Labour Social Work Group submission to the National Policy Forum consultation providing more detailed proposals for a Labour Social Work and Social Care programme for government

About Labour Social Work Group and this response

This response to the Labour Policy Forum Consultation is from the Labour Social Work Group- a member-led group recognised by the Labour Party which seeks to contribute to improved wellbeing and life chances of some of the most vulnerable members of society, by strengthening the place of socialist principles within social work policy and practice and within the broader social care and community public and voluntary sector services.

Because social workers provide services across age and needs groups, and work collaboratively across public services and with people who use services, their carers and advocacy groups, we found that what we needed to say did not fit into any section of the consultation. We have submitted responses under Prevention, Early Intervention and Better Public Services for all, Safe and Secure Communities and A future where families come first but are also providing this longer submission to set out a more complete account of our concerns and proposals.

LEVEL AND COMPLEXITY OF NEED

We want to draw attention to the high level of social, emotional mental health needs arising from neglect, trauma, abuse. This applies to adults and children and especially to families where both parents and children have disabilities or have experienced trauma. Because of this we urge that Labour proposals for public services must take in services for all family members and pay particular attention to services for parents with physical, cognitive, and mental health difficulties, and those who are carers for elderly relatives alongside child care responsibilities. For the same reason we argue that Local Authority adult and child and family social work and social care services must be considered alongside each other.

LOCAL AUTHORITY FUNDING

The first step to ensuring that local authorities can fulfil their statutory and human rights duties to provide the range of social care services to appropriately meet differing needs is to arrive at a new funding model. The present funding system is broken: many are left without necessary services or wait so long that their conditions deteriorate. We concur with Clive Betts MP who opened a House of Commons debate on social care services on 8 March:

‘We cannot carry on believing that the existing local government settlement finance system, with occasional top-ups from Government on an ad-hoc basis every year or so, will sustain adult social care for the longer term’.
The arguments (across children’s and adults’ services) are now incontrovertible for bringing one or more additional government funding streams into local government.

The role of social workers

The policy consultation documents omit mention of social work and social work services specifically (not the case with teachers, police, care workers) despite the well documented knowledge of the crisis in recruitment and retention of social workers and the documented harm and distress that this is causing to many of the most vulnerable adults and children.

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We entirely support the proposals to improve the recognition, recruitment, payment, training, and retention of social care workers in community and residential services. However we need to draw attention to the fact that professionally qualified, registered social workers are a distinct professional group within social care and health services, who are essential to the fulfilment of statutory responsibilities for both children and adults. These include, for example, child protection and instigating care proceedings, safeguarding vulnerable adults, making assessments under the provisions of mental health and mental capacity legislation about whether it is appropriate to detain or restrict liberty of vulnerable people. In local authority services for both children and adults social workers undertake essential roles in assessing the needs of people who have complex and multiple needs, working with families in which relationships are complex, multi-generational and conflictual, forming relationships with people whose experiences and personalities make them resistant to engaging with services they urgently need, mobilising partnerships with people from other services to respond to complex needs and supporting people to exercise choice and achieve greater independence by developing their own potential and accessing the support they need.

Social workers fulfil these roles by drawing on a unique professional set of knowledge and skills, including advanced and flexible engagement skills, the ability to develop and sustain relationships of trust, a systemic understanding of family and inter-professional dynamics, analytical skills, a sound working knowledge of relevant legislation; together with a powerful commitment to compassionate care and human rights.

Labour’s policies towards refugees and asylum seekers are also of relevance to social workers since we have important roles in providing and co-ordinating services to these groups- especially unaccompanied asylum-seeking children and to parents and single adults who have no recourse to public funds.

The position of social workers needs urgent attention, as highlighted by recent reports into local authority and Children’s services from government, Labour LGA, Directors of Adults’ and Children’s Services, professional associations, unions, and the regulator, Social Work England. These combine to evidence that there is an acute recruitment and retention shortage of qualified and especially of experienced social workers. This is leading to a lower than acceptable standard of social work and social care services, especially to those in greatest need and distress and in need of protection from serious harm and abuse. Frequent changes of social worker mean that some of those in the greatest distress cannot establish a trusting relationship with a social worker which is essential if their needs are to be sensitively and professionally assessed and they are to receive the practical and emotional services that the evidence with respect to individuals and whole communities shows to be so necessary. The result is that all too often their circumstances deteriorate and that they can no longer receive the assistance they need in their own homes. In short, an effective, ethical, and reliable social work service is essential to meet the Labour aim to emphasise preventive and community services, and to meet the needs of those in greatest distress and at risk of serious harm.

Our specific recommendations for Labour are:

• A Labour government should urgently fund and put in place a high profile national recruitment campaign to encourage people, from diverse ethnic, social and educational backgrounds to apply to train as social workers in locally accessible training programmes. It should do so in partnership with local authority Adults’ and Children’s Services, Health Service Trusts (especially

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mental health services employing social workers),University Schools of Social Work, people who use social work services and their advocates, voluntary sector employers of social workers, the regulator (Social Work England) and the British Association of Social Workers (BASW). This should include an increase in bursaries for student social workers, so that all entering the profession, whether as students or employees/ apprentices are equitably treated and enabled to complete their training without being burdened by financial worries.

• Noting that the social work recruitment problem is compounded by an acute retention problem, much of it caused or made worse by high vacancy rates, and stress caused by dangerously high workloads, a Labour Government should improve the professional support and supervision available and increase post qualifying training and development services across all the areas of social work, for example by supporting locally based Teaching Partnerships in which local Higher Education Institutions (HEIs) and employers work together
• A Labour government should, additionally, take steps to reduce the need for and extent of social workers employed by profit-making agencies, which imposes additional costs but also crucially means that those who need a social work service are faced with multiple changes of social worker and the impossibility to establish a trusting relationship with the professional accountable for making key decisions about the services available to them.
• LSWG supports the recommendations of UNISON and Labour LGA on workforce development and pay and conditions of service for social workers and all those within the broader social care and social/ community services.SOCIAL WORK/ SOCIAL CARE AND COMMUNITY SERVICES FOR CHILDREN AND FAMILIESHelen Hayes MP spoke out forcibly against the Government’s response to the MacAlister Review of children’s social care, saying ‘There is no vision for the direction of children’s social care. There is no ambition for our most vulnerable children. There is no cross-cutting commitment from the top of government to deliver better for every child and every care-experienced person in every part of our country.’ (House of Commons, 3rd February 2023).We welcome that prevention and partnership are at the heart of Labour’s vision but these needs extending so that there is a similar ambition to make appropriate provision for high level and specialist needs. The twin concepts of prevention and partnership informed by research, policy and practice and set in the context of the current legal framework have the potential to offer a coherent approach to transform children’s social care.Primary or structural prevention is about preventing problems before they occur. It includes a set of universal and targeted policies aimed at radically reducing inequalities.Labour Social Work Group members, from across child and family social services delivery, policy, and research, support the principles and broad policy direction set out in the Policy Forum Consultation Documents. We welcome the critique of the years of neglect, mismanagement, and wasteful expenditure of public funds during the Tory years that have been made by Shadow team members and Labour MPs. We welcome plans to reverse the damage done to ‘universal’ services (child care, youth work, social security system, housing and homelessness services) but have yet to hear of detailed plans to replace the Tory government’s ill-thought through, poorly evidenced ‘improvement’ plans in response to their review of children’s social care. Whilst aware that there

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are limits to the detail that can go into the Manifesto, it is now timely for the Labour Shadow team to work on detailed plans to tackle the acknowledged problems that a Labour government will inherit. Plans are needed both for families who need local authority-led social work services in the community and for children in care and care experienced adults.

Secondary prevention is about helping children and families when problems first arise – or early help – through developing kinship and community networks and preventative children’s services. A failure to provide these services since 2011 has led to an escalation of family difficulties and increasing numbers of young people coming into care. The evidence base for these is already available (much of it from evaluations of the Sure Start centres and others of Labour’s Every Child Matters policies).

Tertiary prevention is about helping children and young people when the problems they face may continue at home, in the community, or in care. The aim is to ensure children across the age groups, including teenagers, their family members, and carers, receive high quality, rights-based support, and care, to prevent longer-term problems and do all that is possible to help young people fulfil their potential into adulthood. Building on structural and secondary prevention this will contribute to creating ‘safer and secure communities’.

We recommend that:

• The Labour government should set up effective cross-departmental structures (to include Local Authority representatives) so that housing, social security, schools, health services (especially child and adult mental health and addictions services), youth and adult justice safeguarding services work collaboratively.
• Labour should consider setting up a Government Department for the Family (recognising families in all their diversities and across generations).
• We urge the NPF to build on the soundly evidenced recommendations of the Marmot Committee, which closely align with proposals in the Consultation document including reducing poverty by raising universal credit to ensure a living income without dependency on food banks and charity – which will also raise minimum and living wage levels.
• We support the developing plans for an early years education, day care and family support service and urge that policy and detailed plans build on the learning from the Labour government’s Sure Start and Every Child Matters provisions.
• However, these should be more fully developed into a comprehensive network of open access Family Centres for children across the age groups, with an emphasis on support for the diversity of families. including kinship families, foster families, and where needed, adoptive families. These must be ‘open access’ and ‘joined up’ with the wider ‘universal’ early years strategies. They should also work collaboratively with the multi-agency ‘targeted’ services for families with more complex difficulties, to bring together education, social work, child protection, youth offending and advocacy services, including for children and parents with physical and cognitive disabilities and mental health and addiction problems and relationship problems including violence.
• Policies need to ensure there is continuity of relationships with social workers and other professionals across ‘early help’ and child protection and in care services.

