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Understanding social care
Kevin Lalor and Perry Share
Overview
There is a good chance you are reading this because you are planning to be, or already are, a social care practitioner. Yet for many in Irish society, even those entering the field themselves, the meaning of the term ‘social care’ is not self- evident. A common question directed at social care students and professionals alike is, ‘What do you do?’ Misconceptions abound and in many cases practitioners are not accorded the recognition or status they deserve, partly as a consequence of a limited understanding of what the term means. This chapter explores the notion of social care itself. Some definitions are examined, phrase by phrase, to see what is involved. A short history of social care in Ireland is provided, placing the current set of institutions and practices in a historical context. Aspects of social care practice are described, such as what qualities practitioners possess; what sort of work is involved; what practitioners do and where they do it; how much they get paid; and the difference between a social care practitioner and a social worker. It is hoped this opening chapter will answer some of the basic questions voiced by students, practitioners and others.
Defining SociaL care Practice
It is difficult to define social care practice. Indeed, it has suited governments and some agencies not to have a standard definition as it helps keep salary and career structures vague. As of March 2013, full implementation of the Health and Social Care Professionals Act 2005, the legislative basis for defining social care practice, has yet to occur. A linked issue is the contested notion of social care as a profession. There is something of a chicken-and-egg situation here: it can be hard to define social care because of the lack of a clearly identifiable profession we can point to as ‘practising social care’; this in turn makes it hard to pin down what social care practice might be. We hope that by the time you have read this book, and certainly – if a student
- by the time you qualify, you will have a clearer idea of what social care practice means. Inevitably, this will be complex: you will have become aware of social care’s flexible nature; its contested position vis-à-vis other practices and
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occupations (such as nursing, social work, counselling, occupational therapy); and, above all, its dynamism. Social care is a rapidly changing and developing field, in Ireland as elsewhere. We hope that you pick up something of this energy from this book, from your studies, from your interpretation of the world around you and from your own practical experience. A concise definition agreed over a decade ago by the Irish Association of Social Care Educators, the body that represents the educational institutions in the field, is that social care is:
... a profession committed to the planning and delivery of quality care and other support services for individuals and groups with identified needs.
This definition is sketchy and could be applied to many helping professions. Nevertheless, it incorporates a number of key terms that help to mark out the ‘professional territory’ of social care practice. Let us deconstruct it:
‘a profession’
Social care practice is not just an ordinary job. Nor is it done on a voluntary or amateur basis, which distinguishes it from the (equally valuable) care that is carried out informally in Irish society by family and community members. ‘Professionalism’ implies an occupation with some status that requires access to a specific body of skills and knowledge.
‘planning and delivery’
Social care is not just about providing services, it is also about devising and planning them. This process requires various skills and types of understanding; for example, an ability to provide hands-on care and support to people, an ability to identify what people require, an ability to plan accordingly, preferably drawing on available evidence and policy guidance, and an ability to communicate directly with people in an authentic way.
‘quality care and other support services’
Social care is about the provision of quality care, and also about providing other supports. For example, advocating on behalf of another, turning up in court to speak before a judge or knowing where best to refer a person who has a specific problem.
‘individuals and groups’
Social care can be provided on a one-to-one basis, but it can also involve working with a small or large group or a community. It requires well-developed interpersonal communication skills and a good knowledge of group dynamics.
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Social care workers are trained, inter alia, in life span development, parenting, attachment and loss, interpersonal communication and behaviour management. Their training equips them to optimise the personal and social development of those with whom they work. In Ireland, the recognised qualification is a 3-year Level 7 degree. In Europe, social care work is usually referred to as social pedagogy and social care workers as social pedagogues.
This description of social care work contains most of the elements of previous definitions and attempts to describe roles, values and formation of professionals in the field. Some key phrases are evident:
‘Social care workers’
This term has been replaced in most educational and many professional settings by the term ‘social care practitioner’. Neither is inherently superior to the other, but we have largely used the latter term in this book for reasons of consistency. It also helps to clearly distinguish social care practitioners from social workers.
‘plan and provide’
This phrase emphasises the autonomous, independent nature of social care practi- tioners, who do more than simply implement the plans of other professionals.
‘professional’
All definitions and descriptions of social care practice claim professional status and the associated benefits of pay, prestige and status. ‘Professions’ are socially constructed and particular groups must advocate for the social privileges that come with this status; it is not enough to simply claim it.
‘personal and social needs’
Social care practice is manifestly a helping profession.
‘Client groups are varied’
While the origins of social care practice in Ireland (as elsewhere) lie in residential child care and work with people with disabilities, the role has now expanded to include multiple settings and groups.
‘support, protect, guide and advocate’
The term ‘care’ is considered in a more dynamic way today than it was in the past, to include ideas of advocacy, education and development.
Understanding social care 7
‘interpersonal relationships’
This is how social care practitioners work towards change: a central idea is that of the ‘self’ as the ‘toolbox’.
‘empathy, strong communication skills, self-awareness and an
ability to use critical reflection’
Education and training alone are not sufficient. As with all the helping professions, particular personal attributes and dispositions are required.
‘Teamwork and interdisciplinary work’
Social care practitioners should be capable of managing the dynamics of working in groups, including interdisciplinary teams.
‘core principles... include respect for the dignity of clients; social
justice; and empowerment of clients’
These core principles are shared with other helping/social professions but have typically not been articulated explicitly in previous descriptions of the role of social care practitioners.
‘differs from social work... uses shared life-space opportunities’
In Ireland, social work is the older profession and has a considerably longer education and training history, based on the British model. Thus, it is not surprising that a description of social care work will emphasise how it differs from social work. In truth, the two professions are closely related and the distinction made in Ireland is less pronounced in other jurisdictions.
We have now discussed several elements that you could assemble to create your own definition of social care practice. Such descriptions will help you to under- stand what social care practice is, but the reality of social care practice does not always adhere tightly to any definition. Some ideals may not be attained; some are favoured in specific situations. There are political debates and disagreements over what social care practice should be. We suggest that you make use of these ideas to examine and think about examples of social care practice you encounter directly or through reading and research. Ask yourself: Which aspects are brought to the foreground? How could things be done differently? How could they be done better? In the broader European context, social care practice is usually referred to as social pedagogy, and social care practitioners as social pedagogues. In the United States, Canada and South Africa, the term ‘child and youth care’ (abbreviated as
Understanding social care 9
the establishment of a registration board for social care work, as provided for in the Health and Social Care Professionals Act 2005. Education of social care practitioners is carried out predominantly in the institute of technology sector, with elements in the further education and private sectors. It is largely confined to undergraduate programmes at Level 7 and Level 8 on the National Framework of Qualifications (NFQ), although with an increasing number of Masters (Level
- and other postgraduate programmes. The number of entrants is not controlled by any overarching body and the number of students of social care practice has increased rapidly and substantially in the twenty-first century (Lalor, 2009). The historical development of Irish social work has been comprehensively described by Skehill and others (Kearney and Skehill, 2005; Skehill, 1999, 2003). It is the story of an occupational group seeking to develop a coherent professional identity, shaped by contemporaneous processes in the United Kingdom and elsewhere. This process has resulted in a recognition by the Irish state that social workers have key, legally defined roles in relation to areas such as child protection and adoption, and also have a specific location in the health services and in the justice services, for example in probation work. Social work education is confined to the university sector, often at postgraduate level, and the number of places is strictly limited and controlled.
Professional convergence?
In practice, internationally, the distinction between social care work and social work is becoming increasingly blurred. The phrase ‘social work’ has different meanings in different countries and is as complex to define and describe as social care work. Sarah Banks, a leading British writer in the field of social work ethics, notes (2012: 1–2):
Social work is... a difficult occupation to encapsulate. It is located within and profoundly affected by diverse cultural, economic and policy contexts in different countries of the world. Social work embraces work in a number of sectors (public, private, independent, voluntary); it takes place in a multi- plicity of settings (residential homes, neighbourhood offices, community development projects); practitioners perform a range of tasks (caring, controlling, empowering, campaigning, assessing, managing); and the work has a variety of purposes (redistribution of resources to those in need, social control and rehabilitation of the deviant, prevention or reduction of social problems, and empowerment of oppressed individuals and groups).
Although social work practice is contested, and varies from country to country, the International Federation of Social Workers (IFSW) uses the following definition to seek to unite all social workers (ifsw.org):
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The social work profession promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being. Utilising theories of human behaviour and social systems, social work intervenes at points where people interact with their environments. Principles of human rights and social justice are fundamental to social work.
