Support needed to usher in era of ‘positive touch’

There
is a link between John Powell’s article "Sometimes when we touch" (19
July) and Ian Merry’s letter about residential staff needing more support (23
August).

Powell
provided the strongest of cases for children in care to receive positive touch
as a natural element of their care. The "no touch" care practices of
the last 10 years are a hidden form of abuse to children already rejected or
abused by their parents. Merry wrote that "unless the needs of staff and
young people are seen as inextricably linked existing tensions will continue to
tear this [residential child care] service apart".

They
are both absolutely right.

Vulnerable
or challenging children need to feel safe in the care they are given by
residential social workers, foster parents, day and family centre staff and so
on. But staff equally need to feel safe that positive touch and holding are
encouraged and supported as an essential element in their duty of care to
children and young people. The same message needs to be clear for teachers.

As
trainers in "keeping safe" for children and staff, my co-trainers and
I have often found that staff are unclear about their rights and skills in
providing safe touch, holding and restraint as acts of care. Yet it is evident
that staff who develop real confidence in these skills – to add to other
positive verbal preventive skills – and who are well supported in this by their
employers, can offer better care to the children they look after.

All
local authorities – and local education authorities in relation to schools –
therefore need to provide strong support through clearer guidelines on the use
of safe touch and holding as well as restraint as a last resort, clear safety
guidelines in which the safety of both children and staff is promoted as being
equal and of the highest priority, and training of the highest quality.

The
government and local authorities need to support staff in replacing the era of
"no touch" with the era of "positive touch" for vulnerable
children.

ANDY
BERRINGTON
Oxford

Mental health and the right kind of support

Will
support, time, recovery workers (STRs) relieve the pressure on mental health
workers (In Focus, page 12, 6 September)? That depends on how we identify the
problems facing mental health services.

One
of the problems facing mental health service users is uncertainty about whom
they will be dealing with on a daily basis. Maybe the STRs will resolve this.

But
earlier research from the Mental Health Foundation indicated that only one in
five of the existing 10,000 community-based mental health staff had any
relevant qualification. Many staff had only a limited understanding of mental
health problems, and service users believed that care staff and volunteers were
failing to understand their needs. The end result has all too often been a
workforce that is demoralised, leading, not surprisingly, to a high turnover of
staff. That’s why we have developed the new certificate in community mental
health care.

If
we see the proposed STRs not as providing valuable one-to-one and ongoing
support but instead as "relieving qualified mental health staff of mundane
tasks" as stated in your article, then are we getting off on the right
foot? Let’s recognise the value of mental health support, and ensure we are
providing the best service possible to people experiencing mental health
problems.

NIGEL
DUERDOTH
Director of research and development
Mental Health Foundation

Assertive outreach far from mundane

The
introduction to your article about non-qualified mental health workers (In Focus,
6 September) suggested that the new grade of worker could free up qualified
staff from performing "mundane tasks".

The
dictionary defines mundane as everyday, ordinary, and therefore not very
interesting. Is this really appropriate as a description of the valuable and
life-enhancing support provided by unqualified staff? The article also refers
to service users’ "mundane needs". As an assertive outreach worker
working with clients with mental health problems, these phrases rankle as they
demean the workforce action team on the National Service Framework for Mental
Health, and unqualified colleagues.

From
what I can gather, the report of the workforce action team on the National
Service Framework for Mental Health suggests that a team such as mine could
easily be converted to performing the "support, time, recovery" role.
And the given reason? To stop the qualified staff disappearing into management.
What "mundane" reasoning is this that would cast aside the positive
aspects of assertive outreach to free up social workers to "focus on
clients’ more crucial needs"?

PETER
WELSH
Outreach worker
London

Let’s respect identity

Your
article on the single assessment process (In Focus, 23 August) made the point
that the contact assessment can be "carried out by an unqualified member
of staff". In general, I agree with this premise. But before we are
carried away on a wave of seemingly simple task allocation, I want to make a
case for skilled data recording at this point of assessment.

During
a long career in nursing and social services, I have come across unskilled work
in recording personal information. People’s names have been spelled
incorrectly, nicknames have been recorded as given names and wrong names have
even been ascribed. Inaccuracies and lack of detail have also occurred with
addresses, dates of birth and other personal data.

The
sad and bad thing about this is that the individual’s identity diminishes. This
is often compounded because, once an error has been recorded, it is difficult
to rectify, particularly by relatives or carers. It seems that once in the
system, incorrect data takes on a life of its own, exacerbated by each visit to
the case. Thus there is a subtle, yet significant, change to the person’s
identity.

My
plea, therefore, is that whoever is allocated the responsibility of collecting
personal data from older people to build up information should have received
training.

ROSEMARY
MORETON
Planning and partnership officer
Blaenau Gwent Council

Union history lesson

The
issues about social workers’ representation ("Little voice", 30
August) are not new. At the end of the 1970s, Unison’s predecessor Nalgo was
dominated by militant social workers whose use of all-out strikes was
alienating many more moderate or far-sighted members of the profession. At the
same time, the British Association of Social Workers recognised it faced
decline unless it took on a trade union role, and so it gave birth to the
British Union of Social Workers.

However,
basic-grade social workers stayed loyal to Nalgo. And BASW was eventually
forced, in the face of enormous pressure from Nalgo, to abandon the infant
BUSW, which lingers on as the British Union of Social Work Employees,
representing staff in the voluntary sector.

Since
then BASW itself has shrunk. Social work’s domination of Nalgo ended when it
merged with others to form Unison. The logic of combining professional and
trade union functions is now, therefore, even stronger, and the large unions no
longer have as much power as they did in the 1970s to strangle potential
competitors.

Anyone
planning to create such an umbrella body should, however, heed Bob Holman’s
observations (Perspectives, 30 August). BASW at its strongest was never as
influential as its predecessor organisations which identified with particular
client groups. And social workers in local government have traditionally given
their primary loyalties to their union and to their specialism. Faced with the
inevitable demise of social services departments, we ought perhaps to be
thinking of new structures that reflect the likely loyalties and common
interests of social workers in the 21st century.

ROGER
HARGREAVES
Glossop, Derbyshire

Keep
homes at home

So
"France and Belgium É are rather like adjoining counties" Kent’s
director of social services, Peter Gilroy, tells us (News, page 5, 6
September). I suspect few people eligible for residential or nursing care
services will want to move to another country for their care. Even if staff are
bilingual, it is unlikely that many other residents will be.

Gilroy,
and other concerned professionals involved in the care of older people, should
not be plotting routes in their European road atlas – they should be
encouraging Whitehall and Westminster to get out more and see the chronic
underfunding that has led to the loss of care homes throughout the UK. It may
be good use of resources for people to travel to German hospitals for
time-limited surgical procedures – but to Normandy or the Ardennes, for the
rest of their lives? Surely we can do better than that.

LES
BRIGHT
Deputy chief executive
Counsel and Care