1. Define the following types of abuse:
a. Physical abuse
Physical abuse can include: hitting, slapping, pushing, pinching, force feeding, kicking, burning, scalding, misuse of medication or restraint, catheterisation for the convenience of staff, inappropriate sanctions, a carer causing illness or injury to someone in order to gain attention for themselves ( this might be associated with a condition called fabricated and induced illness ).
b. Sexual abuse
Sexual abuse includes: rape and sexual assault, masturbation, indecent exposure, penetration or attempted penetration of intimate areas, sexual harassment, involving a vulnerable adult in pornography, enforced witnessing of sexual acts or sexual media, participation in sexual acts to which the vulnerable adult has not consented or could not consent or was pressured into consenting.
c. Emotional / psychological abuse
The emotional and psychological abuse includes: bullying, threats of harm or abandonment, ignoring, shouting, swearing, deprivation of contact with others, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, deprivation of privacy or dignity, lack of mental stimulation.
d. Financial abuse
Financial abuse can include: theft, fraud, exploitation, pressure in connection with wills, property, inheritance or financial transactions, the misuse or misappropriation of property, possessions or benefits.
e. Institutional abuse
The key factor in identifying institutional abuse is that the abuse is accepted or ignored by the organisation, or that it happens because an organisation has systems and processes that are designed for its own benefit and not those of the people using the service. For example: People in residential settings are not given choice over day-to-day decisions such as mealtimes or bedtimes. Freedom to go out is limited by the institution
Privacy and dignity are not respected
Personal correspondence is opened by staff
The setting is run for the convenience of the staff
Excessive or inappropriate doses of sedation / medication are given Access to advice and advocacy is restricted or not allowed
Complaints procedures are deliberately made unavailable
f. Self neglect
Self neglect is different from abuse by others, but it is still a situation that can place people at risk of harm and, potentially, place them in danger. People neglect their own care for a range of reasons of which the most common are: Increasing infirmity
Physical illness or disability
Memory and concentration problems
Sensory loss or difficulty
Mental illness and mental health problems
Learning difficulties / disabilities
Alcohol and drug misuse problems
A different set of priorities and perspectives
g. Neglect by others
Neglect by others occurs when either a support worker or a family or friend carer fails to meet someone’s support needs. Neglecting someone you are supposed to be supporting can result from failing to undertake support services. Neglect and failure to care includes:
Ignoring medical or physical care needs
Failure to provide access to appropriate health, social care or educational services Withholding the necessities of life, such as medication, adequate nutrition and heating.
2. Identify the signs and / or symptoms associated with each type of abuse Physical abuse: bruising or finger marks, fractures, scratches or cuts, pressure ulcers or sores from wet bedding or clothing, black eyes or bruised ears, withdrawal or mood changes, reluctance by the vulnerable adult to be alone with the alleged abuser Sexual abuse: scratches, abrasions or persistent infections in the anal / genital regions, pregnancy, blood or marks on underwear, abdominal pain with no diagnosable cause, provocative sexual behaviour, promiscuity, prostitution, sexual abuse of others, aggression, anxiety, tearfulness, refusal to undress for activities such as swimming / bathing. Emotional / psychological abuse: cared for person fearful of raised voices, distressed if they feel they may be “in trouble”, cared for person being treated like a child, referring to the cared for person in a derogatory way.
Financial abuse: someone is not allowed to manage own financial affairs, person nort made aware of financial matters, very few or no personal possessions, unexplained shortage of money, unexplained disappearance of personal possessions or property, sudden change of a will. Institutional abuse: excessive conformity in daily routines by people using the service such as everybody waking up at around the same time, going to bed at around the same time, having too many similar activities and having meals at the same time. Neglect: medical condition deteriorating unexpectedly or not improving as expected, hypothermia or person cold or dressed inadequately, unexplained loss of weight, clothes or body dirty and smelly, delays in seeking medical attention
3. Describe factors that may contribute to an individual being more vulnerable to abuse Individuals can be more vulnerable to abuse because of an infirmity, mental health issues, memory problems, learning difficulties, advanced age, financial problems or lack of knowledge about their rights.
