Socia care in the community
This content was created and adapted within The Open University and originay pubished as an open educationa resource on the OpenLearn website http://www.open.edu/openearn/. This content may incude video, images and interactive content that may not be optimised for your device. To view the origina version of this content pease go to OpenLearn http://www.open.edu/openearn/. If reading this text has inspired you to earn more, you may be interested in joining the miions of peope who discover our free earning resources and quaifications by visiting The Open University http://www.open.ac.uk/choose/ou/open-content. Copyright 2015 The Open University Except for third party materias and/or otherwise stated (see terms and conditions http://www.open.ac.uk/conditions) the content in OpenLearn and OpenLearn Works is reeased for use under the terms of the Creative Commons Attribution-NonCommercia-ShareAike 4.0 Licence http://creativecommons.org/icenses/by-nc-sa/4.0/deed.en_gb. In short this aows you to use the content throughout the word without payment for non-commercia purposes in accordance with the Creative Commons non commercia shareaike icence. Pease read this icence in fu aong with OpenLearn terms and conditions before making use of the content. When using the content you must attribute us (The Open University) (the OU) and any identified author in accordance with the terms of the Creative Commons Licence. The Acknowedgements section is used to ist, amongst other things, third party (Proprietary), icensed content which is not subject to Creative Commons icensing. Proprietary content must be used (retained) intact and in context to the content at a times. The Acknowedgements section is aso used to bring to your attention any other Specia Restrictions which may appy to the content. For exampe there may be times when the Creative Commons Non-Commercia Shareaike icence does not appy to any of the content even if owned by us (the OU). In these stances, uness stated otherwise, the content may be used for persona and non-commercia use. We have aso identified as Proprietary other materia incuded in the content which is not subject to Creative Commons Licence. These are: OU ogos, trading names and may extend to certain photographic and video images and sound recordings and any other materia as may be brought to your attention. Unauthorised use of any of the content may constitute a breach of the terms and conditions and/or inteectua property aws. We reserve the right to ater, amend or bring to an end any terms and conditions provided here without notice. A rights faing outside the terms of the Creative Commons icence are retained or controed by The Open University. Head of Inteectua Property, The Open University Contents Introduction 4 Learning Outcomes 5 1 Entering the word of socia care 6 2 Home care: workers and users 8 2.1 What is the job? 9 2.2 The service user s perspective 14 Concusion 18 2 of 19 Friday 23 October 2015
References 18 Acknowedgements 19 3 of 19 Friday 23 October 2015
Introduction Introduction In this course you wi expore socia care, a major area of provision in heath and socia care. A societies face the chaenge of supporting peope who, for a variety of reasons, are unabe to function without assistance or supervision. It wi focus on one important area of socia care home care for oder peope. Core Questions How do peope access socia care services? What do home carers do? This OpenLearn course is an adapted extract from the Open University course K101 An introduction to heath and socia care. 4 of 19 Friday 23 October 2015
Learning Outcomes After studying this course, you shoud be abe to: understand the variety of caring activity within the UK for oder peope in the home describe care situations for oder peope in the home objectivey identify aspects of care reationships which conform to principes of good care practice.
