Friday, 21 December 2012
How will the adult social care workforce of the future be affected by public health changes in England? Vic Citarella, Director of health and social care consultancy CPEA, talks to the CfWI.
Vic Citarella is cautiously optimistic about the transfer of public health to local authorities in April 2013. But he believes it will take time before more integrated services and commissioning have an impact. To start with, the majority of people working in social care are unlikely to notice any difference. But with directors of public health championing the need for preventive investment, the benefits of integration and more long-term thinking, there should be positive outcomes for both people who use services and the social care workforce.
“The changes in public health are part of a wider picture of change, which includes personalised care, more emphasis on prevention and adult safeguarding,” he said. “In future, we will expect people in the social care workforce to work across health and social care and to be trained in new areas. This will include making the most of people’s strengths through self care and taking into account components related to their particular conditions, including medication and assisted living technology. A shared approach to training, support and supervision will have to be part of a more integrated approach.”
Inequalities in education and training will need to be addressed, said Mr Citarella. The healthcare and social care workforces are of a similar size, at around 1.35 and 1.56 million, but there has been comparatively little investment in training for social care. If people working in social care are to be trained in areas such as dementia and end-of-life care, the cost will be significant, but will lead to savings and benefits in the longer term.
New organisations such as consumer champions Healthwatch may also help to develop the skills, competence and confidence of the social care workforce.
“Greater integration may be an opportunity for people working in social care to be more innovative and challenging. Sometimes they can see ways of doing things better, but are not in a climate where they can raise issues. If they are all part of the same infrastructure there will be a place for this type of discussion. We may see a more confident social care workforce which is less deferential to medical professionals.”
More personalised services might also mean a more personalised workforce. If social care workers are employed directly by service users or their families, they may take more individual responsibility for their own training, development and practice. With greater choice in the system, they may follow the service user across commissioning boundaries, making workforce planning a challenge.
With many volunteers, community groups and individual carers working alongside paid social care staff, there is a shift towards a more enabling role.
“There is move towards refocusing the paid social care workforce on supporting carers and developing community capacity and networks of volunteers. Investment in self care and assisted living technology also makes the resources go further. There’s an emphasis on ‘doing with’ rather than ‘doing to’.”
There is a huge opportunity for the public health sector to help improve the health and wellbeing of the social care workforce, said Mr Citarella. Directors of public health could play a central role.
“There are high levels of stress and ill health in this workforce. Public health could be more sensitive to the welfare needs of an individualised and isolated social care workforce of over a million people. Occupational health ought to be high up the agenda.”
Planning for the future social care workforce will not be easy, however. “Many people don’t yet understand the complexity, fragmentation and diversity of the social care workforce. Thanks to organisations such as Skills for Care we now know a lot more about this sector than before, but workforce planning will still be a challenge.”
Want to know more about our work in social care? Contact email@example.com.
Tuesday, 11 December 2012
Citation, a company providing HR support, demonstrated the differing advice available from CQC, within No Secrets, The Government Guidance on protecting vulnerable adults and employment law. Essentially in a case of harm or risk of harm CQC advice, and generally the local authority, is to suspend the employee immediately but employment law warns against a knee jerk reaction, that suspension isn’t always appropriate and investigation should take place in a timely manner. It is the employer’s responsibility to suspend staff, based upon their investigation, and also their duty to report conclusions to the relevant professional bodies. The role of a good employer is to undertake any actions in a proper and proportionate manner and Claire Crawley said we need responsible and capable providers to do this.
A major concern amongst providers is the suspension of contracts and that this should only happen when there are serious risks and then local authority representatives need to tell providers what they are doing and why. Sarah Hollinshead Bland, Commissioner Adult Safeguarding in Staffordshire County Council explained that contracts are often suspended during large scale investigations and placements can re-commence when the investigation has concluded and required improvements in practice can be sustained.
Key messages from the day were
• The Safeguarding framework is about improving wellbeing and Adult Protection investigation is just one aspect of the safeguarding process. Many practice concerns are now falling into safeguarding processes and this was on the increase. Managers said if they tried to argue they were told they were failing to act. Social workers couldn’t cope with this increase in activity and whilst they were dealing with safeguarding they were not carrying out personalised assessments and reviews.
