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Evaluation of the Implementation of Local Area Co-ordination in Scotland

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CHAPTER EIGHT MANAGERS' PERSPECTIVES ON LAC

INTRODUCTION

Interviews were conducted with a selection of seven line managers and seven managers with overall responsibility for local area co-ordination in 13 local authorities 22. Respondents were based in local authority social work and community learning departments as well as voluntary organisations. A selection of middle and senior managers were included in the sample. A detailed account of the method can be found in Annex One. Most, but not all, of the management respondents had been involved with the implementation of local area co-ordination in their local authority. Most had attended seminars presented by Eddie Bartnik or had undergone more intensive training with SCLD. This chapter examines the key issues arising from these interviews.

THE LAC ROLE AND REMIT

Management respondents indicated that they had a good understanding of local area co-ordination, although expectations clearly differed between local authorities. In some areas, the LACs had been in post longer than their current line managers and it was they (the LACs) who had explained the principles of local area co-ordination to their managers. It seemed that local area co-ordination had often been promoted within a local authority by a particularly interested individual or individuals who in effect 'championed' the role of the LAC. While this was an important feature of introducing LAC, it could lead to problems when the individual subsequently moved on.

LAC was often viewed within local authorities as providing an opportunity to extend resources for individuals with a learning disability where such resources were limited. It was seen as useful for responding to individuals who may not come into contact with social work services, and for providing support in particular to individuals with mild to moderate difficulties and those on the autistic spectrum, who did not traditionally receive a statutory service.

It was generally agreed by management respondents that it was important that LAC was independent, as far as possible, from other statutory services but that individuals could work effectively with agencies such as social work, health and education, as appropriate. It was also acknowledged by managers that LAC had a different ethos from statutory services such as social work. As one manager commented: "The LAC is about identifying what the possibilities are; social work tends to address what the problems are".

It was considered important that good links were developed with other agencies, although it was recognised that good working relationships developed over time. Managers noted that it was important that LACs were not drawn into meeting the priorities of statutory services and one operational manager suggested that LACs should be challenging statutory services to a greater degree that they were currently. Accordingly, it was seen as important that LACs had an independent base and relative autonomy in fulfilling their objectives, although the extent to which this occurred varied considerably between local authorities.

The distinctive ways of working which characterise local area co-ordination have, according to managers, led to a tendency for people to identify with the worker rather than the LAC role. While this can be a positive factor, it also raised the question as to whether it was individual personalities or the structure of the LAC role which could be seen to be effective. There was no clear agreement over this, although managers did point out they had been 'lucky' with the individuals in post and referred to the enthusiasm, experience and commitment of workers. However, the emphasis placed on individual skills to carry out the role led to some agreement on the need to ensure there was some form of structure around the LAC post. This was seen as particularly important in making other workers aware of the LAC remit and responsibilities.

"I think initially folk thought they were you know, floating about out there with no structure round about them and it's not like that. I think if that was made clearer... that might make the initiative welcome."

There appeared to be some recognition of the importance of strategic links between LACs and other agencies by senior management, but there were often tensions at front-line levels, perhaps due to a lack of clarity among basic grade workers about the LAC role. It was noted that LACs themselves were required to inform the public and workers in other agencies about local area co-ordination. How effectively this was achieved could depend on the LACs' skills, experience and confidence but how this information was received could also depend on individual workers in other agencies. One manager commented:

"In my experience, (...) younger, more inexperienced social workers find it very difficult to work with us and the experienced care managers who have both values that are integral to them doing things the right way and experience, are an asset that an LAC couldn't do without. So it is very personality driven."

A number of managers described the LAC role as similar to community social work of the 1970s and 1980s:

"...I know its like twenty years ago or whatever the community workers then were doing - community development - and then that seemed to become old fashioned and was out of the window. And I think it would be a bonus if we could start going back to that scenario."

