Analysis of the Social Services and Well-being Wales membership survey

Social Services and Well-being (Wales) Act 2014

Membership Survey - Analysis

Allison Hulmes – Professional Officer, BASW Cymru

Introduction

The survey was undertaken following BASW Cymru’s annual conference in 2017 (‘The Social Services and Wellbeing (Wales) Act 2014 – One Year On. What’s Working Well? What Needs to Change?’) to help understand the experiences of Welsh Social Workers since the implementation of the Act. The number of responses from social workers was low (just over 3% of current membership) and this is not criticism, it may well be an example of the huge pressure that social workers are under at this time, as evidenced in the recent UK Social Workers: Working Conditions and Wellbeing study that highlighted an extremely worrying picture of ‘spun out’ social workers at risk of leaving the job they love through high demand and austerity cuts. The responses that were received, provided some rich qualitative data that needs to be followed up and explored more fully.

That we need further understanding of social workers experience is all too clear and the survey results will be shared with the steering group which is supporting Welsh Governments evaluation of the Act. The findings from the evaluation won’t be known for another three years, so BASW Cymru will be rolling out a series of workshops in Autumn of 2018 to have conversations about the impact of the Act, directly with social workers across Wales. Having this direct testimony from social workers is imperative if we are to understand not only ‘what’s working well?’ but also ‘What’s not working well?’ By doing this as the independent voice for social work, we can develop strategies for supporting social workers in remaining competent, ethical and resilient practitioners.

We must also ensure that we collaborate with those who are experts by experience who really are on the receiving end of the Act and whose lived experience must be heard. An example of this is Carers Wales who are doing fantastic work in ‘Tracking the Act’.

One of the responders to the survey, spoke about the importance of case studies and it would be fantastic if social workers felt able to share anonymised case studies to assist our understanding and learning, in how the Act is being implemented and its impact on those who need care and support in Wales and on social work too.

Overview

Marginally more social workers reported that their practice has been positively influenced by the Act, with a lovely example of how a ‘what matters’ conversation had led to better and more creative outcome, for a man needing care and support. It is imperative however, to understand what social workers mean by a ‘what matters’ conversations and whether it’s an assessment. If it is an assessment, then Regulation 3 of the Care and Support (Assessment) Regulations and Paragraph 43 of the Code on Assessment, apply.

Positive responses focused on; the ability to co-produce outcomes – as defined by those needing care and support and their carers; proportionate assessments and ensuring that the voice of the child and parents is

heard. There were also some responders who saw a positive shift towards early intervention/prevention and that another said that changes in safeguarding (didn’t specify if adult or children) have made an impact.

Some responders clearly felt prepared for the implementation of the Act through the adoption of approaches that were realised following the launch of ‘Sustainable Social Services for Wales: A Framework for Action’ plan by Welsh Government in 2011. This plan was centred around key principles that will be familiar in the new Act such as: citizen centred services; integration; reducing complexity; a confident and competent workforce; safeguarding and promoting the wellbeing of citizen. Of course, many social workers will maintain that social work has always been about wellbeing and citizen voice.

Several responders reported that it felt like business as usual and that not much had changed. There is a sense that change to processes is superficial as eligibility and access to support, remains the same.

Themes

Training

The need for more training is a consistent theme. Training in the principles of the Act, in eligibility but also in skills – such as how to undertake a ‘what matters’ conversation and what is a ‘what matters’ conversation. There is also a consistent theme around ensuring that health colleagues, receive training to better understand and implement the Act.

Austerity/Lack of resources

A clear theme across the survey, was in relation to the impact of austerity and Local Authority cuts on the ability to implement the Act and that ‘there are still vulnerable people falling through the cracks’ and that it’s ‘hard to do well with so few resources’. There is no indication that austerity measures are coming to an end and we now have BREXIT on the horizon. What this will mean for Wales as a net beneficiary of European funding, is still to be fully understood.

Implementing an Act, with its focus on individual responsibility for well-being outcomes, may well prove a struggle in an environment where 8 years of austerity measures have impacted severely on the resilience of individuals, families and communities and on the assets and resources within communities, that are meant to replace service provision.

Not being able to help those needing care and support and carers, in finding solutions to well-being outcomes, may also have an adverse psychological impact on social workers who are already feeling stretched beyond capacity.

