Skip to main content

Raising concerns

8 January 2013

A new partnership across health and social care services in Wales that will drive change in workplace culture in the care of older people is being launched, following the findings of a University study.

Raising Concerns in the Workplace: Protection of older people in Wales, commissioned and published by the Older People's Commissioner for Wales is underpinned by an extensive study carried out by Royal College of Nursing Professor of Nursing, Daniel Kelly and Senior Lecturer Dr Aled Jones both of the School of Nursing and Midwifery Studies.

The study gave a voice to front line staff in health and social care settings about workplace culture and how it supported or prevented the raising of concerns. It also explored the dilemmas and barriers that those working with older people may encounter when faced with poor care or practice.

Speaking about their findings, Professor Kelly said: "This report suggests that in Wales we do not yet have a workforce that is confident in making judgements about when to raise concerns. The decision as to whether or not to raise concerns is strongly influenced by workplace culture, by an individual's own judgement about acceptable 'thresholds' as well as the individual's personal morals and ethics.

"Workplace culture must change in order to support workers and also to ensure that the 'norms' of the culture correspond with expectations and standards set out in organisation's policies and professional codes of practice. If this does not happen, some of the most vulnerable older people in our society, who rely on others for fundamental care and health needs, will remain at risk of poor care or even harm."

Based on the findings of Professor Kelly and Dr Jones' study, Sarah Rochira, the Older People's Commissioner for Wales has made a series of recommendations, including the establishment of a National Development board involving health and social care partners that will identify and develop action to change workplace culture in Wales. It is anticipated that the Cardiff researchers will also be involved in this phase.

Other recommendations based on the Cardiff study include replacing the word 'whistle-blowing' with the phrase 'raising concerns'; running a 'speak up' campaign in Wales in 2014; and sharing and developing examples of successful and good practice in the care of older people jointly between health and social care services.

Sarah Rochira, the Older People's Commissioner for Wales said: "As Older People's Commissioner, I have a particular role in ensuring that older people are safeguarded and protected, which is why I commissioned extensive research on workplace culture and raising concerns.

"The report gives voice to those who work with older people on a daily basis, many of whom are unrecognised for the valuable work they do, highlighting the need for greater assistance in raising concerns at an early stage.

"I am pleased that partners working across health and social care have committed to being part of the National Development board. This collaborative working will identify and take forward action that will achieve change in workplace culture in Wales, with the wellbeing and safety of older people at its heart.

"I am confident that we can work together in Wales to deliver the change required to make Wales a safe place to grow older, not just for some but for everyone."

The full report is available here: