PROFILE OF CARE MANAGERS IN STUDY SAMPLE

2.28 Having looked at data about care managers across Scotland, the next section examines characteristics of those in the study sample.

Job titles

2.29 Data were collected about the designations, professional backgrounds, employers and office base of the 32 care managers interviewed for the study. Reflecting the diverse arrangements for care management across Scotland, these 32 workers had 14 different job titles between them. The most common was ‘social worker’: this accounts for 15; there were also two senior social workers. Ten respondents had ‘care manager’ in their job title. In four cases this was followed by the name of the user group with whom they worked (discussed below); other variations included ‘social care manager’, ‘assessment and care manager’ and ‘nurse care manager and assessor’. The job titles of three workers referred to community care in general rather than care management specifically: these were ‘community care worker’, ‘senior community care worker’ and ‘senior community care officer’. The remaining job titles were ‘community occupational therapist’, and ‘social work and housing officer’. The latter was in effect two part-time posts. As indicated above, the sample included three seniors: it also included three mental health officers.

Professional background

2.30 The next table outlines the professional background of the sample, showing that the majority were social work trained. One person whose job title was care manager (learning disability) had a long-standing background in voluntary work in that field. She had no social work qualification but had recently undertaken ‘professional development and management training.’ The latter had covered ‘planning, budgets and training’. Table 2.5 Professional background of care manager sample

Prof. Background Frequency Percent

Social work 22 69

Nursing 6 9

Occupational therapy 3 19

Voluntary work 1 3

Total 32 100

Care managers’ employers

2.31 Most of these care managers (29) were employed by the local authority, two were employed by an NHS Trust and one by a voluntary organisation. This was the Shetland Welfare Trust, a charitable trust set up through oil revenues. However this arrangement was due to change, at which point the care manager would become an employee of the local authority social work department.

Location of care managers

2.32 Finally, in terms of office base, 24 care managers were located within a community care team, five within a local authority specialist team and one in a generic social work team – this was an island authority. Two care managers worked between two bases - both worked part-time within a community care team and part-time in a specialist multi disciplinary setting.

Degree of specialisation

2.33 Over half the care managers had some degree of specialisation within their job, although the extent of this varied considerably. As Table 2.6 shows, 10 worked with one client group only while nine worked with two or more, but not all, client groups in community care. Thirteen care managers worked with all community care groups.

Table 2.6 Range of user groups the care managers worked with

User group No of care managers Percentage

All community care groups 13 40.6 Some or mixture of community care groups 9 28.1

Older people 5 15.6

People with learning difficulties 2 6.1 People with mental health problems 2 6.1 People with dementia 1 3.1

TOTAL 32 100

2.34 Comparing the findings about care managers across Scotland with those in the study sample (although the latter numbers are small), there is a higher proportion of care managers with a nursing background in the sample. In other ways they do not seem greatly dissimilar but it should be borne in mind that care managers were nominated for the study by authorities: the sample is not expected to be representative of the wider population of care managers.

CASELOADS

2.35 Care managers were asked how many care managed cases they were currently holding. The answers ranged from, at the lowest, 6, to the highest, 117. Clearly differences would be expected for a number of reasons, including number of hours worked, local interpretations of care management and policies on case management (i.e.: what ‘counted’ as an open or active case). The care manager who held 117 cases, although normally a part-time worker, had been working full-time for a year due to staff shortages. Many of his cases were ‘review’ cases and 42 were said to be complex. The

total number of care managed cases held by the sample was 1058, the mean being 34. Fourteen care managers also held some ‘non care managed’ cases, while 18 did not. 2.36 There was widespread feeling that caseloads were too high. When asked to identify problematic aspects of care management, volume of work and time pressures was among the three issues most frequently identified by both service managers and care managers. One respondent pointed out that most referrals were marked ‘urgent’, making prioritisation difficult.

2.37 Care managers were asked how many of their cases could be described as ‘intensive’ care management, using the description from the Joint Future Group that this should be aimed at people with complex or rapidly or frequently changing needs. The lowest reported number was 5 and the largest, 51. The total number was 705, with a mean of 23. Comparing the total figures given for care managed cases in their workloads with those deemed to be ‘intensive’, the latter make up 67 percent of the sample’s care managed cases, a point we will return to.