Risk and professional artistry Risk and professional artistry in social work practice:in social work practice:

between the contingencies of streetbetween the contingencies of street--level operations and regimes of formal level operations and regimes of formal

accountabilityaccountability

Tom HorlickTom Horlick--JonesJones and and Colin YoungColin YoungCardiff University School of Social Cardiff University School of Social

SciencesSciences

IntroductionIntroduction

ØØRisk as an allRisk as an all--purpose language of purpose language of administration, regulation and standardadministration, regulation and standard--setting.setting.

ØØHow has the adoption of a framework of How has the adoption of a framework of riskrisk--based practice shaped professional based practice shaped professional practice in social work?practice in social work?

ØØ To what extent are contemporary theories To what extent are contemporary theories of risk useful in capturing features of the of risk useful in capturing features of the real world of social work?real world of social work?

1. The nature of social work1. The nature of social work

What is Social Work? What is Social Work?

ØØDifferent definitions: Different definitions: llBarclay Report (1982) Barclay Report (1982) llGriffiths Report (1988) Griffiths Report (1988) ll International Association of Social WorkersInternational Association of Social WorkersllGeneral Social Care Council (GSCC) General Social Care Council (GSCC)

statement of social work roles and tasks statement of social work roles and tasks (2008) (2008)

An informal definitionAn informal definition

ØØ The tasks of social work makes the tasks The tasks of social work makes the tasks the Israelites had to make bricks without the Israelites had to make bricks without straw look easy!straw look easy!

ØØ Griffiths Report [1988] Griffiths Report [1988] Community Care: An Agenda for ActionCommunity Care: An Agenda for Action(report which lead to the National Health Service and (report which lead to the National Health Service and Community Care Act 1990) Community Care Act 1990)

The international definition, The international definition, adopted in 2001adopted in 2001

““a profession which promotes social change, a profession which promotes social change, problem solving in human relationships and problem solving in human relationships and the empowerment and liberation of people to the empowerment and liberation of people to enhance wellenhance well--being. Utilising theories of being. Utilising theories of human behaviour and social systems, social human behaviour and social systems, social work intervenes at the points where people work intervenes at the points where people interact with their environments. interact with their environments. Principles Principles of human rights and social justice are of human rights and social justice are fundamental to social workfundamental to social work”” (emphasis (emphasis added)added)Care Council for Wales [2003] p.4Care Council for Wales [2003] p.4

Payne (2006)Payne (2006)

ØØAll social work contains elements of:All social work contains elements of:llMaintaining social order.Maintaining social order.llTherapeutic Therapeutic –– reflexivenessreflexiveness –– interaction interaction

between service users and social workers, between service users and social workers, aimed at greater selfaimed at greater self--fulfillment.fulfillment.llTransformationistTransformationist –– changing society. changing society.

Social Work in the 21Social Work in the 21stst Century Century

ØØ Admin and ICT skills (ECDL) Admin and ICT skills (ECDL) ØØ InterInter--personal skills personal skills ØØ Ability to think and act creatively across Ability to think and act creatively across

theoretical boundaries theoretical boundaries ØØMultiMulti--disciplinarydisciplinaryØØ Listening and responding to the service Listening and responding to the service

users / carer voice users / carer voice

General Social Care Council, 2008General Social Care Council, 2008

ØØ Social work makes a particular Social work makes a particular contribution in situations where there are contribution in situations where there are high levels of:high levels of:ll ““Complexity, uncertainty, stress, conflicts of Complexity, uncertainty, stress, conflicts of

interest, and riskinterest, and risk”” (GSCC [2008]:4)(GSCC [2008]:4)

Social work and risk Social work and risk

ØØExposed to greater challenges (e.g. from Exposed to greater challenges (e.g. from the media) than other professions: the media) than other professions: llVictoria Victoria ClimbieClimbiellBaby PBaby PllShipman Shipman llAdult deaths as well, but less press coverage.Adult deaths as well, but less press coverage.

ØØFailures:Failures:ll Inadequate risk assessmentsInadequate risk assessmentsllPoor collaboration with other professionals Poor collaboration with other professionals

ClimbieClimbie –– Lord Laming Lord Laming

ØØ ““the legislative framework is fundamentally the legislative framework is fundamentally sound. Not to the often hapless frontsound. Not to the often hapless front--line line staff that direct most criticism, staff that direct most criticism, …………. . Greatest failure rests with senior Greatest failure rests with senior managers and members of organisations managers and members of organisations whose responsibility is to ensure whose responsibility is to ensure servicesservices…… properly financed and staffedproperly financed and staffed””(Laming[2003]:5) (Laming[2003]:5)

ClimbieClimbie –– Lord Laming Lord Laming –– 108 108 recommendations, inc: recommendations, inc:

ØØ Training of social workers must equip them with Training of social workers must equip them with confidence to challenge other professionalsconfidence to challenge other professionals

ØØ Assessing child without carerAssessing child without carer’’s consent s consent ØØ Document concerns, record visits Document concerns, record visits ØØ Recorded discussions of differences in medical opinions Recorded discussions of differences in medical opinions

(esp. physical vs. non(esp. physical vs. non--accidental)accidental)ØØ No child with protection concerns discharged from No child with protection concerns discharged from

hospital without permission of consultant (responsibility hospital without permission of consultant (responsibility rests with consultant) rests with consultant)

ØØ Those with child protection concerns Those with child protection concerns –– not discharged not discharged without a plan, or a GP!without a plan, or a GP!

