1.1) Definition of different types of abuse are:
Physical abuse – hitting, slapping, pushing, pinching, kicking and burning. Sexual abuse – rape or sexual assault, indecent exposure, penetration and sexual harassment. Emotional/psychological abuse – bullying, shouting, swearing, controlling and ignoring. Financial abuse – theft, fraud and pressure in connection with wills, property or inheritance. Institutional abuse – the maltreatment of a person from a system of power. Self-neglect – when someone neglects their own care.
Neglect by others – when someone fails to meet someone’s support needs.
Identifying signs and symptoms of the different types of abuse: Physical abuse – Multiple bruising or finger marks (especially in well-protected areas such as eye sockets, inner arms or thighs) fractures, scratches or cuts, pressure ulcers and sores from wet bedding, black eyes or bruised ears, welt marks, loss of weight, withdrawal or mood changes and reluctance by the adult to be alone with the alleged abuser. Sexual abuse – Bruises, scratches or bite marks on the body, scratches, abrasions or persistent infections in the anal/genital area, pregnancy, blood or marks on underwear and abdominal pain with no diagnosable cause. Emotional/psychological – Carer seeming to ignore the adult’s presence and needs, reports from neighbours of shouting, screaming and swearing, a culture of teasing or taunting which is causing distress or humiliation and no valuing of basic human rights.
Financial Abuse – People not being allowed to manager their own financial affairs, no information being given where consent has been given to act, family unwilling to pay for services even though the service user has sufficient money and very few or no personal possessions Institutional Abuse – not being given the choice over day-to-day decisions, freedom to go out is limited, privacy and dignity are not respected and the setting is run for the convenience of the staff. Self-Neglect – Physical illness or disability, memory or concentration problems, sensory loss or difficulty, mental illness and mental health problems and learning difficulties/disabilities. Neglect by others – Not providing adequate food, not providing assistance with eating food (if needed) not ensuring someone is adequately clothed and failing to maintain a clean and hygienic living environment. 1.3)
There are a number of factors that may contribute to an individual being more vulnerable to abuse these include, but not limited to: Less aware of their rights. Socially isolated. Need help with personal care/daily living. Unable to express themselves clearly. Limited sex education. Live in poor housing. May need more care than a carer can give. Difficulty in understanding requests or actions. Unaware of how to complain. History of substance abuse. In a relationship of unequal power. No aids or adaptations in the home. Limited life experiences resulting in unable to recognise risky situations.
Outcome 2 know how to respond to suspected or alleged abuse
2.1) If any suspicions of abuse exist, the care worker or individual who suspects its occurrence must report their concerns to the appropriate individuals such as; line manager or senior collegue. Record the facts on appropriate paperwork, listen do not judge the complainant, stay calm and collected and do not tamper with evidence.
2.2) The company or agency that the care worker is employed at will have policies and procedures already in place which need to be followed by their employees in situations where allegations of abuse are brought to light. Most companies’ policies and procedures, would state that the employee must report any abuse allegations to the appropriate person(s) within the company/agency, record the facts on appropriate paperwork, listen not judge the complainant, always establish what it is that has occurred and report any suspicions to the appropriate manager, reassuring the employee at all times and take every allegation seriously, always date the paperwork and have it signed by any witness (if any), take photographs of evidence if possible.
2.3) It is important to take a clear and accurate record of the conversation. Listen carefully to what they are saying. Be aware of the possibility that medical evidence might be needed. Report to your line manager, senior manager, social services or the police. At the first opportunity make a note of the disclosure and date and sign your record. Your notes should: record what the individual actually said, using their own words and phrases describe the circumstances in which the disclosure came about record the setting and anyone else who was there at the time not cloud factual information with opinions or judgments.
Use a pen with black ink, so that the report can be photocopied, and keep the record safe and confidential as your report may be required later as part of a legal action or disciplinary procedure.
Do not clean up location of suspected abuse as this may disturb evidence. If appropriate and depending on nature of abuse, keep documentation safe e.g. bank statements if financial abuse suspected.
