WEBVTT 00:00:06.733 --> 00:00:08.800 So thank you for inviting me. 00:00:08.800 --> 00:00:12.400 In a way, I feel quite humbled because I think Trish 00:00:12.466 --> 00:00:15.933 in her Tricia in her last bit summarised 00:00:16.000 --> 00:00:19.866 all there was to summarise about the role of carers 00:00:19.933 --> 00:00:24.333 and the changing roles and identities that you can have, that you're not just 00:00:24.400 --> 00:00:29.000 a family relative who steps in and help sort your all those other things too. 00:00:29.066 --> 00:00:34.000 You come from particular backgrounds, races, cultures, 00:00:34.066 --> 00:00:37.600 socioeconomic, economic background and even where we are from the social care 00:00:37.600 --> 00:00:42.600 professions ourselves, we bump up against the challenges of the system. 00:00:42.666 --> 00:00:47.933 So it's all kind of say, what I can about this is probably in the conversation 00:00:47.933 --> 00:00:51.666 and discussions at the end that will get a richness about this. 00:00:51.733 --> 00:00:54.533 So I'm Lyn Romeo and I'm the chief social worker for adults 00:00:54.533 --> 00:00:56.200 in the Department of Health. 00:00:56.200 --> 00:00:58.133 That's my email. 00:00:58.133 --> 00:01:03.066 If anybody wants to email me and please do follow me on Twitter. 00:01:03.133 --> 00:01:06.400 So why does social work with carers matter? 00:01:06.466 --> 00:01:10.600 Well, I thought I'd just take two quotes directly from carers. 00:01:10.733 --> 00:01:13.866 When we did some work around trying to shape better resources 00:01:13.866 --> 00:01:17.400 to support social work practice with carers, that 00:01:17.466 --> 00:01:20.466 research and practice led and helped us with. 00:01:20.600 --> 00:01:24.266 And these were two key quotes for me, that it was the social worker 00:01:24.266 --> 00:01:27.266 who was the greatest professional support and who put me in touch 00:01:27.400 --> 00:01:31.466 with a wonderful independent carer who helped to look after my mum at home 00:01:31.533 --> 00:01:34.533 for the last few months before she needed residential care. 00:01:34.533 --> 00:01:39.733 Of all the professionals, she had the most hands on understanding. 00:01:39.866 --> 00:01:41.666 And then another carer, 00:01:41.666 --> 00:01:44.866 the social worker, took the time to be involved in all aspects 00:01:44.866 --> 00:01:48.933 of our journey of supporting our daughter to live well with dementia. 00:01:49.000 --> 00:01:52.866 She listened, understood, disgust, and gave the chance to do 00:01:52.866 --> 00:01:56.066 the things we wanted to support Dad and for him 00:01:56.066 --> 00:01:59.333 to have the respect, dignity and help he needed. 00:01:59.400 --> 00:02:02.733 And those quotes really sum up what's at the core core 00:02:02.800 --> 00:02:06.066 of professional social work practice. 00:02:06.133 --> 00:02:07.733 And that's why it's so important. 00:02:07.733 --> 00:02:11.200 And we've really got to reposition social work and its role in being 00:02:11.200 --> 00:02:16.133 really true, authentic supporters of people and working alongside of them 00:02:16.200 --> 00:02:20.333 in what is a very challenging and demanding 00:02:20.400 --> 00:02:27.000 role as our elders age, as we look after our children with disabilities, our 00:02:27.066 --> 00:02:29.066 brothers and sisters with mental health. 00:02:29.066 --> 00:02:30.600 So I think we need 00:02:30.600 --> 00:02:33.600 we really need to continue to try and strengthen the social work 00:02:33.600 --> 00:02:34.266 practice with carers. 00:02:34.266 --> 00:02:35.466 And it's not necessarily 00:02:35.466 --> 00:02:39.933 always social workers registered, trained and social workers doing that. 00:02:40.000 --> 00:02:44.133 What the local authority does often is social work and there'll be many people 00:02:44.133 --> 00:02:48.666 contributing to that social work practice and the Care Act set it out 00:02:48.800 --> 00:02:54.000 absolutely clearly in 2014, implemented 2015. 00:02:54.066 --> 00:02:58.200 We now have an absolute duty to assess carers 00:02:58.200 --> 00:03:01.733 needs to really listen and understand what's happening to them to support. 