Managers were keen to see an extension of local area co-ordination beyond learning disability to older people and those with mental health issues in particular. Where LAC focused on adults, this was seen as problematic, and had raised the importance of working across the age spectrum to include children and young people in order to respond to transitions. Where this wider remit was already in place there were often problems with funding, as work with children and young people did not always transfer from children and families budgets.

The same as you? expectation that LACs would work with 50 families was viewed by most managers as unrealistic. This was particularly so, given the significant changes that individuals often wanted to make in their lives. Similarly, providing support in order to avoid crisis could often require longer-term intervention. It was seen as important that LACs could prevent people getting into crises, which could potentially bring longer-term savings for local authorities.

Job Structure

As already reported, there were significant variations between the status of LACs within local authorities. According to managers, this had come about for a variety of reasons, but largely due to the pragmatic approach to the implementation of the posts. In some areas there had been ongoing discussions about whether LAC posts should be advertised and recruited on set qualifications and knowledge base, or whether personal experience and personality should be key. Individuals and families had a key role in this process in some local authorities, less so or not at all in others. These factors had contributed to the wide variations in pay scales for LACs across Scotland, discussed in previous chapters. In one voluntary organisation, the line manager had previously worked as an LAC. She described being able to determine the LAC salary scale within the parameters of an allocated budget, something which was clearly not the case for managers located within statutory services.

Managers acknowledged that problems occurred where LACs were employed part-time, or their role was combined with another function (i.e. that of care manager). This tended to happen where available funding had been limited when the post was created, but generally led to confusion (for workers, individuals and families, and other agencies) resulting from a worker's dual role.

Being located within the voluntary sector was identified as a potential drawback for LACs, given the importance of being able to engage with statutory services. However, they were consequently able to take advantage of some of the freedom that came from not working in the statutory sector.

LAC Budgets

As noted in Chapter 5, in some areas LAC budgets had been allocated to the post/s but due to financial constraints within the local authority, were later frozen or dissolved. Managers agreed that an independent LAC budget was important in theory, and it was helpful that LACs were able to manage their own budget, but this often did not happen in practice. It was suggested that there was a perceived inequality where LACs had a budget but social workers, care managers and/or social work team leaders did not. One manager commented that this situation "does not go down very well". Another manager commented that there had been a strategic decision not to allocate separate budgets to LACs in their local authority as social workers would have been "up in arms" if LACs had a budget while social workers did not. Again, this issue appeared to relate to the status of the LAC post and the seniority of the individual worker.

One manager suggested that LAC should be seeking alternative sources of funding for services for individuals and families, rather than relying on statutory services. More importantly, a number of managers expressed concerns that limited funding and cuts in local authority budgets may impact on LAC and any potential expansion of the service.

"The LACs, it's a great idea, don't get me wrong, it's a super idea and there is an area of need out there but there's a basic area of need there that has not been met at this time."

Accountability

Levels of accountability varied between local authorities. In some areas, LACs were accountable to the individuals and families they worked with and to the agencies within which they were based. While a number of local authorities had established Steering Groups when developing the LAC post, many of these were no longer operational by the time the LACs had been appointed and were delivering services.

Strong networks among LACs led some managers to suggest that LACs had responsibility to each other and a number of managers certainly considered support from this source to be an important feature for individual LACs, especially those who were isolated geographically and/or in terms of their remit.

Line managers clearly had a responsibility to the individual LACs whom they supervised and although some expressed degrees of reticence over the clarity of the LAC role, they acknowledged their own responsibility for assisting individual workers to carry out their duties. Operational managers, who tended to work at a more senior level, did not always show the same support for the role of the LAC. They were often more critical, tending to consider the contribution of local area co-ordination in terms of overall service-provision within their local authority. Some operational managers clearly had a significant involvement in implementing LAC and were proactive in promoting this, while others were less enthusiastic. It appeared that, for some managers, their primary concern was focused on obtaining value for money. This perhaps goes some way towards explaining the views of a number of LACs who felt that managers did not always seem to comprehend the potentially distinctive nature of local area co-ordination, nor did they always appear supportive of their endeavours.

