- Social work practices pilots were announced in 2010 to give social workers more autonomy and flexibility in managing cases, with the aim of improving services. - The evaluation studied 8 pilots set up with different arrangements. It found some benefits for staff but the impacts on costs and bureaucracy were less clear due to complex systems and short timescales. - Key challenges included acquiring new skills like HR, developing new IT systems, short-term funding, and balancing innovation with existing structures. The quality of commissioning and ongoing local authority support were also important factors in the pilots' success.

1. SOCIAL WORK PRACTICES PILOTS
WITH ADULTS:
COMMISSIONING & DEMOCRATIC FACETS
Jo Moriarty, Jess Harris, Jill Manthorpe, Shereen Hussein, Michelle Cornes

2. BACKGROUND
Already outlined by Nicky
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3. PILOTS ANNOUNCED IN NOVEMBER 2010
The practices, which would carry out councils' statutory functions
in relation to adults, are designed to reduce bureaucracy for social
workers, give them more day-to-day control over cases, improve
staff satisfaction and make more flexible use of resources. Putting
decision-making and power in the hands of social workers will
mean better, more personal care for individuals. Social workers –
the people who really know their clients – will have flexibility to
create services around their clients. These pilots will explore how
the government can encourage social workers to develop fully
independent groups contracted to local authorities
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4. CONTEXT
•Wider policy aim to expand
public service mutuals
•Adult social care already
heavily outsourced
• Generally agreed that
competition has helped
control prices but less
successful at driving up quality
• Includes numbers of people
financing their own care
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5. THE PILOTS
NE
Lincolnshire
Suffolk Birmingham Surrey
Stoke Shropshire Lambeth
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6. AS OF MAY 2014
• Complicated Care Trust origin. Moved from NHS/LA Care Trust into focus CIC. Staff
already TUPE’d (Transfer of Undertakings NE Lincolnshire (Protection of Employment Regulations)
• Sensing change owned by council, plans to be independent by April 2014. Staff
Suffolk TUPE’d
• Activ8 taken back in house. Staff TUPE’d Birmingham
• First point community interest company. Staff TUPE’d Surrey
• JMC healthcare community interest company back in house. Mix of staff – some
Stoke owners/managers, some TUPE’d)
• People2people social enterprise has been given funding to 2015. Staff TUPE’d Shropshire
• Topaz community interest company funded until 2015. Agency social workers move to
Lambeth self-employment
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7. VERY IMPORTANT
•Information on sites was public knowledge
•Some accounts identify particular pilots
•BUT
•All information presented here is not
identifiable to a particular pilot, person, or
organisation
•Abbreviation SWPwA refers to Social Work
with Practices for Adults
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8. METHODS
A quick overview
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9. DESIGN & METHODS (1)
•Case-control follow up design
•Outcome and process evaluation
•Mixture of qualitative and quantitative survey data collected
between September 2011 and December 2013
• Staff, managers, NHS, voluntary sector, users and carers (details at
end of presentation)
•Compared experiences at start (T1) and 18 months later (T2)
• 50 interviews T1
• 79 interviews T1
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10. DESIGN & METHODS (2)
•Survey sent to practitioners in:
• Social work practices with adults (SWPwAs)
• Other staff in local authority
• Staff in three comparison sites not involved in SWPwAs
• 2978 replies in total (details at end of presentation)
•Response rate 42% at T1 and 39% at T2
•Resulted in standardized information on burnout (Maslach
Inventory) and job demand-control (Karasek’s Job Content
Questionnaire), time allocation, views on SWPwA and other
information
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11. FINDINGS
Focus on a selection of findings related to the discussion today
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12. DIFFERENCES
•Different arrangements
•Outsourced from within local council or contracted with existing
voluntary organisation or transfer of Care Trust work
•Different structures
• Community interest company – comparatively recent development
and some differences to being a registered charity
•Wide differences in scope and activities undertaken
between different pilots
• ‘Messy’ in research terms but reflects reality
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13. MAINSTREAMING START UPS
•Received some start up
funding and access to
advice paid for by
Department of Health
• For example, access to SCIE
& other consultants
• Challenge when developing
something outside structure
of ‘new’ pilots or pioneers
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14. FUNDING
 Important to consider
what support will be
provided and how much
 ‘Christmas Eve’ shopping
analogy
 Funding timescales are
always very short term
There was approximately £10,000 taken
for IT support. There is something like
£15,000 taken for database support.