K101_1 K101_1 1 Entering the word of socia care To give you an understanding of why peope need socia care and how it works, we begin with a case study. This is Ann and Angus s story: Activity 1 Getting to know Ann, Angus and their famiy Aow about 45 minutes To bring the subject of famiy care to ife, you are about to isten to a case study in the form of an audio drama. This wi bring out issues vividy you hear tensions mounting and be abe to imagine the scenes for yoursef. The peope you wi hear are actors but what happens is based on rea ives. Task 1 An incident on the stairs The aim of this first part of the activity is to get yoursef invoved in the compexity of daiy ife in Ann and Angus s famiy. Famiies provide the setting for many key ife processes, so peope s experiences of caring and being cared for are aways interwoven with other important strands of famiy ife. Listen to Audio 1. After istening, make notes in answer to the foowing questions: What are the needs of each famiy member during the audio cip? What is each famiy member feeing during the audio cip? Are they happy? Audio content is not avaiabe in this format. 6 of 19 Friday 23 October 2015
1 Entering the word of socia care Audio 1 Incident on the stairs istockphoto.com / Juanmonino; istockphoto.com / wibs24 Discussion Angus needs to get to the toiet. Needs physica hep getting upstairs. Needs understanding of the experiences and difficuties he faces. Needs mora support. Ann needs hep with the physica task of supporting Angus. Needs mora support. Bob needs to be greeted, to reax after work, have his tea, then go off to pay footba. Zoe needs to be greeted to tak about impications of faiing Engish have tea. Angus fees frightened by sudden oss of strength or contro and by his fa. Bitter about Parkinson s. Anxious to get to the toiet. Seems hostie to Bob. Doesn t want hep from him. Ann fees frightened about Angus s fa. Anxious not to be distracted from heping him. Cross that Bob prioritises footba. Frustrated by Zoe s tantrum. Bob fees frustrated that Ann continues to run such risks heping Angus. Anxious about getting to footba. Zoe fees anxious about faiure and what her parents wi think. Angry about being ignored. It seems that no one in the famiy is happy, at east not at this point. This two minute insight into the famiy s ife demonstrates both the responsibiity of caring and the negative effects it can have on peope s ives. Now do Task 2. Task 2 What is happening to Ann s ife? The next audio is in two parts. In the first, the famiy is in the iving room. In the second part, Ann meets her friend Chery in a pub. Listen to Audio 2 and make notes in answer to the foowing questions: What are the sources of tension between the famiy members? What is Chery trying to achieve? What is Ann s response to Chery? Audio content is not avaiabe in this format. 7 of 19 Friday 23 October 2015
2 Home care: workers and users Audio 2 Tensions round the teevision Chery makes Ann think istockphoto.com / Juanmonino; istockphoto.com / wibs24 Discussion Tabe 1 Zoe Bob Ann Who and what is annoying them? Annoyed with Angus for having the teevision on so oud whie she is doing homework aso irritated that his needs get priority. Wants to watch footba growing irritation at Angus assuming contro of teevision annoyed at being expected to discipine Zoe angered by Angus asserting ownership and suggesting he moves out. The arguing gets to her she turns on Zoe then on Bob then starts vacuum ceaning in frustration annoyed with them a for not getting on together. Angus Has few enough remaining peasures can t even watch his own teevision in peace inadequate son-in-aw aways wants to watch footba and tries to throw his weight around. Underying reasons Maybe she s worried about schoo faiures and wants hep with homework? Is she upset that Angus s needs seem to dominate famiy ife, and that her mother seems preoccupied by caring duties? Bob has to ive in his father-in-aw s house on Angus s terms because Ann is committed to caring for him. Does he fee that if he isn t aowed to be the man in his own home, why take responsibiity for Zoe s discipine? Does she fee guity for spending ess time with Zoe and Bob than she d ike and responsibe for their frustrations with Angus? Does she worry that things are faing apart? Is Angus in pain? Does he find company tiring and confusing especiay young peope ike Zoe? Is he worried Bob wi ure Ann away and eave him hepess? Has he aways thought Ann wasted hersef on Bob? These are ony ideas after a, it s a fictitious case study, so anything goes. The point is to think about how much goes on beow the surface of famiy ife. Chery seems worried that Ann is etting hersef be ground down by her sense of duty to Angus and her promise to her mother. Chery wants Ann to recognise that she is a carer and needs support. Ann resists seeing hersef as a carer. She sees what she is doing as fairy norma, and thinks she ought to be abe to cope. 2 Home care: workers and users Most often, famiy and friends provide much of the support oder peope require. However, some peope don t have famiy and friends to draw on. And for those who do, sometimes there is a strugge to meet a person s fu care needs as was the case with Ann in the audio. This is where socia care comes in and in the foowing activity you wi find out how peope access these services and what they might receive. 8 of 19 Friday 23 October 2015
