How to manage the fall out

    The demand for public accountability under
    Best Value has led to fresh sources of pressure for social care
    staff. And for managers, explains Keith Fletcher, the art of
    complaint management must now be mastered.

    We welcome open government but it puts a lot
    of pressure on our staff. What can we do about it?

    A more open style of local government has
    produced a new cause of staff stress: exposure and its
    consequences. In the past four years the public vilification of
    social services has greatly diminished. In its place, however,
    there is a growing demand for public accountability under Best
    Value: undoubtedly a positive development which will produce better
    services in the end, but it adds greatly to the stresses on
    staff.

    Inspections and reviews of one kind and
    another have rocketed. Complaint management is now a serious part
    of social services and has produced its own cottage industry. The
    process of public accountability and consultation is still, for the
    most part, in its infancy but the greater transparency also creates
    stress. All this has been added to the existing, but relatively
    occasional, heavy duty enquiries such as the Part 8 reviews in
    child protection and the still extensive enquiries into past abuse
    of children on a large scale.

    The management response to the changes
    themselves has usually been very positive. Complaints, inspections,
    responses to government reviews, the public availability of
    information have been all transformed in the past five years. But
    it is time now to manage their consequences for staff more
    proactively.

    Take the example of Sally, who is a care
    assistant in a residential unit. She is unqualified, and the level
    of support and supervision she receives is frankly inadequate
    though she had embarked on an NVQ programme. A few months ago a
    relative of one of the residents complained about Sally’s general
    attitude to him (the resident) and suggested that she had actually
    hit him at one point.

    Because of the allegation, the authority
    suspended Sally on full pay while the complaint was investigated.
    They offered her independent counselling, which she accepted, but
    otherwise had no contact with her while the complaint was
    investigated. The only other person she saw in that time was the
    independent complaint investigator.

    The report found that her approach to
    residents was insensitive, but there was no evidence of physical
    abuse. She was given an informal warning about her attitude and
    reinstated – that was it. There was no written feedback; no
    consideration of implications for change (apart from her own
    behaviour); no detail about the ways in which her approach was
    insensitive nor suggestions about what she should do about it.
    Above all there was no recognition that, however justified and
    appropriate, the process had been devastating for Sally.

    Perhaps this is an extreme example but it
    illustrates the general point: managing greater control,
    accountability and openness includes managing the consequences for
    staff.

    These same staff also need to be encouraged to
    be more critically aware of the world around them. “Whistleblowers’
    charters” are becoming widespread. Poor management, poor practice,
    above all abuse in any form, should be reported; and quite right
    too. But it’s an extremely stressful business, riddled with
    conflict, fear of reprisals, and distress at putting colleagues “on
    the spot”.

    We can’t remove these new stresses but there’s
    a lot we can do to help staff to manage them by support, training
    and willingness to help manage these changes. Policy makers and
    managers are acutely concerned about staff shortages now and there
    are high level discussions taking place everywhere. Stress is a
    serious contributor and many of the reasons for it are well
    rehearsed and include: challenging occasionally violent clients;
    high risk, heavy responsibility, low autonomy, poor supervision;
    macho management and repeated structural change; poor public
    understanding and esteem; low pay; recruitment difficulties;
    pressure from staff shortage and sickness itself.

    We need to add increased exposure to the
    list.

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