Letters to Community Care 20 May 2010

Zero tolerance of violence is unrealistic

The series of articles in 6 May issue (news, 6 May, p4, www.communitycare.co.uk/violence) are welcome for providing an update on Community Care‘s No Fear campaign of 1999-2000.

However, I found the headline “Zero Tolerance of Violence” on the Big Picture (p6) less helpful, as zero tolerance has been largely discredited as an approach1.

Clearly violence cannot be seen as “part of the job”. Social inclusion, promoting independence and maximising choice will all be undermined unless violent behaviour is addressed.

However, understanding violence will lead to the conclusion that it is likely to occur when working with vulnerable people. Becoming intolerant of violence could lead to counter-aggression causing workers to behave in ways that reflect the aggression of service users.

The National Task Force on Violence Against Social Care Staff in England identified a link between the safety agenda and the quality agenda. Balancing the interests of staff and service users is essentially a value-centred approach to service delivery. An effective approach to violence reduction is best achieved where a proper understanding of violent and aggressive behaviour is applied.

Ni Holmes, violence and aggression consultant, Fife Council social work service

1 See, for example, Paterson B, et al (2008). Zero Tolerance and Violence in Services for People with Mental Health Needs, Mental Health Practice, Vol 11, No 8, 26-31

Violence task force proposals from 2000 at http://bit.ly/cTwWis

Action can be taken to reduce the threat of violence

Your coverage of tackling violence and abuse against social care staff will do much to alert local authorities and individuals about the risks, and your case studies show that action can be taken to reduce the threat from violence.

They show the three key steps in reducing violence:

● Well-planned primary prevention, including staffing levels and safe working environments and visit timetables.

● Appropriate policy and procedures, for example guidance on risk assessments and effective procedures to monitor staff whereabouts.

● Improving interpersonal skills with training, enabling staff to de-escalate situations.

These steps, supported by effective managers who reflect on and learn from incidents and encourage incident monitoring really do make a difference.

While recognising the severity and salience of high impact incidents, we recommend that training and organisational change must focus on prevention and interpersonal skills. Improving practice at this end of the continuum can have a significant impact by improving staff well-being and reducing staff turnover.

My company, Maybo, would be pleased to work with local authorities in a statistics-gathering process.

Tim Cooke, head of care, Maybo Conflict Management

The latest articles on violence against social workers 

Universities in denial over ‘failure’

Your editorial comment (6 May) is correct to defend Community Care’s use of the word “failed” in respect of the university reports that were obtained through Freedom of Information Act requests. To argue as Graham Ixer of the General Social Care Council does that “requirements had not been met” and a “remedial action plan put in place” cannot fairly be summarised as “failure” seems to be stretching the limits of language.

Anna Gupta of Royal Holloway accepted in her letter that there had been a need for “new leadership and new staff”. Community Care in the original article (29 April) did not suggest that either of the named institutions had their accreditation removed or that the problems identified were irremediable.

I understand that the GSCC may be sensitive about the word “failure” because it is but a few months since the Council for Health Care Regulatory Excellence published its highly critical report on the GSCC with the Department of Health requiring it to implement its own remedial action plan. 

What hope is there for the development of analytical skill and precision in the use of language by our students if the “head of social work education” at the regulatory body for England is so resistant to the use of clear descriptive language?

Terry McClatchey (Dr), Talgarth, Powys