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Listen
CHAPTER 4 Impact on people who use services and other stakeholders
In this chapter we look at the three areas of evaluation:
- Impact on people who use services
- Impact on staff
- Impact on community
We define impact as the direct experience of the people who use or deliver social work services or who benefit from them.
Impact on people who use services
Performance in this area was adequate - with strengths just outweighing weaknesses.
People in Glasgow who used social work services, were generally positive about their experiences. They spoke highly about most social work staff and said they felt treated with dignity and respect. A number told us that they found it easy to get information about services and thought that there was a good range of services available to them.
Some people expressed reservations, highlighting difficulties in getting hold of information about services and problems in contacting allocated workers. Carers were more consistently critical, expressing frustration with the length of time it took to get a service, with the availability of information and with the level of choice available. The services needed to carry out more assessments of carers' needs.
Many of the premises that people who used services had to use were in extremely poor condition.
Experiences of adults, carers, children and families who use services
Finding out about services
Seven out of ten of those who responded to our survey of people who used services agreed that it was easy to obtain information about the range of social work services that might help them. Around one in five disagreed and some of those we met in our focus groups also raised concerns. For example, some people with physical disabilities told us that they had had inconsistent information about their entitlement to direct payments and some people who had a hearing impairment commented about difficulties in obtaining equipment and a lack of clarity about who paid for and maintained it.
Less than half of carers who responded to our survey agreed that it was easy to get information and a number of those we met during fieldwork described some of the difficulties they had experienced. One group of parents/carers of children with disabilities commented on how little information they had had about the kind of service options they would have been eligible for.
Contact
Most people who used services and the majority of carers reported that they received a good response from social work services during office hours. However, less than half of those who responded to our survey agreed that they had a good response outside office hours. During our fieldwork, some parents and carers told us of occasions when they had had a two to three hour wait for a response from the standby service (Glasgow' emergency service) at which time most were told to phone the police. We discuss the operation of the stand-by service in chapter 5.
Most of the respondents to our service user survey nevertheless agreed that help from social work had been available when they needed it and most agreed that they could rely on social work services.
Some service users we met or who included comments in the survey were more cautious. They reported that they were not always able to get in touch with allocated workers, that workers often did not respond to messages in good time and that they had to wait lengthy periods for services.
Parents and carers of children with disabilities expressed the most frustration about long waiting periods. A number commented in the carer survey about having to wait upwards of 12 months before much-needed supports were put in place.
Quality and choice
Most of the respondents to our service user survey agreed that there was a good range of social work services available to them, with few disagreeing. The majority agreed that they had been given choices about the type of services they received.
Carers again expressed more reservations. Less than half of respondents agreed that the person they cared for had been given choices about the service they received.
Most respondents to the service user survey agreed that the services they received were of good quality and almost all commented that they were treated with dignity and respect. For example a group of people with visual impairments who used social work services described them as 'brilliant'. Some young people we met who had left care also echoed these views commenting about social workers who had 'gone the extra mile' to support them.
Our observations of practice support these viewpoints. We saw many examples of dedicated staff working hard for people, often in difficult and tense circumstances.
Direct payments
Direct payments offer one way for people to exercise choice about the services they use. Although the percentage of Glasgow's population who received direct payments was less than the Scottish average (in 2006 2.1 per 10,000 against a national average of 3.6 per 10,000) 6 the number of payments had been increasing year on year.
The services had commissioned the Centre for Inclusive Living ( CIL) to provide support for people who get direct payments. Staff at the CIL said that the social work services had been slow to promote direct payments but they were of the view that things had improved.
Carers
Later in this chapter we describe the services' initiative of establishing carers' centres across the city. This was a positive step that was warmly received by many carers that we spoke to. Notwithstanding these encouraging moves we think that there is more that the services could do to support carers.
Carers have a statutory entitlement to an assessment in their own right. The services reported that they carried out just 87 separate assessments of carers' needs in 2005/06 although they said that they routinely considered carers' needs as part of overall assessments. Our file reading, however, showed that less than half applicable files contained an up-to-date assessment of the family carer's needs while one in three of those who responded to our survey did not think that they had had their needs assessed as a carer. It is not enough for the services to assume that assessments of the cared-for person will include a recognition of the carer's needs.
