Changing Lives: Report of the 21st Century Social Work Review

Chapter 7: Building capacity for sustainable change

Introduction

In the last two chapters, we have outlined proposals to change social work services in Scotland, making them fit to meet current and future needs. We have outlined proposals which will change the way services are delivered and develop and deploy a workforce fit to meet that challenge.

The changes we set out are major ones, requiring real and lasting commitment to transform social work services at all levels and in all parts of the system. They reflect the consistent messages we have received about the need for change. The same messages have come from the people who use services and their carers and from professionals, managers and leaders. We can only deliver the necessary change if we can continue to have the support of all those involved.

As a result, our final four recommendations are about achieving lasting change. They set out:

• the need for clear leadership and effective management at all levels of the system;
• a new focus on performance improvement to drive change;
• support for transformational change across the system; and
• the need for new legislation that would consolidate change across the system.

10. Social work services must develop enabling leadership and effective management at all levels and across the system.
This requires: a national framework for developing leadership and management; a leadership style that gives staff, users and managers the power to develop creative solutions; strengthening of strategic professional leadership; development of academic leadership; and development of effective citizen leadership.

Qualities of effective leadership

Dedication - This is not just a job but an important job that can make a real difference, positive or negative, to people's lives. Values - of fairness, equity and inclusion, providing person centred services and never forgetting why they are there. Integrity - the ability to keep to their values even under challenge Charisma - the ability to motivate others to treat people as they would like to be treated themselves. Bravery - being prepared to challenge bad practice wherever it may be. Motivation - the ability to encourage others to do the right thing and not just accept the inadequate. Credibility - with a firm base of knowledge and experience Users and Carers Panel

Social work services are complicated, multi-million pound businesses. They employ large numbers of staff, some of whom are highly skilled. The task in terms of leadership and management is enormous. Yet it is one which has not always received sufficient attention to date. Many senior staff spoke to us about the need to keep management control, yet almost nobody spoke to us about the need for enabling leadership. Many social workers did not know who their professional leader was and if they did, few had met them.

In our interim report in April 2005, we suggested that "the need for effective leadership in the public sector as a whole has arguably never been greater, with increasing complexity of need and a continuing shift towards service integration and user centred delivery. Increasingly, that requires that professionals are led rather than managed, enabled and empowered rather than controlled." Further work by our leadership and management sub group has confirmed that analysis.

Our goal must be to empower workers, people who use services and managers to promote partnership and provide a supportive environment where creative solutions can be developed to meet people's needs. This will be a major challenge that leaders at all levels must embrace.

Developing the ability of both services and workers will require visionary, creative leadership at all levels of organisations as well as effective and supportive management. That leadership is needed at all levels of organisations is a point made very clearly to us from our users and carers panel. The panel set out seven qualities of good leaders.

For many in social work services, leadership and management have been inseparable ideas, with line managers being the leaders. This is changing and will continue to change as people work more in multi-disciplinary teams. Over time we expect to see fewer line managers and more people at all levels taking on leadership roles. It is clear to us that leaders need not necessarily be managers, but managers must always be good leaders.

"Leaders aren't all at the top. People throughout the organisation should be given the opportunity to lead. Leadership is about doing the right thing. A good leader sticks to their values and isn't knocked off course."
Users and Carers Panel

A framework for leadership and management

The leadership and management group recognised that developing effective leadership and management are major themes across the whole public services. Van Zwanenberg's (2005) analysis of current leadership development in Scotland explored NHS, education, police and civil service approaches. She identified many similarities in the need for effective leadership across the public sector.

To improve leadership and management skills across social work services, we need to develop a leadership and management framework which makes clear the common qualities of all public sector leaders, as well as those specific to social work services. The framework should be clear about who is responsible for what and be based on social work values. It should identify the knowledge, skills and behaviours needed in a number of settings and levels, across public, voluntary and private sectors. It should place particular emphasis on:

• professional and practice leadership;
• political leadership;
• strategic leadership;
• operational management;
• academic leadership; and
• citizen leadership.

The framework should form a basis for developing leadership and management, promoting opportunities to develop transferable skills and flexible career pathways. It should also make sure that people have the right skills for the job.