00:03:01.733 --> 00:03:05.733 They have a right to support and it's really important that we promote 00:03:05.733 --> 00:03:06.333 their wellbeing. 00:03:06.333 --> 00:03:10.600 That wellbeing principle is that this is at the heart of the character, 00:03:10.666 --> 00:03:13.866 both the people who are in need of care and support, 00:03:13.866 --> 00:03:21.066 but also those family and friends who are supporting them. 00:03:21.200 --> 00:03:22.000 So what do we 00:03:22.000 --> 00:03:25.333 know about social work and carers? 00:03:25.333 --> 00:03:28.866 And there has been research that's helpfully 00:03:28.933 --> 00:03:31.933 research and practice that summarised a lot of the evidence. 00:03:32.133 --> 00:03:38.066 But just to pick up some key research or reviews or reports about social work 00:03:38.066 --> 00:03:44.000 and carers is a long tradition of social workers working with 00:03:44.066 --> 00:03:45.333 parents. 00:03:45.333 --> 00:03:49.066 That's when you engage with a person, you engage with the family, 00:03:49.266 --> 00:03:53.200 you try and understand the network around them and how that works 00:03:53.266 --> 00:03:54.600 and you're coming into contact. 00:03:54.600 --> 00:03:59.800 And particularly actually Alison Milne and her colleague highlighted that 00:03:59.866 --> 00:04:02.066 often when we're visiting older 00:04:02.066 --> 00:04:05.333 people, it's older people themselves who are looking after them. 00:04:05.333 --> 00:04:08.600 And my, my situation was the same. 00:04:08.600 --> 00:04:12.200 I was in my sixties looking after my mother, who was in her eighties 00:04:12.200 --> 00:04:14.466 and actually thinking of myself as an old carer. 00:04:14.466 --> 00:04:17.666 I didn't I didn't actually think of myself like that, but in fact I was 00:04:17.666 --> 00:04:22.600 I was facing my own ageing process and the challenges that I had. 00:04:22.666 --> 00:04:27.000 So it's really at its core, as Tricia quite rightly highlighted 00:04:27.000 --> 00:04:30.466 before, human rights and social justice is at the heart 00:04:30.533 --> 00:04:35.533 of our engagement with and support of carers and the people they cared for. 00:04:35.600 --> 00:04:39.133 And older carers in particular are often a disadvantaged group 00:04:39.266 --> 00:04:44.600 and we cannot assume that they can look after themselves as well somebody else. 00:04:44.666 --> 00:04:45.000 So the 00:04:45.000 --> 00:04:49.533 research evidence suggests that if people get good social work 00:04:49.533 --> 00:04:54.666 support, carers rate the situation is less difficult. 00:04:54.733 --> 00:04:59.200 That's Jill Month, often a colleague 00:04:59.266 --> 00:05:01.200 Moriarty, that also 00:05:01.200 --> 00:05:04.600 in the States that carers who were receiving social work 00:05:04.600 --> 00:05:09.666 intervention reported better outcomes in terms of how well they could cope. 00:05:09.733 --> 00:05:13.800 The quality of their life feeling in control 00:05:13.866 --> 00:05:17.800 and its effectiveness is about that specific combination of skills. 00:05:17.800 --> 00:05:21.600 That is what the profession is all about good assessment skills, good 00:05:21.600 --> 00:05:26.800 knowledge about local resources, the ability to offer ongoing support 00:05:26.866 --> 00:05:30.066 and adopting more of a social model. 00:05:30.133 --> 00:05:32.800 And it was interesting because I thought, 00:05:32.800 --> 00:05:36.533 as Trish did, we in we're in, we understand it. 00:05:36.533 --> 00:05:37.800 We know how to do it. 00:05:37.800 --> 00:05:38.333 But I can't 00:05:38.333 --> 00:05:42.266 tell you how important it was to me when the social worker came to visit 00:05:42.266 --> 00:05:46.000 and would just take that time and give me permission 00:05:46.066 --> 00:05:49.933 actually to talk about how it was impacting on me, how I felt, 00:05:50.133 --> 00:05:53.266 what were the kind of struggles I was having, the issues 00:05:53.266 --> 00:05:57.133 about my changing role in terms of my relationship with my mother, 00:05:57.333 --> 00:06:01.066 but also with my brothers and with the wider family system. 