Meeting the Aspirations of Learning Disability Policy: The Role of the Support Worker
University of Cambridge
Department of Psychiatry
Doctor of Philosophy (PhD)
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Becker, R. (2020). Meeting the Aspirations of Learning Disability Policy: The Role of the Support Worker (Doctoral thesis). https://doi.org/10.17863/CAM.54728
This study investigates the research question: What role do support workers play in enacting learning disability policy in England? Social care policy has developed from a culture of paternalism and institutionalisation, to one that advocates enablement and community-based care. Government policy emphasises choice, independence and inclusion for people with a learning disability but does not recognise the extent of the role that support workers play in enacting such policies. This study uses a qualitative research multi-method approach to explore the relationship between government policy and support worker practice. The study consists of four parts: 1) an examination of the definition and diagnosis of learning disability, and how these have influenced policy; 2) a documentary analysis of care policy, to establish the representation of support workers in government policy; 3) a systematic review of empirical studies to establish the degree of academic interest in the research question; and 4) observations and interviews of support staff to explore their views and experience of working in care. The study findings show that changes in the definition of learning disability are reflected in a policy shift away from a medical framework focused on need, towards a social model focused on ability. Despite this shift, government policy still does not reflect the emotional and enabling role that support workers play in the lives of people with a learning disability, or the needs of support workers themselves. The role of support workers in enacting policy in England is also under-represented in academic research, with studies instead focusing on specialised areas of support work, such as challenging behaviour or stress. The fieldwork identifies tensions between policy and practice exacerbated by resource pressures, with staff reporting that they feel stressed and undervalued. Staff say they are in care work to make a difference but find it challenging to promote choice and inclusion for people who lack mental capacity to engage. This study concludes that in order for government policy to be meaningful and achievable, it must accurately reflect the work and needs of learning disability support workers. In addition, government must engage support workers directly when formulating policy that serves the interest of all people with a learning disability, without compromising the wellbeing of the people who support them.
learning disability, support worker, adult social care, residential care, supported living
National Institute of Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRC) East of England programme, at Cambridgeshire and Peterborough NHS Foundation Trust.
This record's DOI: https://doi.org/10.17863/CAM.54728
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