Executive summary.
As people live longer, more older people require social care and associated services, such as health and specialist accommodation. The social work qualification and ongoing professional development give social workers particular expertise, including in law, which enables them to work with complex, changeable and risky situations. Social workers are central to delivering adult social care, to coordinated work with the NHS and other agencies, and to the provision of advice to other staff.
There are significantly more requests for help from older people than there are for children, but there are proportionately fewer social workers. Most older people who access social care will not see a social worker but instead will talk to a practitioner who has not undertaken a professional qualification.
Social workers need to be deployed to make the most of their unique expertise. Attention is needed to develop, support and retain social workers to work in the specialist area of social work with older people.
Older people not receiving social care input or having to wait to receive social care support, including from a social worker, leads to costly problems, including escalating need and delays to hospital discharges.
Research and policy ambition already signal how social work can reduce pressures on social care and the NHS and enhance wellbeing through upholding rights. Our comprehensive research identified practical ways to harness social workers’ expertise for maximum benefit.
Policy recommendations
1. Name social work as a ‘key profession’ (as it is described in legal guidance) in policy discussions and documents about social care and integrated services with the NHS.
2. Provide clear information and advice about social work and social care to the general public.
3. Include training on social work to NHS colleagues such as GPs and hospital staff.
4. Enable older people, carers and family to access social workers when it is most appropriate, particularly for early advice and for support with complex and life-changing situations.
5. Create systems that support, not obstruct, social workers. Set up systems so that older people have ongoing input from the same social worker when this is needed; reduce IT demands; identify technological solutions to reduce administrative burden; solve issues with access to health records; provide a dedicated desk space; limit bureaucratic checks on decisions; and increase consistency between local authorities.
6. Include training about specialisation in working with older people in social work education and professional development. Provide an experienced mentor to social workers in older people’s services during their first two years in practice and ongoing supervision and support from a social work manager with experience in the field.
7. Resource social work appropriately and co-produce solutions to challenges, in concert with older people. Resources should be focused toward front-line staff, direct care provision and support for carers to allow local authorities to fulfil their duties under the Care Act 2014.
About the research
Our researchers followed 10 social workers across two local authorities between autumn 2022 and spring 2023. We conducted observations and interviews with social workers, older people, carers and other professionals, and looked at records. We asked: what do social workers do; what impact do they have; and how does their context affect their work?
Social workers have unique expertise that brings together: sophisticated communication and relationship skills, particularly in situations of change, crisis and conflict; specialist knowledge of the law and entitlements to social care and other public services; practical knowledge of the local ‘care system’ and services; and ability to advocate as and when needed. They often act as leaders and coordinators in multi-agency systems. Their primary role is to uphold the voices, wishes and rights of older people and carers.
Barriers to good social work include: lack of social care services and understanding of the system; pressure on social work teams; and complexity of processes. Essential enablers include: commitment to the role; organisational support that values social work; peer support; and effective relationships with other services.
Social workers, older people, carers and families say that social work is more effective when there is time to build a relationship and then have ongoing input from the same social worker when this is needed.
Social workers are most valuable: when people struggle to stay in control of their lives, for example, because they do not have capacity to make a decision; in life changing situations, such as a sudden hospital admission; when people are overwhelmed by complexity, for example, when arranging their own care; in a crisis, such as when an unpaid carer becomes exhausted; and when people need clarity.
Our research comprehensively demonstrated that it can make a huge difference to older people’s and their families’ lives when a social worker is the right person in the right place at the right time.
Contact
Dr Denise Tanner, Associate Professor of Social Work, University of Birmingham d.l.tanner@bham.ac.uk
Gerry Nosowska, Director, Effective Practice gerry@effective-practice.com
The views are those of the authors and not necessarily of the funder NIHR School for Social Care Research
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