INTERVIEW ‘Adult social workers have been deskilled
by care management over the past 20 years,’ she says. ‘The model is a very process-driven approach in terms of assessment, care planning and identifying need. We have lost the skills of relationship building and refl ecting. The attachment-based work is to help social workers going into complex situations, particularly where there are issues of loss or identity, to look below the surface of presenting needs and understand more about what is going on.’ Her argument is that by investing more time at the beginning in a skilled assessment, the care and support needs that the local authority has to provide in the longer term are reduced. One example that is pertinent to Sutton is that of moving people out of residential care. Adi says: ‘The skills needed to work with someone who has become dependent on institutional care are very diff erent from traditional care management skills, where the thinking is that once someone is there they stay there. We challenged that in Sutton with people with learning disabilities coming out of Orchard Hill [the last long-stay hospital] and campus homes. Now, 85 people live in the community in their own fl ats.’ The third area for the business case is
community social work. Sutton is six months into a pilot where a social worker is working
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in a deprived area with 30 older people with personal budgets. The pilot’s aim to build community capital and social cohesion sounds altruistic but it has to make sense fi nancially. ‘Over time we expect that the capacity building and support will reduce the need for longer- term care,’ says Adi. ‘It has to deliver cost- eff ectiveness and effi ciency.’ As a crude example, if 10 older people have
a personal assistant for three hours in the morning that is 30 hours’ paid time, but if they meet at the library instead where diff erent people can talk to them on various topics it costs far less and enables them to be part of the community. A more sophisticated example is building support networks around people. The community social worker is looking at setting up a timebank. ‘Instead of having a care package that relies on buying in care you can off er something as well as take back,’ Adi says. ‘Then you are reducing cost to the local authority because in eff ect you are using the