Professional leadership

Many of the changes we identify throughout the report are cultural changes. We cannot achieve them by introducing a new system or by changing structures. We can achieve them by promoting and developing professional leadership. The changes we seek will help to develop leaders at all levels of the system. New roles such as social work consultants will create greater opportunities to provide professional leadership. However every front line practitioner should be a leader, challenging and developing practice, and looking for opportunities to innovate. The new framework will need to capture that and services will need to value, develop and nurture professional leadership skills at all levels.

Political leadership

Effective political leadership at both national and local levels will be vital to the future of social work. We have already emphasised the importance of making sure that social work services are part of a whole system. That is one of the strengths that local authorities bring when managing social work services. However, to be truly effective it is vital that political leaders make well informed decisions about social work. The framework will need to support them in this role.

Strategic leadership

Strategic leadership will become ever more important in designing and delivering services within an increasingly complicated partnership environment. However specialisation is making it increasingly difficult for the next generation of senior social work leaders to develop a range of skills and experience that they will need to function in the new governance framework. As a result we need to pay particular attention to succession planning and strategic leadership skills across public, voluntary and private sectors.

Operational management

Management arrangements in integrated services will become more complicated, with managers having responsibility for mixed teams of professionals and support staff. So it is important to think of general operational management skills separate from leadership skills, recognising that some people will fill both roles. Social work services are sizeable, complex operations and they need effective operational management.

Academic leadership

Academic leaders have a vital contribution to make in both producing the practitioners of tomorrow and in helping to shape practice and develop the evidence base to inform it. They should be opinion formers and shapers influencing the development of social work in the 21st century. We need therefore to make sure that the quality of academic leadership is maintained and developed in order to deliver our aspirations.

Citizen leadership

"People who use services can be both inspirational and visionary." This message from our users and carers panel and others quoted throughout the report, summarise and reflect the value we place on the active involvement of people who use services and their carers at all levels of designing and delivering services.

The review group have benefited greatly from the thoughts and contributions of our users and carers panel, who have delivered well considered and insightful thoughts to help shape our recommendations. The learning from this process should be used to develop and embed in practice a new approach to citizen leadership across social work services. This will be based on the principles of successful participation identified by our Users and Carers Panel.

This will be a challenge. People who use social work services are often the most excluded, vulnerable members of society. Nevertheless, with support, people who use services and their carers can demonstrate leadership at a number of levels:

• at individual level, services must recognise the expertise and strengths of individuals and their families. This can result in a more balanced relationship between services and the people who use them;
• at operational level, people who use services and their carers have a significant role to play in the way services are delivered by being involved in training workers, in recruitment and selection and in evaluating and inspecting services; and
• at strategic level, people who use services and their carers could contribute to designing and developing services and should be involved in service re-design initiatives.

11. Social work services must be monitored and evaluated on the delivery of improved outcomes for people who use services, their carers and communities.

This requires: a performance improvement framework for all social work services, based on outcomes; elimination of unnecessary information gathering; development of tools to share learning and support practitioners to improve and evaluate outcomes; an annual performance improvement report, peer assessed and published by chief social work officers; and inspectorates to use performance improvement frameworks as a means of reducing the regulatory burden on services.

Successful participation
We think that the ingredients of successful participation include: independent facilitation; ground rules; respect; attention to the needs of participants, especially communication needs; information that is summarised and presented in an accessible way; good venues; expenses paid on the day; and commitment from the top to take our views on board. Users and Carers Panel

"We think that being on the User and Carer Panel has been worthwhile for us because we know we have been listened to. We are a diverse group of people and we have learned from each other in an atmosphere of mutual respect."
Users and Carers Panel

Social Work Performance Improvement Framework

One of the reasons the review was set up was that staff, managers and Ministers realised that current inspection processes were not adequate, with a lack of focus on performance improvement. To tackle these concerns a new Social Work Inspection Agency was set up and a sub group of the review was established to oversee the development of a performance improvement framework for social work. This will provide a clear framework of measurable outcomes against which social work services can be assessed. The framework will be designed to be used by service providers for internal monitoring and self evaluation of progress and for external inspections.

