London – Some thoughts and hopes

I didn’t sleep  much last night. Or the night before. Or the night before that. My city is burning. There is a tangible fear in the air. I’m not above it because I feel it and I see it.

I don’t want to listen to politicians being parachuted in (when they finally arrive back in the country) to talk about mindless violence and talking to ‘community leaders’.  ‘Community leaders’ who are self-appointed and seem to want to polarise and divide rather than come together and heal.

Don’t speak to community leaders, come and speak to me. Come and speak to people like me who just want to find ways for sense and our voice to be heard. I’m just as much a part of this community as ‘church leaders’. Why are they credited with greater access to the ‘influential’.

I want people who live here and love this city to find ways to heal her and pull her together. I don’t want the same ‘community leaders’ speaking to the same ‘politicians’ trying to build up their own special interests and agendas.

I want to shout and scream and rage at all those who seem hell-bent on destruction but this is a symptom not a cause.

This is and never was about race. This is about age and belonging. How can you care for a society when society cares nothing for you?

This is a disaffected youth who are devoid of a moral compass because our society values goods and monetary worth over basic humanity. This is what has been learnt. The ‘establishment’ doesn’t work for you but against you. You take what you can.

Perhaps though, these awful scenes and desperate situations will provide an opportunity to build a better society for everyone and to reach out to disaffected youth and marginalised people.

Maybe, this will be the way to build a real, true community and to build a better London.

I love this city. I was born here. It’s my home. It has its rough and smooth.  But it is a good place and it is filled with good people. There are enough of us here to force a triumph for the good.

Riots, Poverty and Assumptions

It would be remiss of me not to mention the rioting that took place in London over the weekend. I work and live in some of the poorer areas of the city and felt, indeed, still feel desperately saddened by some of the pictures and reportage coming from Tottenham, Enfield and Brixton among other places.

I can’t begin to make sense of it. I know the initial trouble grew from anger against the police after the shooting of a local resident last Thursday.

Regardless of the details of the initial spark that lit the tinderbox of malcontent across London, my sense is that it was, for many an excuse to cause trouble.

That isn’t to say there may not be real reasons for anger against the police and against the ‘establishment’ but the way the anger was expressed through mindless violence and looting seemed to indicate that there was also a wish to express anger and rage against lots of other things as well.

The places the riot went, so went the Twitter messages, Facebook posts and groups and the less ‘keyed in’ SMS messages letting others know where to come for random violence. Where to come for looting ‘opportunities’. Where to express ‘anger’ even if sometimes it was unclear what the anger was about or to whom it should be directed. It seems harsh that the ordinary citizens of Tottenham will be the ones to bear the deepest repercussions of the violence and aggression – for whatever reasons.

This morning I was listening to the radio. I heard the host say, ironically I suspect that the people of Tottenham deserved this for not ‘parenting their children’ correctly. For allowing their children to run wild. He said, again, I think it was intended to be ironically – ‘Where were their parents? Or rather, where were their mothers as I’m sure most of them don’t know their fathers’.

Wow.

Let’s just think about the way that we perceive people who live in poverty and poor areas for a moment.

I’m no sociologist. I have though been living and working cheek by jowl with poverty. It doesn’t make me an expert and I am fortunate enough to say I don’t have a lived experience of poverty. I’ve had periods of debt problems.  I’ve had periods of difficulties.  I lived in a single parent family but I haven’t experienced poverty.

Even so, I think that poverty is not necessarily one of the flames that fuelled the protest.  I think there’s an element of wanting excitement, wanting danger, perhaps even – wanting to change the way things are in society that lead to so many and so much injustice, discrimination and pain.

The ‘order’ of things that makes some people own and other people beg. A governing class that can take fancy foreign holidays while the streets of Tottenham burn.

Then there is the looting. Wanting something for nothing. The politics or rather the sociology of envy. The kinds of programmes that fill our evenings of reality star mania that make fame and wealth so easily accessible without the commensurate effort. Without seeing something grow. Without working.

Without work. That’s another element. Can it be a sheer coincidence that the levels of joblessness around Tottenham are some of the highest in London?

Probably not.

While Cameron holidays in Tuscany and Osbourne enjoys the delights of Disneyland (or DisneyWorld or wherever he is), I genuinely wonder if they can ever understand the fears and concerns of the people of Tottenham.

We’re all in this together?

