Abstract
This thesis explores social work with older people living in care homes in England and considers the multiple influences at a personal, professional, organisational and structural level. Social workers’ involvement with care home residents is limited, mostly focused on admission, reviews or safeguarding, and receives little attention in social work research, education or practice. This qualitative study used focus groups (n=4, total participants = 20) and interviews (n=9) with social workers to explore the influences on their practice and to examine the tensions and dilemmas relating to their role. Reflexive thematic analysis was used to analyse the data (Braun and Clarke, 2022).The study draws on several theoretical perspectives, including ‘relational austerity’(Hingley-Jones and Ruch, 2016) and the psychodynamic construct of defences against anxiety, to explain how managerial procedures hinder relationships and connection. The findings indicate that local authority structures, the construction of care homes as ‘safe places’, and the socio-political landscape limit social work’s potential to support older people in care homes. They expose a disconnect between what social workers are mandated to do by their organisations, what they want to do and the constraints they encounter. Social workers’ personal and professional values and responsibilities can collude, collide or connect with organisational and policy imperatives, and this effects how they manage the dilemmas they encounter. The research uncovers the need to connect with care homes and cultivate relationships with care home staff to engage and support the older person. The thesis is grounded in a social justice perspective, which recognises the value of individuals; the research identifies that good social work practice is happening despite a framework of proceduralism, resource constraints and paradoxical policy imperatives.
The study uniquely highlights the significant, but overlooked, potential of social workers to support care home residents. It argues that the absence of a clearly defined role for social workers in care homes is both an indicator of, and a contributory factor to, the invisibility and marginalisation of older people in care homes and makes visible an area of social work practice that appears hidden in plain sight.
| Date of Award | Oct 2024 |
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| Original language | English |
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| Supervisor | Jo Finch (Supervisor) & Alisoun Milne (Supervisor) |