I had lots of thoughts and a few half-written posts to ponder but rather than finish any of them, my thoughts are turned to my holidays as I leave imminently.

I’m going to the United States and will likely drop off from posting for the next couple of weeks – I do, of course, reserve the right to post occasionally but as of now, I’m not planning to.

In the meantime, if you tune in to ‘All in the Mind’ on Radio 4, I recorded a short piece for them which should be aired on Tuesday 14th July – but I wanted to scoot beneath the surface as far as possible so it’s just going to be ‘a social worker’ ..  I’m going to be out of the country and haven’t heard the final edit so if schedules change unexpectedly or it doesn’t happen as planned.. well, it’ll be an interesting listen in any case!

flavouz at Flickr

Back soon!

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Yesterday, Ed Balls announced a plan to fast-track other ‘professionals’ like lawyers, teachers and police officers into social work on a one year ‘scheme’.

He says that this scheme – which will attract a £15,000 payment to those who take up the offer – would appeal to those who might be put off by a three year degree.

I wonder how much he knows about social work itself though outside his departmental bubble. Ten years ago, I took a two year postgraduate Masters course – the kind of which exist currently – and alongside me on my course were former teachers, police officers and even (believe it or not!) a clinical psychologist. Sure, we didn’t get £15,000 but we did two placements alongside the academic training.

I wonder how it will be compressed into one year. My understanding is that it will be ‘on the job’ type training. Perhaps he hasn’t learnt from the difficulties universities are having at the moment in finding placements.

Maybe I’m just too cynical but I have to wonder if Balls is even aware of the post-graduate route to train as a social worker. He seems completely oblivious to its existence – from his comments that social workers should be trained to post-graduate level (a good proportion already are, Balls!) to his comments that some professionals wouldn’t want to leave work to take a three year unpaid degree (the Masters attracts more funding and it’s only two years so no lawyer/teacher etc would be taking the three year route anyway!).

For all that, I don’t want to be too cynical. It isn’t Ed’s fault he is so ignorant but the idea behind it – namely to encourage people to seek a second career in social work – isn’t a bad one. I am just confused as to how the necessary skills can be compressed into one year – after all, as practitioners, they will still need the same knowledge and experience.

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The Guardian reported yesterday that the expected publication of the Green Paper which would outline future funding plans for adult care has been put on hold, having been due for publication on Tuesday. The Case for Change – a presentation of the discussion document – was the precursor of the still embryonic Green Paper and those discussions and debates took up a good proportion of last year.

I haven’t probably followed the progress of the Green Paper as much as I should have – apart from having a vague awareness that ‘it is coming’ but the article made some points that sprung out at me and that I’m sure I’d have caught earlier had I been paying more attention.

The reason that is stated for the delay is some kind of wrangling between the Department of Health and the Department of Work and Pensions – because there may be on the cards a proposed scale back of the Care Component of DLA (Disability Living Allowance) and AA (Attendance Allowance) to use this money to pay towards the cost of care services. In essence (although not in monetary value) they are the same benefit but DLA is paid to under 65s and AA is paid to over 65s (at a lower rate usually but that’s another argument for another day).

In the case of residential care, this money is already taken by the local authority when they fund placements but the proposals, reported in the Guardian, would be used to fund some kind of discretionary ‘social care’ grants which would likely be used to filter this money to local authorities who could then possibly reallocate according to their means-testing.

These benefits are wholly non-means tested and are provided to pay for additional costs related to disability. There are few non-means tested benefits left and understandably they are deemed to be less efficient than those that are targeted to the highest need. It would though, be a political bombshell – hence, the Guardian claims – the delaying of the publication of the Paper.

Personally, I’m torn. I have, first-hand, seen the benefits of a non-means tested benefit for older people. The criteria are clear while often it is a question of persuading people to take what they are entitled to, particularly, in my experience anyway, with older people rather than creating a further layer of tiered funding that it more arbitrary and unfathomable and creates another level of bureaucracy, no doubt.

However, money is needed to fund care services. The money has to come from somewhere and if it is a matter of taking from a blanket benefit paid regardless of levels of savings and assets or raising the bar to accessing services, I’d rather the former.

Whatever is announced there will be political implications. People don’t like paying for care, perhaps it is the line between health and social care that becomes too blurred and we are accustomed to a health service that is free at the point of delivery.

