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CHAPTER FIVE: THE ORGANISATION OF RISK: CONFLICT OR COOPERATION?

INTRODUCTION

The Changing Lives review argues for a new governance of social work which includes clear accountability frameworks, the protection of professional autonomy, learning from mistakes and strong leadership. The extent to which these aspirations can be met within a climate of risk, responsibilisation ⁴ and regulation poses challenges for the social work profession, and it is hoped that this literature review goes some way towards better understanding and addressing those challenges. This penultimate chapter therefore focuses on issues relating not to front-line practice with service users/clients but to the 'behind-the-scenes' organisational issues for agencies and workers who assess and manage risk. To reflect the concerns of the Changing Lives review, the chapter explores differing cultures of organisations (including accountability frameworks, learning from mistakes and supervision/training), the use of risk assessment tools, inter-agency and user collaboration and the 'politics of risk'. As much as possible, the chapter draws distinctions between the three themes covered in this review and assesses the extent to which the language of risk in social work is premised on the basis of conflict or cooperation.

ORGANISATIONAL CULTURE

Organisational culture means the values, norms and beliefs that exist within an organisation, depending on its structure and managerial and operational systems. Because uniformity of structures and systems across agencies is both unrealistic and unworkable, most current theories of organisational culture seek a systems approach: 'the match of people to systems, of task to environment and of the interrelationship between people, systems, task and environment' (Bell, 1999: 17). Bell points out that in child protection work in particular, cultural tensions may well arise between, for example, the police (which may exhibit a masculine, tough, status-oriented and monopolising culture) and social work (which may exhibit a feminine, caring, deferential and power-sharing culture).

Management hierarchies

In a study of agencies involved with vulnerable children or adults with learning disabilities, Alaszewski and Manthorpe (1998) argue that agencies should be the bridge between practice and policy but given their differing interpretations of risk and assessment, this does not always happen. These authors assess the contributions of various theorists of organisational structure, namely, Weber (1947), Goffman (1961), King et al. (1971) and Hood et al. (1992). Weber identified two types of cooperation - one based on rationality and bureaucracy - explicit and legally defined goals, and the other on charisma - faith in a respected leader. Bureaucracies focus on predictability and the negative effects of risk taking; they are also expert-oriented, punishing and non-participative. Goffman's (1961) organisational framework is similar to Weber's - focusing on hierarchy, inflexible rules and procedures, elitism and risk management by strict internal government and by insulation from the external environment. King et al. (1971) adapt Goffman's model, which they define as 'staff-centred' and compare it with a 'child-centred' approach within a child-care setting. Staff-centred residential units, for example, are inflexible, hierarchical and procedural, whereas child-centred units are decentralised, autonomous, and more tolerant of risk taking. Hood et al (1992) identify various dimensions of organisations, of which Alaszewski and Manthorpe (1998) adapt three to the workings of welfare agencies:

• participation versus non-participation in decision making (open or closed to technical or moral advice or values): Hood et al. (1992) note, however, that often experts are not trusted and there is little consensus between them (the BSE crisis and the MMR vaccine issue were recent cases in point);
• allocation of blame versus absolution (blame encourages 'safety' whereas a no-fault approach encourages learning): systems can either encourage learning or openly allocate blame/responsibility, but the latter may result in 'cover-up' by frontline staff and resultant whistle-blowing. Confidential, independent systems can be made available for disclosure of concerns in order to learn from mistakes and change practice accordingly;
• anticipation versus response (proactive prediction of risk or reactive minimisation of resulting harm): the former can result in a false sense of security and measures not being in place to respond to failures to predict; child protection systems tend to operate on the latter basis: rapid response once it has either been identified as likely to occur or has actually occurred.

Given the tacit acceptance that risk cannot be wholly removed, agencies may take steps to transfer blame through a focus on procedures and regulation rather than intervention per se. Munro cites Hood et al. (2000) who depict a 'blame prevention re-engineering' culture, especially in the UK:

"… the organisation introduces more and more formal procedures to guide practice so that they create a 'correct' way to deal with a case. Then, if a tragedy occurs, they can claim the defence of 'due diligence' and show that their employees followed these correct procedures in working on the case. A child may have died but the agency staff can show a clear audit trail of what they did… In a defensive culture, the protection of the agency can start to dominate over the protection of children." (Munro, 2004: 880).

