Study finds Care Act knowledge gaps among social workers and lack of impact of supervision

    Simulated decision-making research finds practitioners do not recognise social work as distinct service under Care Act and over-emphasise need to follow people's judgment of their own wellbeing

    Research results post-it note on mouse
    Photo: Artur/Adobe Stock

    Social workers have gaps in their knowledge of the Care Act relating to safeguarding and the nature of their role that supervision may not be able to fill, a study has found.

    Practitioners seemingly misunderstood key rules under the act and there was no statistically significant effect of supervision on their decision-making, found the research, completed in 2018 but published just before Christmas 2020 by the National Institute for Health Research’s School for Social Care Research.

    The research tested 169 adults’ services social workers in relation to four case vignettes, asking them to identify problems and decisions they would take, and select which of a number of decision-making rules were relevant to the case. Half had been given simulated supervision in relation to the vignettes they were given, though supervisors were prevented from identifying the correct problems and most appropriate decisions for each case, and instead provided active listening and asked probing questions.

    Social work not recognised as service

    The study found knowledge gaps in three key areas. Firstly, practitioners were much more likely to make decisions to assess or reassess a person’s needs or arrange care and support for them, rather than see the provision of social work as a service in its own right. Section 8 of the Care Act lists “counselling and other types of social work” as a service that may be provided to meet a person’s needs.

    In one vignette that was designed to include a need for social work support, 22% of decisions were to reassess the person’s needs, 57% related to their carer’s needs and just 22% involved assessing for or providing social work.

    The second gap concerned the weight that should be put on an individual’s judgment of their own wellbeing. The research found that practitioners relied on rules that led them to accept the adult’s judgment and wishes even where the indications were that doing so would probably not promote their wellbeing.

    Section 1(3) of the Care Act states that local authorities must have regard to the importance of beginning with the assumption that the individual is best-placed to judge their wellbeing, and to the individual’s views, wishes, feelings and beliefs.

    Tendency to follow individual’s judgment of wellbeing 

    However, while vignettes were based on decision rules that required a questioning of the individual’s judgment of their wellbeing, only a minority recognised this. Across the four vignettes, 9% of practitioners relied on the rule that the individual may not be the best judge of their wellbeing, while 27% cited the importance of beginning from the assumption that the person was the best judge. Likewise, 10% adopted the rule that it may not be appropriate to follow the individual’s views, while 51% cited that of having regard to the person’s views, wishes and feelings.

    There were also knowledge gaps in relation to assessment, including that the duty to assess need under section 9 of the Care Act still held if an adult who refused an assessment was at risk of abuse or neglect. Also, practitioners saw their duty concerning the protection of an adult in need of care and support from abuse was mainly to provide information and advice, and to refer to domestic abuse agencies, or less often to a safeguarding team. They did not recognise their duty to complete a needs assessment.

    This is despite protection from abuse and neglect being one of the elements of wellbeing listed under section 1 of the act, which any needs assessment under section 9 should consider, with the person being potentially eligible for care and support if their needs had a significant impact on this aspect of their wellbeing.

    “This implies that an adult with needs which are impacting on their well-being in relation to protection would typically not have such
    needs assessed nor be provided with services to meet them, other than information and advice,” said the research. “They would typically not be assisted by a social worker to protect themselves.”

    About the research

    The study, which ran from 2015-18, was led by Angela Jenkinson, then of Kingston University and now at King’s College London, and also carried out by Professor Jill Manthorpe, director of the NIHR Health and Social Care Workforce Research Unit at KCL, and Dr Marie Juanch and Dr Miroslav Sirota, from the University of Essex.

    One hundred and sixty nine social workers from local authority adults’ services were each given two case vignettes (out of four), developed by a group of principal social workers and a social work consultant, indicating a problematic circumstance and a need for statutory social work intervention.

    The social workers were aksed to note down five problems and five decisions they would take for each case. The social workers were also asked to select five decision-making rules they had most relied on from a set of 40. Half discussed the case in a simulated supervision before doing so, during which the supervisor provided active listening and asked probing questions but did not direct the practitioner.

    The social workers’ answers were then assessed against a set of correct problems and decisions developed by the PSWs and consultant.

    The findings fed into a 2019 practice advice note for social workers on the Care Act, written by Jenkinson and John Chamberlain.

    10 Responses to Study finds Care Act knowledge gaps among social workers and lack of impact of supervision

    1. Nihat January 7, 2021 at 10:02 am #

      Let’s hope this time round our profession actually learns the lessons and makes the necessary structural and training changes to improve our practice and meet the needs of people better. Thanks for the article Mithran

    2. A Man Called Horse January 7, 2021 at 3:22 pm #

      I guess this is what happens when you expect too much from professionals. Make it too complex and people will get it wrong. It is a no win situation for Social workers why would anyone do this job now? No respect from the Government, poor pay, abuse from Social Work England. My advice to anyone thinking of doing this job, is don’t do it, you will never ever be good enough.

    3. Chris Sterry January 7, 2021 at 8:04 pm #

      This article and the research on which it is based is a ‘breath of fresh air’ within Social Work and hopefully ‘lessons will be learnt’.

      However, from past experiences I fear they will not be, for in many instances lessons have not been learnt and the same mistakes still keep occurring.

      Why is this?

      Well the lack of finance for social care could be one reason, for without appropriate finance lessons will never be learnt.

      Another could be not allowing social workers to be social workers, in that management directives being given that do not support social work objectives.

      Social workers moral, which is not good due to the ever increasing work loads and lack of appropriate supervision and not being trusted.

      This and many other reasons is leading to institutional social work, instead of person-centred social work, where the system is more important than the persons needing care and support.

      If this is not changed then effective social work will cease to exist.

      • Jon Qualters January 8, 2021 at 9:34 am #

        I completely agree with the sentiment and argument put forward by Chris. especially lack of respect and finances and letting SW’s be just that, they have had the training (many times) so why not respect their decisions?

    4. Nancy January 7, 2021 at 9:09 pm #

      Ah but professionals love complexity, it helps cover up incompetence. “All professions are conspiracies against the laity”

      • Joy McCalla January 9, 2021 at 8:23 am #

        I would disagree with you Nancy, your statement is an insult to hard working trained and experience people who have to work within a very bureaucratic and complex organisations and systems.

    5. Nancy January 10, 2021 at 7:09 pm #

      Talking about your leaders not you Joy.

    6. Chalie January 10, 2021 at 8:47 pm #

      Not sure what hard work, training and experience has to do with professionalism Joy. Lots of people are hardworking, trained and experienced without the arbitrary validation pf being a “professional”. The insult is in the need to see one group of workers, say delivery drivers, as manual workers with no discernable skills and the preciousness and at times the narcissism of the “professions”. Social work is certainly bureaucratic and riddled with useless systems but the complexity is the con that layers basic tasks in unfathomable, un-evidenced, self serving and mostly pointless ‘policies’. From reading your posts I know that because of your committment and dedication you are a good social worker Joy. Neither of those define professionalism though, they are your own qualities.

    7. Carli January 11, 2021 at 12:18 pm #

      Social workers are assailed by and overburdened with acronyms. Social work academics love jargon, plain English is frowned upon, pedagogy used as an intellectual validation. None of this makes any of us a professional. We don’t have specialist tools that serve one purpose only so why are we so obsessed with this nonsense?

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