While local area co-ordination aims to be as un-bureaucratic as possible, managers indicated that this caused them a degree of frustration. It was pointed out that social workers and others were required to record the work that they did, and some managers put some degree of pressure on LACs to do the same. It was considered important that individuals were accountable for their time - not least to illustrate the impact of their work for follow-up and monitoring.

Managers were very critical of the lead from the Scottish Executive in developing local area co-ordination. One manager described it as "appalling", with local authorities required to "drive the service". Some managers commented that they had felt pressured to adopt LAC but received very little guidance in doing so. Some resented criticisms that had been directed at their local authority, given the lack of clarity in determining aims and objectives of LACs.

"Either they want us to do it, in which case give us direction at the very start how you want us to do it, or it's a recommendation and let us decide ourselves if we're doing it or not, but don't say one thing and change your mind and criticise us."

Lack of additional funding from the Scottish Executive was viewed as particularly unhelpful - especially given the uncertainty of funding in some local authorities. It appeared to a number of managers that there was a lack of clarity in what the Scottish Executive was trying to achieve through local area co-ordination. However, it was suggested that the Scottish Executive could have a role in developing and overseeing a national LAC organisation, something which managers who were supportive of the ethos of LAC considered necessary.

LAC PRINCIPLES

Managers had varying degrees of clarity in their understanding of the principles of local area co-ordination. Regardless of this awareness, there was some concern that the potential achievements of local area co-ordination would be limited when there were staff shortages in other areas of service provision. It was acknowledged that LACs were often drawn into longer-term interventions/support for individuals and families, as well as tasks that were outwith their remit, in order to fill gaps in statutory services.

Some managers questioned the appropriateness of introducing to Scotland a 'service' which had been conceived for use in Western Australia. There appeared to be considerable awareness among managers that this would have its problems:

"I think that the model of social care delivery is different. I think kind of economically and socially, expectations are quite different and I don't think you can really take Australia and draw comparisons with Scotland."

Several managers expressed the view that Scotland had more of a 'dependency' culture than Australia, with the concurrent expectation from families that agencies would provide things for them:

"I think one of the really positive things about the whole LAC model is the idea of enabling people to solve their own problems and empowering them. And I think that's one of the big changes that we haven't really made."

Measuring Effectiveness

It was recognised that measuring effectiveness was difficult due to the flexibility and independence of the LAC role. One manager described LACs as 'free agents', requiring a certain degree of freedom to be effective. Ongoing monitoring and evaluation was seen as somewhat problematic, and one manager commented that it was not in the LAC ethos to keep a 'paper trail'. Nevertheless, this was seen as important for managers in order to monitor the progress of LAC. Some local authorities had commissioned some form of external evaluation, or evaluation was being undertaken from within their own service. Line management and supervision was viewed as a key method of keeping structures in place and monitoring work done. Managers commented that feedback from individuals and families was very positive:

"The soft feedback I get from a lot of people who use the LAC service...is that they really value it and for them, they feel their life has changed. In terms of being able to tick the boxes of people's life outcomes being different I think that's a much slower process."

'Soft' feedback was very positive, but identifying longer-term outcomes was seen as more problematic. Some managers commented that they were awaiting the results of this evaluation, or evaluations conducted within their own local authority to assist them to determine the future of LAC.

It was suggested that the effectiveness of local area co-ordination was limited, in some cases, by unclear objectives and the lack of a coherent management structure. Certainly some lack of clarity about what the initial expectations actually were, meant that it would inevitably be hard to measure if they had been reached:

"Well I don't think it can be [well embedded] because if you have potentially got 32 different variations of LAC how can it be deemed to be well embedded in wider service development and the national initiative?"

