Closed cultures: how advocates can avoid being ​‘part of the problem’

Winterbourne View, Whorlton Hall and too many other familiar names are examples of closed cultures. In these environments, poor practice and toxic behaviour are allowed to become standard, with appalling consequences for the people subjected to abuse.

Advocates can and should be a powerful tool to challenge these cultures and uphold the rights of those at risk from them.

However, the Care Quality Commission’s Out of Sight report acknowledged that advocacy provision is sometimes of poor quality, with advocates failing in their duty to independently represent the person they support. Advocates are at risk of becoming part of the closed culture of abuse themselves.

At VoiceAbility, we’re working to ensure that advocates receive training on the risks to their own practice from working in a closed culture. 

Some of these risks may be as simple as having a regular office space within a hospital, or working as the sole advocate in a setting alongside other health and care professionals. When advocates begin to see themselves as part of a hospital staff team, their practice can change to meet what professionals expect from their other colleagues – and their independence is lost.

We also support teams to foster open cultures in their practice. All advocates are encouraged and supported to reflect critically on their role. Regular supervision takes places alongside opportunities to discuss their experiences both with their local team, and with colleagues across the whole organisation. Shadowing and buddying helps share best practice to new advocates and lone workers. Even actions a simple as wearing a VoiceAbility lanyard or visiting unannounced can make a difference.

Advocacy will never be the sole solution to care failures such Whorlton Hall. But we have a responsibility to those living within closed cultures to be part of that solution.