Sticks a little in the throat to say it while statements are returned to the country from exotic foreign climates.

There needs to be a real effort and a real desire to make this world and this country better.

As for those who proposed, instigated and enjoyed the riots. Those who looted and ruined local communities already hurt by poverty. I hope they are caught and punished. I’m a social liberal and my views tend to drift leftwards but I have no time whatsoever for mindless destruction.

The pictures I’ve seen have been ones of mindless destruction and people enjoying violence. That needs punishment.

As for now, we need to think about these communities. We need to care about the people of Tottenham and places like that. We need to think about the effects of the cuts programmes in areas like this and why the levels of disengagement and disaffection are so high.

We need to heal this city and this country.

No, violence should never ‘win’. Destruction and crime must be punished.

But creating a better community, society and country need to be the goal.

As for today, I’ll share a thought or two with those caught up in the violence, fear and disorder. The people who live in the communities and particularly the people of Tottenham.

I wish them healing and time to build their community back up stronger and better.

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

Elaine McDonald, Kensington and Chelsea and Dignity

Yesterday, the High Court ruled in the case of R (on the application of McDonald)  v Royal Borough of Kensington and Chelsea. This was a further appeal by McDonald against a previous decision at a lower court.

Elaine McDonald is 68 year old woman who worked as a ballerina in her younger days. The press seems to be a little fixated on her former career, and she does have a more glamorous background than many who come to rely heavily on social care so perhaps it is no surprise. Ms McDonald suffered from a debilitating stroke in 1999 and had a further fall in 2006 which led to very poor mobility.  Although not medically incontinent, she required assistance to use the commode during the night.  She had been provided with overnight support to meet her assessed needs related to continence during the night however Kensington and Chelsea were suggesting that this need could be met by substituting this assistance with the provision of continence pads during the night which would, by their nature, demand that Ms McDonald remain in these pads until carers could come in the morning and at intervals to ‘change’ her.

sulle punte

frabattista @ flickr

I wasn’t surprised by the decision by the High Court because there are precedents that led the access of local authorities to resources to be a factor in relation to the provision of services.

In my own working experience, it is impossible to access any kind of home care support overnight except in some very specific cases where there is very high need support and even then, it is much much more likely to be provided to younger adults with physical disabilities. I can count on the fingers of one hand the amounts of times I’ve come across local authority funded overnight support in the last 10+ years of practice.

Sometimes I have to take a step back from what I regard as ‘normal’ practice to understand the outrage at this decision. I realise how I become attuned to ‘local authority’ think and ‘budgetary’ think and that’s quite an uncomfortable thought.

We get used to applying different definitions of ‘dignity’ and what is acceptable because we are aware of the thousands of Ms McDonalds that require support and the existence of a  finite resource. So do you support the Ms McDonalds and assist them to provide a fuller and more dignified life at home or do you provide 8 Ms Smiths with respite care over the year. These are the realities of the decisions and it shouldn’t have to be so.

Perhaps that’s why I’m less surprised by the McDonald ruling and less surprised by it.

There are though horrendous inequities in our system of the provision of social care. Where Ms McDonald in Kensington and Chelsea may be receiving a vastly different service from a parallel Ms McDonald in Newham.  I would venture a guess that there are thousands of potentially very similar cases to Ms McDonald bubbling under the surface ‘in the system’ but because they are not ex-Prima ballerinas and don’t have the will, way and means to bring cases and involve solicitors, we will never know about them.

If anything is, quite literally, the ‘dirty secret’ of social care and health care provision particularly for older adults, it is this.

We have different standards of what we class as being ‘dignified’ for ourselves as for others. What might class as dignity to an older adult has less value and invites less spending to an equivalent younger adult with exactly the same care needs. Those who shout loudest get the most – as far as care is concerned and as far as public interest is concerned.  The shame and pity of the ‘personalisation’ agenda and the flawed implementation of personal budgets in social care have exacerbated this problem further rather than provided a channel to allow for a more equitable system of care delivery.

It sometimes feel cruel and harsh, because it is a cruel and harsh system that it perpetuated by discriminatory systems. Would the warehouse-style very large residential and nursing care homes with 100+ beds be acceptable for younger adults with similar care needs? I don’t think so.   I don’t mean to imply that every large care home is bad and every small care home is good. That isn’t the case. It’s about a fundamental reassessment of what is acceptable in the provision of care for older people in our society.

