Personalisation, Positive Approaches and the role of Staff

Often when we run training, we ask staff members a simple question, with regards to their jobs.

"How do you wish to be seen by the following groups"

• Your employer?
• The people you support?
• The public?
• Your family?
• Your colleagues?"

This might seem like an obvious question, and in fact, many of the responses we get are what you'd expect.  In general the responses received would be along the lines of "professional, empathetic, competent, calm and knowledgeable".  This is pretty obvious stuff.

However, we then ask a second question.  This question often requires us to let them know it's confidential, we won't tell their managers and we won't mention any names.*

 "How do you think you are really seen by those groups?"

This is where the wish to be seen in a particular way, diverges from the reality of how they are seen.
Sadly the responses we get are often heavily negative.

1. My employer doesn't trust me, I only see my manager when I've done something wrong (or they think I have).  I'm not listened to, I don't get support and if something goes wrong I'm blamed!  My employer thinks of me as the enemy.  I get positive input when I'm asked to do an extra shift.  My ideas are never supported.
2. The people I support see me as caring but don't often understand why I'm doing things, or why I can't let them do things.
3. The public think I abuse people in my care and that I'm not really anything more than a bottom wiper.  They think that people in care are either neglected or abused and they don't realise how hard it really is.
4. My family (unless they work in the field) have no idea why I do this and don't understand why I don't work somewhere with more money.  If they work with people who challenge, they will often be asked why they don't just "hit them back".  My family can't get their heads around why I would never do that.
5. My colleagues think roughly the same as me.  We are doing our best with very few resources or often any real idea who to do things.

For us, this leads to a dilemma of massive proportions.

Most of the current training in the social care sector centres around the concept of positive approaches to the people we care for and developing services that are personalised.  We are supposed to treat people as people, not use derogatory words, and not to dehumanise them.  At least that is what the training and guidance would have us indicate.

So, why is it, that this sometimes doesn't happen?  As with all things, training is only one half of the story.  For good training to be useful or indeed for it to achieve what it's supposed to,  it needs a clear support system in place.  It needs the setting conditions for success.  It needs to be reflective of the organisations philosophies and it needs to reflect the way the organisation is run.

It cannot contradict the underpinning concept of the training.  For example, if you expect a member of staff to treat a service user with compassion, understanding, empathy and in a professional manner, but, then you treat the member of staff as if they were a child who is not able to understand, you

• dictate rather than engage,
• shout rather than speak, 
• instruct rather than explain and most importantly in this relationship, if 
• gloss over and just give them a printout or a "policy" rather than educate and get them to understand what you want.

 Then, you as an organisation are failing to continue the chain of events that needs to be followed.  We need to ensure that if Staff are going to have compassion and understanding then that really needs to be the way they are treated.  Learned behaviour is one of the most powerful tools around.
 The relationship between all the parties in care is complex, the service user should be at the heart of the chain, but, each link is only as strong as the weakest link.  These links would consist of

Owners - Managers - Staff - Families - Inspectors

All leading towards

The people that we support

So what are these setting conditions that avoid the chain becoming fragile and the process breaking down?

• Supervision which is designed to coach rather than monitor the person.  Coaching someone to be better at their job will engage the member of staff far more than telling them to be better.  Most managers are unaware (or seem to be) that most staff don't actually look forward to supervision, they see it as a time to get told off and avoid talking about what they don't know.
• Appropriate training linked to need and to policy.  Training that tests knowledge is far better than training that doesn't.  Training that just awards attendance or is so simple you don't need to do the course to pass is actually pretty pointless.  Staff drift off and don't place value in it.
• A debriefing system independent of line managers
• Managers who attend the same courses as their staff as a participant, not as a manager supervising their staff.
• Clear guidance which staff can understand and follow.  
• Don't stop learning!  Organisations who believe they know everything and they haven't got any issues are often the ones in the most trouble. 
• Use positive approaches as a theme for your organisation at every level, not just expect the staff to exhibit it when dealing with those in their care.
• Use personalisation all the way through your organisation, each person works better when they are valued irrelevant of who they are.
• Reward people for doing a good job.  Often, don't take them for granted and be nice to them. 
• People always work better for those they want to work for, not those they have to work for.
• Place value in your staff and they will place value in your organisation.
• Learn.

If you think your organisation is getting it right, then that's great. If it was my organisation I'd personally sing it from the roof tops.  Do a 360 review with hard questions asked, I'd bring in advocates and get them to ask the people we care for what they think.  I'd then put it on all my advertising and make it public information.  However, if you are worried about the outcome of a review, or you'd not want to publish the results, then, it might be an idea to do something about it.
 

Maybe a better question should be,

"Would I be comfortable with a Panorama journalist working undercover in my service?"




  *Unless of course something is happening which is illegal or unethical in which case obviously we have to pass things on.