Registering the Professional Social Care Workers

If you found yourself in need of social care services, perhaps in need of someone to help you with your incontinence or perhaps someone to help you through your day and support you in making sense of the world when your mind has been attacked by dementia, wouldn’t you want to be assured that person is a professional, qualified and registered with an appropriate authoritative body.

In the same way as nurses are registered, doctors are registered, and even, in the last few years, social workers are registered.

Registration means that those practising are more accountable, not just to the body they are working for but also to a national professional organisation who set out the standards and code of conduct as well as taking action against those who fail to meet these standards, with the option of preventing the worst offenders from being able to practice again.

One of the advantages of professional registration is that it gives the individual personal responsibility for their work, conduct and professional development. Personal responsibility is an important motivator to continued professional development as well as being an important factor overall job satisfaction.

There has been a trend, in public services, over the last twenty or so years to move away from this professional accountability by creating another layer of workers below the established professionals, Community Support Officers have been introduced into policing, Teaching assistants in schools have been given greater responsibilities for supervising classes, healthcare assistants have been introduced into the NHS and care managers (or social work assistants) into social services.

One of the key elements of this new level of workers is that they do not need to be registered with professional bodies.

Whether you agree with this trend or not there is an important difference between these unregistered workers and the unregistered workers in social care and that is they sit below the established layer of registered professionals who, in the eyes of the public, take an element of personal responsibility for the particular service provided.

As social care braces itself for another example of abuse in care from Panorama we need to look at the registration of social care workers again.

The idea of registration has been floated about for a decade now with the implementation being off and on so many times I have lost count but we need to seriously take steps toward achieving it.

Of course, being a registered professional does not eliminate bad practice, there a plenty of examples from the General Medical Council or Nursing and Midwifery Council to demonstrate that, but it does give the general public a sense that when things go wrong there is a layer of justice in the system that does not only blame ‘the system’ but tackles the individual. This also helps the professionals in question, the system of personal responsibility allows those who do good work to distance themselves, professionally, from those who fail.

There are many thousands of social care workers in the country who will, it seems, be tarnished by the actions of a few rouge individuals. Professional regulation would, to a certain degree, mitigate this a little. It would help to demonstrate that these heinous individuals are the exception rather than the rule and that, when they are discovered, they will be unable to practice again.

The logistics of professional registration for social care workers are a minefield, which is why it has been constantly delayed, but with more and more people needing some form of social care services surely it is more important than ever. It is also important that social care workers can be recognised as professionals who are providing personal services for the most vulnerable in society.

Let’s start recognising the professional work of the many to counteract the hideous acts of the few

Whose Responsible - Unblurring the Boundaries Will Help Care Provision

Much of the debate surrounding social care at present focuses on funding issues, who pays, how much should individuals pay etc. yet there are significant other issues that need to be addressed.

One of these is how the interface between public services and private providers operates.

Yesterday’s report on healthcare in care homes published by the Care Quality Commission has, perhaps inadvertently, highlighted the issue of where responsibility lays at this interface.

The report states “some homes did not adequately demonstrate person-focused care planning” and “just over half of residents (55%) were aware that they had a care plan in place that sets out their needs.”

Yet contrast this with another recent CQC document entitled ‘What standards you have a right to expect from the regulation of your care home’ (see document here) which states that people who use services should “get the care that you and your social care professional agree will make a difference to your health and wellbeing.”

Comparing the two does raise the question – who has responsibility for care planning, the home or the social services professional? And who has the responsibility for ensuring that the person using the service is aware of that plan.

Obviously  it is important  that both work together  with the individual in preparing the plan but where does the ‘final’ responsibility actually lay? Implementing the plan of care naturally falls with the care provider but once a person enters a care home how much monitoring of that plan takes place by social service care management?

Added into this needs to be the role of healthcare professionals in care planning, the demographics of care provision have changed dramatically over the last 20 years, people are likely to be much older when needing care home provision and are likely to have much greater health needs, particularly due to the fact that dementia is not classed as nursing need despite being a disease, so many of those with dementia are in ‘residential’ rather than ‘nursing’ homes.

With older people in care age related medical conditions need addressing in care planning – who is responsible for ensuring that appropriate health professionals are involved in this? In addition there should also be some form of involvement by those health professionals in assessing the health care needs on a regular basis.

Quite rightly there is a drive to ensure personalisation and independence for all those who access care services but at the same time this should not diminish the responsibility of professionals to ensure effective care planning is in place. Unfortunately the current system has an interface between public service and private provision that blurs the boundaries of responsibility and the only people who lose out because of that are the people who use services.

As the debate on the future of social care moves forward we must look beyond the question of who pays and play closer attention to the issues and responsibilities that have a direct impact on the quality of care provided.