Principles of safeguarding and protection in health and social care – Essay Example

Principles of safeguarding and protection of in health and social care

Hsc 024 principles of safeguarding and protection of in health and social care hsc level 2

1) Know how to recognise signs of abuse.

1.1) Define the following type of abuse.

Physical abuse is an act of another party involving in contact intended to cause feeling of physical pain, injury or other physical suffering or body harm. Sexual abuse is also referred to as molestation this is forcing of undesired sexual behaviour by one person upon another when that force is immediate or short duration or infrequent it is called sexual assault. Emotional/psychological abuse: This may involve the illegal or unauthorised use of a person’s money, property, pension book or other valuables. Institutional abuse this involves failure of an organisation to provide appropriate and professional individual services to vulnerable people. It can be seen or detected in processes attitudes or behaviour that amounts to discrimination through unwitting prejudice, ignorance, thoughtlessness, stereotyping and rigid systems.

Self-neglect is a behavioural condition in which an individual neglects to attend their basic needs such as: feeding, clothing, personal hygiene or medical conditions they might have. Neglect by others is a passive form of abuse in which the wrongdoer is reasonable to provide care for someone who is unable to care for themselves but fails to provide adequate care to meet their needs. Neglect may include failing to provide sufficient supervision nourishment, medical care or other needs. 1.2) Identify the signs and or symptoms associated with each type of abuse Physical abuse: injury’s that are the shape of objects, injuries in a variety of shapes or that have not received 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, changes in behaviour.

Sexual abuse sexual transmitted diseases or pregnancy, or tears or bruising in genital/anal areas, signs that someone is trying to take control of their body image for example bulimia anorexia or self-harm, sexualised behaviour, inappropriately dressed. Emotional abuse: 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 incontance, sleep disturbance, the person feeling or acting like they are being watched all the time, decreased ability to communicate, language being used that is not usual for the service user, defence submission to the perpetrator. Financial abuse: Sudden loss of assets, unusual or inappropriate finical transactions, visitors whose visits coincide with the day the persons benefits are cashed, insufficient food in the house, bills not being paid, a sense that the person is being tolerated due to their income they bring in sometimes with the person not being included in activities with the rest of the family.

Institutional abuse: Treating adults like children, arbitrary decisions making by staff group service or organisation, strict regimented or inflexible routines of schedules for daily activities such as meal times bed awaking times bathing washing and going to the toilet, lack of privacy dignity choice or respect for people as individuals, unsafe or unhygienic environment, lack of prevision for dress diet religious observance in accordance with individuals belief of cultural background, withdrawing people from individually valued community or family contact. Neglect by self or others: male nutrition, rapid or continued weight loss, not having access to necessary physical aids, in adequate or inappropriate clothing, untreated medical problems, dirty bedding or clothing and lack of personal care.

1.3) Describe factors that may contribute to an individual being more vulnerable to abuse. Regarding what makes a person more vulnerable to abuse: Some of the following factors may be considered. Individuals with a sensory impairment for example poor or no hearing or sight that might lead to communication difficulties. Individuals may lack the capacity to understand what is happening or that it is wrong. Lack of capacity could be for a number of reasons and could be long or short term, individuals may be severely disabled, individuals may be emotionally weak and rely on others for care, individuals may have suffered a brain injury and may not be able to communicate, individuals may be unconscious, individuals who do not have a good support around them and individuals being cared for at home who rely on another person for care. 2) Know how to respond to suspected or alleged abuse.

2.1) Explain the actions to take if there are suspicions that the individual is being abused. Keep calm if possible observe what I see around me, listen carefully and do not judge, record the facts immediately on the appropriate paper work, report to the appropriate person, do not tamper with evidence, give person involved as much support as you can, all allegations must be regarded as serious, any suspicious allegations or disclosure that a person is suffering or at risk of abuse should be reported to my manager. 2.2) Explain the actions to take if an individual alleges that they have been abused. If there suspicions that an individual is being abused or the individual alleges that they have been abused then I would report this to my immediate line manager and use the whistle blowing technique if appropriate.

2.3) Identify ways to insure that evidence is preserved.