Outcome 2Know how to respond to suspected or alleged abuse
1. Explain the actions to take if there are suspicions that an individual is being abused There are four key priorities in responding to concerns about abuse: Priority 1: Protect
The most important concern is to ensure that the abused person is safe and protected from any further possibility of abuse. Make sure that any necessary medical treatment is provided, and give reassurance and comfort so that the person knows that they are safe. Priority 2: Report
Any abusive situation must be reported to the line manager, or the named person in the workplace procedures for the Protection of Vulnerable Adults. There may be formal reporting procedures in place in the organisation, or you may simply make an initial verbal referral. However, it is essential that you make a full, written report as soon as you can after the event. Priority 3:Ppreserve
Preserve any evidence. If this is a potential crime scene, you must be very careful not to destroy any potential evidence. Priority 4: Record an refer
Any information you have whether it is simply concerns, hard evidence or an allegation, must be carefully recorded. The evidence should be written down because verbal information can be altered and can have its meaning changed very easily when it is passed on.
2. Explain the actions to take if an individual alleges that they are being abused. The priorities in this case are the same as in the case of suspicion. However the first and most important response is that you must believe what you are told. One of the biggest fears of those being abused is that no one will believe them. Confidentiality cannot be always kept in these cases. You must always be clear, when someone alleges abuse, that you cannot promise to keep what they tell you confidential.
3. Identify ways to ensure that evidence of abuse is preserved. In case of physical or sexual abuse there is likely to be forensic evidence. These must be preserved by the following actions: Do not clear up
Do not wash or clean any part of the room or area in which the alleged abuse took place Do not remove bedding
Do not remove any clothes the abused person is wearing
Do not allow the person to wash, shower, bathe, brush hair or clean teeth Keep other people out of the room or area
If financial abuse is alleged or suspected, ensure that you have not thrown away any papers or documents that could be useful as evidence. Neglect generally speaks for itself, but it is important to preserve living conditions as they were found until they can be recorded and photographed. This does not include the person concerned, any treatment and medical attention needed must be provided.
Outcome 3Understand 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 There are a number of national policies designed to protect vulnerable adults from abuse: Criminal Justice Act 1998
Civil action by the victim
Care Standards Act 2000
Sexual Offences Act 2003
Family Law Act 1996
Offences Against the Person Act 1861
No Secrets ( England ) , In Safe Hands ( Wales )
Safeguarding Vulnerable Groups Act 2006 ( England and Wales ) Protection of Vulnerable Groups Act 2007 ( Scotland )
ASPA 2007 ( Scotland )
Criminal Injuries Compensation scheme
Mental Capacity Act 2005
Police and Criminal Evidence Act 1984
Mental Health Act 1983
Protection from Harassment Act 1997
Theft Act 1968
National Assistance Act 1984
Fraud Act 2006
Office of the Public Guardian
2. Explain the roles of different agencies in safeguarding and protecting individuals from abuse Both nationally and locally, the protection of vulnerable adults forms part of the Safeguarding Adults agenda. Local authorities now have Safeguarding Adults Boards. The local boards are responsible for delivering a multi-agency response to safeguarding adults and to ensure that all partner agencies are recognising and acting on safeguarding issues at a strategic and individual level. The Care Quality Commission regulates and inspects health and social care services including domiciliary and protect the rights of people detained under the Mental Health Act 1983. The Care Quality Commission has a role in identifying situations which give rise of concern that a person or person(s) using a regulated service is or has been at risk of harm, or may receive and allegation or a complaint about a service which could indicate risk of harm.
The Independent Safeguarding Authority (ISA) was a non-departmental public body, that existed until 1 December 2012, when it merged with the Criminal Records Bureau (CRB) to form the Disclosure and Barring Service (DBS). The DBS enables organisations in the public, private and voluntary sectors to make safer recruitment decisions by identifying candidates who may be unsuitable for certain work, especially that involve children or vulnerable adults, and provides wider access to criminal record information through its disclosure service for England and Wales.
