This scenario of course mirrors much risk management in social work – the child protec- tion panel conference in which a group of professionals decides on the appropriate course of action in a child care case is such a form of risk sharing. Here every member of the panel will bear responsibility for making the decision and every member has an input into providing and sharing information on the case to arrive at a considered decision. This in theory minimises the risk of one individual making a decision in isolation without having the necessary knowledge or support to reach an appropriate outcome. Below is an exam- ple of information given to parents by Gateshead Social Services Department on what happens once a decision is reached within child protection.
So far we have explored the idea of risk management and given an example of the child protection conference to outline the importance of risk in social work. You might be think- ing at this stage what connection risk has with social work values? When social workers talk of risk they are employing values. When social workers decide that a particular situa- tion is risky, this rests on beliefs about what is good and what is bad in a situation (Brearley, 1982). Let us take an example of working with people with learning disabilities:
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What sort of decisions can the conference make?
The only decision the conference can make is whether your child’s name should be placed on the Gateshead Child Protection Register. This will happen only if the conference feels there is, or is a likelihood of, significant harm to the child and that a child protection plan is necessary.
If the decision is to place your child on the register, a Social Worker will be nominated for your child and the other people who will be involved in working with you and your family will be identified. This is known as the ‘core group’.
The conference will also make recommendations which will form the child protection plan. These could include:
G whether other kinds of services are needed; G whether there needs to be further assessment; G whether it is necessary to take legal action.
You will be sent a copy of the decisions and recommendations within a day or so of the conference, followed by a copy of the minutes of the meeting a few days later.
If there is anything you are unhappy about you should raise it at the conference or arrange to talk it over with the Social Worker or the chairperson afterwards when they will try and sort things out. If you are still unhappy, however, they will explain what further action you can take. (www.Gateshead.gov.uk/Care%20and%20Health/Childrenand Families/childprotection/ChildProtectionConferences.aspx)
Comment
The social work value in conflict here is that of autonomy, or the client’s right to self- determination in Biestek’s terms. The autonomy of Yvonne to choose what activities she wishes to do conflicts with her mother‘s concern that her daughter may be putting herself in danger. Problems of risk are particularly poignant here in terms of people with learning disabilities’ rights as citizens to make and act on their own decisions. In the past, of course, people like Yvonne have been seen as socially incompetent and in need of protect- ing from the risks and dangers of life. We should not forget about the safety needs of any young person going into an adult environment for the first time, but we account for Yvonne’s right to go out with her friends and her right not to be put in a situation she may not be able to handle. How might Mrs John’s position be modified if Yvonne and her friends had over a period of months been enabled through different forms of social skills and situation training to go out into adult situations? As social workers and care workers, if we value principles of inclusion in society and the autonomy of disabled people to make their own life decisions, then we need to enable people to make positive decisions on their own behalf and have the social skills and support to be able to put them into practice. Although we have not gone into the detail of risk analysis here, it is clear that values are an inextricable part of such risk analysis, as they form the principles upon which a risk analysis takes place, enabling us to choose what is valuable in determining an acceptable or unacceptable risk.
The increasing focus upon risk in social work and indeed wider society has been linked with a tendency to avoid all risk (Kemshall, 2002). In a society increasingly worried about threat, governments become less concerned with maintaining levels of material welfare and more concerned with containing risk through the control and compliance of popula- tions. Individuals are encouraged to make their own life plans through an enhancement of choice in those areas governments withdraw from (i.e. welfare services) but outside of this social conduct is increasingly regulated (Webb, 2006).
Increasingly expert interventions are less concerned with fathoming the great riddles of unconscious life than with a modest sense of problem solving in the face of risk. Experts are particularly concerned with life planning and risk regulation during what
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Mrs John is a single parent with a young daughter Yvonne who is 18 years old. Yvonne has been asked to go out with her friends from college dancing in a local nightclub. Yvonne has Downs Syndrome and her friends all have different learning disabilities. Mrs John is unhappy that the college has encouraged her daughter and her friends to go out dancing as she is concerned that Yvonne may put herself at risk. As she says, this will be the first time Yvonne has gone out on her own with her friends.
What values might be in conflict here?
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Giddens calls ‘fateful moments’. Fateful moments, such as bouts of depression, marriage breakdown and loneliness, are all by-products of a reflexive culture with its emphasis on self-governance and responsibility. If individuals are unable to undertake the responsibility for their own self-governance then experts are required to do it for them. Indeed it’s during fateful moments and crises that experts like social workers are involved (Webb, 2006, p38).
Many social work commentators argue that a preoccupation with risk lies at the heart of child protection practice (Parton, 1998). It has become a key motif around which the work of the personal social services is organised. With social workers preoccupied by risk, they increasingly make decisions which are defensible, rather than decisions which they con- sider to be ethically appropriate. This has led to an unacceptable number of families being involved in child protection procedures experiencing considerable distress and trauma only to be filtered out of the registration process when they are deemed not to warrant further action (see DoH, 1995). Lymbery (2005) suggests that a similar inflation of risk in assessing older people leads to the overprotection of individuals who are deemed unable to make their own judgements about what kind of life they should lead. This becomes more acute when an older person is assessed as being unable to live independently, for example with the onset of Alzheimer’s disease. Society’s failure to adapt itself to the needs of older people leaves older people more open to the dangers of risk. For example, the numbers of older people not claiming their basic pension entitlement leaves an estimated 800,000 older people living in poverty below the minimum considered desirable by the govern- ment. In addition, as social work departments become increasingly focused upon risk, then service users who represent the most risky become the prime recipients for social work intervention and resources, rather than those whose needs may be potentially greater. This in turn leads to a greater focus upon risky service users as the main benefici- aries of resources, particularly when resources become tighter.
