28 November 2006

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.

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