Some ways to ensure that evidence is preserved can include using plastic bags to hold evidence if there is a likelihood that it may be contaminated, not entering the zone where the crime/abuse has taken place, advising the service user not to wash, gain original copies of any CCTV tapes that may be available as well as numerous other activities that can be carried out. 3) Understand the national and local context of safeguarding and protection from abuse. 3.1) Some local systems that relate to safeguarding and protection of abuse include employer/organisation policies and multi/agency adult/protection. Some national policies include for employees in the adult wealth and wellbeing sector, reporting the incident to the line manager. 3.2) Explain the roles of different agencies in safeguarding and protecting from abuse. The line manager will assess the situation and where appropriate will refer to social care direct. The allegation will then be recorded on an SSID by SCD with the referral type of safeguarding adults and the line will then ensure that the referral is logged by SCD. 3.3) Identify reports into serious failures to protect individuals from abuse. Reports into serious failures in protecting adults from abuse will include: a safeguarding referral tool and a no secrets document.

3.4) Identify sources of information and advice about own role in safeguarding and protecting the individuals from abuse. Sources of information with regard to my own role in safeguarding adults would be organisational policies, my line manager and various other acts of parliament. Including reporting the incident to social services and who will then consider the seriousness and if necessary report to the police who can then take any criminal action that needs to be taken, unless the person is at immediate risk then the person who suspects this reports immediately to the police. 4) Understand the ways to reduce the likelihood of abuse.

4.1) Explain how the likelihood of abuse may be reduced by working with person-centred values, encouraging active participation, promoting choice and right. By working with person-centred values (individuality, privacy, choice and independence) we can reduce the likelihood of abuse as the individual is encouraged to live as independently as possible and is classed as an active partner in their own care or support. As a pose to a passive recipient if you are promoting choice and rights of an individual then that person is making their own choices as a pose to having choices made for them so they are more independent. 4.2) Explain the importance of an accessible complaints procedure for reducing the likelihood of abuse. If an accessible complaints produce is in place then people are less confused as of what needs to be carried out in order to report abuse and therefore feel more confident about reporting it reducing the likelihood of abuse. 5) Know how to recognise and report unsafe practises.

5.1) Describe unsafe practises that may affect the wellbeing of individuals. Some unsafe practise that may involve the wellbeing of an individual may involve poor working practises, resource difficulties and operational difficulties. 5.2) Explain the actions to take if unsafe practises have been identified. If unsafe practised have been identified then I would report this to my line manager. 5.3) Describe the actions to take if suspected abuse or unsafe practised have been reported but nothing has been done in response. If unsafe practises of abuse have been reported but nothing has been done then I would report this to my line manager and then there manager. If the organisation had not done anything about this then I would report it to social care direct.


Principles of Safeguarding

Ci: Explain what a social care worker must do if they become aware of unsafe practice. A social care worker must report any unsafe practice to their senior or line manager using the whistle blowing policy keeping a recorded document of times, places and events of unsafe practice and any other evidence they are able to obtain. If the unsafe practice is by the line manager or senior then they must go to a higher member within the company to report unsafe practice so the unsafe practice can be resolved and safe working practice put into place and the disciplinary procedure can also be put into place.

Cii: Describe what a social care worker must do if unsafe practice is reported but nothing is done to ensure it is corrected. If a social care worker reported unsafe practice and nothing is done to correct it the social care worker needs to keep recorded documentation of the person who they reported it too, keep reporting it and keeping recorded documentation as evidence and advise the person performing unsafe practice of what they are doing wrong and work to the practice you know is best. If still nothing is done to correct the unsafe practice the social care worker can contact CQC and advise them on the unsafe practice.

Ciii: Describe THREE factors that may make individuals more vulnerable to abuse than others. Factor 1: Physical Disability – Physical Disability of any form can make individuals more vulnerable to abuse as they often are unable to speak out about who is abusing them or what type of abuse is occurring and makes them more vulnerable to abusive attacks. Factor 2: Age – Age of all types can have an effect both young and old are more vulnerable to abuse.

