The CQC and Embarrassing Toilet Incidents

So the Care Quality Commission (CQC) is once again left feeling like the bloke who leaves a giant stool in his in-laws loo just as the flush stops working. They’re not just flapping around in a panic with their trousers around their ankles. They’re tripping over, hitting their head on the bath and suffering the acute embarrassment of the in-laws calling the ambulance out. 

I’d seen the trailers for last night’s Panorama so knew what to expect. Fiona Phillips flashing her Jimmy Choo’s as the celebrity face of Alzheimer’s and doing a bit of crying. Sorry Fiona, perhaps a little harsh but I do have issues with slebs doing ‘issues’. That’s for another blog.

It was of course revolting television and very hard to watch, even when forewarned is forearmed. The online world is rampant with a thousand calls for action, more respect for elderly people, and Telegraph readers demanding instant dismissal of all care home staff not carrying a Surrey passport. 

But while it’s good and right to howl loudly from the rooftops, we also need to take a step back and ask how we as a society put a stop to this. It would be lovely to think that the extended family will take over when Grandad starts leaving the gas ring on and tries to make toast with a chocolate digestive.

But the nuclear family is long gone in this corner of the world, and those care industry shareholders won’t be giving up their yachts and racehorses anytime soon. So for now at least we’re left with bodies like the CQC and our Safeguarding Panels to protect vulnerable people from the living nightmares we seem to be seeing and reading about every other day.

Still emerging battered and bruised from the ashes of Winterborne View, the CQC now have their old friends Panorama to thank for yet another death by spycam. They didn’t emerge with a lot of credit last night. It would be all too easy to point the finger and join in with a bit of quango-bashing, but in fact I come to praise Caesar, not to stick a knife in his guts.

They have the unenviable task of inspecting just about anywhere in the country that has a roof, paid staff and vulnerable people sitting indoors. They deserve to be cut some slack for that at least, but what concerned me last night was the sheer panic in the face of what was bound to be another incendiary device going ‘BANG!’ in the face of a horrified public.

They declined to appear on camera with Fiona Phillips. Now Fi is hardly Jeremy Paxman in a designer two-piece so why the reluctance? Our national care inspectorate reduced at once to the status of dodgy car dealer chased around by that bald bloke in a parka who makes shows about dodgy car dealers. 

But perhaps with the benefit of past experience, their ‘Panorama Statement’ was robust, reasonable and said all that needed to be said. A media-trained representative could and should have offered that content to the Panorama cameras. More dignity, more transparency, and much less cowboy builder.  

And then there was their slightly embarrassing Twitter campaign emerging almost as soon as the credits were rolling. Their output of Tweets is normally so rare I’d forgotten I even follow them, but last night? A slightly embarrassing flurry of ‘It Wasn’t Me Guv’ postings, and a link to their most recent report on Ash Court

To paraphrase the report: “Ash Court is lovely. I’d send my Gran there.” It contained enough typos to suggest the authorship of a chimp with a bad caffeine habit. Unprofessional, but let’s put that down to the inspector’s report-writing fatigue and almost certain overwork. More importantly, why the apparent whitewash? Well there is that notorious tendency of care homes to get the decorators in as soon as they have a whiff of an ‘unannounced’ inspection, and would we really expect care staff to be stood in front of a clipboard-wielding inspector abusing a frail, elderly woman while chatting away in Spanish and watching Corrie? You can’t punish what you can’t see. 

I don’t write public statements for the CQC or for anyone else other than myself and my business. But I might have asked this of those who will invariably point the finger at the inspoectors: “Did anyone from the CQC actually abuse vulnerable people at Winterbourne View or Ash Court? No. Did anyone at CQC have anything to do with building 60-bed three-tier monstrosities which are more about battery farming than any semblance of residential care? No.”

Their management of the latest care industry furore was undoubtedly poor and unnecessarily defensive. They need to learn lessons. They almost certainly need more inspectors on the ground, and less twonks in suits. But there’s a whole heap of reasons why we’ll keep on hearing, reading and seeing these horrors, and the answers won’t come anytime soon. So for now we need a care inspectorate thrusting it’s face into dark corners shouting “Oi! You!” and not running around panicking over an obstinate plop.

If you can’t be bothered reading his profile, Connor Kinsella is Lead Trainer with JCK Training and writes about himself in the third-person. 

What is Narcissism?