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• Labour should put an end to Tory unnecessary use of ‘pilots’. Central government funding for these services should be allocated to each local authority based on an agreed model for assessing needs.
• Labour should end the profiteering in children’s social care by increasing the supply and range of high quality local authority foster families and Children’s Homes as homely environments where the diverse needs of children and young people in care can be met.
• This should be achieved at the local level and with regional planning as appropriate but without the added bureaucracy and the failed market approach underpinning the Government’s plans for ‘regional cooperatives’.
• Labour must end the discrimination against young people living in independent and semiindependent accommodation by enacting their entitlement to ‘care’ up to 18 years of age.
• Labour should enact legislation to require that asylum seeking children and young people are legally ‘looked after’ as ‘children’ by local authorities under the 1989 Act provisions (within DfE government department remit) and not subject to the authority of the Home Office
• Labour should introduce care experience as a ‘protected status’ under the Equalities Act for all qualified young people.
• Labour should implement the robust research findings on promoting the resilience of young people from care to adulthood. Specific measures that should be put in place for all children in care and care leavers:
• provide stable placements, giving love, attachments and continuity, and a positive sense of identity, including an understanding of their culture and heritage.
• help young people to succeed at school or return later to education which leads to young people developing normative social networks, leisure activities and new opportunities.
• Involve young people in individual decisions which shape their lives, and collective decision making to improve policy and practice.
• preparing young people in self-care, practical and inter-personal skills.
• ensuring young people leave care later, including extending care to 21 – ‘staying put’ in fostercare and ‘staying close’ to their Children’s Homes and existing community networks.
• develop informal social networks, including extended family, partner, friendship, andcommunity support.
• ensure access to leaving care services, to help young people with life skills, education,employment and training, housing, finance and wellbeing, and support those who require additional help – those from diverse backgrounds, young parents, those with mental health problems and disabilities, LGBTQ+, and asylum-seeking young people.Working in partnership:Including the participation of children, young people, family members and carers in decision making, underpins making a reality of prevention. Changes in law since the Children Act 1989 and the ratification of the UNCRC have highlighted the importance of upholding children’s rights which have seen expression through participation in individual and collective decision making, advocacy and rights movements. Recommendations

• Labour policy should ensure that children and young people wherever and whenever have access to rights-based services and have access to independent advocacy services, legal advice where needed, Independent Reviewing Officers, and support by care experienced individuals and groups.

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• The Labour government should Invest in models of social work practice and service provision which increase the involvement of adult family members (including kinship carers and family members of children in care) and carers in decisions about their children.

Funding

There is no doubt that the Labour Policy team will need to come up with proposals to counteract the massive deficits, made considerably worse by the impact of the pandemic and cost of living and housing crisis:

• the draconian cuts to local authorities since 2011, amounting to an estimated £2.2 billion, (including 46% cuts in the ‘early help’ budget and 70% cuts in youth services);
• the Government’s two-year funding plan is totally inadequate and picking off ‘reforms’ is likely to do more harm in both the short and long term to the vulnerable parents and children who need services in the longer term;
• A Labour government must end profiteering with local authorities and vulnerable children being viewed as business opportunities to be competed for;
• the inequity of funding arising from the piloting of family hubs and other governmentdirected ‘innovations’ must end, and funding formula arrived at for family services for all local authorities based on need;
• the dubious ‘assumptions’ informing placement savings (especially in regard to residential care) must be challenged.In summary there is an urgent case for developing a transparent funding model, to ensure equitable resourcing for high quality, needs-led, not-for-profit locally accountable community and out of home child and family social services.SOCIAL CARE/SOCIAL WORK AND COMMUNITY SERVICES FOR OLDER PEOPLE AND ADULTS OF WORKING AGE
  The priority that is having to be given to the NHS’s urgent needs, especially hospital discharge, has unfortunately distracted attention from the fundamental and vital purpose of social care. This includes but goes well beyond the essential role that social care can play in preventing many avoidable admissions to hospitals and costly residential care and nursing homes. As well as the implications for the NHS, these avoidable admissions are actively damaging to the health and wellbeing of the people concerned, bearing in mind that older people rapidly lose physical strength, confidence and self-care skills and become demoralised as a result of even brief hospital admissions, which can compromise their independence and care options on discharge.More than 50% of national expenditure on Social Care and the area of greatest demand and cost pressure on local Councils comes from the needs of adults of working age. This includes people with a wide range of disabling conditions, including the effects of chronic long-term illnesses, physical disabilities, learning disabilities, troubling mental health and other conditions which disadvantage their quality of life and their ‘ordinary life’ opportunities.
  There are huge numbers of people living in their own homes in the community of all ages desperately needing to receive a service, but deemed to be failing to be eligible, or receiving one of insufficient or inadequate quality, often because of the inadequacy of local government funding.

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The current model of social care funding and provision is broken. Social care provision is currently provided in a fragmented and uncoordinated way by many different organisations, mostly from the private sector. Care home businesses have been purchased by private equity companies that have asset stripped them so that they have become unviable, and then withdrawn from the market, creating instability, and undermining the safety and wellbeing of highly vulnerable people. Domiciliary and even more so residential care is currently of variable and too often unacceptably poor quality, although it should be acknowledged that some providers, often smaller organisations, provide care that is exemplary.

We recommend that:

• The future Labour government should urgently provide the funding needed to cover the gap identified by council political leaders of all parties, Directors of Adult Social Services, and NHS leaders, for example to stabilise care providers, to cover the real costs of inflation, more people ageing and living longer with disabling conditions, and to fund the increase in national living wage.
• Labour should prioritise measures that provide meaningful support to relatives and carers and to voluntary organisations working in the community to provide important preventive help.
• Labour policy should give priority to services which enhance the quality of life & independence of people according to their own wishes, as advocated by the #socialcarefuture movement.
• The future Labour government should invest in local councils to enable them to use their detailed and specific knowledge of need in their area, to develop and deliver personalised services to people in their own homes, in partnership with voluntary and community organisations.
• Labour should act urgently to remedy the acute shortage of staff in social care by accepting the recommendations on pay from UNISON and Labour LGA and ensuring that they are provided with appropriate training and career advancement opportunities.
• Labour should review and reform the Benefits system to remove anomalies and injustices such as adults of working age who are reliant on Universal Credit and are unable to work or engage in education due to illness or disability, being charged for essential social care; and adults of working age who are terminally ill being unable to access pensions to which they have contributed until they became too incapacitated to work.AND FINALLY, WE WOULD BE HAPPY TO HELP!The Labour Social Work Group includes practising social workers who have years of experience across the range of service user groups, alongside eminent academic researchers and experienced managers and leaders in the sector. We have links with service user led organisations, professional bodies, Trades Unions, and with other groups who have an interest in social work and social care, and with Labour and Cooperative Party councillors and MPs. We would be happy to contribute further to the development of Labour policy in any way that might be helpful.

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Another chance to read these three powerful letters (published in the Guardian 16 and 24 August 2021) in response to front page article: https://www.theguardian.com/society/2021/aug/11/revealed-englands-pandemic-crisis-of-child-abuse-neglect-and-poverty ). Together they provide a powerful critique of the Government’s Care Review ‘Case for Change‘, from internationally respected social worker/ researcher/ educators who have over the years contributed in UK and overseas to policies and legislative change to strengthen families’, children’s and care leavers’ rights to democratically accountable quality services. See also our Post on a Labour Policy for Child and Family Social Work discussed at a meeting in February 2021 with the Labour Shadow front bench team, and with Labour Local Government leaders.

The acute situation evidenced by Patrick Butler’s article and pointed up in these letters makes it imperative that measures to remedy deficits in services must go beyond this ill-thought-out, Tory-inspired review and beyond the remit of the Department for Education. Secure funding for the child and family social services of all Local Authorities (not just the stop-go ‘innovations’ for the few, given the thumbs up or thumbs down by the What Works Centre’s narrow approach to evaluation) requires a total rethink of Local Government finance. Beyond that, coherent measures to ensure adequate incomes, decent housing, adequately funded public health services and schools, safe environments are essential if the stigma and actual harms of living in poverty and poor neighbourhoods , and the need to unnecessarily come into care, are to be avoided. And that must mean very considerable rises in public spending, and the taxation to pay for it, to make good and go well beyond what was removed during the Tory inflicted years of austerity

Guardian Letters 16 August 2021

Patrick Butler is right that the pandemic has made the crisis in children’s social care

“even more acute” (Crisis in children’s services in England is shocking if not

surprising, 11 August). However, it is difficult to see how the government’s review of

children’s social care will achieve the radical changes needed, for two reasons.

First, it will require a commitment to more progressive taxation and increases in the

minimum wage and universal credit to combat major inequalities, including those

associated with the rising demand for children’s and youth services: childhood

poverty, social deprivation, homelessness, poor health, ethnicity and disability.

Second, it will require the introduction of needs-led funding of local authority

services; the end of exploitative privatised provision, including the use of poor-

quality unregulated accommodation; and the reversal of draconian cuts in local

services from 2010, which against rising demands have prevented children

remaining with their families and communities, or receiving quality care to fulfil

their potential into adulthood.

Prof Mike Stein

University of York

 Your report on children’s social services paints an accurate picture of help and care

for children collapsing and in crisis. The report focused on more demand during the

pandemic, but there has been a longer trajectory of decay, disinvestment and

disregard.

