The issue of closed cultures within health and care services has gained significant attention due to the potential harm and human rights breaches they can cause. At AACA (Advanced Adult Care Assessments), we recognise the importance of actively addressing and preventing closed cultures. This article outlines our commitment to this cause and the measures we take to ensure individuals’ safety, dignity, and well-being within the services we engage with.
Understanding Closed Cultures
A closed culture refers to a poor environment that elevates the risk of harm, including abuse and human rights violations. These cultures can develop intentionally or unintentionally, posing significant risks to individuals and their families.
Identifying Risk Factors
Closed cultures are more likely to emerge where individuals are isolated from their communities, have extended stays, experience weak leadership, lack skilled staff, or face communication barriers. Recognising these risk factors is crucial for proactive intervention.
Our Approach to Closed Cultures
To foster a culture that actively addresses and prevents closed cultures in social care, it is crucial to undertake several key actions.
- Encourage and actively support transparency within the organisation, ensuring that staff are well-versed in the guidance provided by the Care Quality Commission (CQC) and the Association of Directors of Adult Social Services (ADASS) checklist.
- Engage with staff through various channels, such as team meetings, supervision, and mentoring, to promote open discussions. Senior leaders are pivotal in setting the tone and acting as role models for the desired culture.
- Take proactive steps to protect against the risk of human rights breaches and develop comprehensive plans.
- Implement trauma-informed approaches, recognising the increased likelihood of past abuse and sexual assault.
- Recognise the importance of perceiving the distress communicated behind challenging behaviours exhibited by the staff. This multifaceted approach contributes to a comprehensive strategy for combatting closed cultures and promotes a culture of openness, respect, and safeguarding.
Focus on Human Rights
Our commitment involves embedding human rights principles in our fundamental standards. We aim to improve our ability to hear and act on concerns raised by individuals within closed cultures.
Collecting and Using intelligence
AACA emphasises the gathering and utilisation of intelligence to enhance our understanding of risks associated with closed cultures. This information informs our inspection activities and strengthens our advocacy for systemic changes.
Examples of Potential Breaches
We outline scenarios where closed cultures may lead to breaches of crucial equality requirements and human rights articles. This outline includes liberty, privacy, dignity, and the freedom to live.
Signs of a Closed Culture
Recognising inherent risk factors and warning signs is crucial. We’re dedicated to monitoring services closely, identifying indicators, and taking necessary action when symptoms of closed cultures emerge.
Identifying a Closed Culture
AACA employs an intelligence-led monitoring approach. This involves thoroughly reviewing service applications, undertaking intelligence assessments, and conducting tailored inspection activities to understand the care environment comprehensively.
Warning signs identified by CQC include:
- Staff do not see people as equals
- People who are visited less often
- People are a long way from their communities
- People stay for months or years at a time
- People are unable to speak up for themselves
- Weak relationships between families and staff
- Staff do not take family concerns seriously
- Weak management and supervision
- Staff lack the right skills, training or experience to support people
Partnering with Local Authorities to Act
When concerns about closed cultures arise, AACA takes swift action. This includes setting clear expectations for professionals to address problems within specified timeframes. In cases of harmful practice, safeguarding measures are initiated swiftly.
Our Panel Managers are in consistent direct contact with our ISWs. We work to encourage open communication so that professionals relay concerns promptly. Plus, with our offer of ongoing training and expert panel, the ISWs we work with know the importance of closed culture, the warning signs, and the following steps to take.
Supporting Local Authorities
AACA’s commitment to combating closed cultures reflects our dedication to ensuring the highest standards of care. By actively engaging with regulatory frameworks, prioritising human rights, and swiftly addressing concerns, we contribute to a safer and more inclusive social care landscape.
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