00:06:01.200 --> 00:06:01.866 Her her 00:06:01.866 --> 00:06:05.733 very powerful aunts, my powerful aunts who wanted to take over all the time. 00:06:06.000 --> 00:06:09.000 So all of that is something that sometimes it's very difficult to work 00:06:09.000 --> 00:06:13.666 through on your own and a non-judgemental, truly empathic social worker 00:06:13.666 --> 00:06:19.600 who can help you work through that can make such a difference. 00:06:19.666 --> 00:06:19.866 There's 00:06:19.866 --> 00:06:23.133 also evidence that where we do end up reducing social support, 00:06:23.133 --> 00:06:26.466 particularly for those people who are really intensively involved 00:06:26.466 --> 00:06:27.800 in supporting people, 00:06:27.800 --> 00:06:31.200 particularly with high levels of complex needs and disabilities, that that 00:06:31.200 --> 00:06:35.666 then pushes on a risk of increased abuse because of the stress and strain 00:06:35.733 --> 00:06:41.133 that that can present. 00:06:41.200 --> 00:06:44.866 So what's the what are the key messages coming out of 00:06:44.933 --> 00:06:48.333 all the evidence that's there and just the kind of referred refer? 00:06:48.333 --> 00:06:52.133 You also go on to the research and practice website where you'll find 00:06:52.133 --> 00:06:57.066 all of this fantastic work they've done on reviewing the evidence 00:06:57.200 --> 00:06:59.533 that we really need to do a lot more to make sure 00:06:59.533 --> 00:07:03.200 that social workers do develop the knowledge about the knowledge 00:07:03.200 --> 00:07:08.866 that they need, about the needs and the experiences of carers, 00:07:09.000 --> 00:07:12.533 that carers absolutely must be treated as expert partners. 00:07:12.533 --> 00:07:16.000 And it's about working in true, authentic partnership. 00:07:16.000 --> 00:07:19.533 And there's a lot of issues about how the exchange of power 00:07:19.800 --> 00:07:23.000 and that relationship with carers needs to be absolutely key. 00:07:23.200 --> 00:07:27.133 And as social workers always balancing working alongside carers, 00:07:27.266 --> 00:07:30.666 but also keeping the person whose needs 00:07:30.733 --> 00:07:34.200 and care is at the heart of what we're doing at Central as well. 00:07:34.200 --> 00:07:38.800 Balancing those two relationships and working with both the carer 00:07:38.800 --> 00:07:43.066 and the cared for is a real skill 00:07:43.200 --> 00:07:46.600 and also working across the wider 00:07:46.733 --> 00:07:50.800 social network, the family, whatever that family means to that person. 00:07:50.866 --> 00:07:53.400 And there's often a lot of complexity and conflict 00:07:53.400 --> 00:07:59.533 and how often we are managing that, but managing that anxiety, 00:07:59.533 --> 00:08:03.800 that ambivalence, that uncertainty, the ways in which those complex can 00:08:03.800 --> 00:08:04.800 then play out 00:08:04.800 --> 00:08:08.866 and undermine both supporting the person who's often in the main caring role, 00:08:09.000 --> 00:08:12.533 but also very importantly, the person who's relying on 00:08:12.533 --> 00:08:17.066 or needs their family or social network to be supporting them. 00:08:17.133 --> 00:08:23.400 And the stress and strain that that can create both for the cared for person and 00:08:23.466 --> 00:08:26.466 those that are supporting them. 00:08:26.600 --> 00:08:28.600 Now, I just don't know how 00:08:28.600 --> 00:08:32.000 I'll get onto the next one, and I don't know if I can do that. 00:08:32.000 --> 00:08:36.600 Actually can hang on. 00:08:36.666 --> 00:08:37.866 There you go. 00:08:37.866 --> 00:08:40.466 So in summary, 00:08:40.466 --> 00:08:43.666 I suppose, what what are those skills and contribution? 00:08:43.666 --> 00:08:49.933 So firstly, knowledge and really understanding and knowing about policies 00:08:50.066 --> 00:08:55.733 and how they impact on carers and the cared for the legal literacy 00:08:55.733 --> 00:08:59.666 that social workers need to work within the legal statutes 00:08:59.733 --> 00:09:03.866 about a lot of this support for carers and the cared for person 00:09:03.933 --> 00:09:06.933 framed with also. 00:09:06.933 --> 00:09:09.866 And this is something I think sometimes social workers are a bit 00:09:09.866 --> 00:09:13.933 reluctant to feel that they should know more about, but the health conditions 00:09:13.933 --> 00:09:17.066 and the effects that those health conditions and pressure 00:09:17.066 --> 00:09:20.066 really summarise that in relation to Alzheimer's and dementia. 