What is a Support Worker?
Who are these people who wander around with others helping them out? Most people would have seen this, many people recognise the role of a “helper” “supporter” or “carer” the names change, the needs of the person needing the support changes, they may be elderly, or physically disabled, have autism or a learning disability or mental health problems. But what does a support worker do exactly?
To answer that we first have to look at why people need support. Being perfectly well adjusted and successful in life is great, even better if we can teach others how to achieve this, but most of us have problems, none of us get by without help at some point in our lives, but most of us have screwed up something at some point.
It’s the simple things that make life worth living, eat good food, be with someone you love, good friends or your partner or family, work hard, enjoy a glass of wine, go for a walk in the sun, whatever it is that makes you feel good, it doesn’t have to be complex. But imagine if I added to that list, communicate… or feed yourself, meet new people, get a job, make a cup of tea… some things most of us take for granted, things that many people with disabilities can’t do without help.
Let’s take for example someone with a learning disability and let’s say that person also uses a wheelchair. The support workers role will have two main strands, physical support and learning support. The physical support is relatively straight forward to understand, it may be pushing the wheelchair, it may be helping the person shower or go to the toilet, change their clothes. We call that “personal care”. The basics are straightforward indeed, but it’s far more complex a job than it may sound, which falls into the second strand, learning support.
I only call it learning support to keep it simple but within that is a complex array of tasks that may need to be undertaken. A person with a learning disability will be defined by the fact they have difficulty with input, processing and output of information. This can materialise in communication difficulties, literacy and numeracy difficulties, understanding of basic tasks and the ability to complete them, emotional difficulties which is always a tricky one. If you have a learning disability the world and in particular people within the world become a great deal harder to understand and cope with, so many people with learning disabilities need some guidance to navigate the complexities of life, hence the role of a support worker.
I always define people with disabilities simply as: People who need a bit more help than others
We all need help, no one can do everything perfectly, and no one can know everything. Someone may be technically brilliant, a genius in physics or medicine or art, but socially will be very awkward, or someone may be loved by everyone they meet, charming and charismatic but can’t operate a computer. Extreme examples maybe, but the point is, no one is perfect.
Terminology is important, I don’t like the word carer, and care is for ill people, elderly people who cannot do anything for themselves, people at the end of their lives and infants. That said, in all of those categories there’s still a need to help people maintain some independence and to continue to learn, particularly children. We learn through play, entertainment, basic social interaction and daily tasks, it never stops.
“Support” makes much more sense, help is too simple and we don’t want to just help people. Supporting people is more like providing a framework, a scaffold for people to be independent. Many times I have seen people do things for people, like making tea, or making a phone call. That’s not support, that’s doing it. Support is always about enabling the person to do things themselves, wherever possible. That’s not to say the role doesn’t involve doing things for people too, sometimes the support worker needs to model, or be an example of what to do. They should never give up on offering learning experiences. Many people with disabilities have gotten used to not having to do things for themselves and have grown to expect others to do it, this is due to bad habits of staff and some parents/carers, and sometimes it’s due to not having the patience to teach
“It’s quicker if I make the sandwich”
It may be quicker, but that’s not the point. We’ve all experienced some feeling of pride, or achievement by completing something or learning a new skill or mastering an existing skill, let’s not deprive people of this feeling by over-supporting them.
Anyone familiar with the show Little Britain will remember the characters Lou and Andy, a support worker and his wheelchair using disabled person who is in fact not as disabled as he appears, it’s a good joke and probably most support staff have had a similar experience with someone, though not as extreme probably. The very good intentioned Lou tries his best despite Andy continuously abusing his trust and manipulating Lou to his advantage, but of course even in that scenario the disabled person is not entirely responsible for his actions, he is disabled after all, right?
Well, having a disability does define a person as being vulnerable, and that’s why support would be provided. It varies vastly what support people need, from a couple of hours a week to help with correspondence to 24/7 support with everything in their lives.
Support can be around very practical things, making food, cleaning, getting a job. Or it can be around less tangible things, emotions, relationships and communication.
Just imagine the normal day to day things you do, and now imagine not being able to do them, maybe you can remember as a child struggling to learn something and needing some guidance. I always struggled with tying my shoelaces, I learned to do that much later than my peer group. I don’t know why, I can play musical instruments, can fix electronic devices quite well but shoe laces? I still remember the embarrassment and frustration. I also remember people trying to tell me how to do it, modelling by showing me how they tied theirs, but to no avail. I eventually learned by trying and trying and trying…
Who are these people then, these underpaid individuals who support less able people around the world? There’s millions of people who need support of some kind, so there needs to be even more people to support them, the answer is:
Anyone could be.
Some organisations will ask for previous experience, some won’t, most will train people on the job, some may request the person has an NVQ (National Vocational Qualification in Health and Social Care in the UK) or equivalent. But generally support workers come from all walks of life, some people with degrees in psychology do it, some people with disabilities become supporters themselves, some people with no work or education experience can do it. There really is no limit, but what makes a person right for it, the desire to help is not enough, sympathy is no good, sympathy leads to pity very easily, and pity leads to help rather than support. What makes someone right to be a support worker, is the ever elusive quality of empathy, or least the ability to imagine what someone may be experiencing and understanding, and patience, always patience.
