Independent report

Chief Social Workers’ annual report: 2019 to 2020

Published 17 March 2020

1. Minister’s foreword

As the newly appointed Minister for Care at the Department of Health and Social Care (DHSC), I’m so pleased to be asked to contribute a few words to this year’s Chief Social Workers for Adults Annual Report.

Fran Leddra and Mark Harvey, keeping a close watch over adult social work while the original Chief Social Worker Lyn Romeo is on sabbatical, have already given me the benefit of their many years’ experience working in the care and support sector.

As a constituency MP, I already appreciate the important and often difficult work all social workers do, day in day out – using all their skills, compassion, and commitment to make a positive difference in people’s lives.

As we publish this report, government, business, the health and care sector and our communities are uniting to protect those most at risk from the spread of COVID-19. We know social workers will be playing a vital role, not only by sharing government guidance, but particularly drawing on their own talents and experiences to help keep clients, family and friends well. This is a marathon, not a sprint and our thoughts are with everyone already affected by this virus.

Increasingly, cross-government strategies are being influenced by the wisdom and insights of the social work profession, including the first ever government strategy to combat loneliness launched in 2018. Strengths based social work practice, with its focus on reconnecting people with their communities and making the most of their own talents and life goals undoubtedly influenced the approach.

When you consider research has already shown that lacking social connections can be as damaging to physical and mental health as smoking 15 cigarettes a day, social work – with its focus on the strains and stresses of people’s everyday lives - was an obvious profession to turn to for solutions.

Elsewhere, at DHSC and the Department for Education (DfE), both Chief Social Workers (Lyn Romeo for adults and Isabelle Trowler for children and families) were rightly demanding greater support for children, young people and adults living with autism, mental health and mental capacity issues.

The 2-year focused Carers Action Plan (CAP), launched by my predecessor and parliamentary colleague Caroline Dinenage in 2018, has also done much to improve care and support for unpaid carers and the cared for – fine-tuned with the help of adult social work’s expertise in the field. Who better than social workers to spot the warning signs of approaching ill health and identify the help and support needed to avert a crisis?

Broader enterprises, like the government’s Ageing Society Grand Challenge to add another 5 years of healthy, happy, independent living by 2035, also recognise the value, insights and innovations that modern, progressive social work can bring to an ageing, growing and diversifying population.

Fran and Mark are fully committed to these great enterprises. As I hope you’ll discover in this annual report, they have wasted no time building on the work Lyn began.

Together, they are redoubling efforts to improve adult safeguarding, seeking new ways to address health inequalities for adults with autism and learning disabilities, and considering fresh approaches to integrated commissioning and values-based practice, as they commit to transforming care and support in our communities.

The well-established Principal Social Worker Networks are already helping to amplify this work across the country, raising awareness and promoting collaboration between local councils, health and care services, and the broader voluntary sector.

I know they will continue to be vital partners in our collective efforts to define what effective social care – and social work’s place within it – should look like in the 21st Century.

Together, we will work hard to find the long-term solutions to social care provision. We can only do this by forging greater harmony between health and care services and placing person-centred care at the heart of both. I firmly believe social work can lead the way, make change happen, and continue to pioneer innovation, creativity and – above all – compassionate care within our communities.

I’m looking forward to working with Fran, Mark and Lyn to make sure we do exactly that.

2. Reflections on 2019 to 2020 from Fran Leddra and Mark Harvey – joint Chief Social Workers for Adults

It was – and continues to be – an enormous privilege to take on the roles of Joint Interim Chief Social Workers (CSW) for Adults at the Department of Health and Social Care (DHSC).

Our trailblazing – first ever – CSW, Lyn Romeo, is currently on sabbatical and will be back in the role she helped define in October this year. All being well, our first words on her return won’t be “Ah, Lyn, while you were away…”

Since October 2019, we have continued Lyn’s vitally important work to support, sustain and evolve our profession and social work practice.

Over the past 7 years, under her leadership and guidance, we have seen adult social work education standards rise, skills strengthen and diversify, and the esteem and influence of our amazing profession continue to grow within the wider care and support sector.

We will continue to build on Lyn’s transformative approach in the months that remain of our tenure.

This annual report is a good opportunity then to look back over the last year, highlight our profession’s achievements, and reflect on the progress made on the priorities set out in March 2019.

Before we do that though, it seems only right to recognise the immense contribution Lyn has made in her role since 2013.

Not before time, she was awarded the Outstanding Contribution to Social Work Award at the Social Worker of the Year Awards last December. Soon after, Lyn received a CBE in the Queen’s New Year’s Honours List. Like buses, you wait ages for thoroughly deserved accolades, then two come along at once.

The awards rightly recognise more than 40 years of practice and leadership in social work and 7 years leading the profession as Chief Social Worker for Adults in England.

We should also highlight the important work she undertook in 2019 with Isabelle Trowler, the Chief Social Worker for Children and Families at the Department for Education. Together, they reviewed the role of social work in the lives of young people with autism.

Their recommendations fed into DHSC’s current review of the government’s autism strategy. We urge everyone in the profession to contribute to this important review which should be available shortly.

Lyn set out her priorities last March, which were to:

• further embed strength-based approaches in social work practice
• improve our evidence and research base to further validate and inform our profession
• promote the values and contribution of adult social work across health and care and further develop our skills.

So, what has been achieved in that time?

Developing leadership

We believe there has been a step-change in how social work is perceived in the social care system. In particular, the leadership role of Principal Social Workers (PSWs) in local authorities is beginning to fulfil the promise of the Care Act in making social work integral to multi-disciplinary approaches.

Nowhere is this more evident than in the Spring of 2019, when membership of the Association of Directors of Social Services (ADASS) was extended to all PSWs.

In July of that year, Lyn and DHSC published the Capability Statement for Principal Social Workers (PSW) in Adult Services setting out the knowledge, experience and capabilities they require to develop excellent social work practice within their organisations.

The statement supports a move towards consistency in their scope, autonomy, influence and impact across the whole sector and is a springboard to enhancing PSW leadership roles.

We are pleased to continue supporting them, both through funding support for the PSW national network, events and conferences, and a continuing development programme.

