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Article 8 & Hob Nobs

May 8, 2013

A lightbulb moment.

Following yesterday’s post “Article 8 & Jaffa Cakes”, I’ve had lots of Twitter and Facebook conversations and even phoned the CQC for an opinion. And once again, I’ve realised that I’ve bought into something where the reality is very different from the presentation. The whole business of the recording logs is arse about face and I’d fallen for it.

Q: Why does someone have a support package?
A: To be supported in having their needs met.

Q: Why does the person receiving the support have to have their life logged and recorded?
A: They don’t.

The bottom line of recording a client’s life is arse covering. The regulator expects it. There may be insurance implications. Let’s not kid ourselves that the primary function of the logs is to benefit the client. And yet, that is how they have always been presented to me. In fairness, people have told me stories of how logs have been used to benefit them; in identifying patterns; spotting weaknesses etc. Unfortunately, my history with the services hasn’t been like that. Within a few weeks lof logs entering our lives back in 2010, Hillingdon had moved from support to evidence gathering into litigation.

The CQC’s position is that they want to see that the provider is supporting the client appropriately. That the client’s needs that have been identified are being met by the service the provider gives. This is such a shift: the recording is not about Steven and me – it’s about the support. The regulator doesn’t need to know that Steven had a banana for breakfast but they are interested in how the provider supports him with breakfast. The regulator doesn’t need to know that “Steven and his father had good interaction”. I’m not a provider. But they do want to know about the quality of the interaction between Steven and the providers.

A log isn’t a crime sheet: it doesn’t need to emphasise what happens to Steven during a meltdown. But it does need to record what the support did before, during and after a meltdown if the standard of care is to be monitored. It’s a very significant shift and one that I think there is a big resistance to.

A few weeks ago, I found a “crazy 20 minutes” recorded in the log. In that time, Steven had broken the new stereo, tore one of his favourite photos, eaten two packets of ham and thrown the phone. It was a very detailed, vivid description of what Steven did but absolutely no mention of what the support worker did. I’m not making a judgement here – I don’t know if what they did was good or bad; it wasn’t mentioned. All this requires is honesty and responsibility and unfortunately within the care world there is such a blame culture, it’s easy to see why the emphasis shifts to the client in the narrative. I never have a go at the support workers for doing anything “wrong” but I get very cross when things are covered up or Steven is presented as the problem. And it’s easy for that to happen when the support is missing from the narrative.

I know that it must be hard if professionally you think you’re being watched with a critical eye at all times. It took a long time as a counsellor for me to accept that professional supervision wasn’t a platform to be criticised but a valuable learning experience. The pressure of this scrutiny can lead to bad practice. When Steven was at the positive behaviour unit, I wasn’t allowed to see what they recorded about him – I was told it breached confidentiality! But I had sneaky peeks nonetheless. One day I noticed that it was recorded that Steven had eaten steak, mash and cauliflower the day before. Impressed, I praised him for eating the cauliflower, something he wouldn’t have eaten at home. His response was emphatic: “Steven Neary didn’t eat cauliflower. Steven Neary threw it in the bin”. I was told later by one of the support workers that they were told to record what had been dished up, not necessarily what had been eaten. This was very problematic. The social worker started to use “all the new foods” that Steven was eating as a reason for not letting him come home as she was not confident that I would follow this new diet plan. It was based ona lie but the practical consequences for Steven were very grave indeed. This isn’t a poke about her but a statement about the nature of recording when the image of the service takes precedent.

Anyway, following my chat with the CQC and my talks with the tweeps from within the field. I feel much more confident of my ground. I don’t want anything to do with all the bloody recording and if it’s really about monitoring the service, there’s no reason why I have to be involved. I don;t expect it to be easy; I have plenty of experience now of when the spotlight moves from Steven and me to others, it can get pretty messy. At the end of all this is my original poser – why should a disabled person, upon receiving a care package be subject to the kind of scrutiny that wouldn’t be acceptable to anyone else. There is no justifiable answer to that – it’s discriminatory. I might even suggest that it comes close to compromising Steven’s and my Article 8 human rights.

On that note, I’m going to have an unlogged hob nob. Don’t tell anyone.

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From → Social Care

One Comment
  1. swanarchie07 permalink

    Reblogged this on half a decade old.

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