Social Work placements in Private Care Homes (West): Pilot Project Evaluation

Transcription

1 Learning Network West Private care homes placements August December 2009 Social Work placements in Private Care Homes (West): Pilot Project Evaluation In partnership with Four Seasons Health Care, and Glasgow Caledonian University, Learning Network West placed four undergraduate social work students in private care homes in the Strathclyde Health Board area of Scotland in August Learning Network West is one of four Learning Networks funded by the Scottish Social Services Council and Four Seasons Health Care is an independent healthcare provider of nursing homes, care homes and other specialist units throughout the UK. Glasgow Caledonian University provides undergraduate and post-graduate social work qualifying courses. Against a background of increasing difficulty in providing placements for social work students and a growing awareness of the need for healthrelated disciplines to understand each other and work more closely together, placements in non social work settings are becoming more common. The evaluation brief was to conduct a small evaluative exercise of these particular placements with all the stakeholders involved; the available resources did not allow direct engagement with clients or families but some of the feedback from care home staff includes comment on the benefits of the placement to the residents and their families. The Model Four first placement social work students were placed in a private care home, with an on-site link worker; the students were supported by the same practice teacher and university tutor. The placement duration was 68 days. Three students successfully completed their placements, two in settings which cared for older people and the third in a residential home for younger adults with neurological disabilities. This small project is part of a growing trend towards the provision of social work placements in non social work settings (Gordon et al 2009; Gregson and Fielding 2008; Hughes 2009) and it aimed to build on a recent project in the South East of Scotland which created, supported and evaluated nine social work placements in private care homes (mostly) for 1

2 older people (Scottish Care 2009). The project being evaluated here comprised four placements in each of four private care homes in the Central Belt of Scotland. One student left the placement in the early weeks because of issues unconnected with the placement. The other three students successfully completed the placement. One practice teacher was appointed to support, supervise and assess these placements; she is an experienced practice teacher who works independently, that is she is self-employed. These students were allocated the same university tutor. Each care home identified a link worker who would be responsible for the allocation and supervision of the student s work. A two day training session was provided by Learning Network West for the link workers and this was delivered by the project s practice teacher, thus ensuring continuity of contact and support. Methodology A telephone interview was conducted with the practice teacher at the start of the placement period and at the mid-point. Once the placement was completed telephone interviews, based on a semi-structured questionnaire (Appendix 1), were conducted with each student, link worker, manager or deputy manager, the practice teacher and the university tutor. A senior manager in the care home provider organisation was interviewed face-to-face. Findings Preparation for the placements It was anticipated that the students would spend a week on placement preparation at University but, due to timetabling issues, this was reduced to one day. The students felt that this was inadequate but they appreciated the early contact from the practice teacher. The two day link worker training was considered adequate by most of the link workers but was considered too short by other stakeholders. Motivation for being involved At an organisational level the motivation for participation in this pilot was based on pressures on the Learning Network and the University to expand placement settings and availability and a drive across the health and social care sector to facilitate better understanding and working practices between social work and health professions involved in care homes, it 2

3 breaks down barriers. The siting of social work placements in care homes for older people, in particular, can assist those homes to meet the Care Commission s expectations in terms of providing meaningful activities with the residents. It was anticipated that students in all the settings would have the time to work with residents and families in a way that is difficult for care home staff under the constant pressure of responding to immediate care needs. The placements were agreed by the provider organisation whose senior management reportedly presented the arrangement to the care home staff as a fait accompli. The care home management and staff were initially apprehensive about how they would cope with a student and meet the placement requirements in terms of staff training and support, but then found the experience a positive one, everyone benefitted. Development of inter-professional understanding Feedback on whether the placement helped to enhance inter-professional understanding was mixed. There was a consensus that the students learnt about other professional work and some feedback suggests that the care home staff learnt something about the social work role but individual placement experiences varied and it is difficult to draw any concluding data from such a small sample base when response to this question was inconsistent, even within stakeholder groups. Previous experience of this kind of placement No-one involved in this pilot had previous experience of a social work placement in a private care home but the practice teacher had considerable experience of placements in the independent sector. Work on placement who allocated it, what students did, work patterns, use of the activities matrix provided Consistent with the project in the South East of Scotland (Scottish Care 2009), there was an onus on the students to identify their own work. While student work would be approved by the link worker, it was often only allocated after being identified by the student. The students consulted closely with the practice teacher on the selection of work and two students worked closely with the activities co-ordinator to create direct work opportunities with residents and families. The students mostly worked a standard office day but some arranged their hours to suit the needs of the residents in their particular setting. 3

