Other countries employ social workers in care homes – so why don’t we?

In my previous articles, I suggested that social workers are not always as visible as they could be in care homes. 

Their roles often focus on statutory tasks, and this can lead to the perception that they are there to scrutinise and assess, rather than to support. This is not helped by the fact that social work itself can be difficult to define and is shaped by the paradox between ‘care’ and ‘control’ – supporting people alongside carrying out responsibilities shaped by the law. 

Media coverage plays a powerful role in shaping how social workers are seen, influencing public perceptions as well as their own professional identity. An analysis on this from BASW and the Open University found that negative messages may undermine social workers and distract from the real issues facing social care, and that public attitudes towards social workers may be more positive than social workers realise. 

I recently read an article in the British Medical Journal about the ‘crisis in care’, which referenced the campaigning slogan ‘bread and roses’ used in 1910s America to advocate for workers’ rights. Put simply: bread feeds the body, but roses satisfy the need for sustenance. 

This made me think that when social workers are restricted to statutory, transactional roles, they are delivering bread – the essentials, the paperwork. But many social workers understand that bread is not enough and they want to bring roses too, which involves building relationships and finding out what matters to people. 

In my research, many social workers spoke about the work that they did beyond their statutory roles. Practical tasks, like collecting someone’s belongings from their home and bringing them to the care home, were profoundly important in supporting transitions and finding out what was important to the older person, especially if they did not have family. 

This links to My Home Life England’s focus on using the Senses Framework which focuses on a relationship-centred approach for improving care for older people. 

This has six core elements that shape a positive care experience: security, belonging, continuity, purpose, achievement and significance. While these principles are important to older people, you can’t go far wrong if you apply these principles to the workforce too. 

So, do we need to rethink the narrative around social workers in care homes, and take a more appreciative lens? 

One way may be to look to other models of practice. In hospices in England, social workers play an important role in the multi-disciplinary team to support people holistically at the end of their lives. Could this model benefit care homes too? 

Outside of England, other countries, notably the US, Canada, Israel, Romania, Croatia and Slovenia, employ social workers in care homes where they play a greater role in supporting older people, practically and emotionally, with moving to and living in care homes. 

The more social workers engage with care homes, the stronger their relationships become, creating a virtuous circle that benefits older people, staff and the wider care system.

Social work itself has a responsibility in reframing how it engages with care homes. A stronger focus on ageing in the social work curriculum would help to ensure that working with older people is seen as a valued specialism. 

Placements for social work students in care homes could also help reframe the social work role, so that it is not only there at moments of crisis or risk.

Recent research by Manchester Metropolitan University on inter-professional student training in care homes has highlighted the value of such placements: they helped social work students to develop stronger relationships with care home staff, fostering trust and teamwork. 

Structural challenges, resource limitations, and preconceptions might influence the relationship between social workers and care homes. We need to think about how we change the narrative and strengthen connections. Some practical steps could be: 

• Create spaces for connection and partnership working: staff need to respect and get to know each other’s roles; what opportunities exist for joint training or reciprocal shadowing to build trust and relationships?
• Explore opportunities for social work student placements in care homes
• Use frameworks like the Senses Framework to guide staff development and inter-professional collaboration
• Think about how we promote positive stories about care homes and about social work

If we want to adopt an appreciative lens, we need to start by prioritising relationships and seeing the value of coming together as allies to ensure that older people remain the focus. 

Sally  Nieman is co-chair of BASW's special interest group on ageing and social work