Benefits

I’ve made my position clear about ‘benefits’ over the year. ‘Benefits’ are not really benefits at all.

I decided to look at the meaning of the word ‘benefit’ and found (according to dictionary.com)

ben·e·fit

[ben-uh-fit]  noun, verb,ben·e·fit·ed or ben·e·fit·ted, ben·e·fit·ing or ben·e·fit·ting.

1.something that is advantageous or good; an advantage:

2.a payment or gift, as one made to help someone or given by a benefit society, insurance company, or public agency:

3.a theatrical performance or other public entertainment toraise money for a charitable organization or cause.

4.Archaic . an act of kindness; good deed;

Perhaps our national failing is that we still mentally see ‘benefits’ as a gift and not a right.  The payments given to those who have some form of need should not be considered as an ‘act of charity’ by government. It is money necessary to live not money in the gift of the government.

Sometimes language is and can be important.

By Cameron and his Conservative-led coalition like spreading the rhetoric that ‘benefits’ as well as ‘public housing’ should somehow be related to ‘good behaviour’.

This article for example as a case in point which explains

David Cameron wrote in a Sunday newspaper that he wanted to look at going further in welfare reforms, calling for the child benefit payments of parents who play truant from school to be withdrawn.

He suggested a more ambitious welfare reform programme when he posed the question of whether the government should be “asking much more of people on benefits who should be looking for work – or imposing even stricter penalties on those who refuse job offers?”

Cameron moves in a no-doubt electorally pleasing but morally questionable path.

Calling for the removal of child benefit payments to the parents of children who play truant is morally repulsive. It further impedes those who rely more heavily on those child benefit payments. Lets not forget that child benefit will be means tested soon (in a pathetically haphazard way but no matter). Where is the proposal for penalties for those parents who don’t receive child benefit and whose children play truant? Or do they really think truancy only affects ‘poor children’.

It insults our intelligence to make these proposals but they play very well to a public crowd that has been increasingly weaned to divide our own population into an ‘us/them’ dichotomy between those who work and those who do not work.

The government (and the previous government too) persist with a ‘divide and rule’ policy of presenting those who are not able to work against those who do work – well, we should never forget that for those us who aren’t party to the millions in trust funds that most of our government members grew up with – there is a extremely tenuous link between being a have and being a have-not.

The Guardian article goes on to quote Cameron saying

“What about welfare? The old something-for-nothing system we had under Labour had a poisonous effect on responsibility in our society. Again, we’ve already taken bold action – we’re in the process of moving hundreds of thousands of people who are fit to work off incapacity benefit and are imposing sensible limits on the amount of benefit people can take. But again, given the scale of the problem, can’t we go further? Say by asking much more of people on benefits who should be looking for work – or imposing even stricter penalties on those who refuse job offers?”

Something-for-nothing? Really? Personally I believe that people are entitled to a level of support from the state in order to live and that Cameron is playing games with words and assumptions when he appeals to the ‘Daily Mail’ reading crowd. He makes much reference to ‘benefit cheats’ as talks about ‘taking away benefits’ as if it is a reward that we had to well-behaved dogs and it is insulting in the extreme.

I those doubt that reforms are needed but the language in itself in invidious and pushes our thoughts to regard ‘benefits’ and ‘benefit claimants’ in a particularly unfavourable light.

And as an aside, as was pointed out to me, the photo in the Guardian article – well it has a picture of Charles and Camilla. Now THERE’S a family existing on benefits with absolutely no public gain and I think their social housing should be taken away for the genuine good of the nation. But that’s another question for another day..

Technology, Social Media and Social Services – Finding new ways to ‘help’

iPad con dock y teclado inalámbrico

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I have some across lots of discussions and debates about ways of using social media and new technologies and interactions to ‘help’ social services become more effective. Most of it seems to revolve around building online directories and databases of micro providers and services that are available which build on so-called community capacity to improve the way that personal budgets can or might work.

