ver the past few weeks I have been troubled by several reports relating to the neglect – and sometimes cruelty – experienced by recipients of health and social care. When such mistreatment is discovered, commentators explain the progress made in improving standards and that such neglect is rare. This is no comfort to those who have received a poor service and the evidence suggests that neglect is not a rare experience for older people with one in 40 people aged over 66 experiencing mistreatment. This worrying statistic is bad enough but just how confident can we be that even those who have not been mistreated have received a service that has left them feeling cared about?
De-personalisation of care
As we introduce systems to personalise care services, it occurred to me that we need to look at what may have contributed to the “de-personalisation” of care. This is not a semantic point, because de-personalisation leads to a loss a sense of self and self-worth, which in turn can lead to increased dependency and an increased vulnerability to abuse or neglect at the hands of people that are meant to care.
Most of us are not cruel nor desire to be part of a system that is inhumane. However, over the past 20 years I have noticed a steady trend of replacing the “language of care” with that of management and political scientists. This has contributed to care being increasingly defined in the impersonal language of systems, procedures, performance indicators, targets and contracts.
These management systems are so demanding that the professional time now consumed on their maintenance may have replaced care as the prime task.
I am not advocating the replacement of important policies and procedures. But we do need to use the opportunity created by the transformation of care services to look more deeply into what we mean by providing individualised care. It needs to be more about ensuring services are delivered and experienced in a more personal way than just providing bespoke packages.
This need not be costly. Reflect a moment on the personal relationships that you have or have had. I suspect the more satisfying relationships have been those where there was a balance between feeling cared for and cared about. If you reflect further, it is possible that you may find that what made you feel cared about was less about what was done for you and more about how and why it was done.
The transformation of care services requires more than doing new things in new ways, it will require improving traditional services. As procedures and systems are developed, it is essential that the opportunity is taken to ensure they support rather than control the way that services are delivered.
Further, the training and development of staff needs to be reviewed. Capable carers must be developed who can interpret through their own self-awareness and reflective practice how the service they provide may be perceived by their clients – and modify their approach accordingly. In this way, people who receive a care service will be helped to feel they are cared about; a good experience in itself, but also one that will demonstrate that someone is cared for and cared about and hopefully less vulnerable to mistreatment.
➔ Geoff Ettridge is an independent adviser on care services. www.yourcarematters.co.uk
➔ Community Care will be launching an online resource for professionals in personalisation. Keep an eye on www.communitycare.co.uk