Principles of safeguarding and protection in health and social care (HSC 24) Section 1 How to recognise sign of abuse Physical abuse happen when is involved contact planned to cause bodily harm, feelings of intimidation.
The signs are physical suffering or injury, injuries that are the shape of objects, injuries in a variety of stages or injuries that have not received medical attention.A person is being taken too many times or different places to receive medical attention, skin infections, dehydration or unexplained weight changes or medication being lost, behaviour that indicates that the person is afraid or avoiding the perpetrator, change of behaviour. An individual is more vulnerable to this time of abuse if has a disability or a mental problem, elderly people are very vulnerable, the ones with dementia or not having mental capacity. Individual is secluded or isolated or are vulnerable, individuals with a sensory impairment, for example, poor or no hearing or sight that might lead to communication difficulties.The individuals mentally ill or disable, or medically dependent people, such as nursing home patients or residential supporting living or even in their on home. This is because they have nobody to protect them and are often abused by people in their lives who support them or a member of family.
Sexual abuse is the forcing of undesired sexual behaviour by one person upon another, unwanted advances, indecent exposure or harassment, rough washing or touching of the genital area, rape, being forced to watch or participate in sexual acts.The sings are sexually transmitted diseases or pregnancy, tears or bruises in genital/anal areas, soreness when sitting, signs that someone is trying to take control of their body image, for example, anorexia, bulimia or self-harm, sexualised behaviour, inappropriately dressed. Individuals more vulnerable to this abuse are the ones who has low self-esteem and no sense of self-worth. Someone who has been physically and emotionally abused in the past, someone that has been sexually abused. People who have substance abuse problems.The individuals mentally ill or disable, medically dependent people such as nursing home patients or residential supporting living or even in their own home. This is because they have nobody to protect them and are often abused by people in their lives who support them or a member of family. Emotional/psychological abuse may involve threats or actions to cause mental or physical harm, intimidation, not being included, being ignored, bullying, humiliating and blaming.
These include discrimination that relates to age, race, gender, sexuality, culture, religion.The signs for this abuse are difficulty gaining access to the adult on their own, the adult not getting access to medical care or appointments with other agencies, low self-esteem or lack of confidence and anxiety, increased levels of confusion, increased urinary or faecal incontinence, sleep disturbance, the person feeling/acting as if they are being watched all of the time, decreased ability to communicate, language being used that is not usual for the service user, deference/submission to the perpetrator.Individuals more vulnerable to this type of abuse are the ones that may lack the capacity to understand what is happening or that it is wrong, Individuals that may be physically or emotionally weak and rely on others for care, individuals being cared for at home who are reliant on another person for care and support, elderly people that live in nursing homecare. Financial abuse is the illegal or unauthorised use of a person’s money, property, pension book or other valuables.The signs are sudden loss of assets, unusual or inappropriate financial transactions, visitors whose visits always coincide with the day a person’s benefits are cashed, insufficient food in the house, bills not being paid, a sense that the person is being tolerated in the house due to the income they bring in; sometimes with that person not included in the activities the rest of the family enjoys. Any act of theft of money or property, or use of money or property, without the person’s consent, or without the appropriate legal uthority; the misuse of money intended for, or belonging to, an adult by someone who has been trusted to handle their finances, or who has assumed control of their finances by default. The individuals more vulnerable to this abuse are elderly people, the ones that live alone, individuals with learning disabilities, and all disable people, individuals who do not have good support networks around them, and individuals being cared for at home who are reliant on another person for care and support.Institutional abuse involves failure of an organisation to provide appropriate and professional individual services to vulnerable people.
It can be seen or detected in processes, attitudes and behaviour that amount to discrimination through unwitting prejudice, ignorance, thoughtlessness, stereotyping and rigid systems.The signs or symptoms are treating adults like children, arbitrary decision making by staff group, service or organisation strict, regimented or inflexible routines or schedules for daily activities such as meal times, bed / awakening times, bathing / washing, going to the toilet, lack of choice or options, such as food and drink, dress, possessions, daily activities and social activities, lack of privacy, dignity, choice or respect for people as individuals, unsafe or unhygienic environment, lack of provision for dress, diet or religious observance in accordance with an individual’s belief or cultural background, withdrawing people from individually valued community or family contact. Vulnerable to this type of abuse are the individuals in nursing homes, residential living care homes, hospitals and all institutions that provide care an medical services. Self-neglect is a behavioural condition in which an individual neglects to attend to their basic needs, such as personal hygiene, feeding, clothing, or medical conditions they might have.The signs or symptoms are malnutrition, rapid or continuous weight loss, inadequate or inappropriate clothing, untreated medical problems, dirty clothing/bedding, and lack of personal care. The individuals more vulnerable to self-neglect are the ones that already suffer other type off abuse like physical or sexual abuse or they suffered in the past and they weren’t helped; individuals that suffer of depression, other mental illnesses or disable people. Neglect by others is a passive form of abuse in which the wrongdoer is responsible to provide care, for someone, who is unable to care for oneself, but fails to provide adequate care to meet their needs.Neglect may include failing to provide sufficient supervision, nourishment, medical care or other needs.
