Posts tagged ‘research’

August 20, 2012

Keeping up with Research while in Frontline Practice

Gizmo studies Maritime Law

Being based in an ‘integrated’ team alongside NHS staff, I have been frustrated at some of the differences in attitude towards conducting, assessing and discussion of current research as a frontline practitioner. However, this is a better situation to be in than when I was working in a social work team. At least now, I’m aware that there is a difference and by not being given particular time and space to access research articles and journals, I’m being impeded.

While I see colleagues being actively encouraged to undertake research projects, there are no possibilities ever raised for social workers to work in similar ways. This may be wholly about work culture and attitude to research by employers or it may be about professional attitudes to the importance of being updated regarding research but there is a noticeable difference.

I try to remedy this myself and while there will not be time to actively carry out any of the research projects I ponder about – there is nothing as frustrating as seeing the same evidence being published in different ways that tells us nothing that will actually make a difference to the way we practice – I limit myself to literature reviews and trying to keep myself updated with journal articles. Sometimes we discuss them as a team – sometimes I collate the information myself and keep notes on the articles I find. I may even publish some of these literature reviews as blog posts in the future if they would be useful to others.

I used to make considerable use of the British Journal of Social Work but seeing as my access to research literature is limited (possibly like many local authority social workers) to the SCIE (Social Care Institute of Excellence) Athens scheme and they no longer are able to subscribe to that journal, I have turned to other journals to find and source information that is useful to me. It makes me think less of a journal that would play political games with allowing access or not but it is a sharp and important lesson about the need for practitioners to have good access to information.

I have though through the SCIE scheme found

Aging and Society, Journal of Social Work Practice, Practice and the Mental Health Review Journal have been particularly useful for me. It’s worth checking out the resources available via SCIE as any social worker in England and Wales working for a local authority with a gov.uk email address can gain access to them.

The College of Social Work also enables Athens access for members if the email address is a problem but I believe the list of resources available are the same and there is still a block on the British Journal of Social Work being made available.

SCIE provide useful resources generally and RiPfA have some good outlines and policy updates which can be an excellent way to start discussions and conversations in a local service area. I don’t know much about Community Care Inform as it focuses on Children’s Services but it may be something useful if there were a parallel type service for adult social workers – indeed, I’d be happy to pay, individually, for just such a service.

As an AMHP (Approved Mental Health Professional) and a BIA (Best Interests Assessor)  it is crucial that I am constantly aware of both the latest developments in terms of case law and the new interpretations as they arise – I’d say that it is necessary for anyone working in Mental Health to have a good awareness and understanding of current interpretations of the Mental Health Act and the Mental Capacity Act.  I find the 39 Essex Street Court of Protection newsletters very useful to ensure that I am aware of the latest developments. although I do attend both formal and informal training and workshops regularly which focus specifically on case law in these areas.  It is the one area particularly that I find social media enormously helpful – not just in terms of awareness of cases as they arise but as opportunities to discuss them.

Even in the toughest, busiest teams we have to take responsibility for our own learning and ensuring that we do not leave the information and research evidence to pick up cobwebs in the ivory towers of academia. Being a practice educator helps with this as I encourage students to source and discuss recent, relevant research with me in supervision but also try and find some useful and interesting articles myself to discuss.

The benefits of being up to date and knowledgeable about current research are that firstly it encourages competent practice – I don’t think it’s possible to work in a silo of information and evidence that may have been presented when you (we) last studied formally, even if that was a year ago. Things change quickly.

An awareness of research can affect policy and the development of services – I’ve been able to feed into consultations both locally and nationally using references and information that I have gleaned from recent papers and it has added a more authoritative quality to my input. I’ve also been able to discuss and reflect in my own supervision sessions some of the disconnect between what might be positive ways of organising services and the ways things happen in practice.

It has also allowed me to garner a louder voice within the system in which I work. I can build a professional reputation as someone who will invest in my own learning and progress and when I have concerns about the way the organisation might be approaching something, I can back it with references, I’m far more likely to be taken seriously.

We want to create learning organisations but they have to be filled with learning practitioners and standing still is not an option. It doesn’t have to take significant amounts of time although it can if we want it to. It can be about reading through an article with an interesting title and reviewing it mentally before deciding.