At the risk of sounding overly cynical there is nothing ‘innovative’ in my mind about building a directory of services.  To me, this is not a particularly innovative way to use ‘technology’ in social services.  It taking a very obvious and well-trodden route to using new technologies. Providing directories while being useful to a certain group of people again exacerbates the isolation of those who are not party to or able to use them.  Being innovative isn’t always necessary to be helpful but it is very important that new ideas are focussed so we don’t just end up with increasingly specialised, localised directories that might have more ‘interactive’ features and feedback, look more ‘user led’ and compatible with the buzz words of social media but in the end they are brushing the surface of possibilities.

It feels more and more as if that there is a growing division between the ‘haves’ and ‘have nots’ as far as personal budgets have been extended and does absolutely nothing to address or use technologies to address those who reside continually in the ‘have not’ section.

While at work, we labour with database systems that have clearly been developed through conversations between commissioners and software companies without any recourse to frontline practitioners, nice new provider directories are being tinkered around with while the fundamental foundations of the systems we work with remain resolutely inaccessible.

I’ve had a few ideas myself and whilst I lack the technological expertise to see any of these ideas to fruition, this is a kind of ‘wish list’ of the sorts of things I’d like to see.  I’m under no illusion that these are ‘new’ ideas. I am sure similar things already exist in some form but they are things I’d like to see pan out in the longer run. Things I’d like to use at work.

I’d like to see more creativity in the use of technologies to assist with decision making for adults who have some kind of cognitive deficit. I’m a great fan of the ‘tablet’ and ‘touch screen’ model as I think it is intuitively an easier interface to understand.  When I see people instinctively reach out to touch the screen of my Kindle (which isn’t touchscreen!) I realise that we are becoming conditioned to seek the easiest input methods which are about touching a screen and speaking into a microphone and perhaps writing on a tablet. Now, voice recognition has improved, I’m yet to come across very successful handwriting recognition (possibly because I have scrawly almost illegible handwriting) but there is potential there. In the meantime, pictures and touchscreens seem like a good way to go.

Using pictures/sounds/music it can draw on multi-media ‘shows’ and explanations of different options – moving beyond the ‘written word’. Providing documentation in aural form or in pictorial/moving form rather than reams of leaflets. Having recordings of familiar voices or pictures of familiar faces might help to reassure. I’m a great fan of telecare in general with the proviso of always being mindful that the human contact is not replaced but in days where human contact is sparsely provisioned anyway, it may be something that can be experimented with.

Why not a YouTube type video to explain how services can be chosen instead of reams of ‘easy read’ leaflets which really aren’t remotely ‘easy read’. Instead of flooding people with lists of providers (which, while good for some ignores those who are restricted in terms of capacity and carers to choose ‘freely’ the types of services they garner) why not explain and expound in different ways the ways that services can work?

Why not explain providers in terms of what they can actually provide and what purpose they serve rather than creating directories that are meant for people with a good understanding of what they want and need?

I was in a day centre last week and there was a seemingly unused Wii. I wonder if he Kinect might be a better project to develop some type of interactive play, exercise and work as it doesn’t need a controller at all and uses the more innovative way of body movement.  Using participatory games with larger screens in company can provide different stimuli. I know why games developers  haven’t tackled directly the ‘older’ market with games that might otherwise reside in memories but why not repackage old school yard games and board games with Kinects and iPads? It may be a good way to introduce the use of these new technologies in a ‘friendly’ manner which may then see them used in other wider ways – such as directories or personalised information sources. Using YouTube video channels for personally designed ‘reminiscence’ therapies could personalise the delivery of memories and digitise memory boxes where items are not there to build up the frames of someone’s life and people aren’t there to fill in the gaps.

There are many ‘dating site’ type services that match people and organisations. Volunteers to voluntary groups etc. How about a type of match between schools and residential homes? I know it’s something that’s sometimes done locally where I work and having spoken to both providers and some of the kids who go in, they seem to enjoy it and it can change and break expectations – each of the other.  I

We talk of social media a lot and often it is used to provide ‘recommendations’ to particular services through these databases. Perhaps more user and carer led general recommendations can be collated. Crowd source an ‘introduction’ to social services provisions by those currently using the service.

