The Winterbourne View abuse scandal sparked many things: a police investigation, a serious case review and a government inquiry among them. For North Wales-based social care trainer, advocate and former inspector Laraine Bruce, it led to a moment of epiphany: “What was most disgusting for me was that I wasn’t surprised by it. I felt that I could walk out the door and into a care setting and find poor care. I knew I had to do something.”
That something is CareChecker, an organisation launched to ensure that, not only is abuse and neglect driven out of the care system, but that the system truly recognises service users as its customers. It is the creation of Bruce, her husband Roger, Roger Rowett and Rebecca McConnell, who, like her, have significant experience in supporting people with learning disabilities.
Its objective is simple: recruiting an army of “care checkers” to go into care homes or hospitals, listen to what users and their families say about them and try to ensure providers act on what they say.
Bruce’s argument is that the formal care checking system – regulators, commissioners and providers’ internal quality assurance processes – is failing to do this.
She has been doing paid work with disabled people since 1980. But her evidence that Winterbourne View is just the tip of the iceberg comes from other work as a volunteer advocate for families experiencing problems with the care system.
“In the past couple of years there has been a substantial increase in the number of people contacting me,” Bruce says. “They or a family member had suffered some form of abuse or neglect and every single one said no one was listening to them.”
Her diagnosis of why this is the case is familiar: a regulatory system that puts compliance before visiting services; a task-based approach to care in which staff feel they cannot build relationships with users; complaints systems that fail to deliver redress.
But her solution is novel. It rests on the belief that there are already people going into care homes who can act as watchdogs with a little training, awareness and support.
“They could be people visiting family members, professionals such as social workers or nurses, or even hairdressers, who meet [service users] and can talk to them,” she says. “It’s about supporting these people who are there rather than creating a new breed of worker.”
She says people going into care settings often see things that are awry but need to be given the confidence to speak up. “It’s about saying [to staff and managers], ‘excuse me, this lady has been shouting at you for a long time. Can you help her?’.”
CareChecker offers training to such people in making judgements about services, based on the extent to which they listen to service users and act on what they say.
The training draws on guidance devised by Bruce and Rowett for the Care Council for Wales on delivering person-centred care for people with dementia. This urges people working with dementia sufferers to endeavour to see the world from the service user’s perspective by working with them to gather information on their life history, preferences, likes and dislikes.
Bruce wants the “community care checkers” to identify individual service users and gather their perspective on service quality at successive visits to chart progress.
More broadly, she is talking to commissioners and providers to set up a pilot to test the approach more systematically in one area. Services would agree to have care checkers go in every few months and agree to take account of their findings, with the checkers monitoring improvements, and the pilot would be evaluated. “We need to know whether this is successful,” she says.
Though she is keen to help a range of service users, there is one group she has in mind: “People who enter care homes often lose their natural ties. Friends don’t stay in touch. If you put that alongside challenges like dementia and staff who say they don’t have time to listen to them; that’s so dreadful. It’s those people I want to reach.”
Laraine Bruce: a care career
Laraine Bruce ran a residential arts centre for young people, including those with learning disabilities, from 1978-86. She then worked in residential care for disabled adults, before joining Clywd Council, where she managed services for adults with learning disabilities, and then moving into regulation, ending her career at the Care Standards Inspectorate Wales in 2005. Since then she has worked as a volunteer advocate and trainer in person-centred care.
(pic of Laraine Bruce by Neil O’Connor
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