One of the chief things I’ve learnt is that just because an article is presented in an academic journal, doesn’t mean it’s well-written or useful. We shouldn’t idolise academics as there is as great a variety in quality as there is in practitioners but there is no doubt that having an active interest in current academic research and debate is the next best thing to being able to be actively engaged in contributing to research.

Perhaps that’s the next step – one day I’d like to see more effort all round to integrate active research into practice but in the meantime I’ll make all the effort I can to ensure that my practice is current and informed.  It helps keep me hopeful and it helps keep me interested.

I’d love to know if anyone else out there has other information or resources that they use to make sure they keep up to date with research while practicing. It’s a vital way of keeping our knowledge fresh and active.

pic by jmatthew3 at Flickr

June 27, 2012

Making Social Work Work Better

I’ve been trying to be positive about some of the changes taking place at work recently. Being ‘in flux’ is nothing new and I have been working in the sector (and in local government) long enough to be no stranger to reconfigurations.

Being of a mind that criticism is easy but needs to be couched in ways that things can work better, I’ve been thinking about ways that my job could be better and how I could be more effective in it.

Of course, this will go nowhere,  but it’s an interesting thought experiment for me and helps me to retain hope.

There are a few themes I want to consider. It’s a bit of a fantastical ‘dream list’ of where I’d like to see social work in the future.

‘Personalisation’

‘Personalisation’  has been a massive driver but the increased workloads and paperwork have not led to better outcomes for most of the people I work with because the focus of the agenda has been on smaller specific groups of people who have fitted the model of wanting and managing well with direct payments.

There is nothing more morale sapping that completing a review for a service under so-called ‘personalisation’ agendas which have been forced onto people who don’t want them and telling them that they now have a ‘personal budget’ – not to do whatever they want with, but to have the same service provider, providing the same service at a higher cost.

It feels like a con because it is a con. This is not ‘personalisation’. This is language which has been distorted by government and policy and mashed into the conveyor belt which is the only way that local government commissioning is able to operate.

The word and the process of ‘personalisation’ has been hijacked and contaminated by providing a front for more cuts and attempts to disperse responsibilities from the state to the individual.

So how to make things better?

Let us aspire towards excellence. I said to someone earlier in the week, I don’t want to do ‘ok’ work, I want to do excellent work. I want to go home and  be proud of what I have accomplished with someone and their family.

How can this happen? By moving the personal budgets beyond direct payments or managed LA budgets. By bringing people with experience of using services and social workers who are asked to implement the systems, into discussions with commissioning teams. By breaking down block commissioning – which may be more costly. Real, true ‘co-production’ which involves discussion with all groups of users not just those who always come to the meetings. Using Individual Service Funds, using Trust Funds, using small providers, providing genuine choice and different options not just ‘choice’ within the context of what the local authority approves of – for all user groups not just the ‘easy’ ones.

Choices will need to be made in terms of funding but the cost of leaving work feeling that I could have done much better, is not something that I want to aspire to.

Advocacy

I mean by advocacy, being given – and taking where necessary – the role of speaking up more cogently for people who use the services we provide on one hand – and of our own profession on the other hand.

Social Workers have a unique position in seeing the effects of social policy experiments taken at national and local levels. We shouldn’t need to be constrained by managerial approaches which have driven us into the ground because actually, our employers are scared of some of the values we have.

I wonder sometimes if local authorities WANT social workers who are anything other than automatons. Then I think it is a necessary part of my role to be a proverbial ‘fly in the ointment’. Fortunately, I have a manager who thinks in a similar way, but we need to push this upwards to a policy-making and commissioning level.

Rather than waiting for social workers to be given a voice, we need to seize the voice. Newspapers and media companies may want personal stories but I genuinely believe there are stories we can comment on without needing to draw on the lives of those who use our services.

We have to use our voices politically and waiting around for BASW or the College of Social Work is all well and good but we need to do more.

I see a future of social work as pushing it’s own voice out whether people want to listen or not. People ARE interested in social work and what we do, they just don’t actually know what we do.

Political Developments

We are well placed to have a strong voice in political and social developments and must use that. I think it would give the profession as a whole more credence. We must remain clear about the goals of ‘social work’ and why social work is necessary.

‘Social Work’ is more than statutory social work however having social work in local government is essential too.  As skilled professionals who work on the ‘frontline’ we can’t allow our voice to be co-opted by those who claim to speak for us.

