Sandwich Carer

Really interesting blog from ‘sandwich carer’ Jeanne Carlin. Jeanne looks after her severely disabled daughter at home. She also has to manage the affairs of her parents who have complex care needs. What works well for them at Centre Parcs? Why is Occupational Therapy such a maze? What is it like taking on Power of Attorney?


The problems of personalisation

Personalisation is at the centre of the prevailing belief system about how social care should be managed and run. It asserts that people should decide for themselves how their support needs will be met and that people will be “more directly involved in the services they use as well as taking responsibility for costs and risks” (SCIE: Coproduction in social care, 2013). It translates into practical systems of self-directed support and personal budgets that have been universally adopted by local authorities. People are encouraged to ‘shop for support’ rather than waiting for support to be arranged and allocated. No longer are professionals trusted to decide how services will be organised and public money spent. ‘Choice and control’ is the mantra. The job of authorities is to facilitate and regulate the market of providers from which individuals will purchase. Over time, people’s decisions to buy will determine the nature and shape of that market.

Apparently, there are few dissenters. Continue reading

Early indicators of concern

Against all the worry about our ability to protect vulnerable adults in care, it’s good to come across some helpful research that gives us some practical ways to improve practice. This comes from Hull University’s Centre for Applied Research and Evaluation and is focused on ‘early indicators of concern’.

Their objective has been to seek to identify early indicators or warning signs that suggest that abuse and harm are likely to be experienced by the people being supported. The research has enabled the identification of a range of early indicators, which are visible to visiting practitioners and families. They have constructed a guide to enable practitioners and families to recognise early indicators, record evidence and report concerns.

More information here.

Care services and personal relationships

This website has been in place for a while now but seems to have been received quite positively. It was set up by a group of colleagues in Hull in response to questions from care workers about where to get information on personal and sexual relationships for people who may be judged to lack capacity. The section on ‘More Information’ is really useful with its detailed list of resources.

ootiinoo .. getting the most from community groups



  • in a church congregation the person who sits in the front pew gets to find out that the couple in the back pew could benefit from his knowledge of pensions and annuities
  • in a local authority the person who works in the Housing Office discovers that the person who’s a clerk in Trading Standards can sit in one evening a week with his elderly mother
  • in a street the person in number 9 finds out that the family in number 38 would love to look after her dog when she goes away
  • in a football supporters club the person who sits in the South Stand discovers that the person who sits 4 rows behind him also has a disabled son who enjoys rock music
  • in a patients support group the newly diagnosed person can ask for advice from others who have more experience of the condition.

All of these begin with a existing affiliation to or identification with a group or organisation or community and lead to the discovery among the ‘members’ that they have more to offer each other than they could otherwise have known. This is the idea of ootiino.

For more information click here.

A further addition to the Hall of Shame

So now Orchid View can enter the social care vocabulary along with Winterbourne View and the many others dating back to the inception of the welfare state and before. Each time a new recipe for effective regulation and monitoring is prepared. Of course regulation is important along with all the other components of a mature social care system: training, leadership, responsiveness to carers and so on. At the same time we need to look at what it is that allows people who, on the face of it, start out well-intentioned to behave so inhumanely towards those who rely on them. Social psychology has repeatedly demonstrated how people’s personal values can be easily undermined by the pressure to conform or comply with authority. There are other ‘dynamics’ in social care settings that lead people to act with disdain, detachment and, to some extent, denial. Our training and briefings for staff need to help them to recognise the circumstances in which they may feel under pressure to compromise their beliefs and what they know to be right .. and get drawn into a culture of depersonalisation and abuse.

[Footnote .. and another waiting for admission to the Hall of Shame: Veilstone]

Conversation is central to our lives

Think about what our lives would be without conversation. It is central to almost everything we do socially. Yet many people who rely on services have few, if any, conversations. This may have something to do with a speech or cognitive impairment or it may be associated with a memory problem. This is not to say that people aren’t spoken to or that they don’t themselves make every effort to communicate. But their experience is all too often superficial .. and all too often people who can’t readily engage in conversation are passed by or patronised. There are many communication apps but for some people these are difficult to use. We need to find ways to use technologies to support everyone to enter into rich conversations with others. We’re beginning to experiment with the iPad and a bit of software called iBooks Author. More on this here.