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About this book

Social workers often have to handle a great deal of negativity in their working lives. This book celebrates social work practice at its most positive and influential and, in doing so, contributes to a growing literature on critical best practice.

Focused on 12 unique and compelling stories of social work with older people, the authors:

• provide a fresh and realistic insight into life as a social worker, and the dilemmas and difficulties that practitioners typically face

• illustrate how knowledge, theory and research are integrated in professional decision-making and action

• show social workers analyzing their own cases and include reflective questions to help readers formulate their own learning and thereby develop their own practice


This book provides students on qualifying courses with an invaluable perspective on real life practice, and gives qualified practitioners the opportunity to reflect on and better their own practice.

Table of Contents

Introduction

1. Introduction

Abstract
This is a book which places the actual practice of social work with older people firmly centre stage. At its heart are 12 accounts of social work as told by social workers themselves, in which they describe what happened, the relationships they built, the knowledge they used, how they felt and the decisions they made. The stories are rich in detail and each is used to illustrate, examine and discuss what social work looks like when it is done well. If you are new to social work with older people, you will be given a good idea of what the work really entails and the ways in which social workers approach the situations in which they and their clients find themselves. You can start to think for yourself about what you would have done and why. If you are an experienced social worker, we hope you will recognise your own work in what you read and that this will help you to analyse, critique and celebrate what you do.
Karen Jones, Susanna Watson

Relationships

Frontmatter

2. Relationships

Abstract
In the chapters that follow, we explore the highly skilled practice of three experienced social workers as they each demonstrate the central importance of the social worker’s relationship with the client through their humane, compassionate and respectful practice. The work described here gives us a great deal to be optimistic about and much to learn from. The social workers we spoke to were full of energy and enthusiasm for their profession, while the commitment they displayed towards their clients was striking. This is not to suggest that social work which places relationships at its core is either easy to achieve or unconstrained by the context of current practice. In fact each of the social workers we talked to spoke of their unease about the current and future state of social work. We heard, for example, about the necessity of ‘tweaking the system’ and ‘going under the radar’ in order to achieve the quality of practice that was aspired to. A recurring theme was the increasing difficulty of ‘getting away with’ spending as much time as was needed on any single case. All three expressed concern about what they saw as moves towards increasingly brief and prescriptive approaches to practice. These trends were unanimously seen as a threat to the kind of relationship-based practice that the social workers had found to be both effective and highly valued by older people and carers.
Karen Jones, Susanna Watson

3. Rachel and Michael: Careful Relationship Building

Abstract
Questions to ask yourself as you read:
Why do you think Rachel succeeded in building a successful relationship with Michael where others failed?
 
What is an assessment?
 
What made residential care such a positive outcome in this situation?
 
Karen Jones, Susanna Watson

4. Sarah, John and Mary: A Carer under Pressure

Abstract
Questions to ask yourself as you read:
How does John and Mary’s story challenge assumptions about the role of ‘carer’?
 
Why do you think John was so reluctant to accept help?
 
Is it alright to like some clients more than others?
 
Karen Jones, Susanna Watson

5. Eric, Len and Nina: Growing Older with a Learning Disability

Abstract
Questions to ask yourself as you read:
In what ways might the needs of older people with learning difficulties differ from the needs of other older people?
 
Is there a tension between adult safeguarding procedures and relationship based working?
 
Why was time so important in this situation?
 
Karen Jones, Susanna Watson

Working Creatively in Organisations

Frontmatter

6. Working Creatively in Organisations

Abstract
Perhaps one of the dangers of a book like this is that, in focusing on the human ‘stories’ of social work, the organisational constraints and frustrations within which these stories take place are underemphasised. As we have already said, the social workers we spoke to rarely mentioned policy or procedure or the mountains of paperwork they probably had to complete, but talked instead about their relationships with the people they were working with. So, having spent some time looking at the centrality of these relationships, we now want to examine in more detail the reality of working life and the organisational context in which they have to be built.
Karen Jones, Susanna Watson

7. Maya and Bill: Balancing the Personal and the Professional

Abstract
Questions to ask yourself as you read:
Should social workers bend the rules for their clients?
 
Why might the boundaries between personal and professional become blurred?
 
Is self-neglect a ‘lifestyle choice’?
 
Karen Jones, Susanna Watson

8. Trish and Stella: Finding Creative Solutions

Abstract
Questions to ask yourself as you read:
In what ways do operational systems militate against good social work?
 
Can social workers really change the system they work in or can they only find ways around it?
 
How truthful should you be with someone with dementia?
 
Karen Jones, Susanna Watson

9. Sinead and Pauline: A Personal Budget

Abstract
Questions to ask yourself as you read:
What is the social worker’s role when clients are managing their own care arrangements?
 
How can operational systems support good social work?
 
What should you think about when planning a multi-disciplinary meeting?
 
