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I, too, salute the work done by the voluntary sector, paid and unpaid, in providing support and in its employment of social carers. I do so particularly from the point of view of small local voluntary organisations, and of the work they contribute to overall social care. Think, for example, of the preventative work done in Leeds by a body such as Moor Allerton Elderly Care, which works to provide the support that helps to prevent older people from becoming depressed and helpless and looking to the statutory services for help. The noble Baroness, Lady Barker, has already spoken of the way in which local authorities are only able to provide crisis support. There is therefore an increased importance in those who can and will provide preventative services.
At the other end of the scale, I think of Caring For Life, a small local Christian charity in Leeds that provides lifelong help for the vulnerable homeless, many of them with substantial emotional needs. The voluntary sector, however, particularly the local voluntary sector, cannot replace the statutory, and it is often not well supported by local authorities. I continue to regret that there is still some suspicion of faith-based voluntary organisations, another contrast with so much of the European scene.
The frustration of this situation is that there is so much good will and expertise. The aspirations of Options for Excellence demonstrate the good will. The commitment of individuals, of which there are many stories, and the acknowledgement of the care provided in many cases in both the statutory and voluntary sectors speak to those qualities. But we have not yet found the best way to harness all that good will, skill and commitment. It is only with a change of culture—and therefore, yes, of financial priorities—that that good will and skill will become a reality for some of the most vulnerable within our society.
12.23 pm
Baroness Blood: My Lords, I, too, thank the noble Earl, Lord Listowel, for securing this important and timely debate. I shall contribute by focusing on the kind of workforce we need to ensure that children and young people get the quality of service they both need and deserve. The recruitment, retention and
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There are around 110,000 people employed in health and social care services in Northern Ireland, equivalent to around 6.4 per cent of the population, compared with 5 per cent in the United Kingdom as a whole. Yet recent reviews have indicated that there is still a deficit in the overall numbers of health and social care staff needed, and that we must look at pay and terms and conditions for recruiting more staff.
As Members of this House are aware, I am a council member of Barnardo’s here in the United Kingdom and a chair of Barnardo’s in Northern Ireland. I have seen at first hand both the children and young people who need our help and the staff who provide it. I take this opportunity to say how impressed I am by the dedication and commitment of the majority of staff who provide those services. These are qualified social work staff, dedicated to improving the lives of children, young people and their families. However, they are also a professional body of staff and it is crucial that in considering how we move forward in investing in a social care workforce, staff who work in this area of the voluntary and community sector are not forgotten.
When Government in Northern Ireland introduced new pay and grading arrangements for social work staff, trusts did not calculate for those staff who worked in the voluntary sector setting. These staff often worked for organisations such as Barnardo’s which contract with trusts to provide statutory child protection duties. The new pay and grading arrangements significantly increased salary costs and thus the overall costs of providing the service. It also meant that if Barnardo’s could not match the new level of pay, it would struggle to recruit and retain social work staff.
Barnardo’s and other voluntary sector organisations raised this issue with Government. Their response was that the purpose of the arrangements was to improve the retention of social work staff in the public sector. Government must realise that the voluntary and public sector recruit from the same pool of staff and often do the same kind of work. They also fail to understand that contracting with the voluntary sector requires that such staff have to be regulated, qualified practitioners. To retain current staff and to continue to compete in the recruitment market, Barnardo’s had to provide an exceptional additional allowance, which put an additional strain on the charity’s resources.
If the current Government’s commissioning policy, with its focus on engaging with the private and voluntary sectors and enabling them to provide services, is to succeed, it must create an equal playing field. In essence, this means that if the voluntary sector is to deliver effective, innovative and economical services, it must be funded equally and given sensible contracts.
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Too often, voluntary organisations are given 12-month contracts, with renewal often not assured until a few days before expiry. Nothing could be more designed to thwart the success of the voluntary sector or to cause us to lose dedicated and effective staff. For Barnardo’s as a whole this new year, some staff will again not know whether they will have jobs in April because the organisation does not yet know whether the contracts will be renewed. That also means that there are parents and children who do not know whether the vital services they require will continue. This is unacceptable. Public authorities would not treat their own staff like this, and it is unacceptable that they should treat those who work for charities in this way.
