What has become of social work with adults?

Published by Professional Social Work magazine, 8 February, 2022

As a rebelliously inclined product of the 1960s, the challenge for people like me was what to do without compromising all those non-conforming desires to change society embedded in me.

It is what led me into social work. This was the time of Seebohm and the 1971 Local Authority Social Services Act. These were, according to a Cabinet report at the time, to bring in an era of “local authorities providing a community-based and family-orientated service which will be available to all”.

There was widespread optimism that the new social services departments would shift the focus of social work from the individual, the family and their problems, to the community, its needs and rights.

Surely this offered the future I and others were in search of. But what was social work with adults like in 1973 as these new departments brought together welfare officers, mental welfare officers, childcare officers and medical social workers from separate places, traditions and beliefs about their comparative status?

I was in the first cohort of newly qualified generic social workers in a London borough, where anything – and indeed, often everything – was possible.

I recall trying to resist the pressures of neighbours about unwanted people living amongst them within the community. And also how, a year on from qualification, and with no other training except watching how you did it, becoming a warranted mental health social worker.

Where was the theoretical underpinning for what I was doing? Where was the statement of expectations about what newly qualified ‘generic’ social workers should do? Were we generic social workers or generic teams with individual specialisms?

Where were the opportunities to change people’s social circumstances? Much of our time was spent trying to persuade electricity providers not to turn off the power to households unable to pay their bills; the housing department not to pursue rent arrears; intercepting runaway children with the police at London mainline terminals. And worst of all, placing homeless families with young children in appalling bed and breakfast ‘hotels’.

There soon became separation of ‘intake’ (today’s first response or assessment) and so-called ‘long-term’ casework, the beginning of methodologies to determine case priorities, and the organisational structures to support these.

I’ve always disliked crude categorisations of need, not least as they have little regard for the person: who they are, what they feel about their circumstances, what they really want, and any voice for a carer or advocate.

Of course, there was good social work practice with adults in the 1970s and 1980s. But there was not much local authority or professional leadership, other than interpretations of ‘statutory responsibilities’.

I was always more enthused with social workers as part of teams connected to and engaging with their local communities and with local voluntary organisations, as well as working with individual cases.

My colleagues and I didn’t call it ‘patch-based’ or ‘community social work’. We called it ‘a unitary approach’, with whole families and their networks in mind, based on systems theory, a self-evidently much more sensible way of understanding the joined up parts of people’s lives, where they lived and who were the significant people and services around them.

But this ‘patch’ thinking was promoted much too enthusiastically by the influential social administration academic and author Roger Hadley. It seemed, to some, to fit with ideas of the Thatcher government of the time, especially to diminish the role of the state.

When the lawyer Peter Barclay produced his government-commissioned Report on the roles and tasks of social workers in England and Wales in 1982, it was criticised by social policy academic Robert Pinker as a prescription for managerial chaos, and as politically naïve and dangerous by the left. Others, including local authority leaders and directors, warned it raised expectations unrealistically on top of existing workload demands and priorities.

Having said that, for me community social work (dare I say today’s ‘strengths based social work’ and ‘building community capacity’?) felt much closer to the values I came into social work with. It made sense, perhaps more especially when focused on supporting older people and adults with their diverse range of long-term conditions, disadvantages, disabilities and prejudices about them.

By the late 1980s social work was still children and adults. Both had the same values, principles and practice skills. But service and organisational separation were coming. The Children Act 1989, NHS & Community Care Act 1990 and their attendant regulations and guidance, together with political and managerial requirements, made it inevitable.

The Community Care Act, introduced in stages from around 1993, brought us assessment and care management, eligibility, cost avoidance, and increasingly restrictive workload management tools and budget rationing methodologies. There were even nonsensical ‘purchaser’ and ‘provider’ labels attached to some social workers. An NHS preoccupation with discharge from hospitals began dictating public perception of social work priorities.

There were exceptions, such as social work in mental health settings or as approved social workers; social workers passionate about ‘normalisation’ and ‘ordinary lives’ for people with learning disabilities; and the beginning of independent living movements.

But there was often a less positive social work response to these. Carers, issues around equalities and diversity, anti-racism, advocacy, housing options, digital communications and electronic assistance mostly went their separate ways and developed independently of social work.

Assertion of service user rights and wants was often covertly resisted, either because it challenged ‘professionalism’, or because it was extra work or unaffordable.

Social work with adults, at least up until the early 2000s, had significantly lost any direction – unless individual directors or assistant directors tried to give it some. Until 2000 many, perhaps most, directors had a social work background somewhere in their past. But since, this has significantly decreased in the varied new local authority departmental creations.

Priority spending in local authorities was always on children, not least because of perceived greater risk of political reputational damage to the council. That was where many of the best professionally qualified social workers were, or wanted to be. It was where most academic minds and research interests were focused.

Into the 2000s, some councils anticipated the 2004 legislation in favour of separating completely adult and children’s services – and the work of social workers accordingly. I was strongly opposed to this move. It undermined all those unitary, whole person, whole family, life and community engaging concepts which had underpinned my thinking about social work and care.

Perhaps registration within the profession has served to better define the role and task of social workers. Perhaps the shift in focus towards people’s legal rights – rights to be protected, but also to exercise choice – together with the publication of No Secrets: guidance on protecting vulnerable adults in care in 2000 and the ‘discovery’ of adult protection (later safeguarding adults), has helped. Perhaps too regulations around the Mental Capacity Act, Best Interests and Deprivation of Liberties.

Personalisation, statutorily in the 2014 Care Act, has also fostered better appreciation of people’s lived experiences, rights to equal lives, and some meaningful co-production. As independent chair of a safeguarding adults board I’ve observed social workers working positively with the conceptual (and moral) challenges of enabling personal choice, working sensitively around mental capacity assessment and self-neglect, and exercising the professional judgment required to reconcile how, whether and when to intervene in people’s lives.

This is an edited version of a presentation given by Brian to a meeting of the Social Work History Network