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Chapter 11 - Chapter 20 >>

Part I Preparing to Learn

We sandwich these first two chapters between Resource Files which first of all enable you to review other students' experiences. New students can see from this that these other students have persevered successfully with their learning, despite some early traumas. Chapter 2, together with these Resource Files, tackle making the most of seminars and lectures, using the library and learning resources, using books and accessing websites.

 

Chapter 1

Learning is not a straightforward matter of pouring knowledge and skills into the empty vessel of your mind and expecting it to work, magically. We do not live in a vacuum. We have other activities, commitments and responsibilities - work, home and leisure - and when we begin a course of study we have to adjust the lives we are already living to accommodate the new demands this new learning imposes. We may have been away from formal learning in the classroom or the lecture hall for a considerable period. We may have doubts about our ability to cope, in practical terms, or in terms of being able to understand the ideas and carry out the assignments set for us.

It is helpful for us to go through these and other related learning issues at the start of our period of study. We can assess our strengths and the areas we anticipate will be more challenging for us. We can face the challenges better by equipping ourselves in advance with knowledge about how we learn best - what our preferred learning style is. Are we more of an activist, a theorist, a pragmatist or a reflector? Perhaps we're a mixture of two or three of these, depending on the situation in which we find ourselves?

We can also complete a SWOT analysis. This enables us to prepare to build on our previous learning experience. A SWOT analysis invites us to identify strengths, weaknesses, opportunities and threats in our present situation. One of the threats, for instance, to my learning could be the competing demands on me of my work and my home life.

 

Chapter 2 Skills for Studying

We move on in this chapter to considering a group of ideas based around study skills. There is overlap with chapter 1, inevitably, because especially at this early stage in the book, there is so much new material to cover in relation to learning and studying. In order to learn effectively we have to know how to study. The reverse is true also.

This second chapter begins to introduce ideas about doing more basic assignments and using learning resources efficiently to ensure this happens. Of course, some people are work-based and this is an added opportunity, but also a complication. Making time to study is an issue, especially when there are pressures at home as well as at work.

This chapter deals in more detail with some of the main stages involved in doing an assignment: understanding the task, planning time, planning the structure, reading and research, writing the assignment and making sense of feedback.

Work based learning is also tackled. This involves 6 aspects: 1 making a working and learning agreement; 2 identifying and using learning opportunities; 3 linking college and work experiences; 4 transferring experience and learning; 5 being assessed on the knowledge, skills and grasp of values you have demonstrated; 6 giving and receiving feedback.

As a seconded student - that is, supported on the programme as part of your work role - there will be a contractual aspect to this. For example, if you change jobs you may be required to repay fees and your employers may not appreciate you taking days off college.

 

Resource Files

After Chapter 2 there are three of these, each covering a stage in the sequence of locating, reading and extracting information and making it your own in some kind of personal filing system. In the experience of the editor these tasks are the most difficult to carry out of any that students undertake. If the study skills involved are acquired at this stage, success on any course is much more likely.

 

Part II Contexts for Practice

The chapters in this part are accompanied by Resource Files which provide a focus on some particular aspects. Before Chapter 3 which deals with policy aspects, we pose an interesting task in the Resource File, to do with trying to make links in your area between the past and present of health and social care. The people with whom we work will have older relatives who have been shipped off to workhouses, orphanages, mental hospitals. Some of them will have been so traumatised that they won’t talk about these events, but they are still part of their lives and their responses to current services offered are shaped by those experiences.

After Chapter 3, we highlight a few features of policy in health, social care and child care. The Resource File immediately following the policy files gives some background on demographic features – ie. population changes. You will see from this evidence how the proportion of older people – who, incidentally, are living longer in each succeeding generation – is rising rapidly, which has implications for a large proportion of the work of the health and social care sector. After Chapter 5, we focus on some areas of debate and controversy, which touch on our persona, as well as our professional ethical standards and values. At the end of this Part, you will find a Resource File focusing on the nature-nurture debate, which is of relevance to Chapter 8, dealing with the life course. It links also to the Resource File after Chapter 5, raising questions about the ethics of genetic manipulation and gene therapy, because, of course, our beliefs about the extent to which our personalities are fixed at birth or can change relate to ideas about whether it is ethical to shape people’s health at conception by predetermining their genetic inheritance. These issues will have a great impact on the future shape of health and social care services.