Lucy at The Small Places covers the issue of dignity through caselaw, in an excellent, thorough and educational post.

I make no apology for my less erudite post and thoughts.  The more I work and the more I reflect, the more interplay I see between the basic conceits of ethics and ethical judgement in the role that I play as a part of this system that condones this mealy mouthed interpretation of human rights merely on the basis of cost and resourcing issues.

It is accepted because our society is inherently ageist. We don’t want to think or pay for the care of older people. We care more about our collective inheritances and potential house prices than the more collective thoughts about where the boundaries of an acceptable level of care and dignity lie.

If anything, this has impressed on  me the importance of constant reflection on my practice and my work. I can advocate to an extent, from within the system, for the dignity of those like Ms McDonald and I try to. Some I win and some I lose but as long as I make my voice heard through every step of the process I can help to feed the voices ‘from the front line’ back to the more senior managers.

I make judgements and I am the mouthpiece of the local authority. I am an employee but the second that I become complacent, the  moment I stop reflecting on the effects the decisions I make have and the instant that I join that local authority ‘group think’, I lose my ethical compass and my professional judgement.

I talk a lot about important qualities of social workers and social care workers. Respect, empathy and to that I’d add advocacy. It might not always be seen in the internal battles that we fight, but we have to try to fight so as not to accept a ‘normal’ that is defined on the bank balance sheets of the local authority accountants.

Power, Status and Professionalism

power. to protect.

 

kenyee@flickr

I was ruminating over the post I wrote yesterday about the interplay and interaction between being a social worker and being a foster carer and the one aspect that played on my mind was the differential in ‘status’.

I used to think status and professional status was very important to me as a social worker. Don’t get me wrong. I’m very proud to be a social worker but I think when I was first qualified, I was also proud to be doing ‘something proper’ and recognised.

I had, at this point, in my defence, worked for years in the care sector as a support worker and a care worker. I had had friends and family asking me when I was going to get a ‘proper’ job and tell me that my academic qualifications were ‘underused’ in a minimum wage care job.

And I listened. I began to believe. The process towards my professionalisation was one I was proud of. Sometimes if you do a ‘low status’ job or have no job, society makes assumptions about your general intelligence level so being able to prove that I could make it through a postgraduate course was also an element of pride for me. I liked the idea of ‘having a profession’.

But I wonder if I was too taken by status and if the divides and gaping holes that exist between policy makers and practitioners is because ‘status’ is a bar.

For example, yesterday I had an extensive conversation with the Personal Budgets Implementation Manager about a case I was working on. We made good progress on hopefully working on a more creative option for a service user I’m working with currently.

My colleagues were surprised that a) I had approached this ‘manager’ directly and b) that she  had listened.

I thought about this and my role in perpetuating the divides between policy and practice and how status remains such a predominant factor in blocking conversations from the ‘front line’ to ‘management’.

We are institutionalised both by our employers who determine that ‘conversation’ flows in one direction and by our society where we, as a species seem to be keen to label everything, put labels on everything and want to by our nature, know our place in the societal pyramids of power.

So back now to the foster carer and the social worker. Is the foster carer really on a ‘lower’ rung of the ladder of professionalism than the social worker that they can be ‘looked down on’ by so-called professionals? It can honestly feel that way and taking a step back to look at the way I am ‘dealt’ with when I have my ‘social worker’ hat on as opposed to when I introduce and describe myself as a ‘foster care’ is a glimpse into the different statuses that it is accorded.

Status is afforded because power is present and this is something that overrides the social work profession in whatever capacity it is undertaken. Whether it is in adult care management where it can feel as a practitioner that you are pretty reined in in terms of what care can be provided on financial levels, in the eyes of the service user you are the ‘gatekeeper’ to the mythical goal of ‘provision of care services’.

In Mental Health work there are some obvious legal powers under the Mental Health Act but even in day to day care co-ordination, you become the conduit between the multidisciplinary team and the service user. You decide what is important to feed back, what constitutes a concern or a worry and how situations may be resolved or, if necessary escalated.

And we go into people’s homes. We make appointments. We decide on timings to fit into our busy diaries. Sometimes we even cancel appointments. These are all displays of power. Power isn’t about flexing of muscles, it can be as much about sending a letter or making a phone call suggesting a time to visit. Of course, it has to exist but the important thing is never to forget the power differentials and the way that they change the dynamics between user and provider.