However, this manager subsequently acknowledged that it could be an empowering model if each area was able to adapt the post to meet local needs. In some areas there had been resistance to the implementation of LAC due to the financial commitment required, and confusion about the LAC role and how it would fit into systems such as care management and assessment. Furthermore, it was suggested that the same outcomes could potentially be achieved in different ways, through different posts:

"It's the outcomes that are important, how those outcomes are achieved. You can achieve them through lots of different ways and through different posts rather than something specifically known as a LAC."

Overall, it was suggested by managers that effectiveness was determined by the context, where LAC is located and services that workers could draw upon to support people.

Value for Money

There were mixed views among managers about whether local area co-ordination offered value for money. While individual workers were perceived to be making a difference and the service was generally valued, financial and staffing shortages in other areas influenced managers in their enthusiasm for LAC. With a shortage of care managers and money needed for basic statutory services, some managers inevitably viewed LAC as 'added value' or a 'luxury'. One manager noted:

"Obviously I come from a structured social work background and I am looking for more care managers and make no bones about it, it would certainly make my life easier if I had workers and then had a LAC. It would be ideal because it would work so well and that's the way it's meant to work."

One manager suggested that without a bottomless pit of funding it was impossible to carry out the 'pure' function of LAC.

"The issue is that in times of economic stringency […] local authorities have to look at what strategic authorities are, and what are the areas of work where we absolutely have to deliver in terms of the statutory work. And anything else is a luxury; it's the icing on the cake. And I think there is a danger that local area coordination could soon be the icing on the cake."

Whether LAC was viewed as providing value for money or not, seemed to be linked to expectations of the service. One manager pointed out that any notions that LAC would save a lot of money were flawed and should be discouraged. Other managers indicated that LACs will be able to make contact with individuals and families who are not in contact with statutory services, but who may then be referred back to statutory services as a result of their contact with LACs. Another manager commented:

"It would appear to me from the evidence we have got so far that it's an added value service. The people who are in contact with LAC, receiving a service, will also get a range of other services. And there is no evidence yet that LACs have reduced the workload or impact on the community learning disability team, or similar services. (...) It doesn't appear to have any impact on our existing teams and the workloads they have which is what we had hoped would happen (...) If you said to me what would I do, definitely, I would have preferred to have spent the money on additional care managers or workers in a community based team."

Alternately, concerns were expressed by several managers that LAC could be seen as a cost-saving exercise:

"It was decided upon ultimately because the government felt it was going to be a cheaper option. And it was a financial decision rather than a value based decision. So these tensions are there all the time. On the other hand I do think that if given the right resources, given the right support I think families and communities can do an awful lot more for themselves."

"I think we will get better value for money and better outcomes and I am hoping to start to see these coming through in the next 3-6 months but up to now I think I've been spending money which I probably in hindsight could have prioritised and spent somewhere else."

SUMMARY

Managers stated that on reflection, they would have appreciated more time to help people understand local area co-ordination prior to its implementation. The complexity of the role and the need to let other service providers know what it entailed would, it was suggested, have made things easier in the longer term. Some managers also indicated that it would have been beneficial to seek the views of individuals and families about how they would like LAC to operate prior to putting workers in post. A number of line managers indicated they would have liked more time to prepare, consult with individuals and families, develop partnership working and adopt clearer lines of management.

Overall, line and operational managers had mixed views about the efficacy of local area co-ordination, although generally welcoming it. Those who were enthusiastic, were extremely so, largely attributing this to the skills and experience of the workers they had recruited into the post/s. Where others were more sceptical, this was often due to the shortage of other resources within the local authority and the requirement that they managed this shortfall. It was in such contexts that LAC was viewed as a 'luxury' rather than a necessary resource. Managers' responses highlighted the importance of context and the impact this had on perceptions of, and support for, local area co-ordination. The responses from managers were pragmatic, they appreciated the support that LAC was able to offer but their views were located within a context where other services were perceived as under-resourced. In some cases, this would appear to impact on the support they felt able to offer local area co-ordination in general, and individual LACs in particular.