1 Assistant Professor in Social Work, Department of Sociology
2 PhD researcher, Department of Sociology, Durham University
3 Lead in Professional Development, the British Association of Social Workers
About us
The authors of this submission have been working on a project, Empowering Social Workers in Challenging Times: Learning from Best Practice during COVID-19, funded by the British Association of Social Workers (BASW) and the Economic and Social Research Council Impact Acceleration Account (ESRC IAA). In collaboration with the Social Work Practitioner Research Network, we analysed a dataset of 2222 responses from social workers in the UK about their experiences during Covid-19, collected by BASW’s Ongoing Survey on Social Work during COVID-19 (the BASW Survey hereafter).
The findings presented in this briefing note are based on the data collected by the BASW Survey and have not been published elsewhere.
Rationale for submitting evidence
There were 98,000 registered social workers in England in 2019 (Social Work England, 2020), 10,965 in Scotland in 2015 (Scottish Government, 2016), 5965 in Wales in 2017 (Social Care Wales, 2017) and 6,606 in Northern Ireland in 2020 (Belfast Telegraph, 2020). The commitment of social workers to their professional practice is essential for the seamless delivery of social services, care and support to the disadvantaged and vulnerable. Throughout the pandemic, social workers have continued to undertake face-to-face visits where necessary, such as in safeguarding work for protecting children and families (Ferguson, Kelly and Pink, 2020) and conducting Mental Health Act (1983) assessments for people in crisis. Social workers play a critical role in ensuring the most vulnerable in society understand and access the necessary conditions for complying with lockdown restrictions:
We have been contacting/visiting our families weekly and checking that they are coping with the Covid-19 restrictions of lockdown; that they have been able to provide good nutritional meals for the children; been able to collect any medicines/prescriptions that they need; understood what social distancing/shielding means.
Despite social workers’ commitment to their profession, there has been a lack of access to Personal Protective Equipment (PPE) and asymptomatic COVID-19 tests (during the initial rollout); and the prioritization of vaccinations only for social workers directly working with people who are clinically vulnerable (Dunn, Allen, Humphries and Alderwick, 2020; BASW, 2021). This lack of protection is particularly concerning given that most recent statistics indicate working age social workers are more likely to die because of COVID-19 compared to other occupations (Community Care, 2021). BASW (2021) found that 71.5% of social workers agreeing that the COVID-19 crisis had had an adverse impact on themselves. Social workers have exposed themselves to extra risk and feel the lack of recognition for their role in keeping vulnerable members of society safe is having impact on morale. There is a sense that ‘numbers and recordings are more important than social workers’ health’ and a perceived 'lack [of] faith in this profession’.
Data and analysis
Between March and August 2020, 2222 responses to the BASW Survey were received from UK social workers. Analysis of the data showed that many social workers experienced drastic changes in their practice environment and logistics, ethical decision making, and skills needed during the COVID-19 pandemic. These changes were required for meeting the new needs of service users, colleagues, family members, as well as of social workers themselves. These changes also led to loneliness, anxiety and stress in their everyday practice. Under these circumstances, 51.2-56.5% of social workers agreed that they had more support from management to get through the changes (Kong et al., 2021; BASW, 2021). A significant proportion of social worker respondents still felt unable to do their job properly due to the lack of support from managers and employers.
To further explore social workers’ vulnerabilities in practicing during COVID-19 and their challenges in supporting shielding/self-isolating users, the authors ran a separate analysis of a subset of data produced by text search queries of the Survey’s database. The keywords include ‘shielding’ (n=62), ‘isolating’ (n=14), ‘quarantine’ (n=261), ‘high-risk’ (n=45) and ‘vulnerable’ (n=181). Responses that were not relevant to the categories of 1. Social workers who are shielding (n=70), 2. Social workers who are living with someone who is shielding (n=20) and 3. Social workers working with users who are shielding/self-isolating (n=100) were excluded from further analysis.
Analysing the 70 responses from social workers who were shielding allowed us to make sense of their feelings and challenges while practicing during the pandemic. Social workers felt that they were (a) disconnected, (b) unsupported and (c) responsible for the impact of shielding on their work and that of colleagues.
a) Feeling disconnected
Shielding social workers found it very difficult to stay engaged and be part of the team especially when the effective remote communication was not well established with team members.
Shielding at home, confrontation and disagreement …no communication
This sense of disconnection was also felt because of the need for social workers to draw on colleagues’ practice experience and existing relationships built with users for working effectively.
