Risks and barriers to organisations conducting research

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by Martin Stevens, Senior Research Fellow at the Social Care Workforce Research Unit at King’s College London. (2,114 words)

The Health Research Authority (HRA) is currently consulting on various aspects of research regulation in health and social care in preparation for replacing the Research Governance Framework (RGF). The Social Care Workforce Research Unit (SCWRU) has had a long involvement with the implementation of Research Governance in social care and has made a response to part of this consultation. The HRA is currently asking ‘What are the risks to research because of perceived risks of research? and has published a report explaining its proposed approach. There is much with which we agree in the consultation report, specifically:

  • the focus on clear and consistent definitions of terms;
  • the emphasis on collaboration;
  • the promotion of sound arrangements between the different organisations involved in research;
  • the promotion of a quality research culture, within research organisations and also in care organisations; and,
  • the need for more explicit support for a high quality research culture.

However, despite the focus on good collaboration and the need to involve all stakeholders, the document needs to better reflect the experiences of social care researchers, and those responsible for research governance in local authorities. Continue reading →

Making Safeguarding Personal (MSP) – the way forward for adult social care

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by Caroline Norrie, Research Fellow at the Social Care Workforce Research Unit at King’s College London. (952 words)

Professionals working in the adult social care field gathered at Friends House in Euston, London, on 30 June 2014 to share knowledge and experiences of Making Safeguarding Personal (MSP). MSP was initiated by the Association of Directors of Adult Social Services (ADASS) and the Local Government Association (LGA) as a sector-led response to concerns that adults at risk are not being involved in investigations and decisions when councils have concerns about abuse or neglect (adult safeguarding).

Supported by funding from Department of Health (DH) and the LGA, this improvement programme started in 2011/12 with the development of a toolkit. In 2012/13 five pilot councils signed up to the scheme and this year 53 councils participated. The programme has been given increased funding to continue next year across further English councils. Continue reading →

Where next for integration and funding?

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John Woolham

John Woolham

Martin Stevens

Martin Stevens

It is estimated that the NHS faces a shortfall of at least £30 billion a year within a decade and possibly a deficit as high as £50 billion. Martin Stevens of King’s and John Woolham of Coventry University report on an event last month where experts debated funding and integration in health and social care. (1,369 words)

At a SSRG–SSCR event on Integration and Funding of Health and Social Care held at the LSE on 18 June José-Luis Fernandez of LSE opened with a statistical review of the decline of social care service provision since the 1980s, which had become especially marked since 2008-09 with the contraction in public spending—despite increases in the numbers of older people over this period. While this could in small part be due to better targeting and more effective services, his conclusion was that there was a great deal of unmet need in the community. Continue reading →

What can the city banks learn from social care?

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The Registered Managers’ Programme from The National Skills Academy for Social Care aims to better equip Registered Social Care Managers to meet the challenges they face, to reduce their isolation by networking them at local and national level, and to enable them to recognise their leadership role. As part of the Programme, they are funding Local Networks to support Registered Managers on the ground, either where demand has been identified but no Network exists, or to strengthen and expand existing ones.

One such network has recently been established in Cumbria with support from the Social Care Workforce Research Unit at King’s College London, and it builds on earlier work around communities of practice. For more information contact michelle.cornes@kcl.ac.uk

This post was written by the members of the Cumbria Registered Social Care Managers’ Network following their meeting last month.

The focus of this meeting (4 June 2014) was celebrating the work of the huge number of social care workers who do a great job every day and make a really positive difference to the lives of people who need care and support. Inevitably though, the conversation moved to discussing the recent Panorama programme (Behind Closed Doors, 30 April 2014) on abusive care, and the impact programmes like this have on staff in the sector. That led to us thinking about what registered social care managers can do to raise the profile of care that is caring and compassionate?