Ask ‘what do you wish you’d known?’ ‘what do you wish someone had told you?’ and while taking out all the obviously libellous stuff, a local authority must be brave enough to leave in the criticisms. We learn through complains and criticisms and it can take a lot of guts (or anger) to make a complaint or to criticism and that MUST be respected by the service and the individuals at fault and used as a means of improvement.

I don’t want to see local authorities ‘whitewash’ problems in order to gain sparkling OFSTED or CQC inspections. It sullies the whole process and makes the inspections worthless. Regulation should be less authoritarian and more about actually making improvements and making things better for the end user – not about allowing local authorities to produce the ‘right’ results while poor practice is brushed away from the sight of the inspectors.

But back to my point about using social media to crowdsource – it is important that social media ALONE is not used as an ‘answer’. Crowd sourcing must be honest but it must also be broader than putting out an ‘internet consultation’ and having a Twitter account or blog. There must be pounding of the streets too to engage those who are not able to use digital means to put their points across. There should be knocking at doors and face to face discussions – not leaflets, not inaccessible (for some) groups.

Talking about crowdsourcing though, there’s a much better and perhaps more obvious way it can be used and certainly isn’t being used at the moment and that’s to engage other social workers and professionals into putting together more information and useful methods of practice for ourselves. Sure, it needs time but we remain reliant on organisations to provide ‘guidance’ such as SCIE (who do provide fantastic resources) and BASW and the College of Social Work but why none of these organisations who purport to exist to help social work and social care practice actually engage more directly and use social media and open access blogs/discussion groups/forums/micro blogging etc to engage with currently practicing social workers is completely beyond me.

I’ve become very interested in open access education and resources and feel there is great scope for professional engagement and information to build its own resources and information together with users and carers, together with other professionals but there has to be a push for social workers to see the benefit of sharing and finding appropriate ways to share the information that we learn every day.

I have other ideas which will come in different posts  but I’d be interested in hearing other peoples’ ideas for uses of ‘technology’ in the very broadest sense and how they can develop to help the broadest range of people we see in social services – particularly those who are less able to look information up in various fancy online directories.

Commissioning

Yesterday, I caught up with a friend of mine whom I hadn’t seen for a few months. She works in commissioning. She didn’t work in commissioning when we first met but her career trajectory has taken a few odd side steps and there she is.

We talked about commissioning for a while. She doesn’t work in a part of commissioning that affects the services that would be delivered by my part of the service so I felt fairly safe moving into rant mode as I spoke to her.

I wondered, to her, why the process of commissioning is so far removed from the frontline service delivery.

But there are service user consultations, she added. Yes, I replied but they are narrow in scope and where are the voices of those who do not ‘self-select’ themselves on ‘panels’. Where are the voices of those who may not have the capacity to make some of the decisions related to their care needs? Where are the voices of the carers who don’t actually have the ability to leave their homes because of the lack of appropriate respite – particularly older carers? Where are the voices of the voiceless?

She had a good comeback of course and spoke to me about the reams of additional advocacy support she is involved with but it made my heart sink.

You see, all advocacy apart from statutory IMCAs (Independent Mental Capacity Advocates) and IMHAs (Independent Mental Health Advocates) have been withdrawn from the services that I work in. The voluntary sector agencies that might have helped have either been axed or cut back sufficiently that they won’t ‘work with’ people who enter our services.

But back to the commissioners. I wonder why I didn’t know the name of any of the people involved in commissioning services for our local authority in the user group I work with. Why don’t they come to our team and meet with us and talk to us, I suggested to my friend, while, of course, absolving her personally – I know she is both good at her job and dedicated to providing good quality services.

Surely we, who are involved in scoping out support plans, making suggestions about which care agencies might be better than others, we who receive the day to day complaints when services aren’t available or aren’t working, would be useful people for commissioners to engage with? But I don’t even know the names of the people who work in commissioning the services we are asked to use.

