A bit of culture.

Well now. Much has been written about Mazars report into Southern Health’s failings.   The anguish and eloquent anger of LB’s family has touched me greatly.  Their poise and determination in the face of brutal onslaughts is amazing.

In the last 20 years as a social worker I have seen brilliant practice.  I have seen appalling practice. I have seen lives transformed.  I have seen lives destroyed.  Over the last few months I have had particular cause to reflect on what it is that determines how people are treated by organisations.

Culture.

That’s it.  Pure and simple.  Culture dictates attitude. Attitude dictates quality of service.  Culture is determined by leadership.  Large health organisations and social services departments are top-down organisations.  Hierarchical wilderbeasts, stampeding in discombobulating circles at the whim of their political drivers.

Such frenzied behaviour is destroying services.  It is ruining lives. Its prime focus is on the survival of the organisation. Accountability and responsibility appear to have been crushed in the crass new world of managerialism.  Populate the spreadsheets, present the data, please the politicians. Whether the figures are accurate is not the point.  The figures must be pleasing.  Departments must be under-budget. The workers must be toiling harder, faster.

Quality?  Who cares?

There cannot be a single social worker in the country who has not pointed out to their managers that if their authority had adequate administrative staff and effective IT systems they would be freed up to engage in community based preventative practice, instead of sitting in front of a screen most of the day. We even give them a financial reason to agree with us: prevention is cheaper than cure.  Yet when social workers present managers with this truth, they are dismissed as ‘old-school’ or ‘resistant’.  Why aren’t managers succeeding in persuading politicians to let social workers do what they are trained to do?  Are their arguments ignored? Or are they so far removed from understanding the needs of people using the services that the very values that brought them into social care are forgotten?

Service users and carers who complain are branded ‘challenging’. Workers who raise concerns about safety and inadequate practice are victimized, isolated, forced out.  The survival  of the organisational hierarchy is paramount. Southern Health are not alone in their dangerous adherence to the totally flawed belief that managerialism must be right.

Enough now. Organisations must stop blithely spouting the jargon of vision and values, and start believing that the people who use their services actually do matter. Frontline workers already know and believe this, and all they want is to be able to do their best to support them.

Enough.

A letter to my niece.

Dear,

When I met you for the very first time you were dressed as a princess and hiding under your bed. You jumped out and shouted ‘boo!’ and we hugged. You were 7 years old and your new mum had waited for years to adopt you.

I still have the cinema ticket stub of the first film we went to see together. It was ‘Hairspray’. You had the CD of the soundtrack and sang along loudly.

Your mum and I took you to the seaside for your very first time. You refused to wear anything other than your swimsuit even though it was freezing and you had goose pimples and chattering teeth. You were so excited to paddle and make sandcastles and be buried up to your neck in sand.

Your mum asked social services for support to help with your feelings of anger and fear. They didn’t  help, so to give your mum a rest I offered to look after you one night. You came to my house and we had such a good time, cuddling up, munching pizza and watching films. When you were in bed you raged and sobbed. I hugged you for hours, until you finally slept.

I saw that night that under your determined,  playful, cheeky exterior was a little girl who was so frightened and traumatised, and I felt so sad for you.

As the years went by, social services had intermittent involvement with you and your mum. Most of it didn’t  seem to help. Then a social worker came along who seemed different, and was willing to spend a long time with you.  You were not ready to engage with therapy though, and she eventually stopped visiting.

I remember that night 4 years ago when H and I took you to the theatre. When we returned to your house your mum was upset. She had discovered you had been on Facebook looking for your birth mum. And you had found her.

You arranged to meet your birth mum without telling your mum. When your birth mum wasn’t interested in you, but just wanted to know where your baby sister was, you were alone for months with this awful reality of rejection. I’m glad you were finally able to tell your mum what happened. I’m sorry you had to worry alone for all that time though.

You began to run away.  Time after time the police would return you home. Your mum was desperate to help you but nobody had any answers. I remember sitting in your kitchen at midnight talking with you, whilst your mum spoke with the police. You did not believe that hitching lifts, sexting, and having unprotected sex were dangerous for a 14 year old. I just hugged you when I knew my words were making no sense to you. Then you told me again you used to have a pony that lived in your birth mum’s kitchen.

I am so sorry that all the times H and I tried to talk with you we didn’t  seem to make a difference. We racked our brains for hours, wondering how to help, what to say. I wish we had managed to find something.

As you started taking drugs and alcohol, your mum frantically asked for help. Finally you went to respite for 3 weeks. And you never returned.

I am so angry at social services for not helping you get home. You had 6 foster carers in a year. You ran away overnight, then for a few days, and then for a week. We were all so worried. Your mum and I spent hours driving round and searching social media. We argued with social services, and we had meeting after meeting with them.

Then suddenly you turned up on your mum’s doorstep and talked and stayed the night. In the morning you ran again. When you were found you went taken to a secure unit.  Then you were moved to be nearer your birth mum. Social workers didn’t include your mum in this decision, and they have still not given her your new address.

I have no way of contacting you. I know you have blocked us all on social media,  but I still hope that one day you will contact one of us.  When I saw your birth mum had declared on Facebook that you are no longer her daughter my heart ached for you.

You are lovely and funny, charming and sweet. Please remember that, even if you don’t think it’s true. I love you. You will always be in my heart. Please know that I will always be here if you need me.

All my love,

xxx