Tag Archives: social services

A road less travelled: celebrating Gypsy, Roma and Traveller History Month – part 2

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June is Gypsy, Roma and Traveller History Month (GRTHM), which aims to raise awareness of and promote GRT history and culture.

It is widely recognised that raising awareness of different cultures is a key part of addressing prejudice and discrimination.

In this post – the second of two for GRTHM – we look at the inequalities and discrimination that GRT face across education, employment and health.  We also highlight work to address these inequalities and raise awareness of GRT communities’ rich cultural heritage.

GRT communities experience many educational and health inequalities

The recent House of Commons report, ‘Tackling inequalities faced by Gypsy, Roma and Traveller communities’, sets out a comprehensive review of the available evidence across a range of areas.

In education, Gypsy and Traveller children leave school at a much earlier age and have lower attainment levels than non-GRT children, and only a handful go on to university each year.  They also experience much higher rates of exclusions and non-attendance.

There are many reasons for this – from discrimination and bullying, to a lack of inclusion of GRT within the educational curriculum. There are also cultural issues to be addressed within the GRT community itself.

Scottish Traveller activist Davie Donaldson has spoken about the discrimination he faced in school where a teacher refused to “waste resources” by marking his homework because he was a Traveller, who she assumed was “not going to do anything with his education anyway”.  He also discusses how many Travellers within his own community felt he was betraying his roots by attending university. This clearly illustrates the multi-faceted nature of the issue of supporting GRT children in education.  The Traveller Movement addresses this and other related issues in their recently published guide to supporting GRT children in education.

Health outcomes for GRT communities are also very poor compared to other ethnic groups.  Their life expectancy is 10 to 12 years less than that of the non-Traveller population.  Maternal health outcomes are even more shocking – with one in five Gypsy Traveller mothers experiencing the loss of a child, compared to one in 100 in the non-Traveller community.

Poor health outcomes can be partially attributed to the difficulties that many experiences when accessing or registering for healthcare services due to discrimination or language and literacy barriers.  There is also a lack of trust among GRT communities which can result in a lack of engagement with public health campaigns.

Historic fear of engagement with public services

Indeed, there is a historic wariness of public services among many in the GRT community.

In the 1800s, many Travellers had a well-placed fear of the ‘burkers’ – body-snatchers looking to provide the medical schools with bodies for dissection.  Travellers felt particularly at risk because they lived on the margins of society.  There are many Traveller stories about burkers that have been passed on from generation to generation.

Similarly, a fear of social services intervention also exists, following the forced removal of children from Traveller families.  Some were taken into care, and others were deported to be servants in Canada or Australia.

Being aware of these cultural issues, along with the historic criminalisation and continued discrimination that GRT communities face, can help health and social services to understand and empathise with the GRT community when reaching out to them.

Poor employment outcomes and a lack of target support

Gypsies and Travellers were an essential part of the economy in the 19th Century and early 20th Century.  Many were skilled tinsmiths, silversmiths, basketmakers or other crafters.  They also played an important role as seasonal agricultural workers – for example, in the berry fields of Blair and farms of the north east of Scotland.  They moved from place to place, and bringing news and selling and trading their wares.  In the days before roads and motor vehicles, they were a lifeline for rural crofting communities who may have been many days travel away from the nearest settlement.

Time has rendered many traditional Traveller occupations redundant, and today employment outcomes for GRT groups are generally poor.

While more likely to be self-employed than the general population, the 2011 England and Wales Census found that Gypsies and Irish Travellers were the ethnic groups with the lowest employment rates, highest levels of economic inactivity, as well as the highest rates of unemployment.

However, unlike other minority groups, there has been no explicit government policies that support Gypsies or Travellers to enter employment or to take up apprenticeships and/or other training opportunities.  Many Gypsies and Travellers have also reported being discriminated against by employers, making it more difficult for them to find and stay in work.

A lack of robust data

There is a lack of robust data about the different GRT groups in the UK – even something as seemingly simple as how many GRT people there are.

This is because most data collection exercises – including the Census and in the NHS – do not include distinct GRT categories.  If an option exists at all, often it conflates the different GRT ethnicities into one generic tickbox, with no way to differentiate between the different ethnic minorities.  This is an issue that is being increasingly addressed and there are plans to include a Roma category in the 2021 census.

However, there are also issues with under-reporting.  Many people from GRT communities are reluctant to disclose their ethnicity, even when that option is available to them.  This stems both from a lack of trust and the fear of discrimination.

So, while the 2011 Census recorded 58,000 people as Gypsy/Traveller in England and Wales, and a further 4,000 in Scotland, it is estimated that there are actually between 100,000 to 300,000 Gypsy/Traveller people and up to 200,000 Roma people living in the UK.

Raising awareness of GRT culture

While this all may make for some pretty depressing reading, there are some promising signs of progress.

From Corlinda Lee’s Victorian ‘Gypsy Balls’ – where the curious public could pay to come and see how a Gypsy lived and dressed, to Hamish Henderson catalysing the 1950s Scottish Folk Revival with the songs and stories of Scottish Travellers – there have been attempts to promote Gypsy and Traveller culture among the settled population.