A total of 100 PSWs have now successfully completed the leadership development programme run by Skills for Care (SfC).

We also recognise the vital role of supervisor social workers, developing front-line colleagues, directing practice and making sure effective decisions are taken and lives improved.

Building on the post-qualifying standards introduced in December 2018, this year we asked SfC and Research in Practice for Adults (Ripfa) to develop a ‘train-the-trainer’ programme and resources for PSWs so that local leaders can mentor and develop their staff.

We would like to commend local leaders for their role in working alongside others in the health and social care system, developing and implementing integrated services designed to wrap around people.

Nowhere is this more evident than in our work with people with mental health issues. Mark Trewin, currently on secondment to DHSC from Bradford Council, has been leading work with councils and NHS Trusts to develop and modernise integration partnership arrangements to respond to the demands of the NHS Long Term Plan and to promote strength-based approaches.

Many of these local partnerships are long-established and the professional needs of social workers had not always been well addressed.

The CSW’s office has also led HEE’s work to develop new models of integrated partnerships that will support local authorities and social workers to take a wider role in the delivery of mental health services alongside other partners.

This includes supporting NHS Trusts who employ social workers, developing and supporting the Approved Mental Health Professional (AMHP) role through the development of the national AMHP workforce plan and service standards, and developing learning about successful partnerships from the Social Work for Better Mental Health Programme.

A growing number of localities are working to redevelop their local partnerships.

Developing practice

Strength-based approaches in social work are clearly effective and we are pleased to see these are becoming increasingly mainstream. We launched a strength-based framework in spring 2019 that provided a practical framework for social work to help deliver better and more effective services.

For many young adults, as they grow up, the move to adulthood requires a social work approach that understands and responds to their needs and those of their families, making sure social workers in both children’s and adults’ services work well together.

We were pleased to support the Social Care Institute for Excellence (SCIE) to develop and help publish new guidance for social workers supporting young people into adulthood.

We have continued to support the development of individual social workers through continuing professional development (CPD).

Building on the CPD framework for social work with older people, we commissioned the British Association of Social Workers (BASW) to develop CPD frameworks and pathways for social workers who wanted to enhance their skills to help autistic people and people with learning disabilities.

BASW have also run a project to embed these frameworks within our profession, through employers, educators and other networks:

• Capabilities and CPD pathway
• Capabilities statement for social work with autistic adults

We recognise the importance of research and evidence to social work practice and the CSW has worked with the James Lind Alliance to identify and prioritise the most important research subjects; these were published in December 2018.

The CSW’s office has also worked with research colleagues in DHSC, the National Institute for Health Research (NIHR) and the sector to identify how we can address the top priorities in our strategies and research programmes, alongside promoting opportunities to increase research capacity in the profession.

Improving regulation

The CSW has worked closely with Social Work England (SWE) to help develop their professional standards, priorities and emerging work. We were pleased that SWE launched in December 2019 and will work to enable positive change and make sure that regulation is responsive, fair and effective. We look forward to SWE’s first strategic plan which should be published shortly.

3. The Chief Social Worker’s priorities and actions for the coming year

We are delighted to present the Chief Social Workers for Adults annual report for 2019 to 2020. This is the sixth such report to be published since Lyn Romeo assumed the role and our first as interim joint Chief Social Workers since she began her sabbatical year.

As such we will be building on the phenomenal amount of work Lyn has set in motion and ensuring her vision and plans continue.

The last year has seen so much work come to fruition. At the same time, we have been laying the foundations for future endeavours. With this in mind, this report sets out the progress made, the challenges encountered, and our priorities for the year ahead.

These priorities have been developed in conjunction with our colleagues, partnerships and community networks. Perhaps most importantly, they reflect the voices of adults and carers who interact with social work and social care services across the country. Lived experience and our commitment to co-production will be an unbeatable combination as we seek to make good on our pledges.

In taking on the role of CSW, the culture and learning environment led by PSWs has been hugely beneficial. Now, as full ADASS members, they can strengthen their influence in the national conversation as together we debate, discuss and seek to define the future of an integrated health and care system.

We have been proud to work alongside these talented social workers and look forward to the national PSW Network working collaboratively with people who experience social work in their everyday lives.

This year, we want to build a much stronger link between our annual report and PSW’s work plans. Only with strong relationships between PSWs, ADASS, the Chief Social Workers, individuals and communities, can we deliver our collective ambition to improve the quality of social work, achieve what is important to people and fulfil the responsibilities of our profession.

Over the next year we will be asking PSWs to draw up clear plans alongside their Directors of Adult Social Services to demonstrate how they will help deliver the priorities set out in this report.

We will also be asking PSWs to reach beyond their organisations, acknowledging that their leadership role extends into their communities. We want them to recognise, celebrate and capitalise on the amazing work that takes place around them. From hospices to charities, from academia to NHS Trusts, PSWs should be beacons for their profession.

We are committed to research-based practice – knowing what works, what doesn’t and having a strong evidence-base remains essential for people who need our support.

In February, we published a report with RiPfA which highlighted the most effective approaches and interventions to reduce and prevent loneliness. Social workers are at the heart of identifying and working with people and communities to tackle loneliness and isolation and we look forward to working with them, to ensure social work continues to respond to this scourge in our society.

The work during 2017/18 with the James Lind Alliance Priority Setting Partnership agreed the top ten research priorities for adult social work.

We have been working with colleagues in DHSC and the National Institute for Health Research (NIHR) to identify how we can address these evidence gaps, including through the social care research calls, where applicants are asked to consider the JLA priorities when developing their applications.

The focus on the effectiveness of strengths-based approaches in the latest phase of the Policy Research Programmes will be a particularly welcome addition to the evidence base for social work.

The Chief Social Workers’ priorities for 2020 to 2021

We will continue to remain involved in changes and implementation of legislation, including the Liberty Protection Safeguards (LPS), the refresh of the Autism Strategy and the implementation of mental health and transformation in adult social care legislation.

