Blame the Poor – A Riot Rhetoric

I apologise for keeping on one track in my posts this week but I am preoccupied by events of the last week. I’m not the same person I was a week ago. Some of the pillars that I held on both tangible and intangible have gone now, never to be replaced.

There is so much I’m angry about. I’m angry that our ‘so-called’ leaders were all absent and seemed happy to let Tottenham burn, only coming home when the violence spread.

Tottenham, the patter and media seem to imply is a ‘place like that’. It’s not like Ealing or Clapham or Croydon.

There is a lot of ugly rhetoric that has been stoked by the government too. The blame is afforded to poor parenting, poverty, gangs – all, of course, present in places like Tottenham and making easy armchair sociologists of us all – myself included.

The truth is far more complex though as the cases coming through the Magistrates’ Courts testify. It was obvious from Saturday that the situation was exacerbated by opportunism.

Police ‘engaged’ in one area left other areas open to be looted pretty much at will. This ‘model’ spread around London and around the country.

Is it a coincidence that the increase in policing came when the ‘leaders’ returned? I doubt it.

As for those following the story, the Guardian are updating lists of those cases brought up to the Magistrates’ Court. It will make for interesting reading but for me, for the moment, it’s all a bit raw.

The push towards taking away council housing and ‘benefits’ from people found guilty of looting or rioting is ignorant beyond belief in my very humble opinion.

Housing isn’t a treat to be dangled in front of ‘poor people’.

It is actually a basic right so is the ability to live in a dignified manner.

And what about those ‘rioters’ who live in private housing? Or is there an assumption that it must have been ‘poor people’ in ‘council estates’ who caused the trouble.

It is easy to paint broad brushes and make easy judgements – so long as they are judgements made by ‘other people’.

Our minds need to simplify often complicated issues but there’s a danger in jumping to conclusions that can be wholly damaging. My concern is that that’s exactly what the government have and are doing.

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.

There and Back Again

As I finished yesterday, I had left my first job and embarked on my little (well, it was two years) adventure and I decided to return to London and join the ranks of gainfully employed social workers again.

London Eye
I knew it was what I wanted to do. I had grown a little tired of living out of a suitcase/rucksack.  First thing I did was look for somewhere to live. I’d managed to secure room on a friend’s floor for the initial ‘return’ period.

I didn’t have too many boxes to tick regarding accommodation. I was looking for a shared flat ‘somewhere as central as possible’ because I didn’t know where I’d be working and of course, good transport links.

I registered with the social work agency I’d used before going. I needed to work as soon as possible so I thought I’d try and get an agency placement and could apply for permanent jobs in the meantime.

It wasn’t the flood of offers that I had been used to on graduation but a few noted signs of interest. I was concerned at how my two year break would look to employers. I didn’t have a massive range of experience but I got an interview and not only was it in an area ( adults services) that I was familiar with, it was also, by coincidence, in the same borough I had randomly chosen to live in. Walking distance – but just in case there was a useful bus and tube route I could hop on for speed.

I was nervous during the interview with the team manager while I was asked about a fairly standard scenario. I kept thinking about things I’d forgotten to say while I left and the manager didn’t exude any natural warmth, indeed, I could detect a hint of ambivalence at best.  At some points she almost seemed to snap at me. It was not one of those interviews you come out of with positive feelings.

Off I went on my day to day path to wait for the next calls. To my surprise though, they wanted to take me on as a ‘care manager/social worker’ in a much smaller adult services team than I had worked in previously.

I remember saying specifically in my interview that although I had a years’ experience, I had two years ‘out of the field’ and would need some support to get back into my stride. I didn’t want to be expected to pick up the baton immediately. I am glad I mentioned it but I realised in retrospect how hopelessly naive I was. Of course they nodded and smiled but they were paying high agency rates and I was given a caseload of things that had clearly been waiting for allocation for a while.

I was baffled by FACS (Fair Access to Care services) which seemed to have appeared while I had been gone. Direct Payments were beginning to permeate through the systems as had Carers Assessments although no one could really get any services from a Carers’ Assessment so it was just another piece of paper although I’ve tended to find the process of the assessment and discussion can be useful.  Charging was more widespread and the types of services offered where quite different from my previous place of employment.

Each desk had it’s own computer by this point and a new database system  had just been introduced – much to the chagrin of most of the staff.  All reports were expected to be typed up by now. I was also the only agency worker in the team which  had been so different from my previous job. Not only was I the only agency social worker but all the other social workers and care managers (qualified and not) had been there for a good few years. It wasn’t a transient kind of team. People rarely joined and always stayed. A good sign perhaps.