Today, organisations and individuals such as The Traveller Movement, Friends, Families and Travellers, and Scottish Traveller activist Davie Donaldson strive to promote awareness of and equality for the GRT community.

The recent Tobar an Keir festival held by the Elphinstone Institute at Aberdeen University sought to illustrate traditional Traveller’s skills such as peg-making, and there is a wonderful Traveller’s exhibition – including two traditional bow tents – at the Highland Folk Museum in Newtonmore.

There are even more events planned for GRTHM – including an exhibition of Travellers’ art and photography at the Scottish Parliament.

The hard work may be beginning to pay off – just last week, the government announced a new national strategy to tackle the inequalities faced by Gypsies, Roma and Travellers.

Using knowledge to fight prejudice

While there is without doubt an urgent need for practical measures to address the inequalities that the GRT community face – such as an increase in the number of authorised sites available – addressing the fundamental lack of awareness and knowledge of GRT culture is a key step towards eradicating prejudice towards GRT communities.

As well as raising awareness among the general public, there is also a need to for people working in public services – from health and social services to education and even politics – to have a better awareness and understanding of Traveller culture and history, and how this affects their present day needs and experiences.

Gypsy, Roma and Traveller History Month is an ideal opportunity to address the huge gap that exists in society’s collective knowledge about the GRT way of life, their history, culture and contribution to society. All of which can help to combat the prejudice and discrimination that they continue to face.

 Follow us on Twitter to discover which topics are interesting our research team.

Top research resources for social care and social services

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The news in June that the Government’s Green Paper on social care will now be delayed until the autumn (having already been deferred since 2017) brought sighs of weariness rather than real surprise from the sector.

The recent focus on NHS funding, and the NHS’s 70th birthday, has also highlighted ongoing concerns that the funding crisis in other areas, including social care, mental health services and public health is being pushed to the sidelines.

What is clear, is that the need for evidence-based interventions, and proven value for money, is only getting stronger as budgets continue to be stretched.

The value of research

So, what’s the role of research knowledge within social work and social care? The Social Care Institute for Excellence has suggested that research can help practitioners and decision-makers to understand:

  • the social world in which those who use services live
  • why positive and negative events occur in the lives of some and not others
  • the relative success of interventions and their impact on these events
  • the role of the social care practitioner in relationships and interventions with service users
  • how social policies impact on the lives of people using services.

Studies such as cost-benefit analyses or randomised controlled trials are also part of the evidence base although they are less common in social care/social services than in health contexts.

Research takes place in different ways, with different aims. And the outcomes of research can be communicated in different ways. Blogs such as our own at the Knowledge Exchange aim to signpost readers to recent research on particular topics. Other good sources of accessible discussion of research findings include The Conversation blog and Community Care.

Meanwhile, database services such as the Idox Information Service or Social Policy and Practice will provide more comprehensive coverage of issues, bringing together research studies from other parts of the world which are transferable.

Social Policy and Practice

Many NHS Trusts and councils subscribe to the Social Policy and Practice database as part of their package of support for learning and development.

Recent feedback from users has highlighted its strong coverage of many current priority issues in public health, such as:

  • dementia care
  • delayed discharge
  • funding of long term care
  • safeguarding of both children and adults
  • supporting resilience and well-being
  • tackling obesity
  • asset-based approaches

As a UK-produced database, Social Policy and Practice also includes information on topical policy issues such as minimum alcohol pricing, sugar taxes, and the possible impact on the health and social care workforce of Brexit.

The database is produced by a consortium of four organisations: Social Care Institute for Excellence, Centre for Policy on Ageing, Idox Information Service and the National Society for the Prevention of Cruelty to Children.

Idox Information Service

With a wider range of topics covered, the Idox Information Service has been identified as a key database by the Alliance for Useful Evidence. Cross-cutting issues which impact on health and social services, such as poverty, housing, and social exclusion are covered in depth. It also covers management and performance topics.

The Idox Information Service also offers a range of current awareness services and access to a team of expert researchers, in addition to the database. The aim is to support the continuing professional development of hard-pressed frontline staff while also supporting the sharing of research and evidence across the sector.

Meeting the needs of the social care sector

Both Social Policy and Practice, and the Idox Information Service aim to increase the social care sector’s capacity for evidence-informed practice.

As battle lines are drawn over government funding, it’s clear that these will continue to be financially challenging times for public services and that demand for services will carry on growing. Investing in learning and development is one way to ensure that staff are equipped with the skills and tools to be the best that they can be. This in turn will ultimately improve performance and outcomes for the most vulnerable in our society.

To find out more about the history of the Social Policy and Practice database and the consortium of publishers behind it, read this article from 2016 which we have been given permission to share. Trials of the database can be requested here.

Read more about the unique support offered by the Idox Information Service. More information on subscriptions can be requested via the online contact form.