Munro (2004) argues that organisational culture needs to encourage workers to see risk assessment more as a tool which complements professional judgement and encourages constant and critical review, rather than an end in itself. She also argues that social workers need to shift from seeing assessment as revealing 'truth' to assessment as ongoing hypothesis building. Reflective practice is important as is a culture of supervision of workers' practice issues rather than supervision of administrative processes.

Accountability frameworks

Accountability, like risk, is a nebulous concept which defies definition. One dictionary identifies 26 separate definitions of the word, although 'to account' is generally meant to mean 'to enumerate' or 'to be responsible for'. The Queensland Government in Australia (Office of the Public Service Commission, 2004) went further to suggest that accountability meant:

how - and how well - one's responsibilities are being met on actions taken to correct problems and to ensure they do not reoccur. It involves accepting personal consequences… for problems that could have been avoided had the individual acted appropriately (ibid: 4-5).

This definition cannot readily apply to risk assessment or management in social work, not least because it focuses on correcting problems and ensuring a non-recurrence following appropriate action. These terms are not conducive to understanding human behaviour but perhaps are more appropriate to solving administrative or mechanical problems. The Scottish Executive (undated), in its accountability framework for antisocial behaviour, which arguably epitomises one form of problematic human behaviour, has four broad framework objectives:

• to reduce antisocial behaviour;
• to reduce public perceptions of antisocial behaviour;
• to improve the performance of relevant agencies; and
• to improve public perceptions of such agency performance.

However, again the focus tends to be on the 'how' rather than the 'why' of intervention, reducing behaviour to discrete mathematical formulae. Burgess et al. (2002: 1) were commissioned to examine accountability frameworks for the Treasury. They suggest that accountability means being clear 'who is responsible, what they are responsible for and what powers and freedom they actually have to deliver'. This definition offers a more helpful guide on what constitutes an appropriate accountability framework in social work - even though the authors are dealing with treasury matters. They identify several factors for clarification and development in accountability:

• outcomes;
• roles and responsibilities;
• performance expectations;
• review of performance;
• intervention if performance slips;
• incentives for improved performance;
• flexibility of objectives/priorities;
• recognising and learning from achievements/difficulties;
• communication of performance across the whole organisation.

This literature review seems to concur with the accountability indicators of Burgess et al. which could usefully be used in any future assessment of organisational culture in relation to risk assessment and management in social work. However, it is important, first, to assess the stage the organisation is at in terms of its management style and need for accountability. Houston and Griffiths (2000), for example, suggest that an organisation's approach to risk assessment and accountability will depend on its history and current phase of transition. These authors cite Handy's (1985) model of organisations which develop in three sequential phases:

• the pioneer phase, the early period in an organisation where it is paternalistic, expert and has few procedures;
• the scientific phase, when organisations become preoccupied with systems, bureaucracy and procedures following increased customer demand;
• the integrated phase, which is most effective in meeting customer needs, moving away from bureaucracy to adaptability and customer-driven innovation based on participation and democracy. The lack of 'red tape' allows risk taking, fairness and flexibility.

It would seem that the organisations involved in the three themes of social work described in Chapters 2 - 4 are at differing phases of transition according to the above model, although probably mostly are placed within or between phases 2 (scientific phase) and 3 (integrated phase). Certainly the literature reviewed in this report would suggest that there is a government-led preoccupation with scientific systems and procedures in all three themes (although the extent to which the practitioners in each theme have taken these systems and procedures on board is variable). The word 'customer' noted in phase 2 also perhaps relates more to the media, policy makers and the general public than to service users per se; whereas in phase 3, 'customer' relates more to service users (ideally to include those also involved in the criminal justice system).

