Home visits are central to social work but reflecting on the initial contact between a social worker and the person they visit, and the identity of a social worker as a 'visitor' has received little attention in research.
Our co-produced research has found that central to the success of home visits are the small gestures social workers engage in that demonstrate their respect for the person as host. This is vital to going a small way to addressing the inherent power imbalance that exists between a social worker and individual or family. The research project and findings were conducted by myself, Liam Toner (Sheffield City Council) and Michaela Rogers (University of Sheffield).
The project, funded by the Crook Public Service Fellowship University of Sheffield, adopted a participatory research method to explore the perspectives and experiences of social workers and people with experience of adult social care services. The aim was to deliver a co-produced project to develop a shared understanding and increase the relevance of the research questions and research outputs (Jagosh et al., 2012). Public involvement through co-production is an international trend (Brett et al., 2014) and is embedded in UK policy regarding social work and social care research (Department of Health 2012; Social Work England).
The research group included people with lived experience, carers, social workers, social work students and researchers.
The research found that small gestures help to facilitate and enhance a relationship-based approach which is central to social work education and training. Gestures such as accepting a cup of tea, making small talk and offering to take shoes off at the front door may seem like ‘small gestures’, but to a person whose home it is, these gestures are meaningful and symbolic.
Our research identified that people who use services often feel disempowered in their own home by the actions of social workers. The social workers in the group felt that time pressures and an emphasis on ‘professionalism’ meant they were constrained about how sociable, friendly or even vulnerable they could be during home visits.
The group discussed how ‘professionalism’ is used by some as a shield behind which they hide when they need to make difficult decisions as well as a way for social workers to maintain their power. When talking about social workers using the phrase ‘I’m a professional’, one group member commented ‘I know you’re a professional! You don’t need to tell me you’re a professional; we can see that in the way you act. Show me you’re a human!’ For members of the group then, professional social workers were those who would:
- listen
- be emotionally intuitive
- respect the expertise of the person they are working with, their family and their support network
- show vulnerability
- be honest
- develop, sustain and end a relationship
- arrive well prepared
- bring their training, skills and expertise to the table as a resource to share.
This model of ‘professional’ in social work is grounded in the lived experiences of disabled people and practising social workers. There is a continued expectation that professionals will be competent, well trained and will know how to do their job but this definition centres the importance of relationship-based practice.
‘When people come and don’t have a drink and don’t engage, are not on time and haven’t read my notes - this is unprofessional in my opinion, which is different to the professionals’ idea of professionalism.’
Expert by Experience, Sheffield.
Our work continues
Following the project we secured further funding to develop accessible outputs and training resources. We developed mugs and posters and sent them to social work offices to remind social workers before they go out on home visits that small gestures count and can go some way towards facilitating meaningful engagement. We then developed training resources and videos for practitioners and social work students to think about the effects a home visit can have on the person being visited and how the social worker can re-evaluate and reframe what it means to be professional in this space.
The training is currently being delivered and the feedback shows that 100% of attendees found it useful. 100% said it would have at least some impact on their home visits, how they understand professionalism and in using small gestures.
A short film has been developed describing this research.
Contact
If you are interested in learning more about the training or would like access to the resources, please contact Rachael on Rachael.black@sheffield.ac.uk.
References
Department of Health. (2012). The health and social care act
Jagosh, J. et al. (2012). Uncovering the Benefits of Participatory Research: Implications of a Realist Review for Health Research and Practice’. The Milbank quarterly, 90(2), pp. 311–346.