Outcome 1: Know how to recognise signs of abuse
1. Define the following types of abuse:
Physical abuse – Hitting, slapping, pushing, pinching, kicking and burning. Leaving people to sit in own urine and faeces and forcing them to eat or take medication. Sexual abuse – Unwanted advances, indecent exposure or harassment, rough washing or touching of the genital area, rape, being forced to watch or participate in sexual acts. Emotional/psychological abuse – intimidation, not being included or ignored, threats, bullying, humiliating and blaming. Financial abuse – using an individual’s money without their permission or on items they have not requested. not giving correct change back to individual, misuse of property, possessions or benefits. Institutional abuse – poor care in to residents in care homes and day centres, Food and special dietary requirements not being followed and rooms and clothing not being cleaned.
Self neglect – Individual not looking after themselves i.e. not washing, not eating Neglect by others – Inadequate care or denial of an individual’s basic rights. 2. Identify the signs and/or symptoms associated with each type of abuse. Physical abuse – Unexplained bruises, scratches, cuts, fractures, broken bones and teeth. sprains or dislocations, lacerations, burns – including friction burns and scalds, drowsiness, pressure sores, cowering and flinching, unexplained hair loss, significant weight loss, etc. Sexual abuse – Bruises around genital area, recurrent genital or urinary infections, disturbed sleep patterns, vulnerable adult appears withdrawn and fearful, inappropriate dressing.
Emotional/psychological abuse – Individual appearing afraid or worried, depression, anxiety, withdrawing or refusing affection, fearful or agitation, lower self-esteem and self-confidence, shouting or swearing, behaviours such as rocking, hair twisting and self-mutilation, vulnerable adult withdrawn and fearful Financial abuse – unexplained changes to spending pattern, family unwilling to pay for services, although individual has sufficient funds, sudden change of will. Institutional abuse – Individuals are not eating or getting dressed properly, being kept in their rooms and not interacting with anyone else, lack of own personal clothing and possessions, no flexibility of bedtimes, eating times or waking times, dirty clothing or bed linen, misuse of medication, lack of care plans, lack of heating, staff entering into service users’ rooms without knocking.
Self neglect – Individual gaining or losing weight, using drugs and alcohol. living in dirty conditions, poor personal hygiene, poor nutrition, not getting medical help, not being interested in the way they look, long toe nails, not taking medication. Neglect by others – Neglect happens when the appropriate people fail to act, absence of food, water, and heat, poor personal hygiene including soiled clothing, dirty nails and skin, inappropriately dressed for cold or hot weather, bedsore, constant hunger, withdrawn, illness 3. Describe factors that may contribute to an individual being more vulnerable to abuse There are a number of factors which can contribute to an individual being more vulnerable to these types of abuse, including, no or little family contact, their personal communication skills and their past experiences. If the individual has learning disabilities or any other for that matter, this can also make them vulnerable as they may have communication problems and may not understand what is going on around them. This may cause them to not know that they actually need help or that what is happening is wrong.
Outcome 2: Know how to respond to suspected or alleged abuse 1. Explain the actions to take if there are suspicions that an individual is being abused If I suspect abuse through noticing a sign of physical abuse or change in the behaviour of an individual, I will make sure that I ask the individual what has happened telling the individual the changes that I have noticed. If it is in my place of work and the name of the person that abused the individual is known, whether staff or another service user, I must also record and report this. I will listen to the individual carefully, it is up to them to tell me, I would not ask them any questions about this as this is not part of my job role and would stay calm. I will make sure that I record what the individual tells me using the individual’s own words and I reassure the individual and explain that their safety is the most important and that it is my duty of care to tell the manager.
I will let my manager know what has happened immediately and pass this information on in private,my report being also confidential. Depending on what is found out the individual might need to continue to be monitored and a plan of care will be put in place that must be followed to protect the service user. If the allegation is about my manager or the manager is unwilling to do anything, I will follow my company policy of reporting abuse and report to CQC. 2. Explain the actions to take if an individual alleges that they are being abused. If an individual alleges that they are being abused, I will make sure that I listen to the individual carefully to know exactly what happened. If it is in my place of work and the name of the person that abused the individual is known, whether staff or another service user, I must also record and report this, using the individual’s own words; I will not ask any questions or make any judgements about what I have been told and I will stay calm. I will make sure that I record the date and time when the abuse was reported and then sign this record.