However I’d like to see a more cohesive social work voice that isn’t limited to local authority workers and embraces the voluntary sector. I see more social work taking place outside the local authority bounds but we have to use and build our professional knowledge and take responsibility for our collective professional growth and influence.

New ‘Social Work’ ways of working

We can embrace both technology and social media to promote and present different ways to provide ‘social care’ and social services. We can incorporate our professional skills in terms of active learning and reflection to use new forms of communication and collate and innovate in the field to look at the ways we build communities and relationships more broadly and what that can mean to social work as a whole.

We are able to build links more easily both across the sector, nationally and internationally, across different professions but most valuably with users of the services we provide.  Perhaps ‘virtual’ space and communities of interest rather than just location should be considered as places in which some of our expertise could gravitate. We have to take new opportunities and learn in non-linear ways.

Research into Practice

We have to build positive links with universities and organisations committed to research and encourage more practice-based research. We can’t allow the repository of knowledge of the profession to lie solely in academic institutions. Links between practice and academia have to flourish in order for the profession to flourish. Maybe there needs to be more systems of secondment. This may exist in some places already but I haven’t seen it locally.

We talk about using evidence-based and evidence-informed practice but when discussions are raised about changing things locally, we are presented with policy decisions already made. I’d like to have more autonomy personally and as a team to pursue both original research and change models of practice accordingly.

I have to think that things will get better for and in social work. We have some excellent skills that are not necessarily lauded. We are able to draw in the ways that society impacts on the individual and the ways through some of the difficulties faced. We have to shout out this unique expertise and the values that underpin it so both it is recognised as a skill and that we recognise it ourselves as skills we use.

Sometimes we get caught up in the day to day work or caught in the mire of negativity about social work to forget what a fantastic job this actually is. I desperately want it to get better. I believe it will, otherwise, I don’t think I could continue.

March 26, 2012

Researching and Improving Dementia Services

Memory

Today the government has announced an increase in funding for dementia research, indeed, the figures given by the BBC talks about raising the money put into dementia research from £26.6m to £66.6m by 2015.

Great news, really it is. I think it’s essential that there is a focus on dementia and what can prevent and assist those who suffer from and potentially suffer from dementia in the future.

As well as research though there were other strands to the government’s announcements about dementia.

Mr Cameron will set out plans to step up research into cures and treatments and to ensure that the health and social care systems are equipped to deal with the problem.

The highlighted part is the area that sticks a little in my throat as I read it. I do wonder how much the government and ministers are aware of the services that have been decimated (probably more than decimated if we are going to be talking literally) over the last couple of years and the disinterest shown by the general public in terms of improving both health and social care outcomes for those who have dementias.

Money into research and cure is a hopeful statement  – it looks forward and it helps us who are the electors of today have more hope for our future with the fear of losing cognitive functioning in our later (or not so later) years.

Money into equipping health and social care systems to ‘deal with the problem’ of dementia are altogether something else because it isn’t ‘us’ who will benefit – we, todays electors, are the ones who will pay and experience (or at least, the lack of political will on all sides)  shows that no-one wants to pay for the true costs of providing good quality care for older people with dementia in real terms.

I’ve seen a lot of simplistic talk about dementia over the past weeks, months, years. It is not a single diagnosis and it does not affect people in a single way. People with dementia walk and function among us and they are not all older people sitting alone in bungalows waiting for pity – although it’s important to remember that some do live alone without sufficient support or interaction. They are not all people who want or need pity – there is hope for positive life experiences even when ones cognitive functioning is impaired.  We infantilise the process of ageing and those who merely have a diagnosis of dementia and it says far more about those who are speaking and talking in those terms that those who may be bearing the progress of their diagnoses in as many different ways as there are people.

However one thing does need to be addressed and I hope it is addressed by the government today – with money. That is the issue of treatment and assumptions made about people with dementias in institutional care settings. We have had talk about ‘dignity in care’  – particularly in hospital and residential care. This must be approached and tackled in the ways I have previously discussed by putting more people on the ground in terms of nurses in hospitals and increasing staffing levels in residential and nursing homes. We need to back up a determination to provide better care for some of those people who won’t be ‘shouting loudly’ or have families to ‘shout’ for them by placing independent visitors and advocates in these institutional settings and improving regulation and quality control for those who need these services.

