Ethical Decision-Making in Two Care Homes

Abstract

Codes of ethics and conduct each try to set out what society expects of social service workers in their day-to-day practice. The tensions within these expectations are acknowledged in the literature, which reveals a growing concern that personal social service workers should be conversant with ethical theory and its implications for practice. Based on data from a survey of all workers in two care homes for older people, this paper examines the ethical principles underlying day-to-day decisions. Analysis of the data notes some variation in the complexity of response to simulated vignettes, where more autonomous practice was suggested by responses from care-qualified staff and by workers managed by a social worker. Overall, while there is evidence of a consistent commitment to offer the best possible care to each resident, few of these workers, at any level, are aware of the ethical basis for their day-to-day decisions; indeed there is little indication that they are aware that the decisions are ethical at all. This paper suggests that the conflation of rules of the job with moral rules occurs across staffing levels and concludes that all care staff training should include a more specific focus on ethical reasoning.