Earlier this week, Community Care picked up on a report from Public Concern at Work which related directly to whistleblowing in the care sector. It makes for chilling reading and displays the problems which are inherent in adult social care.
As the article states
Public Concern at Work, which runs a helpline for employees who witness crime or wrongdoing in the workplace … revealed figures showing half of all calls from social care were about the abuse of vulnerable adults. In half of all cases where other staff knew about a risk, they were too scared to speak up
When you put this in the context of the CQC abandoning random spot checks and initiating increasing systems of ‘self-regulation’ in care homes and you have an extremely dangerous combination.
The article goes on to give an example
In one case, a social care worker witnessed a carer hitting a resident across the back of the head. He raised his concern with his manager but no action was taken, so alerted the care regulator. In the meantime he found himself ostracised by colleagues after the manager had revealed the worker’s identity. A subsequent investigation by police and social services took place but was inconclusive. The care worker said he felt unable to return to work.
There are a number of things that made me audibly sigh when I read this. Firstly and perhaps most tellingly, it didn’t shock or surprise me. That is a sad indictment of the sector as a whole. I’ve worked in the adult social care sector for more years than I’d like to say and come from a background as a care worker in residential home. I was fortunate to work in a great home with a fantastic ethos but I know how easy it is to become socialised into careless models and how dictatorial some management regimes can be. The other part was that the investigation proved ‘inconclusive’. Often they are when people close ranks and what does that say about the ways that abuse is investigated? Well, I make no secret of my disdain for the policies and ways that these investigations take place with little legal backing. Things are better than they were and I know locally great efforts are made to improve safeguarding procedures – indeed, a new London-wide policy has just ‘gone live’ but I hope the legislative procedures firm up.
Back to the report though, which Public Concern at Work publish here.
The organisation states that the largest proportion of calls that they receive come from within the Adult Social Care sector and relate to vulnerable adults (15% of the calls that they receive) and in their report ‘Speaking up for Vulnerable Adults : What the Whistleblowers Say’ they use some of the data gathered over an 8 year period to look at some of the issues raised to them by whistleblowers in the sector. The report as a whole is quite short and easy to read.
My main concern is the lack of involvement by the regulatory authority (namely the CQC or its predecessor body, CSCI) and lack of involvement. The report takes a sample of 100 cases, 27 of which detailed physical abuse and the respective care regulator (CQC or CSCI) was only involved in 12 of these cases which considering the role of the regulator and the seriousness of the issues raised, is surprising.
Even worse, the statistics related administration of medication where issues such as mixing up medication between residents, failure to administer medication or administering medication incorrectly – where only 3 of the identified 15 cases (from their sample) involved a regulator.
It’s worth reading through the relatively concise report. It doesn’t make for much cheer which is unsurprisingly given the subject matter but emphasises the importance for care staff who often are employed by private companies and may not have redress to a union for advice and support to be better supported by local authorities who commission their services and by the regulatory body (CQC) in raising concerns in a safe environment.
It seems obvious to note but the care worker ‘on the ground’ is the person most likely to be able to spot abusive practices in care settings and particularly in residential and nursing homes. This must be a resource that is utilised and they must be afforded protection through not only well-intentioned whistleblowing policies but well implemented and well known ones that are able to be drawn on and protect the workers involved.
As we move towards more direct payment funded personal budgets and home care settings change, the relationship and responsibilities of care workers and personal assistants that may be directly employed by service users rather than through agencies also should be addressed through policies regarding raising safeguarding (adult protection) alerts.
Until training and awareness around adult protection is as widespread as it is around child protection, we can’t afford to be complacent or make assumptions about what may or may not be reported.