Blog - Enforced Self-Improvement

In my job we have to work towards "outcomes". That can include anything from "not losing your tenancy" to "learning how to cook". As long as it's on the supporting peoples' criteria, and it's something the client needs support for, it's arguably an outcome.

Something's been niggling at me though. And that is "What if the client doesn't want to?"

For instance, I have a few clients who are quite happy to go on as they are. They don't want anything to change. The problem with this is:

- they are funded for a specific number of support hours a week.

- these hours are for "meeting outcomes"

- we're not using these hours to "achieve outcomes"

And so it comes down to a few things

- I'm nagged by management to nag my clients to "improve their skills"

- I'm told that their care plan clearly states they need support in x y and z (although said client doesn't want it or...arguably...need it) which is why they are funded a certain amount of hours.

- I'm told that if they don't use the hours, they risk losing those hours, and even losing their home. (You see, companies who provide care and housing get more money from tenants who need a lot of hours of support. So bye bye to those who's hours drop. Another MASSIVE bug-bear of mine.)

But leaving aside the problem of losing their home (I think that's self evidently unethical, especially if they weren't told before their tenancy that this might happen) should we be nagging them to change?

Personally, I think that as long as they understand the repercussions of their decisions then the answer should be a resounding "NO". I hated that enough when I was a kid. And if I were told daily that my idea of a good life didn't fit the standards I was supposed to have, I'd kick off. Another example of discrimination? I think so.

And yet, part of my job is to nag indiscriminately. My guess is that it is partly to do with care companies worried about losing hours (therefore funding, therefore money), and partly because they are worried about losing their reputations as glorious providers of life-changing support. 

But nevertheless, I choose not to constantly ask my clients if, for instance, today is the day they will finally decide to cook something. And I don't think that should be frowned upon. 

~ Sally Forth