· 3 min read · Features

What happened to duty of care to the vulnerable?


It is high time for the government and HR managers to take a much harder line on recruitment in health and social care.

There is a sizeable minority of care workers who should never be allowed near vulnerable people, as highlighted by recent high profile cases of shoddy care at nursing homes and abused children. 

The problem stems from a risk-averse recruitment culture, in which reference checks are not properly carried out, allowing unsuitable individuals to enter the sector. 

HR magazine readers will almost all have a connection with health and social care workers – these are the vital people who look after the elderly and mentally ill people in your life. 

The majority are heroic, selfless individuals prepared to work with people with complex needs, often requiring levels of personal care at which most of us would balk.

Unfortunately, there is a significant minority who are not suited to caring for the vulnerable, even though they would not show up in a Disclousre and Barring Services (DBS) check. The sort of people who, for example, have no intention of turning up to work regularly and reliably for their shifts. Or those who are ridiculously disruptive, being serially unpleasant to colleagues and managers while delivering shoddy standards of service to patients and clients.

Referencing gone soft

An increasing number of HR professionals in care provider organisations now don't give reference information at all, favouring the risk-averse approach of many commercial organisations in giving dates of employment and job title only. Commercial organisations are free to do their own balance of risk on this as far as I'm concerned. But I don't believe this choice should be open to organisations that have a responsibility for ensuring that sick and vulnerable people are kept safe from harm and receive the best standards of care possible within lean budgets.

Some organisations who get only these standard references back will appoint regardless, ignoring the risk. Those of us who won't appoint if we can only get such basic references risk excluding excellent candidates. Those HR practitioners who won't give full reference information are, therefore, potentially denying their organisations' best performers the right to further their careers.

When we next hear about a failure in services for the vulnerable – the latest scandal involving a hospital trust, a child protection unit or a care home for the elderly or people with learning difficulties – I would urge the authorities to go in and have a good look at the personnel files of the staff. They will see the paucity of information that will have been taken up about their past capability and conduct, or even their basic qualifications or experience to do the job. And then I would suggest they carry out further independent investigation into the backgrounds of the staff who have been found lacking.

The Warner report

It wasn't always this way. In 1992, a high-powered committee, led by Norman Warner, issued the report Choosing with Care. It advocated a robust approach to seeking pre-employment references for people working with children or vulnerable adults. It made a series of recommendations urging employers to be thorough about obtaining detailed references from previous employers, following up with telephone conversations where necessary to obtain a rounded picture of a candidate's strengths and weaknesses, as well as details of any disciplinary offences.

Once upon a time, CIPD guidance also indicated the need for rigour in the selection of such staff, including taking references into the mix. 

All this was before the creation of the Criminal Records Bureau (CRB) and, more recently, the Disclosure & Barring Service (DBS). Now all the guidance available online, including that from the CIPD, suggests a check of criminal and barring records is all that is necessary to clear someone as fit to work with vulnerable people.

DBS checks are effectively serving as a comfort blanket for those with responsibility at policy level to ensure the protection of the vulnerable since they are no longer advising independent reference checking.

Exercise due rigour

My own organisation has always exercised due rigour. As a result, even after an exceptionally robust selection process, I have withdrawn a significant number of job offers every year on the basis of unsatisfactory references – in some years as much as 25%.

There are many organisations in health and social care that don't exercise due rigour. They don't ask for enough reference information from enough employers. They rely on scanty agency references. They don't verify the provenance of references. They often don't bother to ensure references come back before appointing. And, not infrequently, even if they do get reference information that flags up grounds for concern, they ignore it.

The results work themselves through into poor standards of care. I urge the government to make the giving and seeking of detailed and robust reference information in the health, care and support sectors compulsory by law. Recruiters should also exercise rigour when choosing carer workers. Failure to act will lead to more tragedies for the most vulnerable people in society.

Helen Giles is HR director of Broadway Homelessness & Support and managing director of Broadway's Real People, a social enterprise HR consultancy. @HelenMJGiles