A social worker who prioritised quality over timeliness has been suspended from the register for nine months by the HCPC.
A HCPC conduct and competence committee found the social worker did not complete assessments in a timely manner, or maintain documentation, in the cases of 14 service users while working as a case manager in a youth offending team from April 2010 to June 2012.
She also failed to file an intensive supervision and surveillance assessment in time for court.
“The registrant’s philosophy of intervention and quality being prioritised over the timeliness of assessments and the effective management of her practice was unacceptable,” the HCPC panel said.
Commendable objectives
The woman’s manager praised the high quality of her work and panel found that her focus on interventions and quality were “commendable objectives”. But, the panel felt, this quality came at the expense of the other service users she was responsible for.
“She chose to focus on fewer pieces of work to a higher standard. She spent too much time on parts of her caseload without prioritising key tasks. She therefore failed to carry out essential assessments in a timely fashion,” the panel said.
The social worker contested that she was not employed as a social worker at the youth offending team, but the panel said she was still a registered social worker and so bound to the General Social Care Council codes of practice that were in force at the time.
The HCPC found the social worker was unwilling to change, “despite it being demonstrated to her that assessments needed to be prioritised when there were restricted timescales imposed by national standards”.
“Late reports run the risk that timely decisions may not be made when a risk of serious harm to the service user or to members of the public existed,” the panel said. “It is clear from the extensive findings…that assessments were delayed for many weeks and months or not completed at all.”
Remedial action
The social worker was subject to interventions over several years “which went far beyond ordinary management” to ensure she practised safely. Her supervision increased from monthly to weekly, she held an “unremarkable” caseload and had undergone time management training, but continued to work in her own “entrenched way”.
“The provision of late assessments meant that the registrant was not acting in the best interests of those service users,” said the panel. “She also put the public at risk of serious potential harm and undermined the public’s confidence in her and the social work profession.”
The social worker told the panel that, since having her role at the youth offending team terminated in 2012, she had held six short-term contracts including one in “a highly pressurised environment completing initial assessments”.
But the HCPC panel noted that it had no independent evidence of the good practice she claimed and found that the social worker lacked full insight into her failings in part because she had failed to take “sufficient remedial action”, such as undergoing further time management training.
The panel decided that a suspension order was necessary to prevent the social worker from practising so she had time to remediate her misconduct.
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Be interesting to know what caused the historic issues to emerge and the HCPC to review the worker.
This finding is not to be confused with the current management tactics of bullying overworked assessment SWs to keep to DfE deadlines for assessment completion times that are contrary to the Munro reforms. From this we have instances of newer referrals being ignored in favour of prioritising lower risk referrals because they are over the completion time target.
Can we hope that the HCPC will take similar action also against senior managers when their conduct has put referrals carrying the risk of missing time targets above that of referrals carrying actual risk of imminent danger to children?
i totally agree with you, as senior managers are worst that the SW’s who are overloaded with cases some up to 30-40 children, and they should be held accountable by the HCPC.
Analogy being: If a person with a Large Goods Vehicle licence (LGV) driver is employed in a non LGV capacity (e.g. small van) in a van firm, but loses some of a load, their LGv licence will be revoked, even though they were in charge of a small van. Sanctions are sanctions, but how far do they go?
As a student social worker I have been contemplating this very issue as I try to empathise with a service user whose issues required that I spend a lot more time with him to really understand him (not to mention language barrier and alcoholism on his part). I just thought I may be missing the organisational target as I work with this individual to achieve meaningful change in his life. Fortunately for me, may be, is that I am only a student and in a supportive role to the other staff otherwise I may have to abandon the work I am doing with this man (which my manager thinks is great work) to finish a bunch of cases which I might just have to scratch the surfaces and send them over to God knows who to finish so I can achieve the so called targets. Not a good start for me perhaps.
Quantity over quality way to go HCPC
As a social worker with 36 years post qualifying experience, it seems to me that this Social Worker has stood up against a bullying culture prioritising the needs of bureaucracy and targets. The values of neo-liberalism and business have been allowed to pollute what should be caring and ethical practice.