The challenge of engaging with marginalised Traveller, Gypsy and Roma communities

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In March 2018, a Northern Ireland Human Rights Commission report found 13 systematic concerns about Traveller accommodation, suggesting that Traveller communities are subject to an “out of sight, out of mind” mentality from local authorities and service providers. You do not have to look far to find more research, from across the whole of the UK, which highlights similar challenges for, and attitudes towards Traveller communities. Attainment, school attendance, unemployment and community cohesion are all shown in research as being consistently lower among Traveller communities.

Research from IRISS shows that Traveller communities are subject to regular racial, social and cultural discrimination and feel isolated within a society that they feel does not respect them in the same way as other minority groups. Some even feel that it is more acceptable to make a derogatory comment about a Traveller than someone who is from another ethnic group.

Commentators repeatedly highlight that there is very little knowledge or understanding of nomadic lifestyles, and that this can contribute to the racism, abuse and stigmatisation of Traveller people. However, some projects are trying to address the view of Traveller communities and improve their treatment and engagement with other members of non-Traveller communities.

An erosion of traditional lifestyles and cultures

A lack of flexibility around housing arrangements means that, to a large extent, Traveller families are often forced to choose between either poor accommodation sites which allow them to maintain their traditional way of living, or giving up this traditional lifestyle (which is not just a way of living, but also an entrenched part of their heritage and culture) to live in mainstream traditional social housing. One major criticism of local authority and central government supported services is that they are very inflexible to nomadic living; health, education, housing and employment support are all usually reliant on a fixed address. As a result, third sector organisations, charities and specific engagement bodies usually end up taking the bulk of the pressure and responsibility for supporting Traveller families, or Travellers are left to fend for themselves. This can lead to them becoming isolated or reluctant to engage.

Those who make attempts to assimilate often do so at the cost of their traditional way of life, with some even commenting that there is a level of cultural erosion and almost cleansing, and that Travellers are being forced to choose between suitable accommodation and living standards, and their heritage and traditions.

Challenges span generations, and create entrenched barriers

Many Traveller families have poor education and health experiences and there are multiple barriers to Traveller families accessing these services. In schools, it has been well documented that Traveller children have lower levels of attendance and attainment, with higher levels of exclusion and a higher incidence of bullying, discrimination and racist abuse while at school.

In social work, Traveller children are more likely to be engaged with a social worker and taken into care. It is clear that professionals working within these environments need to be trained to react and respond to the needs of Traveller children in a culturally sensitive way.

Practitioners need to be sensitive, aware and flexible where possible to accommodate needs, but this is not always the case and it can make Traveller communities reluctant to engage directly with local authorities on issues. However, there is a growing body of research which looks at art and culture-centred practice to try and engage Traveller communities with their wider community, and to enlighten other members of the community in a positive way about Traveller culture.

Could art be the bridge to build understanding between communities?

Many Traveller communities do not readily have access to art and do not participate in “cultural activities” like attending the theatre or museums or using libraries. They also don’t have any relationship to most art produced. There is very little Traveller representation in art, music, theatre or museum exhibitions and it can be the case that Travellers feel art and culture in the mainstream is not representative of them or their culture, which can also hinder them from engaging.

However, using art and art-based interventions can help to break down entrenched stereotypes and can create a level playing field for people to participate and contribute, particularly among children who may not be as effective at communicating using words or language.

Engaging young children (and their families) through play and cultural activities can help break down some of the barriers and mistrust that communities feel towards one another. Community engagement initiatives enhance trust and can improve relations, but this must be done in a sensitive and inclusive manner. Traditional crafts and arts are something that can be shared across the whole community, not just within Traveller communities.

Non-Traveller children also are at a cultural disadvantage from not having Traveller communities portrayed in mainstream cultural activities. Greater representation in art, TV and books would help integration, help to break barriers, reduce stereotypes, increase understanding of a unique culture in Britain and (it is hoped) lead to greater integration and less hate crime.

Art also has the potential to be used as a tool to engage adults within the community. Using art as part of consultation exercises can make the process accessible and can allow people to be involved who may not usually contribute, helping them to feel they have had a say in decisions made within their community. Art can also be a useful strategy in community cohesion and neighbourhood building activities, with people able to express their opinions and fears through other mediums such as painting, drawing or acting – although establishing the initial engagement can be challenging.

Final thoughts

Art-based practice can be an accessible way to engage and create a dialogue between communities, and help to build a level of trust between Traveller communities and local services. However the activities must be culturally sensitive, and staff within local services must be willing to be flexible and creative with how they engage if they are to create meaningful relationships with Traveller communities.

Follow us on Twitter to see what developments in policy and practice are interesting our research team. 

If you liked this article, you may also be interested in:

Exploring Barnahus: a Nordic approach to supporting child abuse victims

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Barnahus (which literally means Children´s house) is a child-friendly, interdisciplinary and multiagency centre where different professionals work under one roof in investigating suspected child sexual abuse cases and provide appropriate support for child victims.

Learning from the Nordic countries

Barnahus has assumed a key role in the child protection and child justice systems of many Nordic countries, including Sweden and Iceland. While there are some small differences in definition of the model across these nations, the general principle remains the same: to create a one-stop-shop for services that children can access under one roof. Services range from country to country, but usually include a combination of police, criminal justice services, child and adolescent mental health practitioners, paediatric doctors and social services.

