Care Professionals and Partnership Working

Nobody does all of it

Adult health and social care is not one job, and it is not done by one kind of person. Somebody who needs support usually needs several different kinds of it at the same time, and no single professional is trained to give all of them. A person coming home after a stay in hospital might need a check on how the stairs are managed, advice on what to eat, help understanding what money is available, and somebody calling in each morning. Those are four different trainings and often four different organisations. So the useful knowledge here is in two parts. The first is who does what: not a list of job titles to recite, but a working sense of which difficulty belongs to which professional, so that the right person is brought in rather than whoever happens to be there. The second is how those people work as one team rather than as four separate visits, because a person can be seen by four professionals and still be supported badly if none of them knows what the others are doing. This module covers both. What good care looks like from the point of view of the person receiving it is a separate topic with a module of its own.

Five words this topic runs on

Two of these are easy to mix up, and the difference between them is a common exam question.

Who would help with each?

Who first?

A woman who lives alone has been finding the stairs difficult and has stopped going upstairs to wash. Which professional is the most useful to bring in first?

• An occupational therapist, to look at the task, the equipment and the home
• A consultant, because the difficulty is a physical one
• A welfare rights officer, to check what she is entitled to
• A social worker, to arrange a move into residential care

One team, or several organisations

These two phrases get used as though they mean the same thing. They do not, and telling them apart is worth marks.

How a referral should move

Five stages of passing somebody on to the right professional. Put them into the order that gets a useful result.

• Identify exactly what the person is finding difficult, and what they want to be able to do
• Work out which professional that difficulty belongs to
• Make the referral, carrying the reason and the information already gathered
• Tell the person who is coming and why
• Check afterwards whether the change actually helped

What makes partnership working work

Several professionals are involved with one person. Which THREE of these actually make that work as partnership rather than as separate visits?

• Information moves between the professionals rather than through the person
• Each professional knows what the others are doing, and what they are not doing
• There is one agreed plan rather than several separate ones
• Every professional attends every meeting
• All of the professionals work for the same organisation

The person should not be the messenger

There is one sign that partnership working has broken down, and once you know it you will see it everywhere. The person receiving care ends up carrying their own information from one professional to the next. They repeat the same story at every appointment. They are asked a question they have already answered twice. They are the only one who knows what the other three are doing, and they are the one least able to be doing that job, because they are unwell or tired or worried and because nobody gave them the notes. Everything else in this topic is a way of preventing that. Records that the right people can see, one plan rather than four, an agreement about who shares what, a named person who holds the whole picture. Notice that none of those is about any professional being better at their own job. Each of the four could be excellent and the result could still be poor, because the failure is in the space between them rather than inside any one of them. In an exam answer, saying that the person had to repeat their story is worth more than saying that the professionals did not communicate, because it names what actually went wrong and who paid for it.

Complete the partnership words

Several different professions working together around one person, usually within one service, form _____. Different organisations working together, such as health, social services and housing, is _____. Passing somebody on to another professional together with the reason and the information already gathered is _____. The standards a registered worker has agreed to work to are set out in _____.

One winter, four professionals

Mr Price is eighty and lives alone. He has a fall in November, spends nine days in hospital, and comes home less steady than he was. Four professionals become involved and it is worth following what each one is actually for. The GP is the first point of contact, reviews how he is and refers him on, which is what a referral is for: it carries the reason and what is already known rather than starting again. An occupational therapist visits the house, not the man, and asks what he wants to be able to do. He says he wants to keep making his own breakfast. She changes what is in the kitchen and where, and he keeps doing it. A welfare rights officer works out what help with heating he can claim, which matters because a cold house in December is a health question and not only a money one. And a social care officer calls in each morning, which is the only part of this that looks like what most people picture when they hear the word care. Now the part that decides whether this goes well. Those four work for more than one organisation. If the plan is one plan, if each of them knows what the other three are doing, and if the information moves between them, Mr Price has a team. If not, he has four appointments and a story he has to tell four times.

Find where it broke

Five lines from the notes kept about one person over a fortnight. Tap the ONE that shows partnership working breaking down.

• Referred to occupational therapy with a note of the difficulty on the stairs and what he wants to be able to do.
• Occupational therapist visited, fitted a rail, and recorded the visit in the shared plan.
• Welfare rights officer confirmed the claim and let the social care officer know the outcome.
• Mr Price asked the morning caller whether the hospital had sent anything, because nobody had told him what was arranged.
• Review arranged for four weeks, with all four services invited to send an update.

Write the referral

A referral is judged on whether the professional receiving it knows what to do. Choose the option in each gap.

The partnership run

Five quick questions on who does what. Three lives.

Four services, one fortnight

You are the social care officer calling in each morning on a woman who came home from hospital two weeks ago. Three other services are involved. This morning she tells you she has been asked the same set of questions by three different people, and that she does not know what happens next. Work through three decisions.

• What does that tell you, and what do you do about it first?
• You find there are three separate plans and none of them mentions the other services. What is the useful next move?
• She asks you directly what happens next. What do you say?

Explain how the team should work

A man comes home from hospital needing support with the stairs, with his diet, and with money. Three services become involved, each from a different organisation. Explain how those professionals should work together, and what would show that they were not.

• Name which professional would take each of the three difficulties, and say why
• Explain the difference between a multi-disciplinary team and multi-agency working, using this case
• Say what a referral should carry with it, and why a vague one wastes a visit
• Describe what good partnership working would look like here
• Finish with the clearest sign that it had broken down, and say who pays the price for that