Completely agree…qualified 9 years…came in to the profession to actually try and make a difference but bureaucracy and targets now govern what was a caring profession! Doing quality pieces of work that can make a difference doesn’t matter as long as boxes ticked. ..well done on 36 years 🙂
Just when I thought I was a lone voice in the world of stand up for social work(ers). I think we should start a support group even if we will be the only two members.
Ok without knowing ins and outs of this individual case & worker it is hard to comment on the judgement HOWEVER quantity over quality is happening throughout Social Work and it is not only sad but unsafe! Decisions are made on the back of assessments yet due to high case loads, untimely crisis situations (no, never in social work!!!) coupled with the said deadlines the pressure is immense. No time to even think let alone hypothesise in peer supervision or reflect upon cases in supervision with senior, let alone quality work with clients. So I question; how can assessments be of true quality, safeguarding meaningful and effective change brought about for children and families? There are so many more documents to be completed than the evidence based performance documents that just evidence this is a numbers game not a people’s gain.
I wonder whether she really did prioritise quality over quantity. I doubt very much that those people who were rightly expecting some level of service from her (assessments being completed), but found that it simply didn’t happen would think she was providing a quality service.
I found this to be really disturbing. If let’s say her assessments were on time but bad quality she will be in the same position. One could argue that poor assessments can lead to ‘fast’ decisions but running the risk of omitting crucial info that can have a massive impact on a young person’s life. Could you live with that?
I am starting to belive that panel members have never practiced social work. Assessments are a holistic process am I am of the view that the person that I am working with deserves to be given respect and attention to put the right support in place. They are not numbers. I am absolutely outraged particularly because decisions like the above give the message to students that is OK to do a shallow assessments ong asthey are logged on time. Also judging her based on only one role and not taking into account her overall experience ( before and after) sounds like a biased assessment to me.
Maybe they were trying to do their job properly and the deadlines don’t allow it, which works for most as they have no morals.
This isn’t about targets, bureaucracy or quantity over quality. This is about working within a youth offending team where national minimum standards apply to assessing the risk young people pose to the public in a timely manner. Failure to complete them in time leaves young people and the public at risk. Blindly refusing to complete assessments on time because you think your focus is better elsewhere is dangerous and I think the outcome here was justified despite the deliberately provocative headline. We aren’t talking about a situation where they were late doing an assessment because they were trying to do it to a high standard, we are talking about not doing the assessment at all because of focusing on other things. Very worrying.
I must say I am glad I don’t work for the HCPC and the social worker may be better off not working with youth offending. I think she was unfairly suspended if what is written is the real reason for her suspension
I fail to comprehend why she is forced to perform in a capacity that she was not hired for, seems to me that she was being milked and HCPC has not only condoned it but is stooping to bullying the social worker into submission
If her work is of such high quality then was isn’t she placed in a capacity where that skill can be utilized.
I think we all know this – There will always be an erosion of personal values in these settings. The issue (to me) is about control. If you cant control your work load or feel pressurised to carry out some task that erodes your values then its time to ask can i accept a certain amount of uncertainty about the way i practice- or not. If you cant then find another job where your values are not so compromised.
What bugs me about this is the person at the centre of this is despite her being line managed she continued to practice without it seems reflecting that her actions would have consequences on other peoples lives. Despite her good intentions she seemed to think that her way was the only way. If it had been me i would have adjusted my practice to meet the national targets etc and accept that my values around report writing were going to be compromised or look elsewhere for work where i can be more in control of the quality of the work i produce
I am a little confused why this has been taken to the HCPCC when she was not working as a Social worker at the time, it does seem out of there remit if she was not using the protected job title of social worker, I mean the reason we pay an exorbitant amount of money to the HCPC is to use the protected job title. Was there any indication given when this wasn’t dealt with within internal disciplinary Action, to me this highlights the nature of bullying in some organisations. I am also curious how a person is expected to evidence remedial action when they are suspended from practice ?