As for changes in home care – we need to embrace truly personalised care and the ‘personalisation’ agenda beyond managed budgets of block contract agencies providing 15 min ‘spot checks’ to put a microwave meal in the oven for older adults with dementia in their home. This is not dignified and it is not cost effective. Over time, putting more good quality and accessible care into people’s homes will keep people out of residential and hospital settings over the longer term but it will cost.

So I hope these announcements the government makes will look at quality of care and will look at funding of care over the long term for people with dementias who live both in the community and in residential settings.

I hope to see, alongside better funding for research

1) Better support for family/friends as carers

2) Proposals to make personal budgets work well and for different support to be used for those who are not able to engage in the process of choice themselves either because they don’t wish to or don’t have the mental capacity (or family) to do so.

3) More thought put into the funding mechanisms of care for people with dementia both at home and in residential settings. Dilnot or not Dilnot. I’m not in agreement with all the tenets of Dilnot (I’d favour the so-called ‘death tax’ to be honest) but its better than that awful hotch-potch that we have now and what we can’t afford is to allow things to continue and to leave matters up to different local authorities to manage in their own different ways and at different levels.

4) Better non-directed advocacy with muscle for those who don’t have family/friends/community around them (by non-directed advocacy, I mean advocates who specialise and are trained in working with people who may lack mental capacity to ‘direct’ or instruct their advocates)

5) Robust regulation of dementia nursing and residential homes and wards in hospital with random spot checks and high standards.

I’ll be back tomorrow and see how the government does on this announcement.

One day though, I’d like to see a government of any political flavour that truly does look at national interest and not political expediency in terms of policy making.

The triumph of hope over experience.

photo by Ruth Flickr

February 16, 2012

Work! Fair?

There has been much recent debate about the extension of the idea of ‘workfare’ in the UK. ‘Workfare’ is supposed to be an extension of ‘welfare’ seen by the syntax used in the word itself. It is an idea which grew from the idea that people should not receive benefit entitlement as a result of unemployment without ‘giving something back’. In the context in which I’ll be using it, it refers to mandatory work ‘placements’ for people who are not able to secure employment in order to receive benefits that relate to being out of work.  It sounds quite warm and fluffy because of course people should be helped into work and ‘give something back’ but the word also implies a series of sanctions of this work is not undertaken.

Outside the Jobcentre

January 26, 2012

Fostering Aspirations As The Downturn Bites Hard In Tyneside

Another day, another report on the parlous state of foster care. Media coverage, such as it is, homed in on the shortage of carers, variously estimated at between 8000 and 10,000, and on the poor outcomes for children in care in fundamental areas such as educational achievement, incidence of mental health problems and offending behaviour.

None of this is new – the Fostering Network has rendered impotent the word ‘crisis’, so often have they used it over the years – although there is no harm in it being said once again. However the report itself, Fostering Aspirations by the Policy Exchange  has a wider scope, incorporating the views of foster carers and children in care into their analysis of the quality of care and emerging with radical suggestions for tackling the problem, most notably a salary structure for a professional foster care service and an overhaul of commissioning arrangements that would see local authority fostering departments competing alongside the independent sector in a tendering process for placements or a total outsourcing of fostering.

January 21, 2012

Survey on AMHPs and Burnout

Approved Mental Health Professionals practising in England needed to complete a survey about stress and burnout.

The survey aims to determine whether there is a difference in experiences of stress and burnout between the professional groups that perform the AMHP role. The study has been approved by King’s College London Psychiatry, Nursing and Midwifery Research Ethics Subcommittee (REC reference number PNM/11/12-23). It is the first survey of its kind since the AMHP role was introduced and with your help we hope it will yield some useful and valuable data.

It is important that AMHP’s from all professional backgrounds complete the study. However we would particularly like to encourage those from a non-social work background to take part as they are still relatively small in number. An information sheet containing further details about the study is displayed on the first page of the online questionnaire. If you would like to read more about and or complete the survey please click on the link below:

https://www.surveymonkey.com/s/stressandthestatutoryrole1

Thank you in advance for your time and support.

(This message was posted at the request of Janine Hudson, an Approved Mental Health Practitioner and MSc student in Mental Health Social Work at Kings College London)

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