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GUEST COLUMN: Delivering outstanding care to LGBT+ service users

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To mark Pride Month, QCS looks at discrimination faced by some LGBT+ service users and explains what care providers need to do to nip it in the bud.

If asked to sum up the social care sector in three words, what would you say?  In light of the heroic qualities demonstrated in the pandemic, perhaps you’d opt for ‘passion’, ‘dedication’ and ‘courage’? Or maybe you’d choose words that summarise the plight of the sector? Perhaps therefore you’d plump for ‘highly skilled’, ‘hard-working’ and ‘under-appreciated’. While all of these observations would be correct, the three words, ‘person-centred care’, define the culture, spirit and very essence of the sector. It is this ethos that separates social care and healthcare from other sectors. Anyone listening to the testimonies of severely ill COVID-19 patients, who owe their lives to dedicated ICU staff or care professionals, knows that. Both social care and healthcare systems are dedicated to not only curing but caring holistically for the whole person within a culture that respects human rights, promotes equality and tackles discrimination.

That said, not all service users experience a culture of outstanding person centred care. Take the LGBT+ community for instance. In 2019, a review carried out by the Women and Equalities Committee found that “LGBT people… tend to receive lower levels of care than non-LGBT people”. The study also revealed there was “not enough understanding from service providers of the different needs that LGBT people might have”. Finally, the Committee found that “too few health and social care providers are actively thinking about LGBT people when they plan their services” and also that “senior leaders are not doing enough to ensure that LGBT inclusion is hardwired into commissioning strategies”.

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While the findings of the Women and Equalities Committee were quite damning, here, at QCS, we are in contact with over 5,000 providers, and anecdotally at least, we can say that the vast majority have well-developed diversity and equality policies in place which have been deeply ingrained in their working culture. Secondly, ensuring that the LGBT+ community receives the same person-centred care as everybody else, has been a primary focus of the CQC for many years now. In the CQC’s Equality Objectives for 2019-2021, for instance, addressing this issue is its primary objective.

Why do issues still remain?

So, if the majority of providers and the regulator are making positive steps to ensure that minority groups get the person-centred care they deserve, why is there still an issue?

In the Equality Objectives report, the CQC points to another study by Skills for Care, which says that it is “a lack of knowledge and confidence” rather than “conscious discrimination” which seems to be the most pressing issue.

If this is the case, then what can providers do to fix the problem? The solution lies in leadership. If Registered Managers possess the requisite knowledge, skills and training, then they can pass that knowledge on to staff who deliver frontline care.

It is vital too that the CQC ensures inspectors have the same level of training, as they need to ensure that service users – whatever their sexual orientation – receive the same high levels of care.

But, what does delivering outstanding care to LGBT+ service users look like? At QCS, the UK’s leading provider of content, guidance and standards for the social care sector, we have created several policies, which are centred on promoting equality and human rights in care services.

Challenging subconscious bias

Moving forward, we all have a responsibility to challenge subconscious bias. That is not to say that everyone needs to challenge their thinking. Secondly, there’s a gulf in understanding, which grows ever wider. Even some of the most forward-thinking people struggle to keep up with gender identity and fluidity that is very much part of our society today.

Take gender identity, for example. It’s very disturbing to think that in a libertarian society like ours, the practice of conversion therapy – which ‘the Memorandum of Understanding on Conversion Therapy in the UK’ defines “as the attempt to change someone’s sexual orientation or gender identity” – is still legal*.

There also seems to be a dearth of education and awareness programmes around gender identity. It’s absolutely vital that, in a person-centred industry like the care sector, great strides are made – not just to understand the gender identity debate, but to play a significant role in embracing it.

Not everyone in the LGBT+ community, for example, wishes to be referred to as ‘he’ or ‘she’. Some prefer ‘they’.  At the very least, inspectors, Registered Managers and care workers must recognise a service user’s right to insist they are addressed using a non-gender specific pronoun. After all, that is a basic human right and a person’s freedom of choice should always be respected. Sometimes, however, it’s not an unwillingness to embrace gender neutrality that holds care workers back, but simply a lack of understanding.

We, as a sector, should not be afraid to ask questions

It’s a subject that our colleague Danielle, our Customer Experience Manager, has written about recently. In her blog, she made the extremely valid point that it’s okay not to know or be aware of the different phraseology. Instead, Danielle recommends that Managers and staff, who may be unfamiliar with the terms, simply ask questions. Doing so, is the best way to break down barriers and this approach also provides care professionals with a firm platform to deliver the LGBT+ community with the most outstanding care possible.

From there, the knowledge that a Manager has accrued can filter down to the staff through training, group supervision and one-to-one supervision. Moreover, the knowledge acquired can also be put to good use when assessing care plans and creating surveys for staff, service users and their loved ones. These surveys provide both a litmus test of progress and a catalyst for change.

Adapting to generational change

But this debate also extends beyond the realms of gender, identity and sexual orientation. While it is undoubtedly an important part of the narrative, the bigger picture is adapting to profound generational change. It is change that has been talked about for some time.

However, with people living much longer now than they did 30 years ago, the cultural divide between the young, the middle aged and the elderly has become much more pronounced, nuanced and complex too.

There’s a quote that sums this idea up neatly: “The baby boomers who grew up listening to the Rolling Stones” it says, “won’t want to play bingo in their care homes”. This may conjure up a blithe, rebellious and comical picture of baby boomers mimicking Mick Jagger rather than engaging in the more sedentary pursuit of bingo. However, it also conveys a much more serious message. This provides us all with a reminder of the need to continually keep asking ourselves whether the environment, the culture and the laws respect the human rights of every single person who uses care services. If we ignore the question, we’re in danger of losing the one thing that truly defines and differentiates our sector from others. That is person-centred care. On Pride Month, more than any other time, this is something that we should value, celebrate and cherish, not to mention continually strive to improve.

If you wish to find out more about QCS, why not contact QCS’s compliance advisors on 0333-405-3333 or email sales@qcs.co.uk?

*A ban on Conversion Therapy was announced in the Queen’s Speech, but not before a consultation takes place.

Tags : Best practiceLGBTQCS
Sam Lewis

The author Sam Lewis