Safe to be Free

Dementia Care
June 9, 2017

With the recent attacks on London and Manchester, how do we strike a balance of safety and liberty in Health and Social Care?

The tragic and senseless attacks in Manchester and London over the last two weeks does not require a pithy response. I have thought hard about what I could say today, and my mind always goes back to safety, liberty and choice.

Anxious Times

I was going to say since 9-11 we have faced anxious times, but that is not the case. I clearly remember as a teenager working at a department store – a familiar message ringing over the tannoy ‘TIME CHECK IN ALL DEPARTMENTS’. Oh goodness! I swiftly moved around Haberdashery. Checking behind ribbons and bobbins and wool. I remember thinking even then, ‘if you are worried there is a bomb… is it the brightest thing to get the staff to check for it?!’ But we did. Reasonably regularly, and maybe that is where my caution grew into anxiety.

One word

There is one word that must be weighed against my fears, and that is LIBERTY. That balance to shutting ourselves away and never fully experiencing life.

Interview of hope

I interviewed a Manager once who told me how residents with dementia were able to leave the residential home and sometimes walked for quite a bit on their own. How this was monitored and they were safely chaperoned from a distance – my heart leapt and I was uncomfortable. My safety had gone into overdrive. But their system worked and residents had freedom and were kept safe. Useful examples can be found in CQC’s Monitoring the use of the Mental Health Act

Swinging pendulum

There is a balance of safety and choice. Too often I have seen the pendulum swing at both ends and neither is the right thing for individuals.  I read an advertisement by a security company just the other day ‘Protect your residents…keep them in and others out.’

We must always do both.  We must keep people safe whilst they enjoy as much freedom as possible. Here are some top tips to assist you.

Top Tips

  • Ensure you have an effective system so that people sign in and out of the home – Yes this includes inspectors and other professionals – make sure people understand why this is important. Skills for Care’s Standard 13 ‘Health and Safety’ is an excellent source of information and learning to keep people safe from a variety of situations
  • Create welcoming garden spaces that residents can easily access – to help create a space they want to occupy
  • When visiting people at home – If you are being let in, make sure you identify yourself
  • Do not let people in you do not recognise or you are unsure about if they cannot give you the identification you require. Far better that people are safe than avoiding upsetting a professional’s feelings
  • Ensure you have an emergency procedures policy – Make sure your staff know what’s in it! Clear places for people to gather away from danger, and ensure staff know who they are supporting in those situations
  • Have a think about your business continuity plan, have you tested it, what will happen if you need to evacuate the home?
  • Ensure if it is a residential setting the accommodation is clearly signposted and lit
  • Remember – The least restrictive solution is key in Mental Capacity and Depriving an individual of their Liberty needs a Deprivation of Liberties Order. Helpful information can be found here on the SCIE website with further links
  • Ensure your lone working policy is being used, and emergency contact details are up to date for all staff.
  • Managers – know what you need to notify CQC and other regulators regarding.

Many of you will be affected by recent events, we can react in all sorts of ways, but at all times we must remember we stand for person-centred care that allows people safety and the freedom to live their lives.

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Abi Spence

Registration and Inspection Specialist


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