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Transforming services, transforming workforce, chicken or egg ? Access and Care Management redesign: emerging roles for social workers and others

Mary Keating

Purpose

• Coherent map of current and planned regional development of Access and Care Management service delivery mechanisms

• Identify the current and future workforce planning and development needs across professional and other social care practitioner roles.

• Identify models establishing links between workforce planning, CPD and Career Frameworks.

• Support and encourage shared learning from the project

Reception

• Interviews conducted with 12 of the 14 Local Authorities, between August and Oct 2010

• A great deal of interest in the project and desire to know what is happening

• Huge variation in how far Local Authorities had progressed

• First glance much similarity in service redesign - but the devil is in the detail

Assumption Erroneous or accurate?

Widespread use of corporate contact centres for Adult Social Care

Erroneous- All of the Authorities were using dedicated social care contact centres

Reduction in front line social work numbers Erroneous- no reductions planned

Changes to the Social Work role Accurate– big changes to the role some of which remained aspirational rather than reality

Workforce development needs exist for Managers, Social Work staff and other Social Care staff

Accurate- Considerable synergy across the region in relation to manager and social worker development needs.

Conformity in Social Care Practitioner roles Erroneous - Lack of any commonality and huge diversity apparent across the region in title, role and learning and development requirement

Key Findings: Service Redesign

The progress and process of service redesign was at very different stages across the region and there was no standard pattern on the shape and function of services.

• Once the initial assessment had been completed the delivery of “back office” services was diverse.

The great majority of authorities were designing services and teams with a locality, neighbourhood focus. In making an impact on community development this delivery model appeared to be more aspirational than real at this stage.

Key Findings: Contact Centres All of the local authorities interviewed were using or planning to use

dedicated Adult Social Care contact centres as an initial point of contact. For those authorities that had previously used only corporate contact centres, the move to Adult Social Care contact centres had been prompted by quality concerns.

In every case social workers had a presence in contact centres, but how far social workers were involved in supporting initial assessment differed.

There was a link between the numbers of social workers supporting the initial assessment and the level of responsibility delegated to contact centre staff.

Key Findings: Re-ablement

• Where services were recently introduced or still in the design phase re-ablement was seen as an integral element of the customer journey.

• Where re-ablement is fully integrated and delivered by directly employed staff, the skills mix team generally included social workers.

• The skills mix team was most evident in re-ablement services, and there was considerable consensus and emphasis on the need to have social care staff in this service more highly trained

Key Findings: Social Workers

• There were no plans to reduce front line social work posts. • There was consensus on the workforce development deficits

identified for social work staff. Overall the feeling expressed was a sense of frustration that social workers at every level had lost professional confidence and identity

Social Work Roles

• Access/ contact centres *• Re – ablement • Locality teams *• Brokerage• Review• ???? Community development/Marker

shaping* Universally only to be found in Access and Locality teams

Identified social work workforce development needs

• Understanding and delivering outcomes - based assessment

• Cost effective /creative solutions

• Risk assessment / balance/ averse

• Knowledge of community /community development

Key Findings: Middle and First line managers

• The focus for middle and first line management was found to be increasingly strategic.

• A hybrid management/case work social work role had developed or was proposed in half of the agencies.

Key Findings: Social Care Workers

• There were a variety of other social care roles identified within Access and Care Management but there was little consensus on the titles, the level of responsibility and the minimum learning and development levels that were desirable

Key Findings: Culture change

The changes required and the deficits expressed across all levels of social care role, managerial, professional or otherwise, indicate how far removed emerging expectations are from traditional social care roles and how big the task is in assisting staff to understand and make this transition.

The majority of agencies were employing considered strategies to manage the culture change process.

• Where agencies had begun the process of service transformation they were providing action learning or other forms of developmental support, but this was generally only available for middle and first line managers.

Recommendations:

• Social workers and managers

• Social care workers

• Service redesign and workforce planning

Next steps

• Report back to regional Joint Improvement Partnership

• Presentation at ADASS workforce group 4th March

• Workshop for Social Workers at Regional conference 1st March

www.skillsforcare.org.uk