Stories from the front line: Special report on social work in Scotland

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Vilified, under-resourced and struggling to cope with society's ills, social workers are stretched to breaking point. After a month-long investigation, with unprecedented access to the human encounters at the heart of the job, Peter Ross reveals a profession in crisis . . .

ON A bitter February morning with snow on the ground and fog in the air, screeching seagulls chase each other round the CCTV cameras outside a tower block. An old man calls up to one of the flats. A young woman sticks her head out. "Jimmy, wait the now," she shouts. "I've got social work in."

In the living room, Jane Beattie, a 33-year-old social worker, is meeting with David and Tracy, a couple in their 20s. David is a drug addict, a former injector of heroin who now takes prescribed doses of methadone and diazepam. Tracy is a thin, pale woman who spent her adolescence in care, and after the birth of her second child suffered post-natal depression. She walks back to her chair from the window, adjusting the towel wrapped around her head. This is the first time in two years that she has washed her hair.

David, a big man in black, comes through from the kitchen with a steaming mug. He's at pains to describe their morning routine. "We set our phones to go off at eight. Get up. Tea, coffee, breakfast. Have a wash, whatever. Get dressed." He speaks with pride, as if these simple tasks are significant achievements.

Above the electric fire there is a photograph of a toddler girl and baby boy. It's half past nine in the morning, an hour at which you might expect the children to be filling the air with chatter and play. But their room lies empty, beds made, toys stacked. Emma and Jack have not stayed here for five months, not since Jane Beattie came and took them away.

Edinburgh City Council's social work department had been concerned about the children for some time, but matters came to a head when the girl, a year-and-a-half-old at the time, sprayed a bottle of bleach in her face, burning her skin; the marks took months to heal. This was one of a number of accidental injuries Emma sustained because her parents, who used alcohol and drugs, were not up in the morning to look after her.

When Beattie visited the family at home she found the sort of quasi-Dickensian scene familiar to social workers across Britain. "It was filthy," she says. "The kids were dirty. You would pick them up and all the stuff inside their nappies would fall out because they hadn't been changed since the day before, and this was, maybe, one in the afternoon. The girl had no regular routine and was really challenging in her behaviour, and the wee one was just lying vacant. He was two months old but wouldn't interact and made no eye contact. His bottles were lined with scum and mouldy milk."

In addition, Beattie was concerned that the baby had been started on the usual course of inoculations but, as a result of his parents' chaotic lifestyle, these had not been completed. She decided enough was enough. "I went back and said to my manager, 'I'm not comfortable leaving those children there tonight.'" They are two of 312 children who were "accommodated" – removed from the care of their parents – in Edinburgh last year. Since 2007, a total of 1,028 children in the city have entered the care system in this way. At present, approximately 15,500 children in Scotland are "looked after" by local authorities, meaning they are subject to statutory supervision requirements imposed at children's hearings. The number of looked-after children in Scotland is up by over 10.5 per cent since the end of March.

Across the UK, the picture is similar. In England and Wales, applications to take children into local authority care have risen sharply since 2007. This has been attributed to "the Baby Peter effect"; social workers are now less likely to risk leaving vulnerable children with their parents in case the outcome is a similarly horrific death to that suffered by Peter Connelly, known as Baby P, who died with 50 injuries in Haringay in 2007. In Dundee, 197 children were accommodated in 2008, the year 23-month-old Brandon Muir died after receiving a massive blow to his abdomen that ruptured his intestine and broke his ribs; in 2009, the figure rose to 262.

"I think people are afraid to manage and live with risk," Jane Beattie says, "and we're all afraid of what the press are going to say. Everybody's frightened. People are back-covering. Particularly because politicians keep making promises they cannot keep, such as every child will be protected. If a child's going to be killed or harmed, you cannot stop every single case."

To ensure the well-being of Emma and Jack, Beattie has sought place-of-safety warrants which allow them to be cared for by their grandparents. David and Tracy are supposed to have supervised contact with their son and daughter for 90 minutes twice a week.

It is hoped that the couple can meet the standards of a specially created safety plan. If, for three straight months, they can keep their home safe and clean, demonstrate better parenting skills, improve significantly their personal hygiene and stabilise their drug and alcohol use, they may be allowed some unsupervised time with the children that would gradually be increased to allow overnights. Emma and Jack could in time be returned to them. However, at a meeting scheduled for the next day, Beattie intends to ask for a supervision requirement that would prevent David and Tracy from being able to take Emma and Jack from the grandparents for up to one year.

