Talking Sense - Volume 45, No 2, Summer 99
In recent years Sense has been working towards offering ethnically sensitive services. Francesca Wolf looks at what is happening on a national and local level and at what still needs to be done
While researching this article I was told an interesting story. A young man with learning difficulties was assumed by his service provider (not Sense) to have no language. Much of his time was spent mumbling 'incoherently'. One day a Jewish visitor to the home realised he was using Hebrew, reciting prayers he had learnt in childhood. His service was subsequently changed, to give him access to the Jewish community.
What can we learn from this? That we need to take account of people's race, religion and culture - for there is meaning for people in things associated with their roots. That awareness of , and access to, other cultures is essential in order to offer a service which addresses individual needs and reflects the diversity of its users. Lack of such awareness in society is not only impoverishing but can lead to 'double discrimination ' - on the grounds of race as well as disability.
Try to imagine being deafblind. You have little or no hearing and sight and you may have other disabilities also. Imagine then , that you also come from a black or ethnic minority background yet your carers are all white and your environment totally Anglicised. How might this feel?
Sense is aware of the potential for discrimination and is working towards offering ethnically sensitive services. The 1996 report Equal Access in Sense identified shortcomings and led to a Statement of Intent to ensure equal access to services for clients and equal opportunities in employment. This Statement recognised the gap between values and achievements in both areas.
Concerted efforts have been made to improve things both on a national and local level. Sense has looked at what is needed, established a framework of policy, and is beginning to work out services in more detail. A programme of action is currently underway.
National initiatives
Structural changes
Sense's Council - its decision-making body - now includes members from different ethnic backgrounds. The former Mission Statement has been replaced by a new Charter. An Equal Access Special Interest Group advises and supports Sense on questions of ethnicity, as these affect the range of its work. An important change is that Sense now collects data and statistics and regularly reviews ethnic backgrounds of staff and service users.
Service delivery
In the last few years standards have been developed for Sense services which affect every area of activity. These include performance criteria related to people's religious and cultural backgrounds, and individual racial and cultural needs are always included in care plans .
In order to provide a culturally appropriate environment many things need to be looked at, including food, general care, dress , religious practices and gender issues. "Where a deafblind service user cannot make choices for themselves we are sensitive to parental preferences," says Malcolm Matthews , Director of Policy and National Services. "And we try to provide individuals with a range of experiences that link them to their cultural and/ or religious background.
"It is important, for example, that black service users have some contact with other black people, that there are staff from different ethnic groups, that all staff are aware and properly trained, that diet is considered, and that people have some access to their local community." This has been a problem in the past where Sense homes have been run by largely white staff in white communities.
Outreach
Getting services known of and available to all communities is challenging. Malcolm Matthews says, "We have more people from black and ethnic minority backgrounds represented in promotional literature, and can now translate material into other languages on request - but translation alone is not enough. Distribution needs to be in place so materials reach the right people and there also need to be workers who can respond to approaches in the appropriate language."
A proposal has been drawn up for an ethnic communities liaison officer for Asian people in Bradford, and another for a project in Sandwell to identify and set up specialist services for deafblind people from ethnic communities. Unfortunately neither of these proposed projects has yet received funding.
Sense now has cultural awareness training for all regional advisers. It can also make use of a telephone interpreting service when people are seeking advice for whom English is not a first language. But there's a lot more to do.
Employment
"Sense recognises the need to attract and appoint more staff from ethnic minorities, particularly in positions of seniority," says Malcolm Matthews. "Only if our staff includes people from different parts of the wider community will we be able to provide the right services to different communities. We also recognise the great value of a diverse workforce, and that we can learn from the people we employ."
In the regional induction training held quarterly for all new staff members equal opportunities is a core subject and the issue of diversity very much highlighted. "A new equal opportunities policy will shortly be launched," says Malcolm "which will involve us setting targets for training, staff development and recruitment and selection of staff."
Work in the West
Sense West have developed their services in response to a clear need. Four years ago Arsat Ali, a young Muslim man of Bangladeshi origin, arrived at a Sense home. He was deafblind with learning disabilities and his parents had requested a Muslim male care worker.
Rukshana Sanghar, a house tutor of East African Asian and Muslim background, had a brother, Hanif, working in the same field. He was employed as Arsat's key worker and together brother and sister arranged things to meet Arsat's cultural and religious needs including areas such as shopping, cooking and storing food, personal hygiene, and involvement in cultural and religious festivals.
"The staff have been brilliant in the way they have adapted to Arsat's needs, such as buying Halal food and keeping it separate from other food," says Rukshana. "There is a written document and when we are not there they follow it through."
Mike Hanlon, the area manager, says the whole team picked up the importance of cultural and religious customs from Hanif and Rukshana: "They saw the significance of the religious aspects of daily life from the inside, observing how centrally important it was to these staff members too."
Employing staff from different religions shows there "is no one right way", he says, and makes for a more considered response. "Some issues, for example in aspects of personal care, need a sensitive, subtle approach - they can't be decided in a formal planning meeting."