Completely agree with the panel. This social worker put her own arrogant assumption of quality ahead of court deadlines and placed service users at risk. She was given repeated guidance and supervision on managing her practice and decided to ignore this in pursuit of a personal crusade. This was deliberate and consistent bad practice addressed with an appropriate sanction from the HCPC.
While I agree that timescales are arbitrary and short-sighted, and while I agree that social workers everywhere are overloaded, does this mean timeliness doesn’t matter at all?
After all, is your work really high-quality and conscientious if you never meet a child or find out what their needs are? Quality and quantity of work are a balancing-act which social workers battle with every day. This worker seems to have decided it’s an either/or decision. What worries me is the assumption people are making that the work WAS high-quality. How do we know that? While it’s wrong to set timescales based on the organisation’s needs, we should still be working in a way that fits the child’s needs.
I feel the need to work in a timely fashion, not because the targets say so, but because I don’t want the children I work with to suffer harm and I don’t want their lives left in limbo due to one delay after another.
There is also a diminishing return to time spent on assessments: is a 20-hour assessment always twice as good as a 10-hour one? Or a 50-hour assessment five times as good?
As public service employees, as social workers we are accountable. The facts can not be disputed, however it’s the process that is being challenged .
Thanks for this posting and the opportunity to comment.
I am a disabled person and reminded not only of my 2004-2005 experience as a Basic Education Learning Support Volunteer to adults with learning difficulties that developed into my first waged work experience as a domiciliary care assistant under the umbrella of the same charity, 2005-2006.
In the former I was praised by a very experienced full-time care worker for my ‘endless patience with slower learners’, and she later became my acting line manager when I took up what turned out to be zero hours contract, cover duties work at £7.81 per hour with the same charity. As line manager she was supportive and understanding within the realm of her authority against senior management incalcitrance while serial ‘no growth’ budget funding from the local council led to shortage of in-service training. My Acting Line Manager attempted to get me Access to Work support, but the local provider said that she could not take me on as a client because the lack of in-service training available was derisory given the fact that the role involved working with vulnerable adults.
As a consequence the employer’s admin staff offered me cover shifts that I took up or turned down as I took unpaid time weighing up my skills and knowledge against ‘essential information’ outlines regarding each shift. As a JSA claimant submitting fortnightly part-time earnings forms at the jobcentre on signing-on days, I decided that was the safest way for me to proceed in the interests of both service user and myself as inadequately trained and possibly poorly matched to task. Each service user was different and yet the employer expected service deliverers to be ‘all terrain vehicles’.
More on the reasons why I gave up that work after ‘giving it my best shot’ at the guest blog piece Benefit claimants need firmer safeguards, not tougher sanctions.
Yet strategically re ‘targets’, my take on SMART targets as applied under neo-liberal government is not ‘Simple, Measurable, Achieveable, Realistic and Time-limited’, but ‘Spurious, Managerial, Arbitrary, Random and Terminal’.
And regarding the role of those who chop the funding for service delivery, a quotation from Jean-Paul Sartre’s adaptation of the Euripides play ‘The Trojan Women’ strikes me as highly relevant: “Those who give the order seldom see the mess it makes.”
Although I am trying to see this from both sides, I cannot help but think that suspending a worker in this manner is pretty ridiculous. Yes, targets exist that Social Workers are supposed to meet – say, completing assessments or reviews within a specific timescale, is one example…
However, just WHO gets to set these beaurocratic targets? Who works out the amount of time required to complete a specific piece of work, or action – for example, initial assessment, or putting together a care package? How does anyone know if the same action always takes the same time, if carried out with different clients? Do clients with really complex needs, or with severe communication difficulties, for example, take the same time to assess and get to know as clients with very basic needs? Some interventions are naturally quicker than others? Some care packages are very complex, and take time to arrange, establish and review – and even then, they may require constant “tweaking”.