2 Home care: workers and users Figure 1 For severa decades now, home care workers have been an important source of support You now turn your attention to the peope on the front ine of socia care: those who provide home care, and those who receive it. If peope, ike Angus, are to be abe to stay in their own homes, despite significant heath probems, the workers who support them become ever more important. 2.1 What is the job? Going into someone ese s home demands a range of skis in order to work with different peope. Some home care cients are seriousy i and need skied care, incuding the use of sophisticated equipment. Others need hep ony with persona care, such as washing, dressing or shopping. The needs of others may invove countering isoation by heping them to maintain socia contact with peope. Underpinning these different tasks is the need to estabish the right kind of reationships with the cient. Home carers have to baance being friendy and providing company with professionaism and doing the job within the time aowed in the care pan. This is a chaenge for many peope who work in heath and socia care, but it is particuary acute for peope who work in home care, because their job invoves going into peope s homes. They are not working in their own workpace where they can be in contro. Rather, they have to adapt to each person in their home. In the next activity, you wi ook at how this roe pays out in practice. A home carer s job In this activity you expore what it s ike to be a home care worker and a user of home care services. You wi observe visits by home care workers to four cients of the Cardiff-based agency, Somebody Cares. 9 of 19 Friday 23 October 2015
2 Home care: workers and users Activity 2 The home carer s job Aow about 1 hour Somebody Cares provided persona care, domestic hep and support with the activities of daiy ife such as shopping. Since these videos were made, Somebody Cares was sod on to another company and then was shut down when the company reorganised In this activity, think about the foowing questions. 1 What does the home carer s job invove? 2 What skis does it take to do the job and manage reationships? Task 1 Getting to know the case study Start by famiiarising yoursef with the Somebody Cares case study in Video 1. Watch the whoe case study right through, so that you get to know the peope invoved, incuding their different: care needs forms of support provided domestic situations. Video content is not avaiabe in this format. Video 1 Somebody Cares case study Now that you have viewed the whoe case study, it s time to focus in more cosey. Task 2 Focusing in on the job of home carer Revisit each of the four cases in the video. 10 of 19 Friday 23 October 2015
2 Home care: workers and users As you watch each one, ask yoursef the foowing questions: What work does the home carer do for the cient? What practica skis do they need? How woud you describe their attitude to the job? Use the text boxes beow each video to record your answers. Whie you are working on a case, use the menu at the bottom of the screen to pause the video. You wi probaby need to watch each case through more than once. Video content is not avaiabe in this format. Video 2 Case 1: Kevin and Evis visit Brian Video content is not avaiabe in this format. Video 3 Case 2: Liz visits Carice 11 of 19 Friday 23 October 2015
2 Home care: workers and users Video content is not avaiabe in this format. Video 4 Case 3: Evis goes with Aerwyn to his cass Video content is not avaiabe in this format. Video 5 Case 4: Maria goes shopping with Lyn 12 of 19 Friday 23 October 2015