The voluntary sector provides high-quality and often innovative public services. Those services often grow from a local base and are trusted. For those reasons, they must be given a chance to deliver. Commissioners need a choice in spending public money as one aspect of getting the services right. But to allow this to happen, the voluntary sector must be treated on an equal footing with the public sector in terms of cost, contracting and a transparent tendering process. Then perhaps children and young people will get the kind of service they deserve.
Over the past number of years, Government have gone a long way towards ensuring that the service must meet regulatory requirements and that it is as safe and of as high a standard as possible. I am sure that we all agree with that. The social care environment should have an increased focus on standards and regulatory requirements. However, we will undersell this if we do not invest in social care staff in a way that enables them to deliver those standards.
Government have clearly signalled the need for a social care workforce that is founded on high quality and regular supervision, where there is increased multi-disciplinary working and the salary levels and opportunity for training will attract highly skilled people. This will not happen without additional investment across all sectors involved in delivering social care services. Without this investment, the services will not be of the quality and kind that children and young people who are vulnerable and in difficulty need. That is why it is crucial that Government prioritise investment in the social care workforce as part of the Comprehensive Spending Review and why, in doing so, they must ensure that the voluntary sector is fully included.
12.30 pm
Lord Low of Dalston: My Lords, I echo the words of other noble Lords in congratulating the noble Earl, Lord Listowel, on securing this debate today. Social care and the importance of social work have begun to be something of a leitmotif in the debates of this House during this Session. The noble and learned Baroness, Lady Butler-Sloss, and the noble Earl himself both made powerful speeches in the debate on the Queen's Speech. Then we had a debate on adult social care introduced by the noble Lord, Lord Bruce-Lockhart, on 7 December and now we have the
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What has emerged from these debates is the low esteem into which the social work profession and the social care workforce have been allowed to fall, with poor reward and consequent demotivation and the attendant ills of rapid turnover, high vacancy rates, low skill levels and backbreaking case loads all reinforcing one another in a vicious downward spiral. The Government have done much to raise the status of teachers and nurses, but social work has remained the Cinderella among the care professions. This House can play its part in creating a climate in which this trend can be reversed.
Social workers fulfil one of the most difficult tasks for the community. They need to have detailed knowledge of the disciplines of psychology, sociology, social administration, human growth and development, research methods and the law, and to maintain a nice balance between compassion and realism, empowerment and control. They need to be aware of their own needs and prejudices and have the strength to ensure that these do not impact on their work. They deal with those who are rejected by society; often those who have put themselves beyond the reach of the agencies of mainstream society—the deprived, delinquent, delusional and the dysfunctional. It is hardly surprising that they do not always get it absolutely right. As the noble and learned Baroness, Lady Butler-Sloss, pointed out in her deeply impressive maiden speech:
“They are damned if they do ... and they are damned if they don’t”.—[Official Report, 21/11/06; col. 277.]
Their mistakes are highlighted by the media: their successes go largely unremarked.
My wife was a social worker. She recalls a time when she and her colleagues in local authority children's departments were regarded as highly skilled professionals by the public and courts alike, rather than treated with disdain. Thirty years ago, she taught trainee social workers on what was then a highly respected four-year undergraduate course at the University of Bradford. The introduction of a three-year undergraduate social work degree leading to a recognised qualification is therefore very much to be welcomed as one of the best ways of restoring to the social work profession some of the status it once possessed but which it has so conspicuously lost in recent decades.
As we have heard, the Government have done a number of other things which are very welcome. Skills for Care and the Children's Workforce Development Council have been set up to lead on workforce training, qualifications, support and advice. The establishment of the General Social Care Council to regulate the social care workforce and what is now the Commission for Social Care Inspection to register and inspect providers of social care, coupled with the development of national minimum standards on which inspection is based, are all important developments. We have seen the registration of social workers for the first time, and, since April 2005, the
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Enrolment on to the three-year social work degree rose by a third between 2000-01 and 2003-04. As the noble Earl reminded us, government spending on social care workforce development and training in 2005-06 was three times higher than in 2002-03. Those are impressive developments and have the potential to do much to transform the esprit de corps of the social work profession, but they are coming very late and only after a protracted period where the situation has been allowed to slide a very long way. We must also beware the tendency of which I spoke in the debate introduced by the noble Lord, Lord Bruce-Lockhart, for there to be a disconnect between the official picture and what is actually happening on the ground, of which the noble Earl also spoke so eloquently.