It is not easy to remove and keep a child from its parents, and it is not the decision of the social worker alone. It involves discussion with other professionals, such as health visitors and the police, then a sheriff who may choose to issue a protection order that allows the child to be removed to a place of safety for eight days. This is followed by a lengthy series of legal procedures that could, eventually, result in the child being adopted by a new family.

Beattie is pleased with the state of the flat and with how alert David and Tracy seem to be. She checks the safety gate between the kitchen and living room then asks David how his contacts with the children are going. "It was amazing yesterday," he says. "It was the first time I saw Jack sitting up on his own. It felt good to see that, but I felt guilty because I should have been there to see him do it for the first time."

David comes from a decent family in a good part of town. Things started to go wrong when he got into drugs in his late teens. Beattie estimates that drug addiction is a significant factor in 90 per cent of her child protection cases.

Heroin, cocaine, valium, cannabis, methadone. If there was some way to rid Edinburgh of these drugs – and alcohol, too – social workers would have a good deal less to do. Yet every worker I ask says the city's addiction problem is getting worse. Edinburgh's chief social work officer, Michelle Miller, describes substance misuse as "a train coming down the track at us".

Beattie looks at her notes then at David. She has to address a serious incident from the week before. "The thing that's going to come up at the hearing tomorrow, David, is the OD. You overdosed in the street in the middle of the day, and you got rushed to hospital, and the police have a report. How do you think that looks?"

David tells her that he didn't go out to take drugs; someone gave him a spiked drink. Beattie challenges him. "The thing is, David, it's about sensible choices. If people are using drugs and drink quite heavy, do you think they are going to be good pals for you at the moment?"

He shakes his head.

"I mean," she continues, "look what happened up at your previous flat when all those guys broke in with swords because they wanted your maternity grant. You've got to get three months clear of police reports. That's the deal."

The social worker next turns to Tracy and asks why she has missed seven of eight possible supervised contacts with the children. "I didn't mean to do that," Tracy mutters, avoiding eye-contact. She's distant and pallid, barely there. She looks like the ghost of someone pretty.

"What's stopping you?" Beattie asks.

"Nuthin. Nuthin."

"You need to show me you can manage a routine so your kids aren't put at risk," says Beattie. "I can't emphasise to you enough how important it is that you attend your contacts. That's the first thing they're going to look for at the hearing, and Emma and Jack need you too."

The meeting lasts for about an hour. Even though Beattie is the woman who took their children, David and Tracy seem to recognise that she is not their enemy. It didn't feel confrontational. These home visits can be full of anger and dread. Sixty-five per cent of UK social workers have reported verbal abuse from clients, with nine per cent experiencing physical violence. Beattie has grown used to being called a "f***ing whore", to mothers barricading themselves in with their children, to fierce dogs straining on chains; she has discovered sex offenders hiding – like the bogeymen of legend – under beds.

Beattie estimates that she removes a child from its parents' care every few months, and those situations, understandably, can be dramatic, traumatic. "I've had mums running after me screaming and begging, 'Please, please don't!'" she says. "It's awful, it's horrible. You feel like the worst human being on earth. That's when you go back to the office, usually in tears, saying, 'Oh my God, have I done the right thing?'"

Today wasn't like that. Tomorrow could well be. Before leaving the block of flats, she sprays antiseptic gel on her hands.

SOCIAL workers – what the hell are we paying them for? It's a question asked with anger whenever children in Britain are killed by the people who are supposed to love them. It was asked when Baby P died in 2007. It was asked the following year, after Brandon Muir's death. It was asked in 2001, when Caleb Ness, an infant in Edinburgh, was shaken to death by his own father.

In each case, the child had been known to social work teams. The feeling among a great many people, in response to these and other cases, is one of despair at what appears to be a lack of efficiency and the fact that the child protection system is failing those it is designed to protect. It's often assumed that individual workers are incapable of carrying out the duties for which they are employed. And though there is a great deal more to social work than child protection, the reputation of the whole profession has been damaged. So what the hell are we paying them for?

In Scotland there are around 10,500 registered social workers dealing with an estimated 500,000 people at any one time. The approximate social work budget for 2009/10 is 2.8 billion. The profession is, by any measure, a crucial part of society, yet it remains opaque. We know what the police do, we understand the role of paramedics, we comprehend and value fire crews; yet social workers, though they could be considered a fourth emergency service, albeit one that deals with Broken Britain rather than a broken law or leg, remain ambiguous.