• Those investigating safeguarding/abuse allegations, however important they perceive their investigative role, are not outside the general law and have to have proper regard to and for those who face allegations and natural justice whereby there should be no bias against the accused, that there is a right to be heard, to know the case against you, what the evidence is, what statements have been made and a fair opportunity to correct or contradict.
• There are occasions when negotiation is appropriate; that not all bad practice should lead to safeguarding scrutiny. Remember - residents in care homes can be subject to more abuse by poor safeguarding procedures and actions.
Janet Pearson, Director, CPEA
Monday, 10 December 2012
Margaret Flynn Provides Notes From A Department Of Health Stakeholder Event On Positive Behaviour Support
Which principles should underlie physical intervention? The following elements of principles should underlie physical intervention:
• The context should be known i.e. there are risky environments, risky management decisions, risky managers and practitioners and risky practices. The latter would include, for example, undertaking a physical intervention without any knowledge of a person’s biography.
• The traumas people are known to have endured should not be reinforced by any form of a physical intervention e.g. people who are known to have been sexually assaulted should not be placed on the ground and immobilised by body weight
• People’s experiences of being subject to restraint, for example, should be known – are they doing to their peers and staff what they have endured in previous settings?
• Individuals should never be restrained when they are naked or partially naked. Furthermore, when naked or partially naked, they should never be immobilised by body weight
• Any intervention has to be part of an agreed and positive approach
• Chemical restraint, physical restraint, mechanical restraint and/or seclusion should not co-occur
What data is required? Every incident of physical restraint should be recorded as a patient safety incident. What is the point of counting incidents if nothing other than the fact of a physical restraint, for example, is known? Information concerning physical interventions requires a single route.
How we get from where we are now to where we want to be? The NHS Commissioning Board should issue a series of edicts, i.e. Thou shalt…
• Adopt a life-span approach to people with learning disabilities and autism, referencing this in their service specifications
• Put a moratorium on building new secure services or extending such services in the knowledge that if there is a building it will be filled
• Ensure that the Care Quality Commission does not register units which are outwith national policy i.e. Assessment and Treatment units
• Review and challenge the use of the mental health legislation as it impacts on adults with learning disabilities and autism on a locality basis
• Discontinue the office function of long distance commissioning in favour of investing in effective and credible local supports - if Winterbourne View Hospital patients and their families had known the telephone contact details of individual commissioners – it is unlikely that they would have had to resort to calling the police
• Promote the piloting of micro-commissioning – with people with learning disabilities and autism, their families and their local authorities
• Only invest public money and commission services from agencies which are owned by accountable individuals i.e. not opaque corporate bodies
• Ensure that a service’s Statement of Purpose cites “positive behaviour support” and that this is reviewed by the Care Quality Commission
• Cease to believe that (i) compliance with minimum standards results in a safe and valued support service which requires neither monitoring nor evaluation and (ii) that professionals know everything
Margaret Flynn, contributor and note taker, November 2012
Friday, 7 December 2012
The Serious Case Review relied on a BBC broadcast of May 2011, information from the hospital’s ex-patients and their relatives and information from a range of agencies, including Castlebeck Ltd, which owned Winterbourne View Hospital. These thoughts rely solely on what we have learned about the circumstances of adults with learning disabilities and autism who have been placed in hospital settings offering “assessment and treatment.” We believe that the practice of physical restraint at Winterbourne View Hospital is a bracing indictment of inadequate management (remote and long distance) and inattentive commissioning.
We suggest that five sets of observations clear a path to viewing the circumstances of adults with learning disabilities and autism in secure settings. We believe that they point to the necessity of developing very different service responses. We begin with a single tragedy:
1. During July 2006, Derek Lovegrove died as he was being restrained. He was a blind and deaf patient with learning disabilities at Cedar Vale Hospital. The Deputy Coroner observed that “…the system was there, the policy, the care plan – but no one seemed to check that it was followed.” Cedar Vale Hospital was owned by Castlebeck Ltd. After the Inquest they stated, “We will take time to fully consider the proceedings of this past week to ensure that any lessons which must be learnt are learnt and acted upon.” Five years before the exposure of the violence associated with restraint at Winterbourne View Hospital, Castlebeck Ltd could have led the way and distanced themselves, and perhaps other services, from the practices associated with Derek Lovegrove’s death. However, during 2009, Castlebeck still had not learned the lessons. A Heathcare Commission visit found shortcomings in Cedar Vale Hospital’s management of serious incidents and patient restraint. The sequel to the BBC Panorama’s expose of May 2011 was broadcast in October 2012. This gave coverage to a recording of a Castlebeck Ltd employee training Winterbourne View Hospital staff in methods of physical restraint. He recalled an occasion when instead of restraining a patient, he “kicked him in the bollocks.” The programme advised that this trainer had been “suspended some weeks ago.” Thus the “learning the lessons” claim apparently did not impact on either the training or practice of harmful means of physically restraining adults with learning disabilities and autism. Heartlessness and amnesia appear to go hand in hand.