Of course, modern social work practice must also adapt to the sudden, the unexpected, or the unforeseen. We have risen to the challenge during Grenfell, the terrorist attacks in Manchester and London, and we will do so again as the COVID-19 outbreak undoubtedly impacts our communities in the weeks and months ahead. Our priorities, as set out in this report, will flex to cope with the demands placed upon them but they will not be cast aside. The good news is, we’re great in a crisis!

3.1 Transitional safeguarding: criminal and sexual exploitation

It has been positive to see this subject aired more widely, but we still have some way to go in adult social care to understand how to respond to sexual and criminal exploitation.

It is important to remember this does not stop at eighteen and is not an issue which children’s services can tackle alone - our safeguarding services need a different response. Unfortunately, they are often configured in ways which do not support young people after the age of eighteen unless they have a disability.

Social work, informed and skilled in this area, could really make a difference with its strong professional influence in partnership arrangements, helping to prevent long-term mental health issues, avoid further harm and put an end to exploitation.

Building and sustaining relationships is fundamental to our profession, but in building them with people affected by exploitation, we need to be well-educated about trauma-informed practice. Over the coming months, we will:

• hold a roundtable event with national experts to discuss this growing issue
• produce a practice note for social workers
• produce guidance for adult safeguarding teams

3.2 Code of Practice for adult safeguarding: providing consistent support and ensuring high quality safeguarding practice

We both have extensive adult safeguarding experience, and still practice and lead on this area in our local authorities, as well as being members of Adult Safeguarding Boards. Our hands-on experience means we are acutely aware of the variation in practice across the country.

To address this, we will consult widely and produce a Code of Practice which can support every local authority to ensure statutory responses are informed by a consistent and person-centred approach.

The Code, which we anticipate finalising in 2021, will help ensure good quality safeguarding, as well as holding us to account as the lead profession for this statutory duty.

3.3 Learning disabled adults: the right to live a full and happy life

In recent years, there has been a spotlight on the health inequalities that learning disabled adults experience in England every day. The most recent Learning Disabilities Mortality Review LeDeR Report from Bristol University yet again highlights the issues we should all be very concerned about.

The following headlines are just some of the issues that continue to shape the way people in our society are receiving a level of health and care that is unacceptable:

• adults with learning disabilities from Black, Asian and Minority Ethnic (BAME) groups appear to be under-represented in notifications of deaths
• just under half of the reviews completed in 2018 reported that the person had received care which met, or exceeded, good practice
• one in ten (11%) of reviews completed in 2018 reported that concerns had been raised about the circumstances leading to a person’s death
• 71 adults (8%) were reported to have received care that fell so far below expected good practice that it either significantly impacted on their well-being, or directly contributed to their death
• women with learning disabilities died 27 years earlier; men 23 years, when compared to the general population

Around the country, there are many examples of great practice which strive, not just to make a change, but to enable learning disabled adults to demand the care that should be rightfully theirs.

Unfortunately, these projects are not ubiquitous across our health and care system, while social work appears to be worryingly absent from a multidisciplinary solution to these issues.

The reality is that any disparities in health outcomes are the product of social inequality and social injustice. Social work has a duty and accountability, not just to tackle these inequalities but to create and lead solutions. This year, therefore, we will develop clear plans and expectations of social work practice and leadership in this area, including:

• developing public and profession-facing campaigns highlighting what social workers can and should be doing in this area of practice
• working closely with other professionals and organisations to shape and lead work; most importantly, we want to work with those adults who experience the impacts and risks associated with health inequality
• producing practice guidance for social work

3.4 Social work and commissioning – developing a new approach

We will setup a series of roundtables to consider the relationship between social work and commissioning. We will develop a guidance note that will take the very best of social work, its professional practice and knowledge-base, as well as its experience of working alongside citizens, to help shape commissioning principles. Likewise, commissioning models can help influence how social work can support and lead the future transformation of social care.

Too often, social work and commissioning have worked in isolation. Our guidance will draw on the essential values that underpin our profession and the personal stories people share with us, including what works and what needs to change.

We are keen to draw commissioning processes and practice together, becoming a single point that embraces co-production and NICE guidance to provide a clear evidence base. To this end, we will produce a guidance note on integrated social work and commissioning approaches.

3.5 Principal Social Workers – leading the way

This year, we will be asking Principal Social Workers to work with their DASS’s to produce a local action plan based on this report’s priorities. We will also be asking PSWs to share their plans with us and become directly involved in measuring progress towards their implementation.

In addition, we want this to be the year the profession reaches out beyond social workers within our own employing organisations.

PSWs are uniquely identified in the Care Act 2014 statutory guidance as having vital responsibilities and duties. Social work takes place in many adult settings, from hospices and charities, to academia, NHS trusts and many other areas. We know there are many thousands of registered social workers working outside of local authorities and now is the time to reach out to them. We will:

• ask all PSWs to develop an action plan, responding to the priorities in this report
• hold a national event for PSWs to share the outcomes of these plans and celebrate good practice

3.6 Social work and health inequalities: promote the value and contribution that social work and social workers bring to the health and social care system in areas where there are significant health inequalities

We are working closely with DHSC’s Chief Medical Officer (CMO) to ensure social work is core to addressing the social determinants of poor health and improving health outcomes for people who receive social work and social care support. We will:

• strengthen social work in rural areas: looking to areas of good practice, recognising that social work practice should be placed-based;
• ensure social work’s role is reflected in the social care and prevention white paper and government’s plans for social care reform
• engage in the work of Breaking Barriers Innovations to ensure place-based social work is influential in our communities
• work with the CMO and other national partners to support and promote good evidence in this area

4. Action around social care

In this section we are setting out some of the major issues the Department of Health and Social Care has been involved with to improve social care and people’s outcomes.

4.1 Adult Social Care reform

Putting social care on a sustainable footing, where everyone is treated with dignity and respect, is one of the biggest challenges we face as a society. We appreciate that the current system is not working for everyone who needs care – too many people are hit by unpredictably large costs that are hard to plan for; and some are left with little despite a lifetime of hard work and saving. The number of people over 75 is expected to rise by 1.5 million in the next 10 years, and there is a growing population of people under the age of 65 with care needs. As a society, we need to fully value care and recognise where there is excellence. For instance, 84 per cent of adult social care providers are rated as good or outstanding by the Care Quality Commission, and this is testament to the fantastic job that social care staff, and social workers amongst them, are doing.