The framework is being developed through an inclusive approach, involving people who use services, their carers, practitioners, inspection agencies and policy makers. The first stage of development of a performance improvement framework, on children and families social work, is nearly complete. This is structured around the Scottish Executive's vision statement for all children in Scotland. The rest of the framework, including all community care and criminal justice services, will be complete by the end of 2006. The framework will have consistent themes such as the key social work processes of assessment, action planning and review. However, detailed qualitative and quantitative indicators and high level outcomes will vary according to the different needs of the client group.

Developing a culture of self-evaluation and continuous improvement and implementing new quality frameworks will pose a significant challenge and will require determined leadership at all levels. On a practical level the framework aims to minimise any additional requirements for information but we know that much of the data may not be readily available. We also know that IT systems to collect and evaluate information are often inadequate. Without them it will be impossible to know if services are meeting people's needs effectively and economically. It is clear that social work providers must tackle these issues.

Reducing the regulatory burden

There is a similar imperative on the Scottish Executive and other national organisations to reduce the amount of information collected and make best use of that information. We have been concerned by the increasing regulatory burden placed on services by the different inspection agencies and other organisations. This often has a disproportionate effect on social work services which sit at the crossroads of so many policies. It is very encouraging that the performance improvement framework is being developed alongside the Scottish Executive's Efficient Government Unit's work on reducing the bureaucratic burden on local authorities. The new framework must be used to streamline demands on service providers and be used whenever possible by the Social Work Inspection Agency and other agencies. All regulatory bodies should look for ways of reducing the burden of inspection, through more effective integration of approaches and information sharing so that no two agencies are inspecting the same aspects of the same services.

Using outcomes to drive performance improvement

This report has emphasised the importance of using an outcomes approach as the best starting point for performance improvement. This is reflected in the increasing number of outcome agreements between the Scottish Executive and service providers. However, achieving those outcomes is rarely a straightforward process. It needs a different approach to developing and evaluating action plans and a stronger link between actions and outcomes. Evidence based practice has a crucial role to play in this area. Workers will need access to up-to-date research findings, evidence of what works, evaluation tools, methods for carrying out quality audits and successful ways of involving people who use services in evaluating them. Websites such as Care Scotland have shown the value of giving social workers easy access to performance information. They encourage workers to share ideas and practice, allowing services and staff to learn from one another and benchmarking performance. These kinds of tools will play a critical role in developing practice which is sharply focused on performance improvement.

Developing a performance culture

A performance improvement framework has to be supported by a culture of continuous improvement and owned by staff at all levels. Otherwise it just becomes another burden, rather than providing a real opportunity to demonstrate good practice, identify and address poor practice and focus on what really matters to the people who use services. Our evidence suggests that there is considerable work to be done in developing that kind of culture. The new social work governance framework set out in Chapter 6 will play a critical role in this process; so too will bottom up change processes such as the collaborative change networks now being developed.

Performance reporting also has a crucial role to play in creating a performance culture and there are useful lessons to learn from the education sector. The introduction under the Standards in Scotland's Schools etc Act (2000) of public performance reporting on improvement objectives and success in achieving these has helped to embed a performance improvement culture in education services. This could be adapted for use in the more complex and diverse context of social work services. The chief social work officer should therefore make an annual public report on the performance of services, improvement objectives and progress made in achieving these.

12. Social work services should develop the capacity and capability for transformational change by focusing on re-designing services and organisational development.
This requires: new capacity for service redesign and organisational development; organisational development capacity in social work services; evidence based models of service redesign to support performance improvement; proactive use of technology to transform the delivery of services; and national and local fora to support the development of social work.

Developing the capacity for service re-design

We have avoided being prescriptive about structural re-organisation as it's clear there is no one right answer to meeting the diverse needs of Scotland's communities. We do need to re-design services to better meet the needs of individuals, families and communities. This may involve finding new ways of working, breaking down barriers between different parts of the system, developing new roles and making effective use of new technologies and approaches. We therefore need both the skills and the capacity to enable service re-design, informed by the needs of people who use services and carers. Some of this work will need to take place within individual social work organisations, for example changing the skill mix within a team, other aspects will need to be cross organisational, for example looking at services for people with dementia across the local authority, private and voluntary sectors and the NHS within an area.

