Safeguarding Abuse

Outcome 1 Know how to recognise signs of abuse
1.1 Define the following types of abuse:
Physical abuse – force feeding, hitting, slapping, misuse of medication and use of restraint etc. Sexual abuse- rape and sexual assault, indecent exposure, penetration or attempted penetration etc. Emotional/ psychological abuse – emotional abuse, bullying, ignoring, shouting etc. Financial abuse – theft, fraud, exploitation etc.

Institutional abuse – Institutional abuse is different from other categories because it is about who abuses and how that abuse comes to pass, rather than about types of harm. Abuse occurs in a relationship, family, service or institution and it can be perpetrated by an individual or more collectively, by a regime. Self-neglect – is a behavioural condition in which an individual neglects to attend to their basic needs, such as personal hygiene, appropriate clothing, feeding, or tending appropriately to any medical conditions they have Neglect by others – is a passive form of abuse in which a perpetrator is responsible to provide care for a victim who is unable to care for himself or herself, but fails to provide adequate care.

Neglect may include the failure to provide sufficient supervision, nourishment, or medical care, or the failure to fulfil other needs for which the victim cannot provide themselves. The term is also applied when necessary care is withheld by those responsible for providing it from animals, plants, and even inanimate objects. Neglect can carry on in a child’s life falling into many long-term side effects such as: physical injuries, low self-esteem, attention disorders, violent behaviour, and can even cause death

1.2 Identify the signs/or symptoms associated with each type of abuse? Physical abuse – multiple bruising or finger marks (especially in the well protected areas such as eye sockets, inner arms and tights). Fractures – especially twisting fractures and dislocations especially when accompanied with bruising and fingers marks. Scratches and cuts. Pressure sores or ulcers or rashes from wet bedding and clothing. Constant unexplained falls or injuries. Weight loss and dehydration.

Sexual abuse – bruises, scratch marks, bites and burn marks on the body. Starches and abrasions or persistent infection in anal/genital regions. Pregnancy. Blood or marks on underwear. Abdominal pain with no diagnosable cause. Aggression, anxiety and tearfulness. Refusal to undress for activities such as swimming/bathing.

Emotional/psychological abuse – carers seeming to ignore the vulnerable person’s presence and needs. Reports from neighbours of shouting, screaming and swearing. No valuing of basic human rights for example choice, opinion, privacy and dignity. Financial abuse – people not being allowed to manage their own financial affairs. No information being given where consent has been given to act. Family unwilling to pay, from person’s fund, for services, although person has sufficient money. Enduring power of attorney set up without consulting a doctor where the vulnerable adult id already confused. Sudden changing of a will.

Institutional abuse – people in residential settings are not given choices over day to day decisions such as mealtimes or bedtimes. Privacy and dignity are not respected. Personal correspondence is opened by staff. Access to advice and advocacy is restricted or not allowed.

Self- neglect – increasing infirmity, physical illness or disability. Memory and concentration problems. Sensory loss or difficulty. Alcohol and drug misuse problems. Neglect by others – becoming ill, hungry, cold, dirty, injured or deprived of their rights. Neglecting someone you are supposed to be supporting can result from failing to undertake support service, for example; not providing adequate food, not providing assistance with eating food if necessary, and not ensuring that someone receives support with personal care. 1.3 Describe factors that may contribute to an individual being more vulnerable to abuse? Risk factors can be: poor communication between cared for person and the carer – this could be because of a medical condition or a social/relationship issue or a language barrier problem. Challenging behaviour from cared for person. Carer being young or immature. Care having disturbed sleep. No support from cared for person’s family and friends.

Outcome 2 Know how to respond to suspected or alleged abuse
2.1 Explain the actions to take if there are suspicions that an individual is being abused? If someone makes an allegation of abuse to you. You must always believe them. It’s one of the biggest fears of those who have abused is when no one believes them. Don’t make this fear a reality. Reassure them, don’t pressure answers out of them. Tell senior staff. Never put words in their words or twist the truth. Just listen and record everything they say word by word.

2.2 Explain the actions to take if an individual alleges that they have been abused? If you work for a company or agency there should be policies and procedures already in place to follow most would state to report to the appropriate person(s), record the facts on appropriate paperwork, listen and do not judge. Always establish what it is that has occurred and report any suspicions to the appropriate manger. Reassure the individual at all times and take every allegation seriously. Always date the paperwork and have it signed by any witnesses (if any). Take photographs of evidence if possible, if it is of the individual gain consent first and explain why you are doing it. Speak clearly and precise and avoid any leading questions.

2.3 Identify ways to ensure that evidences of abuse are preserved? Record the facts immediately. Report immediately. Do not tamper with evidence. Never agree to the individual that you won’t tell anyone what happened to them. Make sure you record things accurately, sign, date and keep it safe. Don’t talk to anyone about the incident including family and colleagues. Keep room secure.

