New site rules – please read before commenting

In the past week I and others have posted expressed skepticism that the Rotherham UKIP case is likely to be as clear-cut as it’s currently being presented in the media. Others have responded giving reasons why the stated version of events may not be so implausible after all. Some people have given good and informed arguments as to why the latter may be the case, and I’ve invited one of them to make a guest post giving their analysis. Either way, an investigation is taking place, so hopefully we’ll all get some answers eventually.

Alongside this debate, there’s also been a slew of comments about which all I can say is…..Oh dear.

It’s one thing to say why you think Rotherham Council are likely to have made a bad decision. It’s quite another thing to accuse an entire profession of being evil baby-stealers, or part of a hidden political agenda. I think that’s inaccurate and also quite offensive to many dedicated professionals who do a difficult and often unthanked job.

Also in the past few days, I’ve had to delete a comment where the author posted a YouTube video of him interviewing his wife about the ongoing child protection case against them.

As a result of this, a couple of commenters have had their comments unapproved, and I’ll also be keeping a stricter eye on the comments threads.

Just to be clear, here’s the sort of thing that might get your comment unapproved or not approved in the first place.

• Referring to Social Services as “the SS” or “the Stasi”.
• Accusing another site user of being part of a hidden agenda, based on them having a differing opinion to you.
• Conspiracy theories involving Common Purpose, a organisation that strikes me as operating some deeply boring public sector management training, but which is unlikely to be part of anything sinister.
• Making public appeals for support over care proceedings that have been initiated against you. Apart from being against the site rules, doing this really, really isn’t going to help your case and in fact may make it worse for you.
• Dismissing care leavers who give a different view from yours as “token”.
• Telling someone their opinion is invalid because they work for Social Services or the NHS.
• Declaring basic rules of client confidentiality to be evidence of a secret conspiracy.

I appreciate some people may not appreciate this infringement on their freedom of speech. But don’t worry, there’s already an online forum where your views will be appreciated.

 

 

Grim up North? grimmer down South

“It’s grim up North” I am not sure of the origin of this phrase but on a frosty Wednesday morning I know what it means. I also know that in the Social Work world it is grimmer in the South. I think that it is important not to become cocooned in your own place and space and that it is affirming to look around and see what is going on in other places and spaces. Over the last week or so I have been drawn to what is going on in England and most importantly the impact this has on Social Work.

 

Looking at it from the outside I feel for those people who use social work services and for those who provide social work services. The never ending debate on social works public persona rumbles on and almost everyone I have spoken to on the subject has an opinion, but that opinion is undoubtedly shaped by two (or more) influential forces, namely the media and the government. When both seem to line up in opposition to social work it is an uncomfortable place for professionals and service users to be.

 

Let us consider Michael Gove’s recent speech on Child Protection reform. It is disingenuous to suggest that his speech was about Child Protection reform; from my reading of it it seemed more to be about Gove locating social work in the cross hairs and gently squeezing the trigger. Make no mistake his speech was about a root and branch reform of the social work profession, from training and education to direct practice. The focus on social justice and ethical approaches in the provision on support to the vulnerable has long been anathema to politicians such as Gove.

 

Astonishingly he managed not to mention Eileen Munro’s work on Child Protection or the work of the Social Work reform board. To me this is a clear indication that Gove and his government colleagues have a direction of travel and are not going to be put off, especially not by rigorous academic evidence or the expert knowledge and experience of professionals in the field. Gove did however provide some evidence, from a Times journalist, which reminds me, I must set the Sky to record the outcome of the Levenson inquiry, now who owns the Times??? Who is being investigated for press standards and ethics???

 

Most worrying seems to be a simplistic linear view that there are a certain number of “problem families” and that social work should become more ready to remove children from these families and that the adoption process should be simplified to allow for a speedier transition from these problem families into the arms of nice middle class adopters. Social Workers need to become more sensitive to squalor and concentrate less on asking intimate personal questions of adopters, after all anything is better than where these kids were, right?

 

It is packaged up in simple language and simpler terms of reference. Social work is failing the most disadvantaged children. Blame is attributed to the professional and the most vulnerable in our society are played into a political game that seems to have at its heart a desire to erode a fundamental function of social work; asking difficult questions, either of prospective adopters or the systems that people interact with that can, if not checked, disadvantage people who are already vulnerable.