Since 2010, Conservativeled governments have targeted austerity at poor

communities and at public services. Privatisation has been promoted, and well

over £200m each year is now gushing out of children’s services as profits for

international venture capitalists. Poorer services at a higher cost.

The pandemic has not caused today’s difficulties. Instead, it is the virus of an

ideology and intention promoting a privatised marketplace amid cuts that riddle

children’s social services and leave children and families stranded and neglected. It is

a virus that needs to be tackled with urgency.

Ray Jones

Emeritus professor of social work, Chepstow, Monmouthshire

Guardian letters  24 August 2021

In stating “above all, poverty must be reduced”, your editorial is setting the public policy bar very low.

What is required is a much wider societal vision – the implementation of progressive income tax, wealth reform, and public policies to combat major inequalities and injustices, including responding to the accumulated evidence of their impact on health, education, wellbeing and local communities, so young people can remain within their families. See, for example, Kate Pickett and Richard Wilkinson’s interview in the Guardian (‘Inequality strikes at our health and happiness’, 18 September 2018).

A vision of equality and a commitment to the needs-led funding of public services should be the essential foundation stones for any recommendations arising from the government’s review of children’s social care.

Prof Mike Stein
York University

Dr. Robert J. MurphyBA (Hons), MSc, PhD, Dip Soc Admin, CQSW,

  Dip Stress Management Training

Rob is LSWG co-ordinator on Social Work and social services for adults and children with mental health difficulties

Date:               20.7.2020

Labour Party website – ‘mental health a national priority’

Information/issues:

            800,000 children living with mental health disorders according to the Children’s Commissioner

            100,000 children denied mental health treatment each year

            4,500 fewer mental health nurses, chronic shortage of consultant psychiatrists

Proposals:

            Enhanced training bursary for nurses

            Bed cuts force children to go to non-local beds sometimes hundreds of miles from home

            Early intervention is the key to prevent or intervene in cases of abuse, neglect, trauma – i.e. Adverse Childhood Experiences (ACE)

            Extend school counselling services – to help better integrate mental health services with education and give young people somewhere to turn

            Poor mental health arises not just in schools but also in our communities, families, and online

            Poverty leads to injustices such that you are 3x more likely to develop mental health problems, and have higher rates of suicide, addictions and deaths from overdoses. Poverty results in health inequalities.

            Plan for happiness and wellbeing? – Future Generations Wellbeing Act which determines that ‘health in all policies’, ‘health equality audits of all government decisions’

The website cites LSE research which estimates the annual cost of mental ill-health at £105 billion

The website also states that research has shown that half of adults with mental health difficulties had symptoms at aged 14 yrs and yet only 8% of mental health budget is allocated for the treatment of young people.

The Labour Party is committed to tackling the issue of staff shortage crisis, through guaranteeing the rights of EU nationals working in the UK, reintroducing nurses’ bursaries, and lifting the NHS pay freeze

Review of the MHA Sir Simon Wessely DHSC 2018

A few significant conclusions:

            Increasing rate of detentions under the MHA

            Patients’ voice lost or ignored

            Services bureaucratic, uncaring, and coercive

            Over-representation of BAME people detained under MHA

            Questioning how people with learning disabilities and autism are examined/assessed

            Questioning the application of international standards of human rights

The Review noted that:

            49551 detentions under the MHA were recorded in 2017/18

            There was a 40% increase in detention from 2005/06 to 2015/16

            Black people were 4x more likely than White people to be detained under the MHA

            More Black patients, especially young Black men, were subject to Community Treatment Orders (CTO)

            Black people are 8x more likely to be subject to CTOs than White people

            For Black people as service users they experience coercion, stigma, racism, and discrimination amounting to institutionalised racism according to research carried out by Frank Keating and published in 2002 and quoted in this Review

The Review’s recommendations:

            There is a poor standard of care and support in mental health services

            The services ought to be more rights-based and reflect the 4 key principles and values of dignity, respect for persons, mutuality, and reciprocity

The Review concludes that the lack of dignity and trust inspires fear of getting worse and not better when compulsorily admitted to hospital

The new underpinning principles ought to reflect choice and autonomy such as:

            Shared decisions in care plans and treatment

            Statutory advance choice documents (ACD)

            Medication – service users’ wishes taken into account

            Patients entitled to challenge treatments

            Patients can request a second opinion (SOAD)

            Allow a patient to consent in advance to admission ie agree to become a voluntary patient at a future point which then removes the need to use the MHA

The role of the Nearest Relative is also highlighted with a recommendation that this is changed to a Nominated Person (NR)

A number of other issues are raised such as the use of police cells as a place of safety and whether the NHS ought to commission health services in police custody.

In relation to the criminal justice system the role of Magistrates’ Courts is questioned in relation to the remand for assessment of a person under Section 35 of the MHA and for treatment under Section 36 of the MHA

I raised issues which I consider important in the email and papers I circulated previously, including:

The commodification of children’s mental health which is resulting in the increased labelling of children at school has to be a priority. I can agree with the need for a counselling service in each school, but the role of learning mentors is a preventive step which is prior to counselling and a role which is of tremendous benefit for the child, their family, the teachers and the school’s academic targets. 

No one is born with ADHD, OCD, PTSD, bi-polar disorder, schizophrenia or any other psychiatric diagnosis or psychological disorder or condition. These ascriptions are applied by professional experts when a child or adult is deemed to be eligible for these relatively expensive services. Once the child or adult has crossed the threshold into the diagnostic system the door of ‘normality’ typically closes behind them, and they take on the symptomatic identity attributed to them.

I think it is ironic that the Review of the MHA should highlight the need for the implementation to reflect international standards of human rights when the 1983 MHA was itself primarily concerned with trying to establish a balance between civil liberties and compulsory treatments. Social workers as ASWs had a crucial role to play in the preservation of a person’s civil rights and liberties and prevent unwarranted detentions. The irony is that the increasing emphasis on finite and ‘available’ resources, driven by economic goals and unburdening the state and the taxpayers, has resulted in eligibility criteria which preclude, for example, the use of voluntary admission to hospital.

This Review is ironically very familiar because it repeats the dilemmas faced by those who wrote the 1983 Act and demonstrate that the fundamental issues have not changed in relation to legislating for madness in society!

So I think the Labour Party can usefully focus on the requirement for all schools to establish the role of learning mentors as a preventive mental health measure and to supplement this with a school counsellor, recognising a clear distinction in role which will be reflected in remuneration. This is one of the best means of allocating resources which will be of great benefit as a preventative mental health measure.

I also think that the Party needs to develop a strategy for tackling the evident institutional racism within the mental health system in all its features. This must include reducing the number of compulsory detentions and treatments of BAME people, as well as addressing the specific discrimination of young Black men in relation to the use of CTOs, the use of coercion, and the use of antipsychotic medication as a form of restraint and treatment.

The Party must also develop policies which focus on service users’ rights to contribute and even determine the type and quality and features of services and resources which are designed to meet their mental health needs.

I think the use of statutory Advance Choice Documents is fraught with legal, moral and professional pitfalls.

I also think the use of CTOs needs a fundamental review to establish who is using it and in what circumstances.

I also have question marks about the use of personalised budgets in mental health and I wonder how social workers are using them.

I also have fundamental questions about how the Mental Capacity Act is being used in the mental health system but also in relation to older people and people diagnosed with dementia and Alzheimers Disease.

I also think the use of the Nearest Relative has always been controversial, and I am concerned about the implications of changing this role to a Nominated Person role.   

The role of the police in the use of mental health legislation has always been fraught and more has to be done about ensuring that anyone who has to be involved in a potential suicide, domestic violence, and use of compulsory admissions to hospital for treatment or assessments of people in the community and the use of police cells as a place of safety have to be evaluated and effective and constructive policies developed.

I would like to see more evaluation of the use of antipsychotic medication especially in relation to its long-term use, because it has damaging effects on major organs particularly the liver, heart and brain.

I would like to see ECT banned as a method of psychiatric treatment.

I think we need to develop a clear mental health role for social workers.

I think that the Approved Mental Health Social Work role is fundamental to upholding the civil rights of people who are being assessed under the MHA, but I think this is a role that ought to have more credibility and extend more positively into a broader role in relation to children and families.

Food for thought! Where do we go from here?

Sent to Labour Shadow lead on mental health services Dr Rosena Allin-Khan May 2021

This briefing focuses on social work with adults and is a companion paper to that which focused on social work with children and families. Both are from the Labour Social Work Group and are addressed to Labour MPs, councillors, and policy makers. They share similar aims and principles.

Keir Starmer, in his 2020 Conference speech set out a narrative for a Labour government, linking it with Labour’s past achievements and emphasising the centrality of family and community. Labour created the rights-based welfare state including publicly funded and provided social services.

In contrast, there is every indication that the Tories will continue the direction of travel outlined in this paper, specifically: 

• Fail to meaningfully explore ways to adequately fund local authorities
• Continue, against all the evidence, to maintain the stance ‘public sector bad private sector good’ by continuing to replace local authority services for adults with lower quality and (often) more expensive for-profit providers
• Further reduce access to publicly funded social services for adults with care and support needs
• Expect (even) more of family carers
• Fail to provide vital funding of independent living support for people with disabilities
• Continue to ‘lose’ (minimise and under-fund) the social work service within the catch all umbrella of ‘social care’
• Manipulate the character of the social work profession so that social workers are – effectively – reserved for ‘investigative roles’ such as ‘safeguarding’. Opportunities to engage supportively and therapeutically with adults and their carers are already very limited and the well-established preventive aims of social work seriously reduced. This, coupled with the neo-liberal narrative, undermines social workers’ historical public service ethic, political awareness, therapeutic knowledge and skills; commitment to advocacy, promotion ofrights, personal choice and social justice; and capacity to challenge discrimination. Their role working in, and with, communities has all but disappeared.  
• Fail to recognise that effective social work with adults:
  • Means understanding complex relationships, establishing trust, judging risk, managing conflict and facilitating individual and community capacities. These are not ‘jobs’ anyone can do.
  • Requires the ability to work with a diverse range of needs, wishes and ages. A coherent new policy approach to adult social care must complement and interrelate with this aim.   