I will take the allegations seriously and reassure the individual that they are right to tell me as their safety is the most important. I will make sure that I let my manager know and report and record this in private but if the allegation is about my manager or the manager is unwilling to do anything, I will follow my company policy of reporting abuse and report to CQC. 3. Identify ways of ensuring that evidence of abuse is preserved. When a member of staff in a care setting believes a vulnerable adult is being abused it must be reported immediately to his/her Manager or senior, unless that person is himself under scrutiny, in such a case the matter must be reported to higher management.
The well being of the vulnerable adult is paramount and every effort should be made to make sure the victim knows their rights and how to report any issues. If the vulnerable person is in any immediate physical danger steps must be taken to remove them from this potential danger. In cases where a crime is suspected or has been committed, the police must be contacted. The consultation with the police will lead to a decision about how to/who will investigate if this is needed. Sometimes a care home manager will lead an investigation, this may also include the C.Q.C (Care Quality Commission). Any information given by either the victim or those who suspect the abuse is only shared with those who need to know.
Any actions/information received is always documented and must be done a.s.a.p, ideally within 24 hours (to be “safe” in terms of evidence for court if needed). Evidence must always be preserved, for example, physical abuse evidence may include body maps and photographs. Financial abuse evidence would include bank books/statements, any spaces in cheque books where an abuser may fill them in to falsely claim money from the client and sexual abuse evidence may include putting clothing into clean sealed plastic bags or in an instance of rape the room would need to be sealed off to preserve forensic evidence.
Outcome 3: Understand the national and local context of safeguarding and protection from abuse 1. Identify national policies and local systems that relate to safeguarding and protection from abuse National policies – Safeguarding Vulnerable Groups Act 2006, the Vetting and Barring Scheme run by the Independent Safeguarding Authority (ISA), Criminal Records Bureau, Human Rights Act 1998. Local Systems – Safeguarding Adults Boards, Safeguarding policies and procedures for vulnerable adults.
2. Explain the roles of different agencies in safeguarding and protecting individuals from abuse Safeguarding Adults Boards – these bring together a number of different local agencies that work with vulnerable adults to share information and monitor their work i.e. local agencies like the police, MIND, housing teams, advocacy groups. The Police – their role is to safeguard vulnerable adults, investigate all reports of vulnerable adult abuse and protect and uphold the rights of vulnerable adults. CQC – to monitor and provide guidance on what all health and social care providers must do to safeguard vulnerable adults from abuse; the safeguarding policies, procedures and systems developed are in place to prevent vulnerable adults from being abused.
3. Identify reports into serious failures to protect individuals from abuse A report about Castlebeck Care Ltd which failed to ensure that the vulnerable living at Winterbourne View were adequately protected from risk, including the risks of unsafe practices by its own staff. Individuals in Winterbourne View which is a home owned by Castlebeck Care Ltd were pinned down, slapped, doused in cold water and repeatedly taunted and teased by staff in the home. Castlebeck Care Ltd failed to notify the Care Quality Commission of these incidents, injuries to individuals and of occasions when individuals had gone missing. A report about the murder of Steven Hoskin, a young man with
learning difficulties who was abused and murdered in July 2006.