Not having people around me, not having the experience of others to call on, not seeing others… losing connections to people I have worked with in the community
Being in a high-risk group so should be working from home but don’t feel able to due to the current state of the team in and needing to support them and the families we work with.
The increasing pressure to work effectively while shielding led some social workers who were shielding to consider breaking the shielding rules or withdraw from working completely.
b) Feeling unsupported
Alongside the disconnection, social workers who were shielding felt they were not appropriately supported by colleagues or managers to remain an active part of the team. Here, practitioners indicated that by working from home they no longer had access to their professional support network, either formal or informal:
Shielding working from home since 18th March, no team meetings, no supports, no weekly calls to update if I am ok or not. No updates on changes what is happening. Worse working period of my life, mental health has suffered.
This shielding issue is yet to be resolved. In BASW’s (2021) more recent survey, 22.3% of social workers disagreed that their employer had satisfactorily accommodated the fact they were at high risk and/or were in the shielding group during the first UK-wide lockdown. Not only did this place a strain on social workers’ mental health, but it also had major implications for practitioners’ abilities to support their service user groups:
I have an underlying health issue and have to work from home, so my families don’t have the level of support needed from me.
I'm 20 weeks pregnant and despite being in one of the most vulnerable groups I am still being told it would be a choice to self-isolate. In other words, if I don't turn up, I won't be paid.
Some social workers also indicated that despite falling into the vulnerable category they were not supported or indeed encouraged to shield. This highlights major discrepancies in the protection and recognition of the social work role.
c) Feeling responsible for the impact of shielding on their work and that of colleagues
Shielding social workers were aware of the knock-on impact that their physical absence from the work environment was having on non-shielding colleagues. One of the key issues that emerged was about staff shortages for making home visits and carrying out face-to-face work.
Colleagues who are in high-risk categories are now working from home leaving us short staffed for home visits
This was compounded by other parts of the health and social care system making blanket decisions to stop home visiting/face-to-face work. This created more pressure on those teams and services still seeing people in their own homes. An example was the increase in people being referred for Mental Health Act (1983) assessments, without any previous contact with mental health services (BASW, 2020).
Other staff members who continued to deliver face-to-face work on behalf of shielding social workers were also less knowledgeable about the home and family circumstances.
7 out of 9 staff off sick/self-isolating and having to undertake visits for other people with little knowledge of the cases.
The pressure of overloading colleagues and not delivering the best service to users in some cases forced shielding social workers to choose between their safety or that of the people they support.
While the number of responses explicitly referencing practitioners’ shielding family members is small (n=20), their message is unanimously negative and primarily relate to a) risking the lives of loved ones; b) the impact of caring for shielding family member; and c) the impact of not receiving appropriate support.
a) Risking the lives of loved ones
The responsibility of caring for and protecting shielding family members appeared fixed on the shoulders of social workers, irrespective of their already challenging roles.
We have expressed concerns about being potential ‘super spreaders’ for our already vulnerable families as well as potentially infecting the vulnerable people in our own families but have had no response.
I'm worried regarding the lack of PPE to undertake these roles, especially as my partner is vulnerable due to underlying health conditions.
By not acknowledging the reality of living with someone who is shielding, nor providing social workers with appropriate support and adjustment at work, practitioners were forced to risk the health and wellbeing of loved ones.
b) Impact of caring for a shielding family member
Those practitioners living with someone shielding also faced the added pressure of having to care for them in some instances.
I have explained that my husband is vulnerable due to his health conditions: stroke with hydrocephalus high blood pressure and atrial-fibrillation. I am his carer. He only came out of hospital at the end of October and is still under brain injury service and I am his carer and I do not think I should be increasingly face to face contact, but I do not think so far this has been taken seriously.
The stress, pressure and isolation associated with caring for shielding family members is yet to be acknowledged for social workers in any capacity, leaving practitioners in extremely vulnerable situations.
c) Impact of not receiving appropriate support
A lack of support for social workers living with someone shielding was evident and risks a culture of fear building amongst an already fragile workforce (Department of Health and Social Care, 2021). No consideration for practitioner's dual role as worker and carer was given, placing their physical and mental health at increased risk along with those they care for.
I am high risk and so is a family member. I want to work from home, and this has been refused because service needs come first. No protective equipment has been provided- we have purchased our own hand sanitizers.
