CHANGES IN THE CONTENT OF SOCIAL WORK WHEN PROVIDING SERVICES TO CHILDREN WITH INTELLECTUAL AND (OR) MENTAL DISABILITIES IN COMMUNITY-BASED CARE HOMES FOR CHILDREN

Vida Gudžinskienė, Lilita Rimkevičė

Abstract


Due to obligations to the European Union and non-governmental organisations, the process of the transformation of institutional care began in Lithuania in 2012 with the goal “by 2030 to develop a consistent and coordinated system of assistance and services that would enable every disabled child, child deprived of parental care, disabled person to receive individual services and necessary assistance according to one’s needs, to get involved and participate in the life of the community without social exclusion, for every disabled child deprived of parental care to grow in a safe and developmentally friendly environment in the biological, in the absence thereof – in a foster family, in exceptional cases creating conditions as close as possible to the family ones” (Order of the Minister of Social Security and Labour of the Republic of Lithuania “Concerning Approval of the Strategic Guidelines for Deinstitutionalisation of the Social Care Homes for Disabled Children, Children Deprived of Parental Care, and Adult Disabled Persons”, 2012). The successful implementation of the goals of deinstitutionalisation requires the involvement of employees working in social care structures. Therefore, employees of care institutions are identified as one of the tools to implement changes in the provision of social services. T. H. Butler and C. K. Hammond (2003) claimed that the loyalty of institutional staff helps institutions to fulfil their functions. J. Campbell et al. (2018) emphasised the importance of social workers’ values, knowledge, and skills in the implementation of the rights of persons with disabilities.
In the context of transformation, the integration of recipients of services into the community is a particularly important aspect when providing social care services. When working in a community with children with disabilities, in order to achieve full integration into the community, the nature of the work of a social worker acquires a different form than when working in an institution.
The research object of this paper is the content and functions of the work of social workers in the transition from institutional to community-based services. The aim of this article is to reveal the content and functions of the work of social workers in the transition from institutional to community-based services based on the experience of social workers working with children with intellectual and (or) mental disabilities. The following methods were used: theoretical – in the comparison and generalisation of scientific literature and documents; empirical – via semi-structured interviews for the collection of qualitative data; and qualitative content analysis – in the analysis of interview data. In order to reveal the content and functions of the work of social workers in the transition from institutional to community-based services, qualitative research was conducted and the experience of social workers working with children with intellectual and (or) mental disabilities was analysed. This article analyses the following question: How do the content and functions of social work change when providing long-term social care services in a community?
There were 7 social workers who participated in this research, and the research sample was targeted and criterion based. The applied criteria selected social workers: 1) with a degree in social work; 2) working with children with intellectual and (or) mental disabilities in community-based care homes for children; and 3) with no less than six months of work experience in community-based care homes for children. The exact number of respondents was revealed during the initial analysis of the interview text; when the analysis of the interview material revealed a lack of new information, then the data collection interviews were no longer carried out (Žydžiūnaitė, 2012). This research was conducted from October 2020 to March 2021, and followed the principles of voluntariness, goodwill, and confidentiality (Creswell, 2009). In accordance with these principles, this research was organised in such a way that the subjects did not experience any physical or material inconveniences. The subjects, who voluntarily agreed to participate in the research, were contacted by phone to arrange the most appropriate time and place for them to participate in the interview. The subjects were informed in detail about the ethical principles of the research, and were able to withdraw from the research at any time. To ensure confidentiality, the names of the subjects were depersonalised and the names of places were changed. Interview quotes are supplied in their authentic and uncorrected forms.
The results of the research revealed that the reorganisation of social care structures inevitably influenced the change in the organisation of the provision of social care services. A change in the provision of social care services affects the content and functions of the work of a social worker employed in a community-based care home for children.
There are employees of various posts working in institutional social care structures. Therefore, the organisation of work takes place through the structural division of work functions among separate units within the care institution. The provision of social care services in community-based care homes for children changes the order of work organisation, and some posts cease to exist. Thus, in the context of the transformation, for social workers employed in community-based care homes for children the content of the work was supplemented with new functions, including: the purchase of food products and ensuring food production and organisation, the care of clothes and bedding, conducting employment activities, the need to take care of the household, having to go and update the child’s documents by themselves, and ensuring distanced education. It should be noted that the provision of social care services in community-based care homes for children is a relatively new way of providing services, thus care institutions do not have a unified way of exchanging the documents of children with intellectual and (or) mental disabilities – there are social care institutions where there has been no change in the way documents are exchanged. The provision of distanced education by a social worker employed in a community-based care home for children was carried out only during the period of the COVID-19 quarantine in Lithuania. This research revealed that social workers employed in community-based care homes for children assume new responsibilities related to the child, including: responsibility for the child’s health, responsibility for administering medication, and responsibility when travelling with children by public transport.
This research also showed that, during the transformation, the responsibilities of social workers increased to include: cooperation with medical staff, cooperation with schools/educational institutions, cooperation with other institutions concerning leisure/employment, maintenance of the heating system, the search for solutions to household issues, the maintenance of territory, and the provision of information on home meter readings. This research also highlighted the unchanged functions of social workers in the context of transformation. According to the researchers, when providing social assistance to children with intellectual and (or) mental disabilities, great attention is paid to the development of independence. It should be noted that when working in an institution with children with intellectual and (or) mental disabilities, the development of independence was also encouraged. In the provision of social care services, it is important to preserve and maintain the service recipients’ contact with relatives. The respondents noted that when providing social assistance to children with intellectual and (or) mental disabilities, they try to maintain close contact with the children’s relatives and family members. The function of communication and cooperation with the relatives of the service recipients was not affected by the process of transformation.
The role of the social worker working in community-based care homes for children with intellectual and (or) mental disabilities becomes multifunctional and multifaceted. Due to environmental factors, the activities of a social worker become variable, uncertain, and require skills in different areas. In community-based care homes for children, all issues related to household care, such as the maintenance of the heating system or the organisation of the maintenance of territory, are also included in the field of social work. The subsequent change in the functions of social work risks forming a new social worker identity that is different from what is usually seen. Therefore, when providing social care services in community-based care homes for children, it is expedient for the heads of institutions to analyse the need for staff in various positions, and for specialists to organise work in such a way that household and territory maintenance issues would not be left to be taken care of by social workers alone. It should be noted that, in community-based care homes, a closer relationship with the child and the involvement of the child in household chores are likely to contribute to the better preparation of children for independent living.

Keywords


children with intellectual and (or) mental disabilities, community-based care homes for children, institutional care transformation, a social worker.

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DOI: https://doi.org/10.13165/SD-21-19-2-08

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