Chapter 65 – Antonia Kenny (D5SOP4)
Domain 5 Standard of Proficiency 4
Demonstrate a critical understanding of relevant biological sciences, human development, social and behavioural sciences and other related sciences, together with a knowledge of health and wellbeing, disease, disorder and dysfunction relevant to the role of a social care worker.
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KEY TERMS Social care work Health and wellbeing – a holistic approach Relevant and related sciences Human development
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Social care is … working with people in a holistic manner, most importantly recognising the person not just as a label but first and foremost as human, as a whole person. |
Social Care Work
In practice a social care worker ‘uses shared life-space opportunities to meet the physical, social and emotional needs of clients’ (Social Care Ireland 2020). When we leave college, we are equipped with a ‘toolbox’ of skills and knowledge that we can apply in practice. Practice can vary across the lifespan of service users, in different care settings, and when working with individuals, no one size fits all. This is where, in theory, we dip into our toolbox. However, in practice the reality can be quite different – social care workers can wear many hats, encounter many challenges, along with plenty of opportunities!
Relevant and Related Sciences in Social Care
The complexities of social care bring with them the requirement for a knowledge base that is vast and varied. In order to practise with a holistic and interconnected approach, it is important for a social care worker to have an understanding of what is meant by the sciences related to social care practice. Science can be defined as ‘a systemically organised body of knowledge on a particular subject’ (Oxford Languages, online) and some of the key sciences used in social care are biological, human development, social and behavioural sciences. Other related sciences include social policy, nutrition and politics. While the biological sciences study areas such as life and organisms, human development looks at improving wellbeing across the lifespan. Social and behavioural sciences relate to the study of society and individual relationships to it.
In relation to health there are a variety of key theories and approaches to wellbeing. With this in mind, the biopsychosocial model, coined by George L. Engel in 1977, is an approach which interconnects the sciences in a way that can be used in our practice.
TASK 1
Watch the video on chronic pain and the biopsychosocial approach: https://youtu.be/B14_2TS7RHM
Determinants of a person’s health can also be explored using a framework developed by Dahlgren and Whitehead in 1991. This framework maps the relationship between an individual, their environment and their health.
TASK 2
Watch the video on the social determinants of health
Furthermore, the Ecological Systems Theory, developed by Bronfenbrenner in 1979, is yet another framework which a social care worker can examine individuals’ relationships with wider society.
TASK 3
Watch the video on Bronfenbrenner’s Ecological Systems Theory
Health and Wellbeing – A Holistic Approach
The constitution of the World Health Organisation (WHO) defines health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO 1946). In order for a service user to achieve fulfilment in these areas, it is important that we as social care workers view health and wellbeing as being interconnected. This means looking at the whole person, not just from the perspective of labels or through one particular scientific or developmental lens. Each area of human health and wellbeing is linked, overlapping with the others in a variety of ways.
Although labels or a diagnosis can be beneficial when accessing correct support services or understanding behaviour and needs, it is also important for a social care worker to keep an open mind, which can have a beneficial impact on the care a person receives in various areas of their lives. For example, a service user declining to get out of bed in the morning may be interpreted as ‘displaying behaviours that challenge’. This ‘behaviour’ may be communicating to staff, e.g., ‘I’m not happy’ – the reality might be that the person is having mental health issues, possibly due to lack of contact with a family member. Behaviour is communication, and it is important to understand that a particular behaviour may indicate emotional, physical or social ill-health.
Using a holistic and interconnected approach ensures that all the needs of the person at the centre of our care are considered in our practice. It is worth noting that supporting a person with their health and wellbeing means not only applying a person-centred approach but also working in partnership with other stakeholders, including family members, carers and disciplines other than social care.
TASK 4
Take a moment to think what your own current health and wellbeing requirements are. Now make a list under these headings – Physical, Mentaland Social. Next think of actions you can take to meet these needs.
Case Study 1
Susan (pseudonym) is a 26-year-old woman who moved five months ago to live in Meadow Lodge, a residential service for people with autism on the outskirts of a large town. Susan lives with two others; however, they have very little in common apart from their age group. Susan enjoys spending time with family, watching television and walking independently to the local park.
During her time in Meadow Lodge, Susan’s mood has changed from being smiley and relaxed to withdrawn or agitated. Some days Susan declines to leave her bed and often chooses not to eat. As Susan is non-verbal, she at times communicates her mood by acting out towards staff physically – biting, pinching and hitting out. On other days Susan engages positively in daily activities and shows her mood in positive ways such as smiling.
Taking into consideration Susan’s health and wellbeing needs or wants under the headings Physical, Mental and Social, what could be causing Susan’s changes in behaviour and mood? The templates below can be used as a guide.
TASK 5
Step 1: Identify each need or want for Susan’s care plan under the following headings:
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Mental Health & Wellbeing |
Physical Health & Wellbeing |
Social Health & Wellbeing |
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Step 2: Make a plan for each.
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Step 3: Identify the priority areas.
