Deana Savage on workplace violence in the care sector

About the #Every30Minutes Campaign

On average, a care worker is attacked every 30 minutes in the UK. Despite this incredibly high rate of violence, and the fact that health and social care is one of the largest sectors in the UK, this is almost never talked about.

As part of our new #Every30minutes campaign, we are speaking to care workers and care organisations across the UK, to understand the level of violence in the sector, and to talk about what can be done. This time, we spoke to highly experienced carer, and Managing Director of Drury Healthcare, Deana Savage.

About Deana and Drury Health care

In 2001, after seeking a change of pace from working in her London office, Deana Savage took up a part-time role at a small care team in Essex. On her first day, Deana was informed that she would need to cover an on-call evening shift, with no prior experience and no real training. 

Not only did she survive that first day, but within six months she would retrain, become a manager, diversify the company’s output into learning disabilities and mental health, and stay with the company for four years. From that first sink or swim moment, Deana would go on to succeed, not just in this organisation, but in a number of high profile roles across the care sector. Over her long career, she would learn a lot and would see threats of violence first hand.

Deana is now the managing director of a successful health and social care organisation, Drury Healthcare, which she tries to make very different from some of the organisations she’s worked in in the past, and she believes that, through providing highly hands-on and highly specialised care, she can provide a better experience for her staff and her clients.

For Deana, her staff’s safety is paramount, no doubt because of the things she has seen over her career. Her staff are given ample training, whether that’s understanding non-verbal cues when dealing with learning disabilities, or intervention procedures for dealing with aggressive behaviours. She also makes sure that Drury Healthcare’s protocols are updated in real-time, based on frequent risk assessments (or more frequently, if situations or behaviours change). Acts of aggression are carefully documented and investigated.

Violence and its Impact on Healthcare

When we talked about the #Every30Minutes campaign, and how a care worker is attacked, on average, every 30 minutes in the UK, Deana was not surprised. She herself has been called into many situations, as a manager, to de-escalate a potentially dangerous situation. Deana told us about the very tangible impact a violent incident can have on a carers mental health, as well as their ability to provide care.

“Personally I’ve been shocked by the things I’ve seen… It can change how you act. As a carer, you want to be very friendly, very relaxed – as you should be. But after you’ve witnessed a violent act or have experienced it yourself, you feel like you have to put a guard up and it changes you.”

Asked for details, Deana continued “I’ve worked with staff that have been physically harmed and which has resulted in a noticeable impact on their mental health. I’ve known good people who’ve left care because of stuff like that. And I’ve known very experienced carers who feel like they’ve seen it all before… and then they’re attacked and their confidence crumbles and they walk away from the sector. It’s a very hard industry to be a part of.”

“I was working with someone who, one day, their behaviour drastically changed. They went past me and started attacking my support workers and attacking their mum, and that shook me to the core. That was probably one of the worst things I’ve seen… And now I’m very guarded, even when I’m out, say, in a shop and someone starts raising their voice, it’ll put my guard up and I have to detach myself from that situation. ”

How does violence affect employability and turnover?

Deana talked to us about how, not only does the level of violence and aggression affect staff and their rates of turnover but it also means that often vulnerable people will get passed from organisation to organisation, as each team finds that they can’t deal with the level of stress associated with the client.

“You get those cases that go round and round all the agencies. I had one case that we held for four years, before having to hand it back. And at the time, the social worker said ‘I don’t know how you’ve done it for four years’ because before then, the client had been passed between 18 different care agencies.”

And this wasn’t the only case that Deana has had to pass up for the safety of her staff. In one, she stated bluntly, “there was another package we had to give up years ago because our staff were being physically abused.” And yet, Deana tells us, other companies do not always choose to take this path; some companies will keep a case no matter the risk, and it’s those companies that have some of the highest turnover rates. Deana expands on what that’s like:

“You see some organisations recruiting year on year for the same difficult service users. Good staff come in, they start off really well and then the dynamic changes, and they get attacked and the care package starts to break down. And without naming anyone, there are organisations that just recruit new staff and then burn them; recruit and burn, recruit and burn… until they can’t find anyone to fill that role. And is that in the client’s best interest? Probably not, because there’s no continuity of care.”

Could more be done across the sector to help keep workers safe?

Deana tells us that she is unsure if you could take the risk of violence out of care completely, especially when dealing with learning disabilities or those prone to sudden mood changes –I.e those with dementia .

Drury Healthcare has often taken on the difficult clients that other people won’t accept, and Deana knows that there’s inherent risk there. But through planning, and adapting to the needs of a higher-risk client, she can mitigate these risks. 

Unlike when Deana was thrown into her first role nearly twenty years ago, she doesn’t make her staff visit new homes alone, without prior experience. When she hires inexperienced workers, they are trained for three months and complete the care certificate, and then, whether an employee is experienced or not, Deana makes sure they shadow another member of staff until they have been signed off for lone working.

Regulations

We asked Deana whether she thought that there should be more regulations, from the government or from a trade body, in place so that the care she provides is more universal. 

Deana believes that all carers should have a set amount of training, and a set amount of shadowing hours. What’s more, she believes that zero-hour contracts play a huge part in the retention crisis. 

“I can only think of three companies, including ourselves, in all of Essex that properly contract their staff –the rest are on zero-hours…. And I’ve worked for big corporates and they’re all the same. Our staff are more committed and take fewer sick days because we invest in them.”

Deana also told us that she believed that there simply isn’t enough funding in care and that, if you want to protect care workers, you need to fund proper training and real contracts, because otherwise, you get high-turnovers leading to inexperienced carers “going in blind” to potentially dangerous situations. What’s more, in an overworked and underpaid sector, most care workers are rushing from client to client, and don’t have time to properly read a care plan which, according to Deana, may be the best source of information for properly understanding a client’s needs and, indeed, their risks.

Deana finishes by giving advice to care workers and care companies, “At the end of the day, if you have the right standards in place, and you're contracted into the right authorities, you'll always get the work. But if you haven't got a core staff that can trust or that you value, then you haven't really got a company, have you?” –This is Deana’s philosophy, she believes that investing in her staff makes their quality of care better (which is why she still has employees that started with her in 2001), but she knows that, sadly, this is not the norm. 

The Future of Care

Deana thinks a lot needs changing, but she still clearly loves what she does, and believes the sector can get better. When we talked to her, she was excited to be able to get out with a client, put on casual clothes, and truly get to ‘be herself’. 

“After 20 years, I can still get excited about visiting a client –and that says a lot about the industry.” Indeed, the day after we talked, Deana was visiting a client with a learning disability. With COVID still being a major threat, their normal routine is impossible but still she is grateful for the experience, “Instead of going out, we’re going to order lunch in, instead of going swimming, we’re going to exercise in their home… and then we’re going to be playing Monopoly –you can’t beat that”.

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