Keyworking in Social Care
A While back, I had a discussion with a Social Care Worker who was having difficulties with the keyworking system in their organisation and wondering if it would be better to do away with the keyworking system altogether.
This got me thinking about all the different forms of keyworking I’ve encountered over the last two decades; through my work on the frontline with young people in secure care, residential care in a disability service and my time as a social care leader, service manager and educator of Social Care Workers.
The purpose of a keyworker in a social care service is to place the responsibility for ensuring the service user’s needs and wishes are met with one person, or sometimes a team of people. This could include the development and upkeep of a personal plan, advocating on behalf of the person, ensuring that medical or other appointments are scheduled and followed up on and being a point of contact for communication. This is not to say that the keyworker is to attend all appointments or the only person to write in a file or carry out tasks relating to the service user, but the keyworker ensures that these things are being done.
My gut response during the discussion was that of course service users need a keyworker, who would do the necessary paperwork and advocate for service users otherwise? On deeper reflection however, I began thinking about the times staff on my teams had difficulties with their keyworking system and the approaches we took in each of the different cases.
Problems may arise when faced with a service user who has many complex needs and/or who develops a strong attachment to a keyworker to the point of refusing inputs or service from other staff members. An individual keyworker may become overwhelmed with the workload or pressure of the role especially if there is no backup when they take leave. In these cases, it would be appropriate to have more than one person sharing the keyworking responsibility.On the other hand, I have seen situations where a service user did not have a keyworker for a period of time. This happened for various reasons such as long term sick leave or upheaval in the staffing of a service. In these situations, the remaining staff may have agreed to take care of the keyworking duties with good intentions along the lines of "we'll all do a bit". Inevitably, things fell between the cracks, paperwork left undone, proactive health appoints not made and the service user left in limbo.
The key here is accountability, the lack of which can lead to problems. There is a psychological phenomenon known as ‘Social loafing’ referring to perceived diminished accountability where more people there are responsible for something. In real terms, this can be seen when an accident occurs in a crowded space, the likelihood that someone will call for help is reduced, as everyone assumes that someone else will do it. In social care settings, this can translate into individual staff members assuming someone else will tend to a task when there is no assigned responsibility. For example, how many people heard the strange noise coming from the dishwasher at work before action was taken? If this happened in your own home, it is likely that action would be taken sooner.
In keyworking terms, I have seen and heard of many keyworking forms including but not limited to:
· One keyworker, one service user
· One keyworker, several service users
· Two keyworkers, one service user
· Case team, one service user
· No keyworker – everyone on the team, as well as relief staff and agency staff do what they can for the service user.
· One keyworker, service user thinks it’s someone else
· Assigned keyworkers to service user but one individual completes all paperwork, scheduling appointments, follow ups etc.
· Keyworkers that rotate key clients on a set timescale such as on an annual basis.
· Keyworkers who stay keyworking the same service user for years and even decades.
There are many advantages and disadvantages to each of these options and a team might want to try a few different types to find what works best for their service and service users. Regardless of the option chosen, someone must be accountable to ensure that the service user and their needs are not forgotten.
Think about what form keyworking takes in your organisation? Why is it that way? Could there be a better way for the service and individuals to ensure accountability? I’d love to hear your thoughts and opinions on this or if you have an alternative effective system in place where you work, why not drop me a line at email@example.com or comment on the social media post.Thanks for reading,