John was a resident on a long-stay mental health ward when he was assaulted by another service user, who had a history of unpredictable violence towards other service users when unwell.
Though staff at the setting raised a safeguarding concern, which resulted in recommended measures, John reported that he continued to feel unsafe. He asked for an advocate to support him as he felt that the measures recommended weren’t being upheld. He was referred to our Independent Mental Health Advocate (IMHA), Deniz.
Deniz met with John on his ward, and soon noticed there were no staff members present on the floor where he stayed, which had been one of the safeguarding recommendations. She also saw that when John was in the day area trying to get food, the service user who had previously assaulted him was standing very close by and making John visibly uncomfortable.
John felt let down and dissatisfied by the safeguarding process. He felt that formalities had been carried out, but nothing actually put into practice to keep him safe and no further follow-up to check that he was happy with any suggested measures. There was no-one he felt that he could talk to about how the safeguarding plan had been implemented other than Deniz, and he felt frustrated and angry about the situation.
Deniz built a positive rapport with John and took a rights-based approach; this aims to empower people to know and claim their rights and increases the ability and accountability of individuals and institutions responsible for respecting, protecting and fulfilling these rights.
Deniz talked with John about his concerns and how they could work together to develop his confidence to self-advocate and what was needed for him to feel heard. Deniz told John she would speak to staff on his behalf about the initial safeguarding concern and share that he felt there was risk of another incident in which one or both service users might be at risk of harm.
Although there was a plan in place to support John, staff admitted to Deniz that two recommendations – reporting the assault to police and having extra staff on the ward – hadn’t yet happened. Deniz asked staff to express to John what was in place and a timeline for next steps and what this meant practically for him. She also reminded staff that there were different ways to communicate which could help John understand his options and not to fall back on abstract and unnecessarily formal language.
John told Deniz he wanted to get in touch with his social worker and speak to her about the situation as he had a good relationship with her and felt she could support him to move forward. He also wanted to raise an informal complaint. Deniz was able to help with both of these requests and empower John to feel more in control of his future care.
Together with Deniz, John was able to bring about a number of positive outcomes. Staff made sure that the two measures that had not been implemented were put in place, as well as ensuring that John had a daily one-to-one with a staff member in order that he could express any anxieties with an opportunity to resolve these quickly. The other service user was also moved to another ward which also suited his needs better.
Through his positive experience with Deniz and feeling heard and understood, John’s confidence to speak to other professionals grew. He understood his rights and what the staff’s responsibilities were towards him. He felt more able to speak up when he didn’t think that due processes were being followed and able to raise concerns quickly. Communication between John and staff improved and they were able to see that his anger was often an expression of feeling unsafe. At the end of his time with Deniz, John said that he had begun to feel safe again and empowered by the advocacy process.