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‘Camden Model of Social Work’: enhancing capacity in a children’s social work service through live systemic supervision

Paul Dugmore, Portfolio Manager, Social Care, Leadership and Management, Directorate of Education & Training and Consultant Social Worker, and Karen Partridge, Consultant Systemic Psychotherapist and Clinical Psychologist at the Tavistock and Portman NHS Foundation Trust describe the development of the ‘Camden Model of Social Work’ and how it aligns with the THRIVE framework (Wolpert et al., 2016).

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Background: Social work and supervision

High quality supervision supports social workers by enhancing their capacity to manage highly complex case work, and has typically taken place on a one to one basis between an individual practitioner and their supervisor. Children’s social work is a complex arena and over the last few years there has been a focus on system change, facilitated by systemic models being introduced and implemented in several local authorities. This was first carried out in the London Borough of Hackney, famously known as the ‘Reclaiming Social Work’ model.

The London Borough of Camden wanted to develop and improve its children’s social work service and visited local authorities who had implemented similar models to learn about what had been successful. In contrast to other local authorities, Camden was not failing or in need of whole-system change. However, they wanted to embed the whole system approach, moving towards a systemic model where social workers were encouraged to think more widely about their work with families with other colleagues and managers. The goal was to move from an individual supervision model to group supervision, enabling shared learning and the development of shared responsibility and accountability internally, as well as externally with partner agencies. This systemic approach is aligned with the THRIVE framework (Wolpert et al., 2016) that suggests there needs to be close interagency collaboration with shared responsibility and accountability when working with children, young people and their families whose needs fall within “Getting Risk Support”.

The development programme

What we did and how we did it:

While other local authorities have introduced systemic working and trained the whole workforce in a foundation systemic course, Camden was clear that they didn’t want to do this. The Tavistock and Portman NHS Foundation Trust received a clear brief from the local authority to embed systemic practice in the children’s social work service. They devised a programme that prioritised the implementation of a new model of social work supervision across the workforce through live mentoring of supervision groups. The programme was delivered from November 2015 to September 2017 to eight cohorts of staff at every level of the organisation e.g. from the director to front line staff.

All social work staff attended an initial five days of training. This included an introductory day to the proposed changes where staff could reflect on their position in relation to the changes. Two subsequent training days were provided, with two additional days three months later, to introduce systemic ways of working, ideas and concepts. A bespoke programme for the senior management team focused on a systemic approach to leadership and management with Paul and Karen providing on-going consultation. Responding to the brief, they ensured the greatest investment of time and resource were directed at the senior practitioners responsible for supervising social work practice, to embed and sustain the Systemic Supervision Model, key to the Camden Social Work Model. Senior practitioners attended a monthly group in which they received live supervision and mentoring of their supervision of their social work team, using an adapted version of the ‘Bells that Ring’ model (Proctor, 1997).

The ‘Bells that Ring’ model allocates roles and structure to supervision discussion. The unique aspect of the Camden model is the live mentoring of senior practitioners to deliver the ‘Bells that Ring’ model (Proctor, 1997) in the supervision groups. This mentoring continued for six months, and the group supervision for a year.

Senior management were represented in each of the eight cohorts. The Director came to the first cohort and participated in the first five days of training, in addition to being a participant in the senior leadership programme. She also tried to attend the first day of each subsequent cohort, which was key to the success in genuinely embedding the approach across the service.

Sustainability

Camden have subsequently commissioned a series of one off workshops called ‘Systemic Conversations’ that are being co-developed and delivered by the Tavistock and Portman, alongside Camden staff who are ‘Systemic Champions’ to ensure sustainability. The first Systemic Conversation has taken place and was a real success. The service has suggested further developments, including the development of a manual, and they are considering how to improve reach e.g. by providing workshops in an online format to further support sustainability.

As a result of the success of the first phase of the programme, Camden commissioned a second phase, commencing in November 2017. The champions have continued meeting independently monthly, with ongoing bi-monthly supervision from the Trust. In addition, a bi-monthly supervision group is facilitated for team managers, and the senior leadership team is supported to embed systemic practice within their leadership and across the system every other month. The aim of this second phase is to build up the internal capacity of the organisation and ensure they are self-sustaining to mitigate the need for further support from the Tavistock and Portman in the future.

Relationship with the commissioners

The Tavistock and Portman were approached to undertake this piece of work because of their established and collaborative relationship with the London Borough of Camden, and the Trust is the primary CAMHS provider for the borough. The programme progressed quickly from development to commencement. Regular meetings with the commissioners took place to monitor and review progress, which continues with the roll out of Phase 2.

