“There was a lot of fear about jobs being lost. As a senior social worker, I had to re-interview for my role and that provoked a lot of anxiety. But I think, despite that, there was still some excitement.”
“The brokerage agenda had really taken hold in Wokingham and there was a sense that these arrangements might give us some leeway to actually do something a bit more creative.”
Jen Daines is recalling what it felt like when her employer Wokingham Council announced plans to move its long-term adult social work functions to a local authority trading company called Optalis. The company’s name is loosely based on the Latin word ‘Optare’, meaning ‘to choose’.
As a self-confessed ‘cynical social worker’ Daines had her reservations. Is this just a way to save money? Are we being sold off? But four years on from the changes, she’s glad she stuck it out.
“The unexpected bit for me has been that I’m actually happier now,” she says. “This way of working fits with my social work values more and that was a surprise to be honest.”
How does Optalis work?
The council’s decision to set up Optalis was driven by three main factors: quality, efficiency and growth. Senior managers wanted the flexibility to change the structure of services and the way resources are used, in order to deliver care differently and respond to prevailing pressures, both on the provider side and within the team.
This means the company is structured into four service areas – the brokerage and professional support function, which includes a team of social workers, occupational therapists and brokers, plus three provider units for residential care, home care, and community-based services.
Optalis delivers the core of the council’s long-term social work with older people and adults with learning and physical disabilities, as well as commissioning care providers. Referral and assessment teams have remained within the council, as have community mental health services.
“In 2011, we had a number of services thrust together and the emphasis on how we were going to do things and deliver care was different – there’s no two ways about it, it was tough,” says Lisa Evans, joint head of service for the brokerage and professional support team.
This was particularly difficult given that many social workers had been used to working with specific client groups – either older or disabled adults – and now were expected to be experts in both.
“When you come from a specialist niche and all of a sudden you’ve got to be a Jack of all trades, that is very challenging,” says Evans. “There are pressures on our team – we hold a lot of cases (1,503) and the amount of emergency stuff with risks that comes through daily is huge.”
‘Becoming equal partners’
Navigating the new relationship with the council was also a challenge and something that was difficult to prepare for, says managing director Mette Le Jakobsen.
“We’d thought very hard about what the structures were and what the task was but nobody had really been able to prepare for how the relationship works when you’re suddenly a commissioned service on contract to the council,” she says.
“Ninety per cent of what we do here is council work and we do that according to council rules, yet the way we employ our staff, organise ourselves and the culture of the team is completely different, so that relationship has taken time to work out.”
The issues with generating an identity were felt on the frontline. “We were all just the same people, sat at the same desks, but with a different hat on,” says Daines. “A lot of us remember working directly alongside our colleagues, we still do but not for the same organisation.”
“It’s evolved slowly over time,” she adds. “We very much see ourselves as separate now, but that’s important because it reflects that Optalis does have its own identity.”
‘Re-professionalising social work’
Optalis created its identity by focusing on ‘re-professionalising’ the professional roles within the service. These are more clearly defined, which allows the social workers, occupational therapists and brokers to stop being ‘care managers’ and really associate with their identity.
“Establishing the broker role has been one the key changes,” says Evans. “We’ve recruited people from all kind of backgrounds and with different life experience and that has added a new dimension to the team.”
Optalis has also opened the broker role up to newly qualified social workers (NQSWs) who are struggling to get work elsewhere. The NQSWs operate under the supervision of a social worker and don’t themselves practice under the protected title of ‘social worker’. This allows the individual to find their feet and be protected for a period, while Optalis assess their competence.
“We’ve brought them in as brokers so they come into the system, have some experience and consolidate their learning,” Evans says. “It’s ‘a-grow-your-own’ approach and some of those brokers have then gone on to join our social work team.”
Any NQSWs who succeed as brokers at Optalis are supported through an assessed and supported year in employment programme that the company has commissioned. “That has been one of the investments we’ve made that sets us aside from what happens within our local authority,” Jakobsen adds.
The use of brokers has also enabled Optalis to ring-fence where social work is really needed. The brokers are responsible for working closely with clients to create a care package that meets their needs. This has freed up social workers in the team to do the work they were trained to do.