Learning from mistakes

SCIE (2005) uses the analogy of 'near misses' from the aviation industry to emphasise the need for inter-agency collaboration and information sharing so as to learn from past mistakes. The authors define 'near misses' as incidents where something could have gone wrong but was prevented, or something did go wrong but no serious harm was caused. They suggest that current organisational culture in social work has resulted in the needs of at-risk groups being overlooked until the risk of harm is imminent. They argue strongly for greater involvement of service users and carers in the identification and management of risk and in a more frank and open discussion about past mistakes and future opportunities for learning. The SCIE report also develops the concept of 'safeguarding incident', where harm or potential harm is identified as a result of an agency's (rather than a carer's) failure to keep a child safe. Whilst identifying such incidents may engender a learning culture, the authors grapple with the need to 'grade' such incidents, which may well, in theory at least, result in further administrative work for practitioners which in turn might detract from the actual work with a family and create yet more of a 'tick-box mentality' amongst frontline staff. However, the SCIE report concludes that the current culture of blame does not encourage reporting or recording of incidents or mistakes, let alone learning from them, even though practitioners welcome the possibility:

"[T]he majority of people who took part in this study were individually supportive of the idea of learning from mistakes before harm is caused, but felt strongly that, due to organisational constraints, their hands remained quite firmly tied." ( SCIE, 2005: 46).

Alaszewski and Manthorpe (1998) found that child care agencies were most defensive and reactive, whereas learning disability agencies were most open to learning and advice, partnership-oriented and keen to anticipate risk. Their research examined how organisations responded to risk rather than examining why different strategies were adopted across different agencies. They expressed concerns that little research had been undertaken on the role of agencies in risk assessment, given how crucial the structure and culture of an agency is to its shaping of professional practice. Certainly in one study by Francis et al. in Scotland, social workers found certain professionals, notably hospital-based doctors and GPs, to be more bounded by professional confidentiality clauses than by inter-agency cooperation clauses. Although the ground was shifting more towards inter-agency information sharing more recently in child protection cases (without necessarily a concurrent drop in confidentiality levels), Francis et al. (2006) noted differing professional concerns about their responsibilities towards the family and in determining the balance of rights of parents versus children in potential child abuse cases.

Supervision and training

Supervision is one of the key avenues for practitioners to have the time and capacity to reflect on their practice and to identify, discuss and learn from mistakes. However, the culture of the organisation needs to allow for such dialogue with confidence and trust on the part of both the supervisee and supervisor. Stanley's (2005) study of social workers in New Zealand found a positive response to the value of supervision for assessing and managing risk in child protection, but on the assumption that the organisational culture will be welcoming of sharing and learning in supervision, rather than being fearful of reprisals for admissions of failure.

Closely allied to organisational culture and learning cultures is the issue of training in risk assessment and management which should ideally be compatible, if not consistent, across those agencies working collaboratively on risk. Training is an issue both inter- and intra-agency, with differing agencies having differing views about priorities and values. Francis et al. (2006) found wide variations on the impact of the level and consistency of training on different authorities' practices. Equally, inter-agency training is limited, not least in respect of a standardised understanding of risk and the threshold of risk adopted across all agencies. The culture of an organisation will obviously impact on such an understanding of risk and related thresholds. The fact that there is no centralised system for promoting or funding training across the themes of social work may well create additional barriers to inter-agency training. Equally, training is also an essential prerequisite of understanding risk assessment tools and yet McIvor and Kemshall (2002a) suggest that the cost of training staff across agencies on standardised risk assessment tools could be high. Francis et al., (2006) also stress the importance of joint training in raising awareness of the need for inter-agency cooperation and information sharing, but her sample of social workers commented that training had decreased across Scotland in relation to child protection following a surge of activity at the time of the implementation of the Children (Scotland) Act 1995.

Stanley (2005) talks of the 'practice wisdom' inherent in the informal and tacit knowledge gained by social workers over time and he argues that this should be utilised more in developing training materials. Training should focus more on effective practice skills and less on risk identification and assessment. Stanley (2005) also argues for better training opportunities for social work around risk and child protection to boost its standing in the professional hierarchy, which may likewise enhance inter-agency collaboration and consensual decision making. O'Sullivan (2003) found that irrespective of length of service, social workers in one agency who had received the same training were more likely to be consistent in risk assessment decision making. However, in a climate of budgetary restrictions, training is often the first budget to be cut (Titterton, 2005). Yet training not only has practical implications for the work with clients, but also managerial and legal implications for ensuring 'defensible decision making', an approach increasingly cited as the basis for all risk assessment and risk management work (McIvor and Kemshall, 2002a; Scottish Executive, 2006b; SWSI, undated).