3. Identify reports into serious failures to protect individuals from abuse There are a number of ‘failures in care’, in the examples bellow in which it is highlited what can happen when a service, or organization fails to protect the persons under their care. The Bichard inquiry into the deaths of Jessica Chapman and Holly Wells. www.bichardinquiry.org.uk
You can access information on this case from the above link, which will inform you of the outline of the case, the reason for the failure of care, and the enquiry details. This would be adequate to use as an example of ‘failures of care’. Other points of reference:
Ofsted Baby P report
Amy Howson Report
Alfie Goddard Report
4. Identify sources of information and advice about own role in safeguarding and protecting individuals from abuse Your employer will have their own policies relating to abuse, whistle blowing, etc. These policies are you’re ‘working documents’, as they inform your practice on how to meet your responsibilities whilst performing your role. However there are local and national policies relating to abuse, which also have to be considered.
Outcome 4Understand ways to reduce the likelihood of abuse
1. Explain how the likelihood of abuse may be reduced by:
a. Working with person centred values
Person-centred planning is a process of constant review, learning and listening. Person-centred planning focuses on the immediate and the future, taking into account the needs, thoughts, concerns and opinions of the individual, and consulting their family and friends and others within their ‘personal network’. This person-centred approach helps individuals identify their aspirations, and mobilises those concerned – including their personal network, service agents, non-specialist and non- service sources – to help people pursue their own personal ambitions. Services should, in theory, become more flexible and encouraging active participation.
b. Encouraging active participation
There are a few steps that can be taken to ensure active participation. These are: FACILITATE: Make contributing easier. Use tasks. Give preparation. INVESTIGATE: Find out why people are not contributing, what would make it easier for them to contribute. Encourage the use of visual aids. CLARIFY: Clarify expectations and objectives.
DEMONSTRATE: Show how experience-based learning works.
CHANGE: Change the dynamics. Create smaller groups. Silence louder group members. Use temporary rules and gimmicks. CONSULT: Consult the group. Give responsibility. Ask the group to come up with solutions. Be open. Use
c. Promoting choice and rights
This gives the service user the choice to speak out and talk about abuse etc.
2. Explain the importance of an accessible complaints procedure for reducing the likelihood of abuse. By having an accessible complaints procedure, you are encouraging the individuals in your care to ‘speak up’, about any issues they may have. They will not feel threatened, inadequate, or guilty, about making a complaint, with no fear of repercussions if they do complain. If the complaints procedure is easily accessible, the individual will be aware of what to do in the event of a complaint, who to complain to, and what will happen next.
Outcome 5Know how to recognise and report unsafe practices
1. Describe unsafe practices that may affect the well-being of individuals Unsafe practices that may affect the well being and safety of your service users could include: Poor working practices: This could include not having proper policies to protect the service users, not have correct equipment to perform their role (hoists, ppe, etc). Not working to the current standards, therefore putting service users at risk. Resource difficulties: This could be that staffs are not trained correctly to perform the tasks their role involves. It could be that the ‘home’ is understaffed, as the budget is not there to employ more staff.
The staff group may use agency staff, due to sickness, vacancies etc, and the agency staff are not aware of the needs of the individuals. Necessary facilities/equipment is not purchased due to lack of funds, (wheelchairs, disposable gloves, and correct diet for healthy living, utilities (heating and lighting restricted). Operational difficulties: This could be because of staff shortages, so recommended ratio of staff to service users, are not maintained. The staff group may not work as a team, therefore a continuous service is not maintained, and the service delivery suffers. Inexperienced staff ‘acting up’, in a senior role, that may not have the knowledge to perform the role.
2. Explain actions to take if unsafe practices have been identified It is your responsibility to report any unsafe practices, straight away, to your line manager. To “Blow the Whistle” on somebody or something means to report somebody for doing something wrong or illegal, especially within an organization. Your organization may have a “Whistle Blowing” policy, which will protect you and your employment if you report your concerns. Ask your manager or supervisor, if unsure, but follow your organizations policies regarding ‘reporting’ different concerns. You can seek advice from the Adult Protection Co- ordinator or lead person for Safeguarding Adults based at your local Authority/Council. All concerns should be reported accurately. If your concerns are not taken seriously, you must try another route. You must ask for help if you feel “out of your depth” with a particular individual or issue.
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