 

If social workers are not allowed to be reflective, analytical and critical and if students are not encouraged to learn about the complexities of peoples lived experience then that amounts to a reform of the profession on an unprecedented scale. For me it would fundamentally change the nature and scope of what we do. Social Workers operate at the very margins of society, it is vital they have an understanding of why people find themselves there and if social workers find it unpalatable that people are living in such extremes and are willing to challenge it then so much the better. Not just for the profession and for those who use the services but also for those who believe that in a truly democratic country the importance of a unified professional voice that seeks to support the most vulnerable and disadvantaged is vital.

 

Rotherham is a case in point, you may or may not agree with a decision to remove Eastern European children from a family who are members of UKIP but it seems to me that this was a tragic example of a situation that should have been played out in a confidential manner being played out in public for political gain. I question the morality and the ethics of anyone who would seek political advantage from the experiences of children in foster care. These are the very vulnerable children that Gove wants us to believe he can protect more fully, it seems hypocrisy then to conflate their situation to prove his point. And for those in the press who rushed to get this story out there willingness to see the “story” before the children is indicative of a section of our society that has lost some sense of proportionality.

 

Gove does his best to ignore some stark facts, we live in terribly austere times, his government has cut jobs and services, his government has a fundamental belief that public service should be reducing, his government also believe that reducing the support provided by the welfare state is desirable as it offsets the economic crisis, particularly if we reduce the availability of welfare benefits through the aggressive use of means testing, his government believe that privatisation of the NHS is something to aspire to. All of this is an unprecedented attack on the safety net that we have always known to be inadequate even in the most financially secure of times.

 

An active, voluble social work profession is not so much desirable as necessary attacking it and those who use it for political advantage is tragic. It might be grim up North but I fear it is even grimmer in the South

Failing standards belong to failing organisations not their staff

Failing standards belong to failing organisations not their staff.

Rotherham: Truth and Politics

The only time I read my local paper is at the Indian takeaway. Whilst waiting for my korahi chicken yesterday evening, I disinterestedly flicked through the familiar mix of parking problems, noisy neighbours and oversubscribed schools. I nearly skipped the article buried on page 11 about a man who died after an error from his GP, because I was pondering whether to order a popadom. Then I stopped and read it: it was my GP.

Our doctor is kind, caring and hard-working. He treats people as individuals and always makes time for them. On this occasion, the surgery computer system did not indicate that the prescriptions for the drugs his elderly patient required for a heart condition had stopped after the man was released from hospital. Several months on, he relapsed and sadly died. The coroner praised the doctor for his honesty. I can’t recall the actual verdict but the death could have been prevented.

Today’s Daily Telegraph didn’t lead with an avoidable death or for that matter any death. The case of foster carers who allegedly had children in their care removed from them because they were UKIP members has run on all media. It’s been top of 5Live news all day, for example. You would expect Nigel Farage to have an opinion but Michael Gove has swiftly weighed in too. As I write, Milliband is being quoted. Cue outrage at social work.

If UKIP membership is the only reason why these children were moved, I don’t agree with it. They should have stayed where they were. The council said on the news this morning that the children were going to move on anyway. This may be the case. However, the original Telegraph report says the boy was moved the following day and his two sisters soon after. If this is accurate, it does not sound like a planned move to me.

I qualify my remarks with ‘if accurate’ for a couple of reasons. Firstly, the report does not appear to have any corroboration from other sources. They may exist but it’s based heavily on the carers’ account. I thought journalists cross-checked, especially on a headline story, but this is different.

Secondly, it doesn’t chime with my experiences over the years. Judgments about the capabilities of  carers are never made on the basis of a single piece of information, unless of course it relates to a child protection matter or allegation, in which case prompt action must be taken to safeguard the child.

In this case, you would like to think that other evidence would have been considered, such as the history of the carers over their fostering career, the progress of the children in placement, any evidence that the actual behaviour of the carers had negatively impacted on the children (as  distinct from their membership of a political party) and the wishes and feelings of the children. Bear in mind that the Fostering Standards prohibit changes in children’s careplans without consultation unless there is a real and immediate need. If the local authority has other information, they could not possibly break confidentiality and share it publicly, which offers no protection to the storm of media outrage.

Some of the criticism is misinformed. Farage was calling for the immediate reinstatement of the carers but they are still approved carers, it’s just this placement that has ended. Also, he might think about considering the children’s needs first, which is the law after all.

However, what is most significant is why this is a story at all. My doctor will carry on practising, as he should. The competence of the medical profession has not been called into question because a man died. Yet in the case of the Rotherham foster carers, the ability of the entire social work profession has immediately become the issue. This is all the corroboration the Telegraph needed. We know social workers do this sort of thing, don’t we. Leaving aside the fact that as I have already suggested, any judgement is based on incomplete evidence, this is not about the actions of individual social workers or even the authority itself, it’s about how lousy our profession supposedly is in making these judgement.