Cumbria Registered Social Care Managers’ Network

The Cumbria Registered Social Care Managers’ Network at the June 2014 meeting

For the front-line care workers in attendance at this meeting, programmes like Behind Closed Doors are far removed from their day-to-day experiences of delivering care. A good day for some starts with crumpets, toast and jam and a chance to catch up with each other (called a ‘hand over’ in the jargon). There are enormous challenges in delivering good quality care—for example how to be personalised, compassionate and ‘quick’ (in your 15 minute time slot with each resident). Work is often stressful, physically demanding (12 hour shifts) and emotionally draining. Needless to say, the situation is not helped by the current climate of austerity and chronic underfunding. However, the job brings with it enormous rewards and a great sense of personal satisfaction. At the heart of the work is your team, like a family almost, and all the emotional benefits which flow from being collegiate.

Added to this, is the sense that you are making a very real and positive difference to people’s lives. In this business it is the ‘smiles and the thank yous’  that count for most… The six figure bonuses, pay rises, company cars and expenses said to be absolutely essential to recruit and retain the ‘best’ staff in the more compassionate(less) industries are seemingly not so important in social care. Maybe the city banks have something to learn from social care managers in this respect?

Cumbria Registered Social Care Managers’ Network

The Cumbria Registered Social Care Managers’ Network at the June 2014 meeting

Where programmes like Panorama can have a particularly detrimental impact is that they can work to undermine the confidence and integrity of some social care managers. The desire to ‘protect’ the public from abusive care often sees the inspectorates and commissioners of services imposing further layers of monitoring and regulation. However, unless carefully implemented as part of a wider culture of learning and improvement, this can quickly lead to a ‘them’ and ‘us’ scenario in which there is a lack of trust and authentic partnership working. While the ‘best managers’ will follow the rules and regulations, reporting ‘poor practices’ or any ‘safeguarding’ incidents as they are required to do, they can be left feeling demoralised and ‘brow beaten’ by the response. ‘Poor managers’ meanwhile will keep their heads down; they will not engage externally and will remain largely hidden from view, that is, until the television cameras go in.

How to engender trust and authentic relationships (the ‘smiles and the thank yous’) between commissioners and providers of social care services is a question we shall return to in future meetings. Celebrating the role of the social care worker and raising the profile of ‘good care’ has just been a first step.

For more information about this post please contact Michelle Cornes, Senior Research Fellow at the Social Care Workforce Research Unit at King’s College London. The Unit is part of The Policy Institute @ King’s.

Challenge the CQC

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Caroline Norrie, Research Fellow at the Social Care Workforce Research Unit at KIng’s College London, and Esther Njoya, Research Intern at the Unit, report on a meeting held earlier this month at which the Care Quality Commission (CQC) was put on the spot by parliamentarians, professionals and the public.

The public had a chance to ‘challenge the CQC’ at an event held on 11 June at the House of Commons. This was an opportunity for the public, patients, and health and social care professionals to question representatives of the Care Quality Commission (CQC) about its work and especially the proposed changes to the regulation of primary and integrated care.

Held under the aegis of the All-Party Parliamentary Health Group, the meeting was chaired by Dr Sarah Wollaston MP with a panel made up of Chairman of the CQC, David Prior and Chief Inspector of General Practice, CQC, Prof Steve Field. Dr Sarah Wollaston opened the meeting with a brief description of the role of the CQC as independent of government and committed to transparency and the integration of health and social care.

Chairman of the CQC, David Prior

Chairman of the CQC, David Prior

Following the Winterbourne View TV exposé and Serious Case Review the CQC has been making significant changes. These are summarised in its strategy, Raising standards, putting people first – Our strategy for 2013 to 2016, which it has been consulting on. As part of a new inspection regime, the five new key domains the CQC will be inspecting in all services are safety, effectiveness, caring, responsiveness to people’s needs and leadership. The new style inspections are being trialled in hospitals, mental health and community health services, and, since April 2014, in adult social care services and GP practices.