The Barnahus model involves a high level of interdisciplinary working between different teams and allows for a complete package of care and support for a child to be created to reflect their needs. Within the Barnahus centres there are normally facilities including medical rooms, interview rooms, courtrooms, and residential facilities for those young people deemed at risk and who need to be taken immediately into temporary residential care.

Evaluations of areas that use this model of intervention have found significantly better outcomes for child victims and their families because of the multidisciplinary and multi-agency approach. Some discussions have also suggested that creating an adapted model for adult victims could also be a possibility in the future.

Reducing the trauma for victims of child sexual abuse

In England, it is estimated that only 1 in 8 victims of child sexual abuse are identified by the authorities. Children who disclose that they have been sexually abused face multiple interviews in multiple settings to a number of different people, often asking them the same questions. This can be confusing and frightening, as well as traumatic for many children who have to repeatedly recount the story of their abuse. Once the interview process is over, they can also then face long waiting times to access specialist therapeutic support.

The Barnahus model seeks to reduce some of the trauma experienced by victims of child sexual abuse by making the approach child-focused, emphasising the importance of a positive, safe and supportive environment in which to be seen by specialists, give evidence and receive support. For example, within the models used in Iceland children and young people are interviewed and examined within a week of the abuse allegation being made. These interviews are all conducted and recorded in a single location with specially trained officers and medical professionals, and they are then used in court as evidence, avoiding the victim having to revisit court in order to give evidence or testify.

Inside the centre, a specially trained interviewer asks questions, while other parties watch via a video link. Any questions they have are fed through an earpiece to the interviewer. Lawyers for the accused have to put all their questions at this point.

Another benefit to the model is that children who are interviewed are then able to access immediate assistance and counselling; in the current system in England, children may face cross-examination in court months after the alleged abuse, and would have to wait for victim support therapy.

Allocation of funding from government

In 2017, in response to the success reported in the Nordic models, the UK government earmarked Police Innovation Funding of £7.15m to help establish and roll out a similar scheme in London, which would see criminal justice specialists working alongside social services, child psychologists and other services and, it is hoped, pave the way to create a UK-wide Barnahus model in the future.

Building on the existing model in London, CYP Haven, which provides largely clinical, short term care, will provide a multi-agency, long-term support and advocacy service that is expected to support over 200 children and young people each year. Criminal justice aspects of aftercare will be embedded in the service, with evidence-gathering interviews led by child psychologists on behalf of the police and social workers, and court evidence provided through video links to aid swifter justice.

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

If you enjoyed this blog, you may also be interested in our other articles:

Child abuse by children: why don’t we talk about it?

Secure care in Scotland: measuring outcomes and sharing practice

Who’s caring for our young carers?

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In less than two months time the UK will come together to recognise the 700,000 young people in the UK who provide care and support to families and friends, on Young Carers Awareness Day on 25 January.

Every day, children and young people provide physical and emotional care and support to their family members. Helping with household tasks, they care for young siblings, administer medication and deal with the emotional and physical stress of caring for a loved one with an illness. Estimates of the number of young carers living in the UK vary greatly. But Carers Trust suggests the number of young carers to be around 700,000 – that’s 1 in 12 secondary school-aged pupils. And those are only the ones we know about. Too many are falling through the net, going unnoticed and unidentified by services who can support them.

Attainment and employment

Earlier this year we joined in publicising the 2017 Young Carers Awareness Day, whose theme was “When I grow up”. The idea was to help people to understand how difficult it can be for young carers to realise their hopes and dreams for the future without the right support in place. A survey conducted by the Young Carers Trust found that over half (53%) of those surveyed were having problems in coping with schoolwork, with nearly 60% struggling to meet deadlines. Over 70% have had to take time out of school or learning specifically to care for a family member. A third admitted that they have to skip school most weeks.

With over 50% of young carers surveyed by The Children’s Society admitting that their caring responsibilities have caused them to miss days at school, and the burden of caring impacting on the ability of children to engage fully with school activities, it is unsurprising that young carers are twice as likely to be NEET as their peers. In addition, young carers in work find caring responsibilities have a disruptive effect on their workplace attendance, with understanding and flexible employers often being the difference between young adult carers remaining in work or becoming unemployed.

Mental health and wellbeing

Caring for a relative takes a massive toll on a young person. Recent reports published by Carers Trust and the Children & Young People’s Commissioner Scotland (CYPS) both show the significant mental health burden that caring places on a young person. Stress, isolation and anxiety that can come as a result of being a carer can have a significant impact on a child as they lose much of their contact with the outside world, become removed from social groups and miss out on opportunities to experience a “normal” childhood. Projects like Off the Record’s Young Carers Project in Croydon provide support and opportunities for respite for young carers. But it is clear that as child and adolescent mental health services  (CAMHS) are becoming increasingly stretched themselves, it is more important than ever to ensure that specialist services are also made available to young carers.