What is interesting from our perspective is how broad this definition is, and how it could apply to social care practice, for example in:
- The assertion that the discipline is a profession.
- The emphasis on ‘problem solving’, providing services to people with needs.
- The use of theories of human behaviour and social systems to inform practice.
- The goal of empowerment and liberation of service users. This aspect of the professional’s work is perhaps less explicitly stated in Irish definitions of social care work (notwithstanding references to advocacy), compared with social work, where the definition also contains a commitment to principles of human rights and social justice.
Using terms and concepts that we have seen in earlier definitions of social care practice, the School of Applied Social Studies, University College Cork (UCC, n.d.) defines social work as:
... a profession that is primarily concerned with supporting and helping people in a variety of situations and settings. It is also about working in solidarity with socially excluded people and groups in meeting the challenges that their social exclusion creates. Social workers work in a wide range of settings and with different groups of people. Social workers work with individuals, families, groups and communities. Their work can span a wide variety of roles including counselling, group work, lobbying, advocacy and political activism. Social workers often have to network with other professions such as gardaí, doctors, public health nurses, and schools, as well as service-user and advocacy networks. Ultimately, social work aims to support people to live more successfully within their local communities by helping them to find solutions to their problems.
Clearly, there are commonalities across the two professions. Indeed, some suggest that social care practitioners have ‘picked up’ work that used to be performed by social workers, before they were engulfed in such high volumes of child protection case work management. That said, there are considerable differences in the roles, in Ireland and elsewhere. Child protection guidelines, Children First (DoHC, 1999), acknowledge ‘the need for multi-disciplinary and inter-professional responsibility, [but] clearly locate primary responsibility for child protection with community care social work teams’ (Skehill, 2003: 146). This gives priority to the
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duties of parents are important (and are endorsed in the Constitution), but due consideration must be given to the child’s wishes. The Children Act 2001 governs the administration of juvenile justice and, as such, impacts on the work of social care professionals in children’s detention schools (formerly industrial schools and reformatory schools). More recently, the Criminal Justice Act 2006 contains a number of provisions for juvenile justice (Lalor et al., 2007) and, in 2012, the passing of the Children referendum (thirty-first amendment to the Constitution) enhanced the legal position of children vis-à-vis the family. Several influential reports have helped to shape the development of social care practice. Reflecting broader international trends, they aimed fundamentally to reorient the direction of social care provision away from care in large institutional settings and towards care in small-scale units and in the community. They also emphasised the rights of the ‘cared for’ and criticised many aspects of institutional practice. These reports have been extensively reviewed and described by a range of writers (Buckley et al., 1997; Ferguson and Kenny, 1995; Focus Ireland, 1996; Gilligan, 1991; O’Higgins, 1996; Skehill, 2005), so we will not outline them here. The most significant reports were arguably the Tuairim report (1966), Kennedy report (DoE, 1970), report of the Task Force on Child Care Services (1980) and Report of the Kilkenny Incest Investigation (McGuinness, 1993). There has also been a succession of influential reports in the disability sector, the most important of which has been A Strategy for Equality (Commission on the Status of People with Disabilities, 1996). In the education and training sector, the Report of the Committee on Caring and Social Studies (NCEA, 1992) laid out the basis for the range of educational programmes in social care practice. These documents all comment on aspects of social care provision and, amongst other things, have influenced the type of education and training that social care practitioners should receive and changed the skill sets of practitioners. There is now less emphasis on some ‘practical’ skills (such as homemaking and health care) and a greater emphasis on research, policy issues and academic knowledge. There has been, and still is, much debate about the virtues or otherwise of such a shift. Social care practice has long been associated with residential child care. This emphasis has changed dramatically, especially with the decline of large institutions (such as children’s homes) and the emergence of alternatives such as foster care, community-based projects and community child care. The field of social care has expanded greatly in recent years, in Ireland as elsewhere. It has been acknowledged that the types of skills and knowledge that social care practitioners exhibit can be constructively applied in other areas, such as in the care of people with disabilities, in working with older people and in responding to the needs of a broad range of people from drug users to victims of domestic violence to asylum seekers. Inevitably, this brings social care practitioners into contact with other professions, including medical professionals, social workers and An Garda Síochána. Social care practitioners’ participation in multidisciplinary professional teams is now