00:09:20.266 --> 00:09:23.333 We really need to understand some of these key 00:09:23.533 --> 00:09:27.933 health conditions and how they impact and change the nature of the person, 00:09:27.933 --> 00:09:32.800 but also how people cope with and manage that as their family, 00:09:32.866 --> 00:09:37.600 as their daughter, as their sister, as there aren't as their needs. 00:09:37.666 --> 00:09:40.733 And then very, very importantly, the whole health and social care system. 00:09:40.733 --> 00:09:45.800 How many times and I to experience that you think you can navigate 00:09:45.800 --> 00:09:49.666 and understand the system, but it's almost impenetrable and so difficult 00:09:49.866 --> 00:09:53.933 and trying to coordinate across a consultant's appointment, 00:09:54.000 --> 00:09:57.866 the GP's appointment when the O.T’s turning up the carers, 00:09:57.866 --> 00:10:01.600 what they understand, the formal paid carers who are coming in. 00:10:01.666 --> 00:10:05.266 All of this is like a kind of major project management task. 00:10:05.400 --> 00:10:07.266 So as a social worker who was well equipped, 00:10:07.266 --> 00:10:10.400 I thought I'd be able to manage it, but it really bamboozled me. 00:10:10.400 --> 00:10:16.000 So really the importance of social workers being in that help people to navigate 00:10:16.000 --> 00:10:17.600 and support them through the system 00:10:17.600 --> 00:10:21.733 and sometimes deal with some of those practical issues around coordinating 00:10:21.733 --> 00:10:26.933 appointments, ensuring practical help and support is there is so key 00:10:27.000 --> 00:10:28.933 and also knowing about all the 00:10:28.933 --> 00:10:32.466 different resources and services that ability 00:10:32.533 --> 00:10:36.800 to connect with and put people in touch with the right places, 00:10:36.800 --> 00:10:39.000 tell them about the different options that are available 00:10:39.000 --> 00:10:42.866 because it's sometimes just impossible to understand at all. 00:10:42.933 --> 00:10:46.466 And the right service that might be right for people 00:10:46.533 --> 00:10:47.133 with that. 00:10:47.133 --> 00:10:49.200 Of course, it's all about the interpersonal skills, 00:10:49.200 --> 00:10:53.066 the communication skills, having strengths, but it's conversations 00:10:53.266 --> 00:10:58.333 going in and understanding right from the beginning what matters to people. 00:10:58.466 --> 00:11:01.466 What's a good, good life look like for them? 00:11:01.466 --> 00:11:04.400 What are the things they've tried before, and how do we build on that? 00:11:04.400 --> 00:11:08.600 Strength and resilience is at the family housing the carer has and doing that 00:11:08.600 --> 00:11:14.200 with true empathy and a real commitment to genuine co-production and partnership. 00:11:14.200 --> 00:11:15.666 Working, 00:11:15.733 --> 00:11:16.466 working with that 00:11:16.466 --> 00:11:20.666 complex range of social, emotional, psychological health care needs. 00:11:20.733 --> 00:11:24.533 I remember once being with a team where 00:11:24.600 --> 00:11:26.666 I was, it was a multidisciplinary team and asked 00:11:26.666 --> 00:11:28.466 What is it that social work brings in? 00:11:28.466 --> 00:11:32.866 And most of the social worker can just step into that uncomfortableness 00:11:32.866 --> 00:11:38.333 with people and hold onto it, That difficult, complex, 00:11:38.400 --> 00:11:41.666 tense horribleness sometimes that we find really difficult 00:11:41.666 --> 00:11:45.133 but seems to be what social worker does so well. 00:11:45.133 --> 00:11:49.133 And it's really, really important that we recognise this is a true area of 00:11:49.200 --> 00:11:50.266 commitment and support. 00:11:50.266 --> 00:11:53.733 But social workers need to bring to working with supporting carers 00:11:53.800 --> 00:11:56.266 and understanding all the things around these challenges 00:11:56.266 --> 00:11:59.866 loss, complexity, change, the balancing of risk and autonomy. 