The implication clearly is that social workers make snap judgments based on dogma and preconceived ideas. More than this, we are driven by political ideology. In much of the coverage, this deeply flawed and prejudiced perspective has not been significantly questioned. This must be the case – what other reason could there be? It shows how little the public still understand about what we do.

This may have been a carefully considered decision or something that was rushed. It could have been a wrong decision. If so, hold up our hands, but it does not prove one single thing about how social work as a whole assesses the needs of children.

You would think the minister, our minister, might at the very least inject a sense of perspective. Not so. “The wrong decision in the wrong way for the wrong reasons,” he said. I humbly suggest he cannot know that for certain. But there are bigger issues at play here and it suits him to use the profession for which he is responsible for other reasons.

Rotherham is holding a by-election. It’s Labour-held, therefore this decision is the responsibility of the Labour authority even though it would have been made by social workers, i.e. officials not politicians. The assumption that this is a political issue has not been called into question. No coincidence.

Also, the consultation period for government proposals to diminish the significance of culture and origin in decisions about adoption placements is coming to an end. This has been well-trailed over the past year – see some of my previous articles – as a way of removing what the government characterise as impediments to swifter adoption. It’s an important proposal that has considerable opposition as well as its proponents. Whichever position you take, it’s disturbing that a matter about the health and well-being of three little children and public confidence in social work becomes a chance for political points-scoring.  We might look back at this episode in future and ask if anyone truly cares.

Why the #Rotherham #UKIP scandal is almost certainly a load of codswallop

This morning we awoke to a story that sounded like something from the worst nightmares of Paul Dacre’s feverish imagination. Rotherham Council had reportedly removed three children from their foster carers, based on the carers’ membership of UKIP. Nigel Farage, Michael Gove and Ed Miliband have all piled in to condemn the decision. An absolutely shambolic performance in a BBC interview by Rotherham Council’s Joyce Thacker didn’t do anything to dispel the outrage gathering across the media.

But does this story have proper substance? When I read it this morning, there was a distinct whiff of bovine ordure to it. Although I regularly come into contact with looked-after children, I’m not an expert on the fostering process. However, my co-bloggers Ermintrude2 and Abe Laurens are both experienced social workers, and the latter is particularly experienced at working with looked-after children. I promptly sought out their opinions, and their advice has informed this blog post.

There’s a couple of things we already know about the case from the media reports. First, we know that these children were always meant to be staying with the couple temporarily, and there was never any suggestion that this would be a long-term placement. I’d say that’s a big clue from the word go.

We also know that in a previous court case the judge had criticised the council for not adequately attending to the childrens’ cultural needs.

But as well as what we know, we also have to remember what we don’t know. The local authority will have a duty of confidentiality to these children. They won’t be in a position to go into the ins and outs of why they couldn’t continue to be housed by this particular foster family. When I asked Abe Laurens, he commented that, “In my experience such decisions are NEVER made on any single factor alone.” We don’t know what the other factors were.

But there’s something else we do know, and it almost certainly acts as a great big klaxon telling us exactly what this is really about. There’s a by-election in Rotherham on Thursday. A Labour seat is up for grabs, and UKIP are campaigning hard. Funnily enough, Nigel Farage is doing his damnedest to link the decision with the Labour Party.

The UKIP leader said his primary concern was for the welfare of the children and their foster parents, but hit out strongly at the Labour party, despite Today host Evan Davis commenting that the decision was made by “officials” at the council rather than elected representatives.

“This is typical of the kind of bigotry I’m afraid that we get from the Labour party and from Labour-controlled councils….their attempt to close down the debate [over immigration] is just to write off anybody that wants to discuss it as being racist,” said Mr Farage.

And strangely enough, this has come out at the weekend, when the council would be in the least position to come out with a prompt response. What a coincidence!

It’s almost as if this is a media stunt intended to give UKIP a PR coup on the eve of the by-election.

[EDIT: I’m now more of the view that the proximity to the election date is coincidental rather than any deliberate timing, albeit one that’s had the effect of massively throwing petrol on a flame. What does seem clear is that the various political parties are engaged in a lot of electoral jockeying on the issue.]

And with Michael Gove and Ed Miliband lining up to give Rotherham Council a verbal kicking, it’s almost as if they’re desperately trying to avoid losing crucial votes to UKIP on Thursday.

Once again, social workers and vulnerable children are being used as a political football by opportunist politicians. What a surprise.

