Towards Accountability in Social Work: Long Term Social Work in an Area Office

SUMMARY This article reports the results of monitoring the social work of two long term teams in an area office throughout one year with the help of a computerized Case Review System. It describes the characteristics of some 1,400 long-term cases of whom 61% were disabled, visually handicapped and/or elderly and 22% presented problems related to children and families. One of the outstanding features was the concentration on surveillance and review visiting which was reported for nearly three quarters of these cases and was considered the most important social worker activity in two fifths of them. In over half of these long term situations no change was expected and nearly three quarters of the cases were to remain open indefinitely. Another striking feature was the somewhat uneven distribution of social work resources among the different problem groups. Although the physically disabled and/or elderly outnumbered the child/family problems by two to one, they made up only 20% of the cases allocated to individual social workers, while almost all the child and family problems were allocated amounting to 35% of all individual caseloads. But the disabled and elderly received far more domiciliary services and aids to daily living. This exercise has brought into sharp focus the question of how to ensure continuous support and surveillance for the very frail elderly, as the occasional social work visit did not appear to be the appropriate means of support, rarely anticipating or averting crises. The data highlight the challenge which chronically disorganized and disturbed families present to social work skills. The outcomes cast doubt on the wisdom of closing, within the intake stage as low priority, relatively early family problems, and on the sharp division into intake and long term teams. The general issue emerging is the need to formulate more precise social service strategies for those who require long term care by others to some extent—the very old and frail, the chronically physically and mentally disabled and children in long term care—and what specific contributions social workers can usefully make to this enterprise.