Old people are more vulnerable to financial abuse if they are not in control of their own finances along with physical and mental abuse. Children are vulnerable to grooming, sexual, physical, mental and emotional abuse. Factor 3: Mental illness – Mental illness can make an individual more vulnerable to abuse if a person with mental health issues are abused they could see this as normal behaviour and start to abuse others. Dementia can make a individual more vulnerable to financial abuse, sexual abuse and emotional abuse with short term memory loss they are unable to speak out with regards to any abuse.

Civ: Explain how adopting a person centred approach which offers choices and upholds rights can empower an individual and help to reduce the likelihood of abuse. Adopting a person centered approach which offers choices and upholds rights can empower an individual by maintaining their human rights not taking choice away from them and giving them an active role within the care they receive

Cv: Explain how encouraging and promoting active participation can help reduce the likelihood of abuse. Encouraging and promoting active participation can reduce the likelihood of abuse by encouraging social interaction and building effect working relationships with clients so signs and changes in behaviour can be picked up on easily and the client if able to communicate would be able to have the skills from participation in social activities to be able to speak about any type of abuse and would also be out of any immediate dangerous situations where abuse would occur.

Cvi: Explain how an effective and easy to use complaints procedure can help to reduce the likelihood of abuse. An effective and easy to use complaints procedure can help to reduce the likelihood of abuse as it would make it easier for someone being abused or suspecting abuse to report it and complain of unsafe work practice the client would also feel like they can complain and more likely to report and complain.


Principles of safeguarding and protection in health and social care

Physical abuse is when someone hits you or hurts your body. Sexual abuse is when someone touches your body in a way you do not like, sexual abuse can also be when someone wants you to touch them or to wanting you to have sex with them when you don’t want to. Emotional abuse is when someone keeps saying hurtful things that upset you. Financial abuse is when someone takes your money or belongings from you without your permission, someone who is committing financial abuse may also force you to give them things or spend money that you don’t want to spend. Neglect by others is where the people that are supposed to support and look after you don’t give you the right care and support you need. Institutional abuse is where kind abuse is happening to someone in a confined care facility. Self neglect is where an individual fails to attend to their basic needs.

Possible indictors of physical abuse are cuts, bruises, burns, grip or restraint markings, black eyes, bite marks, broken bones or fractures that are not consistent with the explanation offered, spotty balding. It isn’t just the obvious markings you can see that are the symptoms of physical abuse there is also the behavioural side of it which could be running away attempts and fear of a member of staff or care home, describes self as bad and deserving to be punished, may flinch if touched unexpectedly, extremely aggressive or withdrawn, abusive behaviour and language, poor sleeping patterns, fear of the dark, frequent nightmares, drug/alcohol misuse and suicide attempts. Possible indicators of sexual abuse are loss of sleep, unexplained and unexpected mood swings, unwanted and unexpected pregnancy, bleeding from intimate areas, bruising, soreness, torn clothing, unwanted touching/ groping, sexual transmitted diseases, pelvic pain and eating disorders.

Possible indicators of emotional/ psychological abuse are unexplained fear, depression, confusion, loss of sleep, unexplained and unexpected mood swings, withdrawing from situations, loss of self confidence and self esteem, Isolation from friends and family, Increased anxiety, the feeling of guilt and shame, lack of trust, self blaming, avoiding eye-contact, telling lies, aggressive behaviour, emotional instability and suicidal attempts. Possible indicators of financial abuse are unexplained withdrawals from bank account, unusual bank activity, unpaid bills, and unexplained shortage of money for food and clothing, fraud, theft, the person saying they think they may be being exploited, belongings and valuables going missing. Possible indicators of institutional abuse are name calling, inappropriate ways of addressing and care for others, lack of consideration and physical care, inflexible and non negotiable systems and routines.