Personally, I think over the long term, some kind of insurance system is bound to be implemented and is possibly the most equitable but it won’t solve any of the short term issues that are going to arise.

Interesting times.

I’m going away soon. Friday will be my last day at work for a couple of weeks anyway and I’m heading west for a while. It brings to mind one of those panics though when you go through each and every set of case notes and try to imagine all the possible and potential scenarios which might or could play out while away.

I’m also trying to ensure that paperwork is at least showing a semblance of being up-to-date – not always as easy as it sounds (I don’t know though, does it sound easy?).

There is, as is wont to happen, one person I am particularly concerned about. You pass all this on to colleagues of course but we are moving into peak holiday season and increasingly there are fewer and fewer people actually around and ‘picking things up’ is restricted to emergencies. There is a possibility it will be resolved to a point, anyway, this week but I then sometimes feel guilty about imposing my time limitations on other people.

My fears are.. well, I shouldn’t always look at the negative really but there’s someone else who seems to become more unwell whenever I go away, even if it’s for a long weekend but I have to reassure myself that he knows the people to call and things to do and when I’m out of the country there’s little I can do.

This week though, I’m mixing between a few visits and a mad dash through the files to ensure that anyone picking any of them up will have a rough idea of where I’m at and what I’m doing.

Picking up other people’s work on holiday always seems to be something of an issue. The same level of service can rarely be maintained and so, as I ring around to remind people that I’ll be away, I’m aware of the feelings of abandonment as there is not an equal or equivalent offer of service. Sure, I leave alternative contacts (although everyone has these anyway) but somehow it doesn’t feel the same.

And I’m reminded how long it is since I took more than about four days off in a row.

But before I leave, there’s the bluster and rush of trying to get as much done as possible. I’ll need a holiday after all of this!

skyseeker at Flickr

There is a story that has been concerning me over the weekend. It was reported by The Daily Telegraph and while the details of the story are troubling taken prima facie, I can’t help thinking there is a lot that we aren’t being told.

Under the inflammatory ‘Is the state guilty of child kidnap?’ headline, Christopher Booker details the situation where a man was reported by the headteacher of his children’s school to social services because he showed concern about the safety of his children (seems a bit unusual to say the least). The social worker then turns up with the police to take Mr Jones (pseudonym) under a section 136 to a hospital where he was assessed and admitted under Section 2 of the Mental Health Act.

Mr and Mr Jones, accompanied by their younger son, arrived at school to pick up their daughter, they were met by a group of strangers, one as it turned out a female social worker

OK, why is the gender of the social worker remotely relevant? There is no mention of the gender of any other professional in this article, including police officers, so why mention that the social worker was female? It would probably be more unusual if the social worker were male but then, I think the so-called ‘journalism’ compiled from the files of one family who clearly may have a reason to be angry with social services, is intended to outrage rather than inform.

Back to the story, the Jones children were taken into local authority care.

Mr Jones was discharged from hospital by a Tribunal two weeks later. The children remain in care. His wife was at home while this happened. He contacted various members of the legislature, one of whom contacted the newspaper.

Obviously it is a shocking story, but there is a hunch, just a hunch, mind, that there is an awful lot that isn’t being reported here.

The language of the article is almost sneering in its tone. Of course, I wouldn’t expect balanced reporting as the information source is barely balanced. I doubt the reporter has access to full medical records and to be discharged by a Tribunal is not an indication that no mental health issues ever existed. It could be that either it was not sufficient to warrant admission at that time or that the need for the admission had served its purpose.

I can’t imagine why a local authority would benefit from keeping his children away from him unless they had good reason.

Of course, all the blame in the system lies with social workers – particularly the social worker who turned up at school who

..asked, without explaining why or who she was, whether he was Mr Jones. When she three times refused to show him any ID, he was seized from behind by two policemen, handcuffed and put under arrest

I have to say, personally, I’ve never refused a request to see my ID, in fact, we encourage people to ask us but we don’t have any idea of the circumstances and possibly a speedy exit from the school grounds (where this happened) was seen as the most appropriate action. He was not arrested. He was taken under section 136 which says

The police officer must find the person in “a place to which the public have access” and:

• the person must appear (to the police officer) to have a mental disorder and to be in “immediate need of care or control”; and
• the police officer must think it necessary to take the person to a Place of Safety, in the interests of the person her/himself or for the protection of others.