Outcome 3 Understand the national and local context of safeguarding and protection from abuse
3.1) There will be policies and procedures available within the company or agency the care worker is employed by. The national policies and local systems that relate to safeguarding and protection from abuse. Laws which cover work in the field of care:
Care Standards Act 2000
National Assistance Act 1948
NHS and Community Care Act 1990
Chronically Sick and Disabled Persons Act 1986
Disability Discrimination Act 1995
Mental Health Act 1983
Mental Act 1983 (draft MH Bill 2004)
Safeguarding Vulnerable Groups Act 2006
Care Quality Commission (CQC)
Government policies and guidelines:
Working Together to Safeguard Children’ Published 1999
‘No Secrets’. Published 2000
Valuing People: A New Strategy for Learning Disability in the 21st Century’. Published 2001 The Protection of Vulnerable Adults Scheme (POVA) for England and Wales. Published 2004.
3.2) Safeguarding Adults Boards – raises awareness and promotes the welfare of vulnerable adults by the development of an effective co-operative. This group of people come from a wide range of public and voluntary services and other organisations and is committed to ensuring that the work done effectively brings about good outcomes for adults. It is an organisation that draws on expertise and experience from a number of sources. 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. Care Quality Commission (CQC) is the regulatory board and their role is to monitor and provide guidance on what all health and social care providers must do to safeguard vulnerable adults from abuse.
There are a number of charities such as MIND, Age UK etc. who may liaise with the above agencies in protecting individuals.
3.3) Report of serious failures to protect an individual from abuse include: Castlebeck, Winterbourne View, Bristol – Owners failed to protect the safety and welfare of patients at Winterbourne View. Jimmy Saville case – committed many acts of abuse over a number of decades. Was allowed unlimited unsupervised access to vulnerable children. Ian Huntley worked as a caretaker at his local school and went on to murder two young girls. Baby P – Social workers, doctors and police all committed errors that led to the death of this child. Victoria Climbie – despite being on the radar of social services and local authorities including the police, this young girl was tortured before being murdered. Stephen Hoskins – social services staff failed to prevent the abuse and murder of Stephen who had learning disabilities. Mid Staffordshire Hospital – nurses guilty of neglect.
3.4) Sources of information and advice about own role in safeguarding and protecting individuals from abuse include, my line manager, policies and procedures in my Staff Handbook. The CQC, Independent Safeguarding Authority, Police. Additional information can be found in my NVQ Training Book, Online training, the internet and news media.
Outcome 4 Understand ways to reduce the likelihood of abuse
4.1) Person centered values – putting the individual’s feelings and preferences first are the cornerstone of good care and vital in reducing the likelihood of abuse. All too often institutional abuse is caused by staff making choices about the individual’s care that are convenient for them and do not take into account the individual’s preferences.
Active participation – by showing an individual the respect and dignity of truly involving them in all aspects of their care, the likelihood of abuse is reduced.
Promoting choice and rights – All individuals should be made aware of the complaints procedure and statement of purpose of the agency providing their care. Their care plans must be drawn up with their full involvement. By including an individual in their care it allows them to still be an individual and to have their rights and wishes recognised.
4.2) An accessible complaints procedure backs up that individual’s rights. It means that the person knows who they can go to with a complaint or concern about any aspect of their treatment or care. Outcome 5 Know how to recognise and report unsafe practices
5.1) Unsafe practices that may affect the well-being of individuals are unsafe moving and handling without using necessary equipment e.g. hoists. Not monitoring and noting any changes in an individual’s general health and wellbeing. Not adhering to hygiene practices and thereby spreading infection. Not reporting any unusual marks or bruises. Not administering medication correctly and recording to avoid overdosing. Not treating each and every individual with due care and respect. This would include all unsafe practices, unsafe equipment and a being short staffed resulting in time restrictions.
5.2) Actions to be taken if unsafe practices have been identified are follow your agency or company’s whistleblowing policy and inform line manager. Make a full record of the practice and any evidence. This would include all unsafe practices, unsafe equipment and a being short staffed resulting in time restrictions.
5.3) The action to be taken if suspected abuse or unsafe practices have been reported but nothing has been done in response are that I would escalate to the next level, be that line manager, Social Worker, local Safeguarding team or CQC until issue has been addressed. If an individual is in immediate danger I would call the police.