Institutional abuses in health and care in London borough.
Here is an account of national scaled institutional abuses that are rampant practises in every borough of London.
First, you will find below the letter I sent to a borough.
It is about someone attributed with 8 hours a day care by a borough who does not bother having any report about him.
The very stunning point is that this service user is supposed to benefit from large amount and varied help but the pluri-disciplinary staff don’t link nor share any information.
Obviously despite an in principle big team of people at disposal, this lead to a very low standard of care, as explained below.
This story is to highlight because it is the representation of what happens when several agencies or departments are involved, or more definitely not involved with each other.
I have been a carer in the uk for this past 3 years –and 3 years more in France- in different and various positions and I could provide you with other striking examples.
In the case of J, he is a young autistic man, deprived of clear speech and put aside of any social activities and it is why I ask you to read the following.
The point 2 and 3 roman, are very particular to this case also you may not be interested by reading them but please do read the letter and point 1.
Please if you have any questions, I am ready to work on this text or on telling this story to someone willing to rewrite it.
I wish the contents of those facts or a part of it could be published in order to alert the public opinion. I could testify they are all 100 % true, I witness them and there are proof about that.
Looking forward to hearing from you.
Social care and meeting.
I write to you to let you know about an absolutely aghasting borough practise.
It is about the care of your service users.
There is in your borough a person for whom you provide a package of full time care and that has been lasting for years. For doing so instead of employing staff working directly for the council you delegate to a support worker agency what is surely supposed to be a subsidiary of the state or at least supposed to be working hand to hand with the borough and the professional they employ directly.
The fact is that this person’s well being depends on his carer knowledge, serious and following of daily targets and naturally the daily, weekly, monthly reports of his behavioural and activities management, the strategy put in place to improve his chance of linking with people and of engagement in activities.
The shame is that he has several carers, to whom not, even not one report on their activities and monitoring is asked and worse; though it has been years of daily work with him, not one, not even one single meeting implying his team of carers has ever taken place. Do you consider this situation as being appropriate or justifiable at all?
This was the letter addressed to the council.
Their reaction? Dismiss the agency from this particular case.
I am afraid that is no proof of that reality being taken seriously.
Of course, a part of the question is about the policy of the mere agency.
The main priority and sources of immense concern lay not in that particular case though treated as if it was isolated. That example cannot be the forgotten piece of the whole story but simply reflects the kind of no-links, no communication and not even the most remote sign of implementing one. A comprehensively mute bunch of people in charge and without any devices for having a feed-back loop system or for conveying info for a better professional practise, (and after years of having practise like that let s say without doubt, without plan nor the shades of one). The result of a dismantled depleted network it should have been for this situation went on for 5 years.
The council allows one person to be taken everyday for years, 8 hours a day, a person with very serious speech and communication impairment and therefore depending on people knowing him very well to report the way he wants or he needs things and what things to be done.
Instead of that no reports asked, not a single meeting. Like that thousands of hours of get to know the job and performing the job duties, lost.
Even in the case where he does have good carers, without detailed description of how one proceeds, if the main carer leave, the next carers will found themselves without the information that have been gathered in years of pragmatic experiments, observation and hours of practising how the service user will like and need to have people assisting him and with that.
But when you said not a meeting, actually there is.
Only for the means supposed to be at his disposal yield so little advantages:
Here is the situation-
A team of one psychiatrist, one psychologist, social worker, senior carer, and several carers. One or perhaps two meetings a year.
But what kind of meeting?
Not one including his daily workers team, just like if they did not work or did not wish to have objectives while working.
Among this highly qualified persons (psy, social worker…) not one person that will wonder how it come that daily carer are not asked to give reports or to attend meeting for a then possible re-assessment of the needs, capacities, projects and targets of the very young man service user’s life and schedule.
I really like to know how it comes that all these people have readily accepted to leave things in that state. To that question, blatant facts will strike the mind.
One, they manage to pretend to assess a situation without enquiring about the daily happenings or non-happenings which is supposed to be the basis of all decisions and which will have a conclusive effect on everyone else’s deeds towards the life of the service user. . For every case it is the case but this man is deprived of speech, plus when you send people for 8 hours shifts you expect them to do something somewhat intelligible with it.
Two, whereas psychologists, social worker team should try to assess a situation with the purpose of improving or adjusting this situation, the fact is that they don’t try to check out what difficulties his only carers
(and only person who are in real contact with him may come across with. Check on their possible, better put, advisable-should-be-compulsorily-requested questions, claims, projects, strategies, differences, techniques, and if any work done during these 8 daily hours, their practices.
These person who are supposed to look after the well being of a person just don’t ask for any records about what the only staff that are in interaction with that person do.
This fact underlines that they are supposed to assess the life conditions of an individual about whom they know nothing, and about whom they don’t try to ask anything.
There is no pluri disciplinarity team, whereas the taxpayer pays for one and is told that there is. There are several people, agencies who work but do not team up. Who absolutely does not bother about the hackneyed notion from the nvq 1 health and care of the holistic approach.
A team of staff left without aims, without objectives and assessment of their jobs.