As the Prime Minister said, the government will bring forward a plan for social care this year. There are, however, complex questions to address, which is why the government will seek to build cross party consensus in order to ensure that everyone has safety and security and that nobody is forced to sell their home to pay for care.

Social workers will be central to delivery of the government’s reform agenda and we will work in the next year to make sure that the voice of the profession is heard loudly and that our ethics and professionalism are central to improvements.

4.2 Improving the lives of carers

In July 2019, the Department of Health and Social Care published their One Year Progress Report highlighting the progress of the cross-government Carers Action Plan of targeted work to support carers. The report contained a number of actions to improve social workers’ awareness and identification of carers.

Last year, we committed to reviewing and relaunching the carers resources for social work practice with carers which aim to support social workers and other social care professionals to be better at identifying, valuing and working with carers.

We have continued to work with RiPfa to review the resources in partnership with carers and social workers which were launched during Carers Week in June 2019.

We will continue to use these resources to push carers’ issues up the agenda nationally and to drive joined up support at local level. As the Carers Action Plan comes to an end in June this year, we will continue to engage with the profession and build upon the opportunity to promote the vision and value of social work with carers and build awareness to further raise the quality of social work practice.

4.3 Reducing loneliness

We continue to support work to alleviate loneliness. The government’s Loneliness Strategy – A connected society, published in 2018 acknowledged that tackling loneliness is complex and a long-term challenge, requiring action across many fronts. It also recognised the key role health and care professionals play in tackling loneliness and social isolation.

The Loneliness Annual Report 2020 (published earlier this year), provides updates on the progress made against each of the government’s 60 commitments in the loneliness strategy and reports on the good work from organisations tackling loneliness in the last year.

This includes the expansion and improvement of social prescribing to enable more people to get the help they need when experiencing loneliness and the comprehensive guide ‘Reaching Out’, produced by the Local Government Association and the National Association of Local Councils for local authorities, to help spread good practice and encourage knowledge-sharing on tackling loneliness.

The report also sets out the government’s direction of travel on the loneliness journey for the year ahead.

4.4 Improving the lives of autistic people and people with learning disabilities

In December 2018, the government announced it would be reviewing the autism strategy for England and extending it to include children and young people. To inform the review of the strategy a national call for evidence was opened on 14 March 2019 and closed on 16 May that same year.

The government received over 2,700 responses to its the call for evidence. We have contributed to the review through our report, ‘Missing the Point: an exploratory study of social work practice with autistic young adults and their families’. It was developed with the Department for Education and should be published shortly.

The government are using the responses to the call for evidence to inform the development of the refreshed strategy. The government expects to publish the refreshed all age autism strategy in spring 2020.

Looking ahead

DHSC is supporting people of all ages with a learning disability or autism to live well in the community, rather than in inappropriate hospital care. Building the Right Support is the national plan to ensure this happens and we and all delivery partners are committed to implementing Building the Right Support in full.

The NHS Long Term Plan commits to achieving at least a 50% reduction in the number of people with a learning disability or autism who are inpatients in mental health hospitals by 2023 to 2024. Social workers can play a critical role in supporting people back into the community and avoiding inpatient admissions.

Learning from Deaths Mortality Review (LeDeR)

The Department of Health and Social Care committed, in the government’s response to the 2nd annual Learning from Deaths Learning Disabilities Mortality Review (LeDeR) Programme report to several actions to improve care for people with learning disabilities and/or autism to reduce premature mortality. This included a commitment to consult on mandatory learning disability and autism training, which took place between February to April 2019.

In the government’s response to the consultation, ‘Right to be Heard’, published on 5 November 2019, the department set out its plans for implementing the Oliver McGowan Mandatory Learning Disability and Autism Training, working with partners and stakeholders.

Alongside this training, BASW and RiPfA have developed Capability Statements for social work with people with learning disabilities and autistic people. We hope these statements will enable social workers to deepen and strengthen their skills and knowledge to ensure that people receive the highest standard of support from social workers.

4.5. Improving life for people with mental health issues

We continue to see mental health social work as a priority and this part of our work continues to be coordinated by Mark Trewin – the Mental Health Social Work Lead, on secondment to DHSC.

Our priorities this year cover 3 main areas:

• promoting the value and contribution of social work across the health and social care system
• strengthening social work in integrated mental health services
• promoting new models of integration and partnership working where social work values are respected

We have also tried to ensure that mental health services are part of the other priorities within the CSW work – such as the development of strength-based and community based social work led support – even when the service may be based in the NHS.

We have worked closely with the DHSC Mental Health team to ensure that the mental health social work view point is represented in relevant policy developments. This includes the Mental Health Act (MHA) White Paper, which will have a number of changes that are relevant to AMHPs and social workers.

We have also supported the teams working on the Green Paper for Prevention, Adult Social Care reform and the Breathing Space debt support strategy, all of whom will need the support of social workers to work most effectively.

We have also been working alongside ADASS and the LGA to ensure that the NHS England Long Term Plan (LTP) is aligned with social work and councils’ responsibilities, as it has been recognised that it could not succeed without partnership working. This work covers many aspects of the LTP, but especially the community mental health framework, where social work will play an important role in redesigning community mental health services alongside NHS Trusts.

Workforce is one of the most important issues in both health and care services, and so the CSW office has been working with HEE to ensure that social work is part of any future workforce plan for mental health. This includes a package of support and development for AMHPs, including the AMHP workforce plan, AMHP standards and AMHP involvement in the non-medical approved clinician developments.

As many social workers continue to be employed outside the traditional Local Authority workplace, we are also working with the LGA, HEE and NHS Employers on the information that trusts need to successfully support social workers.

4.6 Encouraging people to work in adult social care

When you care, every day makes a difference: driving applications into adult social care

This year, we have been supporting the national adult social care recruitment campaign, which builds on the foundations laid in 2018/19. Its aim is simple – to support some of the most vulnerable in our society by attracting the right people, with the right values, to fill the 122,000 vacancies available across the sector.

