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How many clients is too many?

ACWA Inc - Tuesday, September 05, 2017
This question is often asked in the community services sector but regrettably the answer is not straightforward. As any experienced practitioner will know, a normal caseload is not always the same as a reasonable one. Client to worker ratios have long been a source of tension in the sector as the expectations and needs of clients, practitioners, and employers differ. There is no absolute formula for the correct ratio of clients to practitioners, but there is certainly an identifiable point where a caseload is unmanageable and unreasonable.

Often, when students ask about client numbers they are simply looking for a rough estimate from which they can judge their own potential caseloads. Whilst it is tempting to compare the caseloads of various workers and calculate the average this may not be that helpful in the workplace. The issue is really one of managing client numbers, recognising the complexity of their issues, and acknowledging that not all ‘cases’ are equal.

Case management is a process that has several components including: intervention, assessment, referral, monitoring, planning and advocacy. Clients may be individuals, families, groups, or communities. The complexity of the issues, the frequency of contact needed and the purpose of the role will all impact on the number of cases any worker can effectively manage. The needs of a new client, for example, may change over time from frequent contact to routine visits. A client experiencing a crisis may, in turn, need more attention from their assigned worker. New graduates, and their clients, naturally benefit from a lower client to worker ratio as practitioner skills are developed and honed.

Comparing caseloads may give you a general idea of what is typical for a certain role, it is only a general indicator. Unfortunately, there is little statistical data for the sector at large. Individual organisations are likely collect this information for their own workforce, however, public data is not readily available for each of the service fields.

Some statistical data from government departments providing child protection services is available but recent, and ongoing reforms in states like South Australia, Tasmania and Queensland make older data hard to assess fairly. For the most part, an upper limit of 15 clients is generally considered the maximum acceptable figure in this field, unless special circumstances arise. So, if a comparison can’t give us a clear indication of what a skilled worker should be able to manage, how do we know what’s reasonable?

In our view, a caseload becomes unmanageable, or unreasonable, when taking a practitioner’s skill level and work hours into account, they are unable to provide the expected level of service to clients. Organisations will define their own service standards but as members of a chosen profession, it is expected that community workers will assist their clients to access the services they need and maximise their potential. This means case workers and managers should facilitate, rather than just preserve, a client’s social and economic inclusion.

Most casework positions have an inbuilt tension between meeting performance targets and providing an effective service to clients. When these two imperatives are working against the best interests of both client and practitioner it is time for the worker to discuss the situation with a supervisor or manager. For new graduates, it is important to understand that effective case management is learnt over time and your caseload should be adjusted relative to your increasing abilities. Similarly, for counsellors or therapists beginning private practice, it’s best to start off with a small number of clients building up to the level you find manageable.

Conversely some employers and service sectors develop workloads that, despite placing an unreasonable burden on staff, become the accepted standard that employees are expected to meet. As the demand for community services grows, this is likely to become more frequent. In the case of child protection, caseload caps are becoming common to combat this issue. As we mentioned earlier, a normal caseload is not necessarily an acceptable one.

Heavy caseloads in workplaces typically come about through perceived necessity and this in turn has an impact on staff turn-over and morale. The main recruiters of community workers - charities, and not-for-profits - are often contending with fluctuating and limited budgets. Funding uncertainty has hit homelessness services and community legal centres particularly hard in recent times. For these reasons, hiring additional staff or increasing work hours for part-timers is not always feasible often leading organisations to pressure staff into working harder and faster. The ability to master effective case management, including juggling commitments and prioritising duties is, therefore, a much sought-after skill and valued by employers.

It should be self-evident to employers that it is in their own best interests to provide manageable caseloads for their staff. Those that do not face loss of reputation and consumer complaints, staff stress and burnouts (no matter how many self-care strategies are in place), staff turnover, industrial issues and in the worst-case scenario: staff error.

Most importantly it is the clients who suffer when a practitioner is overrun and cannot devote the necessary time or attention to their case. It cannot be said enough: case work should involve all a worker’s skills and resources to empower the client and help them reach their potential.

This fraught issue of caseload creep is something that concerns us all as workers, employers, consumers, support bodies and community members. As an individual, it is important for you to understand your limit and, when necessary, bring it to the attention of your manager or employer so it can be addressed. You are not doing anyone a favour by overworking yourself and may in fact be putting both others and yourself at risk.
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