Saying that, they were the friendliest and most welcoming team that I’ve ever worked in and there was not a hint of any thought of me being ‘different’ because I worked through an agency. I was immediately taken under the wing of some of the more senior staff members who were the easiest people to ask questions of if a manager couldn’t be found.

And the rather ambivalent manager who seemed to scare me during the interview? She was one of the best managers I’ve ever had and then some more. She had a way about her of making people think she didn’t like them but when push came to shove, she would support her staff up to the hilt and seemed to rather savour arguments with more senior management. As I learnt, she had a fierce reputation throughout the borough but all the staff who worked for her were very protective of her. She spot-checked files when she was walking round the office to check notes were up to date and papers were filed in the right place.

She was also the manager who insisted we never refer to ‘cases’ and ‘files’ when talking about other human beings. Files were the physical paper documents, not the people and not the families. No-one was a ‘case’. They were individuals with hopes, dreams and aspirations. She was very strong on language and did not tolerate and thoughtlessness as she felt it reflected sloppy thinking.  Cases were not ‘difficult’  but rather ‘complex’. People are not ‘difficult’ just because they may not respond the ways we may want or expect to them. They take time or they have complex issues. I still refer to her use of language as a model to ways of thinking and interpreting things that I might find troubling about working in particular routine ways with particular people and families.

They say when you find a good manager, you hang around. Hang around I did.

I applied for the permanent job that my post was covering when I came up and am still working for the same borough although I moved into Mental Health services.

The manager I had, she retired a while back as have some of the people that shared the office with me, but others are around and we bump into each other from time to time.

They were difficult days and I struggled a lot at times, especially getting back some confidence in working in a field when I had been doing so many different things in the meantime but the time out of the country also taught me a lot about resourcefulness and self-belief.

I learnt about living in a different environment and culture and ‘being a foreigner’. I learnt another language. I learnt that there is a difference between solitude and loneliness and that being comfortable with yourself is inherently important. I saw amazing things, went to amazing places, met some amazing people and did amazing things.
Big Ben

Then I came home

Neary, Hillingdon and Best Interests Assessments

Logo of Hillingdon London Borough Council

Image via Wikipedia

The judgement in the case of Stephen Neary was published yesterday. I  held off commenting about the case when it first hit the press because sometimes I feel there is a lack of detail and an overwhelming presence of misunderstanding in relation to reporting about the Court of Protection and the Deprivation of Liberty Safeguards (DoLs).

Now that the Court has made it’s decision and published it’s judgement, I feel a little better able to comment and assess.

I haven’t read the judgement in great detail and have no doubt that I’ll come back to this over the weekend  but I wanted to share and explore some of my initial thoughts about it.

Steven  Neary is a man who is autistic and who was living with his father, Mark,  in the London Borough of Hillingdon. He was receiving extensive support from the local adult services department. Steven was placed in respite care and the borough felt that it was in his best interests to remain at the support unit where he was receiving respite care although his father wanted him to return home. A number of deprivation of liberty orders were made for the period between April to December 2010, which enabled Hillingdon to keep Steven at the support unit (the council claimed that between January and April Steven’s father consented and/or he was not being ‘deprived of his liberty).

The Court found against the Council that Steven had been unlawfully detained by the council between January and December 2010 and had been deprived of his liberty for the entire time with the ‘authorisations’ that the council had granted themselves being deemed to be ‘invalid’.

The other points that the judgement picks up are that the first referral to an IMCA (Independent Mental Capacity Advocate) came in October 2010 and that the matter was only referred to the Court of Protection in October – both of which denied a speedier resolution to this period of detention for Steven.

There are some interesting and useful statements which are given in the judgement.

Firstly the judge condemns Hillingdon for using the DoLs to impose their decisions on the family which goes against the spirit of the Mental Capacity Act 2005 saying

The DOL scheme is an important safeguard against arbitrary detention. Where stringent conditions are met, it allows a managing authority to deprive a person of liberty at a particular place. It is not to be used by a local authority as a means of getting its own way on the question of whether it is in the person’s best interests to be in the place at all. Using the DOL regime in that way turns the spirit of the Mental Capacity Act 2005 on its head, with a code designed to protect the liberty of vulnerable people being used instead as an instrument of confinement. In this case, far from being a safeguard, the way in which the DOL process was used masked the real deprivation of liberty, which was the refusal to allow Steven to go home.