The use of risk assessment tools

The use and dependency on risk assessment tools are closely aligned with organisational culture. Risk assessment tools have often been criticised for being too narrow in focus, in terms of user group or specific risk factors, in particular relating to criminal justice (certain tools cannot account for youth offending, female offending or drug-related offending, for example) and community care (certain tools cannot account for different types of mental illness). Although in criminal justice this has not lessened the use of actuarial risk assessment tools, in community care and child protection there is a tendency to resort to clinical professional judgement as a means of counteracting the limitations of certain actuarial instruments.

Much of the work of community care and child protection is crisis-driven - reactive rather than proactive - and short timescales in such emergency situations do not allow for assessments which take hours, days or even weeks to complete. All risk assessments take time and especially in the child protection field, time is of the essence. Indeed, Francis et al. (2006) found that children and families social workers in Scotland were concerned about the time needed to collate all necessary information in the assessment process, given the possible urgency of the potential risk to the child. Some assessment frameworks have been developed which should ideally be undertaken over a period of weeks, rather than in a crisis situation but in child protection cases in particular, this is not always possible. Booth et al. (2006) also note that a tight timescale works against the building of trust and understanding, not least with parents with learning difficulties and need further time to complete the process in a meaningful way.

Stanley (2005) argues that reliance on risk assessment tools shifts the emphasis and therefore the culpability from agency to worker. It also dissipates the assessment process and narrows the definition of risk. The 'how' has taken over from the 'why' in child protection work. He concludes that 'expert' assessments validate interventions and provide:

a welcome and "objective certainty" within a practice environment fraught with ambiguity and uncertainty… Social workers are drawn to strategies that provide certainty, definition, and legitimation for their actions (ibid: 267-8).

Certainly, this literature review would support the argument that social workers tend to seek assurances, legitimacy and certainty from risk assessment tools that arguably professional autonomy cannot give them, and yet much criticism is also levelled at the reduction in professional autonomy that results from a risk-averse and instrumentalist organisational culture.

Bessant (2004: 68) suggests that 'an overly instrumentalist cognitive approach' (which relies on technical rationality and sees the practitioners as a perfunctory problem solver) does not allow for the building and sustaining of meaningful relationships with clients or for professional judgement (other than the professional judgement required to identify, operate and quantify risk assessment instruments). From a management perspective, risk assessment tools also offer reduced and simplified workloads: they 'entail an uncomplicated process of questions, answers and a little arithmetic' (ibid: 71). Often such assessments are undertaken over the phone and are neither analytical nor reflective and can hinder rather than promote worker-client relationships.

INTER-AGENCY AND USER COLLABORATION

A further theme explored in the literature is inter-agency and user communication and collaboration in risk assessment and management and whether there is a common language of risk between the three themes both inter- and intra-agency. Different organisations have different requirements for risk assessments, and different values and philosophies on which such assessments are made, but they nevertheless have to work in collaboration with other agencies in order to fulfil the terms of their duty of care to clients and/or the public. It is also deemed essential for effective risk assessment that all agencies share and collaborate on the evidence collected and review it on an ongoing basis. However, McIvor and Kemshall (2002a) caution, on a less positive note, that inter-agency working is also deemed essential by some stakeholders to avoid any one agency being held accountable for adverse outcomes. This suggests a risk minimisation approach to risk assessment rather than a risk-taking approach, as outlined by Davis (1996) (see Chapter One, p.5). It also suggests a reactive rationale for collaboration rather than a proactive one.

Huxham and Vangen (2005) differentiate 'collaborative advantage' - where organisations come together to achieve proactive and positive change, from 'collaborative inertia' - where organisations find collaboration difficult, reactive or unproductive. They cite various reasons for wanting to achieve collaborative advantage, including:

• access to resources (pooling financial, technical or human resources);
• co-ordination and seamlessness (one-stop shops to ensure an holistic approach or combined services);
• learning' (mutual understanding and information sharing);
• the moral imperative (that certain issues - crime, poverty, etc. - cannot be tackled by one organisation alone); and
• shared risk (to specifically collaborate to reduce and share the consequences of failure to deliver).

Huxham and Vangen (2005) suggest that collaborative ventures often combine all these rationales, and certainly in the field of social work, inter-agency collaboration to assess or manage risk undoubtedly involves several of the above.