Outcome 3 Understand the national and local context of safeguarding and protection from abuse 3.1 Identify national policies and local systems that relate to safeguarding and protection from abuse? Human rights, health and safety, anti-discriminatory legislation and any safeguarding policies. 3.2 Explain the roles of different agencies in safeguarding and protecting individuals from abuse? Police, criminal (assault, fraud, theft, domestic violence)

Council, to protect people using their service – make sure they’re safe. Extend help where needed to support those experiencing abuse and neglect in their own homes Social Workers, to investigate actual or suspected abuse or neglect CRB, to check an individual’s past to see if they have any criminal convictions. Medical professionals such as GP, A&E staff, nurses, doctors: they can examine, diagnose & treat, they can record: this can include photographic evidence. An Expert Witness: this is a specialist within a subject such as paediatric, geriatrics, and psychiatrics.

The local authority Social Services dept. would carry out an assessment of needs; this would include any unpaid carer of individual. Safeguarding Team, within Social Services dept.: investigates & ensures safety, work with other agencies such as police. A Safeguarding & Protection Officer would lead the Adult Protection Alert. Police: to investigate/prosecute, to work with other agencies, to provide support to victims, to raise awareness of crimes, crime prevention. Care Quality Commission to regulate & inspect care providers. Independent Safeguarding Authority, this includes Vetting & Barring Scheme, to safeguard & protect vulnerable people before employment commences, include CRB.

3.3 Identify reports into serious failures to protect individuals from abuse? Winterbourne view case which was nationally reported and a local abuse case was the Orme house in Lowestoft. Winterbourne view home was more physical and emotional abuse and the Orme house was more neglect and poor living conditions. Winterbourne view case was reported nationally because it was such a disgusting mistreatment of vulnerable people, 11 members of staff were caught on camera after visitors and patients complained about mistreatment. Evidence was captured of staff physically abusing the residents such as slapping, poking them in the eyes, pulling hair and worst of all trapping them under chairs and soaking them with freezing cold water. Emotional abuse was name calling.

CQC was told several times but done nothing about it till someone from the BBC Panorama reporter team went undercover as a carer and videoed the abuse and then went to CQC who finally took notice and done something about it. 11 members were arrested and 6 were jailed. Orme house in Lowestoft was closed down and 15 residents were moved to 3 nearby homes due to poor living conditions and neglect. Some of the issues were electrical problems which are not a major issue but the greater concern was the general cleanliness and the health and well-being of the residents. 3.4 Identify sources of information and advice about own role in safeguarding and protecting individuals from abuse? Training, line manager/ senior colleagues. National policies and local authorities.

Outcome 4 Understand ways to reduce the likelihood of abuse
4.1 explain how the likelihood of abuse may be reduced by:
Working with person centred values.
Individuality
Rights
Choices
Privacy
Independence
Dignity
Respect
Partnership
All of these points represent the rights for adults to live their lives free of fear, violence and abuse. They have the right to be protected from harm and exploitation. Encouraging active participation.

Active participation is a way of working the recognises an individual’s right to participate in the activities and relationships of everyday life as independently as possible. By being active this decreases the feeling of being vulnerable and improves confidence and self-esteem. Promoting choice and rights.

By encouraging the individual to make choices and be involved with the decision making reduces the vulnerability through empowerment and independence.

4.2 Explain the importance of accessible complaints procedures for reducing the likelihood of abuse? If a complaint procedure is clear and easily accessible abusers would be more likely to be challenged on their behaviour. Knowing this would make them less likely to abuse. It also helps vulnerable individuals to feel more protected and more empowered and therefore less likely to accept abuse.

Outcome 5 Know how to recognise and report unsafe practices
5.1 Describe unsafe practices that may affect the well-being of individuals? Anything that would threaten the personal safety of another person, that is physical, emotional or psychological. Things like poor manual handling, not keeping track if a client has taken their medication, not disposing of waste properly, basically every time a short cut is taken on a procedure. 5.2 Explain the actions to take if unsafe practices have been identified? If you believe that unsafe practices are happening, there are several steps that you could take, firstly, talk to other colleagues, they might share your concerns. Secondly, make sure your written records, are up to date and highlight any incidents that you think are relevant, also gather as much other evidence as possible, this could be photographic, written recorded etc., Thirdly, make a senior colleague aware of your concerns (if you think the situation is urgent, you should do this first).

You could also write a letter to the relevant department/manager explaining your concerns simply and clearly. Another course of action that you could take, would be to contact your local trade union or health and safety representative. 5.3 Describe the actions to take if suspected abuse or unsafe practices have been reported but nothing has been done in response? If unsafe practice has been reported but nothing has been done to ensure it is corrected a social care worker has a duty of care and son must report their concerns to the next level of management, the CQC, the safeguarding team at the local social services department or the general social care council and write a confidential report detailing all relevant information.