There could also be factors for the abuser which could include the abuser having lack of training, also abusing their power, sometimes personal issues have a part to play which could include the carer/abuser being stressed or having a history of abuse and continuing the cycle. The signs are malnutrition, weight loss, not having access to necessary physical aides, untreated medical problems, dirty clothing/bedding, lack of personal care, pressure sores wounds, confusion, over-sedation, inadequate or excessive heating, too much or too little exercise or social activity.The individuals more vulnerable to this abuse are the ones that need a lot of care like severe physically or mentally disable individuals, which lack mental capacity, the ones that are living in health and care institutions. Section 2 How to respond to suspected or alleged abuse If there are suspicions that an individual is being abused keep calm, don’t jump to conclusions or make accusations, there may be a perfectly reasonable explanation, give the person the chance to talk or investigate more, report to the senior member of staff or the Manager your suspicions . If an individual alleges that he is abused stay calm take time to listen to them, void asking questions. It may be difficult for the person to talk; they may be worried about how you will react. The person may ask you not to tell anyone else about the abuse.
Always be honest and never make promises you can’t keep. Explain that you may have that you may need to share what you are told, but only to people who need to know. Never promise to keep anything confidential. Ask the person what they would want to happen, if the person has physical signs or injuries try and ensure they are seen by a qualified medical practitioner (e. g. doctor or nurse), preserve any other evidence that may be available. Write down what was said, where it was said and who was there, include any questions you have asked. Record any physical signs or injuries using a body map or hand drawing.
Write a description of any physical signs or injuries including size, shape, colour etc.Always remember to sign and date your notes and any other records you have made and make sure they are kept in a safe place. It may not always be told the truth.
Where you have concerns you must always report them. It can take people a long time and a lot of courage before they speak out and seek help. Few of them are likely to make decisions about what to do overnight.
Abuse is not always deliberate. It may be that someone is trying to do their best in a difficult situation. They may be a relative, friend or carer who needs help or support in difficult circumstances. Section 3 The national and local context of safeguarding and protection from abuse.National policies, legislation and local system are: Human Rights Act, Mental Capacity Act 2005 and DOLS, Health and Social Act 2008, Equality Act 2010, General Social Care Council, Public Interest Disclosure Act 1998. The policy and procedures are for different agencies and professionals involved in safeguarding adults, including managers, professionals, volunteers and staff working in public, voluntary and private sector organisations.
They represent the commitment of organisations to: •Work together to prevent and protect adults at risk from abuse •Empower and support people to make their own choices •Investigate actual or suspected abuse and neglect •Support adults and provide a service to adults at risk who are experiencing abuse, neglect and exploitation. RQIA – The Regulation and Quality Improvement Authority register and inspect a wide range of health and social care services. Their inspections are based on regulations and minimum care standards which ensure that both the public and service providers know the quality of care expected. Inspectors visit nursing and residential care homes and children’s homes in order to inspect all aspects of the care provided to guarantee the comfort and dignity of those using the facilities and to ensure public confidence in these services.
Social Services – Social workers work with people who have been socially excluded or who are experiencing crisis. Their role is to provide support and enable service users to help themselves.They maintain professional relationships with the service users and act as guides, advocates and critical friends. They work in a variety of settings within a framework of relevant legislation and procedures supporting individuals, families and groups within the community. Settings may include the service users own how, schools, hospitals and the premises of other public sector and voluntary organisations. Qualified social worker professionals are often supported by social work assistants, they also work closely with other health and social care professionals like General Practitioners that can detect sign of abuse and can report them to Social services.
The Government introduced guidance called ‘No Secrets’ in 2000, which sets out how the authorities – including health and social care professionals, the police and criminal justice agencies – should work together to reduce the risk of abuse occurring, and to intervene to protect people when abuse does happen. Each local partnership is asked to adopt this policy and procedures so that there is consistency across London in how adults at risk are safeguarded from abuse. However, some local partnerships may want to adapt some aspects of the procedures to meet their local arrangements. For example, some boroughs may have a slightly different approach to thresholds for Safeguarding Adults action. Local partnerships could add an appendix to this policy and procedures.A new Independent Safeguarding Authority – Vetting and Barring Scheme – is to replace the Protection of Vulnerable Adults (POVA) scheme with a more comprehensive system and ensure a safe workforce for those who work with vulnerable adults. ISA (Independent Safeguarding Authority) is responsible for maintaining a list of people who are not suitable to work with vulnerable individuals.
