Relational working under pressure : managing tensions in disability support work

Abstract

The purpose of this study is to make visible a field of social care practice that is largely invisible, lonely and private in nature. It will examine the situation and experience of staff supporting adults with disabilities both in their own homes and congregated settings in the west of Ireland. Historically in Ireland, services for adults with an intellectual disability have changed beyond recognition from the asylum of old to the current emphasis on independence and social inclusion. Standards of housing and the quality of life of service users are increasingly under the microscope with recent attention and inspections from the Health Inspection and Quality Authority (HIQA). However, a largely unexplored area is the experience of the staff in these environments. The role of a disability support worker is multifaceted and complex. Daily duties include personal care, cooking, cleaning, administering medication, supporting social inclusion, teaching independent living skills, managing challenging behaviour, administration and engaging in continuous professional development. This study addresses the relational dynamic within which their responsibilities are carried out. Semi structured interviews were carried out with 26 staff and 8 of their managers. Fieldwork findings suggest that disability support work is nuanced within a complex interweaving of bodywork and emotional labour. The work is fraught with tensions between the desire to act in a caring, nurturing role with a sensitivity to the needs of the service user and pressure caused by time and resource constraints to complete tasks quickly, cheaply and efficiently. This impinges on their capacity to form meaningful service user staff relationships and is further augmented by a disconnect from management and the wider context. Improving our understanding of the experience of staff can contribute to a positive culture of person centredness, enhance the visibility of such practice and contribute to the creation of a strong professional identity in this sector.