Risk and professional artistry

in social work practice:

between the contingencies of street-
level operations and regimes of formal
accountability

Tom Horlick-Jones and Colin Young

Cardiff University School of Social
Sciences
 Introduction
Ø Risk as an all-purpose language of
administration, regulation and standard-
setting.
Ø How has the adoption of a framework of
risk-based practice shaped professional
practice in social work?
Ø To what extent are contemporary theories
of risk useful in capturing features of the
real world of social work?
1. The nature of social work
 What is Social Work?
Ø Different definitions:
l Barclay Report (1982)
l Griffiths Report (1988)
l International Association of Social Workers
l General Social Care Council (GSCC)
statement of social work roles and tasks
(2008)
 An informal definition
Ø The tasks of social work makes the tasks
the Israelites had to make bricks without
straw look easy!
Ø Griffiths Report [1988] Community Care: An Agenda for Action
(report which lead to the National Health Service and
Community Care Act 1990)
 The international definition,
adopted in 2001
“a profession which promotes social change,
problem solving in human relationships and
the empowerment and liberation of people to
enhance well-being. Utilising theories of
human behaviour and social systems, social
work intervenes at the points where people
interact with their environments. Principles
of human rights and social justice are
fundamental to social work ” (emphasis
added)
Care Council for Wales [2003] p.4
 Payne (2006)
Ø All social work contains elements of:
l Maintaining social order.
l Therapeutic – reflexiveness – interaction
between service users and social workers,
aimed at greater self-fulfillment.
l Transformationist – changing society.
 Social Work in the 21st Century
Ø Admin and ICT skills (ECDL)
Ø Inter-personal skills
Ø Ability to think and act creatively across
theoretical boundaries
Ø Multi-disciplinary
Ø Listening and responding to the service
users / carer voice
General Social Care Council, 2008
Ø Socialwork makes a particular
contribution in situations where there are
high levels of:
l “Complexity, uncertainty, stress, conflicts of
interest, and risk” (GSCC [2008]:4)
 Social work and risk
Ø Exposed to greater challenges (e.g. from
the media) than other professions:
l Victoria Climbie
l Baby P
l Shipman
l Adult deaths as well, but less press coverage.
Ø Failures:
l Inadequate risk assessments
l Poor collaboration with other professionals
 Climbie – Lord Laming
Ø “the legislative framework is fundamentally
sound. Not to the often hapless front-line
staff that direct most criticism, …….
Greatest failure rests with senior
managers and members of organisations
whose responsibility is to ensure
services… properly financed and staffed”
(Laming[2003]:5)
 Climbie – Lord Laming – 108
recommendations, inc:
Ø Training of social workers must equip them with
confidence to challenge other professionals
Ø Assessing child without carer’s consent
Ø Document concerns, record visits
Ø Recorded discussions of differences in medical opinions
(esp. physical vs. non-accidental)
Ø No child with protection concerns discharged from
hospital without permission of consultant (responsibility
rests with consultant)
Ø Those with child protection concerns – not discharged
without a plan, or a GP!
Ø Check on previous concerns following admission
Professor Richard Baker quoted in
Shipman report (p.69)
Ø “Since beginning to investigate Shipman in
2000 I have been trying to understand how
it was that he could kill so many without
detection. There were of course system
failures, but it has been impossible to
avoid the question as to why these were
tolerated to the extent that Shipman could
murder over 200 patients. The conclusion I
have come to is that all doctors …… share
responsibility…”
 Risk and professional practice
Ø Criminal justice and the ‘new penology’.
Ø Whither the welfare state?
Ø Assessing risk in child protection.
Ø Probation practice.
Ø Mental health and ‘dangerous’ people.
Ø Health governance.
l and now….
Ø Risk management in social care.
 2. How is risk-based practice
shaping the character of social
work?
 Generating a dialogue between
theory and practice
Ø Experience, gained over a number of
years, of teaching risk theory to in-service
social workers, studying on the post-
qualification course.
Ø Practice-orientation, interactive.
Ø Opportunity for informal discussions of
specific examples of practical experience.
Ø Around 100 PQ students in total.
 Five notable topics
a. The use of risk ideas in documentation.
b. Risk and professional expertise.
c. Use of formal techniques for risk
assessment.
d. The ‘jigsaw’ effect.
e. Risk and accountability.
 a. Risk ideas in documentation
Ø Example: In safe hands: Implementing adult
protection procedures in Wales (2000).

Ø The presence of ambiguities and confusions

Ø Risk:
l to the vulnerable
l to others
l to informants
l (to social care agencies, staff)
Ø Risk:
l Perceived
l and ‘danger’
l assessment (but how?)
l unacceptable (but criteria?)
l management strategy, ‘where deemed appropriate’ (but
criteria?)
 b. The risk-based framing of social work
practice
Professional Pre-risk Risk-based
Regime
Practice Professional Prescribed
autonomy Actions
Basis for action Professional Risk
Expertise Assessment
Who is at risk? Service user Service user,
carers,
professionals,
other
stakeholders
c. Approaches to assessing risk
Ø A range of practices, co-existing across
geographically-close administrative
areas.
Ø Formal techniques:
l Check lists
l Risk matrix
l Risk scores
Ø Hazard or risk management, or a hybrid
of these?
 d. The ‘jigsaw’ effect
Ø Notion coined by Firkins and Smith (2002), prompted
a strong resonance with the students.