So as would usually happen, he was assessed under Section 2 – this would happen with an AMHP and two doctors present. Apparently, according to the article, his wife was taken as well although she was released within the 72 hour limit.
Of course, we’ll never know what actually happened although it is stated initially that questions were raised due to him claiming to be related to various members of different European Royal Families and has connections which mean that his children require additional security measures be taken at school. The reason offered in the ‘documents’ held by the reporter is that Mr Jones suffers from some kind of ‘delusional belief system’.
The tone being that all the claims made by Mr Jones are true. I wonder though if the children had been attending the same school for a while, that the headteacher would have been suddenly concerned enough to call for social services and that there would have been sufficient grounds to at least, admit him to hospital. My own experience suggests that if anything can be done to keep someone out of hospital, it will be, not least on the brutal issue of the cost of a hospital bed.
Whatever happens, we’ll only ever hear one side of this story but some of the vitriol in the comments following the Daily Telegraph article make you wonder at the levels of hate and disgust with social workers in general.
Regardless of this incident, and there may well have been poor practice involved (which I would never condone), the rage of those members of the public who see fit to comment on newspaper articles never ceases to amaze me.. nor the willingness to believe without question a source which can only ever be one-sided.

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It’s been a long week. For a variety of reasons that would probably come over as whiny or irrelevant, it has been one of the more difficult periods of work. It isn’t over yet – I still have Friday to get through but the end is in sight – not least with my longer (well, a week or so) holiday now shifting into sight. One more week of work left before I go.. . . .

On that basis, I thought to share a few links of things that have caught my attention but haven’t quite been able to form coherently into full posts!

I was amused by the Daily Mail story about a weight-loss initiative being piloted in Essex where there is an offer of a £1 shopping voucher for every pound of weight lost. I find the idea vaguely appealing – I wonder if you could put on weight just to earn money by losing it.. I expect not.

Yesterday, the BBC reported that

People living alone in middle-age had twice the risk of dementia than those who were living with a partner.

But widows and widowers had three times the risk of dementia.

It seems that the study, in Finland related to a particular gene type as well. I expect it is about general life patterns, events and social interactions.

In a related story, Time Magazine confirms that for older people (and younger too, I presume) wider social circles and more friends could guard against cognitive decline. I haven’t read Time for a while, but I was amazed at the patronising tone of the article which concludes

if you visit with Grandma more often and let her know that a regular pastime may just help her stay fitter and sharper longer

So thanks, Time, for one more reason to visit Grandma!

Community Care reports that the Commission on the Future of Nursing and Midwifery wants to encourage more mental health nurses to take up the AMHP role and have been disappointed by the low take up.

Interesting that the commission is headed by a junior minister and has it’s own website to take comments and ideas as well as share information. Compare and contrast with the Social Work Taskforce which was set up under political pressure by a minister who hasn’t a jot of interest in any of the issues facing social work and has relied on over-subscribed ‘meetings’ to get the views of social workers although the time and space limited nature of their ‘information gathering workshops’ meant that only those who were able to sign up with days  could even get to attend these ‘meetings’ – no, I’m not bitter.. well, ok, maybe just a wee bit.

And on that note, a very happy Friday – after all, it’s nearly the weekend..

I’ll preface this post by mentioning I have a stinking headache at the moment – but that doesn’t mean I don’t have a lot to say!

Anyone in and around London, the Social Work Action Network which describes itself as ‘a radical campaigning network within social work’ has a conference this coming Saturday at the London Metropolitan University on 4th July between 9.30an – 4.30pm.

They describe themselves as

a loose network of social work practitioners, academics, students and social welfare service users united in their concern that social work activity is being undermined by managerialism and marketisation, by the stigmatisation of service users and by welfare cuts and restrictions.

It sounds very tempting and registration is still open, indeed, it seems that it will be taken on the day.

I had thought to go and still may although I hope it doesn’t sound too negative when I say that from where I am at the moment, in the middle of one of the busiest weeks I can remember for a long time, to then attend a conference all day Saturday might be a bit too much for me all in one week.

I’m generally very interested in the aims and goals though. I have been following (from afar) the scope of SWAN and it seems to me, to be somewhat focussed on academic social work which is not always as closely tied to the front line work or those practising as they might want to appear to be. It’s much easier to be radical in a library.