Partnerships working to provide support

Young carers often come into contact with multiple services. Education, social care, health and others all have an impact on young carers and their experiences and as a result can have a positive impact on their experiences too. Increasingly, services are being encouraged to cooperate in order to create a holistic support network for young carers, which encompasses every area of need they may have, and creates a seamless transition for young carers through all of their interactions with various services. Key coordinators and facilitators are vital in this role.

In the previously referenced report from CYPS, it was highlighted that many young carers felt positive about – and took pride in – their caring role, but that around two-thirds also said they felt “left out of things” at least some of the time. While they care for their loved ones, we need to make sure someone is caring for them.

Young Carers Awareness Day 2018 will take place on 25 January 2018.

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

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World Social Work Day: promoting community and sustainability

Who am I? The importance of life story books for looked after children

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paper family on hand

By Heather Cameron

Every adopted child in the UK should have a life story book – an account of a child’s life in words, pictures and documents containing information on the child’s birth family, care placements and reasons for their adoption – which is given to them and their new family when preparing for a permanent placement.

Local authorities have a statutory duty to create life story books for all adopted children, providing them with a sense of identity and understanding of their early life before adoption. They are a well-established practice in the UK and most local authorities provide guidance on preparing them.

However, research has found that the quality of life story books varies hugely.

Variation in quality

The research, conducted by the Voluntary Adoption Agency, Coram, in collaboration with the University of Bristol, focused on adopters’ perspectives on their children’s life storybooks, which it identified as lacking from the academic literature.

Although adopters welcomed the idea of life story books, they were critical of their execution. And despite accounts of positive experiences, there was a broad consensus that:

  • many books were of poor quality;
  • children had been poorly prepared to explore their histories;
  • adoption professionals and agencies did not seem to prioritise life storybooks; and
  • adopters felt poorly prepared in how to use and update life storybooks with their children.

While 40% of adoptive parents said their books were ‘good’ or ‘excellent’, a third said they were ‘terrible’.

Issues were raised around lack of communication, opportunity to provide input and what was included in the books. One adopter said “We did not have the opportunity to discuss but what I would have said was this is rubbish – all of it is rubbish”. Another said “I can never show my daughter hers because there is stuff in there that I don’t ever what her to see”.

Another theme to emerge was an excessive focus on the birth family, foster family or social worker rather than the child, and the use of inappropriate language.

For those who regarded their books in a positive light, they believed the story was told well, was age appropriate and honest, and didn’t construct a ‘fairy tale’ that would give the child an unrealistic view.

Invaluable

For adopted children, life story books can be key to providing details of their history and background, providing continuity in their life histories and preparing them for a permanent placement.

Often, they are the only thing an adopted child has by way of personal, accurate and detailed information on their past. As one mother commented on the importance of birth photos, “It’s all they have left of their own babyhood”.

Done well, they can be invaluable, as described by one adopter:

‘a good quality life storybook builds a bridge back to that huge part of her that we didn’t see and it is her main link to her past’

It has therefore been argued that life story work should be prioritised and appropriate support provided.

Ingredients for success

Coram’s research highlighted several key things for successful life story work; one being having staff dedicated to life story work.

Bournemouth has been highlighted as an example of good practice for their life story work. Their separate adoption department appointed a dedicated family support practitioner to take on responsibility for the life story books for children adopted in Bournemouth.

In 2012, the council received an ‘outstanding’ rating by Ofsted and was named as joint adoption service of the year.

Also highlighted by the research, was that gaps in the narrative were not helpful, and support for adopters is paramount, as is training for social workers.

To improve the quality of life story work across the board, Coram’s report urges adoption agencies to make considerably better use of life story books and invest in improved training for professionals, while monitoring the quality of books produced and providing better access to support and guidance for adopters to engage in such important work with their children over time.

Bournemouth illustrates the importance of doing life story work well. And as the research concludes, “linking a child’s past and present is crucial ‘bridging’ work in enabling permanence in placements”.

If you enjoyed reading this, you may also like our previous articles on kinship carers and the value of foster care.

Follow us on Twitter to see what developments in public and social policy are interesting our research team. 

Overworked and under-resourced – ‘mission impossible’ for social workers?

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By Heather Cameron

A year on from my previous blog on the emotional pressures facing social workers, have the headlines improved any?

Going by a new Guardian survey of social workers, it would seem that the answer is a resounding no.

The Social Lives Survey revealed that while the majority of social workers enjoy their job, two-thirds say they can’t focus on what really matters and only a quarter feel their workload is manageable. Almost 80% work overtime every day, and 86% don’t get paid for doing so.

Heavy and increasingly complex caseloads was the most common reason given for stress among social workers in last year’s Community Care survey.

Unmanageable caseloads

Unison surveyed social work staff from across the UK about their work at the end of a day in April 2014. Just over half (52%) said their caseload size was affected by covering for staff shortages and nearly three quarters highlighted that there was no formal system in place to help manage their caseloads and ensure they are at a safe level. A significant minority (42%) noted that they left work with serious concerns, the main reason for which was being unable to complete paperwork, followed by being unable to speak to other agencies or professionals involved.

