We can't help the social workers if they won't help themselves

Quite a while ago now I was in a meeting with the Directorate of Social Services in Wakefield trying to persuade them to support Advocacy Action. It turned out later that they weren't having a good day, but since I wasn't asking for money at the time I had a relatively easy ride.

In fact the closest anyone got to challenging me was with the question ‘how are my social workers going to benefit from advocacy?’ The Director, bless her, told me I didn't need to answer that question: the point was, she said, that advocates help service users, not social workers.

I thought it was a good question though, and I insisted on saying that of course if people were supported to communicate more clearly it should be easier for everyone. Ok people may be more assertive or demanding, but at least they will explain their demands and their needs more clearly, and be less likely to resort to shouting or end up crying in despair.

In fact I probably take this further on many occasions as I actively try to empower nurses, care assistants and social workers to make decisions for themselves, adopt more person-centred approaches, and even feel they might be able to question their managers' decisions on occasion…

So it's been a long time since that conversation, and for various reasons I haven't had many opportunities to directly help any of his social workers, until now, and sadly so far is hasn't run as smoothly as I would have liked…

The first thing to point out is that I have managed to make a good impression on the Team Manager, his Senior Social Worker, and the Service Manager (as far as I can tell from their feedback). They have acknowledged that I have helped them to have much better conversations with the ‘service user’ (I'll fall into this jargon for confidentiality's sake).

I've also made a good impression on the service user and their family. They feel happy that their case has been much better described and documented over the last couple of months. We've been through some basic person-centred planning to help with the preparation for the community care assessment, and this has put things into perspective and brought out some issues that had not been discussed before. From their point of view the main problem is that I have been too trusting, and at the end of the day Family Services are still going to turn around and refuse to offer what they need. The sad bit is that last week they were proved to be right, and as we seemed to be near the top of the struggle to get proper services, now it feels as if the fall has been much harder.

It's not all over yet though, and it is worth noting at least a couple of problems that have occurred in my observations of Family Services. I will stress that I am writing this so that people may be able to see and understand these experiences, not in order to make any particular criticisms or complaints.

Problem 1 There's never been any negotiating.

I first became involved over a confusing and badly argued letter that said the service user person was not entitled to a service they'd received. When I went to the meeting that was arranged about the letter, the Manager said he was simply there to explain the letter (which he couldn't do anyway) and the decision had already been made so there was no room for negotiation. This amazed me, because by this time I'd got a lot of background information and the service seemed quite reasonable and in need of some compromise.

I had a discussion with a senior manager about the need for negotiation, which could well have got no further, but then last week, without any information or consultation or apparent consideration of the arguments that the use of this service had been reasonable and legitimate, there was another meeting where again there was no space for negotiation. This second meeting was the conclusion of the community care assessment, but there was no final paperwork, no care plan, and the only item on the agenda was basically that the service would not be offered again as it was too stressful.

Problem 2 Family Services complain that this person is argumentative and difficult…
…but then they back them into a position where they have made a decision and refuse to negotiate, so it's no wonder they become argumentative and difficult.

It’s even worse than this. They really do seem to have decided that it's impossible to communicate with this person. They complained to me that their partner is always butting in, and it's difficult for them to talk to the person directly: then they spent the entire first meeting addressing themselves to me instead of the service user. I sat there for some time looking at the person they were supposed to be talking to and they still didn't get the hint. At one point I suggested they should be talking directly to the person, and they looked at me as if I'd said something rude about their mother…

In fact throughout the several hours I've spent in meetings, every time the service user has become upset and raised their voice the social worker has basically ignored them and just seen the outburst as a barrier to explaining what they needed to explain, rather than a perspective that needs to be engaged with.

Problem 3 The service user has a history of complaining to the Director of Family Services, and to their MP — and getting services

I have been told from the outset that Family Services don't want this to happen, but bizarrely they never listened properly and never opened any spaces for negotiation. Then they said you can't have the services you want.

In between they seem to have ignored most of the material I have helped to provide them with through my direct work with the service user — evidence which if we do make a formal complaint will certainly help the service user to argue their case persuasively.

All of these factors really make a complaint likely. Looking back I can only assume that someone realised they made a mistake early on and has then entrenched and become determined not to admit it, but from my perspective this entrenchment is turning into a deepening black hole they are digging themselves into.

I have really tried to offer opportunities to the social worker that I've had most contact with to avoid this problem, but for whatever reason these opportunities haven't been taken.

Anyway, now I've warmed up with this anonymous blog post, I'm quite looking forward to writing in more gory detail to some senior person who will hopefully turn the decision over and help to make sense prevail. I'll try to put up an update when we get to the end.

Advocacy must be better value than advice

Here's a thought that could put a bit of wind behind the sails of both advocacy and advice projects... [N.B. It is a rough and ready formulation, in keeping with this blog's character - it can be developed into a more polished argument if there is a demand.]

There was much said about the 'huge' cost of putting advocates in every local area: £7.5 million just for one each was mentioned, a cost almost equivalent to the entire IMCA budget; and if this was to be extended to a whole advocacy scheme the costs would rocket.

I can't help thinking about the costs of some of my local and not so local advice services though. The CAB is of course a fantastic organisation, and has many great advisors. It is also old, and established to the point where every town and city seems to feel the need to have sometimes several large buildings stuffed with advisors, administrators and managers. They also have outreach workers in many other local centres. I have no idea what the national total of all the CAB projects is alone, but I bet it costs at least a quarter of a million pounds per year to run the average district branch - and then there are all the other independent and Council run advice centres as well.