2. All policies concerning physical restraint emphasise that it should be the “last resort response.” Castlebeck Ltd’s own policy concerning physical restraint was no exception and yet it bore no resemblance to the practice filmed by an undercover journalist. It was the first line response. We came across no examples of physical restraint being the intervention of last resort. The practice of wrestling patients to the floor and lying across them occurred on a daily and routine basis and yet was not identified as constituting abuse by any professional. Chance determined that there were no tragedies at Winterbourne View Hospital given the filmed evidence of restraint practices and those promoted by Castlebeck Ltd’s own trainer. Records attested to the excessive and harmful use of restraints which involved wrestling adults with learning disabilities and autism to the floor and immobilising them with bodies and objects. These incurred physical pain and injuries, some of which required the attentions of Accident and Emergency services. Even patients who were naked or partially clothed were physically restrained on the floor by staff. It does not appear that exceptions were made for patients whose early lives had been compromised by sexual assaults. Neither was any attention paid to patients’ care plans. As an NHS commissioner observed, “…it is…documented that a mask was used on two occasions. This approach is not written in care plans as being agreed to.”
3. Restraints as practiced at Winterbourne View were pre-emptive. Staff physically overwhelmed patients using whatever means they wanted. Patients were ill-served by their imprecise label of “challenging behaviour.” Staff responded to patients as if self defence was their principal priority.
4. The volume of physical restraints which wrestled patients to the floor and held them there – sometimes for many hours – were under-reported by hospital staff and described in records in fictional terms. Inadequate as these records were, no one took any notice of them. Oblique references to patients “having an unsettled day” and “re-directing patients” were euphemisms for unknown numbers of staff pinning patients onto the floor.
5. It appears that adults with learning disabilities and autism who are patients in hospitals, assessment and treatment and secure services are outwith the protection of legislation. During 2009, it was with some prescience that a Public Protection Unit investigator urged Winterbourne View Hospital to install CCTV cameras. The investigator noted that in view of two incidents, “in which two service users had their teeth knocked out by carers during a restraint situation, both patients appear to have been punched in the face…restraint is usually carried out by two or more people so any allegation of improper or criminal conduct is countered by two people’s word against the victim – the victim always unlikely to make a good witness in a criminal prosecution…no doubt something your staff are aware of…” After the initial Panorama broadcast, staff emphatically denied all allegations made by Winterbourne View Hospital patients which were not captured on film – and even those which were filmed were described by the staff concerned as “horse play…play-fighting…sparring…boxing games…playing.” Accordingly, the Crown Prosecution Service relied solely on film footage provided by the BBC. The Serious Case Review confirmed that Winterbourne View Hospital patients lacked any means of asserting or protecting their rights. They were scandalously silenced.
These findings buttress our concern that adults with learning disabilities and autism have been disproportionately disadvantaged in secure service settings where they may be subject to violence on an unknown scale. Winterbourne View Hospital has taught us about the arbitrariness of cruelty under the guise of restraint and the lamentable lack of interest of all professionals, most particularly Castlebeck Ltd and the commissioners of this service, in ensuring that patients were protected and safe. Such stark findings led us to conclude that there is no place for the practice of getting adults with learning disabilities onto the ground and pinning them there. This form of restraint, as imposed on adults with learning disabilities and autism, in these settings, should not be countenanced.
Margaret Flynn and Vic Citarella
Thursday, 1 November 2012
This is to let readers know about Centre for Justice, an independent not for profit arbitration service developed for the public sector. The service has been created in response to the growing cost of local government disputes and conflict management, the need to save public money and as a way to improve services.