Social work is often seen as a lesser profession than, say, the legal or medical professions, partly because of the predominance of women in social work (often married and working part-time), partly because of the ethos in social work of sharing power and knowledge with clients. In one study of social workers' views of risk (Stanley, 2005), they tended not to problematise risk but accepted it as a 'matter of fact' (ibid: 276). They were also less likely - or less able - to challenge legal perspectives (e.g., lawyers or police) in case conferences. According to Stanley, community-based social workers are more likely to listen to a notification from a paediatrician than from a hospital social worker, because the former has more status as a member of a professional body. Equally, social workers will defer to the Family Court in New Zealand, which adopts a child protection rather than child welfare approach. Inter-agency collaboration also offers a 'rubber stamp' to the final agreement, although as suggested above, that final agreement may be reached more by deference to 'higher authority' than by consensus.

However, professional reports generated through the use of scientific risk assessment tools - irrespective of whether they are collaborative documents or owned only by one agency - to varying degrees 'offer legitimacy in decision-making and validation in removal decisions' (Stanley, 2005: 299). Stanley describes risk assessment as a 'black-box', which if opened, can make visible the mechanisms of risk assessment processes and outcomes. However, this can have both positive and negative repercussions: it can encourage greater inter- and intra-disciplinary dialogue and increased user understanding (Stanley, 2006, pers. comm.), but also can result in risk being seen not as socially constructed or as context specific but as a technical or scientific fact, an opaque process in which science and technical knowledge are 'knowable' and therefore rendered invisible to critical analysis.

User involvement

Although user empowerment has been an aspiration of workers in both community care and child protection ⁵, it has not been obviously successful to date in terms of risk assessment and management, not least because of the focus on vulnerability rather than empowerment of user groups. Risk assessment in community care and child protection is very much addressing issues first and foremost of vulnerability and risk minimisation rather than empowerment and risk enablement. However, practitioners are also known to adopt defensive practice, irrespective of users' wishes, in both community care and child protection. Langan and Lindow (2004), amongst others, note that service users are rarely informed of, or know about, risk assessments carried out on them, and yet such information is shared with other agencies and can label an individual for life.

Within the criminal justice system, offenders (and to a lesser extent accused persons, prior to findings of guilt) are rarely seen as 'users' in the context of partnership or empowerment because they are seen as more culpable than vulnerable, and the prevailing principles of 'punishment' do not sit comfortably with the ethos of empowerment. However, the National Probation Directorate in England and Wales is currently devising basic methods by which offenders can be more involved in the planning and implementation of criminal justice services (Wiggins, 2006, pers. comm.).

Changing Lives encourages the involvement of users in assessments of risk although again it tends to focus on users from community care and child protection rather than from criminal justice. Whilst service user involvement in risk assessment in social work is an innovative and welcome area for development arising from the review, when coupled with the need for social workers to be more accountable to their organisations for effective risk management, it nevertheless becomes another major challenge, as Changing Lives has highlighted.

THE POLITICS OF RISK

Debates about risk are inherently linked to debates about management and governance (Bessant, 2004): such debates promise a degree of certainty, an illusion of objectivity and seemingly unambiguous diagnoses. Bessant also argues that a preoccupation with risk assessment and management allows governments to regulate and control 'problematic' populations rather than to address the underlying problems facing such populations. Service users are taken outwith the contexts of their environments and assessed in a vacuum of individual deficits and problematic behaviours. Such an approach is both informed by and satisfies populist demands for action to reduce risk. Carlen (2002) talks of the 'political risk' of not being seen to do something about crime and much risk management in community care and child protection could also arguably be seen to be addressing the needs of the tabloids rather than those of the wider community.

Gray (2005) likewise argues that the 'politics of risk' approach blames deficiencies on individual shortcomings rather than external factors and allows such calculable risks to be managed by changing the attitudes and behaviour of the individual rather than having to look to improvements to the wider society. Trotter et al. (2001) suggest that in Australia, North America and the UK at least, the forensic and political agenda in child protection 'has overtaken the general social welfare of children' (p. 7), thus limiting the ability of child protection services to offer genuine support to families. Parenting deficits are also the focus of child protection risk assessment, thus blaming individual parents for being at fault for their children's predicament rather than, for example, focusing on issues such as agency policy, practice, funding or other organisational or structural constraints (Gambrill & Shlonsky, 2001).