Ø Decision-making in conditions of incomplete

knowledge.
Ø Information is spread between different
professionals, agencies and other members of the
community.
Ø A practitioner may only possess a few pieces of the
jigsaw.
Ø How to gain the other pieces?
Ø Working with an incomplete picture.
Ø The trade -off between collecting further information
and the immediate welfare of the service user.
 Unknown unknowns…
Ø “…as we know, there are
known knowns; there are
things we know we know.
We also know there are
known unknowns; that is
to say we know there are
some things we do not
know. But there are also
unknown unknowns – the
ones we don’t know we
don’t know.”
Ø Donald H. Rumsfeld,
February 2002
 e. Risk and accountability
Ø Risk-based practice and formal
accountability.
Ø Slippage between everyday professional
practice and what gets recorded in the
paperwork.
Ø Liability issues.
Ø Back covering.
Ø Getting things done by ensuring the
assessments turn out appropriately.
3. A little theory
 Preamble
Ø To what extent can sociological theories of risk
help understanding of the praxis through which
social work is daily accomplished?
Ø The distinction between contingency and risk.
Ø Risk Society, too broadbrush ?
Ø Governmentality, the technical discourse of risk,
and totalisation?
Ø Relevance of other grand theories?
 Some different perspectives
Ø Street-level bureaucracy (Lipsky): ‘a corrupted
world of service’, under-resourced overload,
informal techniques of practice.
Ø Keeping the peace (Bittner).
Ø Professional artistry (Schön).
Ø Good organisational reasons for bad clinical
records (Garfinkel with Bittner)
Ø Conflicting knowledges (Kemshall)
Ø Risk is ‘decentred’ (Horlick-Jones): a chronic,
situationally-specific, ambiguity over the nature
of the risk object; slippage between formal and
informal practices.
 Conclusions
Ø Social workers operate in skilled and pragmatic
ways to address the practical challengers of
heavy workloads, whilst maintaining an
orientation towards the formal demands of risk
management.
Ø Limited explanatory capacity of some grand
theories of risk to capture the diversity and
situational specificity of patterns of risk praxis.
Ø Implications for the development of social work
practice and risk scholarship?
 Contact details
Ø Prof. Tom Horlick-Jones
Ø Horlick-JonesT@cardiff.ac.uk

Ø Dr. Colin Young

Ø YoungC1@cardiff.ac.uk

Ø Cardiff School of Social Sciences, Cardiff

University, Glamorgan Building, King Edward VII
Avenue, Cardiff CF10 3WT, Wales UK.
 References 1
Ø Bittner, E. (1967) ‘The police on skid -row: a study in peace keeping’,
American Sociological Review, 32, pp.699-715. The National Occupational
Standards for Social Work. Cardiff: Welsh Assembly Government.
Ø Care Council for Wales (2003) The National Occupational Standards for
Social Work. Cardiff: Welsh Assembly Government.
Ø Firkins, A. and Smith, S. (2002) ‘Judgement as a resource in child
protection practice’ in Candlin, C. (ed.) Research and practice in
Professional Discourse, City University of Hong Kong, Hong Kong pp.309-
332.
Ø Garfinkel , H. with Bittner, E. ‘Good organizational reasons for bad clinical
records’ in Garfinkel , H. (1967) Studies in Ethnomethodology, Prentice-Hall,
Englewood Cliffs NJ. Pp.186-207.
Ø GSCC (2008) Social Work at its Best . A Statement of Roles and Tasks for
the 21st Century. London: GSCC.
Ø Horlick-Jones, T. (2005) ‘On “risk work”: professional discourse,
accountability and everyday action ’, Health, Risk & Society, 7(3) pp.293-
307.
Ø Horlick-Jones, T. (2008) ‘Risk, praxis and everyday life’, keynote paper
delivered to a session on The Everyday Management of Risk, International
Sociological Association congress, Barcelona, September, availab le from
the author or via: http://www.kent.ac.uk/soru/Tom_Horlick-Jones.pdf .
 References 2
Ø Kemshall, H. (2000) ‘Conflicting knowledges on risk: the case of risk
knowledge in the probation service’, Health, Risk & Society, 2, pp.
143-158.
Ø Laming, Lord W.H. (2003) The Victoria Climbie Enquiry CM 5992.
London: HMSO.
Ø Lipsky, M. (1980) Street -Level Bureaucracy: Dilemmas of the
Individual in Public Services, Russell Sage Foundation, New York.
Ø National Assembly for Wales (2000) In Safe Hands Protection of
Vulnerable Adults Cardiff: National Assembly for Wales.
Ø http://new.wales.gov.uk/social_services/Publications/ArchivedPublic
ations/1348909/safe_hands?lang=en
Ø National Institute for Social Work (1982) Social Workers Their Role
and Tasks London: National Institute for Social Work.
Ø Payne, M. (2006) What is Professional Social Work? Bristol: Policy
Press
Ø Schön, D. (1983) The Reflective Practitioner: How Professionals
Think in Action, Basic Books, New York.
Ø Shipman Inquiry (2005)
Ø (Web-site: http://www.the-shipman-inquiry.org.uk/home.asp