To be fair, they do have a practitioner speaking on Saturday and it does sound interesting so I’d like to be more wholehearted but feel I might just have to see how I feel on the day..

I do want our profession to garner greater respect and to be more proactive in taking those reins back from the naysayers. I believe strongly in the values of social justice and feel it is important for us to stand united together. I just need a bit of brain-recharge time at the weekend too sometimes.

In any case, I’ll be interested in any feedback.

Yesterday, I was on the wards as there was a man who had been admitted to the hospital compulsorily under Section 2 of the Mental Health Act almost exactly 28 days ago. I was asked to arrange and conduct the assessment for Section 3.

digital cat at Flickr

A few random thoughts occurred to me when I arrived on the ward. Firstly that the nursing staff had automatically assumed that this man’s continuing detention in hospital was going to be authorised. I know it can seem a bit pedantic at times but I get a little tetchy when it’s mentioned to me that I’ve ‘come to section Mr X’.

Secondly, that this man asked (and it was noted in the file) for an appeal against his Section 2 about two weeks ago – now it had been probably after the 14 day period for the appeal to be lodged however in this situation he had had to go to the general hospital due to physical health problems – where he had been treated for about 10 days. It’s an interesting point that on his return to the psychiatric ward, he wanted to appeal against the section but the time limit would probably have expired (I am making some guesses here as I don’t know the exact circumstances). I’ll probably look this up when I’m back in the office. Anyway, I’m under no doubt that he wants to appeal now..

Thirdly, he has not yet been allocated in the community team. This is harsh as I think that might have made some difference in the possibility of support in the community.

I’m not sure that he was offered an IMHA (Independent Mental Health Advocate). There was certainly nothing documented and I was met with blank looks when I asked about this. It’s something I can pursue at this point but it really should have been done on admission.

The individual we assessed yesterday liked to talk. He had a lot to say. So we listened. It was not a short assessment by any means as there was a lot of information to put together. He had a lot of thoughts and worries and for lots of good reasons.

In some ways, and I mentioned this to the Section 12 (Independent) doctor, I wish there were a middle ground. I don’t think he is quite ready to go home, or safe to go home but he’s definitely on his way in the right direction and judging by the information in the reports and the verbal information given, he has made massive steps forward since his admission.  One of the key points though is that I think it is very unlikely he will engage with any services on his discharge at this point. I am hopeful though if a care co-ordinator can be introduced fairly speedily and some relationship can be built up there, that he will be home, long before the section expires.

I do hope that before long at least,  he’ll be able to enjoy home leave and a graduated discharge although it can seem harsh using the legislation to back that up.

I know this time though he is going to appeal and it isn’t going to be lost in the file, because I can follow that through at any rate.And refer directly for an advocate – which will be one of the first things I do when I get into the office today.

Community Care reports in their Social Work Blog that the women’s magazine ‘Take a Break’ has taken up the cause of positive social work stories with a headline of  ‘Thank God for Social Workers’ which started with this week’s magazine. This follows on directly from Community Care’s own campaign Stand Up Now for Social Work!.

In the interests of research, of course, I bought a copy of Take a Break.   The article is a couple of pages spread about what good work social workers do and how unappreciated they are.

It makes a change to see something positive to be honest. I sometimes envy our nursing colleagues and the overall angelic perceptions that they attract. Don’t get me wrong though, I could never do the job they do and have the utmost admiration for them – I do feel a bit grumbly at times though that the attention attracted by social workers is usually negative.

It was good to see a major national magazine take up the issue though as well, of course, as Community Care  – which as a magazine directly for the Social Care sector, is an unsurprising supporter!  The only pause for concern I had came at the bottom of the article when they invited readers to write in to the magazine with their own experiences of social workers ‘good or bad’. Now, many people call me a cynic and it wouldn’t be unfair to do so but I have a sinking feeling about some of those ‘bad’ experiences. I know I should be more optimistic though!

The way of the world is that we will always be constrained by issues of confidentiality when speaking out about individual situations or successes. Also, depending on the type of social work practiced, ‘success’ isn’t always easy to measure – especially over the short term.  I’ve harped on about this before but genuinely feel that there is an element of wishing to sweep some of the every day issues that we work and deal with ‘under the carpet’ and that feeds into the overall dismissal of any kind of positive regard for social work.

