Making records count

1. Making records count Or why do we record all this stuff anyway – we want to work with children

2. Not a new issue • ‘apparently unpopular, time consuming practice of social work case recording…’ • Records… can be variously described as ephemeral, incomplete, exaggerated, controlling, therapeutic, injurious, protective, important, obligatory, useful…ie what it actually is is in the eye of the beholder”. • Prince, 1996

3. Poor records = poor practice • “It is not too much to say that a case work agency that keeps poor records is giving ineffective or superficial treatment to clients” • (Sheffield, 1920) The links between poor recording and poor outcomes have been made for nearly 100 years which is not much longer than our profession has been around.

4. Discussion as old as time. • between Beatrice Webb and Octavia Hill, 1886, about recording in social care: • Beatrice – wisdom of writing down “observations so as to be able to give true information” • Octavia – “what you want is action”

5. A social work view “Recording is..pointless but essential” This statement highlights the tension between the different strands of social work activity: • Casework/therapy • Service delivery • Social control (Kinnibrugh, 1984

6. So what do we mean by recording? • We mean all the written material contained in the case work files of people using Children Services. These files may be wholly or partly electronic or they may be in hard copy. • Recording is a crucial part of day to day practice and takes up a substantial amount of practitioners' time. Recording involves: • writing down the work you do; • noting the progress people make towards their desired outcomes; • including the views of the person; • analysis and assessment; and • the life history of the person and its interpretation. • Good records are an essential tool for practitioners to reflect on their on going work with people and plan future work. When shared with the person whose file it is they encourage transparency.

7. What is the purpose of social work recording? • documenting the involvement with the individual; • informing assessment and care planning; • enabling practitioners to review and reflect on their work; • assisting practitioners to identify any patterns; • ensuring accountability of staff; • meeting statutory requirements; • providing evidence for legal proceedings; • enabling continuity when a new worker takes over the case; • providing performance information; • forming a biography - for example, for a looked after child to read at a later date to provide them with their history; • providing evidence for inquiries or reviews; and • assisting partnership working between workers and people using their services.

8. Good recording should: • be drawn up in partnership with the person whose record it is; • record the views of the person whose record it is, including whether they have given permission to share information; • be an accurate up to date record of work, which is regularly reviewed and summarised; • include a record of decisions taken and the reasons for these decisions; • include a chronology of significant events; • be evidence based and ethical; • separate fact from opinion; • incorporate assessment, including risk assessment where appropriate; • include an up to date support/care/action plan; and • record race/ethnicity, gender, religion, language, disability.

9. What kind of records do we generate? • memos • Minutes • Emails • Texts • Letters • Case notes • Chronologies • Reports • Care plans • Action plans • Support plans • Review reports

10. Professional writing is underpinned by professional knowledge which has three components:- • conceptual knowledge based on theory which informs a practitioner’s understanding and thinking about a service user and their circumstances • instrumental knowledge based on research and evidenced based practice which enables a practitioner to be proactive in deciding how to support people • tacit knowledge based on practice wisdom and personal and professional experiences to influence engagement with a service user

11. The tools we have • We have pen and paper • We have computers –both office and mobile • We have dictaphones, cameras, videos, mobile phones • We have places and spaces to record in that we never dreamt of in our youth – facebook, twitter, reality television, google earth, street cams • We are recorded everyday in a myriad of ways and our information is stored

12. The ways we perceive information • Visual information = only what we see without any written words or numbers • Aural information = only sounds • Written information = contained in words and numbers only • Olfactory = what we can smell or taste

13. What information matters most How much of what we take in when we are doing case work do we record. How good are we at pinpointing what senses have been informing our judgements about our information?

14. Non verbal communication • Nonverbal communication ranges from facial expression to body language. Gestures, signs, and use of space are also important in nonverbal communication. Multicultural differences in body language, facial expression, use of space, and especially, gestures, are enormous and enormously open to misinterpretation.

15. Say it with feeling… • According to A. Barbour, author of Louder Than Words: Nonverbal Communication, the total impact of a message breaks down like this: • 7 percent verbal (words) • 38 percent vocal (volume, pitch, rhythm, etc) • 55 percent body movements (mostly facial expressions) This research relates to communication that contains strong emotions, or taboo subjects.