And both crucially and importantly for Supervisory Bodies (who are the PCTs and the Local Authorities) comes this guidance

The granting of DOL standard authorisations is a matter for the local authority in its role as a supervisory body. The responsibilities of a supervisory body, correctly understood, require it to scrutinise the assessment it receives with independence and a degree of care that is appropriate to the seriousness of the decision and to the circumstances of the individual case that are or should be known to it. Where, as here, a supervisory body grants authorisations on the basis of perfunctory scrutiny of superficial best interests assessments, it cannot expect the authorisations to be legally valid.

So this places a consideration on the decision makers or ‘signatories’ at the supervisory bodies to do more than sign. My assumption, as a Best Interests Assessor was that the assessments I send to a Supervisory Body were actually discussed between ‘decision-makers’. Maybe I’m hopelessly naive but I always assumed my assessments were not automatically ‘signed off’.

One of the things I have picked out from the reading through the judgement is the lack of experience and understanding about the DoLs procedure that seemed to be widespread. The judgement explains

He (Mr Neary)then began a dialogue with the social worker about this, which was a learning experience for them both, as neither had any experience of the procedures

It’s a shame that there is so little experience of the procedures by professionals and it indicates (although perhaps I am reading too much into this sentence) the broader misunderstandings that are created by lack of knowledge of new processes.

Later the first Best Interests Assessment recommends

involving an Independent Mental Capacity Advocate (IMCA). The report recommended that four conditions be attached to the authorisation, among them: “(1) Consideration to be given to the most appropriate place in which to provide ongoing care to meet [Steven’s] needs, (2) Consideration be given to referral to IMCA services to act as an independent advocate for [Steven].”

And of this first Best Interest Assessment, the judge says

The standard form used for the report specifically states: “You must consider whether any care or treatment the person needs can be provided effectively in a way that is less restrictive of their rights and freedom of action.” and makes reference to paragraph 4.61 of the DOL safeguards Code of Practice, which refers to the question of “what other care options there are which could avoid a deprivation of liberty”. It would not be right to be unduly critical of her report, particularly as it was the first DOL best interests assessment she had undertaken. She flagged up what became known during the hearing as “the elephant in the room”, which was whether Steven should be at the support unit at all. However, she did not follow up on this. She does not refer to the alternative of a return home as being an obviously less restrictive alternative. Nor does she refer to Steven’s unhappiness at being in the support unit. Nor did she propose an application to court as a condition of the authorisation.

For me, as a Best Interests Assessor these points are crucial in ensuring that least restrictive options remain at the forefront during my assessments.

Of the Second Best Interests Assessment, the judge is more scathing.

The judgement indicates that in June 2010 (as the first DoL was authorised for three months)

A different best interests assessor (BIA2) consulted Mr Neary . He describes her telephoning him at lunchtime for 10 minutes, saying that she had to file her report by 3 p.m.

It’s hardly a full and extensive discussion and for a standard authorisation of a Deprivation of Liberty there is a fairly generous time scale (21 days) allowed to complete assessments – it certainly shouldn’t need to be done in such haste.

In fact this is what the judge says about the report

I have not heard evidence from BIA2, but I have read her assessment. She recommends a three month period for deprivation of liberty. Substantial parts of her short report are cut and pasted from the previous best interests report. She appears to have had cursory contact with Steven on 21 June, the date her report was filed (even though it is unaccountably signed on 18 June). No reference is made to his wishes and feelings. No reference is made to Mr Neary ‘s opposition to the placement. On the contrary, the following appears: “I understand from my conversation with Mr M Neary  that he believes the current care plan is positively supporting his son and his transitional programme.” No reference is made to the possibility of a placement at home alleviating the need for a deprivation of liberty. The recommendation is made for two conditions to be attached, one of which suggests that the three outstanding risk assessments for Steven’s activities should be completed within eight weeks (in the context of a three-month deprivation recommendation). No reference is made to the absence of an IMCA, despite the condition in the previous standard authorisation, nor to the Court of Protection, despite the references in the previous assessment. I regret to say that the report has all the hallmarks of a document completed in a hurry.

Of the third authorisation, the judge notes

On 20 September, the third standard authorisation was granted by the Director for a period of two months. The authorisation makes no reference to Steven’s wishes or those of his father, nor to the possibility that deprivation of liberty would not be involved if he was at home. The purpose of the standard authorisation is described as being for Steven to receive a structured programme to contain his behaviour. Conditions were attached requiring risk assessments of all venues before Steven could undertake activities outside the unit. Consideration was to be given to an appropriate long-term placement.

