Why we shouldn't disregard care worker expertise in care

Last week I attended a day long session as part of my social work course titled "working in partnership" and included lectures and discussion about how social workers can work more effectively with service users, carers and other professionals. At the end of the day we had a safeguarding role play which assigned the roles of social work manager, social worker, CPN, care manager and day centre manager to students and asked them to consider the fictional case of an elderly gentleman, about whom safeguarding concerns had been raised. The "meeting" continued as might be expected with students assuming their roles and discussing the case appropriately. The issue came at the end of the session when we discussed the fact that "Mr Grant" had not been present and how this could have affected proceedings.

One of the students made the point that although Mr Grant had not wished to attend, it might have been helpful for the carer who had been visiting his home to attend the meeting in his stead. This idea was immediately brushed off by the academics present who questioned if the worker would have wanted to attend. They also questioned whether this was a suitable environment for the worker to be present in and seemed to imply they wouldn't have understood the "high level" discussion being made. This struck a number of students in the room who had been working as carers before taking up the course as extremely dismissive and seemed to embody precisely the stigma we had been taught not to avoid throughout the day.

Disregarding the personal views of a few academics, this was not the first time I've felt that care workers aren't seen as an important part of advocating for service users. In the past I worked at a residential school for autistic children. When social workers would visit they would spend a long time speaking with managers, a short amount of time speaking to the unit team leader but no time talking to the support workers. While I accept that some discussions wouldn't need to involve "frontline staff," it always seemed bizarre to me that the social workers wouldn't want to consult with the people who spent the most time with the children they were supposed to be caring for. Similarly in a mental health setting, it was the managers who would be consulted at length, whereas health care assistants were seen as unimportant. 

Attention has been drawn in the media lately to the role of carers and the importance they have to the advocacy and empowerment process, but this seems to have passed by the role of paid, professional carers. In reality paid carers, where there are no relations to advocate and where the service user is unable to self advocate, should be given primacy as it is these workers who spend the most time with the service user who needs the help. All too often care workers get written off as "unqualified" - a by word for "doesn't have a clue," but this disrespects the worker and wastes their valuable contribution. It also disrespects the everyday experience of the service user as it ignores the fact that they probably spend more time (15 minute visits aside!) with the care worker than anyone else. Effective "Partnership working" must include every part of the partnership, to ignore one part of it doesn't help anyone, least of all the service user.