A Culture of Care?

I can’t help it but I’m somewhat unimpressed and uninspired by claims that Castlebeck’s transformation is nearly complete (As reported by The Guardian).  I’m sure Mr Sullivan has done a sterling job in dragging the remains of homes such as Winterbourne View towards acceptable standards but the very fact that such poor standards of care are evident in contemporary care is a shameful indictment on our society.

It riles me not only that such abuse took place in the first instance, but that it wasn’t picked up by the care provider.  Would the abuse still be happening if it were down to Castlebeck to identify it and take action?  I shudder to think that the answer might be a resounding “Yes”.  Also to think what else may be happening within care homes across the UK where vulnerable adults don’t have the benefit of family involvement or carers with the insight to blow the whistle on abuse … or Panorama!

 Having worked with numerous residential and nursing homes, it is not hard to see how totally dependant some vulnerable members of our society are on those paid to provide good quality care:  Care that is monitored and regulated and where safeguarding policies are in place to ensure that those who can’t speak up for themselves are protected from abuse… Really?

I can’t help but recalling one particular home, the manager was sitting in a very well equipped, spacious office when I arrived congratulating herself at the marvel that were her new, glossy brochures. Showing prospective families just exactly how decent the home was with its ample garden blooming with flowers and general good cheer.  Carers smiled on the front cover in a manner that exuded quality, person-centred care from more carers than one could possibly need whilst care-free residents tucked into their gormet meals.

Sadly, the reality was very different:  Insufficiently trained carers that didn’t have the time to answer a call-bell that had been rung for the umpteenth time as the room’s occupant continued to lie in urine soaked sheets.  Then there was the missed opportunity after missed opportunity to spot pressure wounds that were silently getting progressively worse – out of sight, out of mind.  All the time, the owner continued to congratulate herself and confidently sell the homes’ services to prospective new residents and their families.  Oblivious to the reality that was unravelling the other side of her plush office door.

Of course, such business’ need to be well run but when business comes before quality of care something needs to change.  Whole cultures need to change because if the underlying ethos of a home’s manager is developing a thriving business, how can the ethos of carers within that home be anything different … such as caring perhaps.  Whilst I’m all for serious case reviews and learning from past mistakes, I’m not convinced my ministers’ exclamations that, “We must learn from this so that these things must never happen again!”   I fear that they will happen again … and again until the whole culture of care changes to one of … well, care.

I can recall perhaps just a handful of small care homes where the managers rota themselves on shift so they know what’s going on and can identify any training needs.  Where more money is spent on care than on prtraying a good image to prospective new residents.  They may not be glistening with a new coat of paint every 6 months or benefit from TV advertising but they are run with an underlying ethos of care and respect and reflect far more the brochures that are displayed elsewhere, but they don’t have their own glossy brochures.  All they have is a good reputation which gets them by more than adequately.

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5 thoughts on “A Culture of Care?

  1. Couldnt agree more. If you have first hand stories like this there is a place to go to share them. And equally and probably more importantly, if you have first hand stories of excellent service from a care home then go to http://www.carehome-reviewer.com. It has been set up with one mission – to help improve the standards in every care home. No secret agenda, no big corporate wheels to oil, just a chance to help improve the levels of care and make a difference for the old and vulnerable who may have to use the care home sector in the future. Doing something has to be better than doing nothing more than spouting a whole lot of placatory claptrap.

  2. many years ago i was asked to find residential placements for under 65’s with Korsakoffs Syndrome and found only one home i would of wanted to live in myself. It was run and owned by a ex-RMN no commercial chain it looked shabby from the outside, peeling paint etc; and inside the rooms weren’t all regulation size but the actual care was just that CARE tailored to the individual and their unique needs not unit costs and profit orientated. It can be done

    • You’re right. It can be done with hard work. One person once described their attitude towards care as a reflex – They didn’t have to try and be caring, it just happened and was the most natural thing for them to do.

  3. The social work fraternity emphasis is currently on powers of entry into a few personal / family homes where they suspect something negative is occurring regarding the care of someone vulnerable. No hard evidence needed, just a safeguarding policy and law to give you this power to potentially misuse.

    Pit this against the most vulnerable voiceless in both state and private institutions subject to daily neglect / abuse and the Liverpool pathway for being old and dependent. We do not hear the mantra of social work ‘professional bodies’ on this to the same degree. Panorama showed up local social services safeguarding as wanting too, (as has Rochdale, Birmingham for children). The issue with adults will go the same way. There is a vast gulf between carrying out policies and procedures and actually offering guaranteed protection to all the vulnerable when the social culture fails to actively promote this. The belief that something positive is happening when safeguarding investigations occur is not always borne out. Some investigations are the result of textbook theory type judgements- not based on undisputed evidence / disclosure.

    Media frenzy has, in an age where there are more ‘sheep’ than independent thinkers, created a momentum which like a vortex will suck in both innocent and guilty because everyone is making a noise without really knowing or understanding the whole picture, or the truth.

    With the most vulnerable people being in residential institutions of ‘care’ one might have thought that leaving safeguarding to the managers and those running the institutions puts them in a similar position to the BBC currently- people suspect a cover up in poor investigations. So how are these people to be effectively ‘monitored’ and by whom? The CQC is not up to the job of robust monitoring as it focuses on ‘paperwork’.

    As resources are reduced only someone stupid would not wish to look at areas of intervention of the majority of the vulnerable with the potential for maximum impact. But who has the intelligence for this?

    • There are echos of my own thoughts in your response. We don’t have sufficient srtuctures in place for single agencies to ensure the safety of vulnerable adults whether it’s the commissioners, providers or regulators. Even if we did, I don’t think it should be the responsibility of just one. There needs to be a radical overhaul of the system (and probably the care sector as a wole) to ensure that a combined effort of commissioners, providers and regulators work tirelessly together with a single vision – to provide excellent care free from abuse.

      Isn’t it frustrating that in 2012, we’re still dreaming of joined up working!

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