Public incomprehension and hostility are additional pressures on a profession that has stress built into the very nature of the work. According to surveys by the trade union Unison, social workers are struggling with unmanageable caseloads, a situation exacerbated by high rates of stress-related sickness and a high turnover of staff, particularly in the area of child protection.

At UK level there are simply not enough people willing to do the job, and though Scotland has fewer problems with recruitment, retaining staff is a challenge. In Edinburgh, the turnover rate in the Children and Families sector is around 14 per cent, double what it is elsewhere within the city's social work department.

According to one worker, there was a period last year when their team was operating with half the number of staff it ought to have had.

This is significant not just because it means social workers are under a great deal of pressure; the case review of Brandon Muir's death noted staffing problems and workloads as a factor. Unison has warned that unless these problems are addressed, it is only a matter of time before another child, known to social work, dies. "We may seem powerful," one social worker told me, "but a lot of the time we feel powerless."

How can this be fixed? Not with money. Local authority budget cuts are expected to hit Scotland's social work departments hard; yet these have been prompted by the same economic crisis that is forcing increasing numbers of people into poverty and thus putting even more pressure on a social care system less able to cope. It sounds a lot like a looming crisis. "I think there's absolutely no doubt about that," says Michelle Miller. "We'll get by next year, but the year after and the year after that – who knows? It's going to be pretty much unprecedented in terms of the volume of demand and the lack of resources to support it."

The council employs 531 social workers within two departments – Health and Social Care, and Children and Families – and spends around 300 million a year providing services to approximately 21,500 people in need. Frontline staff in Edinburgh are paid between 24,741 and 31,761 depending on experience and skills. In addition to child protection, social workers provide services to the elderly and disabled, to those with drug and alcohol problems, to criminals on probation, to people vulnerable to all kinds of risk.

But those are just categories. They don't get to the heart of it. Social work is society's attempt to impose order on chaos, to use bureaucracy and procedure and good intentions to tackle the random forces of human nature and circumstance at its worst.

None of this is easy or straightforward. As one social worker puts it: "More often than not it's two steps forward, one step back. That's if you get your two steps forward in the first place."

THE necessary trinity of beliefs for social workers is that no-one is born bad, that circumstances make them that way, and that they can change. "I have met people who have committed pretty horrific offences," says David Orr, who works with young offenders, "but I've yet to meet somebody who I would say is evil."

That is the sort of statement that enrages swathes of the British population who consider social workers to be soft touches. And it's true that they can appear startlingly forgiving. One, talking about a violent drug addict and his partner, a woman who was involved in the sexual abuse of her children, describes them as "a nice couple".

What might be regarded as a skewed viewpoint is one consequence of doing a job that reveals the world in its full horror and complexity. If care is not taken, the worker can develop a high threshold of tolerance for unacceptable behaviour. The worry then is that, in an effort to see the good in people, they miss the part of them that makes them monstrous.

It's complicated. Certainly, it is the job of social workers to spot – for instance – abusive and neglectful parents, but this is not always straightforward. People lie. They conceal. They don't answer the door. They do answer the door but the worker is too intimidated to ask the hard questions. Often, too, social workers operate on the level of intuition; but a "bad feeling" they get on a home visit is difficult to articulate and impossible to use as the basis for legal action. The various reports into child deaths tend to focus on system failures and ignore these human factors. But they are very real.

Errors of judgment can also be made in the other direction. A few years ago, Lucy Doyle, a worker in Edinburgh's Children and Families department, removed two children from their drug-using parents. She feels now that this decision was "disproportionate" as it later turned out that supportive family members could have helped look after the children. They have been in foster care since.

Doyle says she has learned from the experience, but it left its mark. "I felt guilt that I caused distress to the parents; guilt that I caused unnecessary distress to the children." She sighs. "You feel guilt about a lot of things. But you have to learn to manage that or you'll never survive in social work. You put it in its place and let it rest. Until the next time."

"I want," says Tamara Gill, "to talk about how you feel when you are losing control."

The room in the Leith offices of the Criminal Justice team is small and bland, with blinds that deepen the afternoon gloom. Gill is in her 20s and has been a social worker for two years. Her client, John, is about the same age and has been a criminal for most of his life. He has a history of violence and house-breaking, and calls himself "an auld-school con" with the same evident pride as a war veteran discussing his old regiment. Now, though, he is suffering from a blood disease caught from injecting cocaine, and is on probation after convictions for assault and breach of the peace.