ØØ Check on previous concerns following admissionCheck on previous concerns following admission

Professor Richard Baker quoted in Professor Richard Baker quoted in Shipman report (p.69)Shipman report (p.69)

ØØ ““Since beginning to investigate Shipman in Since beginning to investigate Shipman in 2000 I have been trying to understand how 2000 I have been trying to understand how it was that he could kill so many without it was that he could kill so many without detection. There were of course system detection. There were of course system failures, but it has been impossible to failures, but it has been impossible to avoid the question as to why these were avoid the question as to why these were tolerated to the extent that Shipman could tolerated to the extent that Shipman could murder over 200 patients. The conclusion I murder over 200 patients. The conclusion I have come to is that all doctorshave come to is that all doctors………… share share responsibilityresponsibility…”…”

Risk and professional practiceRisk and professional practice

ØØCriminal justice and the Criminal justice and the ‘‘new penologynew penology’’..ØØWhither the welfare state?Whither the welfare state?ØØAssessing risk in child protection.Assessing risk in child protection.ØØProbation practice.Probation practice.ØØMental health and Mental health and ‘‘dangerousdangerous’’ people.people.ØØHealth governance.Health governance.lland nowand now……..

ØØRisk management in social care.Risk management in social care.

2. How is risk2. How is risk--based practice based practice shaping the character of social shaping the character of social

work?work?

Generating a dialogue between Generating a dialogue between theory and practicetheory and practice

ØØ Experience, gained over a number of Experience, gained over a number of years, of teaching risk theory to inyears, of teaching risk theory to in--service service social workers, studying on the postsocial workers, studying on the post--qualification course.qualification course.

ØØ PracticePractice--orientation, interactive.orientation, interactive.ØØOpportunity for informal discussions of Opportunity for informal discussions of

specific examples of practical experience.specific examples of practical experience.ØØ Around 100 PQ students in total.Around 100 PQ students in total.

Five notable topicsFive notable topics

a.a. The use of risk ideas in documentation.The use of risk ideas in documentation.b.b. Risk and professional expertise.Risk and professional expertise.c.c. Use of formal techniques for risk Use of formal techniques for risk

assessment.assessment.d.d. The The ‘‘jigsawjigsaw’’ effect.effect.e.e. Risk and accountability.Risk and accountability.

a. Risk ideas in documentationa. Risk ideas in documentationØØ Example: Example: In safe hands: Implementing adult In safe hands: Implementing adult

protection procedures in Walesprotection procedures in Wales (2000).(2000).

ØØ The presence of ambiguities and confusionsThe presence of ambiguities and confusionsØØ Risk:Risk:ll to the vulnerableto the vulnerablell to othersto othersll to informantsto informantsll (to social care agencies, staff)(to social care agencies, staff)

ØØ Risk:Risk:ll PerceivedPerceivedll and and ‘‘dangerdanger’’ll assessment (but how?)assessment (but how?)ll unacceptable (but criteria?)unacceptable (but criteria?)ll management strategy, management strategy, ‘‘where deemed appropriatewhere deemed appropriate’’ (but (but

criteria?)criteria?)

b. The riskb. The risk--based framing of social work based framing of social work practicepractice

Service user, Service user, carers,carers,professionals, professionals, other other stakeholders stakeholders

Service user Service user Who is at risk?Who is at risk?

Risk Risk AssessmentAssessment

Professional Professional ExpertiseExpertise

Basis for actionBasis for action

Prescribed Prescribed ActionsActions

Professional Professional autonomyautonomy

PracticePractice

RiskRisk--basedbasedPrePre--riskriskProfessional Professional RegimeRegime

c. Approaches to assessing riskc. Approaches to assessing risk

ØØA range of practices, coA range of practices, co--existing across existing across geographicallygeographically--close administrative close administrative areas.areas.ØØFormal techniques:Formal techniques:llCheck listsCheck listsllRisk matrixRisk matrixllRisk scoresRisk scores

ØØHazard or risk management, or a hybrid Hazard or risk management, or a hybrid of these?of these?

d. The d. The ‘‘jigsawjigsaw’’ effecteffectØØ Notion coined by Firkins and Smith (2002), prompted Notion coined by Firkins and Smith (2002), prompted

a strong resonance with the students.a strong resonance with the students.

