Speak Up Month

Agnes Tutani

As part of Speak Up Month this October, Agnes Tutani, Cygnet’s Freedom to Speak Up Guardian, talks about the importance of an open culture in health and care settings, where people are encouraged to speak up so that organisations can learn, develop and improve for the benefit of everyone.

Birthed from safeguarding, speaking up ensures that all staff, residents and service users’ safety is protected and upheld.

Service user safety and ensuring that staff feel supported and happy at work is everyone’s responsibility. We all have to be accountable for speaking up if we think someone isn’t okay or we’re worried about something in the workplace.

To truly improve safety and make the health sector a better place to work, the National Guardians Office says that organisations need to place less emphasis on blame when things go wrong and more importance on transparency, learning from mistakes and recognising opportunities for improvement. To date, at Cygnet Health Care we have 147 ambassadors across both Health and Social Care who take responsibility for ensuring a culture where staff feel empowered and able to raise concerns is embedded across the organisation.

Speaking up can take many forms. At Cygnet, there are already many channels for speaking up – from a discussion with a line manager to submitting suggestions for improvements. My role within the organisation is to give staff an extra level of support if they are worried, unsure, concerned or feel they can’t talk to someone within their line management or in their team. By speaking up, the hope is that anything that is getting in the way of high-quality effective care, or that affects their working life, can be identified early and that potential harm is prevented.

I do not carry out investigations, but I help people to have a voice and work alongside the service and the person raising the concern to address it. Issues can also be raised anonymously if preferred. I can escalate concerns to the Cygnet Board and externally if needed, but my hope would always be to address issues before it gets that far.

When we Speak Up, we demonstrate that we care and respect, not only each other but those in our care. I am convinced that when we all take personal responsibility to speak up, listen up and follow up we enable an open culture which contributes to keeping our services safe, promotes learning and improves the experience of all our staff.

The sign of a healthy organisation, is one that listens to its people. We have learnt that the healthiest – and safest – cultures for care are those that are aware, are transparent and are reflective. All of these values are fed by the one crucial skill that we all possess; that is to listen. Dangerous cultures are bred when silence multiplies and staff who do the caring, don’t feel they can discuss what they see, question what perhaps feels wrong, and be supported to raise questions.

Staff need to feel heard and understood, and leaders must demonstrate that they are open to new ideas. Leaders who do not listen will eventually be surrounded by staff who have nothing to say. Staff want and need to be heard; listening transmits respect and builds trust which in turn makes staff feel valued and more motivated. Listening to staff helps to reduce risk, prevent harm and make improvements. A valued, motivated and committed team will improve the care outcomes of service users, so listening is at the very core of better service delivery and improving the lives of our residents and service users.

An important part of the Freedom to Speak Up remit is ensuring appropriate follow-up. Following-up is just as important because its closes the loop and ensures there is the opportunity for change, learning and improvements. People will only have the confidence to speak up if they feel that their voices are heard and that they see evidence of the organisation listening and acting on their concerns. By following-up with good quality and independent investigations, we ensure that every opportunity is utilised to learn as an organisation. Ultimately this will allow the organisation to deliver better care, share knowledge to identify best practice and review guidance where necessary.

We have worked hard to ensure Cygnet Health Care is a provider where speaking up is the norm, and it’s encouraged, a place where people feel valued and fully supported when raising concerns about patient safety or about ways of working or things they think could be done a little bit better. As part of Speak Up month, I urge all those working in the health and social care sector to raise awareness of Freedom to Speak Up Guardians to help foster a culture which will improve the care provided to those who need it.

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