Similarly, in May 2012 the British Association of Social Workers published the findings of its State of social work survey which indicated that 77% of the social workers surveyed said their caseloads were unmanageable. One child protection social worker said “the team I work in currently is working at dangerous caseload levels in terms of child protection work”.

The emotional impact of the challenges of social work were highlighted by a number of respondents, as one mental health social worker described:

“It makes me so sad that this job seems only to be possible if you sacrifice your own health and wellbeing”

The subsequent inquiry into the state of social work report by the All Parliamentary Working Group at the end of 2013 also emphasised the extent of stress among social workers who are overloaded and under-resourced. It heard from a local authority social worker who said:

 “the more cases we have, the more corners we have to cut, and the more corners we have to cut the more we have significant numbers of children for whom we haven’t had the time to do a thorough assessment”.

Another social worker said that as a result of budget cuts, “the conditions for child-centred practice and safe working are being eroded”.

Impact of austerity

A little over two years on from the inquiry, it would seem there is no let up on the impact of austerity on the social work profession.

A huge majority (92%) of social workers who took part in the Guardian’s survey highlighted that spending cuts are affecting services and putting more pressure on care professionals. And it was felt by 88% of respondents that social work isn’t as high on the political agenda as other public services.

With further cuts to hit local authorities from April this year, following the government’s announcement of a 6.7% funding cut for councils, things may get worse before they get better.

To help offset the impact on social care, local authorities will be able to raise an extra £2 billion through a 2% Council Tax precept and the £1.5 billion Better Care Fund.

Nevertheless, it has been argued that this will not be enough to address the immediate social care crisis or to prevent an estimated £3.5 billion funding shortfall by the end of the decade.

‘Bad press’

As well as spending cuts increasing pressure on social workers, the negative perception of the profession was also raised by the Guardian’s survey:

“The government and media need to stop portraying social workers as child-snatchers and do-gooders. They should sometimes focus on the lives we have saved and positively changed.”

It was suggested that newspapers should also focus on the pressures put on social workers rather than always on when things go wrong, and the government should be supportive of the role and address the lack of recognition and support at the national level.

Way forward?

Perhaps the rest of the UK should be looking to Wales for good practice, where the happiest social workers reside.

In Wales there are lower caseloads, more support from managers and better integration with health. According to one social worker, “it’s a better place to be a social worker. Social work is recognised and valued; in England I don’t think it is.”

Social services in Wales have also been more protected from cuts than elsewhere. And you don’t see the same negative language about social workers in Wales as you do in some parts of the media in England, according to the Welsh Government’s minister for Health and Social Services.

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

Further reading: if you liked this blog post, you might also want to read Heather’s other article on engaging fathers with social work.

Social prescribing – just what the doctor ordered?

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blue toned, focus point on metal part of stethoscope

By Heather Cameron

It is widely acknowledged that wider social, economic and environmental factors have a significant influence on health and wellbeing. According to recent research only 20% of health outcomes are attributable to clinical care and the quality of care while socioeconomic factors account for 40%.

With increasing pressures on GPs and lengthy waiting times a real issue for many, particularly those with mental health conditions, social prescribing could represent a real way forward.

The government clearly recognised the importance of social prescribing in its new deal for GPs announced earlier this year, which made a commitment to make social prescribing a normal part of the job.

In response to a recent Ask-a-Researcher request for information on different approaches in social prescribing and evidence of what works in the UK, it was interesting to find that despite the recognition of potential value, there has been little evaluation of social prescribing schemes to date.

Much of the material found focused on specific interventions and small-scale pilots and discussion around implementation. A new review of community referral schemes published by University College London (UCL) is therefore a welcome addition to the evidence base as it provides definitions, models and notable examples of social prescribing schemes and assesses the means by which and the extent to which these schemes have been evaluated.

So what is social prescribing?

Social prescribing means linking patients with non-medical treatment, whether it is social or physical, within their community.

A number of schemes already exist and have included a variety of prescribed activities such as arts and creative activities, physical activity, learning and volunteering opportunities, self-care and support with finance, benefits, housing and employment.

Often these schemes are delivered by voluntary, community and faith sector organisations with detailed knowledge of local communities and how best to meet the needs of certain groups.

Social and economic benefits

Despite a lack of robust evidence, our investigation uncovered a number of documents looking at the social prescribing model and the outcomes it can lead to. Positive outcomes repeatedly highlighted include:

  • improved health and wellbeing;
  • reduced demand on hospital resources;
  • cost savings; and
  • reduced social isolation.

According to the UCL report, the benefits have been particularly pronounced for marginalised groups such as mental health service-users and older adults at risk of social isolation.

A recent evaluation of the social and economic impact of the Rotherham Social Prescribing Pilot found that after 3-4 months, 83% of patients had experienced positive change in at least one outcome area. These outcomes included improved mental and physical health, feeling less lonely and socially isolated, becoming more independent, and accessing a wider range of welfare benefit entitlements.