This briefing focusing on adult social work aims to:

1. Make suggestions on immediate action Labour should be taking to protect social work services for adults & their families and prepare the ground for a more sustainable social work workforce & a more comprehensive coherent service for adults  
2. Summarises the context of social work with adults after 10 years of Tory cuts and neo-liberal assaults on democratically accountable services.

What Labour could be saying and doing now

Labour national and local politicians, policy makers and social workers must take every opportunity to change the narrative about social work with adults and work towards bringing adult and children’s social workers together within re-unified Local Government Social Services functions. Links with measures to combat poverty and engage with social and health inequalities are as necessary now as they ever were. Whilst greater integration with the NHS is critical for adults’ wellbeing, it will only be effectively achieved if parity of funding and esteem is accorded comprehensive social care services. 

The essential components of an integrated approach and a new narrative are:

• Reject the Tory government-imposed fragmentation of political accountability for vulnerable people who need social services assistance & appoint a Shadow Minister and team for Adults and Children’s social services, working closely with the Shadow Housing, Communities & Local Government, Health, Home Office, Social Security, & Equalities teams.
• Challenge the relentless privatisation of care services. Privatisation often costs more and yet provides a lower quality service for users & family carers (care homes are a good example). There is also little accountability for poor quality care.  
• Challenge the stigmatising narrative that adults who are eligible for support from their local authority have somehow ‘failed’ to be ‘independent’ and are unable to manage their own lives and affairs.
• Challenge the terminology of ‘risk’ and ‘eligibility’that permeates social work with adults through the prioritisation of processes and procedures e.g. ‘safeguarding’ and ‘interventions’. Social work is a much broader activity than this and is handcuffed by a narrow statutorily determined role.
• Continue to challenge the now widely criticised model of care management and place emphasis on strengths based approaches but acknowledge that these require proper funding of public services to be effective (local authorities, social care services, housing, universal services such as libraries, primary care, and social security benefits) 
• Engage meaningfully with individuals and organisations who give voice to the experiences of service users and carers. Ensure users and carers can effectively influence policy changes and resourcing decisions & encourage local authorities to embed the practices of co-production & co-design into their structures and operations.   
• Re-engage with social work as a therapeutic profession. Social workers could and should be a source of help, support, understanding and advice rather than ‘the last resort’ for those who are desperate or are abused/neglected.
• Recover social work as a profession that promotes citizen’s rights and entitlements, challenges discrimination, and addresses health and social inequalities: inequalities have widened significantly over the last decade shortening lives, deepening disadvantage & eroding well-being. These inequalities have been amplified by the Covid pandemic.    
• Re-engage with social work as a profession that is accessible to the public and can work preventively – embedding social workers in communities where they are recognised as a resource, where they get to know local people, services and networks, and build trusting working relationships with others such as GPs, housing officers, & the neighbourhood police. Social workers have traditionally been drivers of integrated, coordinated responses to community development & advocates for community groups & citizen led initiatives.
• Commit tothe provision of a well-trained, stable, research minded & experienced workforce: as promoted by Croisdale-Appleby in his report, Re-visioning social work education, 2014). This requires moving away from shorter specialised (in Children and Families and mental health only) pre-qualifying social work programmes and developing systemic incentives to enhance retention of adults’ social workers, offer opportunities for specialisation e.g. in dementia care, learning disabilities, mental health and post-qualifying development.
• Commit to the provision of high-quality specialist roles required in law: Approved Mental Health Professionals (over 90% are social workers) and Best Interests Assessors/Approved Mental Capacity Professionals
• Ensure that family carers are proactively offered an assessment of need and that this assessment is done by a social worker. Increasingly local authorities are outsourcing carers assessments to third sector carers agencies with limiting contract requirements (charities usually). Whilst many do a good job, the agency has no responsibility for the cared for person; this practice contributes to greater system fragmentation, corrodes sustainability & corrupts the independence of charities.
• Ensure that local authority eligibility criteria are based on need and not budget caps and that adults who meet the criteria to receive support (who by definition have complex needs) are offered a social work service. Skill is needed to explore issues of rights, choice, need & wish.
• Commit to engaging with health partners structurally in relationship to improvements to health and social care systems. Although most adults’ social workers work closely with health partners their perspectives & distinctive contribution to multidisciplinary working and patient outcomes are rarely visible in strategic planning or in ‘new’ models of care e.g. Vanguards. Social work tends to be lost under the catch all umbrella of ‘social care’.   
• Acknowledge that means testing of access to publicly funded social care is ineffective & inefficient as well as discriminatory & commit to taking steps towards developing universal social services to which citizens have a right when they need them.
• Commit to a coherent offer in terms of support services across the country. The social care system is very complicated & is a challenge to navigate. Providers vary in terms of quality, provider type (private/charity), costs and availability & there is widespread confusion about what is provided/funded by the NHS, the LA, and what users need to pay for. This commitment should include reengagement with local authorities as – sometimes – more appropriate providers of community and residential care services for working age & older adults with care and support needs (currently, LAs provide very few services directly).

Social work with adults: the context

The 2014 Care Act provides the legal framework for adult social care. Whilst it is regarded – broadly – as a positive and timely piece of legislation, its capacity to deliver on its aims have been severely undermined as it was introduced during a period of austerity. The Tory administration wants to (continue to) reduce public spending whilst simultaneously improving outcomes for users and carers.

We are still waiting for the long promised Green (or White) Paper on the future of adult social care. There have been more than 10 well researched, evidence-based, financially mindful, politically informed, strategic & comprehensive proposals for sustainable adult social care services over the last decade. One of the (still) most relevant is the Kings Fund/Barker Independent Commission on the Future of Health and Social Care in England published in 2014.

Adults’ social workers work with older people with (often chronic) health conditions, people with learning or physical disabilities, mental health problems, dementia, addiction or substance misuse issues and ‘other adults’ with care and support needs. They also work with the family members and others who provide unpaid care. As a consequence of tight eligibility criteria adults’ social workers tend to only see people with complex needs, often at a crisis point, who have few resources. This ‘late in the day’ model means that opportunities to act preventively, and in a way that offers a sustainable cost-effective response, are (often) lost. 52% of publicly funded adult social care services is provided to older people; 48% is for ‘other groups’ of adults. About 8% of users receive a personal budget. It is important to recognise that there is a cross-over between adults’ social work and child and family social services. A significant proportion of parents seen by a social worker have chronic physical and/or mental health problems, a learning disability or a substance misuse problem.

There are estimated to be 8.8m adult carers in the UK, a figure that is increasing due to the growing number of older people with care and support needs living in the community. The carer population is diverse; it incorporates increasing numbers of older people who may have their own health problems, younger adults, and mid-life carers who are often obliged to give up paid work to care.  

More adults (10.9m in 2019) who have care and support needs now self-fund ie they (or their family) pay for privately organised support services. There is a growing group of adults who cannot afford to self-fund but who do not meet local authority eligibility criteria for publicly funded support. Self-funders receive little, or no, assistance in making care related choices despite the complexity of decisions and the, often considerable, costs involved.

Since 2010 central government grants to local authorities have reduced by 40%. The current level of expenditure on adults’ social care services is below the 2010/11 level, despite increasing demand. Key impacts include:  

• The number of adults in England receiving state-funded social care fell from around 1.3m in 2012/13 to 841,000 in 2018/19; of these two thirds are older people.
• In 2017, Age UK reported that 1.4m people aged 65 years & over did not receive the help they needed with ‘essential daily living activities’ such as bathing; a significant proportion received no help at all. Older people on low incomes are most affected.
• If services to adults with care and support needs are reduced, carers are obliged to ‘pick up the care tab’; services for carers are also reduced:

• The number of carers receiving any local authority funded services fell from 308,160 in 2017/18 to 297,300 in 2018/19
• Only about 10% of carers receive an assessment of need (mandated in the Care Act)
• More than 90% of all local authorities respond only to needs that are ‘critical’ or ‘substantial’; in 2018/19 only a quarter of people who approached their local authority for help received (some level of) a social care service.
• It is routinely reported in the British Medical Journal, and evidenced in research, how damaging cuts to local authority budgets have been to the health and wellbeing of adults, how costly lack of social care is to the NHS (e.g. increased admissions to hospital), and how inefficient a lack of joined up planning and working is for all parties. This is linked to calls for a national social care service.
  • A number of trusted organisations have described ‘adequate funding’ for social services as ‘not prohibitive’ (eg: LGA, Kings Fund, Centre for Welfare Reform); they also argue that it would help contain escalating NHS costs.

It is noteworthy that five times more older people are living in poverty in the UK now than was the case in 1986; the highest rate in Western Europe. In 2017/18 in England 2m older people lived in poverty; of these 1m lived in severe poverty. Also, 6m older people lived in fuel poverty.

What next?

In the context of a widely acknowledged crisis in social care – and heightened public awareness due to the Covid crisis of the large number of people who rely on social care – the time is ripe for the Labour Party to engage with a radical review of the sector and, as a key part of this, reimagine the critical role social work with adults and their families could, and should, play. Some would even suggest that what is called for is the present-day equivalent of the 1969 Seebohm Report which laid the foundation stones of generic local authority social services departments and a universal model of care and support.   