ØØ DecisionDecision--making in conditions of incomplete making in conditions of incomplete knowledge.knowledge.

ØØ Information is spread between different Information is spread between different professionals, agencies and other members of the professionals, agencies and other members of the community.community.

ØØ A practitioner may only possess a few pieces of the A practitioner may only possess a few pieces of the jigsaw.jigsaw.

ØØ How to gain the other pieces?How to gain the other pieces?ØØ Working with an incomplete picture.Working with an incomplete picture.ØØ The tradeThe trade--off between collecting further information off between collecting further information

and the immediate welfare of the service user.and the immediate welfare of the service user.

Unknown unknownsUnknown unknowns……

ØØ “…“…as we know, there are as we know, there are known known knownsknowns; there are ; there are things we know we know. things we know we know. We also know there are We also know there are known unknowns; that is known unknowns; that is to say we know there are to say we know there are some things we do not some things we do not know. But there are also know. But there are also unknown unknowns unknown unknowns –– the the ones we donones we don’’t know we t know we dondon’’t know.t know.””

ØØ Donald H. Rumsfeld, Donald H. Rumsfeld, February 2002February 2002

e. Risk and accountabilitye. Risk and accountability

ØØRiskRisk--based practice and formal based practice and formal accountability.accountability.

ØØ Slippage between everyday professional Slippage between everyday professional practice and what gets recorded in the practice and what gets recorded in the paperwork.paperwork.

ØØ Liability issues.Liability issues.ØØ Back covering.Back covering.ØØGetting things done by ensuring the Getting things done by ensuring the

assessments turn out appropriately.assessments turn out appropriately.

3. A little theory3. A little theory

PreamblePreamble

ØØ To what extent can sociological theories of risk To what extent can sociological theories of risk help understanding of the praxis through which help understanding of the praxis through which social work is daily accomplished?social work is daily accomplished?

ØØ The distinction between contingency and risk.The distinction between contingency and risk.ØØ Risk Society, too Risk Society, too broadbrushbroadbrush??ØØ GovernmentalityGovernmentality, the technical discourse of risk, , the technical discourse of risk,

and and totalisationtotalisation??ØØ Relevance of other grand theories?Relevance of other grand theories?

Some different perspectivesSome different perspectivesØØ StreetStreet--level bureaucracy (level bureaucracy (LipskyLipsky): ): ‘‘a corrupted a corrupted

world of serviceworld of service’’, under, under--resourced overload, resourced overload, informal techniques of practice.informal techniques of practice.

ØØ Keeping the peace (Bittner).Keeping the peace (Bittner).ØØ Professional artistry (Professional artistry (SchSchöön).n).ØØ Good organisational reasons for bad clinical Good organisational reasons for bad clinical

records (records (GarfinkelGarfinkel with Bittner)with Bittner)ØØ Conflicting Conflicting knowledgesknowledges ((KemshallKemshall))ØØ Risk is Risk is ‘‘decentreddecentred’’ (Horlick(Horlick--Jones): a chronic, Jones): a chronic,

situationallysituationally--specific, ambiguity over the nature specific, ambiguity over the nature of the risk object; slippage between formal and of the risk object; slippage between formal and informal practices. informal practices.

ConclusionsConclusions

ØØ Social workers operate in skilled and pragmatic Social workers operate in skilled and pragmatic ways to address the practical challengers of ways to address the practical challengers of heavy workloads, whilst maintaining an heavy workloads, whilst maintaining an orientation towards the formal demands of risk orientation towards the formal demands of risk management.management.

ØØ Limited explanatory capacity of some grand Limited explanatory capacity of some grand theories of risk to capture the diversity and theories of risk to capture the diversity and situational specificity of patterns of risk praxis.situational specificity of patterns of risk praxis.

ØØ Implications for the development of social work Implications for the development of social work practice and risk scholarship?practice and risk scholarship?

Contact detailsContact details

ØØ Prof. Tom Prof. Tom HorlickHorlick--JonesJonesØØ HorlickHorlick--JonesT@cardiff.ac.ukJonesT@cardiff.ac.uk

ØØ Dr. Colin YoungDr. Colin YoungØØ YoungC1@cardiff.ac.ukYoungC1@cardiff.ac.uk

ØØ Cardiff School of Social Sciences, Cardiff Cardiff School of Social Sciences, Cardiff University, Glamorgan Building, King Edward VII University, Glamorgan Building, King Edward VII Avenue, Cardiff CF10 3WT, Wales UK.Avenue, Cardiff CF10 3WT, Wales UK.

