Shortly before the Christmas break, Lyn Romeo, the chief social worker for adults, published an interim report reviewing progress on key policy areas. Here are five issues the report raises for practitioners going forward.
1. Social work leaders predict a tough year
The government’s spending review promised up to £3.5bn extra cash for social care by 2020. This comprised up to £2bn through new council tax raising powers and £1.5bn via the Better Care Fund (BCF), a pooled NHS and local authority budget.
Romeo welcomed the £3.5bn, saying it would help “put adult social care on a more sustainable footing”. However, the BCF cash won’t be made available until 2017 and Romeo warned backloading the funding means most councils won’t “see any positive impact in the short to medium term”. Combined with extra demand this will “continue to create challenges for delivery across the adult social care system”.
Romeo’s concerns over the backloaded funding echo those voiced by the Association of Directors of Adult Social Services (Adass) and the Local Government Association (LGA) after the spending review announcement.
The LGA has also questioned the government’s claim that the council tax raising powers will bring £2bn into the care system annually by 2019-20, instead putting the figure at £1.7bn. There are also concerns the move is “regressive” because more deprived areas will be least able to raise income through council tax.
2. New Care Act guidance will include principal social workers
Principal social workers are now in place in every local authority in England but greater consistency is needed in how the role’s implemented, Romeo said. So revised Care Act guidance, due this month, will provide “additional clarification” of both the principal social worker role and the responsibilities of local authorities around it.
On the issue of the Care Act itself, Romeo said progress implementing the reforms had been “broadly positive”. However, some areas were causing increasing concern, including a shortage of social workers to fill certain roles. Community Care understands the most pressing recruitment challenge is finding experienced social workers qualified as Best Interests Assessors (BIAs) or Approved Mental Health Professionals (AMHP).
Demand for social workers trained as BIAs rocketed in the wake of a March 2014 Supreme Court ruling, which triggered a ten-fold rise in Deprivation of Liberty Safeguards cases. In a bid to cope, many councils pulled any BIA-trained social workers into dedicated Dols teams, leaving posts needing to be backfilled in their previous teams. The demand for BIAs has also led to some social workers leaving local authority employment to go independent, adding to the recruitment challenge.
3. Practitioners will be expected to challenge poor MCA practice
It’s almost two years since the publication of a damning House of Lords report highlighted major problems in use of the Mental Capacity Act (MCA). Yet Romeo’s report found the legislation was “still poorly understood and poorly embedded” in parts of the health and care system.
How to improve practice? Romeo said social workers will be expected to provide “leadership and challenge” around the MCA but stressed this did “not equate to sole ownership” of the issue. Other professional groups have to step up and take their responsibilities around the MCA more seriously, she added. Other policy developments, including an MCA resource directory and new National Mental Capacity Forum, should also support improvements.
Romeo’s report reiterates her backing for proposals to revise the BIA role to a new Approved Mental Capacity Professional (AMCP) status. The move is included in the Law Commission’s draft proposals to reform deprivation of liberty legal frameworks. However, the government’s negative response to the draft proposals means the Law Commission will have to make substantial changes if the scheme is to have any chance of securing ministers’ backing. Final proposals will be submitted to the government by the end of the year.
4. Post-qualifying career development will be a priority
One of Romeo’s “key priorities” is to support social workers’ continuous professional development. One of the big challenges is too many social workers feel they’ve “no option” but to move into management to further their career, she said. This is because, the AMHP or BIA role aside, avenues to develop careers in practice are limited.
Romeo said there was a “pressing need” to create a practice-based career pathway offering social workers opportunities to develop higher level specialisms in key areas of practice such as dementia, end of life care and learning disabilities. As things stand these “often receive no professional status or recognition as specialist or advanced practitioner roles”. How to change that? Romeo said she’ll be watching the new accredited roles being tested in children’s services closely to see whether similar reforms could be applied successfully in adult services.
5. Key research will be out in coming months
An academic review of the effectiveness of social work with adults will be published in early 2016. The government commissioned researchers at Kings College London to carry out the research. Romeo confirmed that a draft report has been submitted. It found “overall the results are broadly positive” but little research was available on social work with learning disabled people. A series of pilots to give people with learning disabilities a named social worker to challenge clinical decisions about their care will be “crucial”, said Romeo.
An evaluation of the government’s four social work ‘teaching partnerships’ will be published in Spring. The partnerships aimed to strengthen on-the-job learning and improve the quality of student placements. Finally, Romeo will publish her full annual report – building on the interim report – on World Social Work Day on 18 May. The final report will give detailed examples of “effective practice-led” social work, she said.