16. Listening affects recording • The literal listener – concentrates on the exact words that people use and will often be able to quote verbatim; they are concerned with detail, are very precise, direct and up front with people, and expect people to be up front with them. The literal listener does not like vagueness, ambiguity or confusion, and, if there is ever a disagreement over what is supposed to have been said, will say “But you said”

17. Listening styles • The emotional listener –is less concerned with the exact words that people use, but is far more concerned with how someone appears to be feeling. The emotional listener will note tone of voice, facial expression, body language and any discontinuity between the verbal, and non-verbal, communication.

18. Listening Styles • The meaning listener – works from almost the opposite premises of the literal listener and believes that the most important part of any message is not what is being said, but the hidden messages or agendas. Meaning listeners assume that people rarely day what they really mean, and that it is important to look beyond the words, to work out what lies behind the message.

19. The power of the person “each individual can assume that the sense they make of the world, the meaning they give to their experiences, is somehow an objective fact, and that people do not always sufficiently realise how the same world can be looked at in very different ways” (Liz O’Rourke, For the Record, 2002)

20. Hearing and recording the voice of the child • It can be hard to hear the voice of the child, to feel their perspective is reflected in the written record. • Children tend to disappear from the record as the processes take over. • The challenge is to make recording the child’s voice authentic

21. Fixated on writing it down • So what exactly are we trying to do when we make a record – usually written, usually on a form, usually following a process, and usually on a computer. • SENSE MAKING

22. Critical thinking • To know what to record we have to know what is important. • This involves being able to think critically. • TBU = information that may be factually accurate but does not take the situation forward or enhance understanding or decision making in anyway.

23. Analysis in social work • Analysis, i.e. the ability to break down the different elements within the family • situation and the wider community, in order to understand the relationship between • the various factors that are impacting on the child, the weight to give to each factor • and how they might be changed or influenced. Using information intelligently and • constructing a narrative and hypotheses which can be tested and re-tested are a • daily part of the competent social worker’s task. (Taken from the Munro review report, 2010, written by the London Assistant Directors, in Appendix 3)

24. Puzzles and problems • A puzzle is something that has an answer – even if it is very complex to work out. Once this is worked out then the results can be predicted. This is the premises of the television show numbers. People can be programmed and predicted. • Procedures and computers work on the idea that there is a complex puzzle with an eventual right and wrong answer

25. A problem • A problem is something that does not have one answer – just a number of possible solutions with outcomes that have limited predictability. • It pushes a group to use emergent practice to manage it – in other words you do something, see what happens and then make a another decision based on those outcomes.

26. RESPONSI VE PRACTICE • The difficulty in working in this way is that you can be reactive instead of responsive. • Procedures and policy and IT exist to support responsive practice – that is too limit the number of variables by ensuring that patterns particularly those of past behaviour, and evidence gathered from static situations (usually serious case reviews) are used to contain and guide interventions.

27. IT as part of the solution • Social workers are not against IT….although you could be forgiven for believing that they are. • The perception that ICS is responsible for a legislatively based framework that dictates certain information be recorded at certain times is mis-informed. • Each Local Authority is compelled to discharge their duties under a legislative framework • The ICS mimics this framework – some more clumsily than others. • IT is iterative NOT static –both invention and investment must be on-going

28. Advantages of electronic recording • you can find information more easily when there is a crisis; • no need to interpret illegible, handwritten case notes; • much easier for you to immediately insert information - even if you are not the allocated worker; • managers at all levels in the organisation are able to access individual case records relatively easily; • ease of access for out of hour's staff and other agencies; • enables information to be gathered about unmet need; and • easier to set up performance information systems which allow aggregating of information from individual files.

29. The shape we are in • A lot of focus on social work – its role and purpose • A lot of focus on the difficulty of the role of the social worker – the lack of resources and support, the unreasonable demands of the recording system • BUT is this where the focus needs to be?

30. Building child shaped futures • Agree on the purpose of our recording • Agree on the information we need to collect to carry out our purpose • Agree on the ways we are going to use the information • Build something that helps us manage that information • Use the information to respond to the child and family in the ways we agreed • Record the information using all our professional skills to inform the work – and make it count.

31. Our records and report need to support understanding and decision making in why and how we intervene in the lives of children and their families Report writing needs to be seen as a highly valued task that demonstrates the quality of the professional behind the pen.

32. Making recording part of delivery • Above all a focus on children that is about DOING – recording in a thoughtful and systemic way, using the information that we gather, the growing body of knowledge in our field – to intervene in a focused and meaningful way with children and families in our communities