Table 5.1 shows the percentage spent upon services for people with different degrees of support needs, comparing 2004/5 with 2005/6.
Table 5.1 Percentage spend on services
2004/5 2005/6
Low 6.2% 4.1%
Moderate 36.4% 28.3%
Substantial 52.9% 58.9%
Critical 4.5% 8.7%
Seven out of ten people now only receive support if their needs are substantial/critical. 80 per cent of councils plan to tighten eligibility criteria for learning disability, physical and sensory disabilities and mental health services, with 77 per cent doing the same for older people (Local Government Association, 2006).
In a climate of risk aversion what constitutes risk is dominated by the concerns of profes- sionals and their fears rather than an assessment of what may constitute a risk for the service user. Ethically, the implication is that the needs of the social worker and his/her employing organisation may therefore outweigh the needs of the service user. Risk increas- ingly within social work tolerates little uncertainty or ambiguity. Practice must follow that which is certain and which can be accommodated within the set menu of policies, proce- dures and guidelines, giving the illusion of safety. This expectation of the modern-day social work organisation is inherently unreasonable, life is a risky business and the removal of all risk, even from those seen as dependent, is a life devoid of any real content. Lownsborough and O’Leary (2005) argue that risk is now conceived in a narrow and lim- ited way. They oppose this, suggesting a focus upon a well-being orientation which they differentiate from a risk orientation (see Table 5.2).
Table 5.2 Differentation of orientation
Risk orientation Well-being orientation
G Risk equals danger G Community governance
G Risk is individualised G Focus on structure
G Threat, fear and distrust G Leadership and trust
G Intrusive risk reduction G Community focus
G Punishment focus G Strength focus
G Defensiveness G Supportive
G Vigilance G Family sensitive
G Distrust G Trustful
Source: Lownsborough and O’Leary (2005).
By emphasising well-being we are posing different questions about the possibilities inher- ent within any social work situation. It asks us as social workers to act in an ethically positive and anti-oppressive way. It requires social workers to think of minimum interven- tion in the sense of avoiding unnecessary use of statutory procedures. Additionally, it requires social workers to look at supportive and life-enhancing aspects of a service user’s situation. This asks social workers to focus upon the strengths of communities to manage and support those experiencing problems and by orienting practice around a more trust- ing orientation as an initial response. Its focus is positive, assessing the strengths of service users and the situations they find themselves in.
The realities of current social work practice in assessing risk was brought into focus by the recent Baby ‘P’ case, (Lamming 2009). Although Lamming identified some progress being been made in child protection work he outlines a number of challenges of which, the quota- tion below is significant in reinforcing the importance of a focus upon the families needs:
1.5……ultimately the safety of a child depends on staff having the time, knowledge and skill to understand the child or young person and their family circumstances (p10). Social workers in their evidence to Lamming identified a number of other issues relating to social workers’ experience of child protection issues including high caseloads and lack of
adequate training for working with at risk families were the most prominent. UNISON (2009) the trade union which represents social workers has also entered the debate pro- viding evidence to Lamming and publishing its own research of social workers views. This report is based upon 369 responses drawn from England and Scotland and provides an interesting snapshot of the pressures which social workers experience. As these social workers comments drawn from the report express:
“It is ironic that the Laming enquiry set up procedures to protect children but in some respects these procedures are now harming children because the increased admin and paperwork have let crucial events slip by unnoticed or not acted upon due to lack of time out in the community with the families and children we are trying to protect. Less office-based work would mean that we can bring the 'social' back into social work.” (p2). “I have 30 cases – all of which are child protection, I have been working in social work for 22 years, but it has never been as bad as it has in the last year. One third of our qualified posts are vacant and our admin staff have been cut. I have built up over 100 hours of TOIL but I can’t take it because of the amount of cases I have been allocated.” (p4).
Given the assessments of the organisation and delivery of social work services from both a government appointee and the main union representing social workers it is not surprising that risk management has developed in the way that it has with social workers practising in an environment of increasing workloads with families with higher support needs. The irony is that as a focus upon risk has become more central the opportunity for social workers to work directly with families to prevent risky outcomes for them has become more limited by the procedures designed to protect children. White et al. (2008) in their study of the com- puterised systems used to record and track cases by social workers (Common Assessment Framework) show that the requirements to service this system further limits social workers ability to respond flexibly to the needs of families. It requires social workers to assess and record work within strict timescales and enter information in a limited form. These require- ments do not necessarily fit with the time the social worker has to work with the family that has been entered into the system. Neither does the information entered enable a coherent narrative to be told about the families needs as they are percolated through lan- guage statements that can be best processed through tick boxes into computerised systems of information. This problem is further exacerbated with the increase in workloads and the difficulty in recruiting staff in some areas, UNISON identified:
Nearly six out of ten of our respondents are working in teams where over 20% of posts are vacant. Over a fifth of all respondents are working with a vacancy rate of over 30% (p3).