The moral and economic case for adult social work

By Owen Davies

Social work with adults, and with older people in particular, has had a lot less public and political attention than social work with children and families in recent years.

Whilst this is understandable, given the public response to cases like that of ‘Baby Peter’, it has led to a damaging lack of urgency in dealing with the social work challenges that arise as longevity continues to increase and the numbers of people surviving into their 80s and 90s with long-term physical and mental conditions rise.

In this context, the drift away from expert social work and towards other types of support for older people is very depressing. The College of Social Work identified this trend more than 12 months ago and began a project aimed at demonstrating the value of good social work in adult services generally.

We have published a draft ‘business case’ with the aim of moving towards an authoritative statement about why high quality services must incorporate a social work element.

There is both a moral case and an economic case for social work as a key part of adult services and we are gradually gathering research evidence and case studies that demonstrate this.

We support the idea that the interests of older service users can best be met by a mix of workers – including social workers, occupational therapists, community nurses, and others – but we argue strongly that designing services that minimise social work input is a false economy.

We have some early evidence that inappropriate admissions to residential care are minimised when social workers are involved.

At a seminar we reported the early findings of a community social work project in London. A community social worker had been appointed to work with 30 older people with personal budgets in a deprived neighbourhood with a view to building social capital. The results were promising: service user feedback was ‘extremely positive’ and there was an average reduction of 15% in statutory care packages.

If these early findings are confirmed, then the cost benefits will be very significant.

This process sits alongside the changes that will be brought about by personalisation in services for older people. In the early days of this policy there was some suggestion that social workers had been so compromised by their ‘care management’ role that they could not be trusted to ‘do personalisation’.

This misplaced fear seems to have subsided. As social work has recaptured some of the ground it lost in the bad times, more service users seem to appreciate the social worker’s ability to know how the system fits together and willingness to challenge orthodoxy – to say ‘why not’ when the first response from the finance people is ‘you can’t do that’.

The expected guidance about streamlining the bureaucratic processes following the Care Bill will make it easier for social workers to use their professional judgement to help service users to optimise their choices.

But it’s more than a technical issue and service users consulted by The College in the early stages of the project sometimes expressed concern that they were being ‘palmed off’ with staff with less authority and knowledge than qualified social workers.

It’s not just about skills and knowledge. The values that underlie social work – and I recommend that you read The College’s Code of Ethics – are those that are needed to make personalisation real, and not just a set of requirements in policy reports that sit on dusty shelves.

The College is also supporting other initiatives aimed at showcasing good social work with older people and spreading awareness of intervention strategies that work well.

We are strong supporters of the ‘Making Safeguarding Personal’ project run by LGA and supported by ADASS – the latest phase of this project aimed to attract the support of around 20 authorities but in the event over 50 wanted to get involved. A report on progress so far is due to be published any day now, but we can already see that an explicit commitment to listen to what service users want is essential to raise the quality of safeguarding social work.

We also welcome efforts in some areas to see how revitalising community social work might contribute to the wellbeing of older people. Community social work was a key part of the work of social services departments in the seventies. Perhaps its time has come around again?

At the heart of the issue of de-skilling support services for older people is the question of finance. Understandably local authorities, when faced with severe financial restraints, focus on meeting basic care needs as cheaply as possible.

But it’s a false economy. We will make the argument that focusing on building community assets, expanding the role of social work and shifting the emphasis to preventive services is a wise investment even in times of austerity.

The College has two fundamental aims – to raise professional standards and to explain social work to the public. We are making some progress in getting the message out about what social workers do day-in day-out to protect people from harm and promote their wellbeing. And we know that our members are enthusiastic about the efforts we are making to boost the quality of the CPD options available to them.

I have never met a social worker who is satisfied with just providing a ‘good enough’ service. All too often that is what happens because of external pressures but social workers know that we ought to be doing better. As a society we need to ensure that people who need social work support get a better deal.

Owen Davies, policy advisor at The College of Social Work