A service user file thus life management and planning without the latter are meant to say ‘no futur’
To what everything in place there is not a single attempt at verifying, gathering, assessing, compiling information nor the will of having that.
That is to say there is no way of checks and balances, the basis of democratic system has to provide an info and grievance canal.
Nothing checked; nothing shared.
Nb: It is useless to add that this absence of any checking is open-door to abuse among staff, or hierarchic, towards the service user, or abuse of the time or the means put at disposal.
Three, it is just common doing, and implicitly better for each one not to make comment on anything in a clog.
This young man has been discarded from the system as a whole.
His health condition has for effect him not to be able to stay in place where there is noise.
This young man is ‘barred’ from having any kind of social grouping due to this sensitivity to excessive noise, as the same council has been enable to find for him a place- when you think this is actually happening in London-, a centre where he could have regular encounters with someone else than his carers.
The carers will find themselves being given the schedule of an outcast, with no socialising place in his timetable, taking the pretence that he needs somewhere quiet to feel well, he is left on his own, like if you could not find or even make up a quiet group for people who need quietness to enjoy their time.
With will and cooperation this would be easy to find and to eventually enable J to have at least a weekly meeting where he can meet people instead of none a year he has been imposed with.
In conclusion he is left with only his team of carers, to whom he is totally dependent as for his goings and comings, and all activities, or any sort or planning they will offer. The same people to whom no one asks what they do, how they practise, or to hand out their reflective accounts; and the same people that are left on their own without support, nor objectives.
He is left with not other encounters.
In parallel if you got a problem – violence or abuse in the surrounding of this person or among the professionals, or if the person you look after is subjected to abuses…without the network of a pluri-disciplinary team (it would take two meetings a year, some forms, and shared reports), are you supposed to rely on telling the social services, that demonstrates on that they just don’t talk in any case about what happens in the actual service users’ care.
Because this case has been reported and what they did was to suspend everyone, like if it was a surprise to them that family and team of workers endure problems if they are left cut from other places. Sometimes unsolvable, often leading to the wearing of motivation – one cannot be the only one in the village- stop doing of activities or of their coherence or of their relevance to the need of the service user that without detailed writings will stay unknown, no thinkable continuity to it (there are nonexistent), nothing about what have been done. And about the endorsement of one’s responsibilities? There is no more frameworks and a general fear of taking initiatives since the support and surrounding coming from higher is at zero. This type of organisations always leading to isolation and the impossibility of using the resources needed to render comprehensive care. Dignity.
Like if they were surprised by the absence of this meeting whereas they are the one not asking for any.
Like if it was the fault of the workers that dare pointing out this fact.
Like you I thought that it was the fault of the agency. But in fact the agency itself just look for being competitive, and this include not too much demand from her staff as the salary is limited and that the other agencies don’t ask for reports either since, it is simply not ask by the boss, the leader of the care programs, the councils.
Agencies who are only what they are taken for, a commercial, administrative, logistic, company who merely applies the rules that the very same council ask them to follow.
Provide me with temporary, no-unionised, cheaper, got-riddable-of-at-will-without-contrat-nor-the-inch-of-a-view-inside-the-pyramid (5 years they have been relying on temporary workers for the same job with exactly the same type of care and schedule, not an inch of change, nor the perspective of doing it). Be happy taxpayer, twice as much expensive these temporary agencies, spare our administrators the burden of the responsibilities, of the feed-back to their staff, of a file that is supposed to be filled, gathered, shared and read.
I report that to the council. I had not choice. I wanted to complain about the council but when I went to the government site, they say that if you want to complain about the council then you have to write to the council! How is that possible? Not in a democracy.
It is not an isolated case, just a mistake, an oversight. It is sheer common implementation, professional customs, organisational cordiale entente, systematic arrangement; oblivion.
It is institutional abuse.
The council suspended the staff of the agency that take on them, like if it was the problem.
They suspended the team, not responsible for not having no one to talk, no one who are here for supervise, advise, collect, put further, forward…
They treat the temporary worker like inexistent and when they voice the problems of not being able to link with anybody, they give you the sack.
Madam, sir, sorry about this, I admit, a bit long and heavy description of what is to find inside the thick walls of our institutions, but just a reminder- here described a council job.
No one checks, no one assesses, (those are a very widespread, endemic everywhere happening, but at least in some places they provide to fill up a form that gives you a chance to whistle blowing).
No grievances procedures, no help, no security.
The game was clear. If you speak, they remove you. So what do you do if you need the job?
More vicious than that, no one needs a job in particular but something you desperately need is references.
You may work very satisfactorily for two years with you boss, if the 25th month he decides you have been a rubbish the way long it is what he may just decide to begin saying.
You don’t possess, it should be compulsorily given, here in the uk it is forbidden to ask for it, a regular overview. A say quarterly appreciation of your work by your manager, attestation by what you may appreciate that you cannot work anymore for a person that don’t give you good references, or improve your practise if the comments are justified or by what you are sure that if someone say you are a good worker one month he won’t be totally allow to say that you are inadequate the days you are not anymore in his books.
Also if you spot abuses, don’t report it because who is gonna give you or not access to another jobs afterwards, you former boss.
The system of reference! A lock-up system.
original date: 2010