The Care We Want

Clenton Farquharson MBE, chair of Think Local Act Personal, gave the following speech at ADASS Spring Seminar on the care that he wants. He paid tribute to the person-centred approach of his social worker and made a plea for delegates to remember their moral and legal duty to put people’s wellbeing front and centre.

In 1995 a social worker changed my life.  This is particularly remarkable when you consider that I refused to let her inside my front door for several weeks!

I had experienced an appalling and unprovoked attack resulting in life changing injuries. Good, wonderful people at the hospital saved my life. But those injuries left me trapped in hospital then trapped in my home. My entire life had been turned upside down and I was angry, I was bitter, and I was scared.  

My fierce determination to have absolutely nothing to do with this ‘do gooder’ was matched by her determination to find a way to persuade me to let her through my front door!

And she didn’t give up.  Every day, including Saturdays and Sundays, she would continue to call and knock at my door. And every day, I would send her packing!  These conversations, such as they were, generally took place through the letterbox!

But her sheer tenacity and resourcefulness paid off and one day, I opened the front door and invited her across the threshold. And that’s when my new journey began.  Karen enabled me to become a husband again, a father again, a son again. She helped me regain my life.

And that’s what good social care support does – it transforms lives by supporting people to do what everybody else would consider ordinary. It’s only when the ordinary becomes extraordinary by virtue of accident, illness, injury, that we realise how precious the ‘ordinary’ is.  Going out with your mates.  Picking up a bit of shopping for your mum.   This very ordinary stuff is the stuff of life. 

How did Karen do it?  Karen did it by listening to me without prejudice.  By demonstrating empathy, by investing time in getting to know me. Above all else, Karen saw me as a human being who, despite my devastating experience, had potential to live a good and meaningful life and Karen walked side by side with me to help me get there.

And that’s the care that matters to me. That’s what I want everybody to experience.

Twenty-four years on I would have expected that this approach would be common place.  Sadly, this is not the case.  I recently received a letter from a young woman of twenty-two. I’ll call her ‘Tara’. 

Tara’s mental health deteriorated in December.  She received crisis support over Christmas but was then discharged and left alone without any support. Already paying for her own counselling, Tara had to use even more of what little money she had to buy additional therapeutic support to avoid a downward spiral in her mental wellbeing.

Tara tried to find out how she might be able to use her direct payment but found it impossible to get information.

Instead of being able to have a chat with somebody about her direct payment she was referred for a review. This took four months.  She was then told that she would have to have a reassessment.  She is currently waiting to be allocated a social worker.

She has expressed real fear and concern that she will be reassessed by a stranger who may reduce her direct payment.  She feels desperately alone. Nobody appears able to give Tara the answers and information she needs to exercise some control over her life. 

The difference between my own experience of care and support and this young woman’s could not be starker.  Mine was based on a clear understanding of the importance of wellbeing.  And because my wellbeing was front and centre, my experience was founded on relationships first and transactions second.

Tara, on the other hand, is lost in a maze of health and social care red tape.  She can’t have a conversation, only a ‘re-assessment’ but must await ‘allocation’ before that can even happen.  “Reassessment “? “Allocation”? Even the words are transactional and objectifying rather than personal and hopeful.

A personalised approach has apparently been sacrificed at the altar of processes, procedures and transactions.  And all the while her mental health continues to worsen.

So,

• Twenty-four years after a social worker saved my life
• Twenty-three years after Direct Payment legislation
• Eleven years after Putting People First
• Five years after the Care Act

Where are we?

We have a twenty-two year old woman whose entire life is ahead of her, who has so much to offer and so much untapped potential. Yet she in danger of receiving limited support only when she is in crisis.  

The care I want for all Tara’s everywhere is care that doesn’t only step in when the situation deteriorates but steps up too and takes the time to ask the question – what would a good life look like for you? Takes the time to learn about Tara’s hopes, dreams, wishes and ambitions – in other words, take the time to consider her wellbeing - and gives Tara what she needs to be better informed, better connected and more confident about finding that good (or ordinary) life. 

We have the policy and legislation to do this and we know there are great people out there but considering people’s wellbeing often remains marginal.

My ask of you today is simple but perhaps challenging — those of you who know me will be surprised to hear me being challenging, but let's give it a go.

I want you to do what you all say you already do or want to do. You remember the inspirational book, by Edgar S. Cahn, No more throw away people? Well if we are to stop throwing away people like Tara, we need no more empty words.

It is time to close the rhetoric-reality gap. Take the long view. Keep in mind, your moral and legal duty however difficult it may be to reconcile the different demands and constraints that are placed on you.  And have the courage to remind others of this moral and legal duty.

Please, if nothing else, remember my social worker, Karen, and how she helped me rebuild my life. We should all be working together to do the same for Tara and thousands like her.