He has been meeting Gill once a week for almost a year. It is her job to keep him from reoffending, and today she is focusing on his anger. She wants him to recognise the signs that he is losing his temper so that, in future, he can step back from the brink.

"If you think back to a time when you were angry," she says, "can you think what different parts of your body were feeling?"

John, loose-limbed in a hooded top, walks over to a whiteboard on which is drawn a rough human outline. He picks up a pen and draws a heart with a line coming from it. He writes: "Hurt inside" next to the line, and "racing". He draws a circle for a stomach and writes: "Butterflies" inside it. "That's what happens when I fight," he says. "I just start to lose it. Someone could be f***ing with my wee brother and I see red. I knocked that bouncer out last year."

"What about your hands?" Gill asks him.

"They get clenched up. I pump myself up. In a fight, anything goes. Kick to the nuts. Scratch their eyes out. Dirty tactics. You don't need tools. Knives are a no-no. Elbows, knees – anything's a weapon."

Gill encourages him to continue reflecting on what his body feels like before a fight. But he's getting carried away. The memories are pleasurable. "I've got a mad way of fighting," he grins, miming it out. "I move like a monkey. I constantly push forward, and I get them in a headlock, and then I just rifle their face."

He shrugs. "But this is for people who deserve it, like."

After the meeting, which lasts around one hour, Gill is weary. The mental effort of trying to keep intense individuals like John focused is draining. Of her current clients, 12 have been convicted of violent offences, three are sexual offenders, three are thieves, four have traffic convictions, one is a fire-raiser, one is a racist, and two were caught in possession of weapons. She meets them at the office, in prison if they are on remand, or in their own homes.

Gill and her colleagues also write a social enquiry report on offenders after conviction. This involves an extensive interview, sometimes taking in the person's whole life story, and the completion of forms that predict the risk of harm they pose. These background reports can influence sentencing – an offender might get probation or community service instead of being sent to prison.

The point of Gill's job is to prevent reoffending and keep the public safe. Sometimes that can involve helping a client secure an apprenticeship or a place at college. "We get a lot of people coming through here who have a skewed sense of achievement about, say, how well they can shoplift," she explains. "So a lot of what we're trying to do is find other ways where people can have that sense of satisfaction."

It is a slow process with setbacks along the way. Social work is all about risk management. This is key to what makes the job stressful. A constant awareness of the vulnerability and potential behaviour of clients has a psychological and emotional impact. "You do sometimes really worry," says Gill. "You see people whose lives are becoming very chaotic and that they are going in the direction of going to commit an offence. You spend a lot of time thinking, 'What else can I do?'

"There are days when you do get really stressed, where nothing seems to be going right, or when a couple of clients in your caseload go into crisis at the same time."

The answer to what the hell we are paying social workers to do comes down, in part, to precisely this. We are paying them to live with a level of insight and anxiety that most of us either do not have or are unwilling to tolerate. Social workers know that it's common for young men, when drunk and fighting, to bite off the ears of their opponents. They hear, in detail, what it was like to rape a child. They walk into dirty, stinking rooms, which they will later smell on their clothes, and they walk back out with silent infants who have learned there is no point in crying for food or love.

They are familiar with despair and spend their days among what is sometimes called the underclass. The sort of living conditions that, periodically, make anguished headlines, for instance during the recent trial of the young brothers in Doncaster who tortured two children, are, for social workers, everyday. They work, both literally and metaphorically, in grey areas.

IN her office, with its view over the Pentlands, Marissa Mackinnon puts down the phone and sighs in frustration. She has been discussing one of her clients, a woman with learning difficulties who has reported being raped.

As a social worker responsible for the care of vulnerable adults, Mackinnon, 39, says there is a group of sexually predatory men in Edinburgh who are suspected of targeting women with learning difficulties and passing their details between them. She also knows that the rates of successful rape prosecutions are low, and that when the alleged victim has a learning disability, sexual abuse is more difficult to prove. "It's a bit depressing," she says, with maximum understatement.

A number of Mackinnon's clients are elderly. She is therefore at the sharp end of one of the greatest challenges facing social work. The number of people aged 85 and over now exceeds 1.3 million and is expected to double again by 2033. Looking after them costs a lot of money, but already, all over Scotland and the UK, there have been cutbacks and there will be more to come.

The cuts are likely to hit hardest in non-statutory and less politically sensitive areas. So while it is unlikely that the core work of child protection and criminal justice teams will be directly and significantly affected, care for the elderly and for those with learning difficulties is more at risk.