As we all know, going to court or tribunal is a costly business for councils. The process is damaging to staff morale, the council’s reputation and the client relationships which people work so hard to develop. Courts and tribunals are acknowledged to be slow, risky and expensive. These and complaints procedures can inflame a sense of grievance and cause positions to become deeply entrenched.
CPEA Ltd is exploring the Centre for Justice’s non-adversarial approach to dispute resolution. The model uses a simple process with one specialist lawyer who works with the parties to investigate the problem. This reduces the cost to a fraction of that of going to court or tribunal. The arbitrator offers to mediate between parties at each stage to find a constructive solution. Centre for Justice provides a legally binding result in every dispute. It also enables most disputes to be concluded with positive outcomes through discussion and agreement.
The Centre has been speaking to Heads of Legal Services from London Boroughs and many have mentioned social care disputes over personalised packages and direct payments. Conversations with charities also indicate support for processes which reduce the time and stress involved in going to court or tribunal, and which provide a less intimidating forum for discussing sensitive issues with the local authority.
The primary aim is to save money and time spent preparing for costly tribunals, Judicial Reviews and contract disputes. We believe this time should be devoted to providing essential services to children, families and adults.
The case involving Stephen Neary that came before the courts last year is a good example of how a non-adversarial process could have saved both time and money. The Council involved spent more than a year defending its decision to keep Neary in care.
A judge later overturned that decision, saying the care was neither wanted nor needed. If these decisions go to court, on judicial review or otherwise, it results in a great deal of legal cost and staff time. Not only can this generate considerable stress and hostility, but it can still leave both parties in limbo. While a judge can quash the original decision, this still provides no solution and can force the case back to the start.
If the case goes instead to Centre for Justice, a specialist arbitrator helps Council and client agree the right outcome. The arbitrator advises on the legal issues and decides these where necessary. This enables the local authority and client to find positive solutions for the most intractable and emotive issues.
CPEA Ltd is supporting the Centre is ensuring its work has the best social care practice and professional back-up to its work. Contact: firstname.lastname@example.org or email@example.com Website: www.centreforjustice.org or www.cpea.co.uk
Monday, 1 October 2012
The NHS is currently in the process of implementing a major programme of reform following the passage of the Health and Social Care Act 2012. This is designed to support the creation of a health service that is clinically led, patient centred, dedicated to the delivery of world-class outcomes and focussed on improving the health of the population.
It is essential that there is clarity about responsibilities in relation to safeguarding within these new arrangements – and about how the new system can help drive continued improvement in practice and outcomes.
In the final report (May 2011) of her review of child protection, Professor Eileen Munro expressed concern about the possible impact of the health reforms on effective partnership arrangements and the ability to provide effective help for children suffering, or likely to suffer, significant harm. In response, the Government committed to establishing a co-produced work programme “to ensure continued improvement and the development of effective arrangements to safeguard and promote children’s welfare as central considerations of the health reforms”.
The Government is also committed to working to prevent and reduce the risk of abuse and neglect of adults.
Thus reads the background and context of the new Interim advice from the NHS Commissioning Board on children’s and adults safeguarding – with adults as an ALSO. It goes to recognise itself as primarily geared to children when it says: Although this advice focuses on the statutory requirements to safeguard children, the same key principles will apply in relation to arrangements to safeguard adults. There are, of course, one or two fundamental differences of principle but never mind.
For those who have been wrestling with the health and social care interface in adult safeguarding for many years there is the welcome prospect of the incoming NHS CB and CCGs having statutory responsibilities. Particularly important for patients in commissioned services such as those that were at facilities such as Winterbourne View Hospital - the interim advice is unequivocal about where statutory responsibility will lie in the future.
The description of the designated professionals’ roles in adult safeguarding is interesting in that it expects expertise in the Mental Capacity Act as well as a broad understanding of policy and training across local authorities, police and the third sector. It anticipates this expertise stretching across older people, people with dementia, people with learning disabilities and people with mental health conditions. It does not see them as being hosted within the commissioning support services. Thus their host is likely to be an NHS provider. It is to be hoped that the proposed service level agreements will recognise the potential for conflicts of interest in such arrangements - conflicts that come to the fore in serious case reviews scenarios.