Decision-making Skills
A social care worker’s ability to demonstrate in their practice a critical understanding of the relevant and related sciences, human development and health and wellbeing prevents the risk of them making subjective rather than objective decisions. Anyone can learn the theory from books, but the ability to apply it meaningfully is a skill in itself. As the social care worker matures in their role, so will their understanding and ability to apply theory to their practice. Decision-making occurs on many levels and with many factors that will have an influence or impact a service user at that time or in the future.
Awareness of one’s own values, beliefs and attitudes when making decisions, alongside the service user, based on their needs or wants, is also important. As an example, one social care worker might believe that bread or cheese is unhealthy; another believes that they are not. These ideals will impact how the social care worker supports the service user, unless they possess the ability to take a reflective step back and ensure that the service user is at the centre of the plan. Possessing an understanding, knowledge and awareness of the sciences and health and wellbeing leads to objectivity, allowing for support given to be based on the service user’s needs and wants rather than our own opinions.
Tools
A structure around making these considerations can be created in the form of care plans. As they are live documents and should be reviewed regularly, they change over time alongside the development of the service user during their life span. Recent times have seen changes in the way care plans are documented. Technology has been developed, such as Aspiricos iplanit.
Aspirico’s iplanit, which provides a web-based system that captures information digitally around service user care plans (which can be based on the twelve pillars of the New Directions policy). A user of iplanit can choose to share their password with the people they care about. This means that they can give access to the information uploaded and stakeholders can provide support while keeping the person at the centre of it all. For instance, a sibling living in Australia can give support. Features include pictures, videos and audio clips that can be uploaded, and there is a personal calendar. Care plans are available in an accessible format that is easy to use. As the software essentially belongs to the user, their iplanit journey is ongoing, even if they move between services (Aspirico website).
Tips for Practice Educators
Practice placements provide an opportunity for a student to demonstrate and develop their understanding of the knowledge they have acquired in their education setting. In order to achieve the requirements of this proficiency, it is important that the student is afforded the chance to meaningfully apply the theory around the relevant sciences, human development and health and wellbeing in practice.
The practice educator can kick-start the process even before the student starts their placement. As any overarching legislation is streamlined, it leads to each social care setting having different policy and ethos. Social care is diverse not only in settings but also in staffing roles, leading to many titles and responsibilities. To ensure that the student is well prepared for this, the practice educator can provide the student with a pack before they begin their placement, including specific details of their role in the capacity of a student.
The requirements for the student to achieve this proficiency is that they can critically apply the theory to their practice, becoming competent and confident in their assessment and decision-making skills to meet service users’ wants and needs regarding their health and wellbeing. To accomplish this a student can be asked to research the relevant sciences and theory around health and wellbeing (including health promotion) before starting their placement. A placement educator can suggest theorists such as Bronfennbrenner, Erikson, Engel or Dahlgren and Whitehead, which will may help structure the thoughts of the student and encourage them to look at the bigger picture for the service user.
A placement should provide a student with a safe place to explore and learn. Mistakes will, no doubt, be made and hopefully learned from, providing valuable knowledge to build on as the student matures in their professional life. Within this competency of critically understanding the related and relevant sciences, human development and health and wellbeing, a practice educator can also challenge the student in their understanding and what values and beliefs they carry regarding these areas by allowing space for reflective practice and giving supervision. A practice educator can also provide the tools to guide the student to facilitate theory in its application, such as in care planning documents.
Top Tips
- Prepare the student before their placement commences.
- Ask the student to define their understanding of the sciences, human development and health and wellbeing.
- Challenge the student’s values and beliefs in a supportive manner.
- Use a systematic approach (needs assessment, planning, implementation and evaluation) to set care planning goals.
- Provide opportunities to use care planning tools with guidance from service users and experienced staff.
- Ensure use of a holistic approach when applying theory to practice.
- Address any challenges during supervision.
Suggested list of decision-making questions
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Have you gathered information from all sources (service user, stakeholders, multidisciplinary, history)? |
Are there any gaps in your knowledge? |
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Have you identified any forgotten needs/wants of the service user? |
Have you eliminated other assumptions before finalising your decision – objective or subjective stance? |
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What are the implications of this decision? |
Is this realistic? |
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What are the priority areas? |
What else can be done? |
References
Aspirico (website) What is iplanit? Available at <https://aspirico.com/iplanit/> [accessed 29 March 2021].
Bronfenbrenner, U. (1979) The Ecology of Human Development Experiments by Nature and Design. Cambridge : Harvard University Press.
Dahlgren, G. and Whitehead, M. (1991) Policies and Strategies to Promote Social Equity in Health. Copenhagen: WHO Regional Office for Europe (document number: EUR/ICP/RPD 414(2).
Engel, G. (1977)’The need for a new medical model: a challenge for biomedicine’. Science, 196: 129-136.
Oxford Languages (online) Definition of ‘Science’. Available at: <https://www.google.com> [accessed 5 April 2021].
Social Care Ireland (2020) What is Social Care Work? Available at <https://socialcareireland.ie/what-is- social-care-work/> [accessed 21 December2020].
WHO (World Health Organisation) (1946) Constitution. Available at <https://www.who.int/about/who- we-are/constitution> [accessed 26 January 2021].
