Safeguarding Adults Week: A role for advocacy in challenging unhealthy cultures
7 years after Panorama exposed the abuse at Winterbourne View, an almost exact repeat of the vicious, toxic, bullying culture that had grown unchecked over years was uncovered at Whorlton Hall. Whilst extreme and very public examples, these are sadly not isolated.
What the learning from abuse in settings such as Whorlton Hall has taught us is that there are often multiple signs that things are not okay for the people living there.
The Care Quality Commission have used the term ‘closed cultures’ to describe some factors within care settings that mean that abuse is more likely to happen. Identifying and responding to closed cultures: Guidance for CQC staff.
Understanding and being alert to potential signs and symptoms of abuse is of central importance to advocacy. An advocate may be the only independent person somebody sees on a regular basis. That advocates are trained to look beyond appearances and be alert to the possibilities of abuse that may be happening behind closed doors is paramount.
But to work preventatively we must also turn the critical eye inwards and be alert to the possibility that advocates and advocacy organisations themselves are at risk of becoming part of closed cultures. A finding from a CQC report ‘Out of sight - who cares?’ was that advocacy itself was often “poor quality” and “advocates were not always upholding people’s rights.”
To support the development of an open culture within our organisation, we have created our own organisational closed culture guidance with our Safeguarding Community of Practice.
Advocates often have a difficult and challenging role within care settings. They may be alone or one of only a few individuals working alongside many other health professionals. Advocates can be under pressure to adapt to a way of seeing that maintains an unhealthy status quo.
Becoming part of the solution and not the problem requires being able to stand firm by your own perceptions, your own experiences and most importantly the experiences of the person you represent. Even if this is against a tide of judgement and opinion that may flow in an opposite direction. It means believing and taking seriously everything we are told and never dismissing a safeguarding concern on the basis that the person we support is unwell or has a history of making ‘false’ allegations.
Our new guidance identifies those elements of advocacy practice which increase the risk of aspects of closed cultures developing, and what we must do about it. Working to challenge abuse and prevent it happening in the first place is part of the battle to create healthy, open cultures. Independent advocacy has a vital role to play in this.