Bifurcation

There is also increasingly a policy of 'bifurcation' in assessing and managing risk - offenders who are deemed a risk are labelled and separated from 'ordinary' offenders, with sexual and violent offenders being labelled as high risk regardless of seriousness or frequency of offence and moderate to low risk offenders being sidelined and denied services. In many cases of risk assessment, 'worthiness' determines who is protected and who is prioritised (Stalker, 2003). Bessant (2004: 62) quotes Foucault (1991) in suggesting that such 'dividing practices' are the 'core business' of the sociology of risk: those at risk are separated out from those not at risk and the latter category becomes increasingly small in comparison to the former, given the unlimited number of potential risk factors. Bifurcation is an issue that has been raised in all themes, but particularly in criminal justice and community care, and this seems more to do with resources and visibility (being seen to be doing something) than with needs per se. Thus, bifurcation could be used not only for budgetary reasons but also for political expedience.

Bifurcation is an attractive option where resources are limited, not least given the uncertainty and inaccuracy of much risk assessment work. Identifying and grading 'problem' populations also allows governments to both streamline resources and offer targeted, measurable interventions. Risk assessment is thus used as primarily a resource-rationing device to gauge priorities (Waterson, 1999). Risks can be prioritised to allocate increasingly scarce resources (Kemshall et al, 1997) and can also be used to legitimate professionals as 'experts' in the eyes of not only families but also other professionals. There is an assumption on the part of policy makers and managers that bifurcation is cost-effective: resources could be targeted to specific high risk groups who pose the greatest perceived threat to public safety (Malloch, 2002). However, the number of false positives (people who are targeted as high risk when they are actually low risk) and false negatives (people who are identified as low risk when they should be high risk) arising from such a policy may suggest that there will be increased costs incurred in the future because of inappropriate targeting. However, it is often a false economy since where there is a low threshold for action against potential risk (because of media/public concern), and therefore a net widening effect, there is bound to be a higher number of false positives which have resource implications. Equally, where the threshold is high (to allow greater risk taking as well as to more finely target limited resources), a larger number of false negatives will result in depriving those patients in need of a service and potentially placing them and the public at greater risk in the longer term.

Houston and Griffiths (2000: 1) equate risk in social work with a 'first-order construct' or totalizing scheme against which client need is rationed. These authors argue that the current objectivist approach to risk assessment (where scientific analysis of objects of study is the focus) is technocratic and prescriptive in nature. They argue that this has resulted in a surface, rather than depth, practice orientation:

"Surface interventions are linked to processing and classifying clients rather than promoting understanding of their actions… risk assessment has become formulaic and mechanical." (ibid: 5).

The language of risk is thus managerial not compassionate (Parsloe, 1998; Parton, 1999; Stalker, 2003) and agencies often find scapegoats rather than accepting corporate responsibility. Houston and Griffiths conclude that the way forward for risk assessment is a subjectivist approach based on partnership and meaningful relationships between professionals and families, a concern with the narratives and resilience of children, and an acknowledgement of their right to responsible risk taking:

"professionals need to be dethroned of their expert status and participate alongside parents, children and significant others, to try to attain a reasoned and fair decision" (ibid: 8).

CONFLICT OR COOPERATION?

Much of the literature on risk in social work highlights the dichotomy between reducing conflict and ensuring cooperation. Whilst cooperation results from a client/worker (and worker/employer) relationship that is based on mutual trust and respect, conflict both creates risk and is generated by risk-taking. In terms of the client/worker relationship, Cooper et al. (2003) identify three key principles for effective intervention:

• trust (between workers and clients and between workers and managers);
• authority (for professionals to work with confidence in their own abilities/knowledge); and
• negotiation (between and within agencies).