The best interests assessment, by a third assessor, BIA3, refers to Mr Neary‘s disagreement with the placement and recommends recourse to the Court of Protection as a condition. BIA3 also noted that an IMCA had been requested.

These issues were addressed far too late. Steven returned home in December following a court order.

So where does this leave the DoLs process. I think some of the more useful parts of the judgement relate to an explanation of why Steven was being deprived of his liberty (in legal terms) and what amounts to a deprivation of liberty. We (Best Interests Assessors) have to rely on case law to help us pick together when a deprivation is occurring so it is useful to have further guidance.

The judge also states that the supervisory body should consider further the contents of the assessments it receives rather than just rubber-stamping them.

Although the framework of the Act requires the supervising body to commission a number of paper assessments before granting a standard authorisation, the best interests assessment is anything but a routine piece of paperwork. Properly viewed, it should be seen as a cornerstone of the protection that the DOL safeguards offer to people facing deprivation of liberty if they are to be effective as safeguards at all.

The corollary of this, in my view, is that the supervisory body that receives the best interests assessment must actively supervise the process by scrutinising the assessment with independence and with a degree of care that is appropriate to the seriousness of the decision and the circumstances of the individual case that are or should be known to it.

Paragraph 50 provides that a supervisory body must give a standard authorisation if all assessments are positive. This obligation must be read in the light of the overall scheme of the schedule, which cannot be to require the supervisory body to grant an authorisation where it is not or should not be satisfied that the best interests assessment is a thorough piece of work that adequately analyses the four necessary conditions.

I also rely on the obvious fact that the intention of paragraph 50 cannot be to require a supervisory body to give an authorisation simply because the best interests assessment makes a positive recommendation, whatever the quality of the work disclosed in the assessment. On behalf of Hillingdon, it was accepted for the sake of argument that it would not be bound by an assessment that was in effect so poor as to be “a joke”, so it follows that paragraph 50 cannot be read as if it simply required a positive answer without cogent reasoning. Hillingdon has however suggested that a supervisory body is bound to act upon any best interests assessment that is not grossly and obviously defective.

Against this, the EHRC and the Official Solicitor argue that where a supervisory body knows or ought to know that a best interests assessment is inadequate, it is not obliged to follow the recommendation. On the contrary it is obliged to take all necessary steps to remedy the inadequacy, and if necessary bring the deprivation of liberty to an end, including by conducting a review under Part 8 or by applying to the court. This is in my view a correct statement of the law. The suggestion that the supervisory body is bound to act on any assessment that is not grossly and obviously defective sets the standard too low. It supposes an essentially passive supervisory body. This would not meet the objectives of the Act and would not provide effective protection against breaches of Article 5.

The nature of this process for supervisory bodies is not likely to be very burdensome, given the relatively small number of cases, and if it were it would be fully warranted to ensure that the right outcomes are reached for people who are likely to be the most vulnerable service users. It should never be a rubberstamping process. A standard authorisation has the same effect as a court order and there is no reason why it should receive lesser scrutiny.

For me, this is one of the key points (and the reason I’ve quoted so much of the judgement text). It is likely to strike at the heart of the supervisory bodies and the way they authorise deprivation of liberty safeguards. And good, I say, they are senior managers and earn enough money to be able to take responsibility for the tough decisions that are in place ‘on the ground’.

The other issues that are raised regarding the lack of appeal process and the failure to appoint an IMCA and refer to the Court of Protection more speedily are also crucial in the judgement but for me as a Best Interests Assessor there are number of very useful reminders about the need to display independence in my role as an assessor and to advocate for myself in demanding the time in a working day to produce a good quality piece of work worthy of the difficult decisions that are to be made.

Mostly though, I just wish we had more open systems so that we can better understand the views and improve of knowledge regarding the expectations of what is an over-complicated and flawed system.

As a Best Interests Assessor (and an AMHP) I do not feel beholden to do what is best for my employer. In fact, sometimes I take an almost subversive amount of pride in taking a more independent view and opposing some management decisions by applying the law. However, I understand that I have a certain amount of confidence and bloody-mindedness in my approach.

Perhaps if any changes in the system are made (although I don’t think they will be) a further consideration of independence of the Best Interests Assessor will be considered. I have done Best Interests Assessments for my own borough and for other boroughs when I’ve been ‘loaned’ out and I genuinely feel it is less pressured and easier to be ‘independent’ when you are assessing from a ‘wider view’ of not being employed by that borough. Of course, I hope that I always remain independent but I think it would add a further element of scrutiny.