Sent in March 2021 to Labour Shadow team at Health and Social Care (Jon Ashworth, Liz Kendall, Rosena Allin-Khan) and to Steve Reed Shadow Local Government Minister

This briefing from Labour Social Work Group to Labour MPs, councillors and policy makers:

1. makes detailed suggestions on immediate action Labour should be taking to protect child and family social services and pave the way for more comprehensive policies  
2. summarises the context of child and family social services following 10 years of Tory cuts and ideologically based attacks on democratically accountable services.

What Labour could be saying and doing now

Labour national and local politicians, policy makers and social workersmust take every opportunity to change the narrative about social work with children and families and work towards bringing adult and children’s social workers together within Local Government Social Services Departments. Links with measures to combat poverty are as necessary now as they ever were.

The essential components of an integrated approach and a new narrative:

• Reject the Tory government-imposed fragmentation of political accountability for vulnerable people who need social services assistance and appoint  a Shadow Minister and team for Adults and Children’s social services, working closely with the Shadow Housing, Communities and Local Government (DHCLG), Health, Home Office, Justice, Social Security, Health, and Equalities teams.
•  Privatisation costs. It costs more andyet provides poorer services.
• Challenge the terminology of the  ‘social work industry’. Social work is a public service
• Call for a move away from the discourse of  monitoring and surveillance of children and families through child protection processes and procedures, and ‘interventions’
• Social workers could and should be a source of help rather than threat to children and families.
• Rather than remote monitoring and surveillance, embedding social workers in communities where they are recognised as a resource, where they get to know children and families and networks, and also build trusting working relationships with others such as teachers, doctors, health visitors and neighbourhood police officers, can start to turn the ship away from more and more children being taken from families and with fewer families left without help or hope.
• Foster and residential care provided within communities and neighbourhoods by local councils and with family services and centres to help and assist families when the going is tough.
• A well-trained, more stable and more experienced workforce –moving away from too fast and too fragmented initial social work education and training promising quick promotion into management and maintaining a focus on retention and post-qualifying development
• Whenever we speak about austerity we should say ‘politically-chosen austerity’ as it does not have to be this way. It would, for example, also be sensible and correct to speak about track and trace in England as not ‘NHS Track and Trace’ but ‘Serco Track and Trace’.
• Always refer to us as children and families social worker NOT child protection social worker.
• Speak about community social work to reclaim what have  become the too fragmented organisational structures within many children’s social services, with children being passed between workers and teams.

Why this approach is necessary and urgent

Keir Starmer, in his 2020 Conference speech, set outa narrative for a Labour government, linking it with Labour’s past achievements and emphasising the centrality of family and community. Labour created the rights-based welfare state including social services provided by democratically accountable local authorities. The 1989 Children Act, which had cross-party support was strengthened during the Labour years of 1997-2010. Alongside the reduction of child poverty, services to young families were strengthening through the highly successful Sure Start Children’s centres, improvements were made to services for children and families in the community and for children in care.  But since 2010, Tory austerity policies have seen the numbers of children living in poverty escalating, and year on year growth of children in need of social work services and needing to be protected or to come into care. These have also been years when damage and fragmentation of child and family services caused by vicious cuts to local government funding have been compounded by ill-though-through ‘initiatives’ to support government ‘innovations’ and experimentation usually involving ‘outsourcing’ to private businesses. Local authority services and social work expertise have been reduced, especially in the ability to provide its own residential and foster care services. In house research, training and human services teams have been replaced by consultants paid ‘over the top rates’ for their ‘off the cuff’ solutions barely adapted to the particular circumstances of each local authority.   

There is every indication that the Tories will continue this direction of travel:

• Fail to even look for, a system for adequately funding local government; continue to substitute adequate and reliable funding to all local authorities with one-off ‘innovations’ grants to reward ‘compliant’ authorities and ‘punish’ those who struggle (usually those in areas of deprivation) by imposing new models of ‘governance’ such as ‘Trusts’.
• Continue, against all the evidence, to maintain the stance ‘public sector bad private sector good’ by running down directly provided local authority services and replacing them with lower quality and more expensive private-for-profit run businesses.
  –   The 2014 changes in statutory regulations created the platform which now allows any statutory children’s social work services to be contracted out to private commercial companies. International consultancy firms have been in discussion with the DfE about how they can be encouraged to take on children’s social work.
  –  Almost 40% of foster care placements in England are provided through private for-profit foster care agencies with ownership and profit-taking frequently transferring between opaque international venture capitalists with no commitment to the UK or to its children.
  –  And three quarters of children’s residential care in England is now provided by profit-making private companies with a third of local authorities directly providing no children’s homes themselves.
• Use the proposed ‘care review’ to rewrite the 1989 Children Act to fit with their service-shrinking agenda by removing the rights of parents, children and carers to a quality and carefully regulated social work and care service.
• Manipulate the character of the social work profession through selective funding of social work qualifying and post qualifying education so that those providing services become technicians and no longer have the public service ethic, motivation, knowledge and skills to help those who need their services to insist on their rights and challenge unfairness and discriminatory practices.
  
  Discussed with Labour Shadow Education team February 2021

Warren Belcher, a team leader in an adults social services team, who joined into a recent on-line LSWG discussion on Labour’s policies and future direction with respect to adult social services, has agreed for us to put this blog-post on the website.

Social care can often feel frustrating and difficult to understand even for those of us who work within it or experience it as individual citizens along with people’s families, partners and friends by their side.

Social care for a long time (even maybe forever) has been virtually invisible within our wider society apart from the odd TV documentary, a five minute news slot or a sensationalist ear bashing from the increasingly irrelevant press headline. The viewers/readers naturally move on whilst those impacted by any aspect of social care also continue with real life long after the 48 hour outrage has passed or where our news has turned back to what’s happening in America or informing us all in forensic detail who has won Love Island (who knows next year it might even be me!)

Social care is a massive, complex machine which has a profound and important responsibility for people’s wellbeing. At the moment this machine feels a bit clogged up and has almost run out of oil whilst it’s nuts and bolts furiously try to hang on before the wheels come off completely. Social care is long overdue it’s own MOT or SOS depending upon your own experience and point of view. Its probably fair to say though its been in a bit of a state for a while and despite empty words from politicians, little has been done about it. For all the talk of the ‘green’ paper, its still more likely you will see a forlorn David Banner walking down the street going green after eating a dodgy Nandos rather than getting angry over its content, as we still have no clue about what it might actually say.

Social care at the moment reminds me of when I was a kid, where I kept the same trousers with the same holes in the knees. I kept them until they became shorts by default and along with my happy parents we ignored the problem despite the evidence of my cold knees and the need for more sticking plasters. Social care is similar, it has big holes and has to keep adapting into something which sort of resembles itself to survive. Those sticking plasters are rapidly running out as ‘short’ term spending solutions can only get you so far.

Solutions for social care are often talked about but only really in terms of money because as the population gets older, those financial holes will only get bigger. People won’t have as many assets as they do now to self fund and the baby boomers will start complaining and saying that they are not paying for their care even where they can afford to do so. The politicians will listen, knowing they need their votes because THEY always vote. Politically this worries the parties and will cause a reaction to policy where research into poverty has been time and again ignored but protecting individual assets will be taken seriously where people not experiencing poverty will complain. For the time being though politicians still continue to conveniently forget about citizens and social care, especially those under the age of 65 with complex health and social care needs, learning and /or physical disabilities, acquired brain injury, autism and / or mental health need. Just imagine if these people were the majority voters and more visible in society! Where would social care be then Boris? ……..There is only so much ‘spaffing’ up walls available right now I guess!

What’s missing from the social care debate is the failure to consider pride, expertise, citizens gifts and the successes social care has already achieved, despite the challenges it faces. There is indeed much to celebrate and evidence available to justify social care’s own individual investment. If we care to take the time and interest to look into people’s stories (for those who want to tell us them) we can find many successes to build upon and justify why social care is worth such time, effort and investment. I myself have repeatedly called for a defined department of social care with it’s own Secretary of State, along with a fit for purpose shadow minister. This would provide a platform for partnership, rather than the fashionable buzz of integration, which would never provide social care with any equal worth but would slowly dissolve it’s own identity, despite any reassurances this won’t happen.

We all require a social care sector, irrespective of our political persuasion as we may all become consumers of it much like we all went to school and we all see doctors from time to time. I recognise social care can’t be protected from government ideology which is why a government for the few and not the many will always secretly despise the notion of any visible social care system. If it stood out from the crowd it would simply be easier to dissect. Its suited to being buried away in Whitehall like a perverse version of hide and seek. You only start consciously looking for something when you become genuinely worried you can’t find who or what you are looking for!

I’m looking for investment for all citizens with better public scrutiny, better public understanding and in terms of social work a joined up identity for adult and children’s based practitioners. I’m looking for policy which is based upon rich and accepted research with thoughtful expertise rather than disingenuous political reactions in leadership races. Any policy decision must be for the welfare of all society including those of us requiring support and not just the ones who may exercise a vote. A governments first job then must always be the welfare of its individual citizens and our communities.

The Department for Education and the Department of Health &(Social Care) are failing in their ability to respond to the issues of poverty, community capacity and the necessary role social care has to play as one of the worthy experts. These two departments are not well placed to challenge themselves or their masters as the masters should indeed be citizens not the MP’s fighting it out for pure political gain. Perhaps the creation of a ministry for social care though along with its civil servants wouldn’t do much better but any failings and/or ideology would be easier to expose than it is now. To be truly progressive it simply has to happen which is precisely why it doesn’t.