Here’s the thing… Imagine there are 2 clients that a Social Worker sees. The first is an elderly lady who is newly adjusting to having a hip replacement. She lives alone in a bungalow, and has support from family and neighbours. She is easy to talk to, fully aware of her needs, and good at articulating matters.
The second client is an elderly man with suspected early stage dementia. He also has COPD and therefore struggles with mobility. He is a compulsive hoarder, and as a consequence faces eviction from his second floor flat (which, incidentally, he struggles to access when the lift is not working because his breathing problems make climbing stairs difficult). he finds it hard to communicate, and is forgetful, often missing appointments with his Social Worker as a result. He is isolated from support, as his only surviving family have emigrated to America, and he does not really talk to neighbours because they think he is a little “odd” because of his forgetfulness. Sometimes, when he is particularly confused and out of breath, he can get agitated and aggressive.
Are you going to tell me that to assess both clients, and to put together care packages, and to complete reviews will take the same time? Remember, the first client is quickly able to articulate her needs, always remembers appointments, and has support from family and neighbours. The second has no support network, is isolated, forgetful, sometimes aggressive – and misses appointments.
What if, on top of this, you add the desire of a Social Worker to provide a quality service? To ensure that the clients needs are met. To ensure that any care provided is appropriate, cost-effective, and person-centred. Can this always be done within set – and sometimes very limited – timescales? Does a complex case take as little time to sort out as a less complex case? Somehow, I doubt it – because otherwise IT WOULD NOT BE CONSIDERED COMPLEX!
Whilst some sort of guidelines regarding timescales may be appropriate, I do not think that the imposition of rigid timescales always makes sense. In this respect, I feel that I have to agree with the comment made by Christina. In rushing to comply with targets, a worker may therefore omit to consider – or even to gather – information that is important to a case. The consequences of this may be disastrous for the outcome. Yes, workers should strive to do things in a timely fashion (i.e. they should aim to complete their assessments and other tasks as quickly as is possible given the circumstances), BUT they should always remain aware of those circumstances, and tailor the assessment (including the length of time spent on it) to the circumstances. They should also aim always to be thorough.
What this case highlights, for me, is that there are conflicting demands within Social Work that make the job unnecessarily hard to do. It strikes me that these have come about because nobody appears to have really given any detailed thought to just what the job involves. Especially those at the top! Beaurocrats are given far too much power, and it is their power that drives the Social Work profession in a given direction. Yet nobody asks if this is the right direction. Furthermore, nobody asks if these beaurocrats actually have any personal or professional experience of Social Work.
I say this because, if we allow people with no experience of having undertaken a specific job to set targets for a job, or to dictate how the job ought to be done, then we are in danger of loosing touch with what that job ought to be about. Whilst targets may have some benefits – in that they provide guidelines as to acceptable timescales and waiting times (e.g. for referrals, for reviews), and in that they provide statistical data for analysis – we should beware of making them the be-all-and-end-all.
As Christina rightly points out, it is ironic to consider that a Social Worker may be disciplined for doing thorough, comprehensive work, but not to rigid timescales; or may be disciplined for doing work of a poor standard, rushed and lacking in thoroughness, yet meeting timescales. The punishment is the same, though the “crime” is different. Ought we not to ask which is the more serious “crime”? I can tell you that, personally, I would MUCH rather have a Social Worker who did thorough, conscientious, good work, but maybe not to rigid timescales, than a Social Worker who met deadlines but who cut corners, rushed jobs, and in taking shortcuts missed vital information crucial to cases. Is the latter not how we ended up with cases like “Climbie” and “Baby P”? Far better to have someone who actually makes sure they do their best to assess a client’s needs fully and accurately, and who thus ensures that the right care is in place.
Maybe the issue is that Social Work needs to go back to the proverbial drawing board? To look at the timescales imposed, and whether they make sense or are feasible. To do time and motion surveys of work, and just how long it does take to complete it to a good standard. Maybe there needs to be an element of flexibility to timescales, that takes account of the complexity of cases?
