"Everybody Counts or Nobody Counts"

 

The titular “Wee Room” is a safe haven at the bottom of our garden where friends gather, music is played, books are read and ideas flow. It certainly saved my sanity during lockdown, it was a place I could go, watch the birds, be close to nature and to just be.

“Everybody Counts or Nobody Counts”

 

Some of you may recognise the mantra of one of my favourite fictional cops, Harry Bosch. Created by author Michael Connolly, this is the value base that guides the actions, judgements, successes, and failings of the character.

It is also a phrase I would dearly have loved to have coined, because it has such resonance for me in the professional space in which I operate.

It speaks to the inherent inequalities so many people face because of the perception of value we, as a society, place on them. This has never been so evident as in the current crisis that is being faced in social care.

To a large extent, we have been incubating this situation for years. Under investment, a prevailing narrative that care work is unskilled and, the undervaluing across society of disabled and other marginalised groups.

Add to this a delivery system of social care that is riddled with thresholds, criteria and assessments made by people who have no time to get to know you, understand you or listen to your own assessment of your needs.

In my experience, individuals and families ask for very little, however they do, generally, know what they need, why they need it and when they need it. I also see how quickly things escalate and situations deteriorate when the most basic of needs are not met such as a break from caring, access to education, support with domestic tasks or someone to check in with, to combat loneliness or seek reassurance. Of course, some support needs are more significant and, dare I say it, expensive than others but, the price of not providing them, I would hazard, is, in just about all cases, so much more costly in human and financial terms.

So why can’t we get our act together and make the changes needed?

I am speculating here, but I like to think of it as reasonably informed speculation albeit there are a few sweeping generalisations or perhaps more observations. There is no need to agree with me re the root causes, but I sincerely hope you see the problem.

We seem, as a society, to be so disparaging and distrustful of people who have needs. Particularly needs that require to be met by the state. There is however quite an interesting paradox in that, as a country, we raise millions for “Children in Need” yet we often don’t want to confront the reality of that need, or, indeed, the fact that those children grow up to be adults whose needs don’t magically vanish and in many cases deepen due to repeated trauma.

Whilst working as a social care practitioner, I regularly witnessed the discomfort of people when they encountered deaf/blind individuals in cafes and shops. Often alarmed by vocalisations or finding a reason to move tables, somehow offended by the way someone ate their ice cream.

Too often, we value people for what they have and what they do rather than who they are. The idea that someone’s inherent worth can just be because they share the planet with us, is, I feel becoming increasingly lost. Instagram, filters, Tick Tock, makes us feel like we all need to bring something to the party. Maybe an age thing but it all feels very superficial.

The most concerning indication of how autistic people and others are undervalued, is the repeated abuse scandals that occur in regulated care and health settings. The monotonous cycle of scandal, investigation, recommendations, repeat, suggests that in these settings, nobody counts. Nobody that is who is the recipient of these services. These models of “care” appear to be a breeding ground for the othering and dehumaising of some of the most vulnerable people in our society. Culture, leadership, as well as the total misconception of the role of support staff in people’s lives are among, what are doubtless, many factors that are at play.

There should be no place in social care for control, coercion and cruelty, yet, we see it on an alarming basis. Paradigms that suggest autistic people are somehow broken and require fixing, reinforce othering as well as power dynamics. The current recruitment crisis is likely to be aiding and abetting this race to the bottom in terms of providers commissioned to deliver services. Organisations that have repeatedly been flagged for poor and unacceptable practice continue to operate and, in too many cases, profit from the misery of people who have very little to no say in where they are placed.

Caring professions are undervalued. Perhaps this is because nurturing and supporting others are seen as fundamentally human qualities that we all have. However, delivering quality care is sophisticated and requires a range and depth of skills that require to be learned. You need values and attributes that enable you to do the right thing even when you are faced with highly stressed and dysregulated individuals. Yet at the heart of it, if people treated those they support in the way they or those they love would want to be treated, perhaps we could get to a place where everybody counts.

One thing is certain, no amount of reports and recommendations are going to change a system that is so fundamentally broken. Tinkering at the edges won’t cut it. Leadership, investment and recognising that unless everybody counts, then nobody counts including you, your loved ones and everyone you hold dear.

Let’s all be more Bosch.