Policies and procedures are ‘necessary scaffolding’ in making care providers safer. That’s according to Des Kelly OBE, Executive Director of the National Care Forum. In his blog, Cherishing Registered Managers, he says that policies and procedures should only be a framework within which relationships can develop between care workers and people receiving support.
Des points to Registered Managers, in particular, as the ‘doers’ who carry the major responsibilities for leading improvements to services. Nowhere is all of this more important, than in the area of safeguarding.
Let’s put policies and procedures to the side for a moment, important though they are, and talk in the plainest terms. Is your service good enough for your mum, or for that matter, for anyone you hold dear? 10% of social care providers are ‘inadequate’ at safeguarding, according to the Care Quality Commission (CQC), which applies the ‘mum test’ to its inspections. Safeguarding is a really important issue for the CQC and for the sector as a whole. The statistic above should worry everyone, even those providing good safeguarding practice.
Perhaps consider what the CQC says about Avenues South East Services, who recently achieved an ‘Outstanding’ rating. ‘People told us that they felt safe using the service. They said, “The staff look after me.” People’s relatives told us they were confident that their relative was safe using the service.’ Achieving this can often only happen where support is underpinned by excellent leadership and practice.
Safeguarding and leadership
If you don’t have safe organisations, you probably don’t have good leadership. For leaders, it is about constantly espousing the values of creating those caring, person-centred and safe organisations. Social care plays an important role in helping people with care and support needs to live full lives, free from abuse and neglect. This includes preventing abuse, minimising risk without taking away control from people, and responding proportionately if abuse or neglect has occurred.
Safeguarding is a fundamental CQC requirement for providing ‘Good’ care and support. You can’t think about being ‘Outstanding’ unless you get this essential factor right. An ‘Outstanding’ service is a responsive service. It is transparent to users, carers, commissioners and others, and recognises its own mistakes as a valuable source of learning. Being open and honest is a key aspect of leadership.
The Social Care Institute of Excellence’s (SCIE) report, A definition of excellence for regulated adult social care services in England, says that excellent services treat people with the utmost respect and dignity. The staff in an excellent service get to know the people that they care for and support. They make sure that the following challenging goals are achieved: the service is ‘well-led’; it’s staffed by skilful people; and it has good connections with the local community. This will go a good way to providing a person-centred care and support package, with proper outcomes, for everyone using the service.
Staff should be inspired to have positive aspirations for everyone they support. If you truly value people, you are surely less likely to devalue them to the point where they may be harmed.
Safeguarding and co-production
Another CQC ‘Outstanding’ report now. This time, Prince of Wales House in Ipswich, which has as its ethos, ‘Everyone who comes through our doors will be included in our home and supported to feel safe, secure and wanted’. If you work co-productively with service users, carers and relatives to design services, care plans and policies, then it’s more likely that safety will be fully embedded into the way care is provided.
How is this done? It’s about inspiring staff to involve residents in decision-making and the design of services. If they are involved in shaping services, they can be involved in their own safeguarding. SCIE has helped lots of organisations audit how they involve service users in safeguarding. We know how powerful it can be when, in the words of one safeguarding lead, we have heard the voice of the individual and we are not just making decisions on their behalf. Working co-productively in this way, with all parties, means that providing good safeguarding practice is, perhaps, a much less a daunting task.
Increasingly, leadership is also about looking outside the organisation that people work for; and working in conjunction with others.
Counter-intuitively, in some respects, people are not always safer when they are kept in a single organisation and when they don’t interact with the wider world. Safeguarding concerns raised in 2011, over Winterbourne View, fall into this category. It follows that people should be safer when they interact with a wide range of organisations and people – such as local volunteers, library and leisure services and, of course, other care providers. Good leaders recognise this.
Another service rated ‘Outstanding’ by the CQC, Robert Owen Communities, was praised because, ‘The service worked in partnership with other organisations in creative and innovative ways to improve people’s independence.’
Safeguarding and a systems approach
Organisations increasingly function within a complex system of commissioners, partners, communities and collaborators. To succeed in this environment, leaders need to become adept at working with service users, relatives and volunteers. They also need to be able to operate in networks, working across organisational boundaries, and building shared values and trust. Leaders must remove barriers that stop their staff collaborating with others. This can be described as using a systems approach.
If an organisation seeks to make people safe, then leaders need to ask questions about who they have to work with differently, to achieve that goal. By adopting a systems approach, leaders can learn about best practice, they can reduce the risks of harm, they can assess risk much earlier and they can build a whole systems approach to safety. SCIE’s systems approach was originally developed in our work with child protection, known as ‘learning together’, it looks at how lessons can be learnt in safeguarding.
Safeguarding and legislation
The Care Act 2014 introduced new safeguarding duties for local authorities. These include making sure that local adult safeguarding procedures are in place, for all the various professionals that keep people safe. Local authorities, care providers, health services, housing providers and criminal justice agencies are all important safeguarding partners.
Councils need to make sure that the right enquiries are made when someone has a concern about safeguarding. On top of that, the Care Act now stipulates that it’s the council’s responsibility to arrange independent advocates for people who don’t have anyone else in their lives to support them, and who need help to understand the safeguarding process.
SCIE has lots of resources on good safeguarding practice, from films to guides and from e-learning materials to at-a-glance briefings. There are plenty of other safeguarding resources, from a housing guide looking at safeguarding, to training on the Deprivation of Liberty Safeguards.
Is all of this easy to achieve? Not at all, and not at a time when resources are being squeezed more than ever and it is difficult to find good staff. However, there are ways to improve safeguarding that are cost-effective and that reduce costs over time.
Back to Des Kelly from the National Care Forum, and his ‘necessary scaffolding’. Services should regularly review and develop their safeguarding policies, procedures and values. However, it’s not good enough that the paperwork is simply being filled in correctly. The staff should be fully-engaged with the service, and then fully-engaged with the people they safely care for and support. Des won’t mind if I don’t finish by quoting him. It takes effort, time, constant reflection and learning to get safeguarding right, so I shall quote Aristotle instead. He said, ‘We are what we repeatedly do. Excellence then, is not an act but a habit.’
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