A fascinating study by HM Inspector of Prisons contains this information. And usefully makes the point that social care of prisoners with disabilities and illnesses is not just a healthcare matter, but should also be seen as social care:

In August 2008, 246 prisoners were recorded as having a progressive condition. [This includes cancer]

In August 2008 only 649 (0.8%) prisoners were recorded on LIDS as having a mental impairment. This is much lower than the ONS research and our thematic suggest.

Figures taken from LIDS show a gap between what is recorded and what research suggests is the reality. In August 2008 only 387 (0.5%) prisoners were recorded on LIDS as having a learning difficulty, with an additional 462 (0.6%) recorded as having dyslexia.

In August 2008, 65 prisoners were recorded as having a speech impediment, and 29 as having a severe disfigurement. A further 637 (0.8%) prisoners were recorded as having a disability that fell into the ‘other’ category.

…the Inspectorate’s 2008 follow-up report 26 continued to highlight key concerns which apply both to older prisoners and to those with disabilities, such as the limited adaptations made for those with age-related impairments and disabilities, the continued belief that the social care needs of older and disabled prisoners are the responsibility of health services (which includes the inappropriate housing of older or disabled prisoners in the health services centre), and little individualized care planning.

HM Inspector of Prisons (2009) Disabled prisoners: A short thematic review on the care and support of prisoners with a disability. London: HM Inspector of Prisons.

http://inspectorates.homeoffice.gov.uk/hmiprisons/thematic-reports1/Prisoners_with_Disabilities1.pdf?view=Binary

The CSCI is about to die, or at least be transfigured, transmogrified or transformed, into one of the less powerful elements of the Care Quality Commission. So there’s a report on its six years of existence (five of actually inspecting); mainly cheerful colour pics, which includes one of Denise Platt smiling. There’s a useful list of its publications, and some of its research and collective documents were really valuable.

Commission for Social Care Inspection (2009) Making Social Care Better for People: CSCI 2004-2009. London CSCI.

http://www.csci.gov.uk/PDF/CSCI%20Legacy%2032pp.pdf

An interesting Healthcare Commission document asks what responsibility hospital board members have for governance (what in the not so old days would have been called management) of safety; this means of their patients, we’re not talking here of good old health and safety at work. An appendix helpfully sets out the duties of hospital trust boards, which might easily be transferred to hospice trustees:

• The duty of quality
• The duty of patient and public involvement
• The duty of care for their workforce
• The duty of partnership
• The duty to achieve financial balance.

Frighteningly, the report then goes on to say:

The Corporate Manslaughter and Corporate Homicide Act 2007 brings the issue much more into focus for trust boards. The Act will enable the courts to consider how an organisation’s activities were managed by its senior managers as a whole, rather than focusing on the actions of a single individual. ‘Senior management’ can include those in senior operational management, and those carrying out financial or strategic roles, that is non-executives.

There’s a whole lot more detail there about making sure that safety of patinets is properly dealt with that hospices might be thinking about.

Healthcare Commission (2009) Safe in the knowledge: How do NHS trust boards ensure safe care for their patients? London: Commission for Healthcare Audit and Inspection.

The House of Commons debate on the Laming Report was muted:

Michael Gove (Surrey Heath) (Con): He reports that

“a tradition of deliberate reflective social work practice is being put in danger because of an over-emphasis on process and targets, resulting in a loss of confidence amongst social workers”.

Will the Secretary of State tell us what he will do to reduce the burden of bureaucratic compliance and the number of targets faced by front-line professionals?
Lord Laming spells out in great detail the consequences of the bureaucratic burden…

However, the Conservatives are also keen to keep the pot boiling by having frequent reports to stir up trouble about. As with mental health inquiries in the 1990s, when the Conservatives unwisely agreed to set up a public inquiry in every case of a murder by someone known to the mental illness services, everyone gained the impression that the problem was a whole lot more serious than it was. They are, equally unwisely since they are likely soon to be in government and will have to cope with the consequences, after the same thing with serious case reviews. Laming recommends not publishing the full reports because of confidentiality for children. This is important for children, who are entitled to a life in which their problems are not there for all to see. Michael Gove again:

