1 The Total Transformation Programme, Care Managers...back to social work?

In Control In Control’s mission is to play a key role in the creation of a new system of social care, where people will control their support, their money and their lives as valued citizens 2

The Total Transformation Programme Projects 1.Support systems 2.Conversion of inhouse services 3.Support for elected members 4.Social work* 5.Developing community capacity 6.External provider development 7.IT systems 8.Workforce* 9.Safeguarding 10.Outcomes for citizens 3

Total Transformation local authorities Cambridgeshire Croydon Cumbria Essex Hampshire Hartlepool Hackney Lancashire Leeds Lincolnshire Newham Newcastle Northumberland Oldham Richmond Sheffield Southampton Tower Hamlets West Sussex York 4

Values and Attitudes In Control's 7 principles 1. Right to Independent Living 2. Right to an Individual Budget 3. Right to Self-Determination 4. Right to Accessibility 5. Right to Flexible Funding 6. Accountability Principle 7. Capacity Principle 5

Citizen and State

Citizenship “Citizenship is being someone who has respect within the community and who acts to support and sustain that community. Our commitment to each other and to the public services which support it relies on the willingness of citizens to contribute practically and financially to the strengthening of these services. If we erode citizenship, make participation and contribution harder then we will eliminate the very fabric of the community itself. Citizenship promises better outcomes by strengthening the commitment of each of us to each other and to the whole community”. (Simon Duffy) 7

So: What is changing? Changes:  Relationship of citizen with state  What we expect of citizens  What we expect of public servants  How we view professionals and professionalism 8

Reclaiming Public Service (1) From Street-Level Bureaucrats to Creators of the Conditions for Empowerment.... 9

Reclaiming Public Service (2)  The whole social care workforce  The whole LA workforce  The whole local workforce, including mainstream services in private and Third sectors....connect with people’s sense of who they are, engage the widest possible community 10

Professionals: care managers back to social workers? (1) Caring for People (1989) said case managers should  Identify people in need  Assess needs  Plan and secure the delivery of care  Monitor care quality  Review client needs 11

Professionals: care managers back to social workers? (2) Reclaiming social work:  Set out the common ground between SDS and social work: rights, human relationships, choice & control, resources & assistance  Spell out breadth of social work role: gateway to support, navigator, quality checker, co-ordinator, hazard checker, link to community, counsellor, professional social worker, LA officer  Specify how social work can help (and its limits) in each of the seven steps of the SDS process 12

Steps to choice and control 13

Social workers’ commitment Social work is committed to enabling every child and adult to fulfil their potential, achieve and maintain independence and self-direction, make choices, take control of their own lives and support arrangements, and exercise their civil and human rights. It looks at people’s lives and circumstances in the round, and works with them to personalise social care responses to fit their own individual situations. Its approaches and working methods aim to promote empowerment and creativity. (General Social Care Council, 2008) 14

15 StepThe social work role Step One: My money, finding out how much Professional social workers have a role in helping some people understand and complete the supported self-assessment process; and in coming to terms with the emotional impact of life changes and their need for support. Social work training encourages a holistic view of the person in their social and economic environment, and this perspective is often crucial at this stage. Step Two: Making my Plan The skills and focus of many professional social workers are well suited to support planning, and sometimes the social worker will be the best person to do this alongside he person. Social workers are trained to help people to assess, manage and take appropriate risks, and as we move away from an overly risk-averse approach, social workers are well-placed to assist with more person- centred ways of managing risk. Step Three: Getting my plan agreedIn agreeing someone’s plan the Local Authority social worker will need to ‘think outcomes.’ Social work skills are of great relevance and social workers should be effective and experienced in challenging support plans when these are not completely fit for purpose. In doing this they will help people to make real, informed choices.

16 Step Four: Organising my money Social work skills will be highly relevant for many of the decisions required here. They are in a good position to advise and assist people about the different “management options” for their Personal Budget, and about where to turn for specialist support to make use of each of these. Social workers are often in a good position to mediate between the person at the centre and the Local Authority as commissioner. Social workers may have important specific roles in relation to arrangements such as Individual Service Funds, where there may be a need to advocate on behalf of the person, and to work alongside providers to help them change the ways they deliver support. Step Five: Organising my supportProfessional social workers are trained to think about both individual and system, and link the two. This may be especially important where someone has no-one else in their life to provide help. They are trained to think broadly: The old care management system did not always make use of these skills, but doing so is critical to the success of Self-Directed Support.

17 Step Six: Living Life Under Self-Directed Support, people are fundamentally citizens within a wider community. Social workers are well placed to provide information about what is available and to help people to restore connections and build new relationships. They are also in a good position to provide an on-going “quality check” on what is in place. Step Seven: Seeing how its workedThe journey to make effective use of a Personal Budget over time concerns life changes, some very positive, others in terms of finding ways to come to terms with disability or old age. Social workers are well placed to guide people through such changes; they have the training and professional orientation to assist people to take stock of their progress on these journeys, and to advocate on their behalf if necessary where changes are indicated

Social Workers’ contribution to the new system For example: Step two: Making my plan A system that defines the circumstances where professional social work intervention is required in helping someone to think about and make a support plan. These will be in one or more of the following situations: When the person asks for such help. When the person’s family or others supporters ask for such help Etc. 18

Social Workers’ contribution to the new system Step three: Getting my plan agreed A system that supports social workers to make judgements about support plans based upon an understanding of the person, their strengths and needs, and what is achievable for the person in their situation, making best use of their Individual Budget. (From : In Control, Systems, Practice and Support of Professional Social Work under Self-Directed Support) 19

Newham social worker 1 ‘I feel that I am doing holistic social work: making a difference. I feel that service users have more say, that they are empowered, being independent and being valued. Some people say that social workers are no longer required, however we feel that it is now that social workers are required because we now empower clients; before it was mechanical in the way that a comprehensive assessment was completed and a care plan drawn up.’ 20

Newham social worker 2 ‘I sometimes felt that I was limited in what I could do to bring about the desired change in vulnerable people’s lives by resource-driven service provision and delivery (managers have become more like finance controllers). I was therefore thrilled by the introduction of Self-Directed Support/Individual Budgets as a more flexible alternative...especially in leaving users in control of how services are delivered and in the assessment of their own needs.’ 21

Social Work and Whole Systems Citizens Senior managers Social work 22 Community Families Providers Universal services Health Line managers

In Control resources Self-Directed Support: Social Workers’ Contribution Citizenship Through Social Work: A Discussion Paper from In Control Systems, Practice and Support of Professional Social Work under Self-Directed Support 23

Questions 1.What are the personal challenges for different actors within the system? 2.How will our behaviour be different? 3.What are the specific challenges for social workers? 4.Do we still need social workers? 5.How does the whole system need to flex and change to accommodate the new role? 24