I have no doubt I’ll come back to this case and this judgement. There’s a lot to get through and many issues that I didn’t pick up on. It emphasises the importance of some of the decisions we make and the importance of being personally responsible for the reports I write as a professional.

And for anyone not following Stuart Sorensen’s series of posts about the European Convention on Human Rights on his blog – I’d highly recommend visiting, reading and learning. I have learnt much from them.

Distractions and Uncertainty

Of Local Distractions

I met one of the hospital social workers earlier this week. We don’t actually catch up with each other very often but when we do we always make a point of hanging around in whatever corridor we bump into each other in and chat.

This time, we again commented on the ebb and flow of work which seems to be balancing on an almost perpetual ebb without much flow at the moment.

We are all on edge at the moment. Another reconfiguration is in the pipeline and so many rumours are abounding that it is making it very difficult to actually get very much done.  Announcements and decisions are in the offing and have been put back again and again so all we know is that ‘this is a big one’ and that some jobs are going.

Good place to leave it with us, management team!

Seriously I do wonder if any of the so-called management executives who are paid most highly with their years of skills of organising complex projects ever remember those very first baby steps in communication skills and ponder on the way that rumours spread when a team of people are bereft of actual facts.

So my kind of friend, the hospital social worker, filled me with a swathe of new rumours that I hadn’t heard before about how our jobs were going to be directly affected by these changes and in turn, I shared with him the hotch-potch rumours that I’d heard from another AMHP at a training session a couple of weeks ago who, although she is prone to hyperbole, still seemed to deliver a fairly gloomy outcome of what might happen to all our jobs.

We smile. We chuckle. We remind ourselves how complicit we are in spreading the uncertainty through these rumours. Then I return to the office and immediately tell everyone what I’ve just heard from my new source about the talk that is going around at the hospital. He, in turn, no doubt returns to his hospital team with the latest gossip in the ‘community teams’.

And in the meantime, of course, work goes on. The increasingly distressed calls. The organisation and co-ordination of assessments and the desperate attempts to make some kind of priority from the pieces of information that have been fed through to us.

This is life at the bottom of an organisation when the top is reorganising. This is the pit of the rumour mill where scraps of invented truths and fears are ground together and occasionally spit out nonsense but this is what we are talking about in the large open plan offices. This is what is happening while the government is talking about pumping more money into the NHS. This is what is happening when officials are prevaricating and making the policies that end up on intranet sites that we don’t have time to access and read.

And it made me think of Southern Cross – I’ve been thinking about Southern Cross a lot lately.

Of National Job Losses

The announcement of 3000 job cuts yesterday although, I suppose, unsurprising coming from a company that is in such severe financial straits. Considering that they have sold off their property assets, staff costs are likely to be one of their highest expenditures. I wonder how the staff employed today feel. I wonder how the residents who  might have built up relationships with staff members feel and I wonder how people who are about to make placements in care homes feel.

Am I less likely to place someone in a Southern Cross Care Home today? Yes.

The Independent states that

The jobs to be axed are expected to include over 300 nurses,1,275 care staff, almost 700 catering posts, 440 domestic jobs and 238 maintenance posts

They don’t sound very ‘back office’ to me. Although Southern Cross maintains that this will not affect quality of care provision, it rather makes you wonder what the staff were doing in that case.

Ideally, it would be useful to check the data from CQC inspection reports to see what the inspectors said about staffing. The difficulty is that publicly available inspection reports that are recent enough to give up to date evidence.

I decided to look at a few random Southern Cross inspection reports from the London area.  Professor Google spat out some results and this is by no means scientific as I didn’t have the time for a more extensive ‘study’.

Romford Grange? Good report in 2008. That seems in order. Of course 2008 is three years ago now. A long time between actual inspections but we know they are not actually going to do inspections so frequently now. Still, three years seems to be pushing it. Lots can change overnight, let alone in three years.

Tower Bridge Care Centre? Well, that had an inspection in 2010. Oh good, I think. But wait, that was only because there were concerns regarding medication management that had been raised specifically.