Recommendation 3
The services should increase the number of separate carers' assessments they do. They should ensure all carers are offered an assessment.
Using services
The majority of service users who responded to our survey reported that their social workers had responded quickly to important changes in their lives. The majority also agreed that there was a meeting at least once a year to discuss the services they received. The case file analysis reinforced this picture with evidence of annual decision-making meetings apparent in the majority of files. Some service users we met however, including those with physical disabilities, those with sensory impairment and those with visual impairment, did not know how often their care plans were reviewed or should be reviewed.
Less than half of the carers who responded to our survey had seen a written assessment of the person they cared for and less than half agreed that there was a clear plan that described the services the person they cared for would receive.
Service settings
During our fieldwork, we were particularly struck by the poor condition of many of the premises service users and carers had to use, for example some day care facilities and social work offices. Some settings were highly inappropriate. For example homeless people using social work or homelessness services at the Hamish Allan Centre had to use high security interview facilities that many of them said they found demeaning and frightening. The council runs the risk of giving the impression that it does not value the people who use some of its services.
Recommendation 4
Glasgow City Council should consider how it can improve the poor condition of many of the premises people who use social work services have to use.
Impact on staff
We rated the performance of the service in this area to be weak - having important weaknesses.
We found that staff morale was low. This may have been due in part to the recent pay and benefits review, and to the move into CHCPs. However, we believed that the problem was more long-standing. Although most staff told us that they enjoyed their work and felt that they provided a good service to the public, few of them had confidence in senior management or believed that elected members valued social work.
Senior managers had taken steps to improve communication with staff but these had not had as much impact as they had hoped.
Motivation and satisfaction
Of those staff who replied to our survey, most said that they enjoyed their job. Similarly high numbers of staff felt that they helped people who used services in significant ways, such as leading as independent a life as possible and leading less isolated lives.
However, the results of our staff survey, results from the services' own surveys of their employees in 2003 and 2005 and findings from our fieldwork interviews suggested cause for concern.
Less than half of staff overall (and only a quarter of criminal justice staff) who responded to our survey felt that morale in their team had been good for at least the last six months. Comments in our survey and in our focus groups from staff and managers alike included, "morale is very low", "at an all-time low", "very poor". Some commented that they felt "undervalued". Fewer than one in five agreed that elected members valued social work. Many staff we spoke to at the staff panel commented that they did not feel that managers appreciated their anxiety over issues such as the constant barrage of work flowing into and through area teams. Other staff we spoke to highlighted obstacles that made it more difficult for them to do their day-to-day job such as getting hold of a car seat when they needed to transport a young child or a mobile phone when they were going into a potentially risky situation.
The majority of respondents to our survey felt that senior managers did not communicate well with staff. Common complaints included, "staff are not listened to" and "communication from senior managers is often poor". Some groups of staff such as those in the standby service, said they just felt "out of the loop".
Glasgow City council had just completed a pay and benefits review at the time of our inspection (fulfilling their legal responsibility to do so). Social work had by far the largest group of staff in detriment and this had unquestionably had an impact on staff morale. Discontent among staff had resulted in the threat of strike action during our fieldwork. At the same time the move to CHCPs, which was still bedding in at different rates in each CHCP, was causing some uncertainty.
Though discontent might have been heightened by recent changes, previous surveys nevertheless indicated that there had been a high degree of dissatisfaction for some time. The services' own 2005 survey of staff carried out by MORI found that only 40% were satisfied with morale in their team/unit/project. This survey also identified that morale dropped significantly after the first six months in the service. Sixty percent of respondents said that they were not well informed about was happening in the service and only 19% agreed that communication was good from top to bottom and from bottom to top. Only 15% agreed that senior managers were "interested in listening to staff opinions". Half agreed that "speaking up on issues where you disagree with management can damage your career prospects". Only 5% agreed that they felt valued by elected members.
