Standard Care or Standard of Care?
This item is a follow-on to the previous Neighbourgood Post. I tried to make the point that providing care and support is a complex matter and subject to a wide range of influencing factors that complicate, define or explain the caring relationship. It’s true that people provide and need care for many different reasons and it probably is the case that the standard of care will be determined in some way by many factors. Here, I’m following on from that to consider whether there is a single, sufficient way to define a standard care that will deliver a satisfactory standard of care. Oh and by the way, I just noticed this post in my list of drafts. I thought that I had posted it so, part three is here!
Poor Standard of Care
You must have heard, watched or read something about the Winterbourne View scandal or about the “appalling standards,” discovered at Stafford Hospital. It has been interesting to think about what might a meaningful definition or standard of care for the good support people and organisations provide, but these horror stories raise questions about what causes or constitutes a bad or even abusive standard of care. Poor care is a tragedy and good care is life-affirming, hopeful and reassuring but there are a whole range of caring relationships between the high-quality relationships and the lowest. Where along that continuum do standards cease to be acceptable and how do we know? In the most simple way, I guess good care makes improves a person’s situation and bad care will make it worse.
Does it Matter?
It might! In the previous article I started to raise the question whether the motivation underlying a carer’s support really mattered. Well it certainly will if the motivation is so poor that it leads to low quality or even abusive care. If a person is in a job they really have no relevant skills for, or such poor motivation to do it, it is quite likely that it will lead to a poor service. I have been in superstores of all types and noticed the difference in help provided by store staff when I have a question. You can get a smile from a person that knows the layout of the store, who tries to understand the problem and looks for ways to find a solution which includes a range of options and maybe some comparison between them. Or you might get a person who seems to excel in not being helpful; they don’t know what you are talking about or what type of product you are looking for and don’t really seem to care one way or the other! In the grand scheme of thin
gs, it doesn’t matter so much if a person can’t tell me the difference between 2″ by 10 or 2′ by 8 wood screws and why I might need one over the other but, if you carry this analogy over to the carer providing support to a person getting washed and dressed, then it can make a huge difference. In this situation you would expect the carer to be attentive, respectful, helpful, thorough, capable and have knowledge of the task they are attending to and the needs of the person being supported. I’m not thinking about the service offered by a novice here. We can excuse people who are new to the role, or who don’t know so long as they explain that and show some willingness to develop.
How Do We Know a Good Standard of Care?
There are two approaches to determining what a good standard of care is or I suppose, if you take components from each option there could be three! One is to insist on a list of standards that a person providing care should achieve and the other to provide a list of things that a carer shouldn’t do. These lists could come from a central, governing organisation such as the Health and Care Professions Council, or a professional body like the College of Social Work. They could also be drawn-up by an employer and perhaps ideally, in a discussion between the care provider and the person purchasing care.
The problem with the list of do’s and don’ts approach s they can get complicated, they create arbitrary boundaries and they tend to get bigger as time goes on. I’ve read that Augustine once wrote, “Love, and do what thou wilt.” It seems that this is a simple code of practice that he felt would achieve the life-style he and his followers wanted to achieve but my paraphrase would be, “Get one thing right, and the rest will follow.” The trick would be then, in any caring profession or situation is to find out what that, “One Thing,” might be. I’m not sure what it is but it could be:
- Treat the person you care for with the utmost respect and dignity
- The rest will follow
If you have some better ideas, please chip in and suggest them using the comments form below. I would love to hear from anyone who has experience of care whether that’s receiving it or delivering it and whether that is in a formal or informal setting.
When Things Get Really Bad
If you have a poor experience of care or if you think you know someone who is getting such a poor service it might be abusive then I think that you could talk with someone from Social Services. Of course, if you think it is really serious, you could go straight to the police and tell them. You can find specialist safeguarding workers in social services, the police and some NHS organisations and if you are already in touch with any of these agencies it might be a good place to start there. If the matter isn’t so serious, and you are the person receiving care, then ask the carer not to do whatever it is that causes your concern. If you are a carer, and you want to make sure that you are doing the right thing then find out what it is the person wants to happen, as quickly as you can. You can read about safeguarding here and if you have a concern relating to the abuse of older people, then there’s a UK helpline you can try: 080 8808 8141 or visit their website.