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Safe & Sound - Reflections on the ambiguities of safeguarding in social work
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Safe & Sound - Reflections on the ambiguities of safeguarding in social work

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Modern social work aims to keep people safe. But in practice much of what we do in the name of safety seems to increase risk. How do we really keep people safe and what is the role of social work?

Modern social work aims to keep people safe. But in practice much of what we do in the name of safety seems to increase risk. How do we really keep people safe and what is the role of social work?

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  • Excellent presentation with some pertinent points. I especially liked ...'we replaced love with management'.
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    Safe & Sound - Reflections on the ambiguities of safeguarding in social work Safe & Sound - Reflections on the ambiguities of safeguarding in social work Presentation Transcript

    • Safe & Sound Reflections on the ambiguities of safeguarding Talk for social workers at Hertfordshire University by Dr Simon Duffy on 2nd April 2014
    • What is safety? • We all want to be safe • And I’m not sure about being “risk enabled” • But I don’t just want to be safe.
    • Where are we safe?
    • “A report by an United States healthcare advocacy organisation Healthgrades
 Inc. found that there were over 700,000 “patient safety events” affecting 667,828 Medicare beneficiaries from 2007 through 2009. These events resulted in 79,670 patient deaths and cost the Medicare program nearly $7.3 billion. [Patient Safety in American Hospitals March 2011]” Not in hospital…
    • Not in residential care [Source: Action on Elder Abuse Data - relative risk of abuse]
    • So why do we keep falling back on the institutional response?
    • “It is not easy. What do we do when we don't know what to do? I want that guy out of sight, out sound, out of mind… The situation keeps cropping up in our society, when no matter how liked, esteemed or loved, some people become insufferable to others. No one they know wants to live with them. They are not breaking the law, but they arouse in those around them such urgent feelings of pity, worry, fear, disgust, ager, exasperation, concern, that something has to be done. A social worker or psychiatrist is 'brought in'.” R D Laing
    • Institutions didn’t come into existence because they were safer than communities. Instead: • The loss of jobs and family structures in the countryside • Industrialisation and the lack of work and support opportunities in the towns • Eugenic panic and the fear of difference and the fantasies of racial purity
    • We know only too well that institutions are unsafe.
    • Frances Enquiry: Connor Sparrowhawk drowned in a bath in an assessment & treatment unit. Torture at Winterbourne View, a specialist residential care unit “There was a lack of care, compassion, humanity and leadership. The most basic standards of care were not observed, and fundamental rights to dignity were not respected. Elderly and vulnerable patients were left unwashed, unfed and without fluids.”
    • Even for people in ‘community care’ services institutional practices continue and safety is often imperilled in the name of safety. 1. Michael lived in residential care home. 2. He was threatened by the police, even placed in the cells, after he got angry because he was not free to go to the ice cream van in his street. 3. Yet he walked home everyday from the day centre - by himself - because the day centre was ‘boring’. 4. And his mum tried to quietly teach him independence skills - although worried that she’d be told off by social worker.
    • Safety sometimes does demand control - but only in the most extreme of circumstances and after considering all the other possible options.
    • There is an everyday totalitarianism for many people living in institutional care. Freedom is replaced with order and control. Love is replaced with management.
    • But it’s not just institutions that are unsafe… Communities can be very unsafe too, especially for people in real poverty.
    • These are 44 women working with WomenCentre in Halifax. Each column represents one woman and the combination of problems with which they have to battle
    • WomenCentre have a remarkable success rate in: • Reducing abuse and domestic violence • Keeping children safe • Keeping women out of prison • Helping women get their lives back on track • Increasing mental health • and much more…
    • WomenCentre’s success is built on a sophisticated and holistic model of support
    • They have also developed and led critical strategic developments to prevent abuse and family breakdown across the whole community.
    • So does modern social work support the kinds of relationships between professionals and citizens which really increase safety?
    • Care management systems do not always seem as flexible enough to allow the right mix of hands on work and empowerment: • The emphasis continues to be in placing people or setting up packages of support. • People recognise that others can - sometimes - take leadership roles - but the system doesn’t support it. • Those who need the most support often lose out as time is spent working with others.
    • Patrick left the institution with the most severe reputation for dangerous behaviour. So what made Patrick safe?
    • • Independent living for people with very complex needs • Managed personal assistants - recruited just for you • Individual Service Funds - managed flexible budgets • Totally bespoke support - designed around you Getting the support right
    • A. individualise everything
    • B. find creative solutions
    • C. focus on citizenship
    • Practical guidance to help people develop their own support solutions around: 1. Planning 2. Decision-making 3. Money 4. Housing 5. Help 6. Community 7. Relationships Get practical
    • Does modern social work develop the right kinds of skills to enable social workers to create community-focused support solutions?
    • Many people feared that self- directed support would increase the risks people face. But it seems to leave people feeling safer. Personal and control and well correlated. It is being in the control of others that is most risky.
    • 1. Capacity - assume I can decide 2. Specificity - don’t generalise any incapacity 3. Selection - let me pick any representative 4. Suitability - find a suitable person 5. Best interest - pay attention to what matters 6. Involvement - I can still be involved 7. Review - things change But supporting freedom is vital
    • Does modern social work understand and know how to support freedom effectively?
    • A failure to support effective advocacy by families seems to have been a common pattern for the young people who ended up in Winterbourne View and similar places.
    • On average each person had been in 10 different institutional settings, including: Residential schools (n=3) Acute hospitals (n=3) Residential colleges (n=1) Low secure hospitals (n=6) Specialist facilities (n=6) Residential homes (n=5) All six had been victims of abuse, including: Neglect (n=2) Sexual abuse (n=6) Physical abuse (n=5) Financial abuse (n=1) We seem to be commissioning crime and abuse
    • O’Brien’s model of good support sees safeguarding as a critical element of community connecting. Isolation is the biggest danger.
    • The emergence of Local Area Coordination reflects a desire to refocus energy on preventing crisis and enabling citizenship.
    • Remember most of the people in someone’s life are and should not be staff. Surrounding people with paid staff and regulating paid staff is not the key to safety.
    • Does modern social work know how to work with communities to keep people safe?
    • For more information: ! Web: www.centreforwelfarereform.org ! Twitter: @CforWR and @simonjduffy ! Blog: www.simonduffy.info ! Facebook: centreforwelfarereform ! Campaign: www.campaignforafairsociety.org © Simon Duffy. Rights Reserved. Full copyright details at www.centreforwelfarereform.org