The Options for Excellence review on the social care workforce published last October provides a blueprint for sustaining the momentum in the short term, but the longer-term vision is dependent on available resources. As others have said in this debate, this should be seen as a priority in the forthcoming spending review if what has been achieved in the past few years is not to go for nothing. In 2004, there were still 53,000 social work and occupational therapy vacancies, so there is still a lot to do and the problem is not a small one. According to the report which Sir Derek Wanless produced for the King's Fund last year, in 2003-04, 559,000 people were employed in adult social care plus 120,000 in care-related posts in the NHS. If we are to retain people in the social care workforce, pay must rise. That is not an option which we have the luxury of choosing or not. With an ageing population, a social care workforce with the requisite skills and morale and in the requisite numbers will be a necessity if the system is not to collapse.
I want to say a further word about training. The one major weakness in Options for Excellence was that it did not have a lot to say about training going forward. There was a lot about continuous professional development, but not training, particularly the content of training. My impression is that social work training has been considerably degraded since the days when my wife was studying, practising and teaching. There has been a shift away from teaching the core social work knowledge of human growth and development and the case work skills that are indispensable for understanding the motivation and behaviour of highly vulnerable and emotionally damaged people and providing them with the sort of professional relationship that can help them to grow. What can happen when that kind of foundation is not there was all too plainly demonstrated yesterday, as the noble Earl reminded us, by the report on Orchard Hill, where we heard of institutional abuse by social workers who were said not to have meant harm particularly, but who were just inadequately trained. As a result, they were incapable of understanding and managing the behavioural dynamics of those in their care. If we are going to effectively address personal problems in a timely fashion before
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The move to generic social work in the 1970s, while designed to simplify the complexity of different social service provision and to supply a one-stop shop for customers, largely failed in its aim and served to destroy much of the specialist expertise previously used to benefit children, the mentally ill, the elderly and the disabled. That is nowhere more apparent than in the field of services for people with visual impairment. The principal professional providing support to people with visual impairment is the rehabilitation officer whose role is to provide mobility and other independent living skills training for visually impaired people. While the population of visually impaired people continues to grow, and is set to double over the next 20 years with the ageing of the population, the numbers of qualified rehabilitation workers is in decline.
Only the other day, I received a letter from a rehabilitation officer who said that he was writing on behalf of many of his colleagues who feared that their profession was disappearing. He maintained that the standard of training was dropping and that many courses loosely based around rehabilitation only paid lip-service to the fundamentals of the profession. The Guide Dogs for the Blind Association is currently carrying out a major review of this area and there can be little doubt that it will throw up far-reaching proposals to reverse a long-term decline every bit as serious as that in the social work profession, which the Government will need to take just as seriously as they have the decline in social work.
12.39 pm
Lady Saltoun of Abernethy: My Lords, I, too, congratulate the noble Earl, Lord Listowel, on securing this debate. I shall focus first on those aspects of social work that concern children. I have for a long time been very worried about cases in which children have been removed from their parents on the excuse that they were being abused or were at risk of being abused when there was no real evidence that that was in fact the case and a lot of expert evidence, which local authorities chose to ignore, that the causes of the apparent injuries were quite different.
