4.12 Criminal justice social workers and assistants, addiction workers and medical officers (including doctors and nurses) comprise the dedicated Drug Court Supervision and Treatment Team. They are supported by service providers in the voluntary sector. The Supervision and Treatment Team meet up on a monthly basis to discuss general issues relating to the provision of services to Fife Drug Court. These meetings, which are open to all members of
arise on a day-to-day basis through the operation of the Drug Court. They focus on administrative tasks and procedures, ensuring any difficulties or tensions are addressed, and clarification received as appropriate. The meetings also enable the Team Leader to pass on information to other team members with regard to policies, decisions taken by the Drug Court Team, training opportunities and broader points of interest. The meetings are chaired by the Team Leader and minutes taken by the Criminal Justice Services administrator.
4.13 Social work, addiction workers and medical staff all contribute to the assessment of potential Drug Court clients, and to the preparation of the Social Enquiry Report (SER), drug assessment and subsequent action plan. Medical staff conduct and report on drug testing. Overall responsibility for the preparation of the court report lies with the social worker. A nominated officer from each of the three main disciplines forms the client’s Case Group. This is convened and chaired by the supervising social worker; however the Case Group share responsibility for the supervision and treatment plan. The Case Group assess the client’s progress or discuss any difficulties he/she may be experiencing and are able to inform the court of developments at the (usually) monthly review. Conclusions of the Group are largely reached through consensus, except when in relation to medical treatment.
4.14 The interagency collaboration of different disciplines means that clients are provided with a comprehensive supervision and treatment service, and benefit from workers’ expertise and knowledge in compatible areas of drug dependency and treatment. In practice, however, there is the potential for tensions in the implementation of joint working practice. In the initial stages of collaborative working, there was some lack of clarity about the roles of different workers, particularly in relation to assessment and service provision. The addiction workers’ role appeared to other workers to impinge on both the ‘treatment’ element of the order provided by nurses and the welfare element, which social workers claimed to have some responsibility for. Several nurses had backgrounds in psychiatric nursing and were able to provide motivational interviewing and counselling techniques such as group work, although these areas were also viewed as part of the remit of addiction workers. Despite the fact that some addiction workers had social work qualifications, there were references to them as ‘unqualified workers’:
"I think the addiction worker, as unqualified workers, are actually doing the job that social workers were trained to do. That's not to say there's been any individual animosity, I think that's a structural issue in the way the team has been structured.”
4.15 While social workers were designated case-managers for Drug Court clients, addiction workers and nurses tended to see the clients on a more regular basis (for treatment, testing, individual support and practical assistance in accordance with the treatment plan). While the Case Groups enable all relevant workers to contribute to discussion of the clients progress, it is the responsibility of the social worker to manage the case and to prepare and submit reports (on behalf of the Case Group) to the Drug Court. While all professions are represented at the pre-review meetings, it is the social worker that attends the reviews in open court, where the client is present. While this is generally viewed as expedient due to constraints on time and clarity, individual workers expressed some dissatisfaction with this practice, which had not been originally envisaged in the Drug Court Manual or by the Drug Court Sheriff. In particular, the fact that court reports contained significant information provided by nurses and addiction workers led to blurred boundaries of ownership. There had initially been an element of disgruntlement among addiction workers and nurses when social
workers made changes to their reports, an issue which was described as “quite de-skilling” for the other workers. Team meetings had provided a forum for addressing this issue.
4.16 Staff recruitment and retention has been, and continues to be, an issue for the Treatment and Supervision Team. In October 2002, there were six social workers in the team, five of whom were new to criminal justice. Training was put in place to address some of the difficulties this created around procedures, practice and appropriate terminology for court reports. In the early stages of the Drug Court, staff had been appointed from a number of backgrounds, bringing a range of different professional experiences to the team (criminal justice system, prisons, hospitals, psychiatric nursing). This caused some disruption initially and led to a range of expectations and working practices among team members.
4.17 The physical proximity of the different agencies in Kirkcaldy was perceived to be a
useful mechanism for enabling workers to engage in informal discussions and for information exchanges to take place. Where problems with communication had arisen between team members, there was some difference in opinion as to whether this was due to individuals or agency practices. The Supervision and Treatment Team meetings were aimed at responding to any inter-agency issues and clarifying working practices. Training was used regularly to address needs but also to enhance team working. However, it appeared that each professional group had also started to have their own meetings (addiction workers, nursing staff, social workers).
4.18 Overall, workers viewed multi-professional working as a positive and innovative way
to deal with drug use and offending. However, as one worker commented:
"Yes, I think the difficulty with multi-agency working is that in principle it's an excellent idea drawing on people's experiences, the difficulty is that no-one's really told anybody how to do it.”
4.19 Drug court clients commented that the Drug Court Orders enabled them to access the
support of workers from different disciplines:
"I just feel like my addiction worker, my social worker and my nurse are really supportive towards me, I mean I could always phone them if I’ve got problems. I’ve got their professional numbers and that. I just find them easy to speak to about problems I've been having.”.