With my last social work student, we spoke a lot about power and I alluded that she should reflect on the power relationship between us as well as the power relationship with service users. I smile and I joke with her but there is an enormous power differential between us that cannot go unacknowledged.

And as a foster carer, I accept that social workers will turn up at any point to see the child I have in placement or to just see the home or to check up on us. That’s fine, it’s understandable and I have no problem whatsoever with that, I know it’s a part of the process and I would feel angry if foster carers were not subject to checks but there is a power differential there and it has to be acknowledged  – even if it is not openly acknowledged.

We can never have an truly equitable ‘status’ because social workers can come and check on me and are responsible for my approval as a foster carer but I can’t wander into their home or even office at will (trust me, I wouldn’t want to!).  I think without acknowledging this power differential or by pretending there is any kind of ‘equal’ status we do both parties a disservice.

Once acknowleged, issues of power can be addressed and considered but if it remains unspoken, they can be levered and used for less positive outcomes and ends.

As for ‘professionalism’ in social work, I think we could go round in circles with this one. Respect is helpful but that is a truism that can pretty much be applied to any sphere of life. Is the respect based on professionalism? Only if the professional is respectful and competent.   An incompetent professional can do far more damage than good and the converse is true for a good professional.

Thinking back to the stories of abuse at Winterbourne View,  we see much more obvious displays of power. The power was held by the care workers and exercised on the patients at Winterbourne. There is something within the care sector where so  much work is done with some who for many reasons may have little power that it can attract people who want to exercise power for the wrong reasons – to augment feelings of self-worth or to bolster failings in other areas of their lives. It is important that the power dynamic is acknowledged and guarded against at all levels and that it never ever becomes something that is taken for granted or played on to make others feel threatened or denigrated.

The status, the qualification, the experience and the practice alone don’t make a ‘good professional’ – it is a mixture of all of them and the way that power is used, acknowledged (internally) and processed that create good practice and good practitioners.

We can often talk about qualities that are important for good social workers and social care workers. I wonder if I’ve mentioned it but for the reasons above, I would put the quality of humility very high. We need to listen and be aware of the inherent power we have. We need to ensure the voices we hear are echoed upwards in our chains of ‘command’. We need to listen to experts of their own situation and the people close to them. Sometimes we have to impose and sometimes we have to say no, but we acting with humility is a rich and exceptional quality and one that makes a good social worker.

Learning Disability Week – Hate Crime and Hate Language

I know I’m a bit late to Learning Disability Week – which runs from the 20th June for.. well, a week but it remains a campaign and a group I have a great attachment to coming from years working with adults with learning disabilities before I qualified as a social worker.

The ‘theme’ if it can be called that, is a new campaign, called Stand by Me,  which is being run by Mencap to challenge and hopefully phase out hate crime which is targeted towards people with learning disabilities.
Lady justice - close up

 

raphaelmarquez@flickr

Apart from, I hope, creating more of a stigma towards those who might seek out and target people with learning disabilities there is a focus on the ways in which crimes which are committed are dealt with by the police and the criminal justice system.

Mencap share some chilling but sadly unsurprising real life stories from people who have suffered from hate crime.

While accepting this is slightly different, I have had difficulties trying to pursue prosecutions for people who have dementia and who are the victims of crime and abusive situations due to the way that the systems are currently set up. I hope there is more attention paid to ways that these processes can be improved for everyone.

Hate crime is an offence which is committed against someone on the basis of their membership of a certain ‘group’ in society be that on by their race, class, disability, gender, age, sexual orientation, gender identity and good old Wikipedia, gives an alternate definition of ‘bias-motivated crime’.

To call something a crime indicates that (obviously) there is a criminal act that has been committed for example, a physical assault but I think the discrimination and the effect of actions of hate towards those who have learning disabilities have significant effects on the way our society perceives some members of our society.

For example, name-calling. Verbal and emotional bullying. Laughing and pointing. This might not count as a ‘crime’ but as long as it is acceptable, it may lead to criminal acts. Those who talk about criticism of the use of certain words being ‘PC correctness gone mad’ would do well to remember that with disrespectful thoughts come disrespectful words and disrespectful and flippant words lead to disrespectful thoughts.

The more we create divides between ‘us’ and ‘them’ the more vulnerable we are to dehumanising ‘them’ and it turns to just a step away from the acceptable or non-intervention in a ‘hate crime’.

