What makes a good care worker?

I haven’t been able to shake off the Panorama programme about the abusive care environment at Winterbourne View.  We spent quite a lot of time talking about it at work yesterday as well, at meetings and in the office.

It has pushed my mind back to the time, before I qualified when I worked for about 7 years (5 years full time and 2 years part time while I was studying) as a care/support worker before I qualified as a social worker.

I was fortunate to work in well run small group homes for adults with learning disabilities and had generally very good managers who encouraged person centred planning and the environment would not have tolerated any kind of mistreatment of the residents whom we were charged to look after.

It made me think about the qualities that would make a good care worker. I’m not saying I was particularly fantastic at my job. I enjoyed it and I enjoyed the interactions with the residents – but not being abusive doesn’t make you necessarily ‘good’ at your job.

The most important thing, I think, is not dependent on personal qualities so much as the ethos and environment that you work in. A team of colleagues who show respect to the residents in their own home and who are respected by their managers and each other will not tolerate one ‘rogue’ care worker stepping over the line.

In an environment like the one portrayed at Winterbourne View, there was no regulation or censure by other staff members or managers. The staff who were abusive were openly abusive and so there was a culture that had permeated the home of mistreatment and abuse. I do wonder how much the culture has been instilled in an organisation by management – not that that excuses any individuals from the personal responsibility they hold – but cultures and systems sometimes allow abuse to be perpetuated in an almost ‘Lord of the Flies’ type way when the management take their collective eyes of the ball. It is for that reason that the management of Castlebeck have to take responsibility.

There is also the issue of training of course, but the deeply developed culture of an organisation is more than a matter of training. It helps, don’t get me wrong. Everyone should know the basics and more about an ethos and environment and what best practice demands but training costs and if you are paying staff a minimum wage without allowing them to develop professionally, you won’t have the same levels of satisfaction and retention. Retention is very important in social care settings. I was lucky to have worked in the same two homes for those 7 years. I built up relationships such that I still pop in for ‘parties’ when I get my invites to the annual ‘anniversary’ celebrations (the anniversary of the home opening!).

So taking the environmental and structural issues into account, a good care worker needs patience. This is not necessarily inherent as a quality and I believe it can be learnt. I believe that self-awareness helps as well. Patience was not high on the lists of qualities displayed in Panorama but you need to be able to show judgement and sensitivity in knowing when to talk and when to walk.

Empathy is vital. Being able to see the people you work with and think about how they feel – about how their families feels and most importantly, treating everyone as you or (insert close family member whether child or parent) to be treated. That’s a very simple catch-all and it is hard to teach to someone but it’s a very basic precept. When you see someone with a disability or someone who is particularly old or young as a ‘victim’ or an ‘other’ type of person, it almost gives you free rein to treat them differently. That is a dangerous position to be in.

An understanding of the power dynamics is also vital. Some people seek out vulnerable people to work with in order to feel more powerful. Power silences people and it instils fear. It is important that the peer group are able to identify this and scotch this. This happens across the social work and social care sector. It will never disappear but having an awareness of it can help.

I often tell families of people who are going to look at residential homes to ask the staff about retention levels in the home – how long have they been there? Are they happy? (they may lie, of course!),  how many permanent staff and how many agency staff there are? Try and talk to staff who are carers and not managers.

There is no doubt that there is a lack of societal respect and appreciation for support workers and care workers in general. We allow our most vulnerable to be cared for by those who receive minimum wages and have poor working conditions.  That won’t change overnight but going back to the CQC and inspection regimes in general, it would be useful to have a deeper understanding of organisational cultures so they can be monitored but perhaps that is too big a job to undertake.

As for me, the years I spent carrying out hands-on care in a residential setting have been crucial to my development as a social worker. In some ways, that’s why I think it’s sad that some of the social care experience needed to go into social work has been reduced as I know I wouldn’t have as much to draw on when I go to review residential homes had I not had that experience.

Sometimes I miss the care work.  It was an honour and privilege to have such an important and significant daily role in the lives of others and in some ways, I was working in a much more person-centred way back then than I am now, through the reams of (virtual) paperwork.

8 thoughts on “What makes a good care worker?

  1. Lovely post – I don’t know why but the part when you describe popping in for parties at the residential home you used to work in really stuck in my mind. It’s nice to hear of a home celebrating it’s existence, instead of being a sort of living apology for society. Acts like that can allow care homes to be a place residents feel proud of living in.

    I’m not a massive fan of Camphill, but what I would say about them is they are proud of their heritage and many of the residents are proud of it as well. They celebrate the existence of their community and ethos. Hard to imagine that happening in Southern Cross or Castlebeck homes… (outside of PR publications, that is).

    • Thanks Lucy, I hadn’t thought twice about the celebrations actually but the residents there had moved out of long stay hospitals and they loved it 🙂

  2. As a former support worker (about a decade in total with several agencies at dozens of sites) I agree with this. Support work (as opposed to “care work”) isn’t given a lot of press or attention but it’s a really rewarding job requiring a range of skills and of course personality traits (empathy, creativity, patience, to name but a few). Sadly, due to the open-ended nature of the work and the low pay, it can attract people who lack those skills and who just want to serve time, go through people’s daily care routines keeping the residents ticking over and not much more. When I would do agency work I’d spot the differences between some places where people were put into pyjamas by eight and those where people had the chance to go out in the evenings and have fun. There are a lot of people who have just drifted into the job for want of anything better to do rather than consciously choosing it as a career. I was struck by how different workers had different “theories” about how to do their job. In the main, they were all pretty sensible but it highlights the lack of a consistent professional ethos that would guard against any more toxic cultures developing in isolated workplaces.
    I’m glad to say I haven’t come across anything even remotely like what I saw on Panorama the other day, but there’s certainly a need to boost the status of the role, promote it as a career option and sort out what we mean by good support work, as you are starting to do here!

    • Thanks Colin. I was using support and care work a little interchangeably partly because I think there is little difference in the general public perception but there is a big difference although care work can take on elements of support work and ideally would.

  3. I seriously worry about the degree entry into nursing and social work, whilst I have no quarrel about professionalising the service it can meen that people see certain jobs on the ward and in social work as beneath them, there is a parlous lack of team work all mucking in when it gets busy or difficult, god help us all if we need residential care and the government drive to get people back to work means additional nsupport and supervision otherwise the wrong people will be recruited at best indifferent or neglectful, at worst abusive

  4. I miss working in group homes/residences. My favorite work ever (too bad I can no longer afford to work in them).

    Right now I work in home care however and there’s definitely shady stuff that goes on. Most likely due to the fact that the aides are alone in the homes with the clients and there’s not much oversight. And because of that it’s also hard to know what is real and what is made up too in terms of client complaints.

    • Thanks A – I agree in that i often miss that part of the work. I think having worked in a home, it makes me a little more aware about things to pick up on.

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