As Alan so astutely observes above, each service user or client is different, yet employers and beaurocrats expect that workers can deliver services as though they are “all terrain vehicles” – the same timescales are imposed, the same criteria, irrespective of the nature of the case, or its complexity. This turns Social Care away from being person-centred, and into a “tick box” exercise where interventions and care packages become increasingly “one size fits all”, because workers are obliged (even forced) to put the demands of beaurocracy to the fore. Social Work ought to be a responsive service – based on empathy and a desire to meet the needs of the people with whom that service works. Based around the clients and service users. Thus, we should recognize that some interventions require more time than do others – it is the nature of the client and the client’s circumstances. To try to fit people into boxes, as is the penchant of beaurocrats, does not always work in something like Social Care.
Maybe what we need are different types of Social Worker (and I don’t just mean Adult, Child, Mental Health)? What I mean is that some workers could do short term interventions, and others focus on longer term. We need a service that recognizes and reflects the fact that whilst some cases require only a brief intervention, and may then be closed; others involve long, protracted investigations, collection of evidence, serial interventions, changes of care package, alterations to the care package… For instance, providing meals on wheels is not the same as providing palliative home care to a dying victim of multiple sclerosis! Providing a time-limited care package whilst a person recovers from a knee replacement surgery is not the same as providing lifelong care to a person who has Schizophrenia and suicidal ideations! Can’t the beaurocrats see this?
In my eyes, this case ought to lift the lid on an unpleasant “can of worms” that has been festering away for some time! Questions need to be asked about the role of beaurocracy in Social Care. Questions need to be asked about timescales, quality of care, duration of care…Questions need to be asked about the roles of workers, and whether these represent the best interests of clients. Questions need to be asked about how we determine what is a short-term intervention, and what represents a complex case that may require longer-term involvement.
Oh… and, as an aside, you might like to consider just how UNFAIR and UNJUST it is to suspend a worker for wanting to DO THE RIGHT THING (even if the worker may come across as somewhat naïve or overly idealistic) when Community care have just reported a case in which a Social Worker who was CRIMINALLY CONVICTED FOR GRABBING HER PERTNER’S EX BY THE THROAT, PUSHING HER TO THE FLOOR, STAMPING ON HER TWICE, AND KICKING HER IN THE FACE has been reinstated to the register! If a CRIMINAL can be permitted to practice as a Social Worker, then it seems more than a little harsh to dish out a none month suspension to somebody who is guilty only of putting quality before deadlines.
QUALITY remember! She DID NOT KICK SOMEONE IN THE FACE. She wanted only to pursue QUALITY. How is wanting to do something WELL wrong?
I am sorry for the long previous post, and for the fact that I now wish to add this to it… I’ve come back to this issue, having given it some further thought…
Might it be that the case in question serves to highlight a problem that exists within the Social Work profession – indeed, exists within ANY field of work – and exists naturally? I refer to the fact that Social Workers are human beings, and human beings are all naturally DIFFERENT. Is this not what we are taught during our Social Work training? To respect and value individual differences?
Well, it strikes me that Social Work, like many other professions and jobs, does NOT recognize or value individual difference. Indeed, it fails to acknowledge this fact. Might I point out that because Social Workers are all different individuals, then they will all have different strengths, weaknesses, abilities, interests and working styles. If we accept that Social Workers do all have different talents, and different working styles, then it makes sense to understand that they will also most likely have different values that they bring to their work, and may as a result place emphasis upon different components of the job, according to their strengths.
In working differently – which is perfectly natural to all of us – different workers will see different targets as important, because they are naturally motivated by different things. Thus, some Social Workers will naturally see quality as of greatest importance; others will see meeting deadlines as of greatest importance; some may see being person-centred or empathic as hugely important when compared to other staff; yet others will see the ability to write comprehensive reports, or do thorough assessments as hugely important. Some workers may struggle to find a balance between multiple things that they see as competing in importance. Some workers may become frustrated as to what is important, confused, and give up altogether!
