Safeguarding and Protection in Health and Social Care

Physical: Physical abuse is deliberate physical force that may result in bodily injury, pain, or impairment. Both old and young people can be physically abused.

Physical abuse includes the smashing of furniture and personal belongings, being pushed or shoved, being held against your will,slapped, bitten, kicked, pinched, punched, choked or ducked under water, threatened or hurt with a weapon, threats of violence, locked in or out of the house, hair pulled …burnt with cigarettes, acid, an iron, hot food or water … Signs: bruising, particularly in well-protected and covered areas, fractures, sprains or dislocations, lacerations, burns - including friction burns and scalds, drowsiness, pressure sores, cowering and flinching, unexplained hair loss, significant weight loss, etc….

Symptoms: feeling low, angry and in pain.

see more:sources of information and advice about own role in safeguarding

Sexual: Sexual abuse is when a person is forced or tricked into taking part in any kind of sexual activity. When sexual contact is non-con-sensual it is abuse.

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It can happen to men and women of any age that is both old and young. It can include sexual penetration of any part of the body with a penis, finger or any object, sexual exploitation, making threats about sexual activities, exposure to pornographic material, touching of breast or genitals, kissing, etc Signs & Symptoms; bruises around breasts or genitals, genital infections, unexplained vaginal or anal bleeding, torn, stained, or bloody underwear, disturbed sleep patterns, vulnerable adult appears withdrawn and fearful, inappropriate dressing, etc Emotional/Psychological: is where one person gains power and control over another through words and gestures which gradually undermine the other’s self-respect.

Emotional abuse can be name-calling, blaming, screaming, making threats, yelling, neglecting, manipulation, not listening, withholding affection, belittling and untrue accusations. Signs: 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self-confidence, shouting or swearing, behaviours such as rocking, hair twisting and self-mutilation, vulnerable adult withdrawn and fearful.

Types of Abuse cont.
Financial: is stealing or defrauding someone of money, goods and/or property, allowing others to steal money or property, tricking or threatening individuals into giving away money or property, withholding money, refusing to allow individuals to manage their finances, etc. for example when a support worker is taking money from a service users’ purse without his or her knowledge.

Signs: Signs of financial abuse are signatures on cheques that do not resemble the service users’ signature, or signed when the service user cannot write, unexplained withdrawals of large sums of money by a person accompanying the service user, lack of amenities, such as TV, personal grooming items, appropriate clothing, that the service user should be able to afford, deliberate isolation of service user from friends and family, resulting in the support worker alone having total control, the unexplained sudden transfer of assets to a family member or someone outside the family. Symptoms: include the person feeling fearful, anxious, embarrassed and belittled.

Institutional: abuse happens when the lifestyles of service users are sacrificed in favour of the routines and/or restrictive practices of the home. Institutional abuse comprises neglect, physical abuse, sexual abuse, verbal abuse, discriminatory abuse, psychological and emotional abuse, financial abuse, service users not being allowed to go out, their personal letters are opened and read, their privacy not respected, their interest not at the centre of every decision being made, excessive medication and complaints procedure not made available for the service users.

Signs and Symptoms: 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/Neglect is when a person/carer does not pay attention to their/service users health and well-being. Service users/Carers can neglect themselves/Service users due to illness or depression or might intentionally neglect themselves/service users. The signs and symptoms include: 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.

What to do if you think an individual is 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. I will make sure that 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 make sure that I let my manager know what has happened immediately and pass this information on in private and make sure my report is also confidential. I will only report and record the facts - what the individual has told me.

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. ‘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

Individual Verbally Alleges Abuse;
‘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. I will make sure that I record the detail of all allegations that the individual tells me 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 make sure that I 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. Keeping Evidence of abuse: ‘Ways to ensure that evidence of abuse is preserved are as follows: By leaving things as they are and not touching anything.

By not removing, cleaning or washing what the individual is wearing and by not handling the individual’s clothes or bedding. By keeping the area safe and not allowing anyone to enter into the area. By recording and reporting carefully, confidentially and in full all that was told to me by both the individual and others if present at the time and also what I noticed; stating the facts only. By preserving any first aid items used.

Policies of Safeguarding
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. 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.

Advice Support and Information

Your own Company should have a copy procedures and information regarding Abuse with in their own care home with their own policies outlined. CQC website has a vast array of information to help you with any issue relating to any aspect of Care including Abuse. http://www.cqc.org.uk/

Your Manager, Colleagues and peers.