"Some of the cuts in resources have created a sense of lower morale in the staff," says Mackinnon. "The threshold for service allocation has gone up and up, and it's quite difficult for workers to give that information to clients."

Late in the afternoon, Mackinnon drives to the home of Liz, a woman in her 60s with mental health problems. Her home is chaotic, with rubbish and clutter on every surface. A narrow path has been cleared between the door and the ripped armchair on which Liz sits, banging her fists on her knees, and refusing to discuss tidying up. "I've been living like this, out of bags, for 16 years now," she yells, "and I'll be living like this till my dying day!"

Liz presents a perfect picture of loneliness, yet she is the sort of vulnerable person – not at risk of death, but unable to care for herself – whom social work may well be less able to help in future.

Local authority savings might mean one less visit each day by a carer to an elderly person living at home alone. It doesn't sound like much, but can have a significant impact on quality of life. "It's the difference," says Mackinnon, "between happiness and not."

SAUGHTON prison presents to the world, this Monday morning, a high blank concrete wall, darkened by rain, and a Saltire hanging limp on its flagpole like a damp rag. David Orr, a 29-year-old social worker, is meeting an 18-year-old called Douglas who has been convicted of offences including breach of the peace and theft.

Douglas is a waif in a blue prison top. His IQ is 77. He has angry marks on one arm from where he has abandoned his attempts to carve the word "Mum" as it was too sore. The irony is also painful; Douglas has no meaningful family relationships. He has been homeless since he was 15. The social worker's visit is, in part, to bring him the T-shirts and socks he left behind at the hostel. As Douglas had breached his probation order, Orr no longer has any statutory duty to care for him but is doing so anyway.

"There's really nobody else there for him," he says. "I can undertake small tasks that have some small benefit. So it is an achievement to have brought his clothes. That is a tangible meeting of need. That's the level you are operating at on a case like this."

Orr has been a social worker for almost two years. His motivation is to tackle the levels of disadvantage in Scotland. He sees where social policy is failing and isn't afraid to speak out about that. For him, the job is political. He works with children and young people who are involved in offending and antisocial behaviour.

Though upbeat and energetic, Orr, like all social workers, is doing a job that could cause even the most optimistic person to despair. Every day, he sees the patterns, the rites of passage – the young man growing up in poverty without a father figure, possibly because dad is in prison or dead, who first has problems in school, then develops an addiction problem, and winds up in prison or dead himself, though not without first fathering a son. This cycle suggests a generational weight and destiny too great to be tackled.

"On the face of it, it's pretty bleak," says Orr. "But that means there's room for improvement, right?"

Much the same could be said about the state of social work itself. The sector has had a terrible couple of years, and funding problems mean there are tough times ahead, but there is also a sense that it is on the point of great change.

Partly, this is because social work is increasingly a young profession and new people with enthusiasm and fresh ideas are coming into it all the time. Jane Beattie estimates that, as a result of the high turnover rate, around 70 per cent of her colleagues in Children and Families are recent graduates.

There are drawbacks to this, of course. It isn't great that lots of newly qualified social workers are taking on complex, risky and upsetting child protection cases. There are clear dangers in that.

"I sometimes worry about how limited in life skills they are," says Beattie. "Some have never even lived on their own and yet they are advising people about the most intimate life skills. Some young people are fantastic and do really well; they just have something about them that works in this profession – the character, the robustness, whatever it is. But there's others you feel you have to mother because they look like deer in the headlights."

No doubt this is true and a matter of concern. My own feeling after spending time with social workers, most of them fairly young, is a mix of fear and hope. Fear that the social work system is going to be unable to cope with the demands of the years ahead: the old, the ill, the damaged, the dangerous, the neglected children deprived of a childhood, and the parents who can't parent. Yet hope, too, because the individuals I met, working within the struggling system, seem compassionate, intelligent, tough and committed to making a success of a job that for too long has been associated with failure.

Child deaths make headlines and deservedly so, but what gets lost are the thousands of tiny decisions and actions social workers make each day that make life better for their clients and, somewhere down the line, all of us.

What will stay with me are the words of John, Tamara Gill's client who was trying to create a new life for himself that didn't involve violence. Though full of bravado and chaotic energy, he became still and serious, almost meek, when asked what social work had done for him.

"This has helped me in more ways than I ken how to say," he explained. "I feel like I've been dealt one last hand."

The names of some social workers and all clients have been changed

This article was originally published in Scotland on Sunday on 28 February 2010