Rukshana also works with 14-year-old Rabia Khatum who is a daycare and respite client. Her parents requested a Muslim female worker and that most of Rabia's needs should be met around domestic areas such as teaching her to cook, shopping for Halal food or buying Salwar Kameez (the traditional dress). "Families will not take up the service if it's not ethnically sensitive," says Rukshana.
She believes the last few years have shown an attitude change and is pleased at staff involvement and at how the information she and Hanis have passed to management has been used. But she thinks Sense could further adapt its advertising to encourage more people from ethnic minorities to apply for posts, and that homes could be redesigned to meet cultural and religious needs. Outreach is important too "There are loads of families with disabled children but absolutely no idea of Sense's existence. It needs more promoting in the community."
A sense of identity
Two years ago 42 year old Curtis Huggins*, who is profoundly deaf, has vision problems and is learning disabled, moved from Meanwood Park Hospital into a Sense Home in Leeds. His careworker at the hospital, Shirley Thompson, moved with him. Both are of Afro-Caribbean origin.
She introduced him to West Indian food, helped him decorate and personalise his room, and takes him to the carnival and other West Indian music and cultural events. She has organised appropriate skin and hair products and informs staff, in this and other Sense homes, about diet, customs and hair and skincare.
"If there are black service users in an organisation there should always be some black staff," says Shirley. " For the first 30 years Curtis knew nothing of his culture and had no sense of his own identity. Things are better now for him and he has responded positively. The staff are more aware. But there's a long way to go - for example Curtis' peer group at home are all white, and he rarely sees black people on the street because the house is too far away from his community."
Gaining respect
Despite some progress, Sense still needs to be much more accessible to ethnic communities. Liz Duncan, Sense's specialist adviser in acquired deafblindness says "Sense doesn't really have a profile in, say, Bangladeshi or Pakistani communities, which are traditionally cultures based around community respect and understanding rather than information. Although we can now produce publications in minority languages, this is not enough - they need to be aware of our existence in the first place. And that 's about having a visible worker who would develop a community presence and respect."
Statistics show a relatively high proportion of Sense service users come from an ethnic minority group - 11% as against 5.5% in the general population. The number of black Caribbean people is greater than in the population at large - possibly because fewer had natural immunity to rubella. There is also a high incidence of disabilities within some Asian communities. Tanu Patel, a social worker for dual sensory impaired people in Bradford, says, "This may be related to factors such as lack of vaccination in early childhood, less good medical care, or the fact that minority groups have less access to genetic counselling."
Tanu thinks that Sense's client group will change and the number of ethnic minority clients will grow. But unless the service is culturally appropriate families won't take it up . "Asian families can be wary of sending a child or young adult into a very Western environment," she says. "If you are a Muslim , for example, it may be a daunting thought to send your child somewhere where there is no Halal food , no Asian -speaking people or positive role model and where religious practices are not observed.
"If we want to be around to provide a service we have to change our approach. Otherwise the community won't take up that service or there won't be enough people to serve" she concludes.
With thanks to Malcolm Matthews, Olawale Usman, Mike Hanlon, Rukshana and Hanif Sanghar, Shirley Thompson, Morag Jack, Liz Duncan and Tanu Patel.
Reaching families
Sense has been investigating the need for a Black and Asian Family Network Project . Respondents to a questionnaire said they would like the chance to have: contact with other black and Asian families; mutual support ; a newsletter ; family days, and to celebrate festivals with other families. Sense is now exploring how to establish such a network.
Harnessing differences
Olawale Usman, training coordinator for Sense Barnet, believes it is important to "celebrate difference. Diversity is not just about recognising difference but also about harnessing differences in order to enhance creativity, " he says. " No one should feel outside."
He has been running staff awareness groups since January. "We wanted to focus on equal access and equal opportunities within Sense Barnet with the aim of achieving a better quality of service delivery to the service user and enhancing working relationships among staff," he says.
In the groups Olawale focuses on "real life rather than books or principles". He starts from himself - describing his Nigerian background - and encourages staff to open up and draw on personal experience. "This helps get rid of grey areas and assumptions," he says.
People explore how issues of race, culture, religion affect the way they work, looking at problems solved and concerns which need to be addressed. A list is compiled and possible solutions explored through discussion. "Some issues can be acted on at once - for example redesigning a menu to reflect ethnic diversity; others - such as having a staff mix which reflects the cultural background of service users - cannot be easily resolved and will eventually go to management " says Olawale.
All sorts of areas are covered - from cultural festivals which people may derive joy from to good haircare products for Afro- Caribbean people. Recipes are being shared and an evening of Greek food and music has been held.
The response has been enthusiastic. Some staff have volunteered to collect information about users' background, culture and religion and plan to set up a resource area. There are also plans to make a booklet of suggestions once everyone has attended a meeting. Although in their infancy, the awareness groups have generated great interest, and the initiative may eventually spread to other areas.
