Firm but respectful boundaries for complex people and assumptions that statutory services know best?

15 March 2016

I visited 8 services last week; I would have hit my target of 10 but had to turn back when I came across a huge traffic jam. I travel 40,000 miles a year around CMG so traffic jams are part of my daily working life, particularly on the good old M25. Two of the services I visited were at Alderwood and I was once again extremely impressed with the way that they support some very complex and challenging people. I met a very strong young man with Autism who gave me a bone crushing handshake. I could tell if he had a difficult day, it would be very challenging, but the staff who supported him were very confident and got the right balance between being respectful and being firm with boundaries when needed. I think it is the high level of structure that Alderwood provide that means that they are able to support some of the most challenging people in the country. Their team has kindly agreed to help us to further develop the structure that we provide in our services for people with Autism.

Talking about challenging behaviour, I sat in with our positive behaviour support (PBS) team last week, seeing what they do. I was very impressed with their knowledge, skills and professionalism. They work with our staff teams both training staff and helping to develop PBS plans, based on the thorough understanding of individual’s challenging behaviour. I have worked in this sector for over 30 years and I have to say, the people who work in our Clinical Team are every bit as knowledgeable and skilled as their opposite numbers in the NHS. The reason I mention this is that there is an assumption in our sector that statutory services know best. I was struck that when I came to CMG from the NHS how differently I was treated, with the assumption being, as I worked in the independent sector, I was probably just in it for the money and didn’t have much of a clue. I remember a number of years ago being lectured by a Local Authority team manager in rather patronising terms about what the Mental Health Act involved and had to explain to her that in my previous job I’d been responsible for managing mental health services covering a population of nearly 2 million people. I think this is important because we still come across a ‘master and servant’ relationship between Local Authorities in particular and provider organisations which I don’t think is particularly helpful. Before Christmas, we had a safeguarding issue in one of our services and I was instructed by the Local Authority to attend a safeguarding meeting. I wouldn’t dream of instructing a Local Authority Chief Executive to attend a meeting; perhaps I’m missing a trick?

Congratulations to the staff team at Oakdale Road who received a ‘good’ rated CQC report last week, which was good on all 5 areas. Congratulations also to the Trafalgar House team who have successfully challenged a CQC report rating them as ‘requires improvement’; they have now been re-rated as ‘good’.

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