Professionalism can be defined as an occupation that has a legal status and requires a person to have a specific set of skills and body of knowledge that could help them in performing their duties (Garvan, 2016). Social care can be defined as a profession that involved organizing and providing quality care services for individuals or groups of vulnerable people (McElwee, 1998). Professionalism, in the context of social care, is important so that care users get high-quality and assured service delivered to them in an ethical and sensitive manner (Grant et al, 2018). Professionalism in social care has evolved in Ireland over a period of a century, and is still, probably in need of more changes. This assignment will, therefore, highlight the history of social care and growth of professionalism in its context, and then move on to discuss reflective practice.
The history of social care in Ireland can be traced back to as early as 1858, when it was limited to providing reformative treatment to adolescents and young adults through Reformatory Schools, as mandated by the courts under the Reformatory Schools (Youth Offenders) Act. Next came the industrial school system, which by 1970 had processed over 170,000 young adults or children (WHO, 1961). The Catholic institution also developed a large number of schools, hospitals and reformatory institutions managed by the nuns in Ireland in the 20th Century (Skehill, O’Sullivan& Buckley, 1999). The change from social care as planned or voluntary activity to social care as a professional service was brought about by public disclosure of several terrible cases of child abuse in Ireland, both within the context of their families and at the hands of institutions (Kilkelly, 2012). In January 2002, an Expert Review Committee found that only 55% of social care workers engaged in childcare were qualified and made recommendations to introduce professionalisation. This was followed by the passing of the Health and Social Care Professionals Act 2005 legalising the status of social care workers. Social care workers have to undergo intense training that develops their skill sets and knowledge level and prepares them emotionally and cognitively to handle situations that they may encounter in practice. It also requires that professionals are able to self-reflect and understand their own feelings and thoughts and make the most suitable decision for the people they are supporting (Moss, 2017). The social care workers, in order to get certified, need to undergo training and grounding in the different models of care delivery, which are the holistic model, social model, bio-psychosocial model and empowerment model, and also conform to the code of professional conduct and practice.
Care is defined as a planned and professional service that is delivered to vulnerable groups or individuals who may have special needs due to their being marginalised or disadvantaged in any way. Caregivers are expected to professionally guide, support and provide physical care and counseling in an ethical manner (SCI, 2019). Since the care receivers belong to diverse range of backgrounds, ages, ethnic or cultural orientations, genders, and may need very specific and targeted needs, it is essential that care is delivered to them in a professional manner by caregivers who are trained to work at their optimum in difficult situations (Grant et al, 2016).
Social care comes usually with healthcare and social care spending is increasing at a faster rate than that of healthcare spending. In OECD countries, the spending is 5 percent higher than healthcare spending. Netherlands and Sweden have highest priority for social care, and they spent the highest. However, the highest increase in social care expenditures was in Korea which is a 44 percent increase. These figures are much over the OECD average for social care spending which is only 4.8 percent. Thus, Ireland’s social care is much similar with other notable countries in OECD which include UK, Australia, France, and Germany as they have similar conditions as Ireland (OECD, 2019).
The Health Information and Quality Authority (HIQA), Ireland, is a body dedicated to improving social care services in Ireland through continuous scrutinising of quality-of-service delivery. It operates under the Ministry of Health and sets standards for health and social services, conducts investigations, and scrutinise delivery of quality care and safety, and is responsible for generation and dissemination of information on the subject. An example of such investigations was presented in 2013, when HIQA investigated the case of Savita Halappanavar, a pregnant woman who died at University Hospital Galway, and where HIQA found general lack of provision of fundamental care and timely decision making by her care providers (Health Information and Quality Authority, 2013). research conducted by O Leary (2017), 6 social care professionals and 119 social care students found that almost half the respondents were not able to link theory to practical situations, and a similar percentage acknowledged that they did not believe that it was of any significance to connect theory to situations. Another alarming finding reported by O Leary (2017) was that nearly 50% of the students were passed with barely minimum standards, simply because their supervisors believed that the students would be able to learn on the job. Other investigations include the Kilkenny Incest case 1993 (Skehill, O’Sullivan & Buckley, 1999); Roscommon case 2010; Tuarim Report – ‘Some of our children’ 1966; Kennedy Committee Report 1971; Newton House and Madonna House Inquires 1990s; Ryan report 2000; and Leas Cross Report 2006 (Kilkelly, 2012).