As the advice develops the ‘also ran’ status of adult safeguarding becomes more apparent. Funding is acknowledged only to the Safeguarding Children’s Board. The Director of Adults Social Services may be able to offer advice. Priority is given to numbers of children in need. A muddled message emerges on inspection between CQC and OFSTED. Reminders appear about designated professionals engaged with Looked after Children, around the DfE production of the revised Working Together and about the Royal College of Paediatrics and Child Health. A Safeguarding Children Transition Board is established.
Missing is recognition of the issues around continuing health care, the messages around the care programme approach from Winterbourne View and any acknowledgement of the fact that safeguarding in health and social care involves a massive diversity of provider settings. The third sector is recognised but not the private sector – yet residential nursing care is largely a private enterprise in the small business sector. Private providers are a vital aspect of support at home services - where they are well placed to initiate much needed joined up health and social care in the community. These developments will be enabled by a policy and practice climate that draws on advice that is cognisant that personalised services are safe services and vice versa. That is a climate where providers are partners in the truest sense of the word.
All in all the interim advice smacks of a cobbled together document to allow the timetables for the NHS CB and CCG infrastructure to be met. It has clearly suffered from delays in the production of the revised Working Together and uncertainty about what the eventual Care and Support Act will actually make statutory requirements and when. As a consequence it has the effect of relegating adult safeguarding to an ‘also ran’ shadow to the priority of children.
However the advice ends with the statement: We anticipate that it will be replaced by a more comprehensive document in the autumn, alongside the revised Working Together statutory guidance. It being September we also look forward to adult safeguarding soon emerging from the shadows before the winter sets in.
Available on: education.gov.uk
Even Google finds it first on the DfE website but also available after several search clicks on: commissioningboard.nhs.uk
Thursday, 27 September 2012
About 15 participants - care home training staff, owners and a few consultants plus Charlotte Tuck a communication person from DH enjoyed an educated breakfast at NCVO this week. All the (non-edible) materials for the session can be found at www.nsasocialcare.co.uk
This was one of two NSA member events (another is scheduled in Sheffield on 30th October) to:
- Update on the social care climate
- Report on the survey of Registered Managers – ‘Everyday Excellence’
- Inform about the ‘Careship’ programme on leadership and registered managers with different descriptions aimed at different roles with in sector
- Report on research for NSA on care sector reputation – ‘Who cares’
- Advise on integration thinking with Skills for Care
Sir Stuart Etherington (CEO NCVO) provided a welcome to building and a summary of the environment for the charitable sector. After what might, in hindsight, be regarded an a era of growth the charitable sector he said it was now suffering from reduced giving related to recession and cuts in contracting as public sector reduce costs. Ideas of government about the ‘Big Society’ appear to have gone but he thought they did encompass hopes for increase in social investment, localism and public sector reform. The response of the charitable sector has been more mergers and a focus on core or particular successful areas of work. Sir Stuart acknowledged that the charitable sector were often pressed into contracting for poorly considered care services whereas good social enterprises had access to start up funds to support more radical redesign of services. He expressed a belief that the definitions between charities, social enterprise and public interest were getting blurred in people’s minds if not in legal status. He remarked on the success in changing government proposals that would have damaged tax on contributions.
Debbie Sorkin reminded us of demographic demand and that mismatch with public funding quoted David Behan ‘austerity is the new real’ and Clive Bowman ‘social care is being brutalised’
She thanked SCA for support on pointing out the need to focus on registered managers and introduced the report. NSA response is to support registered managers to overcome defensive practice (illustrated by a story about therapeutic use of pets being banned from a home after a dog tripping incident which caused no harm) and develop links into networks. Marcia Asare will be in charge of registered manager activity for NSA.
Discussion was about poor inspection practice on nutrition, lack of leadership from government but mostly focused on the positive ideas of networks for managers. Some interest was vocalized on ideas about registered managers as local resources (information on issues of ageing for example) but main focus was on dealing with isolation of managers and providing a source for sharing and gaining thoughts on good practice.
Tuesday, 25 September 2012
If you are a teacher, trainer, a social care leader or HR professional wanting to make a difference, then here’s an opportunity definitely worth looking into.
A Quiet Place Ltd. is a well established company in the fields of educational therapeutics, personal development for all and well-being in the workplace. It has a national reputation for its evidence-based, high quality service, offering effective programmes for both prevention and intervention adaptable for all ages and abilities. Deliverable in all settings – the great news is that A Quiet Place is seeking partners across the UK to enter into a franchise scheme help deliver its benefits to new clients.
