Friday, 20 April 2012

Being Gay is Wicked: Language, Leadership & Social Care

"Being Gay is Wicked”

What does that phrase mean? Fifty or sixty years ago it would mean “being happy is sinful” today it would mean “being in a same sex relationship is a really good thing”.

What this illustrates is that the language we use can change meaning quite drastically is a relatively short period of time and while the example above is quite extreme in nature more subtle changes exist that impact on our understanding of everyday things and social care is not immune to this.

Take, for example, the discourse of institutions. The current social care system was created out of a  desire  to get people out of institutions, at that point institutes were the large, impersonal, usually Victorian, buildings that held people with learning disabilities or age related conditions that impacted capacity. These places were notorious for their lack of privacy, dignity and respect where people were treated as objects of pity rather than as individuals with their own personalities, preferences and rights. The people incarcerated in these institutions had no control over their lives, no chances to participate in how their lives were being run and little opportunity for any decision making.

It is no wonder then that the term ‘institution’ developed an extremely negative meaning.

The answer was, of course, to close these institutions and develop smaller care homes for the elderly and frail and those more severely disabled whilst promoting care in the community for the more able.

Yet, just a few decades on, the term ‘institution’ is used to describe those care homes which grew up out of the  desire  to rid the country of those old institutions!

Because of that, and the negative connotations of the word, care homes are seen by the public at large as bad places where the practices of old institutions still take place. Obviously there are bad care homes where institutional practices still take place but, in general, care homes have considerably improved the level of care from the dark days of the institutions.

The principle reasons for painting care homes as bad places is to promote the agenda of more community care and this is a perfectly normal way we operate in language. If we want to show that something is better we contrast it with something that is not as good but there are implications in doing this with social care.

For many there is no alternative to living in a care home. Those with advanced dementia, for example, may need the 24 hour care and support that their families (if they have one) are no longer able to provide. Some, with severe and profound learning disabilities, may benefit from the community setting of a care home rather than the potential isolation of living alone and for other elderly people a care home setting may free them from loneliness.

The negative image of care homes also impacts on the hundreds of thousands of care workers in the country, the majority of who deliver the best possible care they can. Being associated with the impersonal, autocratic staff of the old institutions is hardly a basis for improving moral in the sector!

This is where effective leadership across social care is so important.

To promote social care and to raise the standards those who lead must  present a positive image  of the sector. Being positive does not mean ignoring the deficits and problems of care homes nor does it mean painting a false picture.

Truth and honesty are important traits in leadership as they generate trust as does a recognition that things are not as good as they could be. But the important things is that those deficits are accompanied by visions and goals to show a way to correct those deficits in an achievable way.

Leadership is also about working with what you have got. So there has to be a recognition in social care that care homes are a part of the system, there also has to be a recognition that care homes have changed dramatically over the last few years. The average age of entering a care home has risen and, more often than not, care homes are the final stage of the care process when home care is no longer appropriate for the safety of the individual.

Leadership is about using language that is positive but honest and realising that using stereotypical labels may do more harm than good.