"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.
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