Identity and context influences decision making. I believe the term ‘social services’ offers an opportunity for change. After decades of attempting to move away from the name, it still remains the title which defines aspects of the statutory social care sector. Social services is used by most professionals and is the name the public still associate with statutory social care because they understand it for the good,the bad and indeed the ugly! Social services then should be reclaimed by a profession who have either felt ashamed of it or have lost touch with the public by not seeing it’s relevance within our own office walls.

It also never fails to escape me that those working in social care where the impact on the ground matters most (let’s face it that’s why it exists in the first place) can still be treated overwhelmingly and exceptionally badly both in terms of real investment and valuing the frontline role. Its financially where real lack of worth is so easily exposed as are the consequences regarding retention and quality of consistent care. You only have to compare wages and salary increments within some of the same organisations to see where the injustice are and for too long real wage growth remains painfully stagnant. I’m not sure what the level of profiteering is made off the back of social care commissioning wise, but it’s nothing short of a murky world where no one can be blamed directly and god forbid anyone attempts to ask.

The challenge of decent pay for care and support workers is however complicated and compounded by the high numbers of people employed at that level. Paying a few leaders will always be less of a challenge than paying for the vast majority of direct carers or social workers. Its the same in any industry that those who turn the wheels still only get the crumbs. However the private markets and contract arrangements in social care are still worth investigating, given that vast sums of money don’t trickle down to where the investment is required the most ie paying for the real expertise on the ground delivering direct care and support.

Citizens with support requirements can’t afford not to have consistent care and support workers, yet we don’t price this investment as much as we do for other indirect roles in social care, some of which pay eye watering amounts of money for less impact or possibly no real impact at all. It exposes an industry flawed by a risk of over professionalism over actual impactual care delivery.

The role of day to day social work practice itself within the juggernaut of increasingly corporate organisations is also at risk of increased irrelevance where there is any talk of outsourcing services. Social work must not allow itself to sleepwalk into a exclusive reactionary role as this will be at the expense of relationships and any nuance of grounded practice. The value of such direct practice would be at risk of diminishing to the point it would only be viewed as a stepping ladder to progress further away from direct work where experience and retention is still so desperately required. Social work does not react well to targets and key performance indicators in the same way a salesman measures his/her sales.

Frontline practice is tough, it’s instantly accountable to the people it supports, its on your shoulders when it counts and delegation is not so easy with continuous and shifting expectations when actually trying to see through day to day tasks. Social work is of course necessary at strategic levels but would benefit from moderately recent frontline experience about what works and what doesn’t. It is vital leaders are in touch with the realistic challenges taking place caused by the shear volume of citizens requiring social care support as increasingly reactionary solutions with little growth in employing enough experienced social care staff to meet demand is required or it affects the entire systems they work in.

The Care Act (2014) and Mental Capacity Act (2005) have significantly impacted on such social care systems and delivery. As an example, to make adult safeguarding truly personal requires time and expertise. Arranging a truly fit for purpose capacity assessment, preparing the citizen, supporting their family, establishing a meeting for the assessment, undertaking the assessment, writing up the assessment, organising a best interest decision (where appropriate) and repeating above steps for best interests is a lot of tasks. At the same time the social worker has to establish a protection plan, possibly make several internal and external referrals including to the Police, CQC, CCG and IMCA. They also manage immediate complaints, possible defensiveness and hostility as well as keeping the referer up to date, recording the case notes, recording the strategy discussions and recording decision making tools for managers to make decisions. This all sounds like good practice but multiply that by countless new referrals everyday and you get the picture that the strategic verses the operational can clash. It only takes one missed phone call and one email request for further information not to come though or a cancelled visit for a delay to send a social worker into a spiral of anxiety with a back log created, especially when simultaneously managing commissioning, crisis work, further allocations, covering sick leave for colleagues, expectations of training, attending other meetings and being asked to find solutions for many other things which could constitute full time jobs in there own right. It’s a tough gig day in day out trying to keep on top of all that and many good folk do indeed cope with it.

Social care undoubtedly sits within a big industry focussing on individuals and communities who require support and information in terms of risk, aspiration, safeguarding, daily living, relationships and care support. The individual social worker working within it requires ‘continuous professional development’ with rules, regulations, standards, action learning sets, training and requirements for self reflection and the dreaded critical analysis. We however must not forget the systems these individuals sit within as they must be fit for purpose. If Local Authorities are to remain at the heart of delivering services they must be confident to challenge government visibly and with determination by being honest with the public and the politicians. Most of us are familiar with terms such as ‘lessons will be learned’ at times of reported and very visible significant tragedies. The worry is other micro tragedies are happening before our very eyes every single day. The practice conferences and speakers at them must talk about the challenges of welfare and the impacts for social care which is not free at the point of access. This day to day remains the single biggest area which causes citizens receiving care to feel over overwhelmingly stressed or miserable.

For all the talk of good practice/relationship based practice and the increasingly used rhetoric concerning social justice, our collective challenge must be to reflect and think about actual impact. Despite organisation changes, implemented standards, good practice expectations, legislation requirements and training, have people’s lives in the community really changed for the better in the last 20 years based upon how the organisation of social care has provided its ‘offer’? The resounding thing to think about before answering is to consider the voice of the citizen like Anna to help us provide not just an answer but a better response to the question…….

“Got email to say time for my #socialcare review. Feel terrified. Having PAs allows me to live independently, but I always feel like I’m begging not to have my hours cut. I’ve spoken at national conferences about social care but this makes me feel sick & powerless. Silly but true.” (AnnaSeverwright 08.08.2019)

So do you care?

This is a draft- article accepted with minor changes/ cuts

For the past 40 years successive governments have pushed crucial services out of public ownership and into a profit-prioritised market place. Despite the dismal track record https://www.theguardian.com/society/2016/mar/02/councils-outsourcing-cumbria-public-private-partnership-in-house of the big out-sourcing companies failing to deliver on their public service contracts, and over-charging central and local government, they have continued to have expanding opportunities to make money from the public purse.

This is now being challenged by Labour with a commitment to bring vital services back into public ownership and control https://www.theguardian.com/politics/2019/jul/20/labour-pledges-to-push-councils-into-taking-back-local-services. Nowhere should this be more urgent than for those services which protect and care for children.

From 2010 the Conservative-led governments have forced and coerced local authorities to contract out statutory children’s social services. Widely opposed regulatory changes https://www.theguardian.com/society/2014/may/16/privatise-child-protection-services-department-for-education-proposes were introduced in 2014 allowing commercial companies to get contracts to intervene within families to undertake children in need and child protection assessments and take decisions about the care of children. Companies such as G4S, Serco, Virgin Care, Mott Macdonald and Amey have been hovering around the Department for Education https://www.theguardian.com/society/patrick-butler-cuts-blog/2014/oct/29/governement-advisors-finesse-child-protection-outsourcing-plans-market ready to hoover up the contracts.

The privatisation of children’s social services is already a big money-maker for commercial companies, with money which should be spent on helping children and families now being taken as profit. The owners of these companies are increasingly private equity companies and distant venture capitalists https://corporatewatch.org/foster-care-associates-sold-to-private-equity-firm-capvest-partners/ whose only interest is how much profit can be generated.

Three quarters of children’s homes in England are provided by for-profit private companies. Almost a third of local authorities no longer directly provide any children’s residential care. On 31 March 2018 6990 children were placed by local authorities in private children’s homes. https://www.gov.uk/government/statistics/childrens-social-care-data-in-england-2019. In 2016 the average weekly cost of a private children’s home placement was £3289 https://www.gov.uk/government/publications/childrens-residential-care-in-england.. If there was a profit of 10% (a low target for out-sourced public services) on these placements the total profit being taken in a year is £110 million.

For children in foster care, on 31 March 2018 16,200 (39% of all children in foster children in England https://www.gov.uk/government/publications/fostering-in-england-1-april-2017-to-31-march-2018/fostering-in-england-2017-to-2018-main-findings) were in foster placements arranged through for-profit foster care agencies https://www.gov.uk/government/statistics/childrens-social-care-data-in-england-2019. A government-commissioned 2018 report found that the average weekly cost to local authorities of each these placements was £823 (compared to a cost of £553 for a placement provided directly by a local authority with its foster carers), and that the private foster care agencies were making a profit of 10.5% https://www.gov.uk/government/publications/foster-care-in-england. In a year this totals a profit of £72 million taken out of children’s social services.

In local authorities in England 15% of social workers working in children’s social services are employed through private for-profit employment agencies https://www.gov.uk/government/collections/statistics-childrens-social-care-workforce. This is 5,360 full-time equivalent social workers, and local authorities are paying £335 million a year for agency social workers https://www.bbc.co.uk/news/education-39659252. Assuming a 10% profit this means £3.35 million is being taken as profit each year. But a 10% profit margin must be a considerable under-estimate as the company accounts of just two of the many employment agencies showed profits of £2.1 million (Liquid Personnel) and £2.2 million (Sanctuary) in 2016 as well as salaries of about a quarter of a million pounds being paid to each senior manager. Profits taken from children’s social services by social worker employment agencies in England are likely to be over £10 million a year.

In total, therefore, profits of £220 a year are being taken out of local authorities children’s services by private companies. There are also overhead and transaction costs for local authorities and for the companies of children’s services being marketed and purchased by councils and these are likely to total over £20 million a year – costs which would not be incurred if the local authority were providing the help and care for children.