In addition to being pushed over the railway and falling from a great height, it was also found that Steven had taken paracetamol tablets, had been drinking alcohol and had sustained recent injuries from cigarette burns. In addition he suffered appalling treatment from his abusers who took over his bed sit and he had neck bruises from having been hauled around his home by his own pet’s dog-lead and the backs of his hands had the marks of foot-prints. 4. Identify sources of information and advice about own role in safeguarding and protecting individuals from abuse Local Authority Adult Services Department like Social Services My manager, colleagues
My company’s policies and procedures on safeguarding
Care Quality Commission
Independent Safeguarding Authority
Training and advice from training centres
Outcome 4: Understand ways to reduce the likelihood of abuse 1. Explain how the likelihood of abuse may be reduced by:
• working with person centred values
• encouraging active participation
• promoting choice and rights
Person-centred values include the individuality of the person, the rights of the individual, the individual’s choice, the individual’s privacy, the individual’s independence, the individual’s dignity and the individual being respected. If person centred values are taken into consideration when supporting an individual there is less likely to be abuse as all the staff will be working in the same way and will feel shamed if they abuse because of the way that they have been taught to work. If an individual is considered to have a say in what he or she wants and is at the centre of any decision, it will be more unlikely that there is abuse. The individual will know what suits him or her and will not get so frustrated. I always put the service users I work with, their families and friends at the centre of any decision about them and they are an active partner in their own care.
Individuals decide what to do, where to go, what clothes to wear and are treated with dignity, respect, confidentiality and are able to make their own choices. Individuals’ rights are promoted throughout the service. My service user has the right to do anything that they wish to do and if it is what they want as long as it is not dangerous; a risk assessment is then done to stop any abuse happening. I ensure that I promote service users’ rights and choices by allowing them to make their own choices and support them to have the rights of anyone else. 2. Explain the importance of an accessible complaints procedure for reducing the likelihood of abuse The complaints procedure gives the complainant the right to be heard and supported to make their views known.
An accessible complaints procedure is understandable and easy to use. It sets out clearly how to make a complaint, the steps that will be taken when the complaint is looked into. It also provides flexibility in relation to target response times. An accessible complaints procedure resolves complaints more quickly as the complainant feels that they are being listened to and their complaint taken seriously. This sets up an open culture of making sure that abuse will not be tolerated in any form and encourages the complainant to not accept this.
Outcome 5: Know how to recognise and report unsafe practices 1. Describe unsafe practices that may affect the well-being of individuals Unsanitary conditions can spread infection as cross-contamination can occur and can affect the well-being of the individual and others. Improper hand washing can also pose a risk. Dirty kitchen surfaces and equipment can spread infections, not covering hair when cooking can pose a risk to individual as can not reporting faulty equipment when working or not having cleaning materials can also be unsafe. In terms of health and safety not having risk assessments in place when a service user hurts themselves. Staff not checking when a service user is ill or unsteady on their feet. Staff not recording in care plans about a service user’s well-being and health and not monitoring them.
Other unsafe practices which also amount to abuse can occur such as leaving a service user on the toilet too long, ignoring or not listening to them. Marks on body not taken seriously and complaints not taken seriously can put them at more danger, harm and risk of abuse. I ensure that I keep to all the procedures for checking for abuse and the well-being of the individuals that I work with; by following these and the individual’s care plan I keep within the minimum standards of care and also work in a person centred way to make sure all individuals are happy and safe.
2. Explain the actions to take if unsafe practices have been identified If I identify unsafe practices then I must follow the whistle-blowing procedure and report to the appropriate person(s). I will report to my manager immediately or if it involves my manager then to another appropriate person(s). I will monitor all unsafe practices and make sure that I record and report in full all the evidence and then will talk to my manager because all unsafe practices are dangerous practices that could cause harm to the individual and others. For example, I talked to my manager last month about things being left on the stairs that may cause service users and others to fall over and hurt themselves. She has talked to the staff and now this has stopped.
3. Describe the action to take if suspected abuse or unsafe practices have been reported but nothing has been done in response If suspected abuse or unsafe practices have been reported but nothing has been done in response or if it has to do with my manager then I will report to the next level or manager. If it has to do with my manager then I will report to management, then to the social worker and safeguarding team and to the Care Quality Commission and even to the police depending on the response I get. When I worked in a nursing home there was some abuse of service users being left too long on the toilet and I talked to the nurse in charge and changes were made immediately. I had to record the information and give the nurse and manager a copy of my confidential report. If the nurse or manager had not done this then I would follow the whistle blowing procedure.