Possible indictors of self neglect and neglect by other are malnourishment or over nourishment, dehydration, confusion, inappropriate clothing, under or over medication, skin sores, poor hygiene, untreated health problems hazardous, unsafe living conditions/arrangements, unsanitary and unclean living conditions, an injury that has not been cared for properly, poor coloration, sunken eyes or cheeks, the Behavioral Signs from being neglected are Fear; Anxiety; Agitation; Anger, Isolation, Depression, Non-responsiveness, Contradictory statements; Implausible stories, Hesitation to talk openly, Confusion and disorientation

Factors that can contribute to an individual being abused that that the person may suffer from mental disability, not having the mental capacity to understand what is going on, isolation, being secluded or vulnerable, staff having lack of training, someone abusing their power over someone else, stress from previous abuse, mental illness, lack of self confidence and self esteem.

It is the person that has witnessed or suspects that the abuse is or has happened to report it to the appropriate persons, such as your line manager or higher up the chain of command if you cannot reach your manager or if your manager appears to have done nothing about it. You can also even go to the police or CQC if you feel that the matter is not being taken seriously. Record the facts not your opinions on the matter. Do not judge and do not tamper with evidence.

When someone tells you that they are being abused you should always follow your company’s policies and procedures, listen and not to judge or asking leading and closed questions. Let the person tell you in their own words what has or is happening. Give reassurance to the individual and take the accusation seriously it may have taken the persons to build up a lot of confidence to speak out. Record it on the appropriate paper in the appropriate way and you should always date and sign the paperwork, if there are any witnesses then get them to also sign and date. If possible take pictures for evidence.

To ensure that the evidence of the abuse has been preserved record the facts immediately, report exactly what has been said to your manager ad make multiple copies and store them somewhere safe where no anyone that doesn’t need to know can see them. Do not tamper with any evidence or put your own thought into the accusation.

National policies and local systems relating to safeguarding and protecting adults from abuse are no secrets 2000, equality act 2000, equal opportunities act 2010, human right act 1998, metal health act, mental capacity act 2005, CRB checks, quality care commission and safeguarding vulnerable adults 2013 (renewed) safeguarding vulnerable adults and safeguarding training, employers policy on protection/ safeguarding, multi-agency adult protection arrangements.

The difference agencies and their roles are the police where they would hold the person (people) accountable for their actions, the police will work closely with partners for most of the suitable action, effectively work alongside with partners such as the care company to safeguard the adults, to preserve and secure evidence, take special measures to be put in place to help the vulnerable person though the court process, to take the accusations seriously and professionally, to investigate it thoroughly, professionally and empathetically. The staff, volunteers and organisations will always ensure the persons safety, to be aware and follow the policy and procedures, to work alongside each other and the police, to put the individual first and to empower and support people to make their own choices.

A report of a serious failure to protect individuals from abuse is the Jimmy Savile case; this is the latest case of a failed system. On hospital wards and in his dressing rooms he was able to abuse children, nurses off the hospital ward knew what was happening but told the children to pretend to be asleep when he came to visit. It was believes that someone with such status, power and authority wouldn’t abuse this power and sexually abuse children. When people came forward and try to make allegations against Jimmy Savile they were not believed. Winterbourne View was another case where allegations of abuse was made but it wasn’t until the BBC’s Panaroma series came out on the TV showing the staff of Winterbourne pinning down service users, slapping them, repeatedly taunting and teasing them, service users being does with cold buckets of water, staff at winterbourne was not trained properly and because of this major incidents and accidents were not being filed & reported properly and staff did not know how to respond appropriately to allegations that were made.

The likelihood of abuse being reduced when working with person centred values is gaining their trust, treating the people with respect and dignity, to discuss with that person what they want, when they want it to happen and how they would like to do it. When encouraging active participation let them make their decisions for themselves or make decisions with them but let them have control over their own lives. With promoting choice and rights empowerment is about taking control of your life even if it is a small thing such as breakfast, we all have the right to make our own decisions in our lives.

Anything that puts another person at risk is an unsafe practice such as, not following policy and procedures properly, not reading and following support plans, staff having lack of training, staff thinking or and carrying out short cuts on support people, not giving reading and administering the correct medication, poor manual handling, not disposing of waste properly and not cooking food to the correct temperature.

All unsafe practices that are being carried out must be recorded and reported to your manager so the person can be stopped before either their selves of the person being supported gets injured. You could also talk to your other colleagues to see if they have the same concerns as you.