As DHSC’s Chief Social Workers, our role has been to promote the campaign on a local level by speaking with regional media across England and supporting recruitment events alongside then Minister of State for Care, Caroline Dinenage.

The campaign, which has appeared across outdoor posters, online TV adverts, radio, social media and digital channels, will run until April 2020 and we must get behind it to start closing the vacancy gap.

There are so many opportunities available to people starting out in the care sector and we must show them how varied, fulfilling and creative they can be. Social care roles can include anything from supporting people to participate in community activities, to enabling someone to go to work every day, as well as help with personal care including getting dressed or cooking meals. It could even, for example, lead to a career in social work!

4.7 Think Ahead

We are pleased to continue to support Think Ahead – a charity running a graduate programme to train mental health social workers, funded by DHSC. Graduates and career-changers who join the 2-year programme learn on-the-job in community mental health teams and qualify after a year, then work towards a master’s degree in social work while working full time in their second year.

Over the last year, the programme’s fourth cohort have begun their training. The fifth cohort is currently being recruited and will join the programme in July – this will bring the total number of people to join the programme to over 500.

To date, the charity has partnered with over 50% of England’s NHS Mental Health Trusts, and over 30% of local authorities. 89% of partner services say that partnering with Think Ahead has a broader positive impact on the organisation, beyond direct practice of the participants.

In Spring 2019, an independent evaluation of the programme was also published, containing a raft of positive findings, and concluding that the programme is “worthy of continued support and further development.”

And throughout the year, participants and alumni from the programme have celebrated a number of achievements – those from the 2017 cohort completed the programme, while the 2018 participants became qualified social workers.

Thea Radburn, a member of the programme’s first cohort, was awarded the Mental Health Social Worker of the Year Award, and original research carried out by participants has begun to appear in peer-reviewed journals.

4.8 Return to social work programme

We are pleased to continue to support and encourage the Return to Social Work programme delivered by the Local Government Association and funded by the Government Equalities Office which has launched for a second year following a successful pilot in 2018.

The programme will provide 200 qualified social workers with free, high-quality training and hands-on work placements in local councils across England.

The programme is open to 2 cohorts: those who have been out of practice for 2 to 5 years and those out of practice for 5 to 10 years. The programme also includes comprehensive coaching, mentoring and dedicated interview preparation to enable them to re-register with the Regulator and return to permanent employment.

Anjali completed the 2018 programme after a 5-year career break. She said:

The programme helped me understand social work in today’s context. More importantly it helped me regain my confidence.

Candidates have until 31 March 2020 to apply for the programme via the return to social work website. Further advice and guidance for those looking to return to work can be found via the Returners Toolkit, developed by the Government Equalities Office.

4.9 Improving the quality of Social Work Practice, Supervision and Leadership

Assessed Supported Year in Employment

It’s now 5 years since we launched the Knowledge and Skills Statement (KSS) which set the standard for adult social workers in their Assessed Supported Year in Employment (ASYE).

The majority of local authority employers are now providing newly qualified social workers with the additional support required to enable them to make the transition from education into practice.

We are also pleased to see an increasing number of employers in the health, independent and voluntary sectors participating in the ASYE programme, helping provide greater consistency in social work practice and supervision, regardless of setting.

We will be working with Skills for Care and employers to review and refresh the supporting materials and resources, based on another 5 years of learning together.

Over 10 years, we have established the ASYE as a clear expectation for all newly qualified social workers and we need to make sure it remains up to date and fit for purpose in our ever-changing social work landscape.

We are continuing to support a consistent approach across the profession and are keen to look at learning from children’s services which benefits all social workers, as well as sharing our insights from the adult services model.

For a number of years, we have received feedback concerning the importance of supervision to the outcomes of the ASYE programme, both for how social work practice is assessed and the support which newly qualified social workers receive.

As we move forward to embed the post qualifying standards for supervisors, we can further strengthen the CPD needs of social workers throughout their career, whilst continuing to focus on the quality and consistency of the ASYE programme.

Practice Supervisors

Since new post-qualifying standards (PQS) for social work practice supervisors were introduced at the end of 2018, the Chief Social Worker has been working with social workers and employers to embed the standards and ensure a consistent approach to supervision across all adult settings.

In designing the standards, their purpose was 2-fold – they should provide:

• a consistent approach to professional supervision, with an emphasis on critical reflection focused on practice not process, and
• a clear, practice-based pathway to enable social workers to progress and develop their career

Our early implementation work with Skills for Care and the sector over the last year has helped us to test a range of approaches to recognising and evidencing supervisor capability.

The experience of the Assessed Supported Year in Employment (ASYE) programme, which uses a mix of internal assessment and external moderation, has been instrumental in shaping a skills development pathway and supporting materials for practice supervisors, which we will launch in the spring.

Whereas newly qualified social workers are at the same stage, the supervisor workforce varies from experienced social workers to those more recently promoted to team leader or first line manager roles.

We have therefore, allowed for a more nuanced, flexible approach to how the standards are evidenced, to ensure both employers and the profession are clear about the expected level of capability and the support needed to help staff reach and maintain the right standard.

With Research in Practice for Adults (RiPfA), we have also delivered a Train the Trainer (TtT) programme, to support PSWs and others responsible for practice and workforce development to apply the standards in their organisations.

Feedback has been encouraging, with participants reporting that the programme and accompanying materials and resources will help support the development of local supervision frameworks and systems, which are in line with the standards.

However, we recognise that implementation is likely to be a significant long-term process, as employers and social workers respond to the changes required.

We will continue to work with the sector to support implementation, including evaluating outcomes from the TtT programme and engaging with employers to make sure the right organisational systems and culture are in place to support critically reflective supervision.

Principal Social Worker Leadership Development Programme

100 PSWs have now completed the Leadership Development Programme delivered by Skills for Care since its launch in 2016. It is clear from the continued feedback that they derive a great deal of benefit from the opportunities to learn with and from each other.

Feedback from participants has been overwhelmingly positive, with attendees reporting increased confidence in their role and impact, not just in their team and organisation but in their wider networks and externally.

One of the primary drivers for this increased confidence is the work-related project which all participants undertake, focusing on essential learning points for leadership.