Is it a good or bad thing that anyone can become a support worker? I live in London, and as a large city it acts as a microcosm for the rest of the world, particularly in its diversity. This diversity means two things, one is that there is a range of individuals with a variety of ethnic and cultural backgrounds who require support, many from places where they would get no help for being disabled in any form. And in addition you get a wide range of people who can support others, this can be valuable for matching people culturally if that is their wish, a Jewish disabled person can ask for staff who is Jewish to take them to Temple for example. I believe we should all integrate together, particularly as I am an immigrant myself, but I also believe we should have the right to choose who supports us, providing it isn’t for bigoted reasons, just the same as I choose my friends, people I get on with, or if you are able to choose a team at work, people’s abilities will be important, but the team getting along and being the right mix of personalities will ultimately influence your choices even further.
There are issues with this too, sometimes finding the right match can be a challenge, and support staff who stand out quickly find themselves in high demand. Most staff in any industry have specific skills, are good at certain elements of their jobs, but occasionally someone comes along who can seemingly do every part of their job well. I’ve known a few support workers who can support anyone, anywhere in any situation. This is rare, of the hundreds of support staff I’ve known I can count on one hand the people that have this quality, for the most part we work well with particular types of people. For example, one worker who is very calm and quiet may be brilliant with people who require that to function, undemanding, relaxed but that worker may not be great supporting people who are high energy and need a great deal of energy in return to motivate them in the right directions. But this is a question for managers of services to answer, to get the right people to do the right jobs.
What is a support worker? A helper, a guide, a person with empathy and patience and most importantly imagination, you could apply these qualities to a variety of jobs, that would make a fantastic waiter or parking warden too. But in support work these should be non-negotiable. Does every support worker out there have these qualities? Of course not, it’s an underpaid job for unqualified people. Dynamic individuals will find themselves greater opportunities, which will pay them well, unless they really want to do it.
There are many people helping others who are inadequate for the job, some of these people have the right intentions but just get it wrong, others become abusers and are the type of people responsible for the Winterbourne View scandal. Unfortunately the job attracts bullies as well as people who genuinely like to help, again, it’s underpaid and unqualified.
To define what makes someone good at the job in any reasonable terms we have to understand what good support is. Support should always be individualised, fundamentally the answer is:
Does your support meet the needs of the person you are supporting?
If it does, then you are doing your job right.
The person with a disability may disagree that you are, as they may not realise that you are supporting them in the way they need. Many people with or without disabilities don’t necessarily know what is good for them.
Now that we have that incredibly broad definition of what good support is, how do we know we are in fact meeting a person’s needs, or how are we able to meet their needs, what are the skills and qualities required?
As I said above, certain qualities should be present in anyone in any kind of care/support/social work role.
Is key as opposed to sympathy. What is empathy? To me, and particularly in the context of support work it’s the ability to imagine how someone may be experiencing the world, or feeling about something.
Two people have broken legs, they have a fairly good idea of how the other one feels, how difficult it is to get around, how much of your life you have to put on hold because you aren’t physically able. But two people from different backgrounds are going to experience a broken leg in a different way. A single person who moved away from their family will face different struggles to one who has a partner and family around to help, someone who normally drives versus someone who doesn’t. I could go on, every person’s experience changes how they perceive and navigate their way through life, even with certain shared experiences and feelings.
In being a support worker you need to have some imagination to be able to put yourself in that person’s place, you can never truly know what someone feels like, but you can try. This ability to empathise comes naturally to many, we all have the capacity for some kind of empathy (not getting into a discussion on psychopathy) but not many of us can apply it at will. This is important in a support worker, knowing about a person’s life experiences is always valuable, but with or without that you still need to make an attempt to understand them.
Ability to Communicate.
Understanding someone is a start, but the second step is being able to put that into action when supporting them. Communication is the first thing. Later we’ll look at communication in its own chapter, techniques and strategies are important but like empathy you need a natural ability to communicate too. Noticing the nuances of behaviour and responding appropriately, is it time to lower your voice, change your tone, adjust your body language? We think greatly on these things but an instant and natural response is always best. Being a good communicator of course means being a good listener, communication is a two way thing otherwise it’s just noise.
Ask people in an interview what makes a good support worker and most often the first thing they will say is patience. It’s true, supporting people can often try your patience in a vast variety of ways, it may be behaviour, it may simply be that the person does things considerably slower than you do and one of the big things in support work is waiting, sometimes you have to wait for long periods for a person and you need to be ready to respond at all times. A person with a cognitive disability, or a person with autism who needs more time to process information might mean you have to do a great deal of waiting. Having “patience” for a person would usually mean it’s a person who is insufferable, a person you’d rather not deal with, so it can have a negative connotation.
