Adele van Wyk, social worker and PhD student at University of Edinburgh, reports from Race Equality Week, which is run by London ADASS and supported by the ARC South London Social Care Theme (based at the NIHR Policy Research Unit in Health and Social Care Workforce). (985 words)
The London Association of Directors of Adult Social Services (London ADASS) presented a series of online luncheons as part of its Race Equality Week (7-13 February 2022). In this blog, I reflect on the Thursday lunchtime conversation (10 February), attended by 122 practitioners and managers from a wide range of social care services, which focused on cultural competence in adult social care. In the first section, I share some of my thoughts about the key points made about cultural competence, and in the second, some thoughts about spirituality in care homes.
# Culture is a strength and an asset. Fact: It might be, but it might not.
# All members of a culture subscribe to the same values. Fact: Not everybody is interested in having kosher food or going to the prayer room. Some people stay away from religious celebrations but enjoy the cultural associations with religion.
# People from Asian and black African backgrounds have big extended families supporting them. Fact: This might be true for some, but for many it is not.
Key messages for me raised by Victoria Grimwood, a practicing social worker and manager, were:
- Anti-racist and culturally competent practice is interrelated but different. Cultural competence is an important element of anti-racism.
- Migration background may influence a person’s view on their own culture.
- Discrimination does not always come from the ‘outside’ – people from your own culture sometimes see you as being too assertive or too Westernised.
- Cultural competence needs to be an integral part of the social care workplace (and may entail psycho-education for and by practitioners).
One participant stated that although practitioners want to be culturally competent, current practice guidance is limited and needs to be further developed and informed by practice with adults. In addition, more innovative practice guidance and research are needed to reflect the strengths and asset- based approaches that are characteristic of contemporary social work practice.
The experience of people with migrant backgrounds are likely different from the experience of culture among people who have long been settled in a country or place. As one participant said:
“I have migrated from Africa, but what I define as cultural may be different to someone in Africa … my children who were born here have different experiences of racism than me.”
What does culturally competent practice look like?
Culturally competent practice involves asking an individual about their culture and not assuming, while acknowledging and respecting differences. It further calls for, among approaches, reflective practice, professional curiosity, working in partnerships, and an understanding of intersectionality, rights, and social justice. Values therefore need to be put into practice (action not just words). Other factors that support culturally competent services in parts of London are accessible information, the use of adult family group conference with co-ordinators, and good collaborations between commissioning and provider services, supported by up-to-date population data and analytics about people moving into the area.
Spirituality in residential care
- It is important to consider culture and spirituality in social care as they can be invaluable to people’s well-being.
- Care home residents may have diverse cultural and spiritual needs.
- Spiritual well-being can be found in many places (e.g. in nature, creativity, relationships with others) not only in religious practices.
- There is a lack of attention to older migrants – more studies are necessary to improve health and social care for them.
Through examples of conversations with care home residents, Olivia Luijnenberg, from King’s College London, described how people attach meaning to certain cultural artifacts that relate to their core being and identity. This is often entangled with stories of migration or their cultural background. Although care workers often refrain from having conversations with residents about religion or spirituality, she found that residents are keen to discuss these matters. She suggested that care workers can use culture or spirituality to connect with residents, who may be very frail, by starting conversations or speaking about their own culture (e.g., festivals, foods, traditions).
Ethnicity and religion are important in migration and identity, and evidence suggests that migrants will retain parts of their heritage and culture regardless of how long they have been in a new country. It is therefore imperative that social care and support respond to these inherent needs of people with migrant backgrounds.
As practitioners, we should acknowledge the different beliefs of some cultures regarding the origin and treatment of mental ill health, for example, and the overlap between spirituality / spiritual well-being and someone’s cultural background. Although it is important that safeguarding is responsive to risks of harm, people should be able to talk about their cultural beliefs without fear of their cultural convictions being disbelieved or dismissed. This calls for the use of a combination of approaches, as well as the psycho-education of care workers, psychiatrists, psychologists and social workers to feel more comfortable having conversations about their beliefs and spirituality and have risk assessments that reflect cultural understanding. Furthermore, as Olivia showed, using cultural artifacts may help with conversations about cultural and spiritual matters and further enhance culturally competent practice.
Focus for further research
- The cultural and spiritual needs of people without mental capacity to make specific decisions.
- Innovative practice guidance and research that reflect the strengths and asset- based approaches that are characteristic of social work practice today.