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2.2.2.10. ELEMENTOS DE LA RESPONSABILIDAD MÉDICA En la Responsabilidad Médica existen los siguientes elementos:

2.2.2.11.1. LAS SENTENCIAS JUDICIALES MATERIA DE COMENTARIO

A lot of resistance to the SAF is focused on the standardisation it attempts to enforce. One justification by Social Workers for their reluctance to use the SAF is that case work itself cannot be standardised because of the specific circumstances and issues of each individual case. As such, they feel it is reasonable to edit and augment the SAF according to the specific demands of the case.

“A lot of what we do doesn’t ….. you know, working with people ….. you can only standardize so much. A lot of what we do is unstandardisable. And the things you can’t standardize, maybe they don’t get attention.” (PT1/SNR)

Social Work culture has traditionally accepted, even been built upon concepts of individualised practice. However valuable standardisation is to the management of a service, it is at odds with a deeply entrenched professional culture of individualized assessment. This could even seen to be central to good Social Work practice, enshrined as it is in Social Work guidance, the Children’s Act, and the DoH framework for assessment, and the Social Work Code of Practice.  Social Work guidance notes issues by the Scottish Office explicitly comment that judgement should be used by Social Workers in applying standard approaches to individual children and families. The professional culture in this CFSW reflected this perspective.

“Staff have different styles, different approaches. They would want to tell their own story, in different ways.” (PT1/PTM)

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Resistance to standardisation is justified by Social Workers not in terms of the political autonomy of their profession, or the importance of individual judgement as an expert practitioner, but in terms of the needs of the case, of the child and family on whose behalf they see themselves as acting. The professional discourse which puts the child and family at the centre of practitioner concerns will emerge as a strong theme in the study.

C

ONCLUSIONS TO THE CHAPTER

Social Workers admit that however much they are aware of the importance of record-keeping, in practice it is sidelined in favour of other types of work. In addition to the managerial and technical effect of proceduralisation, there are political and symbolic dimensions to consider. Inscriptions are not merely neutral technical devices of organisation. They occupy a particular cultural and symbolic role and represent particular discourses. For Social Workers, inscription is taken to represent a bureaucratic logic which goes against the practice-based logic central to their professional identity. As such it is seen to demand a fundamental shift in their understanding of what constitutes Social Work practice. It is this political dimension of the SAF as much as the technical shortcomings of the form itself which undermined its implementation. These issues are considered in the following chapters. The limited uptake of the SAF is in some respects a result of the traditional, professional culture of Social Work which values other aspects of practice, such as contact time with clients, over the ‘bureaucratic’ tasks of file and information management.

Inscription is being adopted by Social Work managers with the intention of managing the process and content of the Social Work service and individual practitioners’ work. Inscription is a response to the need for accountability in line with the legal framework which surrounds CFSW and a reaction to concerns about the quality of Social Work practice. Inscription is used as a conscious strategy in the management of the CFSWS to ‘constitute’ the front-line Social Work service

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delivery by creating and managing effective casework procedures. It is used to constitute a service based on consistent and thorough Social Work assessment and intervention. The aim of initiatives such as the SAF is to improve the quality of Social Work assessment, by using the standard format as a pedagogical device, which will require Social Workers to participate in an assessment process based upon principles of good practice. Inscription is also used to create the visibility of practice, through the construction of archival and contractual records, which can be used to represent the work undertaken on a Social Work case. This is useful from an organisational perspective as a means of storing practice knowledge, for use when the Social Worker is not available in person, either because he or she is no longer working on the case, or because the case knowledge is required to represent the case in wider fora. This visibility through documentation is also a means of defending practice and practitioners if the service is subject to legal challenges.

However, the study suggests that there are limits to the capacity of managers to implement inscribing processes. The successful implementation of inscribing processes as a means of managing and improving Social Work practice is limited by the practicalities of implementation. Shortcomings in management guidance and enforcement and the technology and skills available to Social Workers have undermined attempts to improve inscribing processes in the CFSW service. Inscription is also limited by the professional culture of Social Work practitioners, which creates resistance to attempts to standardise assessment and which de- emphasises the importance of archival and contractual record-keeping, causing practitioners to neglect documentation work in favour of other types of work activity.

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CHAPTER SIX:

CONSTRUCTING A SOCIAL

WORK CASE

In this chapter I examine how inscription is used to construct Social Work cases in such a way as to allow the Social Work service to act upon and on behalf of children and families. Although inscription is an important mechanism in the management of cases, it is not the only means by which case work is rendered subject to intervention. I consider the stages of Social Worker activity which are not represented through inscribing. Inscribing requires translation work which can be problematic. There are tensions caused in the translation of case knowledge through inscribing and practical and material limitations to the capacity of inscribing devices to represent cases. In this chapter I also examine how the different functions of inscription set up tensions in the attempt to represent cases adequately through inscribing. Finally, I examine how the representational style of inscribing devices may affect the capacity of inscriptions to represent a case and how the debate about modes of representation is enrolled in the professional discourse of Social Workers.

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