November 2023: This chapter, which is new, highlights the importance of recognising and trying to understand people’s cultural identities when working to safeguard them and promote their needs.
1. Introduction – What is Culturally Competent Practice
To practice in a way which is culturally competent (also called ‘culturally appropriate’ practice), staff and services need to understand and be respectful of the beliefs, practices and cultures of diverse communities. This is very important when working with people whose cultures do not reflect those of mainstream services.
Cultural identity covers many different things. For example, it might be based on a person’s ethnicity, country of birth or religion, or it might be about their sexuality or gender identity. Lesbian, gay, bisexual and transgender people have their own cultures, as do Deaf people who use British Sign Language. Cultural identity is an important part of a person’s wellbeing.
Practitioners need to be able to recognise, and respond to, issues linked to the cultural identity of people they are working with. A failure to do this can mean that opportunities to identify issues which are important to the person or understand why they are acting in a certain way are lost. The importance of this approach has been highlighted by Safeguarding Adults Reviews (SARs) nationally.
2. Why is Culturally Competent Practice Important?
Actions taken in response to safeguarding adults’ concerns (including referrals, safeguarding enquiries, assessments and safeguarding plans) must always take account of issues relating to cultural identity within the lives of the adult and their family.
When adults are treated in a way which is sensitive to their cultural identity, they are more likely to engage well with staff and services and achieve better outcomes, which will keep them, their families and communities safer.
When adults are not supported in a way which recognises their cultural identity, they can:
- feel marginalised and discriminated against;
- suffer low self-esteem and low self-confidence;
- miss out on opportunities to stay safe;
- have their actions misunderstood;
- feel stressed and anxious; and
- experience a loss of rights.
3. Cultural Competence and Safeguarding
Understanding and communicating well with people from different cultures is an important part of providing person-centred care, including safeguarding adults (see Making Safeguarding Personal chapter). Everyone is part of one or more cultures and people can identify with more than one culture.
As also noted in Section 2, people are more likely to have their needs identified, receive appropriate support and experience positive outcomes (including being protected from harm) if their culture is recognised and taken into account by practitioners.
A person’s cultural identity can sometimes make it hard for them to ask for help from services or to protect themselves. This can be because they:
- are worried they will not be believed;
- do not know how to ask for help;
- are worried about possible repercussions for them and / or their family;
- have a lack of trust in statutory services or people in positions of authority;
- fail to realise that their experience amounts to abuse or neglect.
Also, if practitioners do not directly ask the adult about possible abuse and neglect it can mean they do not have the opportunity to ask for help.
Factors linked to culture can also increase or reduce the level of risk the adult is likely to experience. A failure to consider this can lead to an inaccurate assessment of risk, and safeguarding issues may not be recognised.
Issues of culture and faith can never be used to justify behaviour which constitutes the abuse of an adult or child (see for example the chapters on Honour Based Abuse, Female Genital Mutilation (FGM) and Forced Marriage).
If the adult’s first language is not English, learn a few useful phrases or terms from that language. They may also like to teach you a few phrases. In safeguarding meetings for example, the adult and their family may appreciate being welcomed or thanked in their first language.
All cultures have rules about politeness that affect the way people communicate. Be curious and ask questions, sensitively. For example, it is important to address people in the way they prefer. For example, elderly people may prefer to be addressed as Mrs Smith or Mr Patel until they are happy for staff to use their first name. They may always want to be addressed more formally, however.
4. Role of Practitioners
In providing culturally appropriate care, practitioners should have a respectful and sensitive approach which aims to understand how culture can affect different aspects of people’s lives, including the way they feel, behave and are responded to by other people and organisations.
Practitioners do not need to share the same cultural values as the adult to be able to practice in a culturally competent way, nor do they need to be experts on different cultures. However, they do need to be aware of their own cultural values and how these might sometimes be different from the people they are supporting and how that might impact on the adult and their family. This will help them understand people better and provide a more appropriate response.
It is important that practitioners do not make assumptions that all adults from the same ethnic background or same religion will share the same cultural identity or values.
Practitioners should also think about how their actions – and those of the organisation they work for – could affect people from different cultures, including making it harder for them to seek help or engage with support.
When assessing if someone lacks mental capacity or giving information to support someone to make a decision, you should also take cultural factors into account. Using the Mental Capacity Act to make a ‘best interests’ decision must include considering the person’s beliefs and values.
5. Providing Culturally Appropriate Care – Practice Guidance
Often, small changes make a big difference to people. The most important things which practitioners can do include:
- listening to the adult, spend time getting to know them and their families (where appropriate), ask questions about their lives and beliefs;
- asking about what is important to the person, and what being safe means to them;
- trying to understand and meet people’s preferences, and remember that the adult is the expert in their own life;
- do not make assumptions, be aware of your own cultural values and beliefs and how that may impact on the adult and their family;
- look at the adult’s life and experiences as a whole, including their cultural needs, and protect them from discrimination.
Remember that some people may be put off reporting abuse or neglect or engaging with services because of concerns about their cultural differences. It is also important to remember factors which can make it hard for some adults to keep themselves safe or ask for help: These include:
- not being able to read or write;
- not being able to hear;
- not speaking English as a first language;
- fear of authority;
- limited social networks;
- poor quality / temporary housing / frequent house moves which means their access to services is disrupted;
- living in a closed or close-knit community – which can make adults worry about bringing shame on their family.
Cultural competence training should be available for staff in all organisations. It is also important to have an open staff culture, so staff can raise any issues with managers and work out solutions together.
It can sometimes be helpful to match staff with adults from the same culture, for example as a keyworker. However, it is important to ask the adult first and not assume it is what they want. You should discuss it both with them and also the staff member. Be aware that some people may not want to share information with someone from their own cultural background, particularly if there are difficult issues for them, as with safeguarding concerns for example.