Open Eye: An increasing degree of care

Planners in need of evidence that Lifelong Learning has found its way onto people's personal agendas, they need look no further than one new OU course.

Last year 3,000 people, and this year more than 4,500, signed up for Understanding Health and Social Care, a level-one degree course which aims, through looking at our everyday experiences of health and caring, to open up the wider debates about policy and practice. Of those students - residential care workers, community health staff, volunteers, among them - some 67% were studying for vocational reasons. Yet a mere 8% were being funded by their employers, and fewer than two per cent were being given study time.

Increasingly, we have seen the professionalisation of medical health services. Nurses are required to show evidence of professional updating and no-one entering a career in medical science expects that the exam they take to qualify will be the last they sit.

Now, it would appear from feedback on Understanding Health and Social Care, that workers in the less glamorous field of social care - involving care for older people who can't manage alone, children unable to stay with their parents, people with physical disabilities or mental health problems - are doing the same.

After studying the course, students working in these areas reported their learning was already having real-life effects.

"One student working as a carer realised that the place where she worked was contravening regulations and good practice and was able to take positive action to correct this," her tutor reports. Another working "identified a case of neglect and has enabled a care home to improve a specific aspect of their practice."

Evidence that people are using the course to help them do their jobs better is a source of satisfaction for deputy course chair, Jan Walmsley.

The team's original aim was to emulate other subject areas across the OU in providing a foundation level route into study in the School of Health and Social Welfare, which was created to meet the need for professional development and training in the health sector and whose starting point has been higher-level courses.

"We knew we were drawing people in with our study packs but , after that, there was nowhere for them to go," says Jan. "A high proportion of people working in social care don't have any qualifications. The fact that they seem to be aspiring to improve their job prospects is very significant.

"There is a move to have registration of care workers and to improve the level of training in residential care. This course can make a big contribution, but people deserve more encouragement: a clear career structure, a better deal. Some employers, for example Mencap, have sponsored students on the course."

Jan believes improving training of workers in social care is our best insurance against the abuse stories that make headlines. She argues that the course provides the knowledge and confidence to improve standards and recognise abuses. It encourages students to evaluate services by reference to Good Practice Guidelines.

Says Jan: "You wonder how instances like Pindown can continue, and it's partly poor training and failure to provide clear guidelines.

"Such standards are the only hope of getting away from scandals - and I don't think we hear about them all, especially in old people's homes, because we don't value old people. Awareness-raising is one way of giving staff and management the capacity to raise standards."

The relative visibility of service users and providers is another issue the course raises - starting from the premise that from infancy to caring for children or parents we are all consumers. The course's popularity could be seen as proof that we take that consumption very seriously indeed: we want to know our rights, in order to get the system to work for us.

Jan believes there is a long way to go before we challenge those who define and deliver social care the way we have begun to with doctors and specialists and the hospitals they work for. She points out that because we are all users of health services there have always been plenty of articulate, middle class spokespeople.

"The people who use social care are often frail, elderly, chronically sick, confused. They may not always be articulate, or even have the physical means - like access to a telephone - to be active consumers."

One exception is the field of physical disability, which the course studies, where service users have led the way in insisting they have the right to self definition: to keep control of budgets so that they can choose and buy their own care rather than being beholden for decisions.

"Profound personal change" is one side-effect of the course reported by many students, possibly through finding the very fabric of their day- to-day lives validated by its appearance in university level study: a father teaching his children how to brush their teeth... a volunteer doing a sponsored swim for charity... anyone waiting for meals on wheels to call... These are the unnoticed elements of care which touch us all and which the course exposes so meaningfully that, for most students, what they best remembered and enjoyed were "all the bits to do with people".

Said one: "It's increased my confidence and I've discovered an ability to be my own person and not just someone else's wife or mother. Having said that, it's made me value myself more in these roles."

Jane Matthews