If you are interested in finding out more and seeing how you or your team could join this important and growing field see here for the prospectus.
Monday, 3 September 2012
David Lane, Editor of Children Webmag
A full obituary is available here: http://www.icse.org.uk/
Friday, 10 August 2012
1. The institution was a hospital and not a care home
2. The hospital was a CQC registered and regulated service with a statement of purpose concerning the assessment and treatment of people with learning disability, mental health needs, autism and behaviour which challenges services – and sometimes families
3. The service was one that was bought for individuals – by 14 NHS Primary Care Trusts
4. Care management and contract monitoring were not effective either through the care programme approach or through linking payment to service delivered.
5. Strategic Health Authorities had responsibility for the performance of NHS Primary Care Trusts
6. The professional and managerial leadership of the hospital should have derived from a Registered Manager and a Medical Director with Castlebeck company oversight from a responsible individual
7. The responsible individual has not been called to account
8. A GP was responsible for the health care of the patients on a day to day basis and for prescribing medication
9. There were troubling incidents which merited a large scale investigation procedure by the adult safeguarding and the police - notwithstanding the belated reaction to the whistleblower
10. The support worker-led culture at the hospital of ‘its them or us’ was abusive and corrosive. It is one that nurse managers chose to ignore and one where all other professionals failed to pick up the warning signs
11. There is a debate to be had about the possibilities of prophylactic technology
12. Physical and chemical restraints are indicative of regime failure in treatment terms as well as those of control
13. Closed institutions require proactive inspection, care management and challenge to their very closed nature through rights to advocacy and visiting
14. The very existence of Winterbourne View Hospital, and how it was used, ran counter to government policy and local commissioning intentions
15. Finally, the regulator should have a much stronger role wherever ‘monopsony meets monopoly’. This is an inherently dangerous market scenario.
Tuesday, 24 July 2012
The challenge being to quantify both the numerator and denominator. I then embarked on a personal mind search to list the items of resident need and staff availability required to complete the calculation. It is extensive with some items measureable and other less so. There is little value in me sharing the list as it will vary from home to home. It is also an exercise that should be undertaken with residents and staff together. Checklists are useful but no substitute for participation and ownership in something so important. Staff sufficiency is the foundation stone of residential care with their capability, skills and confidence making up all the building blocks.
What this brought home to me is that a rota is a lot more than ensuring sufficient cover by documenting who is on and off duty. A rota is in fact a workforce plan or even a strategy! Think about it.
Monday, 2 July 2012
Question: Do personalised services imply a personalised workforce?
Question: Is safeguarding becoming ‘job creation’?
Question: Should compliance inspectors at CQC and their opposite numbers at OFSTED rejoin the social care workforce?
Question: What is going on with the
Any questions? There remain plenty of organisations to address them – too many some say – but sadly not one with a specific set of answers around integrated children’s services.
One thing that is certain is that, thanks to the National Minimum Dataset, we now know more about the social care workforce than ever before. Surely it is time to start using that data to start answering a few questions and stop the often devastating swings of the pendulum that see workforce initiatives follow scandals and crises – only to wither away during times of ‘other’ priorities.
The social care workforce has enough inbuilt dichotomies and paradoxes of its own – paid/unpaid, regulated/unregulated, professional/vocational, relationship/task, adults/children even life and death – to have to deal with the us and them of politics. The sooner policy makers really permit a sector-led approach to answering the workforce questions the sooner we will all secure improved benefit from the 2 million plus people working to care and support adults and children in the UK.
Monday, 14 May 2012
Pennaf have opened a number of residential care and nursing homes in North Wales and had new starters within their group and therefore required further training. This year the target audience are care practitioners working with older people in the care/nursing homes, project workers dealing with children and vulnerable adults and again maintenance staff who are in contact with vulnerable groups when carrying out repairs.
Sunday, 29 April 2012
A couple of years ago I had the same thought when undertaking some work on possible implications of social pedagogic thinking in the youth services. At the time I googled around a bit and discovered the notion of andragogy. Returning to these thoughts I am increasingly convinced that social care practice in older persons homes benefits from underpinning vision and clarity of theoretical models. Ideas around andragogy offer such a model based on self-directed and informal learning, the diversity of groups, adults as a resource for each other and the pursuit of self-actualisation.
