At our recent research minded event we heard from Anna Bouch (Adult Social Care, Brighton & Hove City Council - pictured right) and Jackie Lelkes (University of Brighton) who have now completed their project and are hoping to get their paper into the European Journal of Social Work shortly. The subject of their project was ‘Wellbeing from concept to practice’, here Anna shares their results:
“The Care Act has created a challenge for social work practice; to operationalise the concept of wellbeing. We have a statutory duty to promote wellbeing, so we wanted to understand how practitioners think about this concept. Do we actually do relationship based practice? These are the concepts that wellbeing is driven by.
The definition of wellbeing is broad and touches all aspects of a person's life - so how do we promote wellbeing? In assessments are we really thinking about this or are we thinking about eligibility criteria?
The Act doesn't give you a very good definition of wellbeing and everyone interprets it differently. Then you consider that we're asking people to think about this when they are under stress, unwell, etc.
We Interviewed 36 social workers and asked two questions:
- What do you understand by the concept of wellbeing?
- And for someone who lacks mental capacity?
We really wanted to find out if we apply the same practices across these two groups of people.
The responses for people with capacity included:
- I think about how fluid wellbeing is for me - and how it might feel for another person
- That holistic sense of who that person is
- Sometimes it’s linking in with things that they’ve lost
- It’s kind of prescribed in our assessments isn't it?
- This wellbeing things I’ve you the idea the the sky’s the limit, we can’t do it
- I suppose it still has to fit in the eligibility
It was clear we had two different thought clusters:
- Artistic 56% of respondents – these people were comfortable with uncertainty, viewed it as dynamic and nuanced, saw the value as in the relationship, appreciated that small things can make a difference, and referred to emotional state.
- Formulaic 44% of respondents – these people saw it as linear process driven by the organisation and its expectations, about containing risk and were risk averse, they felt they had to follow instructions and couldn't question, felt that they can't do this in the context of pressures on them - time poor.
Who's right? Well neither, it’s about balance. We have to work to process AND we need to embrace uniqueness. Consideration of wellbeing is HOW we do something and how we work in Brighton & hove does encourage us to think about the person but within the confines of process.
The responses for people without capacity were very different; all the artists disappeared and only two people talked about the individual. It all became formulaic and about risk. For the people with capacity it was clear that practitioners viewed the client as holding the risk but for people without capacity social workers hold all the risk.
Practitioners who took part in the project found many associated benefits. They found it incredibly valuable to talk about the concept, they liked having their assumptions challenged, and they liked developing things as groups and sharing knowledge.
The key take away points of this research include that:
- how you consider wellbeing is about you as well as the person
- to consider is a process
- it’s always in the moment.