“There was a danger in the past that our involvement in cases could go on for years,” says senior social worker Heather Gibb. “Now it’s much more about ‘what outcomes does the client want’ and once those outcomes have been achieved, you move on to the next person on the waiting list.”
“We are encouraged to be more businesslike in our approach, we don’t keep a case open ‘just in case something crops up’, which maybe in the past we had a tendency to do,” she adds.
‘Reviews success’
This ‘businesslike approach’ was something that social workers had initially feared about the move to Optalis – they were concerned that social work support would end up being costed out. However, it’s actually been very successful, particularly in the case of annual reviews.
When the changes took place, the number of reviews being completed was “unspeakable”, so the team ploughed resources into this area and developed a review team. Brokers undertake the reviews, which are then signed off by the team manager, who is a qualified social worker. Optalis now have 95% of annual reviews completed, which it says is way above the national average.
“We’ve been pushed on targets and efficiency but the way we’ve met that is to cluster reviews,” says Daines. “So, if we’ve got three clients in one care home, we do the reviews at the same time.”
“That’s had benefits because if we’ve spotted themes or issues with more than one client then we’ve picked up on potential safeguarding concerns, which we might have missed if we’d only done the one review,” she adds.
“More often than not we’re also sending the same worker in to do the reviews – that’s efficient and the clients love it because it’s consistent and they’re not having to tell their story twice.”
‘Person-centred focus’
The company has also embraced the potential of personal budgets and moved away from traditional services, which has opened up new opportunities for creative practice.
Gibb recalls one example where she invited a client and carer to help interview prospective social workers for the team. “I thought this would be really good because they are obviously the people impacted by the worker, so I organised for them to come along,” she says.
“They came up with their own questions that I vetted and standardised and I made clear that they wouldn’t have the final say, but that this was part of the process,” she adds. “That felt quite easy because all I had to do was go to Lisa and say, ‘What do you think?’ She said, ‘OK’, and I did it.”
“I’m not sure I would have felt the motivation to do that previously.”
Daines adds that there would have been “an awful lot of bureaucracy” if they had tried to do this in their previous roles. “We still have the same budget pressures and accountability as our council colleagues, but there’s that scope to be more creative, which we’d been desperate for.”
“If you had said to me before moving to Optalis that this would sit quite well with social work values, I would have been very negative about that,” she adds. “But actually the outcome – if you ask the people we work with – they would say it is a better way of doing things.”
This article is far too uncritical. What about the long term prospects when the service goes out to tender, when Optalis are asked to deliver more for less and there is pressure on their contract. Will there still be the same level of choice and creativity then?
This sounds a lot like the early comments people were making when they started turning schools into academies. More freedom and choice allegedly, however it turns out that academies are worse at improving schools than Local Authorities.
This is all well and good, but it is the professional view point, I would be interested to hear from persons to whom they provide a service.
Until these view points are obtained the current outcome can not be truely and correctly analysed.
It sems CC uncritically accepts the PR blather from any LA and puts it up as journalism. The use of brokers is nothing new, it has cons as well as pros. Did the LA really keep cases open “in case something crops up”? That finished 20 years ago with most older peoples services. There’s nothing new in any of this.
It’s very interesting to hear the views of staff working in a contracted out service and I welcome that. However it would be hard for someone who is named, identified and photographed to be entirely candid about their employer in a public forum like Community Care if they had current reservations about their service and their employer, so I am not surprised that other feedback is on the sceptical side.
Perhaps some anonymous comments and honest feedback from clients would provide a necessary balance.
Also it’s puzzling to hear that the changes the staff talk about in contracted services sound exactly like how Older People’s Adult Social Care in the local authority has been working for ages, apart from the possible exception of reviews. It sounds like the same way of doing things rather than a better way – so it would help to know what exactly is different. The only thing I could find was that you had a simple line of command/decision making – you only have to ask your head of service, not wait for a chain of managers to kick things into the long grass, so you can be more decisive about innovations like inviting clients into the interviewing process. It would be useful to see how this looks in a couple of years’ time.