They make block contracts on the basis of cost which deliver poorly. Yet when renewal time came around, exactly the same contracts were dished out. Perhaps we should meet and discuss our respective jobs a little more often.

I feel angry towards the unnamed commissioners in our service. I feel angry because they drop services on us which are basically unsuitable but cheap. They say they ‘consult’ but as I have learnt over my time in the job, ‘consult’ does not mean discuss, it means tell.

I wonder how many of these faceless ‘commissioners’ would be happy to stand alongside me in a hospital as I tell a family they will have to travel miles each way to visit their parent in a residential home because we have nothing available locally. Or stand next to me as I apologise, in my role as a corporate ‘entity’ because the provision of respite which was promised is wholly unsuitable because its all we have to offer.  Or listen to the conversations I have to take about carers rushed off their feet because they are limited to these ‘15 minute’ pop-in visits to desperately lonely people or listen to the discussions about why we no longer do a hot meals on wheels service and deliver only microwaveable meals. Occasionally, I’ve been known to tap out a grumbly email to ‘commissioning’ about particular services – and why I think they work or what I think is lacking – simply because I am not sure what other action to take and I want to ‘do something’. I’ve never really had anything other than perfunctory responses. They seem to exist in a parallel universe of contracts and submissions and plans.

Who was consulted before these commissioning decisions were made? I’m sure people were. Or were they? What backgrounds to ‘commissioners’ have in human services – I honestly don’t know. I don’t know if they have ever had any professional expertise in the areas that they commission for or have just moved up through various administrative ranks without any frontline experience.

I know ‘back office’ is important. I know there are some people that need to commission services. I understand that. I just wish sometimes I knew who they were and the ways that they made their decisions. I wish sometimes they would show their collective faces in our offices to understand better the implications of the decisions they make.

I’m very far from an expert in organisational systems but surely it can only help when different parts of a ‘group’ come to know each other face to face through discussion and understanding rather than the continual barriers that are put up between us by people who feel it necessary to stay in their safe silos.

I don’t want to mistrust commissioners. I just want to know who they are. More importantly, I want to know they understand the effect of their decisions on the people I see every day.

Castlebeck and CQC – Brief Thoughts

Paul Burstow MP addressing a Liberal Democrat ...

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I don’t have time for a long post today, just a few brief thoughts that came to me as I considered the unsurprisingly critical report on Castlebeck by the CQC.

Of course it’s easy to be wise after the event but it leaves a bitter taste in the mouth when the CQC comes down hard on Castlebeck after it required a TV undercover programme to uncover the widespread abuse at Winterbourne View. Where is our faith in the CQC? Well, personally, I didn’t have any to begin with but this report is not a solution, it smacks of a desperation to gain any kind of public recognition of the CQC itself rather than a real attempt to improve any system of regulation.

Regulation costs. Good regulation costs. In the week that the Ofsted is planning two week, unannounced inspections of childrens’ services, I ask why services for adults have been allowed to be neglected?

Yesterday I heard Paul Burstow on the radio on my way home. Two things struck me, firstly that he didn’t seem to have any understanding of the difference between a hospital such as Winterbourne View and a care home. He  seemed to be happy to blame local commissioners for the quality of the placements that they commissioned in hospitals without an understanding of what had led to this situation – namely chasing the lowest prices.  He still is banging on about his so-called Excellence scheme which, if anything, will make things worse as I wrote here. The Excellence scheme is opt-in and it is for companies to pay to be a part of. That is not about excellence, that is about money-making.

The CQC should be demanding excellence from every single service it inspects. Every day. It doesn’t. It demands sufficient paperwork every couple of years, at most. That is how it inspects. Actually, the CQC doesn’t inspect any more. It does not have enough people to inspect, control and check.

We have allowed companies like Castlebeck to rake in millions of pounds of profits on the back of providing poor care to vulnerable residents and patients. We have allowed this because noone is calling the CQC and the government to account for destroying adult care services.