As has been widely reported, inspections are now being carried out by specialists (including experts by experience) within professional areas rather than generalists. Services will soon be graded as outstanding, good, requires improvement or inadequate. The CQC hopes this new grading system will encourage service improvement. The CQC has also undertaken a review of care homes and found about 3,000 care homes with no qualified registered managers; in some of these the owners have been penalised. Finally, a new aim of the CQC is to understand and measure service users’ experiences of integrated working. Final plans will be published in September 2014 and come into effect in October 2014. This meeting was part of CQC’s strategy to engage the public in this change process.

Professor Field outlined in more detail his vision for inspection in primary care, which includes improved access to care for vulnerable people (such as homeless people, people with learning disabilities, and sex workers, among others). The CQC will use ‘levers’ to improve integrated care and its commissioning. The aim is to ‘celebrate good practice as well as shining the light on poor practice.’  He outlined all the areas that are covered by CQC primary care inspection including GPs, dentistry, mobile doctors (e.g. the 111 service) medicine management, prisons and safeguarding.

The majority of this forum was taken up with discussion around a wide range of questions from the audience.

Baroness Hollins, a prominent Learning Disabilities (LD) campaigner, urged the panel to introduce levers to ensure GP practices fulfilled the regulation of noting when a patient has a learning disability. She asked whether the CQC had made any headway in implementing the recommendations set out in the Confidential Inquiry into premature deaths of people with learning disabilities (CIPOLD). She stated that 37% of the deaths of learning disabled people were preventable—making this a discriminated against group. Prof Steve Field replied he was taking notice of the comments and that such implementation might be possible using intelligent monitoring (a new system being developed to combine informal intelligence and formal performance management data).

Several service users and carers used this meeting to complain about lack of joined-up services and inequality between London boroughs in the provision of mental health services. Suggestions were made about providing crisis phone lines, which might reduce hospital admissions. The speakers took notice of these comments and also offered the audience information about making complaints to local Health and Well-being Boards (HWBs) and the CQC call centre in Newcastle.

A representative from Healthwatch asked about links with the CQC and how to make the most of their work (e.g. their role in being able to enter and view services) while avoiding duplication of roles. Prof Steve Field answered that the CQC was focused on ‘listening to people on the ground’ and the HWBs acted like the ‘eyes and ears of the CQC’ and so both organisations should be working together. It was not entirely clear how these mixed metaphors would work locally,

Concerns specifically relating to GPs were raised—for example, out-of-hours services, the trend for phone rather than face-to-face consultations, and regulation of single-doctor practices. Service users asked when electronic patient records were going to be introduced and whether patients would have permission to check and amend their own records. Questions were also asked about regulation of follow-up-care and post-discharge services and insurance for independent midwives.

Another representative from a Healthwatch organisation, who declared that they were willing to support individuals who wanted to expose acts of neglect and abuse in care homes as whistleblowers or witnesses, asked whether there were avenues that such organisations could use to effectively collaborate with the CQC. She observed that they could contribute to the CQC’s work in providing oversight roles for inspections, regulation and monitoring, as it was evident to her that the CQC had overlooked previous cases of abuse scandals—for example the case in The Old Deanery home, which was shown by Panorama at a time when CQC was actually carrying out an ongoing inspection. Professor Field replied by saying that it was unfortunate that such an incident had happened while still under their scrutiny, but that at the time they had relied on information from the management of the home. He reiterated that the CQC welcomes the contribution of Healthwatch organisations who are able to provide information.

In contrast, Paul Beresford MP noted his concern about over-regulation and suggested closer working together of the General Medical Council (GMC) inspections and the CQC. Professor Field replied that this was in the pipeline, and there were general murmurs of approbation to this news.

A representative from the care home sector then put forward the case for private providers. He said there was a danger that good quality operators offering services for people with long-term conditions would be driven out of the sector due to the growth of regulation. He called for increased funding and more training to be made available for care home managers. Prof Steve Field agreed, but noted that care homes should also take some responsibility for training and ensuring that their members of staff have care home management skills and professional qualifications.