Understanding social care 13
quite common, which presents challenges to how people work in these fields. For example, the introduction of models of social care practice to the care of older people will involve a challenge to the highly medicalised practices in this field, where nurses and other medical practitioners have been dominant. This will lead to debate and perhaps even conflict between professional groups. Three social care representative bodies were mentioned above. The Resident Managers’ Association (now the IASCM) was founded in 1930, the IASCW was established in 1972 and the IASCE in 1998. Historically, each of these three organisations had separate memberships, structures, conferences and publications. Recognising strength in numbers, they came together in 2011 to form Social Care Ireland, an umbrella or federation body for social care. It has established a joint annual conference, and the Irish Journal of Applied Social Studies (online in open access format since 2010) has been adopted as its professional journal. The goal is to create a single, vibrant professional body, with special interest groups for education, management and specialised areas of practice (for example, residential child care, intellectual disabilities, addiction work). When the first edition of this book was published in 2005, it was the first integrated attempt by educators and practitioners in the social care field in Ireland to define and describe the practice of social care. Inasmuch as it has been widely adopted by educators, students and practitioners of social care, it has represented one small step in unifying the field of social care. A more extensive body of knowledge has subsequently emerged (for example, Charleton, 2007; Garavan, 2012; Hamilton, 2012; Jackson and O’Doherty, 2012; Lyons, 2010; McCann- James et al., 2009; O’Connor and Murphy, 2006; O’Neill, 2004; Irish Journal of Applied Social Studies ).
WHat PerSonaL quaLitieS DoeS a SociaL care
Practitioner require?
We can see that a social care practitioner must have a wide range of personal and intellectual attributes. ‘Academic’ qualities include: a broad knowledge base, an ability to work independently and as part of a team, research skills and a problem- solving approach. Much social care education and training aims to assist students in developing these skills. In addition, certain personal attributes tend to char- acterise practitioners, such as reliability and trustworthiness, altruism, maturity, empathy and compassion. Social care practitioners must be open-minded and prepared to examine, and perhaps even change, their attitudes towards others. It is open to debate whether these qualities can be taught or are somehow ‘innate’ in people who are attracted to social care practice as an occupation. How a social care practitioner develops as a person and as a professional depends on:
Understanding social care 15
The question of a potential ‘oversupply’ of social care graduates is sometime raised, but difficult to assess. There is no national system to monitor the education of social care practitioners. Colleges survey graduates regarding employment and further education experiences and, although response rates to such surveys are generally poor, they do provide some indication of graduates’ success in securing relevant employment. A 2011 survey of social care graduates of Dublin Institute of Technology yielded a response rate of 83 per cent and showed that only 7 per cent were seeking employment. The remainder were in employment (66 per cent), not available for employment (24 per cent) or in further study/training (3 per cent). Of those in employment, 89 per cent were in the social care sector. These employment levels are more positive than might have been expected given the deep recession that Ireland has experienced in recent years. Overall, there is a strong argument for the ongoing monitoring of graduate output by individual colleges, by the IASCE and by the Higher Education Authority. There have been some significant developments in social care education in recent years. In particular, two documents have been published that will do much to shape the nature and development of the profession. First, the Higher Education and Training Awards Council (now part of Quality and Qualifications Ireland) published national award standards for social care work (HETAC, 2010), which detail the learning outcomes and competencies expected of social care graduates from NFQ Levels 6 to 10 (higher certificate to doctoral level). These standards provide a national benchmark for education providers. They were produced by an expert panel of practitioners, managers and national and international academics, which represents the most comprehensive consultation with the sector regarding education and training standards to date. Second, the Health and Social Care Professionals Council (CORU) has published Criteria and Standards of Proficiency for Education and Training Programmes (CORU, 2012). The Health and Social Care Professionals Act 2005 empowers CORU to approve and monitor education and training programmes for the various health and social care professions, including social care work and social work. Consequently, following the establishment of professional registration boards for each of the health and social care professions, CORU will have an oversight role in approving education and training programmes nationwide. As of March 2013, only the registration boards for social work and radiography have been established. The registration boards for dietitians, occupational therapists and speech and language therapists shall be established during 2013. No date has been set for the establishment of the registration board for social care work.
