Reflective Paper on Support Worker Intervention

My placement took place at a charity agency that have 30 different services across West and North Yorkshire offering supported housing, intensive housing management, floating support, training, community cafes, gypsy and traveller sites and drop-in to vulnerable people in society. The agency works with a wide range of clients including people who are homeless, have mental health, drug or alcohol issues, young and old people, refuges, gypsy, travellers, Roma and people with disabilities. My placement lasted 70 days. I will use Gibbs model of reflection to critically reflect and analyse my work experience with Mr Kingstone. Gibbs reflective model follows 6 steps, description, feelings, evaluation, analysis, conclusion and action plan. An overall conclusion will be given to show how valuable Gibbs reflective tool was.

My role within the agency was of support worker allocated to Mr Kingstone, a black unemployed single male of Caribbean descent aged 55, whose kidneys are failing. Mr Kingstone was referred by another agency. I shadowed a colleague who carried out his needs and risk assessment. Mr Kingstone’s accommodation was in poor state and needed repairs. He struggled to maintain his tenancy because he could not manage his money and pay bills. He did not have any white goods or possessions. There was no carpeting, gas, electricity or food in the flat. Mr Kingstone looked frail and malnourished and presented with poor personal hygiene. He appeared to live in isolation(D4). The summary of needs and risk assessment highlighted high need to relocate Mr Kingstone to a suitable accommodation, apply for grants to buy white goods and carpeting, support him to maintain his tenancy and maximise his welfare benefits. There appeared to be no other services involved besides the hospital carrying out further tests. Mr Kingstone was rehoused. It was at this point I was appointed to support him to meet his needs in order to maximise his wellbeing and live independently(D4). The practice setting was Mr Kingstone’s flat as chosen by him. The time span for the work is long term lasting up to 12 months as per agency policy but either part can terminate at any time. My contact with Mr Kingstone was short term lasting 8 weeks because I was allocated him near the end of my placement. The level of intensity as per agency’s policy was moderate. Work was ongoing and contact with Mr Kingstone was occurring once a week. Review was due at 3 months. During my work with Mr Kingstone, my support came from discussions in supervision with my supervisor and practice educator and also from consultation with my work colleagues, as well as using social work theories and methods of intervention(D1, D5, D9).

Prior to my intervention, I had mixed feelings. I was excited and looked forward to working together with Mr Kingstone to enable and empower him and bring social change if possible through finding solutions to what he perceived as his problems so that he could maintain his wellbeing and independence in all key areas of his life(D4). I also felt apprehensive about the outcome of my intervention. I was not sure whether it would have an impact on Mr Kingstone’s life. My anxieties also came through pressure from myself. I felt incompetent and overwhelmed by the paperwork and accountability involved in the process. In planning and preparing for my intervention, I reread Mr Kingstone’s needs and risk assessment to familiarise myself with the needs and risk identified because these would inform my intervention. To build my confidence, I familiarised myself with all the documentation I needed to complete in relation to the intervention. I also familiarised myself with my agency’s policies and procedures on lone working(D1; D8). I researched theories and models that put Mr Kingstone at the centre of the intervention(D5; D7). I researched on legislation and policy on Housing, Mental Capacity Act 2005 in relation to Mr Kingstone making his own decisions about his needs, Care Act 2014 and the wellbeing principle in relation to enhancing Mr Kingstone’s dignity and control over his life, Benefits policy on Personal Independent Payment in order to maximise Mr Kingstone’s benefits, and Data Protection Act 2018 in relation to sharing information about Mr Kingstone appropriately and respectfully(D5). I also researched on relevant interventional skills. During my intervention, I found it difficult to communicate information on time with Mr Kingstone because he did not own a mobile phone or landline and did not have any next of kin, family or friends. Communication was either in person or hand posting letters(D6; D7). I had to be flexible to fit in with Mr Kingstone’s circumstances. In my opinion, at the end of my intervention we had created a rapport.

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Evaluating my intervention, I managed to carry out a support and risk management assessment in partnership with Mr Kingstone and drafted a support plan(D2). The plan set the goals Mr Kingstone wanted to achieve, the tasks to be undertaken to achieve the goals and reduce risk, person responsible for the tasks, time scales to complete them, record of task progression and task outcomes and date. In recognition of Maslow’s (1970) hierarchy of needs, I had to satisfy Mr Kingstone’s basic biological needs first. Recognising the importance of community resources, I registered him with a food bank and sourced him some household goods from charities. I applied for community grants to buy white goods and carpets. I supported Mr Kingstone to update his records with his General Practitioner, water supplier and post office(D4). I shared information about local GPs and foodbanks nearby(D9). I have learned that qualities of empathy, patience and humanity are important when supporting someone so is honest, reliability and being able to work with the person at their own pace. I became concerned when Mr Kingstone changed his mind about maximising his benefits. He said he did not want to be involved with the “hassle” of the process. I respected his autonomy and self-determination(D2). My work experience with Mr Kingstone challenged my values. I grew up within a large extended family and caring community. People checked on each other often. This helped to keep the social relationships going and lifted people’s spirits. I value my family and friends and structure my life so that I can spend quality time with them. The experience also made me appreciate the values of treating people with compassion and respect, being mindful of individual differences, cultural norms and ethnic diversity(D2). Mr Kingstone appeared to prefer his own company.

Analysing my intervention, I chose practice approaches of person centred and task-centred, perspectives of anti-oppressive and empowerment, assessment method of exchange model, practice and interventional skills of assessment, information gathering, listening, observation, providing information and explanations, working in partnership with the client, managing professional boundaries, record keeping, creating a rapport with the client and advocacy.

