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07th January 2016

A Little Knowledge is a Dangerous Thing? (Part 2)

knowledge-dangerous-thing-part-2In the first blog on this topic we looked at the overriding importance of the relationship between direct support staff and service-users, and ways in which this serves as a two-way conduit for information flowing between the service-user and all elements of the service being provided. The forthcoming Social Services and Wellbeing Act (Wales) points out the need for a “knowledgeable workforce,” and we looked at internal and external barriers to front-line workers gaining clinical knowledge in addition to their understanding of people as individuals.

Knowledgeable Workforce

While accepting that many organisations are very committed to training their staff, it is fair to say that, for many other organisations, training has traditionally been seen as something of a nuisance and an unnecessary drain on resources. As a long standing training provider, I can safely state that hardly a week goes by without a prospective customer asking me to cut down the time that courses take, or to squeeze an impossible number of topics into a single day. When coupled with inspectorates’ expectations of certain topics being mandatory – such as Manual Handling, Basic Life Support, Health and Safety, Safeguarding etc. Once these are completed, there is all-too-often a mentality of “wind them up and off they go” in terms of releasing staff into the workforce.

The Social Care Induction Framework

The introduction of the Social Care Induction Framework, which we have had for the past 18 months but which is set to be enforced more stringently from April 2016, is thankfully a move away from this minimalist approach to staff training. The courses include such vital topics as Communication Skills, Personal Development and Person-Centred Support. These undoubtedly go some way to giving staff a much more holistic, integrated and rounded view of their role.

In the first part of this blog, however, we noted that direct support staff are in a unique position to notice when a person is experiencing ill-health, through being able to spot minute changes in appearance, emotional expressions, vocalisations, compliance and behaviour – to name but a few signs. Staff gaining clinical knowledge to further help them identify the early warning signs of ill-health has been seen as something of an evil, however, either because of the territoriality of experts in the field, or because of fears that this will lead them to label service-users by their conditions. There may be some justification in this second fear – but at the same time we could argue that important signs can be missed if staff members do not know what they are looking for. Occasional and unexpected lethargy, coupled with a particular urine odour, might herald the early onset of diabetes, for example. In the mental health field, a person being preoccupied and suspicious nay signal a relapse into a preventable episode of psychosis. In both these cases, the direct support worker is uniquely placed to spot these early signs.

So do we need to equip direct staff with some clinical knowledge, as well as the very necessary person-centred training that is forthcoming under the SSWA? Our argument is that there is a compelling case for doing so.

*All information is correct at the time of publishing

Nic Bowler

Welsh Care and Social Services Inspectorate Specialist

Dr Nicholas Bowler is a researcher and consultant to government-level [Welsh Government Review of Secure Services, 2009] – specialising in QA/compliance focused projects. He has interests in clinically relevant training, service development and research. He enjoys working with clients to support them in identifying problems and initiating projects to improve practice.

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