National Care Service - social work: contextual paper

4. The shape of social work

The Scottish Social Services Council (SSSC) was established in October 2001 following the Regulation of Care (Scotland) Act 2001. Registration for social workers started in 2003 with compulsory registration by 2005. Also in 2005 the legislation to protect the title of ‘social worker’ was enacted. Social work registration requires the registrant to hold a social work qualification before they are licensed to practice. This registration requirement is different to social care, whose workforce can register and then work towards a qualification.

There were 10,987 social workers registered with the Scottish Social Services Council 2021. The number of registered social workers increased by 0.6% between 2020 and 2021 reversing the recent decreases^[9]. 6,235 social workers worked in local authority services (n=5,666 WTE)^[10]. Fieldwork services^[11] for children and families continue to employ the highest number of social workers 2861 (n=2650 WTE) and 2036 social workers are employed in adult services (n=1851 WTE). 978 (n=914 WTE) social workers work in offender fieldwork services and 360 (n=252 WTE) are categorised as generic.

Social work takes place in all communities across Scotland, from remote and island settlements to urban neighbourhoods. All areas are unique in their social, economic and cultural characteristics. These factors influence the social work role and the skills required to respond professionally and sensitively to each community’s needs. For example, the Iriss Insight^[12] report found that social work practice in rural communities is successful when built upon the assets of a typical rural community, including people and place, familiarity and shared knowledge and a tradition of mutual aid. Practice should address issues of disadvantage, hidden poverty, remoteness and isolation, transport difficulties, and a lack of service choice with few specialist services available. Interventions such as these require an investment of time to build trusted relationships that support community capacity and resilience.

There are three functional areas of social work in Scotland: Children and Families, Adults, and Justice. These areas have continued to evolve around and in response to legislative and policy priorities. Social work has contributed to the development of, and responded positively and pragmatically to, policy and legislative developments that have been increasingly driven by individual categorisation^[13]. This resulted in a move away from a generalised approach to supporting people, which had served communities well, but arguably did not enable social workers to develop sufficient expertise in particular fields. With a disaggregation of generic teams and a subsequent disconnect between the role of social workers across different functional areas, questions over the status of the profession as a single entity were raised. In response, the 21^st Century Review of Social Work concluded that with the shift towards separate functions, there was still a need to retain a single generic profession, underpinned by a common body of knowledge, skills and values. These core values include the delivery of social justice and human rights, promoting social welfare and an equitable and equal society whilst holding the individual in unconditional positive regard. Social workers employ a wide range of approaches across the lifespan of people who need support to balance autonomy with protection; the rights of the self and those of others, to promote empowerment, participation and the delivery of outcomes aligned with people’s needs, wishes and preferences.

4.1 Justice social work

Justice social work (JSW) services are part of a local authority’s duties and in some areas these are delegated to Integration Joint Boards. Justice services are responsible for the delivery of information to the Courts, the provision of community orders and related justice social work interventions, with support from partners including third sector organisations.

The range of services JSW provide include:

• Assessments and reports to assist decisions on sentencing.
• Court services to assist those attending court.
• Bail information and supervision services as an alternative to custodial remand.
• Supervising people on social work orders to tackle offending behaviour and its causes.
• Supervising people who are required to perform unpaid work for the benefit of the community.
• Prison-based justice social work services to those serving custodial sentences that involve statutory supervision upon release.
• Preparing reports for the Parole Board to assist decisions about release from prison.
• Throughcare services including parole, supervised release and other prison aftercare orders to ensure public safety.
• Supporting partner agencies to address public protection concerns through Multi-Agency Public Protection Arrangements^[14] (MAPPA) and Multi Agency Risk Assessment Conference (MARAC) procedures.

The current model for community justice came into operation on 1 April 2017, underpinned by the Community Justice (Scotland) Act 2016, which places duties on a group of statutory partners to engage in community justice planning and to report against a set of nationally-determined outcomes. This relies on effective partnership working at both local and national levels. Community justice partnerships in local authority areas are made up of a number of statutory partners which include justice social work and are supported by Community Justice Scotland, which was established by the 2016 Act.

Within justice social work, there are specific workforce challenges given the nature of the work involved in working with people who can present a risk of harm to themselves or others. Justice social workers require to be skilled in both assessing and managing risk using accredited risk management tools and implementing complex case management plans involving the use of structured programmes of intervention. Justice social workers carry forward core social work values to support the people they work with to enable their access to human rights and support disenfranchised individuals to reengage with their comunities. Justice social workers can also hold additional social work qualifications such as Mental Health Officer status.