Senior managers had taken steps to try to improve communication and staff morale. This had included commissioning the two MORI polls and developing an internal communication strategy in response to their findings.
Elements of the strategy included:
- establishing a staff panel;
- bi-annual annual staff conferences and workshops;
- introducing the "Have Your Say" initiative (that offered direct E-mail contact with the director);
- staff newsletters;
- regular director's briefings to all staff; and
- plans to incorporate questions specifically about social work in an imminent corporate staff survey.
These were promising initiatives that had led to some small but steady improvements. For example the 2005 MORI poll noted that around half the respondents said they were satisfied in their jobs (representing a five percentage point increase from the 2003 poll). Around a third of respondents also said that they felt more informed (around a 10 percentage point increase from the previous poll). However the 2005 poll also noted that there were areas where staff 'remained noticeably less satisfied'. These included lack of recognition from the council or elected members and lack of confidence in senior management.
MORI's poll had highlighted that changes take time to impact. Nevertheless we were aware of managers' frustration that over the previous four years their initiatives had not had as much impact as they had hoped they would. The staff panel had signalled to managers that staff had mixed experiences of the communication strategy and highlighted the panel's own doubts about the extent to which managers listened to and acted on the feedback it offered.
With the move to CHCPs each area was developing a local communications strategy (that would clearly need to link to wider departmental and corporate communication strategies). This is therefore an opportune time for senior managers and elected members to take a fresh look at this issue and review how they might regain the confidence of staff and improve morale.
As a first step managers and elected members should explore more fully with staff the reasons for their apparent lack of confidence in them and in some of the potentially fruitful initiatives they have already put in place. This will allow them to reinvigorate those initiatives that have the most potential.
They could then consider other steps they might take such as putting in place a departmental scheme to reward individual members of staff not just for long service but for good practice; undertaking a back-to-the-floor exercise to increase their visibility and help them better understand the day-to-day work of front line staff; rotational attendance by front-line staff at committee meetings or 'shadowing' of elected members to help staff understand how their work fits into the wider vision for Glasgow's services. Senior managers should also consider ways in which they might address some of the day-to-day irritations that make it more difficult for staff to do their job. They might additionally consider looking beyond the authority's boundaries to the state, independent and private sectors for other ideas about how to communicate effectively and raise morale in a large and diverse organisation.
Recommendation 5
Senior managers and elected members need to address the low morale of many of their staff. In order to improve two-way communication with staff they should review their internal communication strategy, build on what they have already introduced and consider what other steps they might take.
Ownership of vision, policy and strategy
The services' SEQ stated that "Social work services has made significant attempts to engage staff and harness an understanding of our vision, policies and strategies set out in the budget and service plan".
The services' 2005 survey found that the majority of staff were aware of the service values and believed they were applying them. The majority of staff were also aware of the service plan though less than half believed they applied it in their day-to-day work.
The findings of the SWIA survey were mixed but tended to mirror those of the MORI poll. Although less than half of respondents to our survey agreed that there was a clear vision for social work the majority agreed that the services had a clear set of local social work priorities. There were some exceptions. For example, although residential staff had received presentations from senior managers about proposed changes to children's services, those we spoke to stated that they continued to feel ill-informed about the direction of travel for those services.
Most staff agreed that they were aware of the standards their team was expected to follow and the majority agreed that their team performed well against local service targets.
Impact on the community
We consider performance in this area to be good - having important strengths with some areas for improvement.
The services had demonstrated commitment to understanding the community they served by undertaking a comprehensive research of the demographics of each CHCP. They had begun to take steps to involve the community in decision-making within these areas and had made it the primary role of their community development workers to support the development of public partnership forums. They had made efforts to harness capacity within communities to become involved in service delivery through using volunteers and citizen advocates. Most stakeholders recognised the services' commitment to improving services.
The services could have done more to make the wider public aware of some of the good services that they delivered. They needed to do more to reassure stakeholders about what impact changes would have on them.
