Chapter 8: Capacity for improvement
Fife Council provides good social work services to most people. Feedback from people who use services, and from carers, was generally positive. The Social Work Service has a new senior management team with a clear vision for continuing to improve services. It has redefined its priorities, and made significant organisational changes. These changes are strongly supported by elected members, senior Council managers and some major stakeholders such as the police. The Service has committed and competent staff who have a clear focus on delivering quality services to improve the outcomes for people who use services, and their carers.
The Service has undergone significant changes over the last year and more are in the pipeline. It is difficult to know how quickly these changes will result in considerable improvements to the outcomes for people who use services, and their carers, but the prospects for continuous improvement are good.
The capacity for improvement is good, having important strengths with some areas for improvement.
8.1 The previous chapters in this report have identified the major areas where continued investment and improvement is needed:
- improving social work services to ensure better outcomes for people who use services;
- redesigning social work services to meet future needs and pressures, such as demographic and cost pressures;
- developing a commissioning strategy to ensure a systematic approach to purchasing services from the voluntary and independent sectors as well as directly providing services;
- improving assessment and care management, especially carers' assessments and case recording;
- investing in performance management and information technology ( IT);
- improving communication with staff and working with middle and front line managers to develop leadership; and
- working more effectively with NHS Fife to improve outcomes for people who use services.
8.2 This chapter summarises the key strengths and factors that contribute to Fife's positive prospects for continuous improvement, and identifies the most significant challenges in relation to them.
Political and corporate support for the Service
8.3 Fife Council has signalled, in its appointment of a new Head of Service and four senior managers in 2003-04, a desire to continue to improve social work services, whether directly provided or commissioned. This management team has worked hard to focus the Service on social work core business, improve the recruitment and retention of social work staff and implement a new organisational structure, with full support from elected members, senior Council managers and many stakeholders.
8.4 Significant political leadership within the Council has resulted in a marked increase in financial resources and a relaxation of the current Council recruitment practice in order to reduce the level of social work vacancies.
8.5 The Service must now look outwards to its service users, carers, partners and the community and towards being a provider or commissioner of more responsive, high quality services. The political and corporate support for the changes necessary to improve services is strong. Councillors have been and will continue to be faced with difficult but necessary decisions if services are to be modernised and meet the needs of service users and carers. They have already given their support to many changes such as focusing on core business, agreeing eligibility criteria and the choice policy.
8.6 They will need to support managers and staff in implementing more changes to modernise some services, in particular home care and care homes for older people. Support will also be required in implementing devolved budgets, commissioning strategies and a robust performance management culture in order to monitor the progress of the on-going change programme. The internal Council support systems such as information technology ( IT) will need to be prioritised if managers and staff are to be able to achieve better outcomes for all.
Senior management drive for improvement
8.7 The Head of Service and the senior management team have identified a clear direction for Fife social work services and are committed to achieving it. It now needs to be developed and promoted by all managers (senior managers, service managers and team leaders) working together. It should be set out in action plans and a commissioning strategy which identify actions, individuals responsible for the actions, timescales, resources required and performance indicators and measurable outcomes in a way which has not yet been achieved.
8.8 Based on these, sound performance management arrangements should be implemented. Robust contracting arrangements particularly with voluntary and independent sector providers must also be prioritised.
8.9 The Service is at the start of linking service and financial planning on a short term and medium term basis. This process is now being developed by service managers which will help to ensure wider ownership. But more thought needs to be given to ensuring a comprehensive and joined up approach to service development, a commissioning strategy, and the devolved financial management to which the Service is committed. This will need to include robust costing of services and the expedited introduction of a new information system across all services.
8.10 To underpin these changes, the senior management team will need to promote some significant cultural changes, such as a continuous self assessment approach in the Service, and develop opportunities for collaborative working, especially with NHS Fife and smaller voluntary and community organisations.
8.11 The senior management team has accepted that communication with front line staff and first line managers has not been as effective as it could have been. The team also recognises the critical importance of effective communication in the successful implementation of change and the drive for improved outcomes.
8.12 Following the fieldwork, the Council's customer relations management service ( CRMS) has been engaged to develop and implement a communication strategy, specifically:
- a group of front-line staff drawn from all parts of the Service is being set up, facilitated by CRMS, to consult on effective communication mechanisms;
- a development day has been arranged to include social work, education and community services, to consider best practice across services with similar communication challenges; and
- the social work service arrangements for meetings between senior managers and service managers have been redesigned to include regular, formal meetings with team leaders to address the key challenges of communication and performance management.
Focus on people who use services and carers
8.13 Managers and staff in Fife work consistently, and largely effectively, to assist people who use services and carers to obtain a better quality of life. This strength will be essential in improving assessment and care management in the future. Currently the Service does not appear to have a strong explicitly stated culture of working in partnership with service users or carers, as opposed to setting in place care packages of readily available services. The quality of assessments (especially carers' assessments), care plans and the recording of them is variable. Staff are generally not clear about the value of jointly identifying with service users and carers the measurable outcomes which are to be achieved by social work intervention. This approach needs to be underpinned by a strong ethos of promoting re-ablement and independent living. We recognise that this situation is similar in some other councils in Scotland.
Staff commitment and development
8.14 We found that most staff are very committed to social work in Fife. While many did not fully understand the vision for change or own the way in which the change management process has been implemented, most were very positive about working in Fife, for example, they rated their supervision process highly. We judged that when communication has improved, the organisational and staff changes are fully in place, and responsibilities have been clarified by management, then the workforce will be able to focus more on improving outcomes and experiences for service users and carers.
8.15 Of as much importance as this commitment, are the steps taken by the Head of Service to improve the recruitment and retention of staff, in particular qualified social work staff. These include the establishment of senior practitioner posts and the involvement of staff in the 21st Century Review of Social Work. Other steps such as contribution management, manager training, and promoting the roles of staff such as social work assistants are also being taken.
8.16 One of the great strengths of the Service is its workforce. The significant improvements in social work services in Fife that we anticipate happening will owe much to the fact that services are managed and provided by capable and committed people, in both the statutory and voluntary sectors, as well as to strong corporate support and senior management drive.
Determination to promote good practice
8.17 There is a strong tradition in Fife of delivering quality services and committing the resources to do so. There is a clear awareness amongst elected members, staff and managers of the many areas of good practice in Fife. Some of these areas have been externally recognised, for example through four Care Accolade awards. While some staff expressed concerns about the potential impact of the redesign of services, others were clear about the improvements to services that are being sought or implemented, for example in residential child care services. This awareness of good practice and wish to provide or commission quality services for the people of Fife is a positive factor in continuous improvement.