WHat Do SociaL care PractitionerS Do?
Anglin (1992) has observed that social care practitioners work in two main areas, with a very broad range of practices, as listed in Table 1.2.
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table 1.2. Key tasks of social care
Direct service to clients organisational activities Individual intervention Group intervention In-home family intervention Office-based family intervention Assessment of child Assessment of family Child management Child abuse interventions Employment counselling or assistance Life skills training Health management Education remediation Recreational leadership Arts and crafts leadership Counselling on death and dying Therapeutic play Parenting skill training Sexuality counselling Marriage counselling Stress management Lifestyle modification
Case management Client contracting Report writing and formal recording Court appearances/legal documentation Programme planning and development Use and interpretation of policy Individual consultation with other professionals Participation in professional teams Co-ordination of professional teams Contracting for services Supervision of staff, students or volunteers Staff training and development Public relations/community education Organisational analysis and development Policy analysis and development Financial analysis/budgeting
Source: Anglin (1992)
Many of the chapters in this book expand on different types of work that social care practitioners carry out. If we were to prioritise, we might suggest that the main role of the practitioner is to work alongside service users to maximise their growth and development. The social care practitioner is also, crucially, an advocate for change.
WHere Do SociaL care PractitionerS WorK?
In Ireland, social care practitioners may be employed in:
- The state (statutory) sector; for example, the Departments of Children and Youth Affairs, of Education and Skills or of Justice and Equality.
- The non-governmental sector; for example, Barnardos, the Brothers of Charity, Enable Ireland or Focus Ireland. These organisations are fully or partially funded by government.
- Community-based organisations such as community development projects or Garda Youth Diversion Projects.
- The private sector, where there has been a recent increase in providers operating in the residential child care and foster care areas. Companies such as Positive Care Ireland and Fresh Start have grown to become considerable actors in the field.
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concLuSion
Social care has been a growth area in Ireland. It is a demanding but rewarding occupation, as social care practitioners make a real difference in the lives of others. Formal social care had humble beginnings, located within a largely clerical or philanthropic context, but has now expanded to include the statutory, community and voluntary sectors. Social care practitioners are now educated to degree, and increasingly to postgraduate, level. Salaries and career structures have improved since the 1990s. A statutory registration system is being established that will ultimately oversee future professional development in the field. The management and reporting structures in social care practice are moving towards an acceptance of the social care practitioner as an independent, autonomous professional. Social care work remains a rewarding and fulfilling career and occupational choice.
What is social pedagogy? A new
way of working with older people in
Sweden
Mats Högström, riitta nilsson and Per-axel Hallstedt with
Perry Share
Overview
As highlighted in Chapter 1, it can be difficult to explain the concept of social care practice to people outside, or even within, the field. One reason for this is that it has yet, arguably, to develop a coherent and well-recognised theoretical or philosophical basis. It has developed from a combination of elements of social work, youth and community work, different models of therapy, moral frameworks, often religious ones, and very pragmatic notions of action and behaviour. As it develops, it is likely to continue to draw on these sources, but it will also draw on others – and one that may become more influential is the European tradition of social pedagogy. Social pedagogy is a field of practice, thought and research that has developed in many countries of continental Europe over a period of more than a century. It is found in different forms from Norway and Russia to Portugal and Hungary, but receives varying levels of official recognition and respect. In Ireland, there is some familiarity with the social pedagogy of the Nordic countries, in particular Norway, Sweden and Denmark, due to many years of student and staff exchange between Ireland and those countries. More recently researchers, practitioners, government agencies and educators in parts of the United Kingdom have sought to introduce social pedagogy into that state. Given the heavy dependence of Ireland on models of theory and practice from Britain, it is likely that this will provide further stimulus to the development of social pedagogical approaches in Ireland. It might be argued that social care practice in Ireland already shares many features of the social pedagogical approach, as do elements of Irish practice in youth work, community development and community and adult education. This chapter briefly outlines the nature of social pedagogy and some of the principles that underlie it. The bulk of the chapter comprises a case study of the application of social pedagogy in elder care in Sweden. The chapter concludes with some reflections on the implications of moving towards a stronger element of social pedagogy in Irish social care practice.