This is of course to be expected - the concept of going and getting advice from a qualified advice worker has been around for 60 years, and it was given a good boost in the post war growth of the 1950s and 60s. And we do all benefit from these services, not least because we send people there (or take them) as part of our work as (non-advice giving) advocates.

The question now has to be asked though, is all this expenditure really worth it, and should the advocacy sector be asking for a slice of the money? I have to say that although I refer people to the CAB and other local advice centres, I also constantly have discussions with other people about the lack of anywhere reliable to get advice - the queues are too long, the length of time spent per person is too short, and the basic mistakes made with people's DLA forms seem to be too frequent. We send people to advice centres because that is what is done - advocates cannot give advice, Council and NHS staff can't give advice, and we all make the only referral that is open to us in the circumstances.

I should note again, before I get flamed, that this is just a broad picture of advice and not what always happens. On the other hand though, in my 10 years of community work experience in West Yorkshire I've witnessed various feuds and battles going on within and between advice services, neighbouring branches of the CAB who wouldn't talk to each other, a chairman who verbally abused members at an AGM, and numerous threats to cut funding followed by desperate appeals and last minute reprieves as commissioners decide there is no alternative.

There are more important and relevant issues though. Firstly, noticing various scandals and disasters that have occurred over these 60 years of advice services, the legislators have created systems designed to ensure that certain quality standards are met. So now it takes an army of managers and administrators to ensure everything is done properly, it takes months to train people to use the knowledge systems and follow the right procedures, and it takes a long time to see each client, while the rest of the queue is left waiting.

The other thing, connected to all this legislation, and linked to developments in other fields along the lines of providing properly scientific and regulated services, is that advice has to be objective and correct. This is one of the reasons it takes so long to train people to deliver it, but also one of the main reasons that it fails to meet the needs of many of the most vulnerable people who need it.

I think advocates could make a good case for providing an equally essential service, in many ways better than the services I've been describing.

For a start, we have a much better chance of helping people to solve their problems because we place ourselves closer to the people and their problems. We still maintain boundaries, but the boundaries are different: we work with people's own wishes, needs and understandings; we don't try to impose 'best' or 'correct' approaches to solving problems; we go with people to meetings, and follow issues through with them to the end, we meet them in a variety of places but there's rarely a desk or a computer between us. There are many other points - these are the unique advantages of advocacy.

Secondly, we are much easier to train. There are still training issues of course, but we don't have to use complicated computer systems, we don't have to follow rigid procedures, and we don't have to develop a huge expert knowledge and be able to provide the 'right answers'. We do need to be able to communicate (very) effectively with people, and we need to understand that we are helping them to develop and follow their own agenda, without imposing our (or our culture's) idea of best interest or propriety.

All these factors of course mean massive savings: less training, smaller offices, less IT infrastructure, fewer procedures, cheaper insurance because professional indemnity is not such an issue.

There are also other advantages. We can work with many people who are simply not able to understand and follow through with the advice they are given, even if they are able to get to the advice centre. As yet we don't have the squabbling and back-biting of some advice services (also a terrible waste of money). And we are a relatively new phenomena, with proportionately more excitement and enthusiasm amongst our practitioners.

Is there anything I've missed out. I hope you agree that on the face of it advocacy would seem to offer significantly better value than advice. I think there are many more reasons that I haven't covered here, so please let me know your ideas and let's move into those old advice centres...

NAN conference 2006 - Brighton

My main impression from the conference this year was that in some way the advocacy community has matured. At the same time there were lots of young and enthusiatic new advocates, often people who had simply seen the jobs advertised and gone for them, but nevertheless they were saying that they were now in the most inspiring and satisfying jobs they'd ever had...

The downside is that some people were still saying they couldn't explain their work to friends or family (or even some (local) government officials) and there is still an issue about what we do, but I don't think that is too big a problem. I like a certain amount of je ne sais quois in what we do, it increases richness and diversity as much as it may cause problems...

On this note, Rick Henderson did ask, somewhat rhetorically, if we should change the definition of advocacy. I almost got up and shouted YES. The definition that dominates all the A4A literature is the hopelessly ungainly and clearly committee devised*

"Advocacy is taking action to help people say what they want, secure their rights, represent their interests and obtain services they need. Advocates and advocacy schemes work in partnership with the people they support and take their side. Advocacy promotes social inclusion, equality and social justice."

My own definition is more like "Advocacy is about ensuring that people can make their voices heard." Although I've just noticed that the definition I published on the Advocacy Action website is a bit different... At least this is simple enough to be understood by the service users who are often being ignored, even if it doesn't meet everyone else's needs.

At the end of the day I was glad Rick's question was rhetorical, and I don't think the definition of advocacy needs to be changed in the way some people seemed to be suggesting. We need to embrace and champion our use of this word, for we do do something unique and special with it, and our organisations and our advocates have matured and become even more powerful and impressive, and our new recruits are being enthusiastic and empowered, and we were all inspired by yet another successful gathering of 170 advocates all being happy about what they do.

I'm already looking forward to next year...

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* The approach developed in Rick and Mike Pochin's book was much better, and it was a shame A4A couldn't do something along those lines.