Justice social workers employed by local authorities work in teams either based in the community or in prison. The Scottish Prison Service (SPS) commissions the services of prison-based social workers to collaborate with community partners to assess the risk and needs of people in prison, for example, by providing assessments for the parole boards and engaging in risk assessment activites through risk and case management planning. This commissioned service does not include the care and support assessments provided in the community by social workers in adults teams.

In 2021 there were 978 social workers in fieldwork services (offenders)^[15].

4.2 Adult services social work

Adult services social work emerged from the disaggregation of generic social work following the introduction of the NHS and Community Care Act 1990, and the subsequent emergence of the care management process, described as assessment, care planning, implementation, monitoring and reviewing. Whilst care management as a process was not intended to replace the role of social work in adult services it substantively altered the nature of social work practice, particularly in work with older people.

Developing alongside the formulation of a care management approach to adult social work, was the emergence of a growing social care sector split between local authority, independent and third sector providers. Significant service provision formed in learning disabilities, mental health and older people services. The effect of demographic changes and changes in national policy brought about growing demand on adult social work services which resulted in the significant growth of the social care sector. Contributing factors to this increased demand, and expectation of social care services, were embedded in policies such as the Same as You (2000) report addressing the need for increased community services for individuals with learning disability and the Reshaping Care for Older People^[16] change programme that sought to address the anticipated demand on services of an increased aging population.

Since this time, further human rights based policies and legislation has placed expectation and demand on adult social work services, contributing to the increased requirement for a person-centred and human rights based approach to engagement.

In 2021 there were 2036 social workers within local authority adult services^[17]. Adult social work services are broadly arranged across the functional areas of:

• Learning disabilities
• Mental health
• Physical disabilities
• Sensory impairment
• Dementia
• Neurological illnesses
• Conditions related to older age
• Transitions for looked after children and children/young people with disabilities and their families
• Self-directed support
• Alcohol and Drug services

All areas of adult social work services retain significant statutory responsibilities which, in the majority of cases, can only be carried out by professionally registered social workers. The paragraphs below provide a small number of examples associated with particular areas of legislation in which social workers either play a central role or are reserved functions of social workers.

Adult Support and Protection

The Adult Support and Protection (Scotland) Act 2007 (ASP) is designed to protect adults (16 years and above) who are at risk of harm because they are affected by disability, mental disorder, illness or physical or mental infirmity. The Act provides ways of protecting adults at risk of harm. It places a duty on councils to make inquiries about a person's well-being, property or financial affairs if it knows or believes that the person is an adult at risk, and that it might need to intervene in order to protect the individual. ASP legislation prescribes that certain statutory tasks can only be undertaken by Council Officers.

Mental Health

Since the inception of the Scottish Parliament in 1999, mental health law, policy, practice and ethos have developed dramatically in Scotland. For the social worker in the community mental health team, this means evolving practice and progressing understanding of mental disorder, mental illness and various diagnoses.

Social workers bring a social perspective to the concept of mental illness. They work with medical and heath colleagues, as well as with the third sector and others, to provide an effective and balanced service, whilst remaining at the forefront of processes that empower people who use services. Social workers play a significant role in supporting people living with mental illness in the community. Their involvement enables those with complex needs and trauma experiences, including forensic mental health involvement, to live as independently as possible in the community. Adult services social workers offer direct risk assessment of circumstances to support MAPPA through a person centred approach, rooted in human rights and social justice. The social work role is to build effective professional relationships that reflect person-to-person centred care as opposed to being expert to non-expert. This supports the principle that the person is the expert in their own mental health process. The role of the social worker in the community mental health team is to try and understand the person’s illness in their personal and social context, balancing the rights and needs of the person and others.

Social workers work with the individual, family and/or carers to provide support and education on the illness. They also work across other social work services. For example, working in partnership with Children and Families services to promote a parent’s contact with a child; working with justice services; or to work alongside recovery services if someone has a dual diagnosis of substance misuse and mental ill health. Mental health social workers apply their awareness of stigma to mental illness to their work and understand the impact of mental illness across different cultures.

Mental Health Officers (MHO)^[18]

Mental Health was the first practice area to reserve functions to suitably qualified social workers. Only registered social workers with additional appropriate qualification may carry out the duties of a Mental Health Officer as set out in the Adults with Incapacity Act 2000 and the Mental Health (Care and Treatment) (Scotland) Act 2003.^[19]

The MHO will be involved in forensic mental health, in which they are required to work closely in the management and risk assessment of mentally disordered offenders. MHOs work closely with the responsible medical officer, police and, at times, under the MAPPA framework or the Care Programme Approach^[20]. Robust care planning for the individual is required, as is ongoing work that includes reporting to the Restricted Patients Unit of the Scottish Government when COROs (Compulsion Orders and Restriction Orders) are in place.