Taken in by Technology

Taken in by Technology.

Taken in by Technology

As an avid fan of all things technological I will have to admit upfront that I love it. On a daily basis I need to monitor my use and consequent lack of exercise in order to try and restore some balance in my life and look after my physical and mental health. But that is my choice. I know the risks and can weigh up the benefits because I like to think I have enough information and knowledge to make those decisions.

Unlike some people (celebs) who seem to  take great risks with their careers by posting inappropriate and often confidential stuff on social media sites just to get themselves noticed, I try not to use technology for this reason. However increasingly my job and my family depend upon on-line or network communication.

At a recent Union Learning Reps Conference I was made aware of how much technology will become a necessity for the future. People will only be able to claim benefits ( renamed as universal credits) on-line or book appointments with doctors or other professionals for advice. Even policy and law is now made freely available on-line and a lot of research (or grey literature) is only published on-line.

We can also catch up on our favourite TV programmes and even publish ourselves on the World Wide Web ( through blogging and YouTube), if we feel the urge. But what about the people who cannot afford a computer or have no knowledge or desire to find out how to work one.  How will they manage their  health and social care needs and will anyone bother to find out?  It is a concern of mine although I do not always admit it  that technology might become the Big Brother of the future, watching everything we do in cyberspace and reminding us when we need to do things for ourselves.  I am already getting text messages to remind me about hospital appointments which are not always accurate I might add. Will we as society go along with this big conspiracy? I guess a lot of people have already found this out and it will put off others from even getting started. Technology has not only taken us in it has also spat a few people out. Will this be the stigma of the future  – the technologically unwashed of society no longer being in contact with the local community and cast out into the wilderness of the real world? Scary!

 

The UKCP and the Smalley Case – A failure of representation

Time for instalment number……sorry, lost count…..in my ongoing analysis of the Smalley case, a long series of calamities and cock-ups in a fitness-for-practice hearing before the UK Council for Psychotherapy.

Time for me to take a deep breath as I once again run through….

The story so far…The UKCP took over three years to investigate complaints about John Smalley, a Jungian analyst with the Independent Group of Analytical Psychologists. At the end of a long sequence of delays, they decided that seven allegations had been proven. These included smoking during therapy, inappropriately setting two clients up in a business relationship with each other, and making a sexual suggestion about one client to another. Despite this they decided not to sanction him. The fact that he admitted in the hearing that he destroyed his notes doesn’t seem to have prompted a sanction. The UKCP’s laughable response to this is that they didn’t sanction him for destroying his notes because there wasn’t a complaint about destroying his notes. Just as laughably, the UKCP still hasn’t published the hearing outcome, and doesn’t intend to until Spring 2013, a year after the hearings were concluded.

Now let’s look at the manner in which the complainant was represented during the hearings.

Until recently people wanting to complain against a UKCP-registered psychotherapist had to go through a “two-tier” system. First, they would  have to complain to the therapist’s member organisation. If the complaint was rejected, they could then appeal to the UKCP’s Central Final Appeals Panel (CFAP). At present the UKCP is trying to replace this with a “single-tier” Central Complaints Procedure (CCP).

The complainant, a former client of Mr Smalley, made a complaint to his member organisation, the Independent Group of Analytical Psychologists (IGAP) which was promptly rejected as “no case to answer”. The complainant disputed this and took it the Central Final Appeals Panel. Fitness-for-Practice hearings are conducted like a court hearing, with opposing lawyers for the two sides arguing over the case.

Unfortunately this doesn’t seem to have been shared with the complainant. He alleges that he turned up at the CFAP to find Mr Smalley represented by a solicitor and barrister provided by his indemnity insurance. The complainant, on the other hand, states that he quickly realised he was expected to present a case against the opposing barrister.

The complainant is a vulnerable adult with mental health problems. He suddenly, without training or even the opportunity to prepare, found himself in the position of a litigant-in-person, fighting it out with a professional pit bull.

Despite this he seems to have done a good job. The CFAP ruled that IGAP’s rejection of the complaint had been “perverse and incorrect”. They further ordered that a new hearing be scheduled under the UKCP’s new Central Complaints Procedure.

The complainant was, unsurprisingly, pretty angry about the position he’d been put in at the CFAP. He then wrote to the UKCP demanding that this wouldn’t be repeated.

The reply back didn’t assuage his fears.

Sunita Thakore is the Professional Conduct Officer for the UKCP, but as far as I can tell she doesn’t appear to be a lawyer. I searched the online registers of the Solicitors Regulation Authority and the Bar Standards Board, and she doesn’t seem to be registered with either of those. I e-mailed the UKCP asking what qualifies her to present cases against trained lawyers, but the UKCP declined to comment.

