Debbie Sorkin on how good leadership helps you build a safe culture
Safeguarding cases that hit the headlines can be grim. In July, the Times reported: ‘Barton Park care home boss stole millions from residents’.
They recounted how a care home owner called David Barton, described by the judge as ‘morally bankrupt’, groomed residents who had no children and were rich and vulnerable, before emptying their bank accounts and becoming a beneficiary of their wills. He got hold of over £4m in this way and even persuaded one victim, who had Alzheimer’s disease, to give him his classic care collection, which included Rolls-Royces and a Ferrari.
As the report goes on to note, the damage wasn’t just financial. In the case of one couple who were residents, he destroyed the relationship between them and their family and friends, hiring a ‘life coach’ and what were described as ‘psychic consultants’ to ‘make spells to banish their family’.
This awful – and thankfully, rare – case shows how safeguarding is about protecting people and their families from psychological as well as physical harm and abuse. For me, though, one of the key lessons is that by the time it gets to court – or is even reported, it’s too late, in the sense that the damage – financial, psychological, physical – may already have been done.
So as this issue of Care Talk focuses on safeguarding, I thought it would be useful to look at safeguarding through the lens of leadership in promoting a safe culture where such things are less likely to occur in the first place – or if they do, where people feel comfortable in flagging them up. This is about how you protect individuals, like those in Barton House, who don’t have anyone to look out for them. It’s not to say that safeguarding issues will never arise: they can, even in the best of services – but it seems to me that leadership is key to getting the culture right in the first place.
Leadership is intrinsic to safeguarding. This stems from leadership being based on everyday behaviours, and rooted in social care values. The very first chapter of the Social Care Manager’s Handbook focuses on these values, recognising that best practice will be grounded in high standards of personal and professional integrity, alongside commitment to delivering services that centre on, and respond to, the people who use them. This means keeping people safe from harm. In other words, taken from the Handbook, “Treating people with dignity and respect will run through your service like a golden thread.”
In safeguarding, I think there are two things to keep hold of. Firstly, leadership is for everyone, no matter what their job title is or what they do. Secondly, everyone needs to take responsibility for what they do and address poor practice wherever they see it. Abuse of any kind simply shouldn’t get a look-in, and if you see something that looks like a risk, it’s part of your leadership responsibility to follow it up, even in a small way.
So if you feel that something is going beyond people being accorded dignity and respect, and starting to shade into safeguarding, then doing something about it – whether that’s telling someone about it or intervening directly to put things right – and not turning a blind eye – is the right thing to do. It’s what makes you a true leader.
There is clear guidance on safeguarding in The Leadership Qualities Framework (LQF) for Adult Social Care. Ensuring the safety of people who use services is built into the LQF, being one of four components of the section on Improving Services. To ensure the safety of people who use services, leaders need to assess and manage the risks associated with service developments, and balance the need for user safety with other considerations. So good leaders always:
o Identify and quantify the risk to people who use services, using information from a range of sources
o Use evidence, both positive and negative (i.e. what is and isn’t working) to identify options
o Use systematic ways of assessing and minimising risk
o Monitor the effects and outcomes of change.
And you can be a leader whatever your role. If you’re an apprentice, or you’ve just started in your first care role, you can still act to ensure the safety of people you support. In fact, safeguarding is especially important at front-line level, as this is where issues are likely to come to light.
So good leadership includes front-line staff feeling confident to challenge appropriately and being prepared to raise concerns about quality, safety and performance, even if – especially if – this means reporting on the actions of a work colleague, which people often find difficult to do.
If you’re a team leader, you can show you’re prepared to raise concerns and take action if a member of your team comes to you with an issue, and you can instil a ‘safe to challenge’ culture whilst encouraging people to gain independence. And if you’re operating at more senior levels, taking up your leadership role includes actively building that culture.
Balancing this, Improving Services also means Encouraging improvement and innovation. Leaders at all levels have a responsibility to create a climate of continuous improvement, always being on the look-out for better ways to protect people from harm, and enhance their safety, so that they can live the lives they want, being accorded dignity and respect. Dignity is also part of the section on Working with Others, for example through the chapter on Encouraging Contribution, ensuring that people who use services can express their views and participate in joint decision-making, and play an active role in community life. And it’s there in Managing Services, including in the section on Managing Resources, using resources effectively and minimising waste. Why would you want to have someone you support feel unsafe or at risk when they don’t need to?
If you’re in a very senior role, balancing dignity and safeguarding is closely tied in to vision and strategy. It means creating a vision for an organisation that reflects the needs and aspirations of service users – including for dignity and independence; communicating that vision in a way that engages and inspires others; and implementing a strategy to put the vision into practice on the ground. And yes, this means you, David Barton.
Assuming you’re not David Barton, this means embedding safeguarding, both in itself and as the flip side of independence, right from the start. Getting staff teams to think about safeguarding as the standard way of working is key to developing a safe organisation. One way to do this is by embedding personalisation. People who are empowered by having choice and control over their lives, and who feel they are being accorded dignity and are entitled to it, are much less likely to be victims of abuse. And working in a personalised way means that staff see real people whom they treat with dignity and respect – not people they can defraud or estrange from their families for personal gain.
So: if you’re a care worker, and your boss, or your boss’s boss isn’t doing any of this, and no-one’s acting on warnings or warning signs, here’s a short piece of advice: LEAVE. There is a real shortage of good care workers out there (Skills for Care and the National Audit Office both estimate it at around 90,000) and you’ll be much better off somewhere else. It’s worth noting that there there’s a real risk in turning a blind eye, far less in colluding: in the Barton Park case, the Registered Manager and the bookkeeper also ended up in prison.
Aside from being a fundamental building block of care and support, you’ll find that having well-developed safeguarding pays dividends when demonstrating how ‘safe’ your organisation or service is for regulatory purposes. Many of the CQC key lines of enquiry for the ‘safe’ criterion focus on safeguarding and on the confidence that staff feel that they can report on issues and that, if they do, appropriate action will be taken, and fast.
Taking safeguarding seriously can also surface in how a service or organisation works in partnership with others, both within and outside social care. It marks you out not just as a leader, but as a Systems Leader – being prepared to lead across boundaries; where no one person is in charge; where you’re dealing with complex issues with no easy solutions; and where you make progress by being able to work with, and influence, other people. As the LQF notes: ‘Collaboration within and across systems plays a vital role in the delivery of services. Effective leaders work in partnership…to deliver and improve services.’
So safeguarding is at the heart of your leadership in social care. If you’re starting out in your social care career, it’s one of the ways you demonstrate good leadership. If you’re a Registered Manager, or acting in other senior roles, it’s how you embed it and build a leadership culture. But wherever you are in social care, having that constant awareness of safeguarding is one sure-fire way to make good leadership an everyday reality, and to instil quality – even outstanding quality – as standard.
If you have examples of great leadership in your service, please send them in to www.caretalk.co.uk or contact firstname.lastname@example.org.
Debbie Sorkin is National Director of Systems Leadership at The Leadership Centre. Debbie.email@example.com @DebbieSorkin2
 The Times, July 14th 2018: ‘Barton Park care home boss stole millions from residents’: report by Gabriella Swerling, Northern Correspondent
 See: National Audit Office, The adult social care workforce in England, February 2018, based on a c. 1.6m workforce and an average vacancy rate of 6.6%. https://www.nao.org.uk/wp-content/uploads/2018/02/The-adult-social-care-workforce-in-England.pdf