00:11:59.866 --> 00:12:05.200 As I've said before, transitions, which is key, but also, as Trish 00:12:05.333 --> 00:12:09.000 has quite rightly highlighted, the intersectionality issues. 00:12:09.200 --> 00:12:12.800 You know, I was not just an old carer, 00:12:12.866 --> 00:12:17.066 I was a lesbian, I was a single woman, I didn't have my own children and family. 00:12:17.066 --> 00:12:20.800 So therefore it was seen that I would be the one that came back and stepped in 00:12:20.933 --> 00:12:24.000 and took over the role of really being the 24 00:12:24.000 --> 00:12:27.066 hour care and support for my mum and being the boss. 00:12:27.066 --> 00:12:28.866 I remember my younger brother saying 00:12:28.866 --> 00:12:31.733 when we were discussing whether to keep mum at home 00:12:31.733 --> 00:12:33.133 during the last days of her life. 00:12:33.133 --> 00:12:35.600 Well, you're the boss, you need to decide. 00:12:35.600 --> 00:12:38.466 Whereas in fact I'd seen it all as pulling apart. 00:12:38.466 --> 00:12:45.066 But all of those things combined to impact on me as my my role as a carer. 00:12:45.066 --> 00:12:50.200 And I was all those other things too, and how that intersectionality played out. 00:12:50.266 --> 00:12:52.400 But also thinking about my 00:12:52.466 --> 00:12:54.266 my brothers and my mother and 00:12:54.266 --> 00:12:58.800 her sisters, their background, they were immigrants to a new country. 00:12:58.800 --> 00:13:00.266 They had their own culture. 00:13:00.266 --> 00:13:05.866 And how that played out in what was predominantly a kind of Anglo culture 00:13:05.933 --> 00:13:10.933 which leaned heavily towards a health model of support. 00:13:11.133 --> 00:13:15.200 How we balance that back and how we made tried to make anyway 00:13:15.266 --> 00:13:19.200 much more culturally sensitive responses, both to my mother 00:13:19.200 --> 00:13:23.333 but also to the rest of her family, so that the impact of inequalities 00:13:23.333 --> 00:13:24.400 and discrimination is 00:13:24.400 --> 00:13:27.400 just we know so well, as Trish highlighted around the pandemic. 00:13:27.600 --> 00:13:32.600 So key and we as social workers really need to be at the forefront 00:13:32.666 --> 00:13:37.600 of addressing human rights and social justice and really addressing 00:13:37.666 --> 00:13:42.333 racism and the inequalities that are present within our system, 00:13:42.333 --> 00:13:47.933 but very much as well ageism, the way in which ageism impacts on people 00:13:47.933 --> 00:13:52.666 and how often I felt sometimes the things that we needed to do for 00:13:52.666 --> 00:13:56.533 my mother weren't being done because she was just old. 00:13:56.600 --> 00:13:58.600 And that's how sometimes the system sees it. 00:13:58.600 --> 00:14:01.533 And it's just something we really have to try and address. 00:14:01.533 --> 00:14:05.200 Then the system skills being good networks, boundaries, openness, 00:14:05.333 --> 00:14:06.600 having to advocate, 00:14:06.600 --> 00:14:09.933 being alongside of people, thinking about the preventative approach as well, 00:14:10.200 --> 00:14:18.333 and having that life course approach to understanding the caring role 00:14:18.400 --> 00:14:18.866 is great. 00:14:18.866 --> 00:14:21.466 My throat is drying up, 00:14:21.466 --> 00:14:25.933 so key messages, transitions are crucial times. 00:14:26.000 --> 00:14:27.400 So services and social workers 00:14:27.400 --> 00:14:31.133 need to bring those services together to work really well together. 00:14:31.200 --> 00:14:35.400 Being effective coordinators is one of our key strengths and we must bring that 00:14:35.466 --> 00:14:41.533 to being real support for family carriers and unpaid carers and the work they do 00:14:41.666 --> 00:14:46.266 that co-ordination role which just so badly can impact on people 00:14:46.266 --> 00:14:51.066 who are trying to be there to support and carry on caring for their family. 00:14:51.200 --> 00:14:56.066 And we need to be better at recognising this key role that social workers do play.