23 years I have worked in Social Care as a Provider and for at least that length of time successive governments have been trying to join up H with SC.

Over the years I have worked with Directors of Adult Social Care to start this work. Many times over we have re-set the vision, mapped it out, talked about it, forgotten about it and then tried again.

Is it realty that hard. Is it even possible or are we chasing rainbows and unicorns?

I think it achievable but not the way we are currently going about it, that’s for sure.

This should be quite simple but then we put money, budgets and funding into the mix and progress stops. The Government, in this case Kier Stargazer and his pals, need to set a vision with the sector. They “own” the NHS in effect as a public service so that element needs to be told what to do in prescriptive terms (no pun intended).

The tricky part is the Social Care sector as this is fragmented and made up of many providers, some trying to make a profit (big smile), some not for profit and some charitable along with derivations of these.

Money, Money, Money

I did say previously that we should take money from the NHS and give it to Social Care. I did say that the NHS has enough and wastes more than we as a sector would need. Once the mud slinging stops, if we fund social care correctly, the NHS works.

Think about it. Every injurious fall, every infection that needs admission, every bout of flu, covid, chest infections, tricky catheter, etc all goes into the NHS hospital system and that is crazy expensive. And I believe we can avoid a great number of these frequent flyer visits. It’s a small percentage of people creating a big issue.

What to do ….. or, I have a Dream….

Primary Care and Social Care Providers need to work closely. This means stopping the hierarchical approach (I have a PIN And you are an idiot with a QCF) and to commission Primary Care that works for the concentration of people who receive care at home or care in a home.

Imagine, as a provider, if you could pick up a phone and have your call actually answered. Imagine if that was by someone who worked in a supportive multi disciplinary team that supported social care. Wow.

That team could be – GP (essential), nurse, OT, Physio and pharmacy together with some Mental Health support.

Now, what could possibly happen in a cared for setting that this Team could not fix? Most of the common issues could be addressed at first chance rather than a “watch and wait” approach. NEWS2 and RESTORE are useful tools only when properly supported by external health professionals.

There is no doubt in my mind whatsoever that people working with people, consistently, professionally and with mutual respect will get the best results. Currently we have a hierarchy, and care is at the bottom of that particular ladder.

 Now this starts to look a bit more joined up and effective.

A quick hierarchy Safeguarding Case

30 bed plus residential dementia home, mid-week, Manager on duty and available. RPR comes to the home to visit Mavis (not her name) for a DOLS visit.

Mavis is not in a great mood and will only engage with the RPR if her friend Joan (not real name) can sit in. She will not move from her comfy chair by the radiator in the main lounge.

RPR decides that the best thing to do, rather than postpone, is to have a general chat with the 2 ladies in the lounge. Better than postponing.

During the chat, both ladies are sat with various stuffed toys, a bear, a monkey and one or two teddies. These creatures also join in and have an opinion. Why not?

RPR – How are the staff treating you both?

M+J  – terrible, they don’t feed us and they drag us out of bed by the heels every day.

RPR – Oh dear, what else happens ?

M+J – they are rude and they make us walk up 50 flights of stairs to bed. I have to help her and she helps me.

The conversation continues along this line. M+J validate and expand on each other’s concerns.

RPR leaves the home, walking by the manager, senior carers and others. Rushes back to the office, consults with her manager and raises a series of safeguarding concerns re the home and staff.

This happened, not too long ago, in one of our homes.

A couple of days later we get a phone call from a Social Worker with the Local Authority.

“I`m looking at several safeguarding concerns here” etc

Cue a CQC notification of many allegations of abuse, hours spent trying to prove a negative and ultimately no further action on each of the Sec 42 enquiries.

So, I complained to the RPR’s employer which is a charity with the LA contract for RPR/IMCA and some other work.

We hold a meeting with said RPR and her manager. I ask the question, “Why did you not raise this with the manager at the time?”

RPR – “Because I didn’t want to put everyone else at risk of the same harm occurring”.

Stalemate. Angry, frustrated and annoyed provider and manager.

I didn’t say anything because I didn’t want to put others at risk. Judge, jury and executioner. The care home must be doing something. 

Context – 2 ladies with advanced dementia, unreliable, cuddly toys, group meeting and poor questioning technique. But I`ll cover my back if I raise a safeguarding…..

Judgemental and hierarchical.

I later raised this with our Local Quality Monitoring Team. A poo in a swimming pool would have been better received. “It’s just the process. It’s a judgement. We cannot overlook abuse”. Etc

Actually, it’s the attitude of the sector. Guilty until proven innocent. Just the opposite of your actual criminal and their Human Rights.

Support

Would you like to phone a friend ?

Well, the good news is that “The Care Guys” offer a Safeguarding Support Service on a pay monthly basis, together with all sorts of support for RM’s and Providers. Friendly, affordable and real life advice and support.