One member of the audience questioned whether the CQC has capacity to undertake this more stringent inspection regime. Professor Field replied that the CQC was recruiting more staff and that it did have capacity to undertake the work. The best providers will only be regulated once every two years, rather than annually as is currently the case.

As researchers currently involved in projects about adult safeguarding, this meeting provided an interesting insight into the CQC’s vision for regulation. Plans for the CQC to carry out more stringent inspections of social care services and to use their powers to encourage more effective joined-up working across health and social care sounded highly positive aspirations—although the policy shift to more infrequent inspections of the ‘best homes’ needs to be tempered by an acknowledgement of the risks of such homes being quick to deteriorate.

Caroline Norrie is Research Fellow at the Social Care Workforce Research Unit at King’s College London. Esther Njoya is a Research Intern at the Unit.

Following a pathway to impact

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Valerie Lipman

Valerie Lipman

The Social Care Workforce Research Unit is part of the Policy Institute @ King’s, which is furthering the cause of evidence-informed policy and practice. Valerie Lipman, a social gerontologist and a postdoc Intern at the Unit, reports on an event which examined the questions that arise where academia, funders, policy-makers, and practitioners meet.

I went to a great panel discussion last week: ‘The impact of impact: who are we researching for?’. The event, the last of the year organised by KISS-DTC* was moderated by BBC journalist Mark Easton. Lots of talking about the history of research, its purpose, why do we do it, what’s meant to happen to it when done, and who cares? And that for me is the critical question. Who cares, or rather who do I want to care about the research I’ve done? Why would you bother doing social science research unless you wanted something to be different as a result? This view has been the order of the day for some time now, and the proof is in how money is made available for research, and the ability of those carrying out the research to disseminate and inform others.

From their different perspectives three panellists presented the case about why impact matters. In the academic corner we had Dame Janet Finch, chair of the social sciences panel for the REF, arguing a strong moral case that researchers have a responsibility to make their research available and that the ‘impact’ element of the REF is here to stay. Aileen Murphie, Director, DCLG & Local Government VFM, promoted the need for evidence-based policy, though as members of the audience argued this can result in favouring government priorities occluding an openness to new ideas. And representing a position between the academic and government worlds was Anthony Tomei, former Director of the Nuffield Foundation: the voice of independence, risk taker in what research to support and an advocate of the importance of quality research that can effect change.

The time when research was allowed to be an expression of freedom and a search for the new—an opportunity to delve into the unknown and emerge with the prize that would change the thinking and actions of others to make a better world—seems to have passed. On the other hand I’ve worked with people in university research departments who’ve never thought about what the purpose of their research was. It was the job of others to interpret the findings and take it further. Obviously, you shouldn’t know the answers to the questions before you start the research or skew your questions to meet what you want it to show—’policy-based evidence’ as someone at the meeting described it. But there must be a way of deciding at the start that you’ll want the results of the research to matter, so how about building in processes at the outset that stimulate debate as you go along … following a ‘pathway to impact’, as Janet Finch said, not merely waiting till the obligatory conference and a couple of academic papers at the end?

Valerie Lipman was recently awarded a PhD by the Centre for Ageing at the University of Southampton. She is a postdoc Intern at the Social Care Workforce Research Unit, developing material from her doctorate for publication here at King’s.

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*KISS-DTC = King’s Interdisciplinary Social Science Doctoral Training Centre

 

The opportunities and challenges in managing non-UK-qualified social workers in London social work practice

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Dr Allen Bartley

Dr Allen Bartley

Are you a registered social worker who has supervised or managed a social work team and who has worked closely for at least 3 months with a non-UK-qualified social worker? If so, Dr Allen Bartley of the University of Auckland would like to hear from you. Dr Bartley, Visiting Research Fellow at the Social Care Workforce Research Unit, is conducting a new study, Crossing Borders: Social work employers’ and managers’ perspectives of migrant social workers. In this call for participants he explains the rationale for the study and how you may be able to help. Interviews are in July.

