Austerity hit Bristol City’s social care services – when “Better Care” is worse care.
The South West region of the Social Work Action Network (a nation-wide, radical, campaigning organisation of social work and social care practitioners, students, service users, carers and academics) has, in the past 9 months, been pursuing a campaign to persuade Bristol City Council that their Better Care scheme for adult care services in the city is having a detrimental effect on both service user well-being and social worker professional practice.
We wrote to the Director of Adult Care Services in March 2018 expressing our concerns, gleaned following a request for information from nearly 200 social workers, student social workers and service users in the South West of England.
SWAN concerns:
* There has been increased monitoring and scrutiny of service users, experienced by them as intrusive, reframed by managers as promoting independence but seen as cost-reducing in purpose.
* Social workers tell us that the cost reduction agenda is openly pushed by managers with little regard to service user need
* Service users tell us they are increasingly reluctant to contact adult care because they are scared that it may trigger an intrusive and oppressive review.
* Pre-payment cards are being used to control service users – again, social workers and service users believe, to reduce budgets.
* Management are pushing practices that would appear to be unlawful under Care Act guidance: e.g. assessments dependent on agreeing to accept a pre-payment card; offsetting carer support against personal budgets/packages of care.
* Social workers are experiencing dwindling community/voluntary resources but being put under pressure to refer service users to them because they are of no cost to the authority.
SWAN’s Conclusions
* SWAN believe that Bristol City Council Adult Care Services have listened respectfully to what we have to say.
* BCC accepts the problems of austerity and cuts but insist that the Better Lives model (bought for an undisclosed cost from Impower the social care consultancy firm) is good because it is both effective and social workers like it.
* The Council accepts that they need to ensure there is more discussion about these issues amongst social workers and this is going to be facilitated through the Social Work Board.
* They also accept that there needs to be far more service user involvement or co-production as they called it.
* Whilst SWAN is pleased to have been given a hearing and to have had some of its arguments accepted, we do not believe Adult Care Services are going to do anything about the poor state of services for older and disabled people in Bristol, beyond raising the issues internally.
* SWAN does not know how any progress will be monitored and evaluated.
* Fundamentally, there was no acceptance that a change of direction was required to make things better for both service users and social workers.
* SWAN believes that Bristol City Council needs to fight back against central government’s continuing policy of austerity which Bristol Council have put into action by making huge cuts to services at all levels.
* Bringing care services back into local authority democratic control would be a start to ensuring service users get the services they require, and for which the local authority would be accountable.
* The involvement of service users in the planning and delivery of services would ensure that those services meet their expressed needs.
More information and details of these concerns, and the Bristol City Council response
The Social Work Action Network (SWAN) is a radical, campaigning organisation of social work and social care practitioners, students, service users, carers and academics. We are united by, amongst other things, our concern to challenge the disastrous effect of austerity on social care, and the domination of social work and social care services by managerialist perspectives and practices which prioritise budgets, targets and outcomes over the needs of the people who use services. We campaign nationally and regionally against injustice and the marginalisation of service user’s interests and social work professionalism.
Some service users with substantial needs are required to keep detailed diaries of their daily living. Managers then require social workers to study the diaries, looking for parts of the day when care or support from personal assistants is not needed. Those periods (sometimes of only 15 minutes) are then totalled up and reframed as opportunities for independence, when care is not required. Their personal budgets are reduced accordingly. This is even being applied where an individual has been assessed as requiring 24 hour care for their safety and well-being.
Some service users have been allocated a pre-paid card to buy their care, as is their choice according to the law. We have information that service users are being
threatened with withdrawal of resources if they do not accept a pre-paid card even if they do not want one. The pre-paid card is like a credit card that has a service user’s personal budget added. They can then spend the amount allocated following assessment of their needs, on the services and resources that they believe will meet those assessed needs. It is useful for some service users but others find it intrusive and restrictive. Council like them because they can monitor expenditure more easily – how much is being spent, and on what. It also, as the manufacturers indicated in their sales pitch, means that Councils can reduce a service user’s allocation much more easily.
One area of focus for Bristol’s Better Lives programme is on community resources. SWAN is very committed to this as a way of working – ensuring service users can receive the services they require in their local communities, but again, the ravages of national austerity policy means there are fewer of these services available. We raised the issue of accessibility to these community resources. Social Workers are being pressured into referring service users to these services even though, without adequate transport or support available, they are not readily accessible.
SWAN strongly argues that genuine co-production with service-users is essential. It is our view that involvement by service users in policy, practice and service development in Bristol, is tokenistic and that BCC needs to prioritise this way of working. SWAN argue that knowledge and expertise required is already in the city, and that both Disabled People’s Organisations and SWAN are sources of advice.
Social Workers have given us information suggesting that BCC management is pressurising them to act unlawfully. 1) There is evidence of service users being told their level of personal budget is dependent on accepting a pre-paid card. 2) Social workers are being told to include care provided by relatives as part of their assessed needs. Both of these practices are outside of The Care Act guidance.
For further information please get in touch with the South West region SWAN contact:
Mark Baldwin (Dr), Senior Lecturer in Social Work (retired)
Mobile: 07757506472 Email: harkmark52@yahoo.com