Another random check on Camberwell Green Care Home  – oh, an inspection in 2010, surely that’s a good sign? Silly me, the recent inspections seem only to be where there are problems identified. Here’s what the report says

The service has been performing poorly for some time and matters have not been addressed by Southern Cross.They have started to do that recently but that has lead to lots of staffing changes and a turbulent time including managers leaving quickly. The ship has been steadied by a management team who have been sent in to the home. This inspection has identified some of their successes but more work is needed and a key need is for a stable, consistent management team to be in place. Until such time we can only view the home as adequate

Care planning is not personalised and is not considering all areas of individuals need, therefore the care arrangements are not always well informed.
The complaint’s procedure needs to be improved, it has to be open and transparent with complainants feeling that they are listened to and that issues are acted upon. Communication too is not as good as it should be, all issues whether they are minor concerns or not must be addressed.
Despite staff receiving up to date training on Safeguarding Vulnerable people,
procedures are still not fully robust at the service.

Burgess Park? Oh, it had 4 inspections in 2010. That’s what I call exceptionally good monitoring. Ah, one look at the most recent report and you’ll see that it is because there are problems that there has been so many inspections.

For example, their April 2010 inspection report states that

Our observations of a lunchtime on the second day of the inspection showed us that the systems for shift planning need to be improved. We saw that one member of staff was the only person in the dining room where there were fifteen service users. They needed various degrees of assistance and we observed that the lack of staff caused difficulties for them An example was a service user who had to wait an unreasonably long time to be assisted to go to the WC; another service user fell asleep while waiting to be assisted to eat her meal.

and while the July report says that these issues have been ‘addressed’ and more staff were recruited, it does make you wonder where the cuts are going to come from.

Lauriston House? Home to 100 older and disabled  adults – last inspected in 2007.  In fact, a random glance at the ‘most recent available assessments to view’ tells a sorry tale.

Previous reports

  • Inspection report 2007/10/26
  • Inspection report 2006/09/06
  • Inspection report 2005/11/15
  • Inspection report 2005/08/05
  • Inspection report 2004/12/14
  • Inspection report 2004/06/29

Oh, it got a good report. In 2007. But for 100 people, that’s a pretty poor show. In fact, if anything is to tell the tale of the toothlessness of the CQC and the way that CSCI was heading prior to it’s inception – it’s that list of dates. Look on it, ministers and make a decision if that is the level of scrutiny and regulation you want to maintain?

Back to the job losses though. So what will that mean for today’s residents and staff? Uncertainty. Rumours. Whispering.

Whatever we say when we look back at what we can achieve and improve today for our own old age and for that of our children – we definitely can’t say we are living in uninteresting times.

Weekly Social Work Links 18

Maybe not quite so weekly but I was away last weekend and unable to put anything together. Back now and ready – very ready – for the long weekend.  Here are some of the posts I’ve come across over the last week that caught my eye.

A post on the Social Work Tech Blog is always a treat and I love the ideas in this post which show how a ‘self-care’ plan can be developed on the iPad – but don’t be fooled, the concept is transferable to pen and paper too (with attached PDF).

Jae Ran has a fantastic, thoughtful  post about research ethics. As I commented on the post, it shows the importance of understanding and knowing the methodology behind a research study – very relevant for promoting and using more evidence-based practice.

SocialJerk writes a beautiful and heartbreakingly moving post about sexual exploitation of girls and shares a story or two that cut deep and reminds us that of the importance of those strength-based approaches in practice.

I love the international perspective that social media and writing about social work has enabled me to have and in ‘A Social Worker’s View’, S.Wangene, based in Kenya, writes about a challenge which predominantly faces women in Africa and Asia and I had not been aware of – Obstetric Fistula and she follows up that post with another one about the challenges of Fistula treatment in Kenya

Staying with the international tilt, Dorlee at Social Work Career Development has another of her fascinating interviews – this time with a dramatherapist.

Hold my Hand is a blog written by a Social Worker who works in a nursing home and she relates the story of a woman she works with who has had a nightmare and how she is able to help.

On a slightly different tack, a couple of weeks ago, I discovered ‘Noone Sleeps Rough for a Free Sandwich’ which is a blog written by a support worker in a hostel in London (I think!). She shares the stories of her work and it really is an insightful read.  This is her most recent post about what she’s been up to on an overnight shift.

And In the Space of Reasons – not a social work blog but actually the blog of an academic who is involved in the study of the philosophy of mental health, writes about the recovery model in mental health services. It is worth reading for anyone who is involved in mental health.

Ladybird shares a story that her son wrote.

And a goodbye to ‘Diary of a Social Worker’ who is closing down his blog. Sorry to see it go.

In the face of the Sharon Shoesmith judgement yesterday, I will just link to the Guardian editorial which just about says exactly what I think about it but it is written with much more clarity and less ranting than I’d be able to muster.