The CQC criticising Castlebeck – of course it will but remember this is on the back of one television programme with hidden cameras. What about the thousands of homes without hidden cameras? Where are the checks? Where is the scrutiny? Where is the excellence?

Why Deaf Awareness?

This is a guest post by Suzie  Jones@suziejones2010 . Many thanks to her – cb

Why deaf awareness?

When you think about the people you meet and talk to in your everyday life, I wonder if it crosses your mind that one in every six has a hearing loss? That’s 10 million people in the UK and this number is growing steadily with exposure to loud noises at an ever younger age. Over half of people who are 60 or older have a hearing loss. (and one in six has a vision loss, that equates to approximately 2 million who may be partially deafblind).

So, what’s a deaf person? Most of you will think that someone is a deaf person because they use sign language. But you may be mistaken. There are an estimated 50,000 to 75,000 deaf people who use British Sign Language (BSL), the rest will be using hearing aids, cochlear Implants, speech and lipreading.

How would you recognise a deaf person? The most obvious clues are they don’t respond to noises behind them and may be looking at you intently when communicating. They’re lipreading, and some of them probably don’t realise they are doing it. If you see someone wearing a hearing aid, don’t assume they are hearing like you are. The majority of deaf people have what is called a perceptive hearing loss, this is permanent, and it makes sounds not just quieter, but distorted too. Have a listen to this simulation :

Blindness cuts you off from things, but Deafness cuts you off from people says Helen Keller. How true this is. Communication is probably the most important thing to a person. If you can’t communicate you get frustrated, lose your confidence, withdraw from socialising with others and some people become suicidal and think life is over. Friends and colleagues think the person is being rude, ignoring them on purpose, or is simply not interested in them anymore. Yet communication is needed to tell people what you want or need, how you feel and to take and give instructions. It is no surprise, then that deafness is a major cause of mental health issues.

So how can deaf awareness help social workers? The best deaf awareness training will equip you with the knowledge to understand exactly how deafness affects an individual and an understanding of the diversity of people who are deaf and how they react to it.

From those who think being deaf is wonderful, to the point where they celebrate the birth of a deaf baby, to those who literally fall apart when they lose all of their hearing, sometimes overnight. It will also give you skills to speak clearly, know tactics you can use to make yourself understood and show you why deaf people make so many mistakes in lipreading and appear to not understand you.

It’s not just about what you see on the lips, lipreading is only 30% accurate, the rest is intelligent guesswork and can be extremely tiring. Deaf awareness will also teach you about the support that is available to aid communication and access, from registered communication professionals to technological equipment, like loop systems, TextRelay and other aids.

Deaf people really do blossom when they are treated with respect and given the opportunity to partake in things that other people take for granted. Such things are opportunities to go to the local leisure centre, to go to social events, to attend a subtitled screening at the local cinema, or even a tour of the local museum.

If you know how to make these accessible, you’re on a winner. After all deaf people are legally entitled to these things, it’s a fact though that most of them still a luxury or out of arms reach for many of us.

Don’t think that we can “make do” using family or having a sympathetic friend to be with us to do this communication support. It’s not independence, it makes us “needy” and reliant on people. We have a right to make our own choices in life and the freedom to say so without being influenced by the opinion of others. That’s the difference between providing professional communication support or not.

So next time you see an opportunity to go on a course to learn about deafness, do take it up. Don’t think that by learning BSL only is going to make you “deaf aware”. It won’t. You need to know who you’re learning it for before you start. If you would like a course run in your local area, do get in touch with us, we are here to make things better and raise this much needed awareness throughout the UK. The more people who are privy to this valuable knowledge, the better we can all make life for the 10 million people who are living with deafness every day in silence.

Suzie Jones

www.deafcomm.co.uk

Light Touch Inspections, Winterbourne View and the CQC

There was a report on the Community Care website on Friday that the CQC were ‘calling time’ on their so-called light touch inspection ‘regime’ thereby rolling out potentially to annual inspections for adult services and care homes.

