University of Chicago
Type of paper: Thesis/Dissertation Chapter
Principles of Safeguarding and protection in Health and Social Care
1. Knowing how to recognise signs of abuse
1.1. Define the different types of abuse
There are many different types of abuse that are usually classifed in 5 main headings. These include: Physical
Physical abuse is the act of a person making contact with someone to intentionally caus pain, harm or injury Sexual
Sexual abuse is forcing sexual contact or bhaviour, towards a person who doesnt give consent. In some cases people are deemed unable to consent due to age or mental health.
Psychological abuse is where a person is subjected to mentally stressing situations whic causes motional distress. Abusive realationships are a prime example of psychological abuse where there is an imbalance of power and the abuser has control. Finanical
Finanical abuse is where an indvidual tries to take control or gain access to anothers finanances illegally and without the persons consent. Institutional
Institutional abuse is the mistreatment of a person within a care environment. Usually due to lack of staff training and unacceptable standards of service. Self – neglect
Self – neglect is where a person does not care for their basic needs, such as their basic hygine. People who self – neglect regularlly put themselves at risk of harm or place themselves in dangerous situations. Neglect by others
Neglect is where a person responsible for the care needs of another fails to meet their needs. This is usually because they do not relise the importance of giving the care that is needed or they choose not to.
1.2. Identify the signs and symptoms associated with each type of abuse.
The potential signs for physical abuse can include:
Fractures and dislocation
multiple bruising in well-protected areas of the body
scratches or cut
pressure ulcers, sores or rashes
black eyes or bruising to ears
scalds or cigarette burns
a history of falls, injuries or a history of accidental overdose unable to provide an explanation consistant to their injuries clinical intervention without any clear benefit to the person deteriouration of health without an obvious cause
loss of weight
inappropriate, inadequate or soiled clothing
withdrawal or mood changes
carer’s resistance to allow people to visit
reluctanc to be left alone with the alleged abuser
The physical signs of sexual abuse are
bruises, scratched, burns or bite marks to the body
scratches, abrasions or persistent infections in the genital regions pregnancy
recurrant genital or urinary infections
blood or marks on underwear
abdominal pains with no diagnosabl cause
As well as the physical signs their can also be behavioural signs which act as an indicator of sexual abuse, these can include: provocative sexual behaviour or promiscuity
sexual abuse of others
self-injury or self-distructive behaviour such as alcohol and drug abuse or repeated suicide attempts. behaviour that invites further exploitation
disappearing from a home environment
aggression, anxiety or fearfulness
reluctance to be left alone with the alleged abuser
refusal to undress for activities such as swimming or bathing Psychological
The potential indicators for psychological abuse can include: refusal to be left alone with the alleged abuser
carer seems to ignore the person’s needs and presence
reports from neighbours of shouting, screaming and swearing
Fearful of raised voices, distressed if they feel their in trouble a culture of teasing or taunting which causes distress and humiliation the carer refers to the cared for person in a derogatory way no valuing of basic human rights cared for person being treated like a child
The signs and symptoms that are associated with financial abuse can include: very few or no personal possessions
unusual change in spending pattern
unexplained shortage of money
unexplained disappearance of possessions
family regularly asking for money from the persons allowance family unwilling to pay from person’s funds for services they get person not made aware of financial matters
enduring power of attorney set up without consulting a doctor where the person is already confused other people taking over person’s property
person not being allowed to manage their own financial affairs sudden changes of a will
There are many signs and symptoms of institutional abuse but the key factor to identifying it, is that the abuse is accepted or ignored by the care organisation. Examples of this are: complaints procedures are deliberately made unavailable
access to advice and advocacy is restricted or not allowed
excessive or inappropriate doses of sedation or medication are given the setting is run for the convenience of the staff
privacy and dignity are not respected
freedom to go out is limited by the institution
refused choices over day-to-day decisions such as mealtimes, bedtimes, what to wear or use the toilet Self-neglect
The signs and symptoms of self-neglect can sometimes be hard to recognise as it could be that the person has decided on this lifestyle choice and is happy to live this way. These situations are difficult to make decisions and a balance must be achieved to ensure we don’t remove a person’s ability to choose how they live yet safeguarding and protecting vunerable people. The signs to watch for can include: becoming ill regularly
loss of weight
being dirty and unwashed
wearing soiled clothing
an unclean living environment
withdrawal from sociaty
Neglect by others
The signs and symptoms of neglect by others are similar to self-neglect but the person relies on others for their care. For example not given adequate food or given assistance to eat
doesn’t get support with personal care and fails to maintain a clean living environment being left alone
not supporting communication needs or aiding with mobility
failing to maintain medical or health care needs
not supporting social contacts
1.3. Describe the factors that may contribute to an individual being more vulenerable to abuse.
Every individual is open to abuse and there are many risk factors that can make a person more vulenerable to abuse. However a person may still be abused when no obvious factors are present. Some factors that are known to contribute to the risk of abuse are: poor communication between the person and their carer
challenging behaviour by the cared for person
young or immature carers
carers feeling unable to carry on or strong feelings of frustration person and their carer have a history of a troubled relationship carer having an alcohol or drug dependancy
carer believing that the person is being deliberately difficult or ungrateful carer not taking on the roll of carer willingly and had to make big lifestyle changes carer having more than one care responsibilities
person being violent towards carer
carer having disturbed sleep
both person and carer being socially isolated
financial or housing pressures
delays to provide support
no family support or contact
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 you suspect an individual of being abused it is important that you speak to the individual and allow them to be open with you. Listen to the individual and do not judge their word. Try to establish what it is that has occurred without asking any leading questions. Reassure the individual that they are being taken seriously and that you will help them to make it stop. Ensure that the facts are recorded on the appeopriate paperwork and is signed and dated; making sure to report the incident to a senior member of staff.