So for me, it is a very important campaign but must not just be restricted to those who commit criminal offences against people with learning disabilities. It must also be targeted at those of us who use flippant and insulting language to describe people with learning disabilities.

Someone who describes their phone as being ‘retarded’ because it doesn’t work (yes, that’s a real life example from someone who should know a lot better), that’s the first step towards dehumanisation and degradation of people with learning disabilities and yes, I was accused of ‘political correctness gone mad’ when I challenged this but I maintain and always will that the connection between language and respect are inherent.

So targeting hate crime isn’t just about systems and criminal offences although that is absolutely essential to target. It is about the people around us, the words we use and the respect we afford to other human beings. When we treat people with disabilities as ‘different’ or ‘others’ and dismiss them and their needs, we allow hate crime to flourish.

Safeguarding Adults Awareness Week

I learnt from my Twitter stream (thanks to Lindsay_Pike) that as well as being Carers’ Week, this week is also ‘Safeguarding Adults Awareness Week’.  I had never come across this as a ‘week’ before so used my carefully honed research skills to type ‘Safeguarding Adults Awareness Week’ into Google to see what it might be about.

There seem to be some local events arranged in Windsor, Kent and a nice sand sculpture in Cornwall as well as other places, it had certainly completely passed me by.

While the very scientific poll undertaken in Rotherham on the site of the councillor who was promoting it says that

76 % of the people surveyed were aware of safeguarding. A similar survey two weeks ago showed 54% recognition. The campaign of posters on the back of buses had been particularly successful.

I wonder if this ‘week’ though is truly ‘national’ and how important awareness is to identification and work to fight against abuse of adults who might be at risk of abuse.

There is a vast chasm between awareness of abuse towards adults and children – for me the division is arbitrary at best. Abuse of a person with knowledge/power/influence towards someone who lacks the ability – cognitive/physical or emotional to guard against it should be tackled regardless of the age of the so-called ‘victim’.

Why should society deal differently with the perpetrator according to the age of the person who is abused if the power differential is equivalent?

This is why I find the divisions and differences between the way that safeguarding is managed in childrens and adults services so different.

There are a lot of assumptions made though in the world of safeguarding. One is that anyone ‘old’ or anyone ‘disabled’ is automatically a s0-called ‘vulnerable’ adult. That isn’t necessarily the case.

But when someone who is at risk of being abused is – the responses from all parties can be patchy.

Perhaps that is why there is a differential in the way that safeguarding is investigated – the determination of being at risk is more straightforward with children because there are clear age boundaries to guide when an action is abuse and when it isn’t.

With adults, it is a value judgement about capacity and power relationships and that loaded word that I can’t quite find a perfect replacement for – vulnerability.

What makes one adult more vulnerable to abuse than another and is there a continuum of vulnerability that can cloud the way investigations are dealt with? In some situations it is brutally clear – Winterbourne View, for example, but when an historically abusive relationship between a husband who is physically violent towards his wife progresses as she develops dementia – at what point does it become an issue for social services to step in?

Between two ‘capacitious’ adults where there are no children involved, this would not be a situation for social services. With a progressive dementia or other vulnerability, it does.

For me, this is a very live issue as I work with a few people who have historically been in abusive relationships and when we intervene and when we are able to intervene becomes a very key judgement in a safeguarding investigation.

The key issues of human autonomy and human rights come into play in so many of the judgements we make regarding decisions of when and how to investigate safeguarding issues and what is and is not a safeguarding issue.

For me, I find I relate much more to the philosophical tenets of rights, responsibilities and ethics as I try and fit together the marginal decisions and the importance that an assessment of capacity can have on the life of another. The ability to reflect on the day to day decisions that might otherwise be taken speedily become more evident and more clear.

I can’t escape of the heavy moral responsibility that I feel in my day to day work. Every decision I make about prioritising, about capacity and in much clearer terms about hospital admissions weigh increasingly with the thought of implication, choice, rights and outcomes.

A thoughtless and unexamined practitioner is a dangerous practitioner.

Sometimes we can choose to overcomplicate and overanalyse but without consideration we can forget the power that we have.

So this week of Safeguarding has more or less passed me by but it is something that I’ll ponder on for much more than a week. I hope that next years’ week, if it exists, has some more thought and coherence behind it (and that it doesn’t coincide with Carers’ Week!).