These issues increased stress and pressure among social workers, potentially contributing to the high percentage (58.8%) of social workers agreeing that working during COVID-19 had negatively impacted their own mental health (BASW, 2021).
In relation to supporting users who are shielding/self-isolating, 100 responses were collected from social workers expressing concerns about (a) the impact of self-isolating/shielding on the person and other family members, (b) themselves spreading the virus and (c) the reduced public trust in the profession and damaged partnership working due to the lack of PPE.
a) Impact of shielding/self-isolating on the person and their family members
The pandemic has affected the wellbeing of people in the UK, with 75% of respondents to the Opinions and Lifestyle Survey (COVID-19 module) indicating that they were either somewhat or very worried about the effect that COVID-19 was having on their life. Meanwhile, 56% agreed that there was actual impact on their wellbeing including boredom, loneliness, stress and anxiety (ONS, 2021). Social worker respondents in our study also expressed similar concerns about increased family stress due to COVID-19 and shielding/self-isolating and its impact on family functioning and domestic abuse.
How can we keep children safe if the family home is self-isolating? We know that in times of stress children are more likely to experience some abuse, school holidays are always hot spots, and I am concerned if schools shut, and our children are not seen as much.
From the perspective of social workers who are dealing with safeguarding issues, the ripple effect of increased stress and anxiety in some families can mean increased risk of harm on minors and vulnerable family members. In addition, ‘families using crisis as a shield to prevent [social workers’] access’ created new challenges for safeguarding work during the pandemic.
Not being able to engage with the family face-to-face with regards to high-risk cases. Some coming up with statements that they have Covid19 symptoms when they clearly do not have it just to avoid contacts from professionals.
...In child protection, what should we do when people are self-isolating but it’s not able to be proven this is a case? When it’s appropriate for that [statutory intervention]? [or] If this is a family using this situation to evade/avoid social workers and so children are not seen.
While shielding/self-isolation was sometimes used as an excuse to evade social workers’ assessment and monitoring, closure of schools and community services made it even more challenging to identify cases of abuse and ensure robust assessments were carried out to prevent further harm.
b) Spreading the virus
Social workers had to continue carrying out home visits/face-to-face work during the national lockdown in the UK without sufficient access to PPE provision. Face-to-face work is critical to supporting people who do not have capacity to independently engage with social services/care remotely. For example, young children, families where safeguarding issues are involved, and people with mental health issues.
As a psychosis specialist it is also hard to do remote communication. Some service users have delusions and paranoia about technology, and others have limited access to it. This is showing a big discrepancy in the services we can offer, which is impacted the poorest and most vulnerable as internet access is becoming so essential.
While social workers were taking personal risks to ensure the safety of the vulnerable, there was always a worry of spreading the virus while visiting individuals/families and bringing the virus back to colleagues and family members.
I complete assessments and support communication between witnesses/accused persons who have contact with the criminal justice system. My primary challenge is in deciding if and whom I should visit. Most of my clients are vulnerable due to age, physical, mental or other hidden disabilities or a combination of these.
many families are unwell and workers are expected to go into their homes to undertake statutory visits, putting the worker at risk of contracting Covid-19 and passing it on to other families who can have some health vulnerabilities.
Our evidence, alongside the latest evidence on how ethnicity, gender, age and poverty might relate to one’s susceptibility to contracting COVID-19 and illness outcomes (e.g. mortality rate) (HM Government, 2021), suggests the importance of seeing vulnerability beyond ‘clinically vulnerable’/ shielding population to include social vulnerability as an interactive factor shaping illness outcomes and their wider impact.
c) Insufficient protection and its impact on public trust in the profession and partnership working
Insufficient protection for social workers also reduced service users’ trust in the profession. Social workers said that they had to ‘regain trust of vulnerable clients’ and that ‘families [would] refuse to allow social workers in for visits due to shielding’.
My superiors are giving little to no advice and guidance on safe practice...[in] regard to the health of their employees or indeed the vulnerable people that we are visiting... people are reluctant to let us visit and care homes have closed the doors to us entirely.
Schools are ambivalent about meeting. Some foster carers are also concerned about the health risks for themselves and the children in care. Meetings are being cancelled.
Not providing sufficient protective equipment and tests to social workers further undermined partnership working, such as with schools, refuges, residential care homes, that is crucial for addressing the complex needs of the vulnerable individuals and families.
Recommendations
References
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