Principles of safeguarding and protection in health and social care

Outcome 1: Know how to recognise signs of abuse

1.1 Define the following types of abuse.

Physical abuse:- Physical abuse is defined as any physical force or violence that results in bodily injury, pain, or impairment. It includes assault, battery, and inappropriate restraint.

Sexual abuse:- Sexual abuse refers to any action that pressures or coerces someone to do something sexually they don’t want to do. . It can also refer to behaviour that impacts a person’s ability to control their sexual activity or the circumstances in which sexual activity occurs.

Emotional/Psychological abuse:- Emotional and Psychological abuse includes a range of non-physical controlling behaviours that cause emotional damage and undermine a person’s sense of well-being.

Financial abuse:- The misuse of a person’s funds and assets; obtaining property and funds without his/her knowledge and full consent, or in the case of an elderly person who is not competent, not in his/her best interests.

Institutional abuse:- Institutional abuse is the maltreatment of a person (often children or older adults) from a system of power. This can range from acts similar to home-based child abuse, such as neglect, physical and sexual abuse, and hunger, to the effects of assistance programs working below acceptable service standards, or relying on harsh or unfair ways to modify behaviour.

Self neglect:- Self neglect is unlike other forms of abuse which relate circumstances where there is a person other than the adult at risk who is causing significant harm to themselves.

Neglect by others:- Neglect is the failure of any person who has responsibility for the charge, care or custody of an adult at risk to provide the amount and type of care that a reasonable person would be expected to provide.

1.2 Identify the signs/or symptoms associated with each type of abuse.

Physical abuse

SIGNS

SYMPTOMS

Unexplained cuts, bruises, scalds, burns, bruises and scratches. Injuries and wounds in concealed places.

Appearing sedated i.e. over use of medication

Withdrawn and quiet

Nervous, Tearful, Anxious

Unwilling to undress/ show areas such as sacrum, arms, torso. Unexplained pain i.e. with holding of medication

Sexual abuse

SIGNS

SYMPTOMS

Vaginal/rectal bleeding/discharge/infections

Sores in genital areas

Bruising – especially on the inner thighs

Bite marks, scratches to breasts, face or neck

Difficulty in sitting/walking due to discomfort in the genital area Torn, blood stained clothing

Unexplained problems with catheters

Sudden onset of confusion

Pain, itching

Withdrawn

Nightmares/night terrors

Depression

Changes in behaviour

Fear of making decisions

Obsession with sexual matters

Loss of weight

Emotional/Psychological abuse

SIGNS

SYMPTOMS

Change in body language – avoiding eye contact

Changes in appearance – unkempt

Unexplained changes in behaviour

Withdrawn and depressed

Frightened, anxious, aggressive

Fear of being wrong

Loss of weight

Financial abuse

SIGNS

SYMPTOMS

Lack of money for basic necessities such as food and heating Missing property such as ornaments, jewellery and family heir looms Unexplained withdrawals from bank accounts

Inability to explain what is happening to their income

Become secretive

May self neglect due to lack of funds

Fearful of spending money

Anxious, depressed, emotionally unstable when abuser is mentioned

Institutional abuse

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

Self neglect

SIGNS

SYMPTOMS

Absence of required aids, canes and walkers

Inappropriate clothing

skin sores

poor hygiene

Confusion

Dehydration

Malnourishment

Under or over medication

Neglect by others

SIGNS

SYMPTOMS

Weight loss

Deterioration in appearance or personal hygiene

Inadequate food, drink or medical care

Bed sores, rashes

Unhygienic and unsafe environment

Changes in behaviour

Depression

No interest in life

Lack of social interaction/stimulation

Lethargy

1.3 Describe factors that may contribute to an individual being more vulnerable to abuse. The client might have a mental disability such as; dementia or autism which might make it harder for them to convey to the care worker if they are being abused or ask for help due to their diminished mental capacity. If the individual is secluded or isolated or vulnerable this can make it easier for them to be vulnerable to abuse, especially self neglect as they might feel that they are not worthy or not care anymore about their overall health and wellbeing. The abuser, in this case the care worker may either lack the appropriate training or they might be 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. Outcome 2: Know how to respond to suspected or alleged abuse