The patience really needed comes in the form of giving time, give people time to express themselves, give people time to think, time to make decisions. Putting pressure on people only leads to hasty choices.
Creativity and imagination are closely linked, the ability to be creative also links to the ability to communicate. By creativity I mean a variety of things.
The ability to change your persona slightly, for one person you may need to be full of life, bubbly and energetic, for the next person you may need to be calm, minimise your communication, one person needs a soft friendly tone of voice, the next very clear directions. Often in my career I have put on different characters, still myself, not pretending to be someone else, but changing my demeanour, quite often nothing like I normally am.
Many people struggle to change the way they present themselves, but to a degree you have to play a character, or think like you’re in a different setting. Just like in a job interview you won’t reveal certain aspects of yourself, it’s not lying, just performing. Often when support goes wrong it’s a mismatch of staff and individual, and often it’s the staff who are unable to adapt as we cannot expect a person with Autism to adapt to the same degree…remember your imaginative leaps…
Creativity also takes the form of improvising, being able to change tack and pace quickly, particularly in a crisis. I will be the first person to tell you that you need structure for many, predictability and familiarity but unfortunately the world is unpredictable, a huge uncontrollable environment filled with living creatures that do seemingly random things. You need to be ready for this, planning is magnificent, but you can’t plan for every eventuality. Something as simple as a train being cancelled or a shop not having the product a person wants can be difficult to cope with, ideally you have phoned ahead or checked TFL for updates, but things happen, have a back-up plan, know your environment. Musical improvisers don’t just make noise over each other… some do, but for the most part that creative process is about listening, knowing your instrument, using imagination to conceptualise the next step, support work is the same.
Some people seem to have endless enthusiasm.
“This coffee is soooo good!! I love the world!!”
You know the type, but for most people our enthusiasm comes and goes, sometimes we’re just too tired, sometimes it’s because only topics of interest can get us enthused. But when I say enthusiasm in relation to support work I mean the ability to be interested It’s not jumping for joy and being full of energy all the time, it’s showing people that you want to hear them, showing people that what matters to them, matters to you. I’ve lost count how many times I’ve supported someone to do or see something I have little to no interest in, I’ve seen many films I would never watch in my own time, eaten in cafes I wouldn’t set foot in, let alone eat their food of my own accord. The enthusiasm again relates to empathy, try to see what the person is getting out of it.
I’ve had to support people to cook meals I really think are horrible, but that doesn’t matter, it’s not about me. If I am going to endure Shrek again, I will act as though it is marvellous… or if I have to help someone cook tinned rice pudding I will discuss that fact it is a British classic… My opinion doesn’t matter. There is the issue of informed choice in regards to “bad” or unhealthy decisions, so as a support worker you need something very fundamental… common sense.
There have been numerous occasions where I have been supporting a person to deal with a relationships issue, while I was in the middle of the break-up of my marriage, or telling someone the health and financial benefits of cutting down on drinking when I had just spent £50 on my credit card in the pub because I was broke, but they do not need to know this at all. I wouldn’t necessarily say I was practicing what I was preaching, but I certainly knew what was wrong with my own behaviour, and theirs. I cannot, and nor would I try to stop someone from living their life how they want (unless someone is at serious risk as a result) but I will give them the information they need to make an informed choice.
More accurately, a lack of embarrassment, when supporting people with disabilities you may often find yourself in situations where that person says something rude to someone, or behaves in an “unusual” way, you can’t be shocked, you can’t be embarrassed.
I often tell people I am “un-embarrassable” not to be confused with shameless, and it’s not entirely true, there are things that will embarrass me, but not at work. This is for several reasons.
Firstly, it may be a difficult situation in public, you need to keep your cool and deal with it efficiently. For example, you are supporting someone and they decide to take off all their clothes on the bus, as you are looking out the window trying to figure out if your stop is coming up before you know, they are naked. You don’t have time to worry about how you feel, you need to protect their dignity and support them to get dressed quickly.
Another reason is that you being embarrassed may in turn embarrass the person, may stigmatise them, it’s important to not make people feel bad, because often they are not in control of what they do, or it is communicative and feeling bad about trying to communicate won’t help anybody.
These are the qualities which I have seen in support staff in varying degrees, which has led to successful support, there are plenty of other virtues a person can have that will make them even better, or offer a different kind of quality support, but let’s not be greedy.
That covers the essentials, within each of those qualities everyone is going have very different ways of applying them, which is good, individuality is important, different personalities is important. I’ve certainly been guilty of not seeing a support worker’s value, thinking they maybe aren’t right, then I see them working with someone and all the qualities come out.
 BBC Skit comedy series with Matt Lucas and David Walliams
 Winterbourne View was a residential home and subject of a BBC Panorama program in 2011 revealing serious abuse and neglect of disabled people. The scandal caused national changes in legislation around residential care homes.
 Something of great interest to me, but an entirely different discussion to the normal variances of empathy in people. I highly recommend Simon Baron-Cohen’s Zero Degrees of Empathy
 Transport For London