are detailed below. There was great diversity in respondents’ perceptions. The unmet training needs identified most often concerned knowledge about the law, financial knowledge and skills, issues relating to specific user groups, and the roles and tasks of care managers. No topic was identified by more than 14 out of the 64 respondents. However, there was not a great difference between the two sample’s perceptions, although service managers were more likely to identify the need for financial training and care managers, for “general updates”, perhaps reflecting some anxiety about keeping abreast of all the recent and current changes in policy and practice. The first difference may be accounted for by the fact that, as we have seen, most care managers were not responsible for budget holding and therefore may not have seen this as a priority; the desire to keep abreast with policy developments may reflect the fact that care managers are not always given full information about these, (a point made during one of the case study visits) or, if they are, may not always have time to study them. Only three care managers did not think they had any particular unmet training needs at present: none of the service managers took that view.
Table 5.4 Reported unmet training needs of care managers
Type of training need No of care managers
reporting it No of service managers reporting it Total Legislative changes 7 7 14 Financial 5 9 14
Specific user group issues 7 5 12 Care manager role/tasks 6 6 12
Assessment skills 4 6 10
General updates 7 2 9
Management 3 2 5
Professional training 2 2 4
Intensive care management 1 3 4
IT 1 2 3
Negotiating skills 0 3 3
None 3 0 3
5.14 It is interesting to note that six care managers and six service managers identified a need for training about the roles and tasks of care managers. There was criticism that the new skills required for care management had not been taught. Most described this in quite ‘basic’ terms, almost as something that needed clarification, with one care manager, for example, reporting that he had drifted from social work into care management without any real guidance about how to do it. However a few service managers saw their staff as already very experienced and skilled and talked about the need for more specialised, in- depth training that would not ‘patronise’ practitioners. Not surprisingly, then, there is a need for different training programmes aimed at staff with different levels of experience, skills and knowledge. As some respondents recognised, this training will have to take account of intensive care management, as the Scottish Executive intends.
5.15 Various other unmet training needs were identified by the sample. Those listed below were each mentioned by only one or two respondents:
• more formal induction courses
• networking skills
• working collaboratively with carers
• awareness of health agencies’ structures
• liaison with other agencies
• how to meet needs innovatively
• managing limited resources
• recording unmet need
• risk management
• planning and developing resources
• physiotherapy/OT skills
• time management
• welfare benefits
• direct payments/ILF.
5.16 No respondents identified a need for training in screening referrals, despite the fact that 10 of the 17 care managers in the sample who were involved in screening had not been trained to do it. Findings presented earlier in this report suggest that many care managers would also benefit from training in care planning.
5.17 Finally, care managers were asked how their training needs could best be met. The point made most often, strangely perhaps given the general paucity of training, was the need for follow-up and refresher courses, having time to reflect on and consolidate what had been learnt. The importance of joint training was stressed by several: this was also identified as a priority by a number of service managers. Some thought that joint training would help standardise roles across disciplines for care managers and inform professionals about resources available in other agencies. While some care managers preferred in-house courses, others wanted to have training outwith the department, for example, in an academic setting. Three care managers found informal, professional forums were often the most useful way to learn, providing an opportunity to exchange ideas and experiences with colleagues.
SUMMARY
5.18 Managers had high expectations of care managers in terms of skills, knowledge and experience. Assessment and ‘people’ skills were seen as the most important attributes, with knowledge of resources, finance and legislation also being important. 5.19 Just over half the care managers felt their professional training had been a good preparation for care management, while a smaller number did not. This was not related to discipline. Eight care managers reported they had received no in-service training in care management. Both service managers and care managers tended to be vague about the content of training. Just under half the care managers had been given some input on aspects of the care management process but this was often several years ago. In 21 authorities, some joint training had taken place. Care managers tended to be more
positive about the usefulness of the training received than were service managers. Despite the fact that they were responsible for care management in their authorities, nine service managers had not had any training in it and, overall, service managers had received less training than care managers. Two administrative staff had received training specific to care management.
5.20 A long and diverse list of unmet training needs among care managers was identified. Those most often mentioned were law, finance, specific user group issues and care manager role and tasks. The research findings suggest that screening and care planning should also be considered. There is a need for different levels of training to suit differing needs and levels of experience.