£240 a year is equivalent to local authorities employing 480 children’s social workers in England. With each social worker helping about 20 children and families each week that would mean almost 10,000 more children and families getting help at any one time.

There should, therefore, be strong financial incentives for local authorities to provide rather than purchase these vital services for children. But even more important, poorer quality services are being bought at a higher cost from these companies.

Eight four per cent of children in private children’s homes, and 50% of children in private fostering agency placements, are not within the area of the local authority https://www.gov.uk/government/statistics/children-looked-after-in-england-including-adoption-2017-to-2018. Children are being placed at a distance in children’s homes and with foster carers unknown to social workers and their managers. The children are less visible and more vulnerable. Private children’s homes pay their staff less and have fewer staff than local authority children’s homeshttps://www.gov.uk/government/publications/childrens-residential-care-in-england. Short-term come-and-go agency social workers have little knowledge of the children and families with whom they are working and children and families give up having relationships with a conveyor belt of social workers. Agency social workers who may be here this week but gone next week are placing children some distance away in one-off spot-purchased placements about which they and the local authority have little information. It is a disaster which is not waiting to happen but which is happening today.

So it should be a priority for government, whether Labour or not, to turn away from the commercialisation and out-sourcing of children’s social services. A start would be for local authorities to be compared and reported on what proportions of the children they are looking after are in care directly provided by the local authority and what proportion of social workers they employ rather than buying from agencies. It would also be a start for local councillors to commit themselves to caring for children within their communities rather than sending children away to be cared for by those who are unknown to the council.

GENERAL SOCIAL PROTECTION

1. Incorporate the Convention on the Rights of the Child into UK law. UNCRC article 4 2. Recommit to end child poverty through a progressive taxation system and social policies which tackle structural inequalities. Implement the socio-economic duty in Section 1 of the Equality Act 2010, which requires public bodies to work towards reducing inequalities arising from socio-economic disadvantage. UNCRC articles 2, 3, 4, 6, 23 and 27

3. Redress negative effects of Universal Credit: remove the five-week waiting time which has led to families living in debt, and withdraw sanctions which cause families misery and fear. Reinstate social security for all children: remove the two-child limit, under-occupancy charge (‘bedroom tax’) and the benefit cap. UNCRC articles 2, 3, 4, 6, 18(2), 23, 24, 26 and 27

4. End discriminatory social security for asylum seeking families, ensuring equitable levels and the removal of the stigmatising and restrictive state (ASPEN) debit card. All children to have full and equal access to social protection (including health, education, social care) regardless of their immigration status. Abolish the policy of no recourse to public funds in its entirety for families and care leavers. UNCRC articles 2, 3, 6, 18(2), 22, 24 and 26

5. Review the diversity, availability, resourcing and quality of education, health and social care services for children and young people in the community and away from home – encompassing NHS and local authority provision and the voluntary and private (for profit) sectors. UNCRC articles 2, 3, 4, 6, 20, 24, 28 and 29
Our focus is children’s social care though other services and areas of policy (education, health and social security for example) deeply affect the lives of children, young people and families. The changes we propose would give the most help to children and families presently in the greatest need. We recognise the time and cost implications of our measures, though believe they can be afforded and implemented with the right political will. Some of our very specific proposals inevitably require further discussion and consultation with those most affected.
These 30 pledges combine comprehensive measures to support families with vital improvements to children and young people’s care and protection within the community and especially for those who no longer live with their families. All of the pledges relate to existing obligations within the UNCRC; we have signposted the most pertinent articles accordingly.
6. Introduce a comprehensive children’s workforce strategy integrating health, education, social care and youth justice to ensure sufficient numbers and capacities to meet the needs and uphold the rights of children and young people within the community and in residential (including secure) settings. UNCRC articles 2, 3, 4, 6, 18(2), 20, 24, 29, 37c and 40

7. Introduce a statutory principle of ‘close to home’ for children’s mental health in-patient services and other specialist residential provision. Ensure no child is forced to live many miles from home unless this is in their best interests, and their wishes and feelings have been given due consideration. Introduce statutory waiting times for children, young people and parents in need of mental health care, and provide information and assistance to help people access this support. UNCRC articles 2, 3, 4, 6, 9(3), 12, 20, 23, 24 and 42

8. Remove the ‘reasonable chastisement’ common law defence so that children have the same protection from assault as adults. UNCRC articles 3, 6, 12, 19 and 37(a)

9. Close child prisons, ensure children’s contact with the criminal justice system is a last resort and develop the capacity of local authority secure children’s homes for those children for whom it is unsafe, at the present time, to live within the community. Ensure no child is criminalised as a result of abuse and/or exploitation. To protect children from damaging contact with the criminal justice system, substantially raise the minimum age of criminal responsibility. UNCRC articles 2, 3, 6, 19, 20, 37, 39 and 40

10. Continue the UK’s commitment to the Dublin III Regulation. If leaving the EU, establish the agreements necessary to ensure that children seeking protection can be reunited with family in the UK. UNCRC articles 2, 3, 10 and 22

11. Review leave policies for children subject to immigration control and ensure the child’s best interests is a primary consideration in all decision-making, ending uncertainty and providing security of residence. European national children in the UK to be automatically granted settled status. UNCRC articles 2, 3, 6, 10 and 22
FAMILY SUPPORT

12. Adequately fund local authorities to meet their statutory obligations in the Children Act 1989 (using calculations produced by the Local Government Association, the Association of Directors of Children’s Services and others). Accordingly, strengthen the capacity of local authorities to provide financial and other support to families to prevent children entering care, to prevent offending by children and to prevent children being deprived of their liberty – as the 1989 Act intended. Ensure that access to support services for vulnerable children, including those in kinship care, reflects their needs rather than being dependent on their legal status. UNCRC articles 2, 3, 4, 6, 9(1), 18(2) and 20

13. Amend statutory guidance to the Children Act 1989 to make it explicit that no child can be separated from their family and brought into the care system due to poverty or homelessness alone. Establish a national programme to support careexperienced young people who are becoming parents, with the aim of keeping families together. Introduce polices which keep families subject to immigration control together. UNCRC articles 2, 3, 6, 9(1), 18(2), 20 and 26

14. That kinship care be actively explored for any child who cannot remain at home, with financial and other support for carers (and ensure local authorities are adequately funded to provide this support). As a minimum, grant kinship carers the same access to support as adopters, including the right to paid leave and opportunities for specialist training. UNCRC articles 2, 3, 6, 18(2), 20 and 26

15. Reinstate and expand universal, nonstigmatising services for children, young people and their families – from early childhood through to young adulthood.
UNCRC articles 2, 3, 4, 6, 18(2), 23 and 31
INCLUSIVE EDUCATION

16. Make it unlawful for schools to exclude primary school children (fixed period and permanent). Establish a national initiative for achieving inclusion, backed up with resources. Replace the current Admissions Code and amend other national policies to end discriminatory practices in school admissions, exclusions and offrolling, especially against looked after children. UNCRC articles 2, 3, 6, 23, 28 and 29

17. Review the impact of formal testing and assessment on children’s development (including their mental health), to move to a system which puts children’s interests first while continuing to hold schools to account. UNCRC articles 3, 6, 12 and 29

18. Review the support offered to children with special educational needs and disabilities, with a view to substantially increasing resources and the capacity of families and services to work together to ensure each child enjoys their rights to education, health and social care. UNCRC articles 2, 3, 4, 6, 9(1), 18(2), 23, 24, 28 and 29

19. Extend free school meals to all primary school children, and establish pilots of universal free school meal provision in secondary schools in the country’s most deprived areas. UNCRC articles 2, 3, 4, 6, 18(2), 27 and 28
CHILDREN IN NEED OF PROTECTION

20. Ensure every child has access to an independent advocate so their wishes and feelings are understood and taken seriously. UNCRC articles 12, 13, 17 and 42

21. Ensure timely counselling or other therapeutic support is available to every child who needs it. UNCRC articles 2, 3, 4, 6, 24 and 39

22. Ensure homeless 16-and 17-year olds without the care of their family receive their entitlements to care, protection and support under Section 20 of the Children Act 1989. UNCRC articles 2, 3, 4, 6, 12 and 20

23. Ensure semi-independent supported accommodation is subject to registration, regulation and independent inspection, and that providers are required to safeguard and promote each child’s welfare. Introduce a legal presumption that children in care stay in accommodation where they are provided care and support until at least 18, unless this conflicts with the young person’s wishes and is not in their best interests. Prohibit the use of semi-independent supported accommodation in all circumstances for children under the age of 16. UNCRC articles 2, 3, 4, 6, 20 and 39

24. Establish a national implementation team, with the requisite skills, authority and professional respect, to ensure the findings of the Independent Inquiry into Child Sexual Abuse are acted upon. Prohibit pain-inducing and other forms of dangerous and harmful restraint techniques in all children’s settings as a matter of urgency. UNCRC articles 2, 3, 4, 6, 12, 19, 24, 34, 35, 36, 37 and 39

CHILDREN IN CARE AND CARE LEAVERS

25. Put loving long-term relationships at the heart of the children’s care system – including children’s relationships with their brothers, sisters and extended families. Amend the third corporate parenting principle in the Children and Social Work Act 2017 (“to take into account the views, wishes and feelings of those children”) by adding “including the changes care experienced people want to see in the care system”. Ensure social workers have the time and support to build and maintain meaningful relationships with children and young people. UNCRC articles 2, 3, 4, 6, 12, 20 and 39

