Promote Professional Development: Sample Essay

Professional Development in Health & Social Care

By Daniel Dutton (4th August 2019)

Continuing Professional Development (CPD) is a term used to describe the wide range of learning activities that individuals undergo as part of their professional growth. It is not limited by formal training and can also include the collation and analysis of feedback, reflecting on aspects of work, on-the-job experience and independent research. It can be thought of as lifelong learning.

CPD is an essential and fundamental part of working in the health and social sector because it makes learning a conscious and proactive activity, keeps us up-to-date with the latest legislation and best practice and helps to prevent our skills from becoming obsolete.

In this essay, I will be reflecting on my own professional development since starting my career in the health and social care sector and looking ahead towards my future aspirations.

But first, it will be useful to explore exactly what ‘reflection’ is and some of the different theoretical models of reflective practice.

Reflection is the process of thinking about a previous experience and asking what could have been done differently to lead to better outcomes for everyone involved. The insights that are unearthed from doing this can then be used in similar situations in the future. The payoff of using regular reflection as part of CPD is that an individual’s practice gradually improves and experiences are turned into learning opportunities.

“Learning is the process whereby knowledge is created through the transformation of experience. Knowledge results from the combination of grasping experience and transforming it.” (Kolb, 1984). In essence, Kolb is saying that experience can be used to gain knowledge and he developed a four-step experiential learning cycle which explains how this can be achieved:

1. Concrete Experience – The cycle begins with a new experience.
2. Reflective Observation – The learner reflects on the experience to discover new meanings and any gaps in their understanding.
3. Abstract Conceptualisation – The learner develops new abstract ideas from their experience or modifies existing ideas.
4. Active Experimentation – The learner uses these new ideas and concepts in future experiences.

When the learner has completed step four, they can return to step one and reflect on their new experiences.

Through his research, Kolb also discovered four types of learning styles. Of the four, I am of the converging style due to my preference towards thinking and doing rather than feeling and watching. This means I like to work independently, solve problems, find practical uses for ideas and theories, experiment with ideas and deal with technical tasks rather than interpersonal issues.

Gibbs (1988) builds upon the Kolb model by providing more depth and introducing two more steps to the reflective cycle, which help the learner to develop the links between their experiences and their knowledge and learning. “It is not enough just to do, and neither is it enough just to think. Nor is it enough to simply do and think. Learning from experience must involve linking the doing and the thinking.” (Gibbs, 1988).

The Gibbs reflective cycle consists of:

1. Description – What happened?
2. Feelings – What were you thinking? What were you feeling?
3. Evaluation – What was good and bad about the experience?
4. Analysis – What sense can you make of the situation?
5. Conclusion – What else could you have done?
6. Action Plan – What would you do differently next time?

Gibbs agrees with Kolb’s theory that experience must be actively transformed into knowledge via the use of reflection. “Without reflecting upon this experience it may quickly be forgotten or its learning potential lost. It is from the feelings and thoughts emerging from this reflection that generalisations or concepts can be generated.” (Gibbs, 1988).

Both models demand that there is a deliberate process between the experience and the learning and this process is known as reflection. Both models were also developed to be used for any learning experience, however Kolb’s model was designed primarily for educators whilst Gibb’s model is used mainly in healthcare. Gibb’s model introduces the concept of thinking about the thoughts and feelings that were present during the experience and asks questions that force the learner to explore the experience in more detail.

Personally, I much prefer to use the simpler Kolb model as I do not believe that the Gibbs model offers a lot more for its added complexity. I find that when I think about an experience I naturally consider what I was thinking and feeling at the time. I do not feel that I need Gibb’s extra step to do this. Similarly, the ‘analysis’ and ‘conclusion’ steps of Gibb’s model seem to me to be adequately covered by Kolb’s ‘abstract conceptualisation’ step.

To me, the simplicity of Kolb’s reflective cycle also makes the reflective process an easier and more enjoyable activity, which means I am more likely to perform it in my day-to-day practice.

This may be because I have worked for most of my life in the ICT sector and my roles have often involved coding. All coders are taught to write programs that are as efficient as possible without sacrificing results, which is why I often have an innate ability to break things down into their simplest form. This also links in with my preferred converging learning style.

I did not start working in the health and social care sector until 2013 when I was thirty-four. Having been a self-employed website designer for the previous five years and being profit-driven for my whole working life, I decided I no longer wished to be motivated by money but wanted to have a positive impact on the lives of others and ‘give back’ to society.

Having very little knowledge of the industry, I was surprised to discover that entry into a care role required no previous qualifications or experience. I saw an online job advert for a newly-formed care company and applied.

My first position as a Support Worker required a short face-to-face interview, an assurance of flexibility on my part and a check with the Disclosure and Barring Service (DBS). Performing enhanced DBS checks are an important legal and regulatory requirement for health and social care employers because they provide safeguards to ensure that employees are safe to work with vulnerable individuals.