References 1References 1ØØ Bittner, E. (1967) Bittner, E. (1967) ‘‘The police on skidThe police on skid--row: a study in peace keepingrow: a study in peace keeping’’, ,

American Sociological ReviewAmerican Sociological Review, 32, pp.699, 32, pp.699--715. The National Occupational 715. The National Occupational Standards for Social Work. Cardiff: Welsh Assembly Government. Standards for Social Work. Cardiff: Welsh Assembly Government.

ØØ Care Council for Wales (2003) Care Council for Wales (2003) The National Occupational Standards for The National Occupational Standards for Social Work. Cardiff: Welsh Assembly Government. Social Work. Cardiff: Welsh Assembly Government.

ØØ Firkins, A. and Smith, S. (2002) Firkins, A. and Smith, S. (2002) ‘‘Judgement as a resource in child Judgement as a resource in child protection practiceprotection practice’’ in in CandlinCandlin, C. (ed.) , C. (ed.) Research and practice in Research and practice in Professional Discourse,Professional Discourse, City University of Hong Kong, Hong Kong pp.309City University of Hong Kong, Hong Kong pp.309--332.332.

ØØ GarfinkelGarfinkel, H. with Bittner, E. , H. with Bittner, E. ‘‘Good organizational reasons for bad clinical Good organizational reasons for bad clinical recordsrecords’’ in in GarfinkelGarfinkel , H. (1967) , H. (1967) Studies in Studies in EthnomethodologyEthnomethodology,, PrenticePrentice--Hall, Hall, Englewood Cliffs NJ. Pp.186Englewood Cliffs NJ. Pp.186--207.207.

ØØ GSCC (2008) Social Work at its Best . A Statement of Roles and TGSCC (2008) Social Work at its Best . A Statement of Roles and Tasks for asks for the 21the 21stst Century. LCentury. London: GSCC. ondon: GSCC.

ØØ HorlickHorlick--Jones, T. (2005) Jones, T. (2005) ‘‘On On ““risk workrisk work””: professional discourse, : professional discourse, accountability and everyday actionaccountability and everyday action’’, , Health, Risk & Society,Health, Risk & Society, 7(3) pp.2937(3) pp.293--307.307.

ØØ HorlickHorlick--Jones, T. (2008) Jones, T. (2008) ‘‘Risk, praxis and everyday lifeRisk, praxis and everyday life’’, keynote paper , keynote paper delivered to a session on delivered to a session on The Everyday Management of RiskThe Everyday Management of Risk, International , International Sociological Association congress, Barcelona, September, availabSociological Association congress, Barcelona, September, available from le from the author or via: the author or via: http://www.kent.ac.uk/soru/Tom_Horlickhttp://www.kent.ac.uk/soru/Tom_Horlick--Jones.pdfJones.pdf..

References 2References 2ØØ KKemshallemshall, H. (2000) , H. (2000) ‘‘Conflicting Conflicting knowledgesknowledges on risk: the case of risk on risk: the case of risk

knowledge in the probation serviceknowledge in the probation service’’, , Health, Risk & SocietyHealth, Risk & Society, 2, pp. , 2, pp. 143143--158.158.

ØØ Laming, Lord W.H. (2003) Laming, Lord W.H. (2003) The Victoria The Victoria ClimbieClimbie Enquiry CM 5992. Enquiry CM 5992. London: HMSO. London: HMSO.

ØØ LipskyLipsky, M. (1980) , M. (1980) StreetStreet--Level Bureaucracy: Dilemmas of the Level Bureaucracy: Dilemmas of the Individual in Public ServicesIndividual in Public Services, Russell Sage Foundation, New York., Russell Sage Foundation, New York.

ØØ National Assembly for Wales (2000National Assembly for Wales (2000) In Safe Hands Protection of ) In Safe Hands Protection of Vulnerable Adults Vulnerable Adults Cardiff: National Assembly for Wales. Cardiff: National Assembly for Wales.

ØØ http://new.wales.gov.uk/social_services/Publications/ArchivedPubhttp://new.wales.gov.uk/social_services/Publications/ArchivedPubliclications/1348909/safe_hands?lang=enations/1348909/safe_hands?lang=en

ØØ National Institute for Social Work (1982) National Institute for Social Work (1982) Social Workers Their Role Social Workers Their Role and Tasks and Tasks London: National Institute for Social Work.London: National Institute for Social Work.

ØØ Payne, M. (2006) What is Professional Social Work? Bristol: PoliPayne, M. (2006) What is Professional Social Work? Bristol: Policy cy PressPress

ØØ SchSchöönn, D. (1983) , D. (1983) The Reflective Practitioner: How Professionals The Reflective Practitioner: How Professionals Think in Action,Think in Action, Basic Books, New York.Basic Books, New York.

ØØ Shipman Inquiry (2005) Shipman Inquiry (2005) ØØ (Web(Web--site: site: http://www.thehttp://www.the--shipmanshipman--inquiry.org.uk/home.aspinquiry.org.uk/home.asp