26. Extend the legal entitlement of ‘staying put’ to young people living in children’s homes to 21 years of age and ensure these arrangements are properly funded. Amend local authorities’ statutory obligation of maintaining and providing suitable accommodation by adding, “including the prevention of homelessness”. Existing statutory guidance ‘Extending Personal Adviser support to all care leavers to age 25’ and ‘Local offer guidance’ recognise that care leavers may benefit from a range of support services up to 25 years of age: amend this to similarly extend entitlement to independent visitors, independent reviewing officers and specialist services. UNCRC articles 2, 3, 4, 6, 12, 20 and 39

27. Ensure individuals who were formerly in care have priority for assessment for support services including housing, mental health and drug and alcohol services, and finance local authorities to provide ongoing support for care leavers for as long as they need it. UNCRC articles 20, 24, 26 and 39
HUMAN RIGHTS AND CITIZEN PARTICIPATION

28. Put respect, equality and fairness at the heart of our public services, bringing an end to programmes and policies which demean and stigmatise communities. Invest in ‘active offer’ independent advocacy services across all public services, for all age groups, so that those in need do not stand alone. Create new spaces and legal arrangements so that children, young people and adults who need or use public services can lead and influence their design, development, delivery and improvement – at the local and national levels. UNCRC articles 2, 3, 4, 6, 12, 13 and 42

29. Reinstate legal aid for advice and representation over all aspects of social protection, including family separation, housing, social security and immigration. Ensure non means-tested legal aid is available where serious human rights matters are under consideration, including inquests held after a child or adult has died in the care of the state. UNCRC articles 2, 3, 4, 6, 12, 24, 26, 27, 37 and 39

30. Extend the right to vote to 16 and 17 year-olds. UNCRC articles 12 and 13

LETTER SENT TO THE MANIFESTO TEAM 

Dear Labour team and parliament colleagues with an interest in the future of social work and social care for children and adults

DETAILED POLICY PROPOSALS ON CHILD AND FAMILY POLICIES WRITTEN BY PROFESSOR RAY JONES 

SOCIAL WORK AND SOCIAL SERVICES FOR CHILDREN AND ADULTS

Children’s social work and social care services have been damaged over the past 10-15 years, as a result of budget cuts especially to local government, but also through a series of unevidenced, and minimally debated government initiatives, mostly intending to open up policy formation and service provision to large private consultancies and private for profit service providers. Below are proposals from members of the Labour Social Work Group about detailed commitments which should be considered for inclusion in the  Labour Party Manifesto and policy for children’s social work and social care services. There is considerable support for each across the policy, practice and research communities as can be seen from the following recent official reviews and inquiry reports:

• The Education Select Committee with its Conservative majority and chairs.
• The All Party Parliamentary Group (APPG) report on children needing support and care
• The APPG on social work.
• The National Audit Office inquiries on social work.

PUBLIC SERVICE PROVISION AND PRIVATISATION

1. Labour will rescind the 2014 changes in statutory regulation introduced by the Conservative-Liberal Coalition Government which allows any organisation or company, including profit-making companies, to receive contracts and payments to undertake:

• Children in need assessments and the setting and managing of children in need plans.
• Section 47 child protection inquiries and the setting and managing of child protection plans.
• Decisions to initiate care proceedings and the management of orders emanating from care proceedings.
• Crucial decisions about the safety and welfare of children, and necessary involvement and intrusion into families, should not be undertaken outside of the direct accountability and transparency of local authorities. They are not functions and responsibilities to be managed by non-public for-profit or not-for-profit organisations where the contracting process creates complexity and opaqueness in accountability, where transparency is restricted by contracting out the services to non-public organisations, and where costs are increased by having to set, let and manage contracts.
• Labour will also give notice that local authorities over a three year period should reduce their use of profit-making private foster care agencies and privately owned and managed children’s residential care which is syphoning as profit significant amounts from children’s services budgets.
• The progress of local authorities to reduce their reliance on profit-making and profit-taking direct care services for children will be monitored through annual public reports submitted to the Department for Education, which will be renamed as the Department for Children and Education, and the Department for Children and Education will produce an annual overview report on the progress being made.

Within the annual public report from each local authority, and the annual overview report from the Department for Children and Education, there will also be an account of how local authorities are reducing over a three year period their use of social workers who are not directly employed by the local authority but recruited through private profit-making staffing agencies.The rationale and intentions of the commitments above are to:

• Tackle the considerable sums of money which are intended to fund children’s social services which are seeping out of children’s social services as profits taken by private companies and their owners.
• Increase the local authority immediate oversight of, and responsibility for, the safety and welfare of children and the care of children not living with their families.
• Reduce the complexity and fragmentation which is increasing in the arrangements for children’s social services with the result that children in care are now often placed in foster and residential homes largely unknown to local authorities and the children’s social workers.

 PERFORMANCE BY LOCAL AUTHORITIES

7. Labour will require the national children’s services inspectorate, OFSTED, to contribute to the continuing development and improvement of children’s social services rather than only to inspection and rating of services.
8. Labour will require OFSTED to develop a plan and process where it has regular engagement with senior councillors and managers within local authorities to monitor and reflect with the local authority on its performance and progress, to advise on actions which might be necessary within the local authority, and where and when necessary to alert the Secretary of State for Children and Education to any significant concerns about how a local authority is fulfilling its children’s social services responsibilities.
9. Where these concerns are of such a magnitude, and where the Secretary of State is not confident that they will be appropriately and positively addressed by the local authority, the Secretary of State will have the power to appoint through statutory regulation a person of sufficient seniority, experience and expertise to give direction and directives to the local authority on how it is to provide its children’s social services. In the first instance this will be for a period of three years, a period which might be extended.
10. In exceptional circumstances where a local authority fails to follow the directives it is given the Secretary of State will have the power to remove the responsibility for the services from the local authority and to transfer the responsibilities for that area to another local authority.
11. To assist local authorities, and especially local authorities of particular concern, to improve their performance, the Local Government Association will be funded through a Statutory Children’s Services Specific Improvement Grant to create a regional children’s services improvement service.
12. Labour will cease the process of local authorities being required or choosing to contract their statutory children’s social work services outside of their management and control. Where local authorities have already taken this action, the local authority will be required to inform the Secretary of State for Children and Education how it will resume the direct management and control of these social work responsibilities at the end of the current contract with another body, or within three years, whichever is the shorter period.
13. The manifesto commitments above in this section are to:

• Make explicit that statutory children’s social work functions are a direct responsibility to be delivered by local authorities.
• Make clear that where a local authority is not performing well enough in delivering these responsibilities the local authority cannot distance itself from the responsibilities by contracting them out to another body but must follow directives given on behalf of the Secretary of State to improve its performance.

SOCIAL WORKERS

21. Labour recognises that the major issue for children’s and adults’ social services is not recruitment into the profession of social work but developing and retaining social workers post-qualification.
22. Labour will continue with the generic university-based undergraduate and post-graduate degree-level integrated qualifying education for all social work students. This will aid retention as social workers with a generic first professional qualification will be able to remain in social work whilst, if they choose, changing career paths and service areas.
23. Labour will introduce the regional oversight and planning of qualifying and post-qualifying social work education through regional social work education consortia to include as the statutory partners the local authorities providing personal social services in the region and the higher education degree providers.
24. Each regional social work education consortia should review the pattern and sufficiency of social work education provision in its region and produce a plan as to how this is to changed or continued over the next five years. This should take into account the assessment by Social Work England of the quality of the current social work qualifying degree programmes within the region, and where these degree programme are a major resource in recruitment by neighbouring regions their consortia should be consulted.
25. Other agencies employing social workers in each region should also be consulted about the plans for social work education in the region.
26. Regional social work education consortia should also develop ‘practice education agencies’. These will be social worker employing services which provide a focus on social work education and will be the major resources within the region for the practice placements of qualifying social work students, and especially on their final qualifying placements. The ‘practice education agencies’ should be assessed and accredited by Social Work England.
27. Labour will require Social Work England to produce national frameworks for post-qualifying education based on social work’s Professional Capabilities Framework and it is through post-qualifying education and qualifications, related to role responsibilities and career development, that specialisation will be recognised and promoted. This will assist career progression and retention.
28. The development of post-qualifying education will receive funding through a budget managed jointly by the Department for Children and Education and the Department for Health (and Social Care) which will be created from the current funding being committed to the programmes providing specialist and restrictive initial social work qualifications for a relatively small number of social work students.
29. Using this funding, Labour will also continue with payment of bursaries and course fees for social work students.

HELP FOR CHILDREN AND FAMILIES

23. Labour is very concerned that statutory social work and social services with children and families has become focussed on monitoring families and taking invasive and coercive action to intervene when there are significant child protection concerns.
24. This intervention will remain necessary when children are at risk of significant harm, but Labour will want children’s social work and social services to be re-set, within the framework which is in place within the 1989 Children Act, to work in partnership with parents to assist them to care for their children well.
25. It will re-route the funding allocated through ‘troubled families’ programmes to local authority children’s social services so that they can provide family assistance services, intensively provided when necessary, to work with families and other agencies to help maintain, and where necessary, improve the care of children.
26. In particular, learning from the research on Sure Start and family centres, Labour will work with local authorities to provide help for families with young children and throughout a child’s childhood.

This policy paper is written jointly in 2019 by members of the Reclaim Social Care Group (linked with Socialist Health Association and the Centre for Social Reform.  LSWG is linking up with these in arguing for an inclusive and collaborative and FREE social care service   See https://www.centreforwelfarereform.org/library/fully-funded-social-care.html

LSWG committee  would be interested in comments of LSWG on this paper.