The impact of this element of the programme has been significant, enabling participants to lead some really innovative activities within their organisations.

Examples of leadership impact include: development of new practice approaches and frameworks, including quality assurance; strengths-based case file audits; more opportunities for learning and development and promotion of social worker wellbeing.

We are also pleased to welcome a small group of Principal Occupational Therapists who joined PSWs on the programme for the first time last year. The general consensus amongst those who attended is that the experience enhanced mutual understanding and collaboration:

All the Principal Occupational Therapists and Principal Social Workers enjoyed learning together and were amazed at the synergy of approaches, ideas and models used in our professions. We all agree that we finished the course with a great appreciation of our fellow professionals and how we can all add value to our practice in social care, whatever professional toolkit we utilise… We were very proud to have this opportunity to study alongside Principal Social Workers and highly recommend the Skills for Care programme for future Occupational Therapy strategic leaders in social care.

We are delighted to say that the sixth cohort of 20 PSWs together with 5 Principal Occupational Therapists, commenced their 5-day programme in January 2020.

4.10 Improving evidence through better research

The past year has continued to see a sharper focus on social work and social care research that aims to increase our understanding of the effective practice approaches, interventions and services that improve the quality of care and support people receive.

Work is underway to develop research in response to the issues and uncertainties identified in the Top 10 James Lind Alliance (JLA) priorities for adult social work that we published in 2018.

How social workers can best support people who self-neglect is the first to be taken forward, with several proposals considering this issue – a further research call later this year is expected to cover the longer list of priorities.

We are especially pleased to see recognition for the role and contribution of social work across integrated social care in the National Institute for Health Research (NIHR) programmes, including research on the impact of strengths-based approaches (SBA) and improving social care partnership working.

Following the success of the first Research for Social Care (RfSC) call last year which saw the launch of 12 projects, a second call was announced in January this year.

With a focus on new ways to design and deliver social care which improves outcomes for people who use and work in social care services, including unpaid carers, we hope this programme will be a valuable addition to the evidence base for social care.

We also welcome last year’s announcement by the Economic and Social Care Research Council (ESCRC) and the Health Foundation, of a 5-year programme to promote research into practice and build networks across the UK.

The programme is in the final stages of developing its structures and governance processes and we have advised that the Chief Social Worker should be included in the Board membership, alongside the active involvement of experts by experience.

As social workers, access to high quality, up to date research and evidence is essential if we are to make the best decisions for people and improve how we work with other agencies and professionals.

As Lyn acknowledged, it can be tempting to fall back on familiar solutions and ways of working, especially when time is at a premium. That’s why we are also focusing on developing research awareness and capacity in the sector, helping to create a research culture in adult social work settings that already exists for health professionals.

As we continue to move towards further integrated health and care, we have a real opportunity to collaborate and learn from each other, for example through local Clinical Research Networks (CRNS) which encourage social care research through local integrated partnerships.

In their role as systems leaders, PSWs are key to facilitating these connections and making the case for research capacity development in their local organisations.

We look forward to continuing to work with colleagues in DHSC and across the health and care system to shape and embed research which raises the quality of social work practice and leadership and delivers the best outcomes for citizens and communities.

5. Partner organisations

This section describes some of the activity that DHSC has funded or encouraged with sector partners to develop and extend best practice and support social workers’ professional development along with observations by key partners.

5.1 The Principal Social Worker Network

The Adult Principal Social Worker (PSW) Network has continued to promote the role, the values and importance of social work.

2019 was a very busy year for the Network, with a change of chairs not once but twice over the year due to job promotions. Just like the Principal Social Worker Network for Children and Families, it is supported through a contract arranged by DHSC with Skills for Care.

It continues to support frontline practitioners in social care and health, and work in partnership with various other organisations and individuals. The publications, actions and keynote events listed below are a testament to the leadership, engagement and dedication, the network is increasingly renowned for:

• development of World Mental Health Day e-book
• promotion of Deafblind Awareness Week – coproduced a book with citizens
• development of World Social Work Day E-book
• achieved sign off from ADASS for PSW’s to become members
• judges at Skills for Care Accolades
• active members with our partners at various events – BASW, SCIE, TLAP, NICE, DHSC, Ripfa, Kings College
• published articles in Community Care
• new social media platform – Twitter and Facebook accounts
• weekly newsletters as well as a quarterly update newsletter following a national meeting
• attendance and involvement at All Parliamentary Group on Social Work and Mental Health Act
• PSW national meetings 3 times a year and one joint meeting with Children’s Network
• presented at ADASS Spring Seminar twice with positive feedback received
• involvement in Kings College statement around social workers and the care act
• involvement in the development of Social Work Apprenticeship scheme
• publishing of PSW roles and responsibilities document and knowledge statement with DHSC and ADASS
• attendance at CSW Advisory Group Meeting
• produced a report on the new SWE standards and handed the report into SWE consultation group
• involvement in BASW Stakeholder Reference Group, Learning Disability Project
• attendance at UEC Clinical and Professional Leadership Group to promote social care
• attendance at NICE Social Work Engagement Advisory Group
• continue to promote and a PSW rep to be involved in all ADASS Peer Reviews with LAs
• Social Work Health Check redevelopment
• development and analysing of Annual PSW Survey with Skills for Care
• NICE Medicines support campaign – shaping, developing and promoting within social care
• Strengths-Based Social Work presentations to a wide range of audiences
• attendance at Digital Capabilities for Social Workers – Advisory Group

5.2 British Association of Social Workers

The British Association of Social Workers (BASW) is the independent professional association for social work and social workers across the UK. Throughout the year we have valued working closely with the DHSC and Chief Social Worker for Adults (CSW) on shared projects and being able to represent the voice and views of our members in CSW and DHSC forums.

Lyn Romeo’s inclusive approach to involving sector leaders, one gladly maintained by the interim CSWs, has built a shared approach to development amongst key stakeholders across the adult social work sector.

We were delighted that Lyn contributed to our UK Annual Conference in Belfast in June 2019 alongside her equivalents from all countries across the UK.

As the representative body for social workers and as the UK representative body for social work globally, we value the in depth work we do with DHSC and the CSW in England while offering UK-wide ad global perspectives on social work to CSW and colleagues across the sector.