I gave details of two cases in the debate secured by the noble Lord, Lord Giddens, on 22 June last year, reported in Hansard in Volume 683, col. 947. Now I have heard of another one, in which the children have been removed from the mother on the grounds that they were in danger of being abused, and are about to be adopted. Of course, in none of these cases can I, even as a Member of your Lordships’ House, obtain any details of the evidence or copies of the judgment of the judge who heard the case in the family court, so I cannot make any judgment myself as to the rights and wrongs of the cases. But these cases have raised questions in my mind as to whether the social workers involved were sufficiently highly trained to make the
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I have read or tried to read the White Paper, Options for Excellence, which is, I am sorry to say, as ill written in ghastly jargon and as ill set out as the report on the conventions of the House, on which I spoke on Tuesday, was well written, readable and well set out. Recruiting sufficient social workers seems to be difficult and the training is sometimes inadequate. When numbers are short, it is not going to be easy to spare people for ongoing training and, in any case, training in schools and colleges, while very necessary, is no substitute for training under an experienced practitioner on the ground. A huge variety of different career development projects is probably a very expensive way in which to promote recruiting. Nowhere in the report did I see any suggestion that the way forward might be to pay social workers, carers and so on better, which is the first thing I should consider if I were having difficulty in finding recruits. I am no economist but when I was young I learnt the basic law of supply and demand. When the demand exceeds the supply, the price goes up. In this case, the price is the salaries of the workers. I echo the views of the noble Baroness, Lady Blood, on this, and the views of the noble Lord, Lord Low of Dalston, on this matter and on training.
The same applies to shortages of carers, nursing assistants and auxiliaries. Again, the most important kind of training that they can have is out in the field. A short time ago, a friend of mine was in hospital having had a very serious operation after which she could not move without help. One evening she was attended by a new young nurse, who told her that she was absolutely terrified, that it was her first time on the ward and that although she had been through nursing college and passed all her exams with flying colours, she had never been at a bedside before or been taught any hands-on nursing. That is why I say that training in the field is absolutely vital.
12.44 pm
Lord Hylton: My Lords, I thank my noble friend for introducing this debate. I shall try to develop what he indicated as regards fostering and foster parents. That is where more than two-thirds of the 60,000 children in care are placed. The best estimates show that there is still a shortage of some 8,000 foster homes, which is roughly a 20 per cent shortfall that is most severely felt in London and the south-east. The background to that shortage is the need to be able to place children near their families, friends and existing schools and to be able to give some degree of choice of placement to the older children.
Before now I have described foster parents as being in the very front line of social care. Their role is one of the most personal forms of social service imaginable; they have to give sympathy, understanding and love equal to what they would provide for their own children. A foster parent is called on to be the consistent adult in the lives of children. That is surely the great need of children whose birth family has broken down. It appears that some 44 per cent of
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It is fairly obvious what should be provided to achieve stability in placements. There must first be fully adequate pay and allowances. Foster parents should not be expected to make a financial sacrifice when providing an essential public service. Housing, including housing benefit, and pension arrangements will be important, especially in high-cost areas. Economic provision of this kind must be complemented by good selection, training and support on the job. If all these factors are available, there is a good prospect of recruiting and, even more importantly, retaining, high-quality foster parents.
I hope that I have summed up the essential preconditions for stable placements for very vulnerable children. I therefore warmly welcome last year’s decision to lay down national minimum allowances for fostering. I recognise that some local authorities and private agencies already pay more than the minimum rate. Pay should always continue while foster parents are waiting for a new child; such gaps could well be used for training and for mutual support between parents. I welcome the Green Paper, Care Matters, of last October, and particularly the fostering proposals in chapter 4. However, I urge the Government to consider carefully the detailed comments on this chapter from the Fostering Network. These concern more than just one government department.
It is good news that the Children’s Commissioner is now fully active. I trust that he will be influential in raising the status of foster parents so that they are seen and rewarded as indispensable carers. The recording and supervision of private foster arrangements is another urgent issue. I wonder whether the Minister can give us any news of progress on that point. So, too, is the development of special fostering arrangements for children who have a history of being abused or trafficked into this country for gain. I invite the Government to consider whether the financial responsibility for children who are unaccompanied asylum seekers should move from the Home Office to the Department for Education and Skills. Such children certainly deserve to be treated according to best practice. That means that they should not be deported on reaching the age of 18 when their attachment to this country may have become very real and their links to the country of origin have attenuated to the point when they are almost minimal.
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