There was a lump sum taken for
accountancy support from the council. I
don’t know exactly what that all adds up
to. But, thankfully, we’ve been left with
an adequate amount of money. I think
we’ve actually needed the time to use it
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15. ADVICE FROM THE OTHER SIDE OF THE
FENCE
 Organisations bidding for
contracts may be
tempted to under cut
unavoidable costs
 Contract departments
need to set ‘fair’ rate
 Risks of organisation failing
 Need to control costs
But maybe, we went too far the other
way to prove that we weren’t being
given any special resources ... We
were all buying our own kitchen
equipment and changing the toilet
seats and all the rest of it and
cleaning … We did everything. It was,
in some ways, it was too much.
.
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16. INFORMATION TECHNOLOGY AND
RECORDING SYSTEMS
 Challenges of linking with
local council IT systems
 Access to individual records
and how to record
information
 Wider issues of how to gain
benefits from new
technology
 Very difficult to measure
community development
Trying to be creative, we thought
okay, we are going to ask if we can
have Skype or similar for reviews …
We were told we couldn’t have Skype
because of the risks … It’s taken us
ages really to get an [alternative]
system … We still haven’t been able
to set it up properly
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17. ACQUIRING NEW SKILLS
 Culture change in moving
from a large organisation
to a smaller one
 Opportunities to learn
through University of
Bristol and SCIE meetings
 Most learning from each
other and from the LA
commissioners
What we’ve really had to do and learn how
to do … was about the HR side. Stuff that as
a worker in the council, you don’t ever have
to consider … HR say, ‘Right, these are the
forms you’ve got to fill in when you are
shortlisting people for jobs and you have to
read through them and you mark them and
this and that and the other and hand them
back. We’ve had to develop our own HR
system. So that’s been a real learning curve
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18. THE LOCAL/NATIONAL DIVIDE
•Considerable sums spent
on legal advice
• Participants thought this
could be better provided if
they had had access to
national resource
• Contracting out needs
resources
• For instance VAT, human resources
(HR), responding to complaints,
avoiding legal challenge
• Few SWPwAs controlled any money
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19. MAKING THE COGS RUN SMOOTHLY
Identifying training
needs
Budgets,
financial
advice and
accounting
Information
systems and
equipment
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20. LEADERSHIP
 Enthusiasm and
commitment of individuals
was a key theme
 Within the SWPwAs
themselves
 Among those whose role in
council was to help the
SWPwAs work
 How to channel this more
widely?
I am passionate about social work and
social care and doing the best for our
communities and I think it’s better
served outside of local authority
control than inside of it. And we save
money by doing so, which has got to be
a good thing for the community as well
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21. ASPIRATIONS AND REALITY
Intended outcomes
• Assessments would be quicker
and less bureaucratic
• Savings would be made when
compared with standard LA
•Would improve service quality
• Could build up better
relationships with service users
& carers
Reality more nuanced
• Most budgets not devolved so
impact more muted
• Complex systems made it hard
to identify costs
• Clearer for specialist SWPwAs
• Over time, social workers felt
they were not spending enough
time with clients
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22. STAFF COMPARISONS
•Many of the SWPwA staff viewed working in a new
organisation positively
• They had made a positive choice to move
•SWPwA staff had lower levels of burnout (but started out
this way)
•SWPwA staff had greater levels of autonomy (but started
out this way)
•Work satisfaction high but also experienced uncertainty
about pilots’ futures
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23. ROLE OF COMMISSIONING
‘One key finding
of this study is
that the quality of
commissioning is
important to an
enterprise such as
a SWPwA’ (p 135)
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24. TIMESCALES AND PRESSURES
•Local and national
election cycles
•Funding cuts
•Most participants thought
timescale for evaluation
was not long enough
•Would a longer timetable
have made a difference to
outcomes?