Organisations must take responsibility and ownership for any changes made, drawing on their expertise and that of their staff and the people who use their services to decide how best those services can meet local need. However it is clear that they will need access to new capacity for service re-design to do that well. The Scottish Executive needs to invest in developing that capacity, bringing together service providers and their planning partners and enhancing programme management and organisational development expertise. Taking forward this work on a regional basis, with the active engagement of all partners will allow for shared learning and support the spread of good practice.

Building organisational development capacity

Changing cultures will require the capacity to make change happen within organisations. Organisational development skills are not, typically, well developed within social work services. Indeed discussions with front line social workers revealed their perceived inadequacy of change management approaches within their employing organisations. It will be essential to ensure that leaders at all levels and in all parts of the system are equipped with the organisational development and change management skills and are committed to achieving necessary changes.

Developing effective service re-design approaches

The performance improvement sub group has explored several evidence based models of service redesign. Two models in particular appear to have value in improving service delivery and outcomes: collaborative networks and logic modelling.

Collaboratives are a bottom up approach to service redesign, providing the opportunity for teams to think creatively about the range and type of services they provide. Teams identify a problem then test potential solutions through small scale rapid cycles of change (plan, do, study act). Each change tested is evaluated, to achieve effective sustainable solutions. The learning is then shared across a network.

Logic modelling starts from agreeing a desired set of outcomes for a group with similar needs and identifying evidence based activities which will produce these outcomes. These activities are put together into a programme which is consistently applied by staff with appropriate skills and then rigorously evaluated.

Further testing should be followed by the roll out of tools and approaches that can support local change.

Making effective use of technology

The pace of technological change is growing, bringing with it many opportunities and challenges. The increasing availability and accessibility of communications technology will make mobile working much cheaper and easier. It can be used to minimise the time spent on bureaucracy and maximise the time available to work with users of services. It will enable people who use services to get better, faster information about services and to communicate with providers in ways and at times which suit them. Geographical mapping and predictive technology will give providers new tools to match services more accurately to demand. Electronic information sharing is a powerful tool to support integrated working. Assistive technology is already helping older people to lead more independent lives. For social work services, the challenge is to exploit the power of technology to help workers 'work smarter', to promote social inclusion and ensure the interests of the most vulnerable are protected. In Figure 3, we highlight potential uses of technology and where and how they have been applied to social work services.

Figure 3 - Technology and social work services

Issue	Technological solutions	Examples
Information sharing (in system) Assessment Administration	Electronic stores, templates, recording meetings electronically, predictive analysis tools Electronic booking systems	Child protection messaging system, North and South Lanarkshire Councils and NHS Lanarkshire Inter-agency information sharing about children subject to a child protection investigation or on the child protection register. Text messaging alerts go to designated officers of updates Fife Council hand held computer system Using a palm-size PC and wireless technology OTs can access remotely the equipment store database, assess equipment needed, demonstrate it to users, place an order and arrange the delivery date. This has resulted in a reduced waiting list, faster delivery times and better information about stock availability and usage.
Accessible information Self-assessment Access to equipment	Web sites, on-line self assessment, assistive technology	West Dunbartonshire Council self-assessment Self assessment tool will give users access to three types of service, welfare rights advice, equipment and adaptations, carer respite and bathing service. West Lothian Council: Smart Support at Home: The Caring Call Centre Promotes social inclusion by making smart technology available to all households with a person over 60 to maintain quality of life through use of technology. A range of services is available using varied technologies supported by a call centre and call alarm centre. Overall, project helps maintain service sustainability.
Communication	E-mail, text messaging, voice-activated systems video-conferencing	Renfrewshire Council: Rentext A text messaging system for people who are deaf and for young carers. Provides a means to provide information about services, replacing phone calls and letters.
Service redesign	Process re-engineering	North Lanarkshire Council predictive technology Piloted predictive analysis technology to predict the likelihood of an older person remaining at home or being admitted to long-term care. Information from the pilot showed likely admission to care by each social work team, offering the possibility for informed service redesign.
Workforce mobility Workforce safety	Portable devices (phone, PDA, blackberry, tablet, laptop, digital pen)	Leeds City Council - Use of digital pens Captures data from Community Care Assistants using a digital pen and digital paper forms to record visits made and actions taken. Information is transmitted direct to the main system via mobile phone. The system is user friendly, allows the client to retain a paper copy of the visit and gives mobile phone access to staff allowing easy transfer of information.
Workforce learning	Virtual learning	Leading to Deliver Programme Participants have access to Robert Gordon University Virtual campus and through it to the Virtual Library and discussion fora

Providing a forum for social work development

One of the spin offs from the events to seek the views of front line staff and managers was the exchange of ideas and experiences that they generated. We quickly became aware of how little opportunity social workers have to meet with others doing the same work both within and across organisations delivering social work services. This highlighted the need for social work practitioner forums where people can learn from each other and have a voice in making policy at local or national levels.