 

Chapter 3 Development of Health and Social Care

This chapter gives some broad indications of how health and social care have developed, alongside each other and quite close in their ideals and assumptions, but in many ways separate. Their

development has fits into the context of a wider public desire find ways of dealing with poverty. This has preoccupied politicians and citizens for many centuries and their efforts to curb poverty are reflected in legislation from Elizabethan times. In the 1900s, great advances in understanding about how disease was transmitted accompanied public health reforms, notably the foundations of our modern sewage systems in the towns and growing concern about hospital hygiene, both of which extend to the present day.

Social care has also been inextricably linked with education in its concern for children and adult personal development, and with social housing provision in its concern for healthy living. The twentieth century has seen a progression of attempts to connect health and social care with concern for people in their own communities and recently a greater concern for service user and carer involvement in decisions that affect them and in planning and managing services. Modern debates about health also focus on health promotion and how to reduce inequalities in health provision.

The chapter acknowledges the succession of organisational changes which have taken place in how health and social care services are delivered, in the wider context of biological, psychological, social and spiritual knowledge. More services are contracted out; Health and Children’s Trusts have been created; internal markets have been created for the commissioning and delivery of services; partnerships in the public, private and voluntary sectors accompany increased joint working for people with particular needs, such as mental health; special procedures exist for safeguarding adults and children; there are single assessment processes for adults. These are all part of attempts to respond to the complexity of human needs for health and social care.

 

Chapter 4 Sociological Contexts for Practice

This chapter deals with a tiny fragment of sociology, the study of society. In this brief space we can only touch on certain social influences. We have chosen those which are linked with what we call social divisions. Basically, a social division is a way of describing how each of us belongs to different 'sectors' of society, such as class, race or ethnicity, gender and so on. This grouping of ideas and perceptions shapes how we experience the world and how other people relate to us. It happens, for instance, that a person's gender is a key distinguishing experience from others. Imagine how it would be for you if you, and others around you, were dealing with 'you' as the opposite of the gender you are now.

We go on to deal with a key division, linked with inequality, that of discrimination. People often are treated unfairly on the basis of one or more social differences, the 'social divisions' we have referred to. This discrimination can arise from personal prejudice, but it can also arise because of wider sociological factors, such as cultural assumptions and stereotypes and structural patterns of inequality.

We deal in this chapter also with violence and abuse, which arise partly as a result of the abuse of power, which in turn, perhaps, is a reflection of patterns of social relationships. These are not simply psychological matters to do with the forces inside a person compelling him or her to act in a particular way. We can see, for example, that families can be both 'ideal happy families' and the opposite of this - settings for domestic and child abuse.

So, we see in this chapter that adopting a sociological approach isn't a question simply of rejecting or neglecting personal or psychological issues, but rather of trying to broaden and deepen our understanding of these issues by developing a fuller appreciation of the sociological factors that contribute to them.

 

Chapter 5 Values Contexts for Health and Social Care

This chapter introduces you to values as a central aspect of health and social care work. It is necessary to think about this topic, so we haven't burdened the discussion with facts about this or that set of ideas, values or principles. It is more important at this stage for you to join with us in exploring the origins of values and the relationship between our personal and practice-based values.

Practice values include 1 valuing people; 2 respect for people; 3 equality of treatment. In the process, we raise in this chapter some of the difficulties in practice which are related to our values. One of these concerns how there may be a clash between your personal values and the values of the organisation you work for.

 

Chapter 6 Physical Basis for Health and Well-being

This chapter reviews briefly the physical basis for normal human functioning. The many specialised aspects of this cannot be dealt with in this chapter. Physiology, as it is known, is the study of the functioning of a biological system. We begin the chapter with the fundamentals of how our bodies are shaped by cells, genes, tissues and organs. As we visit each aspect we indicate some of the main diseases and conditions which affect them. We refer briefly to the following in this chapter, with a view to giving readers unfamiliar with the subject an opportunity to become more familiar with its outlines: cells, genes, tissues and bodies; endocrine system; blood and cardiovascular system; liver; nervous system; skin; lymphatic system; respiratory system; digestive system; urinary system.

Finally, we deal with three themes which cut across these broad aspects: 1 infection and immunity; 2 inflammation; 3 thermoregulation.

This quick tour should enable you to know the difference between a genetic and a congenital disorder, what DNA is, what a stem cell is and what is the difference between hypothermia and hyperthermia.