The MHO has specific duties in relation to working with the Mental Health Tribunal Service, court and criminal justice system and in relation to specific directions from mental health tribunals. The MHO also works closely with the Chief Social Work Officer^[21] to provide support and advice in relation to the workforce, as well as to report any risk issues to the Chief Officers Public Protection Group. Mental Health Officers are involved in the assessment of individuals experiencing mental disorder who may need compulsory measures of care, treatment and, in some cases, detention. The role carries considerable autonomy and responsibility and involves working alongside medical and legal professionals.

Adults with Incapacity

The Adults with Incapacity (Scotland) Act 2000, provides a framework for safeguarding the welfare and managing the finances of adults (age 16 and over) who lack capacity due to a mental illness, learning disability, dementia or related condition or where there is an inability of the individual to communicate.

The Act requires the social worker intervening under this legislation, to evidence an adherence to principles based in human rights and that actions taken recognise the past and current wishes of the individual. There are specific requirements for assessing capacity, and collaborative working is required across several disciplines. For example, there is a need for consideration of appropriate methods of communication for the person being assessed to enable their understanding (wherever possible) as part of the assessment process. Additionally, interventions through this Act require to be the least restrictive and to offer benefit to the individual, a requirement that often sees social workers engaging extensively with family and other disciplines to ensure the individual’s expressed wishes are taken into account. Social workers are often delegated by the Chief Social Work Officer as the day-to-day guardians of adults with incapacity. There is a requirement for social workers to work with the Mental Welfare Commission for Scotland, courts and the Office of the Public Guardian (Scotland).

4.3 Children and families social work

All children and families require support from universal services such as health and education. Social work services are provided by children and families social work to children under 18 years (including pre-birth) and their families when additional support is needed or when children are at risk. However, if a young person has been looked after by the local authority, a social work or social worker-led service may continue up to the age of 26.

The reasons why social work involvement may be necessary are very varied, but usually the parents and/or children, or the whole family, may be experiencing a combination of practical, emotional and relationship difficulties. Children and parents in all income groups and with a wide range of disabilities, emotional and relationship difficulties may be assessed as in need of a social work service. However, families from areas of higher deprivation are significantly more likely to receive statutory social work services^[22].

Social work services may become involved with a family through different routes. A family member may request a social work service but it is more common that they will be referred by someone they know, usually a professional such as a health visitor, doctor, teacher, youth worker, or community police officer. Anyone who considers that a child is being harmed or is at risk of suffering harm should refer the child for a social work assessment to decide whether a formal child protection service is necessary. Social workers will usually work with those being referred to explain why they consider that this is necessary and what might happen next. Social work departments also work with children and families where there are welfare concerns which do not meet the definition of “harm” to provide support, guidance and advice to the child and family to ensure the correct and proportionate support is given to the child at the right time by the correct people. This early and effective intervention is provided in line with the Scottish Government’s commitment to GIRFEC (“getting it right for every child”) principles and the aim is to help children and young people to grow up feeling loved, safe and respected so that they can realise their full potential. Section 22 of the Children (Scotland) Act 1995 places a duty on local authorities to safeguard and promote the welfare of children in their area who are in need and, where consistent with that duty, to promote the upbringing of children within their families. Every local authority in Scotland provides social work services to fulfil these statutory duties. In 2021 there were 2861 children’s social workers in local authorities.

Children’s and families social workers contribute to a range of service and policy areas. Examples include:

• Child protection
• Adoption
• Fostering
• Looked after children
• Family support
• Transitions for looked after children and children/young people with disabilities and their families
• Child and Adolescent Mental Health Services
• Care experienced children and young people
• Youth justice
• Implementation of The Promise
• Young carers
• Kinship care

The paragraph below provides an example associated with a particular area of legislation in which social workers play a central role:

Children’s Hearings

The Children’s Hearings (Scotland) Act 2011 and its subordinate legislation imposes a variety of duties on the Chief Social Work Officer and local authorities. As a result, social work services play key roles in the effective operation of the children’s hearings system. This includes such matters as mandatory referrals of children in need of compulsory measures of care to the children’s reporter and the provision of reports to assist decision making within the system by children’s reporters, panel members and sheriffs who are subsequently able to make informed decisions in the best interests of children. Social workers also enable the legislation and system for welfare and justice to operate by being the statutory supervisers of children placed on orders issued under the hearings system. They have a role in ensuring that children are bestowed with the statutory measures of care, protection, guidance and control that have been decided by a hearing. This interventionist work is balanced by also ensuring important human rights based principles (such as minimal intervention, child’s welfare and the child’s views being heard) are promoted. Invariably the social worker assumes the role of lead professional in the multidisciplinary arena within the children’s hearings system, planning and coordinating care and multidisciplinary resources for the child and its family.