This year we completed two pieces of work commissioned by DHSC following extensive stakeholder engagement – capabilities statements and continuing professional development pathways for social work with people with learning disabilities and autistic adults.

Social workers’ skills and values are essential to making improvements in these priority fields of practice. Empowering and skilling social workers to be change agents and act with more confidence in systems of care is essential to quality and better citizen experience. We have extended this project to develop tools and sector commitment to embedding these capabilities statements.

We have worked in collaboration with DHSC on the review of the National Autism Strategy, Mental Capacity Act Amendment Act (2019) and continue to have member representation on national forums and working groups including the national stakeholder forum for Liberty Protection Safeguards Code of Practice.

We have worked closely with the Chief Social Worker and partners to host a national conference on the role of social workers in disasters and maintain collaborative partnerships with Principal Social Workers and leaders in the sector with a sector leadership role for the development and implementation of a national digital capabilities project with SCIE, DHSC, HEE and NHS Digital.

We look forward to working with the interim Chief Social Workers in the year ahead on collective priorities and to influencing government proposals in the future of adult social care.

5.3 Social Care Institute of Excellence

The Social Care Institute for Excellence (SCIE) has produced two major new resources aimed specifically at social workers.

The first, Preparing for adulthood: the role of social workers was commissioned by the Office of the Chief Social Worker for Adults, and builds on work carried out by the Innovation Unit and SCIE, looking at how a Named Social Worker approach can improve support to people with learning disabilities.

The resource takes the lessons from that project, and applies them to people with learning disabilities as they enter adulthood, and includes a framework for social workers, which sets out the five aspects of practice that are needed for good transition support to take place:

• the right support, systems and commissioning
• an understanding of social care law, social work theories and adolescent development
• a commitment to human rights, and the confidence to apply this
• the ability to work effectively in multi-agency settings
• a focus on each person they support – what they want, what their family wants and what the social worker can do to support them to achieve their goals

The second resource is a suite of materials designed to support improvements to social work recording. Incorporating accessible guidance, films, and scenario-based learning, it was cooperatively developed by social workers and people with lived experience of having social work case files.

The resource gives social workers genuinely useful help in understanding the importance of case recording, and in how to maintain clearer, more person-centred files.

In the year ahead, we will continue to work on two projects for the sector with the British Association of Social Workers (BASW):

• digital capabilities of social workers, and
• embedding new capabilities statements for social workers supporting people with learning disabilities and/or autism

5.4 Skills for Care – Professional Development for Social Workers

Since new standards for social work practice supervisors were introduced at the end of 2018, DHSC commissioned us to work with social workers and employers to embed the standards and ensure we have a consistent approach to supervision across all adult settings.

In designing the standards, we were clear that their purpose was 2-fold – they should support:

• a consistent approach to professional supervision, with an emphasis on critical reflection which is focused on practice not process, and
• a clear, practice-based pathway to enable social workers to progress and develop their career

Over the last year, our early implementation work with the sector has helped us to test a range of approaches to recognise and evidence supervisor capability. The experience of the ASYE programme, which uses a mix of internal assessment and external moderation, has been instrumental in shaping a skills development pathway and supporting materials, which will follow publication of this report.

However, unlike newly qualified social workers who are at the same stage, the supervisor workforce varies from experienced social workers, to those more recently promoted to team leader or first line manager roles.

In ensuring consistency in how the standards are evidenced, we have allowed for a more nuanced, flexible approach to ensure both employers and the profession are clear about the expected level of capability and the support needed to enable staff to reach and maintain the right standard.

We have also delivered a Train the Trainer programme to support PSWs and others responsible for practice development, to support implementation of the standards. Feedback has been encouraging, with participants reporting that the programme and supporting guidance will help them apply the standards in their organisation.

5.5 Think Local Act Personal

Despite a difficult time for social care, with well-publicised challenges and frustrations, Think Local Act Personal (TLAP) achieved a great deal in 2019. Our core messages about personalisation and community-based support, enabling people to have a life not a service, have gained wide support.

TLAP’s role is convening, collaborating and co-producing with all parts of the system, including people with lived experience, commissioners and providers. We model this behaviour and demonstrate co-production in all our work. Many stakeholders - from the APPG on Adult Social Care to the NCASC annual conference - are working with us and seeing the benefits of this approach.

We continued to promote Making it Real as a catalyst and marker for change. It has influenced a number of key national documents and policy initiatives including LGA’s High Impact Model, the Quality Matters framework and CQC’s Key Lines of Enquiry.

We’re delighted that more local authorities and providers are working with us to develop a more personalised approach through using Making it Real.

TLAP supports the sector to develop and spread innovative models of care and support that are rooted in people’s lives. Our partnership on the Social Care Innovation Network promotes pioneering approaches to care and support and the system change required to create the conditions for such change.

Allied to this, our directory of innovations in community-centred support is one of the most viewed resources on our website for commissioners and providers.

We published guidance to the sector, including Reimagining Social Care, Stories of success in support planning and guidance on the use of pre-payment cards.

Our events were well attended by social workers, providers and commissioners, covering topics including care markets and quality and how to build community capacity.

It was a privilege this year to work with DHSC at this year’s International Initiative for Disability Leadership in Washington US to share England’s transformation journey. Our participation at this event generated international interest in our products and ways of working and is testament to TLAP’s role as steward to remind the sector to be more human.

Clenton Farquharson

Clenton Farquharson MBE, is chair of Think Local Act Personal, and a disabled person. He is a member of the NHS Assembly, current chair of Quality Matters, trustee of the Race Equality Foundation, and ambassador for Disability Rights UK.

5.6 Social Work England

On 2 December 2019, Social Work England formally became the new specialist regulator for all social workers in England.

We believe this presents an exciting opportunity for the social work profession. Our regulation will be centred on raising standards, protecting the public, and working in collaboration to ensure that people who use social work services receive the best possible support whenever they might need it.

A vital aspect of our preparatory work his has been our dialogue and collaboration with all those who have an interest in social work, be they a social worker, social work educator, or someone with lived experience of social work.