Background to the study

Social work is a global profession practised in over 140 countries. Its spread and development have been accompanied by a drive to attain professional status and a coherent international identity through the work of a number of international organisations concerned with social work practice and education, such as the International Federation of Social Workers (IFSW) and the International Association of Schools of Social Work (IASSW). The global nature of the profession is reflected in the large number of international professional and academic social work publications and, in Europe, the imperatives of various EU directives and initiatives such as the Bologna Declaration have motivated social work educators and registering authorities to move towards a closer alignment of practice standards to a European norm (Walsh, Wilson & O’Connor, 2009).

That social work as a profession aspires to such a globalized outlook is premised on an assertion that the profession adheres to a central set of values and ethics that transcends national boundaries (Welbourne et al., 2007). Similarly, higher educational programmes in social work across a number of countries now stress ‘universal social work professional values’ such as self-determination, confidentiality, being non-judgemental, acceptance and the respect for diversity (Welbourne et al., 2007; Calderwood, Harper, Ball & Liang, 2009).

As a result, social workers in many countries may feel that they belong to a transnational profession. This perception is reinforced by both government immigration policies and by the global recruitment activities of social work employers. Social work agencies have been actively recruiting and marketing to migrants the benefits of living and practising in the UK, in an effort to fill gaps in its social care system (Hussein, 2014; Christie & Campbell, 2009; Simpson, 2009;). In the UK, between 2003 and 2004 there was an 82 percent increase in the number of overseas qualified social workers entering the country, with the greatest numbers coming from Australia, South Africa and the US (Welbourne et al., 2007), though changes to UK immigration policies more recently have seen a shift towards recruitment from across the European Economic Area (Hussein, 2014). This internationalization of practice has led us to conceptualise social work as inhabiting a transnational professional space (Bartley et al., 2012).

That transnational professional space is not without its challenges. However universal they may be, social work values and ethical codes are always interpreted through the lens of national or regionally-specific historical, social, political and cultural norms (Welbourne et al., 2007; Simpson, 2009). These norms are manifest in a range of challenges that confront transnational social workers: in employment practices and workplace cultures; in negotiating new sets of legislative imperatives and political tensions; and in gaining recognition and acceptance of the validity and transportability of their educational qualifications, skills and practice expertise gained overseas; and in navigating the particular forms of ethnic and cultural diversity and the attendant politics that manifest in local sites and impact on social work practice.

Taking part in the study

As part of the Research On Workforce Mobility network (ROWM) at King’s College London, the Crossing Borders team has partnered with Dr Shereen Hussein, Principal Research Fellow at the Social Care Workforce Research Unit, to replicate in London a study currently underway in Auckland. We plan to interview social work employers and managers in London about their experiences of supervising non-UK-qualified social workers practising in the local context. We will conduct the interviews in London throughout July 2014, or if you are not in London during this time we can arrange for a video or telephone interview.

We would like to hear from you if you are:

  • a registered social worker who has supervised or managed a social work team; and
  • have worked closely for at least 3 months with a non-UK-qualified social worker; and
  • willing to talk about your experiences and reflections.

Please contact: Dr Shereen Hussein to arrange an interview on 020 7848 1669 or shereen.hussein@kcl.ac.uk.

We invite participation from professionals in both statutory, for-profit and voluntary (not for profit) organisations of varying sizes (from very small to very large), and across a range of fields of practice. This study is part of a larger comparative study involving professionals in New Zealand and Australia.

More information: on the Crossing Borders project web page and in the Information Sheet for Study Participants (pdf, 2pp).

Dr Allen Bartley is a New Zealand-trained sociologist who migrated to New Zealand from the United States in 1992. Based in the social work programme in the School of Counselling, Human Services & Social Work at the University of Auckland, he is part of a research team investigating the transnational dynamics of the social work workforce in New Zealand. Additionally Allen is involved in a project exploring the use of social media by migrants in Auckland, and its impact on their sense of identity and belonging. He is Visiting Research Fellow at the Social Care Workforce Research Unit, King’s College London (from July 2014).