The case went before the Central Complaints Procedure. As with the CFAP hearing, Mr Smalley was provided with a solicitor and a barrister by his indemnity insurance. The complainant was not willing to be represented by Ms Thakore and paid for a barrister out of his own pocket, costing him several thousand pounds.

So, the lesson would appear to be that if you want to make a complaint against a UKCP-registered psychotherapist, you’ll be up against a barrister, and you could be representing yourself, or have your case presented by a lay member of UKCP staff, or have to pay for your own lawyer.

Hardly seems fair.

The Death Pathway

Let’s join the debate. Who in the healthcare profession likes killing people?

Patient Stories – Will we learn?

Today the Patients Association published a report ‘Patient Stories’ (PDF). It focuses on thirteen different stories. These are stories directly about the experiences of patients through hospital systems and discharges. Some are told by family members when the person involved and some are told directly.  Some are anonymised and one is from a doctor who received treatment herself.

The format of ‘telling stories’ is a good one because it makes for interesting reporting. It personalises tales that we know about poorly managed hospital discharges which take place before they should because we hear the voices of those directly affected and it is easy to see the lack of humanity in some of the systems that exist in acute health care.

Sometimes what is remembered is a single comment which may have been made by a busy member of staff in an offhand manner, for example, in relation to Margaret Allen, her sister writes

‘my (other) sister called the hospital to enquire after Margaret’s health before her death. The answering nurse replied that Margaret was ‘screaming away nicely’ and held the phone out for my sister to hear her cries’.

There are some shocking details in some of the stories of miscommunication, arrogance and rudeness of staff, basic care not being given but sometimes it is these snippets of language which are telling in terms of respect and attitudes of professionals towards staff.

While it may be possible to write these off as ‘individual stories’, I think that would be an massive error because there is an enormous amount of learning and themes which can be traced – not just through these stories but through the similar ones that have emerged over many years.

There is a consistent lack of flexibility and a lack of listening in these processes.

An example would be in the story of George Robertshaw who was admitted to hospital and was discharged in a way that his GP felt was ‘unsafe’ due to it being so rapid and was discharged in thin pyjamas in the winter – so that when carers did arrive to him he was cold, hungry, very thirsty and still not well.

His daughter writes

‘Following my father’s death, I again spoke to someone to inform them of my father’s demise and that I would be making a formal complaint re procedures. She told me directly that she would ask a nursing director to phone me back in a day or two, This never happened. No call, no communication, no nothing. I again rang and I was told that they had informed whoever it would be and that they would remind them. I got the impression that the relevant person was present but did not wish to speak to me and was telling the person on the phone what to say

Again, this could be claimed to be an isolated incident but as a rule of thumb and as someone who takes quite a lot of verbal complaints about the services that I provide, I tend to assume for everyone one person who complains or whose family complains, there are far more who will not have the confidence, strength or understanding to do so. It is important that systematic errors are challenged and improved but it is also important that clarity of information and respect are given to those who use services.

I wonder if that same Nursing Director would have been so slow to respond to her own manager? No? Then treat the people who use the services, particularly if they have a complaint with at least enough respect to contact them in the same time frames – even if it’s a matter of updating them with no additional information.

An organisation which is not willing to take or deal with complaints, cannot be a ‘learning organisation’ which is willing to improve.

I don’t have time to identify the issues in all the stories but it is worth reading as a snapshot of some of the care which is being given in hospitals in this country.

Of course there are good stories, and there are fantastic staff. The very first section of the report is based on positive feedback but we cannot ever become defensive about the systems as they exist and must treat each of these experiences as areas of learning. Sometimes it isn’t always about resources, it’s about respect and it’s about listening and responding.

Yes the NHS is wonderful and many of us have personal stories of gratitude, I have many myself, but if there is anything that can be done by any one of us to make things better, we absolutely must.

The main lesson I will take from these stories is to make sure that every interaction is bounded in dignity and respect. Mistakes happen but they can be resolved by listening and learning from those who experience them.

Defensive organisations that won’t encourage criticism are dangerous organisations. These lessons are just as important in all social care organisations as it is in health care.

The saddest thing about these stories is that we have heard similar before. There have been commitments between increasing ‘compassion’ in nursing and care staff but the systems need to become more compassionate too and far more responsive and flexible.

This is a series of awful stories and experiences but they must be learning experiences so that some positive may come amid the extreme pain and grief caused.