Lack of consistency/integrative approaches

Many responders were concerned that a lack of understanding of, and hence a lack of consistency in applying the legislation, is in a seeming lack of ownership by health colleagues. This creates difficulties in integrated teams, especially where the manager is a health professional. This will have implications for Welsh Government who are committed to the integration of health and social care.

A lack of consistency wasn’t exclusive to health colleagues but is seen as a feature within and across local authorities.

Carers

The numbers of responses that related to carers was low and this may be indicative of a lack of understanding around the new legal duties to carers under the Act.

The questions with some of the responses are listed below:

Do you feel adequately prepared to work within the Social Services and Well-Being (Wales) Act 2014 (SSWb Act)?

87% responded ‘yes’.

13% responded ‘no’.

Is ‘Information, Advice and Assistance (IAA) meeting the well-being needs of those you work with? Please give an example.

Responses that came from social workers working with children were:

More could be done.
Needs still not being met.
Hard to measure.
The principles are good.
Very hard to do well with so few resources.
Early intervention and preventative services are still being developed.
Don’t know I’m based in a safeguarding team.

Responses that came from social workers working with adults were:

IAA is working well in secure estates.
Sometimes working well.
Avoiding people coming into services by signposting.
Still work to do with linking central contact point with other aspects of IAA across the Council.
There are still gaps in promoting the ‘active offer’ and offering advocacy services at first point of contact.
I feel we have the information to pass on to citizens.
Feel I can advice citizens of what’s available.
We are needed to be more aware of the social activities of the locality, so we can advice people of what they may be able to access.
We started looking at the notice boards in the centre of each Town, looking at what’s on.
Now listed as part of assessments.
I believe we are more aware of assistance there is, so we can help other people and guide them to services or activities they didn’t know about.
There is an IAA service with multi-professional input.
District nurses are in IAA service and third sector broker is located at the front door.
The multi-disciplinary function at the front door needs to be strengthened to meet the requirements of the Act.
IAA is still a work in progress in some areas.
Often, it’s the ‘how it’s done’ rather than the ‘what is being said’ that can make all the difference.
IAA staff need to be skilled and experienced to deal with the range of IAA that’s ‘out there’.
I have referred to local area coordinators – don’t know outcome.

Responses from social workers working with carers were:

More could be done to signpost carers to services and benefits that they are entitled to, rather than making them difficult to claim.
IAA working well but there is an increase in uptake for carers assessments – front door needs to be strengthened to meet the requirements of the Act.

Have the eligibility criteria for care and support (through a care plan) influenced your current practice? Please give an example.

39% of respondents said their practice has been influenced, some of the responses were:

A ‘what matters’ conversation resulted in a man being allocated a direct payment to have someone to help with his basic needs as well as play table tennis with him.
More flexible working for carers.
Our format has changed to be more about support for the individual.
Daily, we are currently working to the outcomes defined by the service user and their carers and together try and create a plan of how we can support them in meeting their outcomes.
We read prior to admission if added to enquiry information.
Yes, but still a work in progress.
Some social workers apply the new criteria as defined in the Act.
More emphasis on early intervention, prevention and reablement.
Made it easier to concentrate on what matters to individuals.
Focuses workers on the right issues without being too service oriented.
Like the concept of proportionate assessments and ensuring the voice and views of the parents and child is sought and recorded.
Changes in safeguarding have had more impact.

51% of respondents said their practice hadn’t been influenced, some of the responses were:

My current practice was geared up to this Act before it emerged.
No, as these tend to be filtered at IAA stage
Not really changed much due to client group.
There are still vulnerable people falling through the cracks because they don’t fit certain criteria.
No change.
Although processes have changed, eligibility criteria to access support has not changed. There are limited funds due to cuts and this is having an impact on support services.
By the time they get to me, eligibility is already established.
No major changes in this area.
Some social workers struggle applying to apply new criteria, there is a general lack of consistency with some disciplines ie in-house domiciliary care and their understanding of the new requirements.
Some social workers still doing the same thing and some LA’s have stated that in some cases ‘if it was provided for in the past, it still wouldn’t be provided’.

What’s not working well?