A giant in the field of autism: Reflections in honour of the life of Dr. Lorna Wing

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Valerie D'Astous

Valerie D’Astous

It has been said that a better tomorrow is built based on the efforts, determination and resilience of leaders of the past. English psychiatrist and physician, Dr. Lorna Wing was such a leader. She was instrumental in carving a path and showing us the way to move forward in the research of autism and improving the quality of life for individuals with autism. The world wide autism research community has lost its matriarch with Dr. Wing’s death last Friday, 6 June at the age of 85.

Dr. Wing focused her career on autism after receiving the diagnosis for her only child in the late 1950s. She was instrumental in defining autism as a spectrum, identifying the triad of impairments in autism, coining the term Asperger’s syndrome and helping to establish the National Autistic Society. She has been witness to and an agent for change in the research of autism and the autism community since its early beginnings.

Autism was first described in 1943 by American psychiatrist Leo Kanner and in 1944 by Austrian paediatrician and medical professor, Hans Asperger. Autistic Spectrum Disorder is a complex neurological developmental disorder that affects the way a person communicates and relates to people and the environment. The term ‘autistic spectrum’ is often used because the condition varies from person to person and can range in form from mild to very severe. Very little knowledge and few services were available when Dr. Wing’s daughter was diagnosed. For over 50 years, Dr. Wing was instrumental in autism research and advocacy, expanding our knowledge and promoting services and support for people with autism and their families.

In honour of the devotion and accomplishments Dr. Wing achieved in the recognition and understanding of autism spectrum disorder and for all people living on the autism spectrum we must continue her momentum, persisting in making steps in autism research, supportive services and collectively working towards what we have yet to achieve.

Dr Lorna Wing OBE 1928-2014 remembered at The National Autistic Society

Valerie D’Astous is a PhD Candidate at the Institute of Gerontology, King’s College London. Her research study focuses on the health care and supportive needs of adults with an Autism Spectrum Disorder. Of particular concern for her is investigating how people with ASD are able to maintain their wellbeing following parental caregiving.

Recognising the value of people who are paid to care

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Katie Graham, Research Associate at the Social Care Workforce Research Unit, reports on care workers taking strike action in Doncaster.

During the last few months many care workers in Doncaster have been on strike. A three day strike ended on 22 April and union members have now started a further two weeks of action. UNISON members are taking action against changes to pay (including reducing weekend enhancements), sick pay and holiday entitlement. These planned changes are being implemented following the NHS loss of its contract to provide supported living services in the area. Given the rarity of unionisation and action within care work and the precedent that the proposed contract working terms and conditions would set (as more and more previously public sector services are transferred to the for-profit sector), it is curious that there has been such limited national coverage of the ongoing strike action.

In other parts of England social care providers and local authorities (the commissioners or funders of much social care) are subject to sharp criticism over the poor contractual conditions of care workers within commissioned services. Some home care workers have to endure zero hours contracts (Joseph Rowntree Foundation report) and non-payment of travelling time leading to below minimum wage payment. It has been confirmed by Care Minister, Norman Lamb, that there are 307,000 care workers on zero hour contracts (Community Care, 2013); work by this Unit has indicated that at least 150,000 workers in the social care sector may be getting paid less than the minimum wage (Hussein, 2011). And in 2013 the Low Pay Commission expressed its concern that social care workers are particularly vulnerable to poor pay and conditions of employment. The situation has been highlighted in the press and the House of Commons in part due to a recent court verdict in late 2013 (Whittlestone v BJP Home Support Limited) which ruled on the illegality of the non-payment of travelling time.

