Familiarity Breeds Contempt

Over the course of the past months, who could help but feel a plethora of emotion as the horrors of Winterbourne View have unfolded before our very eyes: Absolute disgust that an organisation could get to the point where such blatant institutional abuse becomes a part of daily life, anger at the systems in which we work as they are revealed as insufficient to protect the most vulnerable in our society or perhaps a heart-wrenching empathy towards the vulnerable and a passion that things have to change and something done… but what?

It will hopefully have challenged us all as a professionals.  Is it just possible that as we go about our business there is a very real danger of becoming complecent unless we keep on out toes and remain true to our professional standards and ethical practices?  I’ve been reminded how very important the role of those who commission services and the need for greater accountability when choosing services for individuals who can’t choose for themselves.   Are we pressured into choosing the cheaper option even when we know in our heart that it isn’t the most suitable?  Do we sigh a sigh of relief and accept without question when we find a service that will accommodate the individual with particularly challenging behaviour knowing that the option will be limited? Do unrealistic case-load sizes prevent us from spending time to think outside of the box and identify the very best service and then think how it might be achieved? Do we have a professional relationship with providers when a less formal relationship can be so much easier? If we become too familiar those so important boundaries can become distorted and increase the risk of poor practice or even abuse going unnoticed or being excused.

I started my social care career working in a residential home for children with autism and it must be said that in my experience the majority of carers are decent caring people who go the extra mile.  Most don’t get paid heaps, have to work shifts but still turn up at work asking how they can make the next 8 hours the best they possibly can for those they have come to work for.  However, there are some for whom that isn’t the case and over the past couple of weeks we have seen 11 photos that will probably remain imprinted on our minds long after the media frenzy has died down.

I’d really like to hear how recent events have perhaps challenged you as a health or social care worker as you strive to help deliver the very best services to those who need them. I also look forwards to hearing how the Department of Health is going to drive service commissioning, delivery and safeguarding forwards.  What is agreed upon is that there needs to be a radical overhaul of social care; what doesn’t see so clear is what that will look like.


2 thoughts on “Familiarity Breeds Contempt

  1. Thanks for sharing your thoughts, some useful considerations. There’s certainly a lot to be said for values and ethics being at the heart of good care and for me that is exactly what recruiters should be teasing out at interviews. Not finding people who can answer a series of largely uninspired questions about how to care for someone; that can be taught. A good value base can’t be taught, it’s instilled in us from childhood and remains with us.

    I completely agree with your comment about procurement. A shiny building sometimes masks a whole plethora of bad practice. Conversely, I’ve see older buildings run extremely well because all the focus in on care rather than the image portrayed.

  2. A thoughtfully developed post, thanks for taking the time to contribute. In an ideal world, we would only ever employ people with such a passion to help others they’d probably do the work for free … However …

    Having worked as a carer for children with autism in some pretty challenging situations, I can certainly relate to the concepts that you are presenting and also the dangers of not being able to ‘snap out of possibly dangerous behaviours’. That said, it was evident that some carers had the ability to do exactly that and others weren’t able to; it wasn’t always the experience or knowledge of carers that was the determining factor. For many years now, I have been asking myself what made those carers (and I would like to think that I was one of them) different?

    Your comments about resources during interviews are spot on in my opinion. We don’t have the luxury of endless pots of money to spend refining interview process’ to find the perfect candidates. Even if we did, it may not be the best use of public funds. That said, I’m not sure that some of the larger, profit-making companies in social care are using public or private funding wisely. Take Winterbourne View as an example: Thousands of pounds per week per patient. With a turnover such as theirs, Castlebeck (and others) should be at the forefront of solving issues such as those being discussed, not creating them! My experience of interview though (albeit not a huge amount of experience admittedly) is that a series of knowledge questions are asked and if the answers are right, the position is filled. I would like to see employers move away from a heavy dependence upon identifying knowledge and identify the personal values of candidates. After all, knowledge can be learnt.

    Values are pretty elusive concepts but I do think that they are at the heart of such issues. Values are fluid yet something we strive to capture and recreate to develop the perfect staff team. I did see an article recently on the Community Care (1) website that attempted exactly that. It would be interesting to see some of their research behind the development of their tool. We have minimum standards of care that are imposed by the state but also personal preferences of service users themselves. What I consider an acceptable value base might appear imposing and completely unacceptable to someone else. Of course, recruitment is just one element of safeguarding vulnerable adults and without quality training and supervision, the right recruitment process might be in vain.

    It clearly isn’t as simple as just saying organisations should just employ the right people but I do think that we have some way to go to reach acceptable standards. It will be interesting to watch the developments at Castlebeck and how they ensure high quality standards of care. It is interesting to see that they identify on their website that all service users have access to independent advocacy. Another safeguard that is seriously lacking for service users elsewhere.


    (1) http://www.communitycare.co.uk/articles/09/10/2012/118578/the-recruitment-tool-that-aims-to-spot-care-staff-with-the-right-values.htm

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