2.1 Explain the actions to take if there are suspicious that an individual is being abused. If any suspicions of abuse exist, the care worker or individual who suspects its occurrence must report their concerns to the appropriate individuals such as; the care coordinator and line manager. Record the facts on appropriate paperwork, listen do not judge the complainant, stay calm and collected and do not tamper with evidence. 2.2 Explain the actions to take if an individual alleges that they are being abused. The company or agency that the care worker is employed at should have policies and procedures already in place which need to be followed by their employees in situations were allegations of abuse are brought to light.

Most companies’ policies and procedures, would state that the employee must report any abuse allegations to the appropriate person(s) within the company/agency, record the facts on appropriate paperwork, listen not judge the complainant, always establish what it is that has occurred and report any suspicions to the appropriate manager, reassuring the employee at all times and take every allegation seriously, always date the paperwork and have it signed by any witness (if any), take photographs of evidence if possible. 2.3 Identify ways to ensure that evidence of abuse is preserved. Always record the facts immediately on the appropriate paperwork. Do not tamper with the individual’s clothing or bedding.

Preserving any fist aid items that are used.

Not tampering with the area of abuse; i.e. if it occurred in the client’s living room, the care worker should leave the area as they found it and ensure that no one else enters there. Report evidence immediately to your line manager.

Do not tamper with any evidence collected or given to the appropriate person(s) within the company. Have an efficient storage system to ensure that all evidence is kept safe and remains confidential.

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. National Policies:- Safeguarding Vulnerable Groups Act (2006), the Vetting and Barring Scheme run by the Independent Safeguarding Authority (ISA), Disclosure and Barring Service, Human Rights Act (1998).

Local Systems:- Safeguarding Adults Boards, Safeguarding policies and procedure for vulnerable adults.

3.2 Explain the roles of different agencies in safeguarding and protecting individuals from abuse. Safeguarding Adults Boards:- These bring together various local agencies such as; MIND, the police, housing teams and advocacy groups; that work with vulnerable adults and enable them to effectively share information and monitor their work.

Police:- The police are expected to safeguard vulnerable adults by, investigating all reports of vulnerable adult abuse and to uphold and protect the rights of vulnerable adults.

Care Quality Commission (CQC):- The CQC’s role is to monitor and provide guidance on what all health and social care providers must do in order to safeguard vulnerable adults from abuse this includes; the development of procedure and policies used in order to prevent vulnerable adults from being abused and monitoring the correct use of said policies and procedures in all health and social care settings. 3.3 Identify reports into serious failures to protect individuals from abuse. A report about Castlebeck Care Ltd which failed to ensure that the vulnerable individuals living at Winterbourne View hospital were adequately protected from any risk or harm, including the risks of unsafe practices that were carried by its own staff. Individuals at Winterbourne View were pinned down, slapped, doused in cold water and repeatedly taunted and bullied by staff. Castlebeck care Ltd neglected to inform the CQC of these incidents of abuse, injuries to individuals and of occasions when individuals had gone missing, even after some employees had informed the management of their concerns.

A report into the murder of Steven Hoskin, a young man with learning difficulties who was abused and murdered in 2006. Not only was pushed over the railway and had subsequently fallen from a great height, it was found that he had consumed some paracetamol tablets, he was intoxicated and had sustained recent cigarette burns. In addition to this, he suffered appalling treatment from his abusers who took over his bed sit and he had visible neck bruising as a result of being hauled around his home using his pet dog’s lead, he was also found to have marks of footprints on the backs of his hands. 3.4 Identify sources of information and advice about your own role in safeguarding and protecting individuals from abuse. Company’s policies and procedures on safeguarding

Manager, colleagues

Training and advice from training centres

The internet

Books

Care Quality Commission

Independent Safeguarding Authority

Social Services

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:- If person centred values are taken into account when offering support to individuals, the likelihood of abuse occurring will be diminished; as all the staff will be working in the same way and will feel ashamed if they abuse their clients because of the way that they have been taught to work. If an individual is expected to have a say in what they want and make their opinions be the centre of any decision, this will make it unlikely for abuse to occur as the individual will know what suits them best and will not get so frustrated with the level of support being offered to them as it would be tailored to suit them.