Most of us know that describing ourselves as ‘narcissistic’ isn’t a good thing to put on a job application, and definitely isn’t a selling point on But what does the term actually mean, and how does it manifest (in it’s most extreme flavours) as a psychiatric disorder?

Narcissus is a character from Greek mythology. He was the son of a God and Goddess and were he around today would no doubt be described by Beliebers and the like as as ‘totes buff’. But Narcissus was only too well aware of his own buffness and rejected numerous come-ons from lots of water nymphs and other mythological characters. Why? Because none of the boys, girls or hermaphrodites (this is Ancient Greece after all) who fancied him were deemed by Narcissus to be anywhere near good enough for him.

To cut a long story short, Narcissus caught sight of himself in a pool and fell in love with his own reflection. Which wouldn’t have been too bad if he hadn’t become so obsessed with his gorgeousness that he couldn’t prise himself away from his own image long enough to get a bite of whatever they ate in Ancient Greece, and eventually died of starvation.

You’re probably thinking of more modern analogues of this mythical tale, but we don’t need celebrities to recognise the clinical reality of being smitten by one’s own self-esteem. A person diagnosed with Narcissistic Personality Disorder (NPD) might be thought of as pathologically self-obsessed, vain and arrogant to the point that they really are very difficult people to warm to. They are, like their namesake, so ‘in love’ with themselves they reject the attentions of others as being little more than an irrelevance. But they may just tolerate people who can a) achieve objectives for themselves such as the confirmation of their wonderfulness, or b) are of such high status that they are actually seen as almost being good enough to be in the same room, and c) may provide the narcissist with material resources and family associations to confirm their exalted sense of self-worth.

This is often a person who, to anyone else but themselves, is actually a rather strange, unlikeable person who tells very tall tales to confirm their own inflated opinion of themselves – in fact, some of us sometimes refer to NPD as ‘Walter Mitty Syndrome’.

I once worked with a colleague who would tell anyone that would listen (a rapidly diminishing number, surprise surprise) about his previous exploits of derring-do as a member of the SAS. Now anyone who knew this chap would immediately know that this and his many other stories were patently ludicrous, but he not only told these obvious lies with great and even entertaining conviction but even seemed to actually believe them himself. This is very typically narcissistic. The last time I saw him he (a mental health nurse) was being arrested at work for a serious assault on his wife, and much to the relief of his former colleagues was never seen again.

In extreme circumstances, NPD erupts in crime or extreme violence, usually as a means of perpetuating a lie or a self-belief.  The Brian Blackwell case is an example of where narcissism becomes more than just irritating and unlikeable, but a potentially sinister and dangerous psychiatric disorder. The Theresa Riggi murders are another example about which I have previously blogged and edited for the #mhchat Narcissism Twitter debate. Fortunately most of will never meet a Brian Blackwell or Theresa Riggi, but may certainly know someone who spends an awfully long time staring at their reflection and being very (ahem) wonderful.

We Need to Talk about Derek

Mrs Kinsella looked at me quizzically. “But you absolutely loathe Ricky Gervais” she observed, very accurately as always. For  Derek was to be (as the C4 PR people would have us believe) thirty minutes of Gervais taking the piss out of the learning disabled.

For a social care blogger this was vitriol central, especially for one who always suspected The Office DVD box set was mainly bought as a Christmas present for ‘smart’ people pretending to be huge fans but who, if the truth be told, would have rather unwrapped  a JML Nasal Hair Trimmer.

Tuning in to Derek last night was for me a little like watching non-league football. Guaranteed disappointment, guaranteed moaning, guaranteed catharsis. The difference being non-league football is usually funnier.

I watched the first 10 minutes with a set of blades and a knife sharpener, smugly tweeting ‘Verdict so far. About as funny as Ricky Gervais’. But I clung on. Only because I felt I had to and certainly not because the opening scenes (involving a dodgy haircut, comedy custard and a fall into a pond) were exactly rocking my world of laughter.

But by the time the titles were rolling I found myself deeply disappointed. I had to put my knives away. I actually bloody liked it. Had I finally ‘got’ something by Ricky Gervais?

And it made me ask two questions. First up. Just how often do we see either care of the elderly or the learning disabled feature in any sort of TV drama, let alone one created by a bloke who hosts Oscar ceremonies? Almost never, so a doffing of the hat for that alone.

And for the second big question. Was Gervais taking the piss? Well I for one didn’t think so.

