Dr Ruth Allen: Chief Executive, British Association of Social Workers

The Care Act 2014 (the Act) was broadly welcomed by social workers from the outset. It expressed key social work values and good practices like no other recent legislation and, through Statutory Guidance if not on the face of Act, recognised social workers’ specific contribution, roles, and skills. It created a single, clear framework for care, support, prevention, and safeguarding, replacing decades of piecemeal laws and policies. This clarity has revitalised social work and the role of social workers over the past decade.

But we have to be honest; the profession’s practical capacity and resources to support people effectively and consistently, to protect their rights and implement the Act’s spirit and provisions, has declined since the first years of the Act - even as our understanding of what empowering social work can has increased.

Severe financial, workforce and social challenges have gathered pace through austerity budgeting, the crisis of COVID-19, recent inflation and cost of living hike and worsening poverty."

We have had better ways of working but far fewer resources to fulfil the personalising intention of the Act over the years, particularly in early help and prevention. But before turning to these difficulties in more detail, I want first to give an overview of the value of the Care Act and the hope of progress that it still embodies. Our task as a profession in the next period is to work together to build on what we have and what we have learnt, to influence policy and finally achieve realistic, sustainable funding at national level so we can fulfil and exceed the promise of the Care Act.

Beginnings

As many longstanding social workers will remember, the Act came out of a fundamental rethink of the purpose of social work, care, and support in the early years of the millennium. Extensive public and professional consultation - and most importantly listening to and involving people using services, their carers and families – brought forward milestone policies that shaped change - such as ‘Valuing People’ (2001, 2009) for adults with learning disabilities, ‘Putting People First’ (2007) focused on personalisation, choice and control, and ‘Carers at the Heart of 21st Century Families’ (2008). It also brought the game changing Mental Capacity Act 2005 which has transformed the ethics and practices of choice-making in care.

This new thinking and many more developments since have overturned the era of care management in social care derived from the NHS and Community Care Act 1990. This had, in reality, deliberately reduced public professionals, including social workers, to gatekeepers, rationers and brokers in monetised transactions. 

Through the Care Act and the statutory guidance, relationship and rights-based social work with adults has come in from the cold - after over 30 years of care management had devalued social work skills and professionalism."

Optimism, opportunity, blocks

The Care Act and guidance embodied a new ethos and optimism about how state actors and citizens could cooperate and work co-productively for better care and support. Its wellbeing and prevention principles focused on that would enable people to live optimal, chosen (‘Gloriously Ordinary ’) lives for as long as possible. The Act’s relationship to our powerful human rights and equalities legislation was clear and has been part of a nexus of progressive and democratic legislation that is vital and precious to social work. It underpins the difference we can make with individuals, and what we can advocate for when services are wanting.

The focus on wellbeing, prevention, involvement and community was an ambitious new departure. It signalled requirements on public bodies to tackle the social determinants of need and inequality (and coincided with public health being returned to councils). It promised a new partnership approach between public professionals and citizens within which people would be supported to access their social and human rights earlier and more preventively.

Over the last decade, the implementation of the Act has reasserted the importance of authentic human relationships as the crucible of practice. It has emphasised people’s abilities, strengths and agency as well as the need for community and social connections, and for recognition and respect for diversity in personal needs, wishes and experiences. In many ways, the Act has ‘re-humanised’ the ambition of care and support for adults and with this brought a revitalised role for social work. It brought statutory duties in closer alignment with fundamental social work values, ethics and practices, not only in England but also globally as echoed in the current international definition of social work: Social work is a practice-based profession and an academic discipline that promotes social change and development, social cohesion, and the empowerment and liberation of people. Principles of social justice, human rights, collective responsibility and respect for diversities are central to social work (International Federation of Social Workers 2014). 

However, the development of the Principal Social Worker (PSW) leadership role within councils has been a particular success. Now embedded and elaborated in the statutory guidance, all councils are encouraged to ensure they appoint PSWs who are given ‘credibility, authority and capacity to provide effective leadership and challenge ’. Their role in ensuring quality and good professional practice is strengthened by the demands of the new Care Quality Commission inspection regime for adult social care. PSWs are there to focus on good social work practice, on personalised support and safeguarding, and on and outcomes for people, not bureaucracy and resource-driven decisions; to be the ethical heart of the organisation.

And here, of course, is the rub. Through the introduction of the Care Act and all the sector efforts to shape and elaborate it, we have seen a new and much better form of social work emerge and in some places flourish. We know so much more about what excellent social work can do and how we should train, develop and lead social workers. But this is happening in the stoniest of contexts.

Holding on to the good for better days ahead

Plummeting council funding through over ten years of austerity has led to concomitant real terms cuts across social care and the whole ecosystem of public and third sector services upon which care and support depend. "

This and other factors such as the COVID-19 pandemic and changes to immigration rules have brought instability to the workforce. The failure of government to reform social care funding and policy in the context of rising poverty and inequality has undermined the Care Act’s intentions and its fundamental promise of support for wellbeing for the population.

In 2020, during the pandemic crisis, the Coronavirus Act enabled easements to the Care Act including councils being able to prioritise need against revised criteria on the basis of increased demand, workforce pressures and not being able to comply with duties. While little used, it showed how we cannot take rights in law for granted. In this time of worsening crises in public bodies’ budgets, including the rise in s114 notices, social workers have a key role as guardians of the spirit and word of the Act and the sector as a whole need to protect the vision of the legislation.

As austerity has taken a terrible toll on what services can do for and with communities, and as poverty in the general population has increased, the role of social workers as advocates, expert practitioners and defenders of the Care Act’s intentions and fundamental ethos is all the more needed.

Looking to the future, our social work with adults’ group in BASW England calls for the statutory guidance of the Care Act to be refreshed to empower social workers to use their skills and make professional judgements that support and promote more comprehensively the principles of wellbeing, choice, and control. The guidance should also promote the supportive working conditions necessary to sustain delivery of the ambitions of the Act.

I would like to thank Maris Stratulis, Jason Brandon, Liz Howard, Denise Monks, and Hannah Scaife for their ideas in preparing this article.