2.2 Explain the actions to take if an individual alleges that they are being abused.
When an individual speaks out about abuse it is important to take the allegations seriously. Reassure them that they can tell you everything and you’ll do everything in your power to help it stop. Make a written account of what has been said making sure to include only the facts and not your own opinions. Sign and date the paperwork and report it to senior members of staff for them to take the matter further.
2.3 Identify ways to ensure that evidence of abuse is preserved.
to record the facts immediately making sure to sign and date the paperwork record any physical signs of abuse using a body map, try to describe the injuries size, shape and colour try not to tamper with any evidence unless you have to for the wellbeing of the individual if you have to touch anything, record what you have done
report the evidence to senior members of staff immediately
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.
Both nationally and locally the protection of vulnerable adults forms part of the safeguarding adults agenda. Local boards are responsible for delivering a multi-based agency to respond to the safeguarding of adults. They are also responsible for conducting Serious Case Reviews when someone has died as a result of abuse. Nationally there are legislations that provide the basis for dealing with vulnerable adults that are being abused. Such as the Care Standards Act 2000, Safe guarding vulnerable groups act 2006 and the Mental healt act 1983.
3.2 Explain the roles of different agencies in safeguarding and protecting individuals from abuse.
Many different agencies are responsible for safeguarding and protecting individuals from abuse this is to ensure that abuse if easyer to be found, recorded and report to the right authorities. These agencies include: Medical professionals such as GP, hospital staff, nurses, docors etc. They can examine, diagnose & treat abuse, they will record all evidence including photographic evidence. An Expert Witness such as paediatris, geriatrics, psychiatrics etc can report evidence of abuse The local authority would carry out an assessment of needs, through social workers. This would assess the risks of abuse for the individual The Safeguarding Team, within Social Services investigates & ensures safety and will work with other agencies such as police.
A Safeguarding & Protection Officer would lead the Adult Protection Alert. The Police will investigate and prosecute abusive cases, they will work with other agencies, to provide support to victims and raise awareness of abuse. Care Quality Commission regulate & inspect care providers, ensuring that safeguarding policies are being adhered to. Independent care homes, following safeguarding policies, to safeguard & protect vulnerable people before employment commences, including CRB checks
3.3 Identify reports into serious failures to protect individuals from abuse.
The biggest example of failures to protect individuals from abuse would be the report by the Care Quality Commission on the services provided at Winterbourne View. Despite a senior nurse alerting the care home’s management and the CQC on several occasions about cases of abuse, his concerns were failed to be followed up. CQC inspectors found that the home had failed to ensure people under the care of Winterbourne View were adequately protected from risk CQC also added that the home failed to meet standards required by law such as: managers did not report majors incidents to the CQC
planning and delivery of care did not meet individual needs they did not have robust systems to assess and monitor the quality of services they have not responded to, or considered complains about the service investigation into the conduct of staff was not robust and didn’t safeguard individuals they didn’t take steps to identify the risks of abuse or to avoid abuse happening they ignored allegations of abuse and did not respond appropriatly they did not have steps in place to protect individuals from abuse used exessive use of restrait
staff were inexperienced and untrained to deal with the individuals in their care
3.4 Identify sourses of information and advise about own role in safeguarding and protecting individuals from abuse.
There are many ways to access information on safeguarding and protecting individuals from abuse such as national polices and proceedures, individual care plans, local authorities polices and proceedures, training in areas such as safeguarding and information from management.
4. Understanding ways to reduce the likelihood of abuse.
4.1 Explain how the likelihood of abuse may be reduced by:
working with person centered values
encouraging active participation
promoting choices and rights
Ensuring that the individual maintains the right to make choices for themselves. That they are confident and have a vision of self worth to help individuals feel less vulnerable towards abuse. Understanding that they have a choice to be heard and knowing that they can share anything and that information will be taken seriously will reduce the likelihood of abuse taking place. Active participation builts self esteem, refusing to tolerate abuse and be more likely to report it.
4.2 Explain the importance of an accessable complaints proceedure for reducing the likelihood of abuse.
When the complaints proceedure is clear and easily accessable an indivdual is more likely to report an incident of abuse and abusers will be more likely be investigated on their behaviour. Knowing this would make them less likely to abuse. Individuals that are vulnerable to abuse will feel protected and empowered to report any incidences of abuse.
5. Know how to recognise and report unsafe practices
5.1 Describe unsafe practices that may affect the well-being of individuals.
In a care setting unsafe practies that affect the well-being of individuals
Staff feel pressured to cut corners due to lack of time and for example may not wait to ensure that medication has been taken properly Staff are unsure of the individual’s correct needs and then don’t deliver the right care the individual needs Lack of training for all staff could lead to poor moving and handling of an individual Inexperienced staff in a senior role
Lack of correct equipment or equipment is broken or unavailable puts the individual act risk of harm
5.2 Explain the actions to take if unsafe practices have been identified
Staying in line with policies and proceedures we have to ensure that the safety of the individual is protected and away from any risks. Report everything to senior management and write down what is suspected and why on appropriate paperwork and try to preserve the evidence of the practices without endangering others.
5.3 Describe the action to take if suspected abuse or unsafe practices have been reported but nothing has been done in response.
If nothing has been done in response to reporting to a senior member of staff, the deputy manager or home manager should be informed. If again noting happens the local safeguarding authorities such as council, police or other agencies should be contacted to invested the matter further. The CQC should also be contact about the matter. Keeping all information that has been reported written down with times and dates of the unsafe practices,when they orginally reported and to who you reported it to.