Whilst andragogic thinking may sound a long way from practice reality it has the potential to give greater credibility to self-directed care and personalisation in care homes. Good practitioners know that choice, dignity and individualised approaches based on relationships is the right way to work with residents. For them practice is not about ‘task and finish’ but about ensuring a valued life experience. Andragogy offers the practitioner the theory to put these beliefs into practice. It creates a platform for debate and discussion to share good practice at conferences and workforce development events. It could create the same space and confidence for care practitioners in older persons homes to learn from the views and opinions of professional colleagues as residential child care demonstrated last week in Cardiff.
Educationalists debate differences between pedagogy and andragogy – between children learning from teachers and instructors as opposed to a more self-directed model for adults. Social pedagogy advocates that children grow and learn in different ways at different times – using hands, head and heart. Social andragogy could be shaped as the theory that (re) introduces lifelong learning, self-directed support, cooperative care and the benefits of group living into all forms of residential care including older persons homes. Find out more and google ‘andragogy’.
Thursday, 22 March 2012
Tuesday, 20 March 2012
Perhaps you can see a need to move forward here. What would be a good first step? Here are my top tips for starting to embrace these technologies.
- Get together a social networking roadmap that will clearly identify social networking sites that could be usefully embraced by your team. Each site should have a realistic description of the benefits, current and future risks your employees could open you up to
- Start with some form of survey or assessment of current social networking practices and if possible, future needs too. A policy that does not fit the actual circumstances of your organisation will be ignored - and thus do more harm than good
- A Facebook ‘Page’ can be set up for your organisation, similar to a personal profile. People will ‘Like’ your ‘Page’ and this will show in their individual News feeds and will promote your organisation: you can import a database of names and invite people to join up and ‘Like’ you, so include your workforce, partners, influencers and so on. Think carefully about the information you post there. Don’t make it too text heavy, don’t use very formal language and try and use multi-media regularly to add interest
- On Twitter, you need to follow people in order to have interesting tweets to comment on and to get the latest industry news. Mix it up – choose Twitterers from your personal and professional life. Check the profiles of people who are following others who you follow. Follow at least 30 people to get a lively home page. Then start posting your updates. Don't expect many to follow you immediately
- One, perhaps often overlooked benefit of using Twitter, is how good an informational digest it provides. In that sense, it’s less about what you can bring to the conversation, but instead provides (very much like the RSS feeds of old) lots of very short snippets of news from a wide variety of sources. Some of the ‘news’ is not news as we would know it – and a lot of it can be extremely funny, moving and entertaining. Judge for yourself!
- LinkedIn operates as the equivalent of business card system and it’s an ideal way to keep in touch with or do research on your peers, people you’ve met at events, key people in social work, and so on. As well as having your individual profile, note that your organisation may also have a presence. Such a profile can tell people a little more about the work you do and the value you add. It also links to the profiles of all your staff, providing another way for your clients, service users and job seekers to connect with you on a professional level
- Be warned that Facebook and Twitter – and even LinkedIn – are not the place for safe, slick public sector communications. People want to hear what the Head of Social Services at X council thinks – but not the emasculated ‘official’ version – but the message that sounds like it’s from the heart. That’s what will engage people…
- Don’t forget to offer frequent training regarding these technologies and the organisation's approach to social networking. Insist that employees think before they click, tweet or post! State unequivocally that employees must comply with all policies covering confidential information.
What's not to 'Like' about social media in the social care sector, in other words?
Vic Citarella’s twitter address is @cpeanose
Wednesday, 29 February 2012
Employee mental well-being should be an integral part of the boardroom agenda, on a par with physical health. Leaders should insist that regular monitoring of progress or issues is reported to the board. The Chartered Institute of Personnel and Development (CIPD) has found that 70% of employee mental health problems are either directly caused by work or by a combination of work and home. In light of this, there simply is no excuse for this not be a mainstream issue for leaders to address. By proactively managing mental well-being in the workplace, leaders are not only dealing with their legal and ethical responsibilities, they are also looking after their bottom line as well. Absenteeism and presenteeism are responsible for losing British organisations billions of pounds, so how can this subject be ignored.