Employers in the Care sector must carry out a background checks on all staff and to report to ISA any concerns. There was a “systemic failure to protect people” by the owners of a Bristol hospital at the centre of abuse allegations involving vulnerable adults, care watchdogs have said. The Care Quality Commission has published its findings following an inspection of services provided at Winterbourne View, owned by Castlebeck Care Ltd, in Bristol.The report comes after the BBC’s Panorama filmed patients being pinned down, slapped, doused in cold water and repeatedly taunted and teased despite warnings by whistleblower Terry Bryan. Mr Bryan, a senior nurse, had alerted the care home’s management and the CQC on several occasions, but his concerns failed to be followed up. After considering a range of evidence, CQC inspectors found Castlebeck Care had failed to ensure that people living at Winterbourne View were adequately protected from risk, including the risks of unsafe practices by its own staff.
Harold Shipman graduated from Leeds school of medicine in 1970, and moved to Todmorden in 1974 to practice as a GP. In 1975 he was caught forging prescriptions for pethidine for his own use, and was fined ? 600 and ordered to attend a drug rehabilitation clinic.For the following years, he worked in several temporary jobs before securing a position as a GP in 1977 and eventually setting up his own surgery in Hyde in 1993. Dr. Linda Reynolds of Brooke Street Surgery in Hyde reported to the coroner in March 1998 that she and Deborah Massey from Frank Massey and Son’s Funeral Parlour both had concerns about the high death rate of Harold Shipman’s patients.
A particular area of concern was the number of cremation forms for elderly women that needed to be countersigned, and Dr. Reynolds believed Harold Shipman was responsible for their deaths. The matter was brought to the attention of the police, but they were unable to find enough evidence to press charges.
The Shipman Inquiry later blamed the police for assigning inexperienced officers to the case, the first failing of the authorities which led to a further 3 people being killed before Shipman was eventually arrested and convicted. Shipman’s last victim was found dead at her home on 24th June 1998. He was the last person to see her alive, and signed her death certificate recording ‘old age’ as the cause of death. The victim’s daughter became concerned when a solicitor informed her that a will had been made by her mother, leaving everything to Shipman and nothing to her or her children. My sources of information and advice are policies and procedures, the Manager of Care Home, care plans, your local authority, trainings, books and internet. Section 4 Ways to reduce the likelihood of abuse.The main factor is in person centred approach to count and treat everyone as an individual with respect. Treating every individual with dignity, make informed choices, respecting every individual’s views, encouraging and supporting in active participation, helping individual service user and all worker (regardless position) to make complaint and comments and maintaining confidentiality.
All of the above practices can help individuals to gain their self-esteem and recognize their values, rights and powers what protect them from being abused. Active participation means truly involving that person in their care so that choice, dignity and respect are addressed fully.Encouraging active participation builds self-esteem, and the person will refuse to tolerate abuse and will be inclined to report it, they’re also around other people which will help to build friendships in which they can share things they may tell one of them if abuse may happen and one of them may pass it on to help. Promoting choice and rights is also addressed by active participation and an accessible complaints procedure (which should be visible somewhere in the setting or may be included in a service user’s ‘welcome’ pack) 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. Complaints are good way of considering how well the services are provided, it also helps us to identify if there are any weaknesses e.
g. potential for abuse and neglect.A complaints procedure should be simple to follow because it encourages people to raise their concerns and it indicates that organization will respond to those concerns rather than ignoring them. If it’s too difficult to make a complaint the abuse is likely to continue. If it’s easy to make a complaint the abuse is likely to be dealt with sooner. On a bigger scale complaints make government to bring changes in their policies according to people demand. Section 5 How to recognise and report unsafe practices.
Anything that would threaten the personal safety of another person that is physical, emotional or psychological can be described as an unsafe practice.Things like poor manual handling, not keeping track if a client has taken their medication, not disposing of waste properly, and if we let cases of abuse go unreported, not only could we be subjecting the victim too even more harm but we could be encouraging the abuser to victimise others; basically every time a short cut is taken on a procedure. If you believe that unsafe practices are happening, talk to other colleagues, they might share your concerns.
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. Make a senior colleague aware of your concerns, if you think the situation is urgent, you should do this first or talk directly with the Manager. 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. If no action was taken to a report abuse or unsafe practice you must go to the next superior in position. After you have reported the incident you still have a duty of care to your service user.
If you feel that your patient is still at risk then speaks with your line manager regarding your concerns. If you feel your line manager is not taking appropriate action, or you suspect your line manager of abusing a patient then most company policies would state that you would need to contact the Regional Manager or the Director of Care. You would also need to contact an inspectorate body.