I also think, in the UK at any rate, the profession hasn’t really helped herself. The GSCC (General Social Care Council) has presented some kind of mish-mash of post-qualification that has led to increasing specialisation. Is that any surprise as there is only two registered social workers on the ‘’Council’ of the General Social Care Council (both very distant from any kind of front line practice – one took the management and executive route and the other is an academic) – this is supposed to be the body that is responsible for overseeing the registration of all social workers and social work students – that upholds the codes of practice that we are obliged to work towards and, as they claim, it is their job to champion social care and to help give it the recognition it deserves.

And of course, as a government QUANGO, they are appointed and accountable to the government departments and the mealy-mouthed politicians who have no interest in promoting social work as a positive channel for change.  So what do we pay them for? (because we pay a fee, of course, to be registered). We pay to hold our names on the lists of registration – but why isn’t the GSCC ‘speaking up for social work’ when one of it’s listed aims is to champion social care?

I haven’t seen much evidence for it. I get more value from the 78p I pay for Take a Break to be honest.

So I’d urge anyone so inclined to go and grab a copy of Take a Break (and if you have the answer to the crossword on p48, I’d be grateful – I need to win that deluxe bedroom makeover!).

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The Guardian printed an article earlier in the week about a poor take up nationally of telecare. Telecare (assistive technology)  is the system of various automatic alerts that are often used in local authorities for the care of older people.

The most familiar might be an ‘remote alarm call’ system – perhaps a pendant worn around the neck or wrist with a big red button to be pressed in case of a fall. At which point (at least with the systems I’ve worked with) a disembodied voice echoes from a small box-like device asking if any assistance is required. If there is no response or a call for help (because sometimes the button is pressed accidently or sat upon by visiting social workers.. yes, I’ve done that more than once) people will attend (they have keys) and respond appropriately.

red at Flickr

But the world of ‘Telecare’ has expanded exponentially – or at least, I thought it had.

We have fall monitors which can test the pressure on ‘usual’ chairs or beds and alert the appropriate team if there isn’t anyone on that particular chair/bed for a programmed period of time (and it can be set so that the bed monitor is only active between certain hours and the same with the chair monitors).

We have gas detection monitors, C02 monitors, smoke detectors and heat monitors and flood detectors which all report back to a central office in case the person in question is not able to alert anyone.

There are, as I have actually been directly involved in recently, have ‘door monitors’ that can detect if someone ‘wanders’ out of a front door at night.

And probably lots of other types of equipment that I haven’t even begun to explore.

I was surprised at the poor take up because as the article notes, a lot of money has been thrown at the project – it’s certainly been very evident in our local authority. Perhaps the poor take up is related to seeing it as a ‘replacement’ service for home care workers. I’ve never considered that but more of an additional service – a kind of safety net.

Again, in my own Borough, the funding provided by central government has been used to provide the service as free on demand so we are able to offer these services to users at no current cost (although we have to explain that this may change in the future as the funding runs out). Perhaps that is why we have been more successful in rolling out the services than some.

And I have not personally known anyone considering reducing face-to-face care as a result of Telecare being implemented. Sometimes it is a more of a case of peace of mind for the carer who might not live in the same house, as much as needed for the user. I have certainly used that line as persuading factor, you know, ‘get the gas detector for your daughter’s sake, not because you wouldn’t know exactly what to do if you smelt gas during the night’.

So why the low take up, the Guardian presents a concerning but unsurprising conclusion.

In 2006, the government made £80m available in grants for English councils to pilot telecare and other forms of assistive technology…But there is uncertainty about how much of the £80m, which was not ring-fenced, was spent on telecare, as opposed to other uses

Of course the main worry has been that these new technologies will lead to a decrease in care visits but I haven’t seen it used in that way yet, and I hope it never will after all, the needs that are met are very different.

I am actually rather glad that I work in one of the authorities that seems to want to take this forward though as I’ve seen a lot of direct benefits  – in fact, someone I work with currently managed to leave the gas on and this was alerted through exactly this system. It might have been a lot longer if there had been no electronic trigger.

I can’t see it being anything other than an integral part of the packages that are delivered increasingly in the future. Technology does not have to be our enemy and it does not have to replace people.