Reflective Case Studies

Cherie Bryce - Reflective Analytical Study

The purpose of this reflective analytical study is to focus on a piece of work undertaken whilst on placement; I will look to reflect on my ability as a practitioner with focus on my knowledge of theoretical approaches and understanding of legislation, policies, and procedures. For my first direct placement as a social work student I have been part of a local authority Community Care Team (CCT), working with adults over the age of 65 or living with disabilities. Through this placement I have been given the opportunity to work alongside individuals and carers, assessing their needs and implementing service that can best support them.

To comply with the Data Protection Act 1998 and to respect the dignity

and privacy of the service user (Scottish Social Service Council (SSSC) 1.4) I will refer to the individual as Case F throughout.

Case F is a white, 89 year old female who lives at home. Case F never married and never had any children however she has a strong relationship with her niece who provides emotional and financial support.

I was allocated as Case F’s case worker after her niece requested for a community care assessment to be undertaken to consider Case F for residential care. Case F was currently in hospital after being admitted for a chest infection. Case F felt she was unable to carry on living at home on her own and felt her needs would be better met in a care home. Case F has been known to the service since July 2013, she has had a number of previous assessments complete of her needs by social work. Case F lives alone with a sheltered housing complex, she was an active member of the shelter housing community regularly taking art classes and contributing to coffee mornings.

As Case F has had previous contact with social work, information was stored on the Social Work Information System (swis); this provided me with a good basis to collect information in relation to Case F’s circumstances both past and present and prepared me for social work contact. To allow for me to gain a holistic perspective of Case F’s situation I used Collingwood et al (2005) The Three Stage Theory Framework Stage 1 – KIT, placing Case F in the centre, I was able to note all information sourced from previous assessments and professionals in relation to Case F, this included personal details, likes and dislikes and family. I found this tool particularly helpful to collect and consolidate information into one

single form. However I ensured I was being open minded as the information may not be reflective of the current circumstances.

Legislation provides local authorities and in turn social workers with duties and powers, as a student within a community care statutory social work office I have been giving the responsibility of carrying out such duties. From my experience on placement I have found the Social Work (Scotland) Act 1968 to be the overarching piece of legislation that outlines my role and powers, section 12A (1)(a) of this act details the local authority’s duty in relation to assessing needs for services. Case F’s niece requested for Case F’s needs be assessed for residential care, as her allocated case worker it was therefore my duty to assess Case F and determine if, under the local authority’s Fair Access to Care Policy (2016), her needs were sufficient enough to be provided with a service. Abiding by S 12 of the Social Work (Scotland) Act 1968 I ensured I provided advice and guidance to Case F whilst promoting her wellbeing.

As detailed by Dunk-West (2013), assessments are fundamental in social work practice as they highlight needs. Within the organisation the assessment paper work is referred to as a Joint Assessment, also known as a J1, completed alongside this is a support plan known as a J3. By taking an exchange model approach to the assessment, as outlined within Lishman (2009) I ensured I saw Case F as an individual, I included her views as well as the views of professionals involved such as the GP and hospital nursing staff allowing me to gain a wider understanding of Case F’s circumstances and abilities. Stepney & Ford (2012) suggests this approach is an empowering method. However I felt this was unsuccessful at times due to Case F’s low motivation and confidence in herself. I focused on reminding Case F of her abilities and the assets she obtained, I continued this empowering approach to encourage Case F to take control of her life as she is the expert of her situation, Okon (2011). I was aware of my presences as a worker and I ensured I showed empathy, listened and took a non-judgemental approach, as noted by Lishman (2009) these attributes are importing to service users.

When analysing the information I had collected I felt it particularly helpful to consider Hopkins (1978) systems model of assessment. This approach allowed me to consider Case F’s situation, taking into account social, economic and political factors that influence her. I felt it was a variety of past experiences, health and influence from family that all contribute. I will explore her past experience late in this paper taking a theoretical approach but in terms of

her health Case F is prone to infections in her chest due to chronic obstructive pulmonary disease (COPD), each time Case F suffered an infection she then worried she was going to die alone, in turn this had a knock on effect on Case F’s mental health.

Anxiety would arise resulting in Case F wishing to live in a care home with carers present 24 hours a day. A pattern of behaviour was apparent throughout previous assessments and case notes. In addition to this I felt Case F’s niece was worried for her aunt due to her past experience of a supporting her father through a move to a nursing care home, circumstances relating to this differed significantly to Case F’s situation however, reflecting back I feel the anxiety from Case F’s niece was projected on to Case F adding to her own

worries.

Looking at Howe (2009) I considered what was the best course of action was for Case F, although I had gathered evidence, taking an evidence based practice (EBP) approach to assess and analyse the situation did not provide me with the answers in relation of what to do next.

It was my professional judgement that was required to make a decision. Looking at the discussion by Gibbs & Shlonsky (2004) EBP is a systematic way that includes evidence to answer questions whist considering the service user’s opinion and views as well as professional judgement. At this point I felt nervous and doubt my abilities, I remember wishing for my practice teacher to just tell me what to do, however looking back this was a milestone development for me on placement, I began to feel confident that the work I undertook as part of the assessment fully supported my professional decision and therefore I felt I had made the right decision for Case F to return home. This decision was not accepted by Case F’s niece who disagreed with my decision. She began to question my ability as I was a student and asked if I was qualified to be doing such assessment, I suggested she could come and meet with my team manager and I to discuss the decision

further.