Response to a different approach to supervision

Perhaps not surprisingly, there was a variable response to having CAMHS clinicians deliver a different approach to supervision with some practitioners being completely open to change, embracing and fully engaging with the programme, whilst some were more sceptical and took longer to engage. Some have remained sceptical and continued to not engage – perhaps evidence that not everyone is open to changing traditional working practices?

Overall senior practitioners were positive about their experiences of live mentoring, however some did acknowledge finding it challenging and exposing at times. The commissioning of Phase 2 of the programme took a while, meaning many people who had completed the first phase of the programme were asking when the next phase was going to start. As the programme was delivered to 250 staff, the programme was delivered in cohorts. The first cohort started in November 2015 and finished the following November, so they had a gap of a year before Phase 2 was commissioned in November 2017.

Some practitioners really embraced group supervision but there were challenges with staff turnover meaning newly recruited staff did not receive the additional offer. The champions were very active, requesting more support from senior management to embed the model.

Is all supervision now group supervision?

There will always need to be some individual supervision where management oversight of cases takes place. The aim was to ensure a process-based supervision took place, alongside the management supervision, so that cases could be really thought about in depth, both the dynamics in the families and between the social worker, the family and the system.

The Camden Model of Social Work and the THRIVE conceptual framework

The work Paul and Karen are also doing connects with CAMHS clinicians being integrated within Camden Social Work teams: key to the implementation of THRIVE. The idea is that social workers and professionals don’t just refer a family to CAMHS for CAMHS clinicians to do that work. Instead, the work can be done by the social work professionals themselves in situ with support and consultation from CAMHS clinicians. The THRIVE framework supports such multi-agency working, and one way the Tavistock and Portman is trying to facilitate this is through CAMHS clinicians attending systemic supervision sessions to discuss cases with the relevant social work team. This is a relatively new development that is being rolled out, but isn’t necessarily consistent across the board. It is perhaps working better in the Looked After Children’s (LAC) Team than Child in Need, as a result of LAC having had CAMHS clinicians integrated with them for much longer.

Top tips to support whole system change

  • A lot of work needs to be carried out to integrate levels and ensure there are working relationships between the different levels of management, alongside consistent messages being promoted across all levels.
    • The champions are representative of all parts of the service and different levels, so it isn’t just social workers, it also includes senior practitioners and senior managers.
    • There are extended management meetings, providing senior practitioners with forums to present their work.
    • It’s important to provide such mechanisms for different levels of staff to come together to share and work collaboratively to embed the model.
  • There needs to be both a vertical and a horizontal training structure.
    • In Camden, everyone attended the initial training, in mixed cohorts with specific interventions for different levels of staff depending on their role.
  • Having a clearly articulated Theory of Change: aim, outcomes and what they could be measured against would be helpful to have a robust and thorough evaluation to demonstrate the impact that the programme has had on practice, particularly with the end user: the family.
    • A ‘Preparing for Change’ day took place before the introductory training which was aimed at illuminating people’s models of change and linking that to a systemic way of thinking.
      It is important to get feedback from every level about how participants are finding the programme.

Future plans

There is a lot of interest from other areas about this work and the local authority have supported visits to share learning about this approach to supervision.

The London Borough of Camden has a good reputation for its children’s services, it has just received a ‘Good’ Ofsted report in November 2017 with ‘Outstanding’ in some areas. The Camden Model of Social Work programme was positively commended in the inspection report executive summary:

“Social workers enjoy working in Camden and benefit from manageable caseloads and analytical, reflective group supervision. This is underpinned by systemically trained senior practitioners, working cohesively with highly skilled child and adolescent mental health services (CAMHS) staff who are integrally located across frontline services. This allows social workers to explore and implement imaginative and bold approaches to assess and support families.”


Further developments of the programme have begun to think about how best to connect the approach within the wider multi-disciplinary context embracing perspectives across different agencies. Camden were successful in receiving innovation funding from the Department for Education specifically in relation to working with young people aged 10-13 years old who have been identified as being at risk of going into care. Camden want this work to be based on the Camden Systemic Model of Social Work so senior practitioners who have been trained in this systemic way of working will also be present at these multidisciplinary meetings taking a lead in the multi-agency planning process.

References

Dugmore, P., Partridge, K., Sethi, I., & Krupa-Flasinska, M. (2018). Systemic supervision in statutory social work in the UK: systemic rucksacks and bells that ring. European Journal of Social Work, 21(3), 400-414.

Proctor, K. (1997). The bells that ring: A process for group supervision. Australian and New Zealand Journal of Family Therapy, 18(4), 217-220.

Ofsted. (2017). Inspection of services for children in need of help and protection, children looked after and care leavers and Review of the effectiveness of the Local Safeguarding Children Board. London: Ofsted.


For more information about the Camden Model of Social Work please contact Paul Dugmore at: PDugmore@tavi-port.nhs.uk.

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Written May 2018.

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