4 Students and links used the activities matrix (Scottish Care 2009, Appendix 5) most heavily in the early part of the placement and they found it helpful and reassuring at the initial stages of working out their role and relevant tasks. Advantages of the placement The placement enabled the students to meet and work alongside other professionals, to explore the social work role and to consider discrimination as experienced by older people and those with neurological disabilities. The students had the opportunity to work with residents both at an individual and group basis and with families too. This supported the development of their communication skills and their appreciation of the discrimination faced by people who are resident in a care home. The homes reported an increase in their understanding of the social work role and perspective and one manager reported that the placement helped the staff to move to a more holistic and person-centred, as opposed to taskfocussed, approach to their work. The students brought new ideas and ways of working to the care homes; the life-story and reminiscence work was particularly appreciated in the light of the time pressures on the regular staff. One student helped the home develop their dementia strategy. These areas of work helped the care homes to meet the Care Commission s expectations, it gave us an extra member of staff for these tasks. Challenges of the placement A major challenge in these placements was the care homes initial lack of understanding of the social work student role. The students found it challenging to be the lone social work professional in that setting and to have to take a lead in identifying relevant work. The care homes identified the time commitment as a challenge they had not fully appreciated the time that would be involved in having the student. There needs to be a clear understanding by the whole care team as to what the student is there to do. 4

5 The practice teacher and the tutor agreed that this kind of placement would not afford the depth of work required for a final placement. To offer intensive work to only some residents would be problematic. Suggestions for change Some of the stakeholders felt that they would be better prepared for the next social work student, now that they had experienced the process once. Most respondents were clear that the care homes needed to have a greater awareness of the needs of the social work student, the time demands on the link worker and the kind of work which the student could undertake. It was suggested that one or more of these three students could talk to new students before they take up a placement in a care home. It was also suggested by more than one respondent that the activities co-ordinator might act as the link worker in care homes for older people. Willingness to participate in a similar project in future All those involved in the project from the care homes would be happy to take another social work student. Similarly the organisational management is keen to continue to develop this model of working and Scottish Care is actively supporting these developments. Other comments The Practice Teacher was identified as a vital support to the students and the link workers throughout the placement. The next most important source of support was the activities co-ordinator in each home. The attitude and personality of the student was seen to be an important factor in the success or otherwise of the placement. A positive approach and an ability to identify their own work and role resulted in the best outcomes. Discussion of responses This project can be considered a success in that three students completed their placement and the care homes are happy to take social work students in the future. The experiences of each placement varied according to the level of engagement of the link worker, the fit of the student to the setting and the response of the student to the challenges of finding a role and identifying appropriate work. While the link workers mostly felt that the two day training course had met their needs in terms of preparation, this view was not supported by 5