2 Home care: workers and users Discussion Here are our thoughts. Again, don t worry if they are different from yours. Tabe 2 What work do they do for the cient? What practica skis do they need? How woud you describe their attitude to the job? Evis and Kevin with Brian Move Brian with hoist, wash and dress him, prepare breakfast Use hoist, hep Brian to fee safe as they wash him, basic cooking, heath and safety knowedge Very professiona, but aso friendy, see themseves as supporting June s carer roe, with defined roes and responsibiities Liz with Carice Evis with Aerwyn Maria with Lyn Make bed, hep wash and dress, bath twice a week, shopping Domestic skis, socia skis Ready to be fexibe and friendy, but aso very professiona and cear about boundary between work and friendship Accompany Aerwyn to computer cass and snooker Socia skis, keeping Aerwyn company, supporting him without taking over Ready to be fexibe (e.g. abandons uniform at Aerwyn s request), but cear about boundary between work and friendship Accompany Lyn and hep with shopping as directed Mainy socia skis Maria carefuy foows Lyn s instructions, they have a cup of coffee together, but both know it is a working reationship Boundaries As you have seen, being a home care worker is not straightforward. It is not about being a friend, athough it is about being friendy. Workers must respect heath and safety requirements, they must be cear about their responsibiities, and they must be competent to carry out quite a range of tasks. They need to manage reationships so that they can do 13 of 19 Friday 23 October 2015
2 Home care: workers and users what they need to do in the time avaiabe. Cients cannot contact them individuay outside the aocated working hours. Figure 2 Preserving the boundaries between cient and care worker Marking out the boundaries between work and friendship is important. Uniforms hep. As we as being practica, they indicate that this is a job, not just a casua heping-out arrangement. Despite these professiona boundaries, home care workers can find the job quite upsetting. Liz Randa, whom you saw on the video working with Carice, commented to the team who recorded the fim how hard it coud be: I think it s hard keeping it so professiona. A ot of them die in our job. The office can t contact us a, etting us know, and you might find out a coupe of days ater. I think reguar carers obviousy they re contacted. But it might be somebody who I ony go to once a week, but I ve been going there for tweve months or so. And you find out that they ve suddeny gone into hospita, and when they come back out, we maybe in for a fortnight, two months, three months whatever they might not come back on my rota. And I think Oh I can t go you can t go and see them. Uness it s down on your rota to go down and see them. So that s quite hard. Because you do get fond of them, you can t hep it. We you woudn t be human I think, if you didn t. Liz s refection is a reminder that there is an emotiona side to home care work for which workers may we need support. 2.2 The service user s perspective We now switch from the care worker s perspective to that of the service user or cient as they are referred to in our case study. The Loca Government Ombudsman (LGO, 2012) highighted the foowing points from compaints it had handed: Unreiabiity: care workers did not aways come when they were expected, or they were ate. 14 of 19 Friday 23 October 2015
2 Home care: workers and users Short visits: some as brief as 15 minutes, which did not aow time to compete the tasks, or exchange peasantries. Frequent changes of staff: this meant that service users did not get to know the workers. Poory trained staff: staff did not aways have the right skis or attitudes, or did not treat service users with respect. This creates a pretty beak picture of home care. The next activity provides a different perspective on it. Activity 3 Home care: the cient's perspective Aow about 1 hour For this activity, you go back to the scenes you viewed in Activity 2, but this time, you ook at them from the cient s perspective. As you watch each case study again, consider the foowing questions. What are the cient s reasons for having home care? Is there any choice of care worker? What does the cient vaue about the care worker? Video content is not avaiabe in this format. Video 2 Case 1: Kevin and Evis visit Brian Video content is not avaiabe in this format. Video 3 Case 2: Liz visits Carice 15 of 19 Friday 23 October 2015
2 Home care: workers and users Video content is not avaiabe in this format. Video 4 Case 3: Evis goes with Aerwyn to his cass Video content is not avaiabe in this format. Video 5 Case 4: Maria goes shopping with Lyn 16 of 19 Friday 23 October 2015
