Nothing about me without me, the phrase is frequently trotted out. Does reality – live up to that?
Too many people are excluded from decisions about their care and support, either deliberately or through systems and practises that make practical engagement almost impossible. Too many people are denied their legal and human rights, particularly in care settings. This is not always due to bad faith on the part of care professionals. It is sometimes be due to lack of awareness of rights, blanket bans, immediate budgetary restraints. Though understandable, this situation is not acceptable.
As well as causing great distress to individuals, the impact of such practises can be damaging to care providers.
For example, let’s look at what happens when someone’s voice isn’t heard in decisions about their care. Lack of input into care planning can lead to inappropriate care, slower recovery, and greater costs. Poor (or sometimes non-existent) discharge planning leads to longer stays, more costs, higher re-admittance rates, even greater costs. It breeds resentment and discontent for service users, fraught working relationships for staff and increased budgetary pressures for managers and commissioners. This is a cycle we can’t afford to repeat, yet it is seen on countless occasions.
Or alternatively, look at what happens when rights are infringed. The failure to inform people of their rights to an advocate could leave hospitals open to legal liabilities. Inappropriate use of the Mental Health Act, particularly its uses as a threat, can invalidate any supposed consent given by people; leaving medical pracitioners in a situation where they are providing treatment outside legal structures, unprotected by the Mental Capacity Act.
At a system level, lack of involvement in care planning, lack of service user voice leaves people more open to abuse. It leaves organisations open to criticism and action from inspectors and regulators, such as the Care Quality Commission. And it leaves organisations failing in the task that they have set themselves; to provide valued, safe, effective and dignified care.
Too often the barriers to change seem insurmountable. Immediate pressures, historical precedents, lack of specific support around rights based approaches. It’s all too easy to wait for a better time to change culture, or to believe that we are trapped in the current model. In the meantime people will endure undignified care, risks will increase, costs will increase, liabilities will increase. No good will come of such inaction.
We want to support you towards a better way of working. We want to help you become more responsive to the people you support and care for. That’s why True Voice offers a consultancy service to help you identify and address these problems, making your service more responsive to the voice of service users, better focused, more effective. We’ll help you identify breaches of rights, address issues of legal compliance and make sure everyone is contributing to person centred support. To find out how we can help you come see us at the True Voice website.