A recent review of the implications of adult social care budget cuts by Community Care (McNicoll & Stobart, 2014) illustrated the strategies councils are using to manage their limited budgets.  These included increasing the eligibility criteria (threshold for public funding entitlement), strict limits on care packages (e.g. no overnight care and reduction in the length of calls), increasing charges to service users, a ‘cap’ (upper limit) on council expenditure on social care, with budgets allocated to care managers to ensure they ‘understand fully the implications of their decisions’ on finances.  In spite of the government promising guidance for local authorities to address these concerns within the commissioning process another strategy seems to be the outsourcing of previously public run services and the re-negotiation of existing contractual arrangements with voluntary and for profit organisations. These may potentially reproduce the very conditions that have lead the care workers in Doncaster to take decisive action and the difficult decision to strike.

The Joseph Rowntree Foundation (Carr, 2014) recently released a summary of three major research projects looking at care work and low pay. These suggest that the evidence that connects low pay and poor quality of service is inconclusive.  However, it is emphasised that a combination of pay and working conditions including supervision, training, appropriate amount of time to fulfil tasks, need to be considered to ensure ‘job quality’ for the care worker and a quality service.

Historically there has been limited unionisation of care workers working in residential and community services, therefore there has been limited collective response to poor working terms and conditions. The policy of personalisation is leading to the development of a more dispersed and fragmented workforce. This makes the struggle, by those in a position to organise and collectively campaign, particularly difficult and important. By whatever means, there needs to be a wider recognition that ‘care work’ in its multiplicity of forms including practical tasks, assisting, prompting, skill development as well as relationship building, emotional support and developing trust in often intimate domestic situations, should be valued both financially and socially.

Care workers have always experienced low pay for demanding work so little has changed. In recent years we have seen undercover reporters exposing shocking images of abusive practices in residential settings and recently the BBC televised further instances of abuse and neglect of older people in residential care homes by care workers. Many such instances have been rightly responded to both by the criminal justice system as well as the regulator, the Care Quality Commission (CQC). However, there is a problem in individualising the blame (on a ‘bad apple’) rather than seeking to understand and address the systemic failings in how we organise and value front line social care. The combination of dismay at the regular practice of organisations creating savings by non-payment of care workers’ travel time and the ongoing strike action by UNISON members in Doncaster for commensurable terms and conditions of employment in an outsourced service, highlights the need for research and policy to take a holistic view of our care industry, recognising how the material and working conditions of the workforce must be directly connected to the quality of our care services.

Dr Katie Graham joined SCWRU in early 2013 and is working on a NIHR School for Social Care Research funded project comparing the costs and benefits of different models of adult safeguarding.

Student placements in children’s service departments: lessons from Canada

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Dr Mary Baginsky

Dr Mary Baginsky

Mary Baginsky is Visiting Senior Research Fellow at the Social Care Workforce Research Unit at King’s College London. Here she suggests how universities and social work services could be brought into closer partnership.

Both Martin Narey’s and David Croisdale-Appleby’s reviews of social work education have reported on the shortage of placements for social work students, as well as raising questions about consistency in the quality of those that do exist. The President of the Association of the Directors of Children’s Services (ADCS), Andrew Webb, has also said that there is neither the range nor breadth of placements to keep pace with student numbers. Martin Narey went so far as to say that the endorsement process should include an evaluation of the quality of practice placements and recommended that universities which fail to provide every student with at least one statutory placement (or an alternative which is genuinely comparable and accepted by employers as comparable) should not receive endorsement from The College of Social Work. There is, perhaps, an alternative approach whereby the placements a student has completed on their registration are recorded. Anyone who had not completed a statutory placement in the relevant sector would then be required to do one subsequently if they wished to be employed in a statutory setting. The cost effectiveness of this would need to be calculated.

However, making this and similar suggestions does not get away from the seriousness of the situation facing courses and students, but neither is it confined to social work students. The Nursing Times (12 February 2014) reported that student nurses are struggling to get good practice placements because hospital wards are overstretched and staff too busy to supervise them.