I chose the exchange model of assessment (Smale et al. 1993) so that the assessment and the process reflected Mr Kingstone’s agenda. Even though I was his support worker, I recognised that Mr Kingstone is an expert in himself (Smale et al. 2000). This assumption conditioned the definition of goals and the communications between me and him, which took the form of an exchange in which power in assessment was shared(D2).

I chose the task-centred approach (Epstein and Brown 2002) because it is time limited, structured and goal-oriented. Using the task centred model phases, I helped Mr Kingstone to identify the problems as he perceived them at the time. I assisted him to break down and detail the problem areas and redefined these where necessary. I encouraged Mr Kingstone to prioritise the problems according to his own views. His goals were to receive the correct benefits, apply for grants to buy white goods and to develop tenancy skills. Mr Kingstone and I worked in partnership to identify the outcomes and agreed on a contract. We set a review date of 3 months to evaluate progress(D2). In my opinion, task centred approach helped me to instil confidence, trust and hopefulness in Mr Kingstone by enhancing his capacities and strengths thus empowering him and enhancing his self-esteem. I drew on a range of skills such as active and accurate listening, observation and information gathering so that I could make an effective intervention(D7). I was trying to see and understand what might have caused Mr Kingstone to live the way he does. Mr Kingstone appeared mentally competent and understood the consequences of living under conditions such as his. Person centred approach (Rodgers 1961) enabled me to develop a non-authoritarian, significant and meaningful relationship with Mr Kingstone(D7). Through working in partnership with him and applying a problem-solving focus, we were able to address some his presenting needs.

In choosing the anti-oppressive perspective, I understood that Mr Kingstone’s life experience may include oppression. I also understood that there might be other divisions occurring because of inequality and discrimination, such as poverty, living in a disadvantaged geographical area, mental distress and employment status(D3). Mr Kingstone is a single, middle aged, black, unemployed, male, of a particular class background and living in poverty. He has dreadlock hair and presents unkempt. In my opinion, people might ascribe him stereotyping and labelling characteristics. I also recognised the impact on Mr Kingstone of the power invested in my role as his support worker. I minimised power hierarchies by asking how he wanted to be addressed, in setting relationship boundaries(D1). He chose to be addressed as Mr Kingstone. I wrote the record of the assessment and support plan jointly with him and asked if he wanted copies. Each week we discussed and agreed on tasks to be tackled. I advocated on his behalfand saw him in a holistic and human way(D4).

In conclusion, my intervention was successful because I worked in partnership with Mr Kingstone. I should have used narrative approach (White and Epston 1990) to enable Mr Kingstone to describe his own life in his words so that I could know him better. I was limited by the time frame allocated for each visit. The idea of using a strengths perspective (Saleebey 1996) sounded appropriate at first but became a challenge for me because Mr Kingstone appeared reluctant to engage with any service. I could not use the systems theory (Bronfenbrenner 1979) because Mr Kingstone was reluctant to talk about his life experience and he did not have any next of kin or family and there were no other agencies involved with him from whom I could gather more information about him. During my intervention I discovered that there were times I wanted to do things to help Mr Kingstone in respect of his accommodation, health benefits and social interactions. I have recognised that this was my own value base of wanting things to be sorted out for him. I have also learned I need more knowledge and skills of working with people who self-neglect and are socially isolated but have full capacity.

I plan to improve my knowledge and skills by researching and understanding theoretical knowledge about effective social work interventions and social knowledge that will help me to solve problems I confront in my daily practice. I will concentrate on sources of knowledge, for example books and articles, that come directly from social work practice and its practitioners. I also need to gain more confidence in support planning so that I am able to take a client centred approach. I will meet the objective by shadowing and asking for support from my colleagues and discussing in supervision with my practice educator. This will help me to strengthen my professional confidence and development.

Gibbs reflective model helped me to look at different aspects of my intervention with Mr Kingstone in detail. The model helped me to promote self-improvement by identifying my strengths and weaknesses and acting to address them. I was able to link practice and theory by combining doing and observing with thinking and applying knowledge. I explored different ideas and approaches towards doing and thinking about things. It was an easy model to use and I now understand the value of reflective learning and of using a reflective model.

References

• Bronfenbrenner, U. (1979) the ecology of human development experiments by nature design. Cambridge: Harvard University Press.
• Epstein, L. and Brown, L. (2002) Brief treatment and a new look at the task centred approach. 4^th edition. Boston: Allyn and Bacon.
• Data Protection Act (2018) http://www.legislation.gov.uk. Accessed 12 October 2018.
• Department of Health (2005) Mental capacity act. London: TSO
• Department of Health (2014) Care and support statutory guidance: Issued under the care act 2014. https://www.gov.uk/government/publications/care-act-statutoryguidance/care-and-support-statutory-guidance Accessed 14 October 2018.
• Maslow, A. (1970) Motivational and personality. New York: Harper Collins.
• Rogers, C. R. (1961) On becoming a person: A therapist’s view of psychotherapy. Boston: Houston Mifflin.
• Saleebey, D. (1996) the strengths perspective in social work practice: extensions and cautions. Social Work 41, 296-305.
• Smale, G., Tuson, G., Biehal, N. and Marsh, P. (1993) Empowerment, assessment, care management and the skilled worker. London: HMSO.
• Smale, G. and Tuson, G. (2000) Social work and social problems. Basingstoke: Macmillan.
• White, M. and Epston, D (1990) Narrative means to therapeutic ends. New York: Norton