Together, we have developed the professional, education and training standards that are the foundation of social work regulation. The register is now open, and our online account established for all social workers to sign up and upload their CPD.

Our fitness to practise processes will allow us to resolve complaints at the earliest appropriate stage and with the full involvement of the profession.

Our Education and Training Quality Assurance approach will help ensure that social workers emerge from their training ready to practise, able to meet our professional standards, and join our register.

Our regional engagement team will ensure that our commitment to collaboration and continued conversation with all those with an interest in social work remains at the heart of what we do, and how we develop as a regulator.

Our first 3 years will see us focus on establishing our organisation, learning from and with the sector, and developing our ambition for ourselves and for the social work profession.

6. Examples of innovative social work

We asked 3 local authorities to present short summaries of innovative work that have done. If you would like further details, please contact the authorities directly.

6.1 Cornwall

Darren is living more independently by using Technology Enabled Care

Darren has moved from having 24-hour carer support to living independently in a self-contained flat – with support available if he needs it – with the help of a sensor-based monitoring system.

Darren lives at Pendennis House, a supported living provider in Wadebridge, Cornwall. There are monitors in place around his home that can detect any out of the ordinary movement and alert staff in the nearby hub. He also has special assistance phone which allows him to call someone at the hub if he needs to.

Pendennis House Manager Nancy Jeffs said:

People we support are given a higher level of independence and using the sensor-based technology means that they have less restriction placed on their life.

They can use the special assistance phone to contact someone should they need urgent help and staff are on hand seconds away if needed. We have seen people’s confidence levels soar using this technology and this has spread into other areas of their lives, having the confidence to pick and choose activities they want to get involved in.

Ann Smith, Cornwall Council’s Principal Social Worker said:

Cornwall Council is embracing new and innovative solutions to people’s care needs, looking at how we can support people to live happy, healthy and independent lives using technology enabled care. In Darren’s case its clear to see how a different solution to the more traditional care packages means he can live safely and independently in his own home.

You can hear more from Darren in this short video:

Living independently with the help of Technology Enabled Care

6.2 Brighton and Hove

Research and practice must go hand in hand

At Brighton & Hove City Council our social work teams are working to build stronger relationships with researchers in local universities.

It’s an approach that is already showing real benefits.

With the support of the DASS and the Principal Social Worker, we’re working with researchers and with colleagues in our public health team to ensure that the organisational approach to research becomes embedded in culture and practice to deliver system-wide benefits.

The social work teaching partnership has opened up opportunities for front line social workers to design and lead on primary research projects based on questions generated directly from practice.

With one completed project and 2 more in progress, social workers are embracing new opportunities to build on their research skills and contribute to an evidence base for social work approaches and interventions.

In addition, social workers have been supported by managers to facilitate and participate in peer group meetings called ‘journal clubs’ to discuss and reflect on a mix of research papers.

These meetings mean that front line social workers identify practice themes that are important to them and use theory-led discussions to directly inform their practice.

The journal clubs started in hospital services. They have quickly gained a positive reputation and have now been set up more widely across the directorate.

The combination of social workers driving their own research projects and using a clearer evidence base for decisions has raised the profile of the profession and improved outcomes for people with care and support needs.

The journal clubs have made research meaningful and are enabling practitioners to apply a reliable knowledge base to complex care decisions.

Social workers say they value highly the time given to use and think about research in practice, and that this has bridged a gap between academia and front-line work.

The success of embedding research into practice has required buy-in and commitment from social workers, managers and senior leaders.

It has resulted in strategic and practice-based research collaboratives that are beneficial to individuals, social work and the wider community.

6.3 Norfolk

Social work in 2020 in rural community

For those unfamiliar with the county of Norfolk, it is mainly a rural county that covers approximately 2,074 square miles with four major built up areas, where about 40% of the population live. Rural communities can present different challenges for social work, and Norfolk is no exception to this.

Challenges Norfolk face in rural communities include increased traveling times for both practitioners and carers, lack of agencies within the local community and family members moving into towns and cities for work opportunities.

Norfolk has a strength-based approach to practice, which initially was based on Partners for Change ‘3 conversation model’.

Over time this approach has developed into Norfolk’s Living Well approach that puts conversation between equals at the heart of social work, enabling our practitioners to learn:

• what is important to the person
• their strengths and talents
• what is working well and what they want to change
• what they would like to achieve
• how they would like to be supported

In working in rural communities, it is also vital to have good links with other partners including health, housing and police.

In Norfolk we have developed different arenas to support multi agency working that includes ‘Early Help Hubs’ and ‘NEAT’ (Norfolk Escalation Avoidance Team) in each of our localities.

Early Help Hubs are a base for professionals to come together and share information (with consent from the individual) in order to receive the most appropriate and effective support at the earliest point.

They were established through a strong partnership with public and voluntary sector organisations who work together to support individuals and families. Professionals work together to recognise concerns and referrals are dealt with in the most appropriate way with the aim to reduce duplication, delay and ensure the most suitable service is identified.

NEAT is a single point of access for urgent, unplanned health and social care needs where co-located staff work together to coordinate and deploy an integrated multi-disciplinary team response using existing services that will support and manage people and carers safely in the community through a period of crisis, using the most proportionate level of intervention and promote independence by identifying and addressing additional support needs through Integrated Care Co-ordination and linking people to their own support networks.

A real-life case example of NEAT is when an outreach nurse made a referral into the NEAT team following a visit the night before by paramedics.

The patient in question showed increase confusion, had not eaten recently and had been sleeping on the sofa as they were unable to manage the stairs.

They already had a diagnosis of dementia and a unitary tract infection was also identified during the referral process. A care and support plan was in place already which consisted of three calls a day to support with morning, lunch and tea time routines.

An action plan was agreed during the MDT huddle where a visit was completed that day to access the stairs and see if downstairs living would be more suitable and reduce the risk of the patient climbing the stairs. An increase in care to include an evening visit was provided by Norfolk First Support from the following day with shifts being arranged for that evening to cover the evening call.

The outcome was that the patient was able to remain at home with an increase in his care package and further equipment. The case was then passed through to the locality Social Work Team to complete a face to face visit after the crisis had passed.