About Jenni Brooks

Biography: I currently work on a project exploring the feasibility of evaluating life story work for people with dementia (funded by the National Institute for Health Research). Previous projects looked at how physically disabled young adults take on control and management of their own support arrangements; good social care for people with very complex needs; and at the role of family carers in social care assessment and support planning.

I’m also interested in the role of music in dementia care, and in the development of the role of ‘personal assistant’ as part of the social care workforce.

Workplace personal assistants – what do we need to know?

While I finished my PhD, I worked as a personal assistant (PA) for a physically disabled woman. At first I worked evenings in her home, but later I switched roles and accompanied her to work.

I was surprised to find how different the role was. At home my job had been roughly how you might imagine a more traditional ‘care assistant’ job – largely making food and household chores. But as a ‘workplace PA’ I was taking notes in meetings, filing, and working on complex spreadsheets and reports.

I was always with my employer, of course, and she gave step by step instructions if needed, but the days went more smoothly because I knew how to use a spreadsheet, and could judge what parts of meetings were important enough to write down.

It was an interesting experience, and one I’ve continued to reflect on since.

I was at work, but within my employer’s workplace. My contract and confidentiality agreement were with her, not her employer. If I was late, that made her late through no fault of her own. My behaviour and appearance reflected on her, and if I had been untidy or rude to her colleagues she would have felt responsible.

My employer’s colleagues were used to having her PAs around, but other people seemed unsure about how to react to me. Some would acknowledge my presence, offering me tea (always welcome), asking my name to write in minutes (unnecessary), and trying to include me in discussions in meetings (inappropriate). Others would focus on my employer (good) and act as if I wasn’t there at all (not so good).

I haven’t seen much written about the professional role of workplace PAs who support a physically disabled person. Having spent several years as a workplace PA myself, it seemed to me that my role was very different to someone supporting a learning disabled person or someone with mental health issues at work.

It is likely that more PAs will be needed as people take increasing control over their own support arrangements through both social care and workplace schemes. We need to know more about the current and potential roles of the workplace PA. That’s the only way we can provide appropriate support to workplace PAs themselves, the disabled people who employ them, and to their employers.

What do we already know?

What do we already know about workplace PAs? Not much. The Department of Health’s Social care workforce research initiative (Qureshi and McNay, 2011) acknowledged the current lack of information about PAs more generally, and identified a need to collect routine information such as numbers and levels of pay.

Similarly, the Framework for supporting personal assistants working in adult social care (DH, 2011) recognised the need for a better understanding of personal assistant working, including the range of tasks carried out by PAs, particularly given that they are likely to be working in isolation with little opportunity for reflection and professional development.

There is some mention in such work of supporting people to take an active part in their communities, including access to education and employment. But there is very little, if anything, written specifically about PAs supporting people at work.

Employment rates of disabled people are relatively low. In 2012, only 46.3% of working age disabled people were in employment, compared to 76.4% of working age non-disabled people (Office for Disability Issues). In 2010, young disabled people were twice as likely to be not in employment, education or training as non-disabled people of a similar age (Equality and Human Rights Commission, 2010).

If we are to meet disabled people’s employment aspirations, there must be appropriate support. For some this will include workplace PAs.

The Access to Work scheme is the primary mechanism for supporting disabled people in work at present. A recent review (Department for Work and Pensions, 2011) described this as ‘the government’s best kept secret’, and suggested demand had been kept low by lack of advertising. In April-December 2012, Access to Work granted 11,580 awards (out of a total of 33,180) to pay for support workers, but does not indicate how many of these were to physically disabled people.

Specific questions that need answers

If we are to improve support for workplace PAs, the people who employ them and their employers, then we need some specific information. I suggest some initial questions should include the following.

  • Numbers: How many physically disabled people in employment use a PA at work? How many workplace PAs are there?
  • Roles: What roles do workplace PAs have? If they also work as a home-based PA, what are the differences between the roles?
  • Payment: How much are workplace PAs paid, and where does the money to pay them come from?
  • Recruitment: How are workplace PAs recruited?
  • Career development: What is the employment background of workplace PAs (and do they consider themselves to be part of the ‘social care workforce’)? Do they consider being a workplace PA as a career, or a temporary job?
  • Issues and relationships: What issues have disabled people using PAs experienced at work (with PAs, colleagues, or employers)? How do workplace PAs find relationships with the disabled person, their colleagues, and others in the workplace? How do employers feel about having PAs in their workplace?

For disabled people, particularly those applying for their first jobs, knowing about the role of a workplace PA may encourage them to aspire to a job they may not have otherwise considered. For the organisations who support them, an understanding of the specific requirements of the job will help with recruitment and retention of suitable PAs.

It’s tempting to group workplace PAs with the rest of the social care workforce. But by doing so we risk planning for the recruitment of the same people through the same channels as we have always done. Workplace PAs aren’t necessarily paid with social care money, and while their work may include some personal care, it’s likely to include other specialist skills too. If we think only in terms of social care workers, we risk losing the expertise of people who may be perfect for the job, but who haven’t considered a social care career.

