Safety for Citizens
                Talk for Norfolk: March 2010


© Simon Duffy. Rights Reserved. The author must be cite...
Activating our collective citizenship is the
key to promoting safety
Citizenship is vital to safety
1. Self-determination - I am at greater risk of
   abuse if I cannot direct my life, if I c...
Institutions are very unsafe
 1. Diminished self-determination - it is very hard
    to be heard when you have no authorit...
Self-directed Support improves
safety

              1. Good risk management
                 demands personalisation
    ...
Self-Directed Support is risk
1.      management
     First Contact - Initial
     support, direction and
     possibility...
30


25


20


15


10


 5


 0
      Positive      Support   Choice and        Plan      Maintain     Active part     Ri...
10




                                                                                                    Hidden Voices:
...
Service Area                            % failing
User focused services                     22%
Personal care             ...
Challenges ahead

1. Institutional assumptions about
   how best to reduce risk are still
   powerful and seem ‘intuitive’...
1% 6%   6%
                                   Who keeps
                        9%         citizens safe?
                ...
Contact Details
     Simon Duffy
     Centre for Welfare Reform
     The Quadrant,
     99 Parkway Avenue, Parkway Busines...
Safety for Citizens
Safety for Citizens
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Safety for Citizens

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Talk by Simon Duffy of the Centre for Welfare Reform for Norfolk County Council on safeguarding, social care and personalisation.

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  • Safety for Citizens

    1. 1. Safety for Citizens Talk for Norfolk: March 2010 © Simon Duffy. Rights Reserved. The author must be cited if images or slides are used
    2. 2. Activating our collective citizenship is the key to promoting safety
    3. 3. Citizenship is vital to safety 1. Self-determination - I am at greater risk of abuse if I cannot direct my life, if I cannot communicate and if I am not listened to. 2. Direction - I am at greater risk of abuse if my life does not suit my preferences or character and if I am perceived by others as lacking social value. 3. Money - I am at greater risk of abuse if I lack money or if I cannot control my own money. 4. Home - I am at greater risk of abuse if I cannot control who I live with, who comes into my home and if I cannot protect my privacy. 5. Support - I am at greater risk of abuse if I’ve no one to help me and if I cannot control who helps me. 6. Community life - I am at greater risk of abuse if I am not part of my community, if people do not know me and I have no chance to contribute to it. 7. Rights - I am at greater risk of abuse if there
    4. 4. Institutions are very unsafe 1. Diminished self-determination - it is very hard to be heard when you have no authority 2. Devalued lives - self-expression and personal development threaten institutional thinking 3. Impoverishment - economic power is nullified 4. Sheltered, but homeless - a home is more than a roof - vital to control privacy and security 5. ‘Care’ not support - the paradigm of ‘care’ already assumes the passivity and relative lower value of the person ‘in care’. 6. Disconnected from community- it is mostly other citizens who report abuse and it is structures of power within institutions that make it hard for people to not collude within institutions 7. Rightless - the shift to focusing on abuse not crime is a symptom of institutional thinking
    5. 5. Self-directed Support improves safety 1. Good risk management demands personalisation 2. Self-Directed Support is consistent with Health & Safety Law and the Mental Capacity Act 3. Shifting the primary locus of decision-making closer to the person improves the quality of
    6. 6. Self-Directed Support is risk 1. management First Contact - Initial support, direction and possibility to spot risks 2. Assessment - Finding out about the risks that the person faces and defining an indicative entitlement 3. Capacity Test - Making sure the person can be in control, has the right support and representation where necessary 4. Support Planning - Enabling the person to develop their own plan, with support if necessary 5. Plan Review and Sign- Off - Checking plans, offering advice and ensuring risk is well- managed 6. Outcomes Review - Checking outcomes and if necessary changing resources, supports or
    7. 7. 30 25 20 15 10 5 0 Positive Support Choice and Plan Maintain Active part Right Help to Your own Staying Managing Allocating difference tailored to Control over creatively support in their amount of people in a skills and motivated in Risks resources to lives individual. lives networks community. help to timely way knowledge work fairly people Helped Same Worse
    8. 8. 10 Hidden Voices: Hidden Voices: Older People’s Experience of Abuse 7.5 Older People’s Experience of Abuse An analysis of calls to the Action on Elder Abuse helpline. Written by Action on Elder Abuse and published by Help the Aged 5 Help the Aged Action on Elder Abuse Action on Elder Abuse Data (2004) 2.5 Home Sheltered Housing Hospital Care Home 0 Relative Risk
    9. 9. Service Area % failing User focused services 22% Personal care 26% Protection 29% Managers and staff 33% Organisation and running of the 23% business Standard % failing The needs, wishes, preferences and personal goals for each user are 48% recorded in a personal service user plan Staff are supervised and appraised 43% Safe procedures for medication, with users keeping 42% control where possible Rigorous recruitment and selection procedures 39% The risk of accidents for users and staff is minimised 37% CSCI Report - State of Social Care - 2005-2006 - Failure to meet minimal standards in domiciliary care agencies
    10. 10. Challenges ahead 1. Institutional assumptions about how best to reduce risk are still powerful and seem ‘intuitive’ 2. Incoherent legislation under-pins social care and safeguarding duties are not clearly defined 3. Public understanding is weak on these issues - perverted by partial news coverage and the vulnerability of the social work profession The way to resolve these issues is to radically reform the welfare state in order to enhance, rather than undermine, citizenship.
    11. 11. 1% 6% 6% Who keeps 9% citizens safe? 3% 3% People recieving ASC Paid Social Care Staff Family Carers 54% Self Funders in Regulated Services 18% Other Connections (x6) Self Funders in Non-Regulated Servic 1% People recieving NHS Paid NHS Staff Non-eligible but Vulnerable Only citizens can keep other citizens safe
    12. 12. Contact Details Simon Duffy Centre for Welfare Reform The Quadrant, 99 Parkway Avenue, Parkway Business Park Sheffield, S9 4WG T +44 114 251 1790 M +44 7729 7729 41 admin@centreforwelfarereform.org www.centreforwelfarereform.org
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