Once my DBS check came back clear, I began a 12-week probationary period in a supported living setting with two young adults with learning disabilities, mental health conditions and Autistic Spectrum Disorder (ASD). My training consisted of a short induction and a twelve-hour shift shadowing another employee before being able to work on my own. I did not receive any formal training until around six months later. This consisted of a series of in-house half-day training sessions on learning disabilities, mental health, ASD, safeguarding and medication administration. Unfortunately, by this time there was very little covered in the training that I had not already learned through experience or my own research.

On reflection, I believe that my organisation did not provide adequate training regarding the role, responsibilities and duties of a health and social care worker. It felt as though I was thrown in at the deep end and left to sink or swim. I often felt unsure about my rights. One individual that I provided care for was very aggressive and violent and I did not know if I had the legal right to use force or restraint if he attacked me. Another individual was clinically obese and I did not know if it was right to withhold food from him for his own benefit or not. This left me with a lack of confidence in my abilities and sometimes fear and foreboding about going into work.

Although there were a lot of negative aspects to this experience, there were also some positives. My manager and many of my co-workers had previous experience in the industry and were always happy to provide guidance. This also resulted in the team becoming close-knit as we faced many difficult situations together, which developed a camaraderie. The experience of learning ‘on-the-job’ helped me to develop my initiative and taught me how to identify whether situations were ones I could manage myself or if I needed to request additional support.

In addition, it spurred me on to conduct my own research and increase my own knowledge, skills and understanding independently. 

During supervision, appraisal and in informal chats with senior management, I would express my concerns about the poor induction and training procedures. Having the systems in place to obtain formal support through supervision and appraisal ensured that my concerns were treated seriously and were more likely to be actioned because they were recorded. Although expressing my views in an informal setting may not in itself have spearheaded the changes I was looking for, it did reinforce my formal concerns and kept the issues at the forefront of other’s minds. Also, at the end of every training session I would write on the feedback form that the training would have been far more useful within the first month or two of me starting in the role.

Looking back, I feel that I expressed my concerns using the correct channels, however the change took far too long. If I was faced with a similar situation today, I would have been more assertive and put more pressure on senior management to make the required changes in a more timely manner. I feel that the increased self-confidence, knowledge and understanding I have today as well as my standing within my organisation would allow me to push through corporate changes faster.

Over the course of a couple of years, my own feedback and the feedback of others helped senior management steadily improve training and induction for new starters as well as long-standing staff. Thankfully, today, my organisation has a more robust recruitment and induction policy and staff are provided with more opportunities to pursue industry-standard qualifications and participate in formal training, however I feel we still have a lot of room for improvement.

I would like to see my organisation ensure that all new starters complete (and are awarded with) their Care Certificate as part of the induction process to ensure that all staff are competent in their role. As Skills for Care (2019) state on their website “The Care Certificate: is the beginning of the career journey for those new to care; is a foundation for health and adult social care integration; ensures those new to the sector are supported; is endorsed by the Care Quality Commission (CQC); is a CQC expectation – all employers should now be offering it.”

I was not required to complete the Care Certificate as it was not introduced until 2015, however I did complete my NVQ Level 2 in Health and Social Care in this year and, in 2017, I completed my Level 3 Diploma in Health and Social Care. Between 2017 and 2018, I was involved in a year-long training pilot organised by Skills for Care for aspiring managers. In 2017, I was also promoted to the position of Senior Support Worker. Shortly after this, I was offered a promotion to Manager but have not yet taken it due to personal commitments, however the offer is still open and I currently perform most managerial tasks in collaboration with my manager.

My manager has been a fantastic source of support for professional development, providing guidance and encouragement throughout my journey, both formally and informally. I have supervision with her every two months and an annual appraisal.

My manager and I performed my most recent appraisal in February 2019 (see appendix A) and the feedback I received was that I am already working at management level and would perform well in the role when I am ready to step up. This gave me further confidence in my abilities. I also requested the opportunity to be involved in other management activities that would support me with my work on my Level 5 Diploma, which my manager agreed to delegate to me. I raised concerns with my manager about some issues that I had with our organisation, particularly poor communication between teams and the handling of confidential information. My manager agreed with me and said she would be working with other managers to resolve these issues.

I recently (and uncharacteristically) forgot to sign the medication administration record (MAR) sheet for an individual’s medication twice in two weeks. My manager informed me of my error on both occasions and on the second occasion filled out a professional competency form as part of company policy. This formal process prompted me to look at the reasons for my mistake and on reflection I deduced that I had had difficulties due to recent changes in organisational policy – the MAR sheet had gone from a paper-based format to a digital format and then back to a paper-based format. I had forgotten about the most recent change and was still recording medication administration using the digital format. Although the changes in policy contributed to my error, it was still my responsibility to ensure that I adjusted to the changes and assured her that I would put a reminder on my phone to ensure that it did not happen again.

As this example shows, it is important that mistakes are acknowledged and analysed in a transparent way so that they can be rectified promptly and any potential further impact reduced. By learning from mistakes, we reduces the likelihood of them happening again and improve overall practice. The Skills for Care Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England (2013) sets out guidance for best practice in this regard by stating that Healthcare Support Workers must “be able to justify and be accountable for your actions or your omissions – what you fail to do” and “report any actions or omissions by yourself or colleagues that you feel may compromise the safety or care of people who use health and care services and, if necessary use whistleblowing procedures to report any suspected wrongdoing.”