2 Home care: workers and users Discussion Here are our thoughts. Again, don t worry if they are different from yours. Tabe 3 Brian and June (Kevin and Evis) Carice (Liz) Aerwyn (Evis) Lyn (Maria) What are the reasons for having home care? Needed hep at home to get out of hospita quicky after amputation Keeps her out of a care home, aowing her to stay in her own home To keep him company and attend casses, pay snooker and have a augh with him Aows her to be a free agent and ive her own ife, despite disabiity Is there any choice of care worker? Brian does not aways have the same care team (sometimes it s two men, sometimes two women) Choice is important to Carice, who compained when Liz was taken away, and got her back Evis says Aerwyn did not ike the first worker he was offered, and asked for a change Lyn has a variety of workers, and seems to ike them a What does the cient vaue about the care worker? Brian appreciates the work done for him, whoever does it, as it has got him out of hospita Carice vaues Liz s approach, and the fact Liz knows her so we, even down to the shopping ist Regards Evis as a friend Says: A my carers treat me as a human individua, and that Maria is kind, joy, good company, and never rushes her You have seen the vaue of home care as a way of enabing peope to ive in their own homes, with a reasonabe quaity of ife, rather than in a residentia home or, in Brian s case, a hospita. These service users get a higher standard of care than those who compained to the Loca Government Ombudsman (LGO). There is some choice of care worker, some fexibiity, 17 of 19 Friday 23 October 2015
Concusion and the fact that no one comments on reiabiity suggests that they can indeed rey on peope arriving when they are due. They vaue peope who get to know how they ike things done, who are friendy, who treat them as human beings. Meeting peope s needs in ways that are both professiona and friendy, and fexibe and reiabe is not straightforward. It is, however, a very important responsibiity. How woud Carice manage if for any reason Liz or another worker was unabe to come? She might be in considerabe difficuty and distress. To run a care agency that can provide the fexibiity and, at the same time, the reiabiity of service that cients want is a significant chaenge. Concusion Access to socia care starts with an assessment of need by the oca authority. The benefits and barriers associated with accessing socia care can shape how easiy peope adapt to this change in their circumstances. Having ooked at access, you then considered what home care workers do in their provision of socia care. Home carers hep peope to ive independenty in their own home. Fexibiity and reiabiity, kindness and respect were seen as key persona quaities. Friendiness is important but care workers must maintain persona boundaries and not become friends. Home care workers provide a vita service in enabing peope to stay in their own homes when they have care needs. Home care workers work to a care pan which determines what they do for each cient. Home care workers need to manage reationships with cients so that there are cear boundaries between being friendy and being a friend. At times this makes considerabe emotiona demands. Persona quaities are important, but not enough. Home carers need technica skis too. Peope vaue home care that is reiabe and fexibe, and which is deivered with kindness and with respect for them as individuas. References Loca Government Ombudsman (LGO) (2012) LGO reports on key emerging trends in adut socia care compaints [Onine]. Avaiabe at www.go.org.uk/news/2012/ju/goreports-key-emerging-trends-adut-socia-care-compaints/ (Accessed 8 January 2014). 18 of 19 Friday 23 October 2015
Acknowedgements Acknowedgements Except for third party materias and otherwise stated in the acknowedgements section, this content is made avaiabe under a Creative Commons Attribution-NonCommercia-ShareAike 4.0 Licence. The materia acknowedged beow is Proprietary and used under icence (not subject to Creative Commons Licence). Gratefu acknowedgement is made to the foowing sources for permission to reproduce materia in this course: Figure: Figure 1: (eft): Chares Hewitt / Huton Archive / Getty Images; (right): istockphoto. com / SoStock. Course image: Copyright Apeöga / Getty Images; istockphoto.com / kickstand; Design Pics www. fotosearch.com; Aexander Raths /123RF; istockphoto.com / Sean_Warren; istockphoto. com / STEEX; xaanx / 123RF; istockphoto.com / Sivia Jansen; Fotosearch. Audios 1 and 2: images used for iustrative purposes ony. Every effort has been made to contact copyright owners. If any have been inadvertenty overooked, the pubishers wi be peased to make the necessary arrangements at the first opportunity. Don't miss out: 1. Join over 200,000 students currenty studying with The Open University http://www.open.ac.uk/choose/ou/open-content 2. Enjoyed this? Find out more about this topic or browse a our free course materias on OpenLearn http://www.open.edu/openearn/ 3. Outside the UK? We have students in over a hundred countries studying onine quaifications http://www.openuniversity.edu/ incuding an MBA at our tripe accredited Business Schoo. 19 of 19 Friday 23 October 2015