The above lapses called for establishing specific codes of performance and behavioral conduct for care workers. Also, structural formalisation was introduced in the way care was delivered, reporting was undertaken, and accountability was established (Skehill, O’Sullivan & Buckley, 1999). Ireland established the Health Information and Quality Authority (HIQA) under the Ministry of Heath, and after the passage of the Health and Social Care Professionals Act (2005), CORU (Health and Social Care Professionals Council) started regulating professionals by promoting high standards and has initiated the registration board for registration of social care workers in 2015 (SCI, 2019).
The social model of care places the care user at the center of care and dictates that all planning be done in the person-centered manner and keep the individual needs of the care user in focus. The social care model states that caregivers need to focus on the strengths of the service users and family, rather than work towards eliminating their weaknesses. This strength-based approach is targeted at empowering the service users and reducing their dependency on professionals being strength based and need focused, this model also calls for a partnership approach where the care user and caregivers make joint decisions, and also involve inter-agency cooperation in order to deliver the optimal care to suit the needs of the service user. Also, this model calls for community integration as well as reflective practice for the professional – where the caregiver is engaged in self-reflection and evaluation in order to arrive at better solutions. According to John O’Brian, there are five accomplishments that a professional caregiver needs to aspire for – enabling his care user to participate in the community, get respect and dignity, exercise choice, enjoy social relationships and learn competence to perform meaningful activities (O’Brian, 2019).
A professional caregiver needs to be a reflective practitioner, so that he or she is able to connect the practice to theoretical knowledge and refine his behaviour (Thompson, 2009; Fook, 2015; Thomson, 2009). Reflective practice enabled me to assimilate this learning and build upon my experience with my service users. As a professional, I follow Kolb’s (1984) experiential learning approach by indulging in reflection after I go through the cycle of abstract conceptualisation, active experimentation and concrete experience (Smith, 2016), and in this manner, I am able to link my concrete experiences with theory and build upon my previous knowledge further (Kolb, 1984).
I also align my approach with the new model of care, which is holistic in nature and aims to consider the physical along with psychological, social, spiritual and environmental needs of the care user. Also, reflective practice enabled me to manage the ethical code of conduct and to perform well on key identifiers of professionalism, which are – having the knowledge base, attitude, being responsible and autonomous, and having a positive public image. Also, CPD proposes that have encouraged me to reflect as an integral part of each stage of my service delivery, have helped me to review, plan, implement and demonstrate my knowledge well.
This assignment traced the evolution of professionalism in social care in Ireland from early 19th to the 20th Century, where social care started being seen as a professional undertaking, requiring people who were knowledgeable, trained, skilled and had the right attitude to operate in complex situations. Also, the structural changes in the care delivery system – the setting up of the HIQA, the SCI, the Health and Social Care Professionals Act 2005, the CORU registrations and CPD were discussed. The person centric and the holistic model of care were discussed and the importance of professionalism in delivering care underscored. The importance of reflection in personal practice as it is related to personal work experience was also discussed.
References
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Garvan, J. (2016). At the crossroads: the health and welfare of new mothers. Contemporary nurse, 52(6), 753-770.
Grant, A., Lagdon, S., Devaney, J., Davidson, G., Duffy, J., Perra, O., &Monds-Watson, A. (2018). A study of health and social care professionals’ family focused practice with parents who have mental illness, their children and families in Northern Ireland. Final report. Belfast, Ireland: Queen’s University.
Health Information and Quality Authority. (2013). Investigation into the safety, quality and standards of services provided by the Health Service Executive to patients, including pregnant women, at risk of clinical deterioration, including those provided in University Hospital Galway, and as reflected in the care and treatment provided to Savita Halappanavar. Retrieved from: https://www.hiqa.ie/sites/default/files/2017-01/Patient-Safety-Investigation-UHG.pdf
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Retrieved from: https://socialcareireland.ie/wp-content/uploads/2018/01/O_Leary-S_Professionalisation-Managing-Quality-in-Social-Care-Education-new.pdf
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