At a glance 29: Personalisation briefing - Implications for social workers in adults’ services

Published: October 2010

Key messages

  • Personalisation reflects social work values: respect for the individual and self-determination have long been at the heart of social work.
  • Social workers have a central role in developing and delivering personalised services to achieve better outcomes.
  • Social workers can make a distinct contribution as their work is about developing relationships and understanding people in their context.
  • People will increasingly determine their own support, but many will continue to want social workers to help manage risks and benefits, and to build their self-determination.
  • The majority of social workers feel that social work has a role to play in all aspects of personalisation such as prevention and early intervention.
  • The role of the social worker may develop as personalisation progresses.
  • Change will be supported by The College of Social Work and a programme of comprehensive reform of social work.
  • The key national social work bodies have pledged to promote the distinct contribution of social work in adult services.

Introduction

This At a glance briefing examines the implications of the personalisation agenda for social workers.

Personalisation means thinking about care and support services in an entirely different way. This means starting with the person as an individual with strengths, preferences and aspirations. It means putting them at the centre of the process of identifying their needs and making choices about how and when they are supported to live their lives. It requires a significant transformation of adult social care so that all systems, processes, staff and services are geared up to put people first.

The traditional service-led approach has often meant that people have not received the right help at the right time and have been unable to shape the kind of support they need. Personalisation is about giving people much more choice and control over their lives and goes well beyond simply giving personal budgets to people eligible for council funding. Personalisation means addressing the needs and aspirations of whole communities to ensure everyone has access to the right information, advice and advocacy to make good decisions about the support they need. It means ensuring that people have wider choice in how their needs are met and are able to access universal services such as transport, leisure and education, housing, health and opportunities for employment, regardless of age or disability.

The distinct contribution of social work

Social workers have a central role in developing and delivering personalised social care and support services. The vital contribution of social work to personalisation is affirmed in a statement on the future of social work in adult social services produced by key organisations in social work, including Association of Directors of Adult Social Services (ADASS), Department of Health (DH), Skills for Care, British Association of Social Workers (BASW) and Social Care Association (DH, 2010). Social work is focused on supporting independence, and promoting choice and control, for people facing difficulties due to disability, mental health issues, effects of age and other circumstances. Its distinct contribution is to make sure that services are personalised and that human rights are safeguarded through:

In adult services, social workers are essential to the delivery of personalised services and to achieving better outcomes with adults of all ages who need services, support or protection.

HM Government, 2010

Social work has an important role in supporting people facing life-changing circumstances and working with people whose rights may be undermined through abuse and neglect. Social workers in multi-disciplinary teams contribute a holistic view with a perspective of the whole person, rather than a focus only on their symptoms or circumstances, and are therefore in a good position to support better person-centred outcomes.

Values and skills that social workers bring to personalisation

Personalisation originates at least in part from social work values. Good social work practice has always involved putting the person first and promoting independent living; values such as respect for the individual and self-determination have long been at the heart of social work. In this sense the underlying values of personalisation are familiar.

It is quite fascinating for me that we are now going back to things that I believe were happening a number of years ago and I am rediscovering skills that I had forgotten.

Social worker, Putting People First website, 2009a

Social work and its values can potentially shape the responses to personalisation of the entire health and social care workforce. Listening, empowering individuals, recognising and addressing potential conflict, safeguarding needs and the capacity of individuals, being sensitive to diversity and putting people in control should be central to the way staff and services treat people from the first point of contact. Social workers could have a leadership role here, particularly in the advanced professional role envisaged in the career structure proposed by the Social Work Task Force. (Social Work Task Force 2009)

At one point social work was all about keeping people safe and now it is keeping people safe while enabling them to lead a life that they always wanted to lead.

Social worker, Putting People First 2009b

Using social work skills for better outcomes

Social work skills will continue to be important to assessment, support planning and review. Critical reflection and relationship-based working will ensure that individuals can identify and achieve their chosen outcomes. As personalisation progresses, social workers may find themselves doing more direct social work, drawing on therapeutic skills as well as skills in community development.

