Like everyone else involved with social care I watched Panorama (which showed hidden camera footage of abuse at a care home) the other night. I wanted to watch it live so I could time a couple of prepared tweets to pimp some new functionality on our BetterCareGuide web site, so I was also watching the #panorama twitter stream. I have been involved (albeit peripherally) in social care for many years and am no longer shocked by this sort of abuse. Saddened, perplexed, dismayed by my inability to find a quick fix – all of those, certainly. But as long as there are elderly or disabled people who need care, inequality (more of this later), cheap electronics and an audience, Panorama will have its regular care slot every 12-18 months.
So let's deal with the simple stuff:
This is massively outside my area of expertise (my Mastermind subject would be programming languages 1993-1996) but I think there are two fixes – one partial that can and should be implemented now, and one full, long term and almost certain (sadly) never to be implemented.
It is impossible - for the regulator, the management, service user relatives or anyone else apart from the service users (who are often not able to speak for themselves) and individual care workers – to fully monitor the way in which people are treated in their room in a residential home (and even harder in a domiciliary care setting). So the response should not be to throw more money at the problem, it should be to try to make monitoring unnecessary.
Make care workers feel like more than just cogs in the machine. I have long been in favour of stimulating the micro-provider end of the market simply because here care workers are closer to (or are) management. So management can more easily see how care is being delivered and care workers identify more with the business and its aims and ethos.
One of the problems with the care system in this country is that regulation and training are proportionately less of a burden for larger providers. In these businesses the distance between senior management and the coal face can be vast, both in terms of geography and levels of management. So you can end up with carers like we saw in Panorama – but you don't have to, and I have met senior managers who I think are doing the right thing to keep standards high in their organisations, but it is clear that the management of Forest Healthcare were not.
Safe in the knowledge that nobody on earth is going to read this far down, I can now get a little bit more controversial / speculative: Poor care exists in this country because of income inequality.
I just made this up, but I suspect there is something in it, and it isn't too big a jump from the research that has been done by Kate Pickett and Richard Wilkinson in The Spirit Level (or watch cute video introduction) to my unresearched guess. Perhaps they will include it as a case study in a sequel.
Last week the National Audit Office put out a document called "Implementing Transparency" part of which (8.2 - if you are interested) said that we need open data about social care “to support users in choosing how to spend personalised budgets”.
Tonight Panorama will give weight to that by showing that regulator data is sometimes a long way from current reality, whereas (as many a hotelier knows from TripAdvisor) data collected from the fickle public can mount up very quickly if something is wrong.
Open data is very important to me and I believe that transparency and openness in the long term increases performance and eventually open organisations will always benefit over those who hide their murky ill-doings. I also like playing with open data and this weekend I took part in Rewired State's National Hack the Government Day at the GDS offices in London. My hack (involving Met Office data) even won a prize, but my cup failed to completely run over as I never got to shake the hand of Mike Bracken who was meant to award the prizes (he didn't turn up).
Our comparison web site BetterCareGuide.org has a commitment to keeping its data open, but actually collecting data about social care providers is non trivial because:
Most of my time I spend dealing with open formats, open data or open source software.
The other day I was having a conversation with someone who works for a public body, funded by public money which prompted me to think about a more general culture of openness. They said that the organisation in question was 'very open' yet when I asked them how much of that public money had been spent on a particular project they were not happy to tell me - suggesting that if I really wanted to know I could find out though a freedom of information enquiry.
The Freedom of Information Act is a great tool for openness but that kind of misses the point. If openness is desirable (and the existence of the FOI tells us that government thinks that it is and I certainly believe that it is) then it needs to be baked in to the culture of the organisation and all employees should feel empowered (or even obliged) to respond to such questions.
As I see it there are five possible reasons why the person in question was not prepared to give me the information (which they admitted they knew). In ascending order of likeliness they are:
Adult social care technology expert, open source advocate, cyclist, parent, volunteer teacher, former (very easy) world record holder and reluctant blogger.