6 all the other stakeholders nor is it supported by the data collected in the telephone interviews. The most engaged link worker, whose placement was the most successful in terms of other responses, felt that longer training would have helped her to appreciate the requirements of the student more fully while the least engaged link worker felt that the training had been too long, suggesting an enduring lack of understanding of the needs of the student. A number of problems which were reported within the interviews suggest that none of the link workers were sufficiently aware of the requirements of the placement, particularly in relation to the social work role. The lack of understanding in the homes of why a social work student was being placed there was a barrier initially and, for some of the placements, it continued to be a barrier to the students learning. [my] Link said she was 'baffled' at the SW placement. The link workers did not really know why a social worker was there. It is possible that more extensive training of link workers would have alleviated the problems of lack of knowledge of the social work role and skills. It was acknowledged that the practice teacher provided crucial and on-going advice and guidance to link workers; quite a bit of that work might be more economically undertaken in an extended training course. All those consulted agreed that students who are self-starters and who are able to identify their own learning opportunities coped best with this kind of placement. This finding accords with the findings of the project run in the South East of Scotland earlier in 2009 (Scottish Care 2009). There is some concern that other social work professionals will denigrate this placement experience, to the detriment of the student s career progression. This concern has also been expressed by the students in the South East of Scotland project because of negative feedback from colleagues about the placement setting. More university input on the learning potential and the social work issues of care home settings may help to alter the perception of those placements as of lesser quality. Once a critical mass of students has undertaken such non-traditional placements an attitude change may well follow. 6

7 Recommendations On the basis of the information gathered in this evaluative study the following recommendations are offered: 1. Practice teaching in non social work settings should continue to be provided by an experienced practice teacher. 2. Intensive support by a practice teacher should be integral to this kind of placement until it is embedded in the work of the care homes. This support demands more resources in terms of practice teacher time than a standard placement. That time should be made available because the support of the practice teacher was the keystone of the successful completion of these placements. 3. If possible the same practice teacher should be used for these placements until they can be mainstreamed into the practice learning element of social work courses. 4. Training of link workers from settings which have no experience of social work students should be longer than two days. 5. The learning opportunities of care home settings should be incorporated into the University curriculum. 6. Students preparation for care home placements should include some input from students who have undertaken placements there and who are positive about that experience. Conclusion This small evaluation considered the perspectives of most of the stakeholders in the social work placements of three students in private care homes, two of which catered for older people and one for younger adults with neurological disabilities. The care homes benefited considerably from the work of the students and the evaluation findings suggest that this setting can be a rich learning experience for students. The placements contributed to inter-professional understanding which is a policy objective across the health and social care sector. Quite a bit of good learning was achieved by the students and the challenges of the placements did not include any insuperable obstacles to the development of these settings as part of the social work education of a greater number of students. 7

8 The care homes involved and the care providing organisation are happy to offer similar placements again. This is an important positive outcome of the project and testament to the hard work and engagement of the students and the practice teacher. Some recommendations are offered and they include the continuation of some of the elements of this pilot project and the development of others. Moira Dunworth For the Scottish Social Services Council Learning Network West January 2010 Electronic copy available from References Gordon, J., McGeoch, M. & Stewart, A. 2009, "Finding the way forward: Planning for practice learning in the West of Scotland", Journal of Practice Teaching and Learning, vol. 9, no. 1, pp Gregson, L. & Fielding, J. 2008, "Student social workers in school settings: A practice assessor's perspective", Journal of Practice Teaching and Learning, vol. 8, no. 2, pp Hughes, M. 2009, "Development and implementation of social work practice learning opportunities in NHS settings with no previous experience of social work education", Journal of Practice Teaching and Learning, vol. 9, no. 1, pp Scottish Care 2009, Practice Learning Opportunities In Care Homes: A report of a project to provide social work practice learning opportunities in private care homes in the South East of Scotland, Workforce Initiative. 8

9 Appendix 1 Questionnaire for use with telephone interviews How were you prepared for the placement and was that preparation adequate? Why did you agree to becoming involved with this pilot? Did the placement help to develop understanding between social work and the other professionals involved in the care home? Have you had a social work student on placement before? Who allocated the student s work and what kind of work did she do? Did she work shifts? Did you use the guidance template provided? From your perspective what were the advantages of the placement? From your perspective what were the challenges of the placement? Do you have any suggestions for change in future placements? Would you be willing to participate in a similar project again? Any other comments? 9