Pressured services mean older people missing out on access to social workers

New research attempts to shine a light on the valuable contribution of social workers for older people and highlight staffing issues in the sector.

The research project, a comprehensive and detailed look at what social workers do to support older people, shadowed social workers in local authority adult social care services for 6 months, and interviewed older people, carers and professionals about their experiences.

The findings highlighted the valuable differences social workers can make in older people’s lives – a service that many older people are unaware is available to them, and an area of social work that is still grossly understaffed.

The research found that the specialist knowledge of social workers related to later life combined with their expert personal skills and a commitment to upholding rights and dignity in order to offer something of unique value, especially in life-changing situations or when older people and their families were overwhelmed.

Researchers also noted the positive difference social workers made, ensuring that older people came home from hospital with support to manage risk and received dignified care. They provided families faced with huge life changes advice and reassurance when planning or paying for care and therapeutic support. They also helped to safeguard older people’s rights including protection from financial abuse or loss of liberty when they were unable to make decisions themselves.

Despite the clear advantages that engaging with a social worker could bring, the qualitative research also revealed that most older people were unaware of their legal entitlement to such a service. Many did not know what social work was or what social workers did.

Last year’s ‘state of the adult social care sector and workforce in England’ report by Skills for Care, found an 11.4% staff vacancy rate, which researchers said was hampering older people’s accessibility to such services. Complex processes including multiple form filling and difficulties accessing NHS records are also in need of improvement, and although older people and their carers value being supported by the same social worker over a period of time, social care systems often pass people from one social worker to another, leading to poorer experiences of care.

Case studies involved in the research also highlighted the substantial lack of access in rural areas. One research participant had to go into a care home because there was no care available in her own home. Another got stuck in a care home because there was no social worker to arrange for her to get back to her own home.

Dr Denise Tanner, Associate Professor of Social Work at the University of Birmingham, led the NIHR-funded research alongside Dr Paul Willis, from SPS, University of Bristol and Effective Practice.
“Social workers have a central role in ensuring older people are able to access the social care they may be legally entitled to,” Dr Tanner said.

“And this research shows the transformative potential of social work. However, unlike children or adults with a learning disability, most older people won’t see a social worker but rather an experienced worker who has not undertaken the same level of training.

“At a time when social care is under increasing pressure with nearly half a million adults waiting for an assessment, it is essential to consider how we can enable older people, carers and families to access a social worker at the right time.”

People facing life-changing events such as hospital admission or possible loss of their home, those unable to communicate their wishes clearly, and those overwhelmed by huge financial decisions are encouraged to seek social work support.

As a result of the project, researchers are calling for a range of measures including resourcing social work and social care appropriately, and co-producing solutions to challenges with older people, and providing clear information and advice about its value.

They are also calling for the enablement of older people, carers and family to access social work advice early to prevent issues, for example by deploying social workers in local authority ‘first point of contact’ services.

“In order to provide the level of support for older people that is needed in this country we require enough social workers to be trained, existing social workers to be supported and retained, and social workers to be deployed thoughtfully, without time wasting barriers to their work,” Dr Tanner added. “It took five years for social workers in one of the local authority areas we studied to get access to the NHS system but there still isn’t a shared record.

“Maintaining continuity of social workers also needs to be taken out of the ‘too hard to do’ pile because our research has shown that this is fundamental to a good experience of social work. It is also vital that older people, carers, families and NHS colleagues understand what social workers offer so that they can benefit from the unique knowledge and skills that social workers bring.”