Key social work organisations see social work skills as vital to:

Case study 1: Self-directed support

In Hartlepool the current care arrangements are being radically transformed into a model of self-directed support. The local authority/Northern Ireland health and social care trust, in taking the model proposed by In Control, asks its social work staff to amend not their core values or their professional identity as skilled helpers, but rather to rethink how they make sense of these values and identity, and in particular how they should discharge their duties such that citizens gain control of their lives. One social worker comments: ‘I am more comfortable now thinking outside the box to promote good outcomes. I feel safe in doing this as the social worker bit lets me really communicate with the person rather than following scripted forms that can get in the way. Many of the support plans now are outcome- rather than process-focused and this is a real change from the earlier support plans which often resembled traditional care plans.’ (Tyson A, 2009)

Case study 2: Working with families to achieve inclusion and independence

Joe has autism, with no speech and is profoundly deaf. Following placement breakdown he had lived in hospital for four and a half years and was physically restrained on occasions with high levels of medication. His social worker worked closely with his family and the new provider, to develop a person-centred plan, which has enabled Joe to have a full and active life. He is now extremely independent in most aspects of household tasks, communicates through use of symbols on key fob, uses public transport and works twice a week as part of the RSPCA maintenance team. This has been a team effort with all participants working jointly and being equally important in achieving a successful outcome. (Hertfordshire Person Centred Planning Team, 2010)

It is important to remember that personalisation is not only about personal budgets and selfdirected support, but applies to people in all care and support settings and includes things like community capacity building. That social workers have a distinctive role beyond working with individuals was recognised in the In Control project:

The ethos and focus of professional social workers should mean that the profession is almost perfectly poised to work with people in just this way: to amplify strengths, make connections, foster understanding and capitalise on assets.

In Control 2009

How social work practice may develop to provide better outcomes for people

Giving people control of their own resources and determining how their needs are met is transforming social services. Many people will want to organise all their support and services themselves, based on good information. Others will want help from peers and user- and carer-led organisations. However, many people who use services indicate that many will want social work support to manage risks and benefits, and to build their self-determination so that they can take control or make difficult decisions.

People value a social work approach based on challenging the broader barriers they face; they place particular value on social work’s social approach, the social work relationship and the personal qualities they associate with social work.

Shaping Our Lives, 2008

A new term used in the context of personalisation is ‘co-production’, which recognises that people who use social care and support have assets and expertise. This means more power and resources being shared on the frontline, so that people who use services and carers are empowered to co-produce their own solutions alongside social workers and other social care practitioners. This could mean social workers and people who use services and carers developing new, innovative local support organisations together.

People value the support that social workers offer as well as their ability to help them to access and deal with other services and agencies.

Shaping Our Lives, 2008

You need to instil in the person a sense of their own achievement and the fact that they can do it. Once somebody starts to write their own job description for a personal assistant the psychological change in them is massive.

(Social worker, Putting People First, 2009b

Consultation feedback has shown that the majority of social workers feel social work has a role to play in all aspects of personalisation such as prevention and early intervention, building social capital and promoting people’s choice and control over care and support. (DH 2010)

The joint statement on the future of social work in adult social services, by the key national bodies in social work, identifies areas which social work might develop into as personalisation progresses:

One of the current roles for social workers is to ration resources and identify priorities. They need to manage resources effectively and efficiently and in a way which maintains a focus on achieving the chosen outcomes of people using the service. People who use social care and support services recognise the limitations social workers can face when working within the constrained rules and resources of organisations (Beresford, 2007). As organisational and budget issues can impact on people’s relationship with social work staff, it is important that policy makers are open and transparent about rationing decisions.

How will developments in social work be supported?

Following Building a safe and confident future (Social Work Task Force, 2009), there is a programme of reform for social work in England. Recommendations concerned training and continued professional development, regulation, standards for employers, supervision, frontline management, a national career structure, licence to practice, public understanding, social worker supply, a national reform programme and the creation of a College of Social Work.

The Department of Health, ADASS, BASW, Skills for Care and the Social Care Association in their joint statement on the future of social work in adult social services has pledged to help social workers in adult social care to develop even greater skills and knowledge for the future and to develop career structures that keep and reward social workers who stay in practice and continue their professional development.

References

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Personalisation briefings

What is personalisation?

Personalisation means recognising people as individuals who have strengths and preferences and putting them at the centre of their own care and support. The traditional service-led approach has often meant that people have not been able to shape the kind of support they need, or received the right help. Personalised approaches like self directed support and personal budgets involve enabling people to identify their own needs and make choices about how and when they are supported to live their lives. People need access to information, advocacy and advice so they can make informed decisions. Personalisation is also about making sure there is an integrated, community-based approach for everyone. This involves building community capacity and local strategic commissioning so that people have a good choice of support, including that provided by user-led organisations. It means ensuring people can access universal services such as transport, leisure, education, housing, health and employment opportunities. All systems, processes, staff and services need to put people at the centre.