…Crucially, Lord Laming recognises that serious case reviews—the policy inquests that follow the death of a vulnerable child—are valuable tools for learning lessons to enable us to avoid making similar mistakes in future. He points out that the lessons from serious case reviews need to be better learned and more widely disseminated, but he fails to recommend that they now be published in full. Refusing to publish serious case reviews after a child’s death is like keeping the information from an aircraft’s black box secret after an aviation disaster—it prevents us from learning the lessons that we need to…

One LibDem is sensible about children and adults services (of course she is sensible, because she thinks what I do):

Annette Brooke (Mid-Dorset and North Poole) (LD): … I would like what has happened with adult social services to be taken on board in relation to the reorganisation and children’s services. We give somebody one and a half jobs, and then put adult social services on the side. Vulnerable children become vulnerable adults, and I understand that 15 authorities are pulling adult social services back, but one at least has a very low rating. Lord Laming has one paragraph on that matter, which should be looked at as a matter of urgency…

And also a Conservative politician, raising their standard question about leaving it to the local authority, raises an important wider issue relevant to the social services, which Ed Balls chooses to ignore in favour of noting the usual Conservative anti-centralisation line:

Mr. Andrew Mackay (Bracknell) (Con): Does the Secretary of State share my concern that it was not necessarily always a good idea to merge education and social services departments, and that it is not always a good idea to split up child services from adult services? Does he agree that giving local authorities the flexibility to decide how such services can be most effective is the right way forward?

Ed Balls: As I pointed out in my response to the Opposition spokesman, there is a widespread consensus on the importance of the Every Child Matters reforms in the 2004 Act, but regrettably the Conservative party is outside that consensus. As Lord Laming says, there is no doubt that bringing such services together under one local authority department has provided a more integrated approach to support children. It is clear that we have further to go, which is why we will ask the National College for School Leadership to expand its remit to support directors of children’s services. But do I think that there should be local authority discretion to deviate from the 2004 Every Child Matters framework? Absolutely not.

But that’s not what Andrew McKay asked; he asked whether merging with education was right. Education is a universal service whose people do not understand or care about the full horrors of what sometimes goes on in deprived and oppressed families and children; the same is true for health, where the focus is too much on individual care rather than the responsibility to do something about the social environment in which the poorest people live. Which is why a local authority department with a focus on social deprivation was valuable, and this has been lost in the specialistaion of the last two decades. This is an issue with haunts social work internationally. Many European countries have ministries and local departments of social welfare because they focus on their responsibility for social change and development, not just individual education and healthcare.

House of Commons Hansard: http://www.publications.parliament.uk/pa/cm200809/cmhansrd/cm090312/debtext/90312-0007.htm#09031256000005

The House of Lords, congratulating one of their own for his report, picked up the crucial tension in the report, but the point on bureaucracy was clearly a Conservtaive line, because Lady Verma made the point in almost exactly the same way as the Conservative shadow in the Commons.

Baroness Verma: …The noble Lord reports that,

“a tradition of deliberate, reflective social work practice is being put in danger because of an over-emphasis on process and targets, resulting in a loss of confidence amongst social workers”.

I think that all noble Lords would appreciate it if the Minister could clearly set out what the Government intend to do to reduce the burden of bureaucratic compliance and the number of targets faced by front-line professionals…

…The noble Lord’s report makes clear his opinion that the central bureaucratic tool used to help children at risk—the comprehensive assessment form—is,
“in danger, like other tools, of becoming process-focused or, even worse, a barrier for services for children”

What will the Government do to simplify this area of bureaucracy?

Baroness Walmsley:… The Government promise updated statutory guidance so that every practitioner knows what to do. But it is not for Whitehall to do this in detail; it is for the Government to give the professionals the tools they need in the way of training, resources and a sensible workload so that they can spend sufficient time with clients and sufficient time to reflect on and discuss their practice and their decisions with other experienced professionals. Then they will be able to make the right decisions themselves.