This is my initial attempt to get some of my musings about this written down. I’ll be developing my thoughts further over the next few months, not least about whether ‘workplace PA’ is the appropriate term. I’m interested in anything anyone has to say, either about their own experiences, or just thoughts on reading this. Please get in touch.

Jenni Brooks (jenni.brooks@york.ac.uk), Social Policy Research Unit, University of York

Twitter: @JenniBrooks

References

Department for Work and Pensions (2011) Getting in, staying in and getting on. Disability employment support fit for the future Accessed 1st Feb 2014

Department of Health (2011) Working for personalised care: a framework for supporting personal assistants working in adult social care Accessed 1st Feb 2014

Equality and Human Rights Commission (2010) How fair is Britain? The first triennial review Accessed 1st Feb 2014

Office for Disability Issues Disability facts and figures Accessed 1st Feb 2014

Qureshi, H. and McNay, M. (2011) Overview and synthesis: DH social care workforce research initiative 2007-2011 Accessed 1st Feb 2014

Assessing the needs of carers

Updated 21st August with link to project findings.

National Carers Week invited everyone to consider the impact of being a carer on a person’s life. Carers were also encouraged to make sure they access the support they need, both practical and emotional.

Carers’ own needs can easily be hidden. Social care policy and practice emphasise the rights of disabled and older people to have choice and control over their own personalised support arrangements, usually in the form of a personal budget. Family members who provide ‘regular’ and ‘substantial’ support also have rights to separate assessments of their own needs and support to meet these needs.

These policies have, however, developed separately from one another, despite the interdependencies of service users and carers. There is therefore a danger that, in focusing on the needs and rights of service users, those of carers can be overlooked.

Our research, carried out at the Social Policy Research Unit, University of York, examined how social care practice balances the interests of older and disabled people with those of family carers. We focused on disabled and older people with cognitive or communication impairments and their carers, as the latter were particularly likely to be heavily involved in their assessments and support planning. The study involved

  • A survey of councils in two English regions
  • Interviews with senior personalisation and carer lead officers, and focus groups with front line practitioners, in three councils
  • Interviews with pairs of service users and their carers

We found that both carers and service users were happy for carers to be involved in service user assessments. Carers helped people explain their needs to social workers, and interpreted what professionals said to service users. Disabled and older people felt supported and reassured by having someone present who knew them and their needs, even if the carer remained quiet. Professionals also appreciated having carers involved.

Professionals frequently talked to service users and carers together, at the same time. This was thought of as a ‘joint’ or ‘holistic’ assessment which provided an opportunity to get a picture of the family situation as a whole – although it did not allow carers to discuss their own situation in private or consider the emotional impact of care-giving.

Most carers remembered being asked about their ‘willingness’ and ‘ability’ to continue caring at this time, but many could not remember being asked about their own needs. The Carers (Equal Opportunities) Act 2004 says carers should be offered separate assessments of their own and the opportunity to talk about their own needs that extend beyond their care-giving roles to include, for example, leisure activities and employment.

While many carers in the study had been offered a separate carers’ assessment, few had taken this offer up unless it was necessary to access a specific service. Some felt a separate assessment was pointless, as it would not lead to extra support, while others felt they had already talked enough about themselves during the service user’s assessment. Some front-line practitioners could also not see the point of a separate carer assessment.

However, without a separate carer assessment, the only time carers talk about their own needs may be during service users’ assessments. If the only questions addressed to carers in these assessments are about the practical care tasks they carry out and their ‘willingness’ and ‘ability’ to continue performing these, there is a danger of carers’ wider needs being overlooked or ignored. This is far from the intentions of the 2004 Act, which aimed to increase the social inclusion of carers.

As skilled professionals, many social workers will ask wider questions and delve deeper into carers’ lives and their support needs in the course of service user assessments, but where are these needs recorded? Some practitioners expressed concern about the lack of space on service user assessment forms to record carers’ wider needs and wishes.

This study suggests that

  • The value of separate carer assessments needs to be much clearer, both to practitioners and to carers themselves.
  • Where carers do not take up the offer  of a separate assessment, service user assessments should provide space for detailed discussion and full documentation of carers’ own support needs
  • When separate carer assessments are done, they need to be routinely linked to service user assessments.  Practitioners also need to be clear about the processes that facilitate this.

A summary of the findings of our study is now available on the project website. Please contact us if you have questions about the research.

Dr Jenni Brooks (jenni.brooks@york.ac.uk), Dr Wendy Mitchell, Professor Caroline Glendinning

Social Policy Research Unit, University of York

The research was funded by the NIHR School for Social Care Research. The views expressed here are those of the authors and not necessarily those of the NIHR School for Social Care Research or the Department of Health, NIHR or NHS.