Some of the responses were:

I don’t understand if there are limits.
Lack of resources within children’s services.
All that is not working well is down to the structures within prison service.
So much expectation on family and friends, when they are already at breaking point.
Still very process driven, health and social services working with different approaches and assessments.
Support from senior management needs to be improved to embed positive practice.
It’s not been implemented.
Paperwork lagging.
Funding restraints have direct impact on what services you can offer to support families.
Other agencies not up to speed on their responsibilities and duties.
Lack of training in the Act for health colleagues.
Needs to be more education and ongoing television exposure about the Act.
Agenda should be kept ‘live’ and staff should receive regular training.
Consistency across teams and disciplines and understanding of requirements from those teams.
Health don’t believe the Act applies to them, this is problematic in integrated teams, where the integrated team is managed by a health professional.
Lack of resources in early intervention.
Co-production is challenging due to different perspectives as to what it means.
Reduced budgets and trying to work differently, this is proving challenging.
Language in the Act.
Not enough ‘buy in’ from partner agencies, when they see the title of the Act, think it’s for social services only.
The forms in my LA have made a simple process complicated.
The national outcomes are an unnecessary statistic driven diversion and the categories are rubbish.
Scoring. People are very confused.
This is seen as for adults not children.
The original meaning of measuring citizen’s sense of achievement is lost. People focus on debating this and miss other important concepts.
Somewhat confusing for child protection work and is harder to apply to personal outcomes principles if the parent is the cause of the risk. It is possible to do well, but not a ‘neat process’ to fit safeguarding.
Focus still on needs not wellbeing/personal outcomes.
Some citizens have the same care plan that they’ve had for years as staff do not have necessary skills to have ‘difficult conversations’ with them in line with ‘what matters’ and what other support is available to them.
Many citizens don’t want change, they believe services are for life and they still expect social care staff to tell them what they can have, rather than how they can achieve their own well-being.
Reviews of care plans need to robust and amended to reflect the change in needs/personal outcomes.
No systematic recording of views/perceptions of service users/people in receipt of services.
No systematic recording of unmet need.
Making IT and recording systems work for practitioners doing more with less time.
Impact of loss of admin/business support.
Need clarification from Welsh Government about priorities and how this can be realistically achieved.
Lack of resources/trained therapists to meet therapeutic needs of individuals. The reality is for some difficulties, there are no quick fixes and bureaucracy doesn’t allow for creative community development approaches.
Proportionate assessments.
Definition of ‘at risk’ is very broad and a bit vague.

What do you think needs to change?

Need a better understanding of eligibility.
More children’s services workers.
More therapeutic resources for children in need of support.
It’s all down to a slow change in culture, so time.
Councils need to prioritise their budgets.
Increased joint working and a multi-disciplinary approach across the life-span as well as wrap around services.
More focus on developing skills, strengths-based conversations and capturing outcomes from the perspective of the service user.
More focus on training and working in a genuinely co-productive way.
It needs to be implemented.
Better joint working to avoid duplication.
I’m not sure in this austerity climate. I believe the well-being doesn’t go far enough. It states carers can have assessments but does not state what they’re entitled too. Given the cuts the criteria will get tighter thus rendering the well-being Act pointless.
Opportunities to repeat/update training and to ensure health colleagues receive appropriate training throughout the organisation.
More colleagues feeling confident in their practice and understanding of the Act.
Our culture needs to change and how we live and support our friends and family without it feeling like it should be someone else’s job. By all of us helping each other.
The Act needs to be promoted further as not everyone knows about it.
Case studies, cooperation of politicians to change current services to provide early intervention/prevention services.
Better reablement services.
Pressure should be put in health by Welsh Government to make the Act as relevant to them.
Language in the Act – it’s appalling that young people are referred to ‘categories’. I know a lot of social workers and young people hold particularly strong views about the awfully oppressive and depersonalising wording in the Act, the negative affect of such language in the legislation on shaping their self-identities.
Our forms – the drive for stats.
Have Courts/Ombudsman had training in this area?
Social care staff would benefit from training regarding communication skills – ‘what matters to you’ conversations. Tapping into personal outcomes and options to achieve them. Having difficult conversations etc.
The public needs to have a clear, realistic message to advise them of the changes, that social care has changed, what they can expect. That services will be there when they need them and will be reduced when they don’t need them.
Mechanisms to gather base-line information across health and social services and third sector, to know what the current picture is (e.g. parental substance misuse) and identify where we need to get to, built in is how we measure if we’ve changed outcome.
Training on assessment. Where does child protection fit into assessment?
Greater clarity on thresholds of risk.