The evaluation also reported that there were reductions in patients’ use of hospital services, including reductions of up to a fifth in the number of outpatient stays, accident and emergency attendances and outpatient appointments. The return on investment for the NHS was 50 pence for each pound invested.

Similarly, the Institute for Public Policy Research (IPPR) has recently argued that empowering patients improves their health outcomes and could save money by supporting them to manage their condition themselves.

IPPR suggests that if empowering care models such as social prescribing were adopted much more widely throughout the NHS we would have a system that focused on the social determinants of health not just the symptoms, providing people with personalised and integrated care, that focused on capabilities not just needs, and that strengthened people’s relationships with one another.

Partnership working

With a continued policy focus on integrated services and increased personalisation, social prescribing would seem to make sense. In addition to providing a means to alternative support, it could also be instrumental in strengthening community-professional partnerships and cross-collaboration among health, social and other services.

The New Local Government Network (NLGN) recently examined good practice in collaboration between local authorities, housing associations and the health sector, with Doncaster Social Prescribing highlighted as an example of successful partnership working. Of the 200 referrals made through this project, only 3 were known to local authority and health and wellbeing officers, showing that the work of social prescribing identified individuals who had otherwise slipped through the net.

And with the prospect of an ageing population and the health challenges this brings, a growing number of people could benefit from community-based support.

As Chair of Arts Council England, Sir Peter Bazalgette, notes “social prescribing is an idea whose time has come”.

Follow us on Twitter to see what developments in policy and practice are interesting our research team.

Further reading: if you liked this blog post, you might also want to read Heather’s earlier post on the health and wellbeing benefits of investing in public art.

Fathers and social services – is there a failure to engage?

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paper family on handBy Heather Cameron

With failure to effectively engage with fathers repeatedly highlighted in serious case reviews over the years, it is worrying to hear that such failure is still evident within the social work profession.

Failure to engage

Just last week, a High Court judge heavily criticised children’s social workers for their “unprofessional” and “reprehensible” case building against a father whose child was up for adoption. The case involved making a decision on whether to return a two-year-old girl to her father and three siblings or allow her to be adopted by the couple she had lived with for the previous 16 months.

The judgement stated that the social workers’ evidence expressed opinions that they were not qualified to make, describing it as ‘psychobabble’. The judge also noted that this evidence was ‘entirely at odds’ with the evidence of qualified professionals and that the local authority gave insufficient weight to the observations of professionals working with the family.

The social workers were also criticised for continually referencing a “clearly out of date” parenting assessment completed in 2012, stating that this “still apparently colours their view of the father”.

It would seem that there could be deep-seated barriers within the social work profession preventing effective engagement with fathers.

Barriers

In fact, there has been much research around the barriers to fathers’ engagement.

It has been widely suggested that an inability among social workers to believe that a father has changed following past negative behaviour, and traditional assumptions and stereotypes about gender roles, have long played a role in preventing engagement.

An article published in 2009 which explored the representation of fathers in the social work literature argued that a pervasive and influential negative attitude towards fathers is widespread in the social work field.

More recently, a feasibility study highlighted that an analysis of serious case reviews conducted from April 2005 to March 2007 across England found a tendency for professionals to adopt ‘rigid’ or ‘fixed’ thinking, with fathers labelled as either ‘all good’ or ‘all bad’, leading to attributions as to their reliability and trustworthiness. The influence of mothers (which can be good or bad), traditional approaches by the profession in relation to gender and parenting, and fathers being reluctant clients were also cited as barriers.

Such barriers have also been demonstrated by men’s experiences. A study which examined the experiences of fathers involved with statutory social work in Scotland highlighted that respondents reported feeling marginalised from child protection processes and facing barriers to contact with their children. Some men had experienced false accusations of sexual abuse, resulting in long-term involvement with child protection professionals; and some of the respondents felt that they were regarded with suspicion by professionals, with statutory conditions still being applied even after criminal charges had been dropped.

With such long-standing perceptions and approaches within the profession, it would be ill-advised to think that these can be fixed overnight. Nevertheless, there are signs that attitudes are changing.

Changing attitudes

A recent blog by Senior Evaluation Officer at the NSPCC, Nicola McConnell, acknowledges these tendencies within the profession but is confident attitudes are beginning to change. She highlights that only recently had she noticed that on most occasions she had not been interviewing ‘parents’ but almost exclusively mothers:

“although services aim to work with parents, for a range of reasons including social organisation and gender expectations, services for children really tend to work with mothers.”

McConnell argues that this can lead to ‘flawed practice’ and discusses how professionals can improve their work with fathers through early engagement and taking a non-judgemental approach.

Facilitators of engagement have been consistently emphasised across the research:

  • Early identification and involvement of fathers;
  • Taking a proactive approach to engagement;
  • Making services relevant to fathers.

And the benefits of effective engagement have also been widely acknowledged. Numerous studies have emphasised the importance of engaging fathers for both children’s outcomes and risk management.