All employers should include safeguarding mental well-being into their standard operations, particularly when employees and/or organisations are embarking on change processes, which can be and are very challenging times for everyone. Training from the leadership down in proactively managing mental well-being, including offering additional support to staff or simply leading by example, is essential. Safety net support such as coaching and occupational health needs to be incorporated into health and well-being policies.
Leaders should be ensuring that management have a huge positive impact on mental health. Good line managers are essential in spotting early signs of distress and initiating early intervention, whereas poor line managers may make the situation worse or even be the cause of mental health problems through their approach, management style of behaviour.
Leaders should be insisting that comprehensive and, more importantly, mandatory mental health training for line managers is introduced and embedded into the culture and development plans for their employees. This training and change in culture will ensure that the organisation develops employee resilience and emotional well-being.
Steve Scott is co-founder of CSP Coaching LLP firstname.lastname@example.org
Monday, 27 February 2012
Focusing on Registered Managers is a good idea, I have a lot more confidence than I had when I started in this role and I know that I provide a good service, (a CQC inspection last week confirmed this!), but it has taken me quite a few years to get to this position. It would be good if Registered Managers were supported to get to the same point quicker than I have! I still haven’t worked out how to get down to a 40hr week!
My worry would be whether Registered Managers could be released from their roles to attend forums and training – when I undertook my Registered Managers Award seven years ago most of us were doing it in our own time and since then thinks have got busier. However I think we need to somehow start taking control we can’t have all and sundry waltzing into our homes telling us how to run them…
Thursday, 16 February 2012
- to tolerate and contain uncertainty, ambiguity and complexity without resorting to simplistic splitting into good/bad, black/white, us/them, etc.
- for self-authorisation, that is, the capacity to find the courage to act in situations where there is no obvious right thing to do
- for reflexivity, that is, to take oneself as an object of inquiry and curiosity and hence to be able to suspend belief about oneself; all this as a way of sustaining a critical approach to oneself, one’s values and beliefs, one’s strengths and weaknesses, the nature of one’s power and authority, and so on
- to contain emotions such as anger, resentment, hope and cynicism without suppressing them and hence to be both passionate and thoughtful.
Monday, 13 February 2012
In these circumstances I did what many of you may do. I Googled him and in doing so I realised that this was something that Ian would have appreciated. In so doing I lighted upon the theme of what I want to say about Ian today. Although it is only five years since Ian’s death, with his illness, it is all of ten years plus since his last major publication on social care practice. For those of you that don’t know that was the 2000 Personal Care Planning in long term social care of older people - empowering service users - written with Susan McClean. As an aside, and I am getting diverted from my chosen theme here, this publication is still available from SCA and was and is ahead of what a lot of social care organisations are practicing even now.
Now in the 10 years since that Mallinson/McClean publication Google has exploded alongside other technological advances and social media. In 2000 the information revolution and knowledge economy was just being ignited in the
the busy world of social relationships on the Internet - he would addressing the issues of communication up front. As a distinguished man he would have found a way to distinguish himself and those around him.
I have concentrated on one particular strain of thought that hopefully does justice to Ian’s memory. If you do Google Ian you can read all about his achievements in social care and other fields. In particular I would commend Joan Becks memorial piece to this event in 2007 published in SCAs magazine and available online or Natalie Valios’s item in Community Care 2000 when Ian was Association President.
However for me the inspiration in Ian was not about looking back, however valuable that maybe, but in forever looking forward and side ways as that was the type of man he was. I was lucky to have been his colleague, collaborator and conspirator for some 15 years and just thinking about what he would be doing today excites and inspires me still. He would probably be preparing an electronic wallchart of the forthcoming changes in legislation in social care - now there’s an idea worthy of Ian.
Saturday, 7 January 2012
- Treating people with dignity and respect.
- Making sure food and drink meets people’s needs.
- Making sure that that the environment is clean and safe.
- Managing and staffing services.
- having choice and control over day-to-day and significant life decisions
- maintaining good relationships with family, partners, friends, staff and others
- spending time purposefully and enjoyably doing things that bring them pleasure and meaning.
- Open to all providers who are compliant with essential standards and want to participate
- Funded as an alternative to the prevailing model of contract monitoring
- Simple but be capable of gradation as in: aspiring, progressing and demonstrating
- Consistently and credibly evaluated involving both service users and qualified sector specialists.