Karen Jones, Susanna Watson

Difference and Disagreement

Frontmatter

10. Difference and Disagreement

Abstract
The stories in this section all involve situations of difference, disagreement, tension or conflict. None of them include violent or threatening incidents of the sort that social workers working with older people are likely to face only rarely. Rather, they are the more subtle, everyday incidents that arise when long-standing tensions resurface or when relationships become strained by changed circumstances or differences of opinion. Sometimes differences are compounded by fear, misunderstanding or the fact that those involved simply do not know which way to turn. The social workers in the following three chapters respond to these challenging dynamics by demonstrating a wide range of skills and practice approaches, while the varied contexts and situations within which these episodes of practice are set raise a number of issues and topics for discussion. Some of these are themes that have emerged elsewhere in the book as characterising good practice in any circumstance, while others are specific to the stories that follow and relate particularly to work in circumstances characterised by difference and disagreement.
Karen Jones, Susanna Watson

11. Sue and Alice: Working with Complex Family Dynamics

Abstract
Questions to ask yourself as you read:
How might family roles and responsibilities change as an older person becomes more dependent?
 
Is there a limit to how far social workers should respect people’s lifestyle choices?
 
What social work skills are needed to balance competing needs and perspectives within a family?
 
Karen Jones, Susanna Watson

12. Fiona, Jack and Esther: Supporting Unwise Decisions

Abstract
Questions to ask yourself as you read:
Why is it sometimes important to support people’s unwise decisions?
 
What are some of the challenges of working with older people who support disabled adult children?
 
Do you think that any more could have been done to promote Esther or Jack’s best interests?
 
Karen Jones, Susanna Watson

13. Judy and Dorothy: The Older Person as Expert

Abstract
Questions to ask yourself as you read:
In what ways was this intervention shaped by Dorothy’s strengths?
 
How far should family members be expected to provide care?
 
Why is a ‘critical’ approach important in social work practice?
 
Karen Jones, Susanna Watson

Rights, Risks and Good Judgement

Frontmatter

14. Rights, Risks and Good Judgement

Abstract
It would be quite possible to analyse all the social work practice we have described in this book in terms of rights, risks and social workers’ good judgement. In Chapter 8, we saw how Trish tried to ensure that Stella was not exploited financially whilst giving her as much control over her money as possible; Chapter 3 described Rachel’s work with Michael, in which she slowly and carefully worked with him to introduce support on his own terms, allowing him to make the decisions. Maya, in Chapter 7, had to negotiate with Bill about accepting some support so that he could achieve his main aim of getting home as quickly as possible. The imperative to promote a client’s rights and autonomy and yet to try to ensure that they do not come to harm is at the heart of what social workers do. It is built into our professional standards and ethics (The College of Social Work 2013; Health & Care Professionals Council, 2012) and woven into the fabric of day-to-day practice.
Karen Jones, Susanna Watson

15. Nada and Joan: Making Difficult Decisions

Abstract
Questions to ask yourself as you read:
Should social workers try to influence their clients’ decisions?
 
Would you have done anything differently?
 
Can care homes be a positive choice or only the lesser of evils?
 
Karen Jones, Susanna Watson

16. Jane and Mr Wilson: Using Legal Powers

Abstract
Questions to ask yourself as you read:
Why is multi-disciplinary working so important in this kind of situation?
 
How can intervening in a person’s life against their will be positive?
 
If Mr Wilson had refused to move from hospital into a care home, what would Jane’s options have been?
 
Karen Jones, Susanna Watson

17. Matt and David: Positive Risk-Taking

Abstract
Questions to ask yourself as you read:
What do you think David’s father might have been thinking?
 
How can you tell the difference between agreement and compliance?
 
If you had been David’s social worker, would you have done anything differently?
 
Karen Jones, Susanna Watson

18. Conclusion

Abstract
As we said in the Introduction, social workers often shy away from describing the work they do in positive terms. It may be that we are simply unwilling to ‘blow our own trumpets’, but the argument we have put forward in this book is that social work has developed a default position of negativity, a ‘deficit culture’, which has come to characterise much of what is said and written about it. At first sight, the notion of ‘best practice’ may appear to be a problematic one: there is something hard and definitive-sounding about the word ‘best’, which seems out of place in a profession that has taken critical reflection to its heart. However, in his book on social work theory, David Howe (2009) helpfully looks at the ways in which ‘best’ is used both to describe an objective, measurable outcome (the best score in a competition) and a subjective value (the best meal). He argues that, in social work, as in much of life, the judgements that we make involve both quantitative and qualitative evaluation — weighing up hard, factual evidence along with our own and others’ experiences, moral values, feelings and relationships. The question social workers constantly have to ask themselves is ‘What is the best course of action in this case?’ (p. 201). This is an ordinary, not an exceptional kind of ‘best’ — the best that we can do with this person, at this time, within this set of circumstances.
Karen Jones, Susanna Watson
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