House of Lords Hansard: http://www.publications.parliament.uk/pa/ld200809/ldhansrd/text/90312-0012.htm#09031272000680

My sentiments entirely. You may have seen the very sensible article by Simon Jenkins earlier in the week, which contrasted the government’s treatment of bankers with its treatment of Sharon Shoesmith, the former Director of Children’s Services for Haringey, the unfortunate authority that dealt with the Baby P case that has caused all this fuss. I agree with him that Shosesmith should take her medicine quietly; most directors of social services and the like that I know are perfectly well aware that they will be lumbered with the blame and got rid of for anything that happens on their watch; this isn’t of course true for politicians.

Jenkins, S. (2009) Shoesmith’s biggest mistake was not to be a bank boss. The Guardian 11th March 2009

http://www.guardian.co.uk/commentisfree/2009/mar/11/simon-jenkins-ed-balls-babyp-shoesmith

Well have you had your letter then from the two Secs of State ? It comes via email of course, so if you’re not a computer-enabled social worker you might not have done. Of course, we all know that most social workers spend most of their time staring at computers, so perhaps you will have had your letter.

It is new for the Secs of State to bother to write to social workers to say how they appreciate us. Although one might be cynical of such things, it is good to see them making this effort. I only wish they actually took the trouble to find out about social work and its possibilities. Fat chance. Perhaps this will change; I’ll keep my letter to quote back at them every time one of their minions says stupid things about social work.

Being able to send the letter is also a product of registration, for which we have the present government to thank, and the value of new technology, which makes it worth writing to all of us.

You can see the Laming Report, which led to all this unaccustomed appreciation on:

The Lord Laming (2009)The Protection of Children in England:A Progress Report. (HC: 330) London: TSO.

http://publications.everychildmatters.gov.uk/default.aspx?PageFunction=productdetails&PageMode=publications&ProductId=HC+330

I just want to reprint the section on reflective and critical social work. There is far too much denigration of this approach to social work, because I think performance indicators, targets and guidance is all that governments can be shown to do. But encouraging practitioners to be really professional in what they do is far more important, and far more difficult.

3.15 The role of social work staff and managers is particularly critical in ensuring enabling action to protect children. There is concern that the tradition of deliberate, reflective social work practice is being put in danger because of an overemphasis on process and targets, resultingin a loss of confidence amongst social workers. It is vitally important that social work is carried out in a supportive learning environment that actively encourages the continuous development of professional judgement and skills. Regular, igh-quality, organised supervision is critical, as are routine opportunities for peer-learning and discussion. Currently, not enough time is dedicated to this and individuals are carrying too much personal responsibility, with no outlet for the sometimes severe emotional and psychological stresses that staff
involved in child protection often face. Supervision should be open and supportive, focusing on the quality of decisions, good risk analysis, and improving outcomes for children rather than meeting targets.

Returning to Laming’s report on child protection, one of the things he is after is toughening up on the requirement for social work students to have placements in statutory agencies where they do work that involves implementing social workers’ legal responsibilities.

But as Bill McKitterick, the former social services director who does what all SS Directors do and became a freelance consultant, is quoted in Community Care as saying (rightly in my view) that local authority children and adult social care departments should do more in providing placements.

Anyone who’s been involved in social work education knows that most local authority social care managers would rather drink bleach than let any of their staff supervise a student; they all have so much to do in the short-term that looking after their own long-term interests in recruiting new staff and helping the profession develop can go hang. The more senior they are, the more bleach they would be willing to drink.

Our experience here is that many students make a really valuable contribution and are interesting and fun to supervise. I think a lot of social workers know this, but their managers don’t want them to know that there are worthwhile things to do that don’t involve filling in stupid forms, and they certainly don’t want people around who might propagate this naïve view that social work is not really about filling in stupid forms..

I have an answer to this problem, that I offer to the world. The daily fee for supervising a student is, I don’t know but not far off £30.00, but it’s lost in the maw of the department. I would give each supervisor £20.00 of this and their immediate manager £10.00. For a 100 day placement, supervisors would get £2000.00 and the manager £1000.00. Then you’d get statutory placements.

It’s the proper private sector approach to the problem, and we’ve all got to learn from business. Haven’t we?