This is especially true for more serious cases such as the recent Panorama investigation into the abuse of vulnerable adults by staff at Whorlton Hall Hospital (Undercover Hospital Abuse Scandal, 2019). The television programme documents staff willfully neglecting and ignoring patients with learning disabilities and autism and when they did interact with the patients, it was to taunt, provoke and intimidate them. Inappropriate restraint was also used on occasions and some of the staff appeared to have complete disdain for the individuals they were supposed to be caring for. Both the public and industry perception of the footage was one of shock and horror with Dr Paul Lelliot describing the abuse as ‘sickening’ (Care Quality Commission, 2019).

My own reflections after viewing the programme were that some of the staff were unsuitable for a care role and appeared to have a lack of training. There was also an underlying culture that this sort of practice and behaviour was acceptable. On an organisational level, I believe that the privately-run company did not have fit and proper recruitment policies or quality assurance systems in place to adequately detect and manage errors and abuse.

The implications for the company were that the hospital was closed down, the patients transferred to other facilities, the staff involved immediately suspended and ten employees were arrested. Over the coming months, they will also have to cooperate with the police investigation. (BBC, 2019).

During the aspiring manager’s pilot I underwent in 2017, I connected with other professionals external to my organisation that would help me with my professional development. This includes my local Skills for Care area manager who keeps me up-to-date with training opportunities and care workers and managers from other organisations. Sometimes, the workers and culture within an organisation can be blinkered, so it is useful to have the wider viewpoint and support of others within the industry. They may also have specialist knowledge, information or unique experiences that would not be readily available internally. 

One such example was when I was explaining to a member of my cohort that I was getting a lot of phone calls from my staff for things that they really should be able to manage themselves. She advised that instead of telling them what they need to do, simply ask them what they think they should do. I tried this and nine times out of ten, the employee knew the answer to their own question. By affirming it with them they became more confident in their own abilities and began to trust themselves that they knew the answer without calling me. Consequently, the phone calls reduced.

To examine my professional development going forward, I have created a personal development plan (PDP) with my manager to use as a roadmap for my progress (see Appendix B). We worked on this in partnership because it is important that selected learning activities and opportunities are both beneficial to the organisation as well as the individual and are relevant to the job role.

We agreed that my strengths are that I am exceedingly well organised, very focused on my own professional development and have the knowledge, skills and understanding to be working at management level. However, currently I lack the experience of having full management responsibilities and this is the area we agreed that I should develop in. One option was to take on a full-time management position, however I declined this (in the short-term) as I felt my current personal circumstances meant that it would be very difficult for me to put the requisite time and effort into the role. Instead, we agreed that my manager would delegate more managerial responsibilities to me to assist with my learning alongside working towards my Level 5 Diploma in Leadership and Management. This would include tasks such as staff supervisions and appraisals, developing rotas and checking timesheets – I am already responsible for monthly finances. My manager agreed to mentor me in these responsibilities. Then, I will step up into management within the next two years.

My goals to take on more responsibility and complete my Level 5 Diploma have been prioritised to begin immediately, with the step up into a management position within two years. I will evaluate my PDP by reviewing it on a monthly basis and reflecting on my progress. I will ensure that I am on track with my learning and make adjustments to the plan if and where necessary.

These goals fit in with my own learning style of converging, which incorporates the thinking and doing aspects of learning. Undertaking my Level 5 Diploma will provide me with a sound theoretical foundation (thinking) and the increased responsibilities will give me the opportunities to experiment with this knowledge (doing).

References

• BBC NEWS. (2019) Whorlton Hall: Hospital ‘abused’ vulnerable adults. [Online] Available from: https://www.bbc.co.uk/news/health-48367071 [Accessed: 6th August 2019]
• CARE QUALITY COMMISSION (2019) Statement on Panorama: “Sickening abuse of vulnerable people”. [Online] Available from: https://www.cqc.org.uk/news/stories/statement-panorama-sickening-abuse-vulnerable-people [Accessed: 6th August 2019]
• GIBBS, G. (1988) Learning by doing: A guide to teaching and learning methods. London: Further Education Unit.
• KOLB, D. A. (1984) Experiential Learning: Experience as the source of learning and development. New Jersey: Prentice-Hall.
• SKILLS FOR CARE. (2013) Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England. [Online] Available from: https://www.skillsforhealth.org.uk/images/services/code-of-conduct/Code%20of%20Conduct%20Healthcare%20Support.pdf. [Accessed: 6th August 2019].
• SKILLS FOR CARE. (2019) Information for Employers. [Online] Available from: https://www.skillsforcare.org.uk/Learning-development/inducting-staff/care-certificate/Information-for-employers.aspx. [Accessed: 4th August 2019].
• ‘Undercover Hospital Abuse Scandal.’ Panorama (2019) [Television] BBC, UK, 21:00 22 May 2019, BBC1. 59mins. 

Appendix A – Appraisal

Appendix B – Personal Development Plan

Daniel Dutton (July 20th 2019)