It has recently been highlighted that children with positively involved fathers tend to:

  • Make better friendships with better-adjusted children;
  • Have fewer behaviour problems;
  • Be less involved in criminality and substance abuse;
  • Do better at school;
  • Have greater capacity for empathy;
  • Have higher self-esteem and life-satisfaction.

Good practice

A project highlighted in a recent article in Children and Young People Now which aimed to increase social workers’ engagement with fathers and father figures has had positive results. Following the intervention at one local authority:

  • the percentage of fathers involved in their child’s core assessment rose from 47% to 82%;
  • the percentage of fathers invited to the initial case conference rose from 72% to 90%;
  • and the percentage of fathers whose involvement with the child was discussed at the initial case conference rose from 78% to 100%.

Social workers reported improvements in their practice, including motivating fathers to change problematic behaviour, engaging abusive men in discussion about their behaviour and assessing fathers’ positive qualities. It was also reported that some children had been placed with their fathers instead of being taken into care as a result of their new approach.

So progress is being made, illustrating that it is possible for engagement barriers to be overcome.

 

The Idox Information Service can give you access to further research and good practice on social care services – to find out more on how to become a member, contact us.

Further reading

Caring Dads: Safer Children – interim evaluation report (2014, NSPCC)

Engaging fathers in child welfare services: a narrative review of recent research evidence, IN Child and Family Social Work, Vol 17 No 2 May 2012, pp160-169

Fathers’ involvement in children’s services: exploring local and national issues in Moorlandstown, IN British Journal of Social Work, Vol 42 No 3 Apr 2012, pp500-518

Don’t ignore the father, IN Community Care, No 1818 13 May 2010, pp16-17

*Some resources may only be available to members of the Idox Information Service

Child obesity – public health or child protection issue?

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By Heather Cameron

The issue of childhood obesity is in the spotlight again. Just weeks after the Channel 4 series Junk food kids: who’s to blame? highlighted shocking stories of children having gained several stones in weight and children as young as four with rotten teeth, a new study reveals that parents rarely spot obesity in their children.

The results of the survey, given to nearly 3,000 families, showed that nearly a third, 31%, of parents underestimated the weight of their child. It would therefore be fair to say, as highlighted by one of the researchers, that “if parents don’t recognise a child is obese then they’re very unlikely to do anything to help their child move to a more healthy weight. Then it’s a potential major public health crisis being stored up.”

Obesity experts have called for stricter rules on the advertising of unhealthy foods and drinks in a bid to help address this public health issue. And the public would seem to support this, according to a recent poll, which revealed that almost two-thirds of Britons surveyed want a ban on junk food TV ads until after the watershed.

But is the childhood obesity epidemic just a public health issue?

There has been a high degree of contention for some time over whether obesity should also be considered a child protection concern. Numerous news reports have questioned whether children should be taken into care if they are considered obese and potentially at risk of harm.

Just last year it was reported that up to 74 morbidly obese children in the UK were estimated to have been taken into care over the previous five years, according to figures obtained under Freedom of Information laws.

Prior to this, an article from Protecting Children Update that looked at physical abuse in children highlighted obesity as a form of abuse, suggesting that many professionals see obesity as a form of neglect.

Similarly, the researchers of a much cited paper published in The BMJ in 2010 – When does childhood obesity become a child protection issue? – argue that parents who refuse to help their overweight children to lose weight are neglectful. They say that whilst obesity alone is not a child protection issue:

“consistent failure to change lifestyle and engage with outside support indicates neglect… childhood obesity becomes a child protection concern when parents behave in a way that actively promotes treatment failure in a child who is at serious risk from obesity.”

The report raises questions over how obesity should be addressed in terms of child protection, however, noting that there is evidence that families of obese children were being unfairly accused of abuse where rare genetic conditions were involved. It also suggests that removing obese children from their parents may in fact make matters worse.

With a lack of published evidence and guidelines for professionals, the report therefore suggests the following framework for action:

  • Childhood obesity alone is not a child protection issue
  • Failure to reduce overweight alone is not a child protection concern
  • Consistent failure to change lifestyle and engage with outside support indicates neglect, particularly in younger children
  • Obesity may be part of wider concerns about neglect or emotional abuse
  • Assessment should include systemic (family and environmental) factors

There is certainly no room for complacency, considering the knock-on effect the failure to recognise obesity could have on the nation’s health, not to mention health and social care services.

 

The Idox Information Service can give you access to a wealth of further information on public health and social care topics, to find out more on how to become a member, contact us.

Further reading

Some resources may only be available to Idox Information Service members.

Overcoming obesity: changing hearts and minds, IN Community Practitioner, Vol 87 No 3 Mar 2014, pp16-18

Process evaluation outcomes from a global child obesity prevention intervention, IN BMC Public Health, Vol 14 No 757 2014

The inactivity time bomb: the economic cost of physical inactivity in young people (CEBR, 2014)

Preventing child obesity: a long-term evaluation of the HENRY approach, IN Community Practitioner, Vol 83 No 7 Jul 2013, pp23-27

Is obesity a child protection issue?, IN Community Care, No 1833 2 Sep 2010, pp16-17