’s often with people who are skilled, but not necessarily qualified, that people can articulate what their needs are.”

As their roles have changed, so too have social workers. “They now see the world differently – that it’s best to listen to [users] rather than be prescriptive,” he adds.

Thomas, meanwhile, plans to put the skills he has learned to use as a social worker, having applied for a council-sponsored training place.

(picture above: support planner, James Thomas)

More on Community Care/Unison’s personalisation survey

Social workers says bureaucracy is damaging personalisation

Support for personalisation plummets among social workers

Councils dogged by slow progress on personalisation

How bureaucracy is stalling the spread of personalisation

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