It is not surprising that the pressures under which children’s service departments are operating and the number being judged to be inadequate by Ofsted are having an effect on the willingness of managers and practitioners to take students on placements. I am well aware of good practice around the country where universities and local authorities have established strong working relationships. They are usually distinguished by a commitment of the university and/or the local authority to take on responsibility for placements at a relatively senior level. This is usually linked with a commitment on the part of local authorities to embed placements in their workforce strategies and on the part of universities to provide a high level of support, not only to students but also to authorities. As training budgets are slashed and more authorities struggle to retain experienced staff such support from universities is an important factor in being placement-possible if not placement-friendly. In the past some authorities have complained that they have had to take what (and whom) universities have offered but the world has moved on. It is in the interests of both parties to collaborate over the training of existing and future practitioners and this is the conclusion that more authorities and universities are reaching.

Thirty-five years ago Hayward (1979) wrote that:

The assessment of practice aspects of the course has traditionally been regarded as different in quality and far more problematic than the assessment of coursework. (p.175)

Assessment of student practice is still the issue that is commonly cited by practice educators and university tutors as the one that is most likely to lead to disagreement, whether this is in terms of practice educators’ concerns about aspects of the student’s practice or perceived generosity or leniency of one party. On a recent visit to Canada I encountered two initiatives that could be introduced in this country and which have brought universities and social work services into closer partnership.

First, there are many examples in the literature that illustrate how individuals come to quite different outcomes when making an assessment and there are also many examples in the literature of attempts to devise competency-based checklists. One of the most reliable is the Objective Structured Clinical Examination (OSCE). The OSCE is used as an assessment tool for licensing exams in nursing, medicine, midwifery and other subjects in the UK, Australia, Canada and the United States. It is used to assess knowledge, clinical skills, and the transfer of knowledge into practice while providing a standardised assessment method irrespective of variations in client or assessor. Marion Bogo, Professor of Social Work at the University of Toronto, has developed an OSCE for social work which is now being used and adapted across Canada and USA. It consists of ‘laboratory’ interviews and structured reflective exercises to see how the student has integrated concepts. OSCE performance and reflections are rated on standardised scales. Initial tests and subsequent applications have shown that the test is a valid tool for assessing practice, even though further development is required. It is being adopted in a number of countries and the question arises as to why it is not as prominent in this country. It is time and labour intensive which, in the current climate, is likely to prove a disincentive. But it is hard to remember a time when this would not have been the case. As well as a potentially more reliable way of assessing students it also offers the opportunity for universities and practitioners to work together on its development.

The second suggestion comes from a visit to McGill University in Montreal. Anyone taking a student on placement who is attending McGill is required to take a course on supervision before the placement. Not only is this a way of attempting to ensure the quality of placements, it means practice educators engage with McGill at an early stage and the university then builds on this relationship in a number of ways. One way is by inviting their practice educators to regular meetings with the faculty members of the Social Work department. I was fortunate to be able to attend one of these meetings and I was struck both by the understanding of the course that the practice educators displayed and by the breadth and depth of the discussion. So while administrative and progress issues around the actual placements were covered, there was much more discussion of issues around the integration of theory and practice and of specific elements of the training. It was evident that there was a shared understanding of the curriculum, which must in turn benefit all involved but most of all the students on placement. It represented a real partnership of practice and academy that is often talked of but not often achieved in England. It is a model that would transfer to this country but again one that demands a significant level of commitment.

It may not seem the most sensible approach to suggest initiatives that will take even more time and application. But it seems that while social work courses have been forced to address the criticisms leveled against some academic input for its lack of rigour and consistency, similar standards need to be applied to placements and ones that go beyond the revised Practice Educator Professional Standards, however welcome these have been. Practice and professional trainers need to address this subject together. They will find many ways of doing so but perhaps these two examples could be in the portfolio of actions they consider.

Dr Mary Baginsky is Visiting Senior Research Fellow at the Social Care Workforce Research Unit, King’s College London. Follow Mary on Twitter: @abbotsky

Reference:

Hayward, C. (1979) A Fair Assessment: Issues in Evaluating Coursework. London: CCETSW.