 

Chapter 7 Psychological Basis for Health

As we say early in this chapter, psychology deals with the mental life of people, but this statement oversimplifies and cannot do justice to the breadth, depth and wealth of psychological ideas which contribute to health and social care practice. This chapter reviews the main theories and ideas in psychology on which professionals in health and social care tend to draw. Prominent among these are the theoretical perspectives which have led to psychoanalytic, psychodynamic, therapeutic, clinical, cognitive behavioural and developmental approaches.

We perhaps should highlight the many applications of psychology under the ‘clinical’ heading, which is concerned with assessment and treatment. Developmental and psychoanalytic and psychodynamic theories have also led to approaches to paediatrics (work with, study and treatment of infants and children and their diseases) and in mental health. There is also social psychology, which has contributed to the study and practice of work with and within groups.

 

Chapter 8 Human Growth and Development

This chapter deals with perspectives on the ways people move through what we call the life course. Clearly, there is a sense in which our title, Human Growth and Development, implies that childhood is about development and growth. Some critics have complained that this title implies that maturity and growing older are subjected to the ageist assumption that after adulthood comes the slow decline to old age and death. We use the term life course to give potentially equal weight to youth, maturity and growing older and to avoid any such implication. We also examine four different sets of ‘formal’ theories on the life course: biological, psychodynamic, behavioural and environmental/ social.

 

Part III Knowledge for Practice

In this part, we move to consider the great body of knowledge required in order to practise as a health and social care worker. In one sense, the practitioner needs a little of everything, but to provide too much would be to expect professional qualifications in a dozen related health and social care professions. We have tried to keep a balance in this part of the book between knowledge which is too basic and knowledge which is too detailed.

The Resource Files introduce topics of particular relevance, which can be used as the starting point for more detailed study. After Chapter 10, we introduce the changing nature of child protection policy, which is a topic in its own right; after Chapter 12, we introduce the complex topic of careres and caring, which develops on a daily basis. One tension we have in this book is between following the separation of adult and children’s services in social care and ignoring this and including material on child care and families. We have adopted the latter course. At this point, study of carers could include the much neglected area of young carers, who at present fall between the two areas of adult and children’s services.

Later in this Part, there are two Resource Files headed Health Promotion (1) and (2) sandwiching the chapters dealing with substances and their abuse. The first gives some background on government policies to tackle drug and alcohol abuse. The second gives an indication of how the treatment of smoking may be tackled.

 

Chapter 9 Safeguarding Adults

Abuse of adults takes many forms. Whilst all abuse is emotional in one way or another, there is also physical, sexual and financial abuse, the latter occurring much more when people are vulnerable. For example, older people and people with learning disabilities may be vulnerable in different ways to other people taking advantage of them. The theme of violence is used in this chapter to link abuse against adults in general, with domestic (criminal) violence. It should be noted that we avoid using the term 'domestic' as far as possible. This is because it seems inappropriate to domesticate a criminal offence of violence, even by implication.

We also deal with safeguarding adults, referring to the values informing practice: independence and self-determination, choice, rights and fulfilment. We refer to the Protection of Vulnerable Adults (POVA) guidelines. There are also procedures for the practical protection of vulnerable adults and the practice study shows how these are put into practice. The safeguarding checklist is as follows: alert, referral, decision, safeguarding strategy, safeguarding assessment, safeguarding plan and review.

 

Chapter 10 Child Protection

We deal first in this chapter with the policy context of child protection. The history of scandals and inquiries from the Maria Colwell inquiry of the early 1970s to the Laming inquiry into the death of Victoria Climbié has accompanied attempts to legislate lapses of professional practice out of the system, from the Children and Young Persons Act 1969, through the Children Act 1989 and the Children Act 2004. Attempts have been made also to assert the rights of children, through UN Conventions and the Human Rights Act 1998. The chapter deals also with the organisational structures which have been put in place in the early twenty first century to deal with child protection, namely the Multi-Agency Protection Panel and the Safeguarding Children Board.

The chapter goes on to consider how the process of child protection works, from assessment, through investigation to intervention. It refers to direct work with children. This includes the important responsibility of listening properly to children, perhaps developing storytelling with children and drawing on holistic skills to communicate with children, using toys, drawing, resource books. Often this is multi-disciplinary work using health practitioners, social care workers, social workers, psychiatrists and play therapists, among others.