They argue that in English speaking countries, the preoccupation is with thresholds and short-term crisis intervention, resulting in risk aversion and a questioning of the professional role. In European countries, however, it is the relationship with the family that engenders trust and risk taking and validates the professional role. Technical manuals tend not to work because they become part of the system rather than external to it. Human relationships cannot be predicted like machines can and manuals are also static instruments which can never fully or effectively measure dynamically evolving human processes. Chaos, they argue, need not result from a lack of manuals and technical control; what is needed is a different method of achieving the same result. Cooper et al. (2003) recommend setting up 'confidential spaces' where those concerned can cooperate in resolving problems without recourse to conflictual and compulsory measures and to establish 'negotiation forums' where formal steps are taken to resolve conflicts before resorting to adversarial means. They also argue for:

"the rights of adults and children to exercise the maximum feasible autonomy over their own affairs, even in circumstances of acute interpersonal conflict and risk." (ibid: 86).

They also caution against structural change, without concurrent cultural change in professional views (both managers and workers), and argue for increased professional autonomy, accountability, reflection, community involvement, mediation rather than adversarialism and diverse access points to services and advice. Such change will encourage worker confidence, authority and therefore job satisfaction; and the public will trust professionals more if they are seen as responsible, open to negotiation and accountable to all stakeholders.

McNeill et al. (2005), in a supplement to Changing Lives, identified three approaches to work with offenders which the review's authors have implied could be relevant in promoting behavioural change and reducing problematic behaviour across the board in social work, not just in criminal justice. These were:

• accurate empathy, respect or warmth and therapeutic genuineness;
• establishing a therapeutic relationship involving mutual understanding and agreement about the nature and purpose of intervention;
• person-centred and collaborative working, taking into account the client's perspective and using the client's concepts.

These three approaches cannot be effective in a climate of conflict or mistrust but require all parties to work together towards a common goal. Just as these three approaches can apply to offenders and other service users alike, it is argued in this literature review that many of the principles and philosophies behind the specific work of each social work theme can equally apply to other themes. Concepts such as vulnerability, trust, authority, autonomy, reciprocity, empowerment and negotiation are not peculiar to one or other theme in isolation but are concepts that should be common to all individuals and working practices, regardless of needs, expectations and desired outcomes.

It is acknowledged that the organisations collaborating in the social work field in social work are currently disparate in their cultures and remits and within risk assessment and management, there are also disparate views operating about the definition and language of risk. However, it is important to encourage a common language of risk that is neither stifling of integrity nor restricting in scope. The predominant current approach for workers is defensive practice and for managers defensible decision making - risk minimisation at the expense of user and worker empowerment. This makes for conflict between agencies in risk assessment and management. However, if the common denominator for managing risk is a) the well being of users and their families; b) the concurrent safety of the public; and c) a working environment that promotes trust, efficiency and effectiveness, then the aspirations of the Changing Lives review can more easily be realised.

SUMMARY

This chapter has explored various models of organisational culture and concludes that in order to learn from mistakes, as the Changing Lives review recommends, organisations involved in risk assessment and management need to adopt a more participative, holistic and proactive approach which allows dialogue between workers, users and managers and organisational flexibility and performance incentives. Not only should working conditions be appropriate for such an approach, perhaps equally importantly, supervision needs to be non-judgemental and encouraging. Training also needs to be ongoing and relevant to, and encompassing of, the ethos and expectations of all collaborating organisations.

In addition, users should be seen as equal partners in the process and outcomes of risk assessment and management, giving greater respect to the views, rights and needs of offenders and accused persons as well as those suffering from mental health issues, disabilities or neglect. This and the preceding chapters have highlighted the tensions between user empowerment and rights and the needs of organisations to ensure defensible decisions are made in respect of the care and control of those at risk. Given that Changing Lives promotes greater user involvement in risk assessment and other social work interventions, there is a need to find ways of better developing trust, reciprocity and openness between all parties - users, carers, workers and managers alike. However, to do this requires not only cultural change within organisations but also political change in the governance of risk. Policy and practice initiatives in risk management need to demonstrate confidence and commitment to encouraging rather than restricting the capacities and well being of the vast majority of service users and not be driven by a hostile media backlash in a small minority of cases. Equally, professional autonomy and recognition of the skills and experience of workers should not be dismissed in favour of administrative convenience or managerial 'back covering'. Risk has to be seen as a potentially positive as well as a potentially harmful issue, that allows worker discretion to support risk taking amongst client groups but also ensures that all efforts are made to reduce the likelihood of harmful results.

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