Care workers should not be ‘Jacks of all trades’


Posted on January 30th, by geoff in Caring Times, CT blog. 5 comments

By Caring Times editor GEOFF HODGSON

Wouldn’t it be marvellous to have an open-ended training budget which included staff cover for when people were doing the courses, because there are lots of courses on offer; diabetes awareness, managing dysphagia, Parkinsons, glaucoma, macula degeneration, general sight loss, hearing loss, sarcopenia, apraxia, aphasia, renal dysfunction, skin care, dementia, end of life care, to name just a few in no particular order.

Knowledge is great, even if it’s just for it’s own sake, and where it can be applied it’s even more great, and there should always be blurred boundaries between professional disciplines as this facilitates two-way communication, but I think there is a danger that we might expect care workers to shoulder responsibilities that rightly should be borne by health professionals.

Care home residents tend to be getting on a bit and it’s a fair bet that they will suffer from one or more of the conditions mentioned above, and of course care workers should be taught about dementia, and potential problems regarding nutrition, hydration, skin integrity and the like. They should likewise be trained to be observant and to report changes in a resident’s condition. But we should not expect them to be diagnosticians, and we should not allow health services to duck their responsibilities to care home residents by setting up superficial courses on clinical practice. After all, ‘a little learning is a dangerous thing’.

I groan when I read that ‘only 20% of care home workers have been trained in recognising renal dysfunction’ or similar. That is not their role.

Well trained care workers have their own body of knowledge and professional expertise which enables them to deliver safe, compassionate, high quality care, and I would no more expect a care worker to explain apraxia to me than I would expect a physiotherapist to be acquainted with a resident’s childhood memories or dietary preferences.

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5 responses to “Care workers should not be ‘Jacks of all trades’”

  1. I appreciate that Care workers shouldn’t be expected to be clinical experts in the same way a medical/nursing specialist would, but there is value in care workers – many of whom value the opportunity for additional/more in-depth training – having a good understanding of the symptoms of particular conditions or the way they affect people’s daily lives, if only so that they can better tailor the care around their needs.

  2. Derek Barron says:

    I was left wondering – whose responsibility is it to recognise the signs and symptoms of renal dysfunction? A resident who has dementia? A resident who has a cognitive impairment and can’t fully express fully the symptoms they are experiencing? Perhaps a family member on one of their visits to the resident?

    I don’t expect care staff to reach a differential diagnosis, but I would expect them to be able to identify a reduction in renal output, a discolouration or pain, related to the impairment. As the people who have the greatest amount of contact with our residents the more knowledge they have about both health and care issues the better they will be at their job.

    We recently ran two workshops on delirium and dementia, our care staff were thrilled with this new knowledge, which in turn helps them to intervene early and hopefully divert deterioration.

    Sorry, but I think care and health knowledge are inextricably linked – they are part of the whole person, to try and divide them is unhelpful.

    DTB

  3. John Burton says:

    I broadly agree, Geoff, but how did we get here? Why have we got training companies offering training for 99p per person? Why are so many so-called certificated training courses assessed on line with multiple choice questions? Why have we got care workers who are trained to give “right answers” to stock questions on safeguarding and whistle blowing (for example) but don’t pick up the signs of abuse or neglect?
    Care work is above all relationship work. If the home that you are working in, and the organisation that runs the home, and the whole of the social care structure and ethos stops substituting “training” and “auditing” for understanding, connectedness, concern and relationships we will have real care (as we already have in many really good places). And being a top care worker in a really good place is a profession to be proud of – and should of course be paid accordingly.
    No one will thank me for saying this but 90% of social care training is dishonest window dressing, encouraged by CQC, SfC, all the big players and of course the training companies that churn out this superficial rubbish.

  4. John Burton says:

    Oh! I forgot to say that it’s Dignity Action Day on February 1st but there’s not time to get everyone through the Dignity Awareness course so you’ll just have to fake it! On Feb 2nd you can go back to normal.

  5. geoff says:

    In answer to Derek’s comment, I suggest that it is the GP’s responsibility to recognise the signs and symptoms of renal dysfunction. I believe it is the care worker’s responsibility to report the signs and, where the resident makes them known to the care worker, the symptoms, and to observe fluid intake and output and encourage good hydration.One does not need to go on a course in nephrology to be able to do that.


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