What is social pedagogy? A new way of working with older people in Sweden 21
Fristrup (2012) notes that ideas about old age are changing. Rather than being segregated, older people are now expected to participate in, and contribute to, society more extensively than before. This presents a challenge to traditional institutions that provide care for older people, which in Ireland, as in many other societies, tend towards a medical model of care that focuses on older people’s deficits rather than their capacities (see Chapter 18). Social pedagogy has been identified by some as a new and better way of working to support Europe’s ageing population. The remainder of this chapter features a case study of the application of social pedagogy with older people in Sweden. While social pedagogy is an established means of working with children and young people in that country, it has not yet been applied on an extensive scale to working with older people. You will note the issues of communication, activity, self-actualisation and sociability that underpin the social pedagogical approach, as well as its basis in certain philo- sophical concepts and sources.
caSe StuDy
introduction
In 2006 one of the social districts of the city of Malmö, Västra innerstaden, employed two ‘elderpedagogues’. Elderpedagogues are social pedagogues who have been trained to work with older people, using the theories and techniques of social pedagogy as it has developed in Sweden and elsewhere. Research among a sample of elderly people in Malmö had found that older people were mostly content with the care they received in residential care settings and through home help services, but a significant number complained about long and dreary days during which nothing much happens. This finding reinforced a growing awareness of the connection between health and social situation and that close relationships, physical activity and having something meaningful to do promote health and wellbeing for older people. These circumstances called for new measures, something different from the traditional care provided. Social workers in a home help service identified a number of older people who were lonely and unhappy. To alleviate this situation, a project was launched in which two elderpedagogues, Lotta and Beata, were employed. Lotta and Beata began to visit the older people and succeeded in establishing good relationships with them. In one case, Beata offered to accompany Elsie, an 82-year-old woman, to the hairdresser’s salon. This visit offered a mutual interest and potential topics of conversation. It was also the first time Elsie had been outside her home in a year. She had been afraid to leave her apartment due to a combination of depression and a fear of going out alone. After a few more visits Beata thought Elsie was ready to meet new challenges. Beata and Lotta had started conversation groups at the neighbourhood day centre
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and so Beata suggested to Elsie that she visit the centre. They went there together and Elsie found it to be a friendly place with many other older women in similar situations. After making a couple of visits to the centre with Beata, Elsie began to go there unaccompanied. Lotta and Beata aim to improve the situations of the older people they work with. Their educational aim is to put an end to loneliness and to persuade individuals to socialise with other people. They must consider carefully the best way to approach this process. For example, Beata had to reflect on the opportu- nities available to Elsie and how they should be presented to make them appealing to her. Embedded in this process is the eternal question of pedagogy: Are you allowed to influence the other? (Hallstedt and Högström, 2005; Nilsson, 2004, 2006). Is Beata a transmitter of certain values and norms (such as that it is ‘normal’ to meet and socialise with people)? To avoid coercion, Beata needed to engage with Elsie in a symmetrical relationship.
communicative actions
We can draw on the concepts of communication developed by the German social theorist Jürgen Habermas (1984) and ask: Is the elderpedagogue in this situation bound to communicate to reach success (as a means to an end) or is there an opening for communication that seeks to reach mutual understanding? The second option is the right one for the pedagogue. Take a common situation where an elderpedagogue is convinced that a specific activity would be good for an older person. This activity is something that the older person really could prosper from and is within cultural norms (otherwise it would not be possible to reach an agreement). Elderpedagogues must understand, however, that while they are in a position to persuade the older person to take part in the activity, the older person’s views and arguments against the proposal are valid. So, when is it right to use persuasion in this kind of relationship? When can persuasion lead to a mutual understanding? One way of looking at this is to take the relationship between the two parties into consideration. Persuasion can be used only when there is an element of symmetry in the seemingly asymmetrical relationship. The element of symmetry, or equality, in the relationship makes it possible for the older person to oppose the elderpedagogue’s proposition, and present alternative arguments. The proposition is something that the elderpedagogue really wants to happen, not just something that should be done as a duty or part of the job. We can distinguish between the preferred in a personal sense and in a professional sense. There is a difference between personally feeling that something is right and knowing that it is right from a professional point of view. It is professional authenticity that matters in professional life. It is possible for the parties to meet in communicative dialogue within this professional framework. They are communicating for a successful outcome, but, crucially, this communication is based on the development of a mutual understanding between them.