The message that I am trying to convey is simple. That ALL Social Workers are DIFFERENT, with different working styles. This naturally impacts upon what they view as the most important targets at work. Those workers who see quantity as important will find it easier to meet targets than those who naturally see quality as more important – the former are more motivated at work by the quantity target!. However, in viewing quantity as the most important demand, such staff may risk skimping on the quality of their work. Other staff may strive always to do quality work, but in working this way, take longer to do some things than those who may cut corners. Staff who view quality and quantity as conflicting demands are likely to find it difficult to regulate the balance between the two. And perhaps they are justified in feeling this way, because it is NOT right to sacrifice quality for the sake of quantity. However, nor is it right to constantly miss targets.
The point, here, is that targets are things that require CONSTANT assessment and revision. They also ought NOT to be inflexible. If it becomes evident that conscientious, hard working and thorough staff are more frequently missing targets than staff who cut corners, or are less thorough, then one ought to question whether it is the TARGET that is WRONG. Clearly, the evidence would then suggest that it takes LONGER to do a GOOD job than the target allows for. Again, if it becomes evident that staff feel pressurized to cut corners in order to meet targets, this is an indication that the TARGET may be UNREALISTIC. Yet again, the implication is that the target does not allow adequate time for the job to be done in a thorough, competent and conscientious fashion. The Social Work profession ought to be taking this on board. What ever happened to learning from staff feedback?
Furthermore, I might add that this matter highlights the fact that many employers, and managers, do not seem to be fully aware of the diversity of their workforce in respect of skills, experience, working styles… I would argue that it makes sense for any employer, and manager, to be well aware of workers’ individual traits and working styles, because that is how they become best able to manage and to maintain a healthy, functional workforce. If, as pointed out earlier, all staff are different, then their different strengths and weaknesses, and different working styles may well mean that they are suited to different types of work, to different tasks. Some Social Workers may therefore be better suited to short-term intervention styled working, others to long-term interventions. Some Social Workers may be very adept at doing quick assessments of simple needs – in and out quickly, with a small care package, review, and close the case. Others may be better suited to working on complex cases that require interventions and evidence-gathering over protracted periods of time; cases that need sensitive handling and which cannot be closed quickly.
Because of their individual working styles, different staff might benefit from different training opportunities, and different styles of supervision. After all, I had thought that the supervision process was meant to assist the worker in effecting reflective practice – a component of which should be the ability to address a person’s individual working style, and use it to its maximum potential. If employers, and managers, are not making themselves aware of staff members’ individual differences, then how can they seek to manage these staff effectively, and use their individual differences in a way that suits both the staff member in question, and benefits clients? Knowing the strengths, weaknesses, values, motivation levels, goals, targets and individual working styles of your staff is VITALLY important in providing a good service to clients. In knowing these things, you know better how to DEPLOY your staff effectively. In failing to address these things, you lead to failure of your organization because your staff ARE that organization.
Sadly, I sometimes feel that the world of work has lost sight of this; that we no longer recognize that staff are individual people, and that it is these individual people on whom the success or failure of a working venture – and ultimately a workplace – rests. This is not a problem solely attributable to Social Work; it may be seen in many places, especially places where there is an attempt to beaurocratize work. This problem of quality versus quantity, and of attempting to de-individualize the workforce may be seen as endemic within the NHS, the Police, the Teaching profession, the emergency services… ALL of these are also faced with the problem, and pressure, of trying to meet targets whilst also dealing with funding cuts, lack of resources, short staffing, changes in working hours or regulations… and the need to continue to provide a quality service. In situations such as these just WHAT remains important? The competing demands mean that some issues become prioritized, often at the expense of others. Is this acceptable? I think not! But, we all DO need to ask ourselves this…
In a situation where there are competing demands – a situation which in a worker creates a feeling of conflict of interest, and thus unease – just WHAT is likely to give?