'I feel brave enough to be visible' says boss of LGBT+ home care firm in podcast

Homophobia and transphobia is “horrendous” but there’s a lot care leaders can do to make LGBT+ people “feel safe” says Ramses Underhill-Smith, the boss of UK’s first LGBT+ home care provider who explains why it matters in the 'Let’s Talk About Care' podcast.

Mr Underhill-Smith is the managing director of Alternative Care Services, a London-based home care provider supporting LGBT+ people’s right to “be themselves”. He spoke out about his experiences as a transgender man in Episode 12 of the podcast.

‘You just don’t know' that you have LGBT clients

The care boss opens up about his childhood growing up in North London with seven siblings and describes “working really hard” to fit in.

“It’s extremely difficult for any trans person. Shaming is huge and that’s something that people weaponise quite a lot. A lot of people commit suicide and all kinds of things …mental health issues. I don’t think I’m champion but today I feel brave enough to be able to be visible.

“The ethos of Alternative Care Services is to allow people to be themselves. If you’re non-binary, whoever you are, we respect that."

The home care firm has a mixture of LGBT and non-LGBT staff and residents and not making any assumptions is important, he says.

“We won’t come in and say ‘Mr’ so and so. You might present one way and maybe want to be addressed another way. Those are the questions we ask. We make sure that you’re satisfied and we respect your choices. If someone says I’d prefer a gay male carer then that’s what we’ll try and accommodate.”

Mr Underhill-Smith has called for more inclusive care and has stood up for LGBT+ rights as a speaker at events such as the Care Show.

The managing director says: “I’ve often heard it said ‘We don’t have any LGBT clients’ and I’m thinking that that’s probably not true, you just don’t know that you have.

“With our staff who are from the LGBT community, they feel safe. They can come in and be themselves. We’ve had staff that have left and come back because they’ve gone places and the homophobia and the transphobia is horrendous.

“We are becoming more and more aware of things and people are demonstrating and marching and asking for their rights.

"I think more care agencies will start to look at this but it’s like anything. It’s going to take time. If the management are trained appropriately they’ll make sure the staff are trained appropriately.

"If you go into your manager’s office and homophobic comments are part of the banter, you’re going to feel that you can take that out into the wider community because that’s what you’re getting taught from above."

Home care boss looks to create LGBT friendly care home

In the exclusive interview, Mr Underhill-Smith told homecare.co.uk he was looking to enter the care home market.

He says “there’s a demand” from his clients asking about LGBT+ friendly care homes. Partners find caring for their loved one at home has become too much, while others are seeking respite care offered in care homes.

He says: “Some of our clients are now wanting to go into care homes. I need to feel that I can keep my clients as safe as possible. We would be a new care home establishment. It’s a difficult call, particularly at this time.”

Mr Underhill-Smith wants to lead by example and is putting Alternative Care Services through the accreditation process for the Pride in Care quality standard.

Alice Wallace, director of the charity Opening Doors London also spoke as a guest on the podcast, to urge all care homes and home care agencies to go through accreditation for the charity's quality standard.

“It’s a really valuable resource for organisations in terms of improving their rating [CQC]", says the charity director.

When it comes to the care sector, Ms Wallace says in-house staff surveys can reveal a lot. “There’s a higher number of people who’ve said yes they’ve witnessed homophobia going on, either against staff or clients but they don’t know how to respond.”

Every care provider needs Pride in Care says charity

While a number of care groups had signed up to go through accreditation earlier this year, the COVID-19 pandemic meant they “deprioritised” going through the assessment but are now starting to get back in contact. Once Pride in Care accreditation is achieved, it lasts three years. But Ms Wallace encourages care providers to stay in touch after accreditation to maintain "inclusive care."

She says care staff should be trained and understand that if, for example, a transgender care home resident has dementia and has forgotten they have transitioned, how they wish to dress and "present themselves" that day should be respected, even if that's different from the day before.

The charity director retells the story of one individual who was so fearful of the homophobic abuse previously received from care workers in their own home, they refused home care.

Before finally agreeing to let any more care workers in, the individual made a bonfire in the back garden of all personal mementos.

They burned all the photographs they had of their partner in the fire. Ms Wallace says, so that “the next time somebody came into their home, then they wouldn’t be subjected to the abuse that they’d been subjected to.”

Care homes and home care agencies can apply for Pride in Care accreditation by emailing: Prideincare@openingdoors.org.uk.

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