Community perception, understanding and involvement
In preparation for the CHCPs the social work research team produced a report on the demographics of each CHCP to provide baseline data on the population. This included numbers of service users, gender, ethnicity, health indicators and deprivation areas and associations between this and social work involvement. The research team completed this piece of work at the time of transfer from area teams to CHCPs. This was a positive step that should provide the CHCPs with crucial demographic data to help shape their services. In chapter 5 we note that the services intended to use updated information about service demands to review allocation of staff across the CHCPs.
With the development of the CHCPs came the expectation that each would develop public partnership forums ( PPFs). The PPFs have three functions; to inform local people about the services available in the CHCP; engage local people in discussion about how to improve services and; to support wider public involvement in planning and decision making. Each of the CHCPs had progressed this to different stages.
Good practice example
The services had retained a community work service to facilitate community capacity and stakeholder involvement. Their primary role in CHCPs was that of developing and supporting PPFs. This was at an early stage and the impact of their involvement had yet to be seen.
Elected members acknowledged that there were still some tensions between CHCPs and community planning partnerships. Some staff and stakeholders commented that there was still some work to do to make sure that there was sufficient and appropriate representation on the various locality groups. This included a need to ensure that PPFs linked into established or emerging community planning groups.
To further the involvement in CHCPs two places on CHCP committees were set aside for representatives from the PPFs. This represented two of the eight committee places available and some stakeholders and staff expressed reservations whether this would be sufficient to properly represent community interests.
Many senior managers we spoke to felt that the services had made progress in involving communities but that they could do more. We were surprised that the services had not involved its communication team more in advance to let the community know about the move to CHCPs and what it would mean for them.
The services had not done as much as they might have done to let the community know about the positive impact of their services. For example all the carers we met spoke highly of the nine carers' centres but were not aware that the services had set these up and continued to fund them. In addition the services had played a part in maximising the income of many in the community. During 2005/06 the welfare rights service protected or increased benefits by £4.88m and the money advice service supported people to manage debts totalling nearly £8m. The services also had the largest community service scheme in Scotland that carried out a wide range of tasks of benefit to the community but did not make this known to the wider public.
Good practice example
The services had developed and funded nine locality based carers' centres to support unpaid carers in their caring role in the community. Seven of the centres were now run by voluntary organisations. The centres had a budget to purchase short breaks or home based respite both at times of crisis and on a planned basis. They provided an employment pathway for former carers to make use of their skills. The centres also had a developmental role and had been involved in public information strategy. Carers we met commented about the positive impact of these services.
Impact on other stakeholders
Most of the organisations who responded to our stakeholder survey recognised the services' commitment to improving services. Comments included - 'services are committed to inclusion and addressing poverty'; 'there is continuous striving for quality'; and 'there is a long-standing commitment to social justice'.
Many stakeholders compared the services' high aspirations with a more limited capacity to deliver, commenting about the 'scale and lack of resources' and the 'lack of resources to deliver'.
Among voluntary and independent providers those providing children's services were the most positive about relationships with the services, some of which went back a number of years. Providers had some reservations. They expressed frustration and anxiety about what they saw as constant re-organisation over which they had little influence. They were also uncertain about how the CHCPs structure might effect partnership working arrangements, especially for those providers operating on a city-wide basis.
In chapter 6 we describe some of the constructive ways the services involved service users and carers in decision-making and planning.
Community capacity
There was huge potential within Glasgow to capitalise on community capacity, that should be enhanced through the transfer to CHCP status and the development of PPFs. It is important that there is a clear strategy to achieve this across the five CHCPs.
We are aware that there are difficulties in recruiting foster carers in many parts of Scotland. However the services had made good strides in addressing this by undertaking a successful recruitment drive in 2006 that resulted in the approval of additional foster carers and adoptive parents. A best value report of adoption and fostering services in January 2005 involved extensive consultation with relevant stakeholders. One result of this review had been an increase in allowances to assist recruitment.
Some resources, such as lunch clubs, were using volunteers from local communities to help deliver services. The services were contributing to the development of a corporate strategic volunteer framework.
Advocacy providers told us they use citizen advocates who had supported over 1000 people a year, predominantly those from black ethnic minority and learning disability groups.
The services also used sessional workers to provide befriending services for children at risk of being accommodated and for other service users.
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