As the article emphasises

Bower said that the CQC had favoured a “proportionate, risk-based, light-touch” approach to regulation – in which services were left uninspected for up to two years in the absence of issues coming to light – but service users, providers and staff favoured more inspections.

“What people want, particularly people who use services, is for us to put our boots on the ground,” she said. “Inspections are a really positive quality assurance for providers.”

It’s hard to believe Bower would have been saying this if she had not been forced into the position by the Winterbourne View scandal where substantial abuse was uncovered.

A shame that she did not show more backbone and spirit in protecting the organisation that was handed to her to lead when all the cuts were coming hard and fast. It did not take a genius to work out that the only reason the so-called ‘light touch’ system was implemented in the first place was to save money. The problem is, that it has stripped the CQC of any credibility it might have had as a regulator.

And yesterday, this same CQC criticised Winterbourne View and it’s owners, Castlebeck had misled that self-same regulator about issues that where taking place and abuse that was taking place while they were inspecting the service.

Interesting to see the Independent highlight the issues which the CQC raised as criticisms of Castlebeck

Inspectors said they found people who had no background in care services had been working at the centre, references were not always checked and staff were not trained or supervised properly.

They added Castlebeck failed to meet essential standards, required by law, including:

:: The managers did not ensure that major incidents were reported to the Care Quality Commission as required;

:: Planning and delivery of care did not meet people’s individual needs;

:: They did not have robust systems to assess and monitor the quality of services;

:: They did not identify, and manage, risks relating to the health, welfare and safety of patients;

:: They had not responded to or considered complaints and views of people about the service;

:: Investigations into the conduct of staff were not robust and had not safeguarded people;

:: They did not take reasonable steps to identify the possibility of abuse and prevent it before it occurred;

:: They did not respond appropriately to allegations of abuse;

:: They did not have arrangements in place to protect the people against unlawful or excessive use of restraint;

:: They did not operate effective recruitment procedures or take appropriate steps in relation to persons who were not fit to work in care settings;

:: They failed in their responsibilities to provide appropriate training and supervision to staff.

While there is no excuse for such considerable failures, you’d think that a good regulator worth it’s proverbial salt should have picked up some of these issues through a thorough and robust regulation system.

Remember this is the same Bower who has promoted extensively the use of whistleblowing and family members as a ‘resource’ to augment their inspection processes. And then the organisation feigns upset when things are concealed to it.

How did we come to this? How did we, as a society, allow the organisation that regulates Health and Social Care to be stripped bare due to a resource-led decision and blunt its teeth so incredibly that people who depend on these services can have no confidence in its position to protect?

Money, cost, closed eyes and an ability to discharge responsibility for the care of those in our society who need particular protection has led for this situation to emerge.

Unfortunately I can’t go into details about some of the things I  have seen over the past week that makes me feel  much more strongly about these issues but suffice to say this – which, in itself – could even be too much.

I visited a care home which had an ‘excellent’ star rating. Yes, the stars are outdated but it is an easy way to check and remains so. There had been no inspections over the past year, at least, anyway. Excellent. And it looked it on the outside. My involvement was due to a large scale safeguarding investigation. Let’s just say it was very far from excellent and had been for a number of years, including when the last ‘excellent’ inspection rating had been given.

The inspections depend too heavily on self-reported data and too little on ‘feet on the ground’ and investigations skills. I sometimes wish I could try doing a really thorough, wholesale inspection of any given inspection service. I’ve worked in residential care. I know what I would look for. It angers and upsets me that self-reporting and the ‘light-touch’ were ever permitted for purely cost-related reasons.

But the CQC says it is increasing inspections – still it will not be close to previous levels. To see them criticise Castlebeck – all well and good – but it doesn’t take the responsibility for inspection and regulation away from them. It bears some resemblence to the social workers who are told they are more easily led by parents who conceal information from them. If the social workers are chastised for ‘believing’ why not the regulator.

It makes me angry. Maybe time to invest in regulation and inspection and demand better services that actually protect against, rather than mask poor care. It is ever more important.