Similarly, there was little opportunity for the leaders of the profession to debate professional matters. A workshop on the future role of the chief social work officers identified a strong desire for this kind of forum to be facilitated, giving them the opportunity to share ideas, learn from one another and engage with leaders from academia and the private and voluntary sectors.

At national level we decided that there was no easy way for representatives across the whole social work sector to influence policy making nor anywhere that policy makers could turn to seek the views of social work.

As a result we have decided that we need a new structure of social work fora which provide a way to improve practice and help develop policy. These should include the following:

• a local practitioner forum in each local authority that brings together representatives from all fields of practice across public, private and voluntary sectors. The forum will provide a way to involve workers in developing practice and influence policy and be a powerful resource to chief social work officers;
• a national practitioner forum would bring together the chairs of each local forum and provide a voice for social workers into national policy making. This forum should hold a conference each year as a way of sharing and debating best practice;
• a national social work leaders forum would bring together leaders from public, voluntary and private sectors, academia and regulatory bodies. They will have a particular role in supporting the development of professional leadership; and
• an overarching social work forum, chaired by a named minister, bringing together representatives of policy makers, leaders, practitioners, academics and regulatory bodies from social work and other public services. Its remit will include supporting the development of social work practice and the implementation of the Review's recommendations. It will have a powerful role in shaping the future of social work.

13. The Scottish Executive should consolidate in legislation the new direction of Scottish social work services.

In chapter 1, we set out three conclusions that we have drawn from our work:

• doing more of the same won't work. Increasing demand, greater complexity and rising expectations mean that the current situation is not sustainable;
• social work services don't have all of the answers. They need to work closely with other universal providers in all sectors to find new ways to design and deliver services across the public sector; and
• social workers' skills are highly valued and increasingly relevant to the changing needs of society. Yet we are far from making the best use of these skills.

The remainder of this report has set out recommendations aimed at addressing these problems through:

• developing the capacity to deliver personalised services;
• developing the workforce; and
• supporting transformational change.

The last of the six objectives, set for us by Ministers was to consider the need for changes in the legislation underpinning social work. We have deliberated long and hard on whether new legislation is in fact necessary. None of the recommendations we have set out in themselves require legislation to make them happen. However we have concluded that new legislation would make a powerful statement. It would set a landmark in the development of social work in Scotland, consolidating the significant changes we propose and laying the foundations for practice in the 21st century.

In particular, new legislation should:

Provide a new foundation for personalised services
The current legislation is based on a model of welfare and doesn't reflect the type of modern service delivery we envisage. Taking a whole system approach to the way we deliver public services requires a new approach, that positions social work's contribution in the wider context of public service delivery.

Embed performance improvement
Developing clear expectations and duties and a focus on meeting agreed outcomes would influence the way in which services are resourced, developed and inspected. Legislation in the schools sector has had a powerful impact on the quality of service from which social work could learn.

Enshrine citizen leadership
Recognising the centrality of the experience of people who use public services, legislation could embed requirements for all providers to actively engage people in the design and delivery of services.

Implement new governance arrangements
Effective governance of social work is critical if we are to protect both the people who use services and those who work in them. If new governance arrangements are to work, duties and expectations need to be set out clearly, enabling change.

Develop social work practice
Finally, we need to develop the practice of social workers and ensure that they are able to do the work that they are particularly well equipped to do. We already have protection of the title social worker, that needs to be underpinned by definition of those functions that only a social worker can do.

Further debate is required on the detail of what any legislation would or could hope to achieve. Such debate should build upon the work of the review, consolidating its recommendations and setting a new landmark for 21st Century Social Work.