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25. READ ALL ABOUT IT…
•Final report
• 275 pages long
• 6 page summary too!
•Updates on:
http://www.kcl.ac.uk/sspp
/policy-institute/
scwru/res/roles/s
wpa.aspx
•Follow @scwru on twitter
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26. DISCUSSION
Some aspects for us to discuss
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27. RECOGNISING COMPLEXITY &
ENCOURAGING DEBATE
‘All evaluators now
understand that what
works in Wigan on a wet
Wednesday will not
necessarily work in Thurso
on a thunderous Thursday’
(p xvi)
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28. SOME SIMILAR THEMES
•SCWRU study of social care
practice with carers
•Challenges of complying or
going under
• Risks to traditional roles in
campaigning or advocacy
• Balance between ‘innovative’
and established organisations
• Value of local authority
support
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29. TAKING LESSONS FORWARD
• Outcomes depend on the measures of service quality that will be used
• Continuity of support? Specialist services and so on
• How can local democracy relate to outsourced services (for example,
large regional voluntary sector or private sector)?
• One SWPwA already doing work in another LA outside region; another wanting
regional work
• What does/should remain in house?
• None of the pilots took on responsibility for hard financial choices. Only one did
safeguarding
• Hard to answer some of the policy ‘holy grail’ questions, such as
reducing costs/bureaucracy or improving integration
• Could SWPwAs be a challenge to integration?
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30. AND FINALLY…
Before we move onto the discussion
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31. THANK YOU …
• Practitioner, manager, consultant,
voluntary sector group representative,
service user and carer participants, staff
at Social Care Institute for Excellence
(SCIE) , colleagues from University of
Bristol, members of Project Support
Group, and other stakeholders
• Thanks, too, to the local authorities that
volunteered to act as comparison sites for
our surveys, to Rose Marie Bennett who
assisted with interviews and to members
of the Social Care Workforce Research
Unit’s User and Carer Advisory Group
• To you for listening
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32. ACKNOWLEDGEMENT AND DISCLAIMER
•This research was funded by the Department of Health’s
Policy Research Programme. The views expressed in this
report are those of the authors and not those of the
Department of Health
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33. SOURCES
Slide number Source
1 Image from SCIE Social Work Practices website:
http://www.scie.org.uk/workforce/socialworkpractice/
3 Speech extract from Community Care, image ITV news
4 MutualsTaskforce report:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/617
76/Public-Service-Mutuals-next-steps.pdf
6 Update on pilots from Community Care with information on staff added:
http://www.communitycare.co.uk/2014/05/28/next-steps-adult-social-work-practice-
pilots/
13 SCIE Social Work Practices website:
http://www.scie.org.uk/workforce/socialworkpractice/
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34. SOURCES (2)
Slide number Source
18 Photograph of Gray’s Inn
23 LGIU report on commissioning: http://www.lgiu.org.uk/outcomes-matter-effective-commissioning-
in-domiciliary-care/
25 Final SwPA report available at: http://w4
ww.kcl.ac.uk/sspp/policy-institute/scwru/pubs/2014/reports/Social-Work-Practices-w-
Adults-FINAL-EVALUATION-REPORT-2014.pdf
28 Fragmentation and competition:
http://www.ingentaconnect.com/content/tpp/vsr/2014/00000005/00000002/art000
07
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35. INTERVIEW PARTICIPANTS
Stakeholder interviews # at T1 # at T2 Total
Pilot lead/manager 9 8 17
Social worker, pilot 10 11 21
Host commissioner/lead 11 7 18
NHS 5 5 10
Voluntary sector 11 9 20
Consultant to LA 4 1 5
Service user & carers n/a 38 38
Total 50 79 129
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36. SURVEY RESPONSES
Staff survey # at T1 # at T2 Total
Host 988 771 1759
Comparison 548 399 947
Pilot 109 163 272
Total 1645 1333 2978
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