It’s easy to understand why many would take offence, especially those of us with personal or professional ties to the subject. In an excellent interview with disability-rights campaigner Nicky Clarke, Gervais is guarded about whether or not Derek is meant to have a learning disability. But few who have worked or lived with a ‘Derek’ would have failed to pick up the cues.

To the uninitiated our anti-hero is a scruffy, greasy haired, socially awkward oddball. Surely he’s living in some sort of supported accommodation and working at Remploy (ahem) sticking labels on coffee jars? Well, no. He shares a flat with a friend, goes for post-work beers with a female colleague (the ‘Glasgow Kiss’ scene was deeply satisfying) and he works in an elderly care home. 

For me at least this was a sharply and well researched study of those of us who don’t spend hours being acerbic and witty on Twitter, who don’t give a monkey’s toss about the politics of anti-disablism, but who can be refreshingly honest (and funny) about the stuff many of us would rather not discuss. And while he might may not care a fig about the latest in SuperDry casual wear or snappy Hoxton haircuts, he does care deeply about other human beings. Give me a Derek over a MENSA membership any day.

Call me old fashioned but if a TV show looks like a comedy, sounds like a comedy and your PR people say it’s a comedy, then it should be a comedy. But putting that to one side, when Kerry Katona’s pubic topiary provides a cultural highlight I for one can only applaud original drama starring positive portrayals of the vulnerable, the awkward and the uncool. 

Talking Out of One’s Arse: The News Media and Armchair Psychology

Daniel Bartlam was yesterday sentenced to life imprisonment for killing his mother. Apparently inspired by screen violence in the guise of horror movies and TV soap storylines, he’s inevitably been dubbed the ‘Coronation Street Killer’ and provoked the now customary howl of online indignation. So far, so predictable. But along with the indignation has come a digital tidal wave of armchair diagnosis. The cod psychology inspired by this case features ‘inner worlds’, ‘trauma’,  the effect of pre-watershed television violence and, most alarmingly, the possibility of child abuse as a mitigating factor. But one feature all these armchair theories have in common is the almost complete lack of history, evidence or narrative around either Bartlam or the offence itself.

Shortly after the sentencing of Bartlam, The Guardian’s Comment is Free section ran an article titled Why Children Kill Parents. Accompanying the piece was the now familiar and rather haunting photograph of Daniel Bartlam. Philippa Perry, the writer of the piece, is a psychotherapist and author of a book called Couch Fiction.  She apparently specialises in work with adult survivors of childhood abuse. If she had any specific experience working with violent young people, or even ‘children who kill parents’, it didn’t appear on her author profile. At the time the piece was first published* her profile also mentioned that she was married to well-known artist Grayson Perry.

I was puzzled from the start. If The Guardian wanted a companion piece and online discussion around the Bartlam case why not find someone from the world of forensic child and adolescent psychology? And what was the relevance of the author’s marital status? This seemed the editorial equivalent of asking me to write a ‘pop-science’ piece on quantum mechanics because I use a mobile phone, or inviting Frank Lampard’s ex-girlfriend onto Strictly Come Dancing because well, she used to be Frank Lampard’s girlfriend.

To her credit the author made no attempt to ‘diagnose’ Bartlam, and presumably did her best to quickly bang out a few hundred words at the request of The Guardian’s CiF editor. She more or less stuck to her area of expertise which is helping adults who’ve been abused. But is that telling us anything about ‘Why Children Kill their Parents’? And more pertinently, did the author have anything to say about a case where there is absolutely no reported evidence of abuse as an explanatory factor?

No, of course not.

But what alarmed me even more than the article itself was the swarm of armchair psychologists, usually hiding behind silly avatars and even sillier acronyms, gathered online to spout thousands of words on everything from John Bowlby’s Attachment Theory to how the victim should never have bought her son an iMac. In keeping with the article itself, abuse was a constant theme from our cohort of keyboard shrinks despite no evidence whatsoever that this was in any way connected to the case.

At this moment in time nobody but those closely involved with the Bartlam case knows anything about this boy nor the circumstances of the offence beyond the bits and scraps reported by the news outlets.

For the online media (of which The Guardian is only one example) to be spreading and encouraging ill-informed or completely non-informed speculation as to how a 14-year old boy can become a hammer-wielding murderer is more than just pissing into a very strong wind. It is harming those personally involved in the case, harming our understanding of violent young people, and spreading even more ill-informed psychological rubbish than is already the case. 

And that’s a mighty big case.

*The Grayson Perry reference has now been removed from the author’s Guardian profile.