Social workers are “pivotal” to the success of direct payments but need improved training to build their skills and confidence.
That was one of the key messages from a report from Think Local Act Personal (TLAP) designed to help councils boost the number of direct payments and the experience people have of using them, in the face of a year-on-year decline in take-up.
While many practitioners supported the aims of personalisation, they struggled to navigate situations where people did not want full choice and control over their support, said TLAP, a sector coalition charged with promoting the personalisation of care and support.
A user-led organisation that contributed to the report also said that social workers did not always understand direct payments well due to a lack of training, which it said was one of the biggest barriers to take-up.
Improved training, development and support for practitioners – to enable them to champion self-directed support while remaining sensitive to the preferences of those who did not want full choice and control – was among 12 recommendations for improving direct payments set out in the report. It also called for people to be more involved in, and provided with enhanced information and advice during, the assessment and care planning processes.
Falling numbers of direct payments
Under the Care Act 2014, people have a right to a direct payment where they, or someone on their behalf, have the capacity to request one and the capability to manage it, this is an appropriate means of meeting their needs and there is no prohibition in regulations on them receiving one, for example, if they are subject to drug or alcohol treatment orders.
The government has also made promoting choice and control a key plank of its social care reforms, set out in a white paper published last year.
However, the number of people using direct payments in England declined in every year from 2017-18 to 2020-21, leaving 26.6% of social care users receiving, down from 28.1% in 2015-16, found a King’s Fund analysis of official data released earlier this year. Among those aged over 65, the proportion stood at 15.3%.
The think-tank suggested reasons for the trend included a lack of support to manage payments, over-prescription by councils in their use and a lack of choice of services, particularly where a person does not want to employ a personal assistant.
In its report, TLAP said that not only was there scope for “many more” people to take a direct payment, but also “much that can and should be done to improve the experience of taking and managing a direct payment”.
Training and support need for practitioners
Drawing on its experience of working with Essex council to improve direct payment delivery, a review of research and feedback from four councils and two user-led organisations, the report said that practitioners needed “good support and information to feel confident in supporting people to take and manage a direct payment”. One of the user-led organisations said: “Social workers do not always understand direct payments. There is a general lack of training. This is one of the biggest barriers.”
One authority TLAP spoke to, which had made direct payments the default option for care and support, had provided social workers with significant amounts of training and support to “demystify” the process of taking and managing a direct payment. This included showing practitioners video clips of older people sharing their experience of direct payments to tackle assumptions that they did not work for those over 65.
TLAP said research had found social workers, while committed to personalisation, felt conflicted and struggled to find the right intervention when the individual did not want full choice and control. The report said that, while this area required more attention, in research and practice, practitioners needed to respond to people’s circumstances and choices.
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A TLAP spokesperson said: “Great interventions by social workers can positively transform people’s lives, especially when those conversations include the option of taking a direct payment to enable people to have the fullest degree of choice and control over their care and support. TLAP’s experience is that this is too often the exception not the rule; our new reports aim to promote change.
“Social workers can provide the essential lubricant of clear information and advice so that everyone understands the purpose of direct payments and how the local system operates. Practitioners and their employers need to demonstrate leadership and the right values. They need confidence working with direct payments, whilst remaining sensitive to people’s individual circumstances and choices.”
Peer support ‘cannot be contrived’
The report also highlighted the value of peer support, particularly in providing people with information, advice and support on using direct payments. However, it found this was variable between areas, even taking into account long-term disinvestment by councils in user-led direct payment support services.
“Disabled people often want to provide peer support to each other around direct payments, but whilst councils can and should do everything they can to support this, they can’t make it happen as if it were a commissioned service,” it added.
The report also said action was needed to improve leadership, to ensure a strategic commitment to direct payments, and commissioning, in order to promote greater availability of small-scale, personalised services.
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At some point, we will have to ask the question about how much we can ‘reasonably’ expect from a social worker/ assessor. By that, I mean in terms of specialist knowledge in all areas, keeping up to date with all legislation and case law, policies, theories, best practice, and then actually apply that to working with people and trying to juggle huge caseloads because there’s not enough money to employ more workers. Not to mention the recruitment and retention issues even if there was money.
Except that you are not meant do and know all of this on your own. To borrow, begs the question what all the PSW’s, leads, strategic managers, supervisors, budget holders and the rest are for.
So, are the managers etc. supposed to know it all? I think the expectation is that social workers know it all in the council I work for.
Managers are paid their wedge and given time and support precisely so they can keep up with legislation and regulations and to disseminate this to their staff. Otherwise what are they doing with their role? Seniors and managers and their assorted helpers should know it all between them. Your council expecting you to know it all all by yourself is the reason why CC is full of reports chronicling service failures and appaling tragedies. Hold your managers to account, don’t do your and their jobs too.
I’m pretty sure our managers aren’t given the time for the either. My manager has to do all CPD in their own time as there no time in the w ok taking day between, meetings, supervision, responding to emails and supporting us. I know the manager very well. So I know this to be true.
Direct payments: Social workers need more traing.
MCA: Social workers need more training
Tackling poverty: Social workers need more training
Autism: Social workers need more training
Safeguarding: Social workers need more training
Begs the question, what are social workers actually trained for?
Simple. We are trained to stare at incomprehensible assessment forms in front of barely functioning computers shilly shallying to the tune of pretend professionals who are unable to see a world beyond the “hubs” in which real people with real lives never intrude. As any social worker who has had the humiliation dished out by “the panel” can readily attest.