Service user group criticises ‘narrow focus’ of Care Act review

Service users have criticised a review into a local authority’s compliance with the Care Act for its “narrow focus” on social work practice.

Disability organisation Equal Lives said the review into Norfolk council’s adult social care department focused only on improving the productiveness and job satisfaction of social workers and failed to address the wider issues for service users.

This included the impact of “unrealistic and unmanageable” cost savings and budget deficits faced by the council on older and disabled people, the group said.

The review, carried out by the Social Care Institute for Excellence (SCIE), came after Equal Lives reported the council to the Care Quality Commission and the Department of Health. The group accused the council of “disregarding” its statutory duties, a claim Norfolk denied.

The complaint was not upheld but the council agreed to commission the SCIE review to audit 30 cases, including nine selected by Equal Lives.

Mark Harrison, chief executive of Equal Lives, told Community Care that the findings of the SCIE review were “completely inadequate and incomprehensible for service users”.

“We are supportive of social workers, but the reality for older and disabled people in Norfolk is that many are not getting a service they need and those that do are seeing that service slashed or removed altogether.”

Tony Hunter, chief executive at SCIE, said the review was about “identifying the effectiveness of care experiences and outcomes” and while serious pressures remained, he believed the findings and recommendations had been viewed as “helpful and positive” for enabling Norfolk to move forward with implementing the Care Act.

‘Difficult conversations’

The aim of the review was to identify whether Norfolk had put in place the appropriate tools to meet the Care Act and the extent to which current practice complied with the principles and duties of the act.

It looked at frontline practice and the council’s approach to assessments and reviews, as well as eligibility determination, personal budgets, care and support planning, and information and advice on direct payments.

SCIE said that issues around funding and its impact on social work practice were “not specifically in the scope” of the review, but were raised by participants.

For example, the review found many members of staff “felt anxious about having difficult conversations with individuals about meeting needs amid budget cuts” and while they were “aware of the limited amount of financial resources, they were not always fully equipped with the skills and knowledge to have these conversations”.

It also found that the “lack of time and budget reductions” had compromised social work practice. SCIE recommended that the council carry out an audit to determine whether social workers have enough time to properly deal with all allocated cases.

Other recommendations included changes to terminology to avoid confusion about the council’s roles and responsibilities under the Care Act, and a review of the way the council communicates with people who use adult social care, including carers.

‘Wish list of recommendations’

However, Equal Lives criticised the review for focusing only on improving social work practice, not “the effectiveness of social care for service users”, and for setting Norfolk recommendations that were “virtually impossible to deliver” in the face of budget cuts.

The group added that the “situation could only get worse” and pointed to new cases coming into its advocacy service, which replicated similar issues for service users.

Harrison said: “We wanted an independent inspection of adult social care in Norfolk because we believed there were not enough available resources to meet legal duties under the Care Act and we still believe that to be the case.

“It has been confirmed by research, everyone is saying that social care is underfunded, so the SCIE review has set Norfolk an impossible task.”

Equal Lives is now calling on Norfolk to consider shifting its adult services provision to a model similar to that seen in Shropshire, where community interest company, People2People, delivers community social work services on behalf of the council.

“Norfolk is trying to achieve better outcomes for service users more cost effectively. The Shropshire model, if implemented effectively and resourced properly, seems like a great avenue to go down,” the group said.