Encouraging active participation:- Ensuring the active participation of the individual in the daily activities that they require support with such as; choosing their meal of choice will not only foster their independence, it will also prevent abuse from occurring as the individual will not be afraid to voice their displeasure with anything if they are routinely being encouraged to do so.

Promoting choice and rights:- Promoting the individual’s choice and rights will decrease the incidences of abuse occurring as they will have a clear understanding that they should be allowed to make their own choices like; what they should wear and the care workers should also support them and ensure that they have teh same rights as anyone else. 4.2 Explain the importance of an accessible complaints procedure for reducing the likelihood of abuse. An accessible complaints procedure resolves complaint more quickly as the complainant feels that their complaint is being taken seriously and they that have full access to how to make a complaint, the steps that need to be taken when the complaint is investigated further and provides flexibility in relation to target response times. This sets up an open culture of making sure that abuse will not be tolerated in any form and it also encourages the complainant not to accept any form of abuse occurring.

Outcome 5: Know how to recognise and report unsafe practices 5.1 Describe unsafe practices that may affect the well being of individuals. Unsanitary conditions can arise as a result of care workers neglecting their client, this is dangerous as it can spread infection as cross contamination can occur and pose a threat to the client’s well-being.

Not carrying out adequate risk assessments in service user’s residences can cause the service user to injure themselves which will cause a problem if no one is around to call for or offer help to the individual.

Instances where the service user is left in their soiled bed linen for a prolonged period of time, ignoring or not listening to them in general or to their concerns also amounts to abuse, as the care worker is neglecting the service user.

Marks on the service user’s body and complaints not being taken seriously and can put them at more danger, harm and be at risk of abuse. 5.2 Explain the actions to take if unsafe practices have been identified. If unsafe practices have been identified, the care worker must follow their company’s whistle-blowing procedure which should be made available to them in their care worker handbook; and report the instances of unsafe practices to report to the appropriate person(s) i.e. my manager immediately or if it involves them then to another another appropriate individual within the company.

5.3 Describe the action to take if suspected abuse or unsafe practices have been reported but nothing has been done in response. In the event when suspected abuse or unsafe practices have been reported but nothing has been done in response to them or if the complaint involves the care worker’s immediate manager then they should escalate the matter and report it to the next level manager, then to the social worker and safeguarding team and to the care quality commission and even to the police depending on the response received.



Principles of safeguarding and protection in health and social care

Outcome 1: Know how to recognise signs of abuse

1. Define the following types of abuse:

Physical abuse – Hitting, slapping, pushing, pinching, kicking and burning. Leaving people to sit in own urine and faeces and forcing them to eat or take medication. Sexual abuse – Unwanted advances, indecent exposure or harassment, rough washing or touching of the genital area, rape, being forced to watch or participate in sexual acts. Emotional/psychological abuse – intimidation, not being included or ignored, threats, bullying, humiliating and blaming. Financial abuse – using an individual’s money without their permission or on items they have not requested. not giving correct change back to individual, misuse of property, possessions or benefits. Institutional abuse – poor care in to residents in care homes and day centres, Food and special dietary requirements not being followed and rooms and clothing not being cleaned.

Self neglect – Individual not looking after themselves i.e. not washing, not eating Neglect by others – Inadequate care or denial of an individual’s basic rights. 2. Identify the signs and/or symptoms associated with each type of abuse. Physical abuse – Unexplained bruises, scratches, cuts, fractures, broken bones and teeth. sprains or dislocations, lacerations, burns – including friction burns and scalds, drowsiness, pressure sores, cowering and flinching, unexplained hair loss, significant weight loss, etc. Sexual abuse – Bruises around genital area, recurrent genital or urinary infections, disturbed sleep patterns, vulnerable adult appears withdrawn and fearful, inappropriate dressing.

Emotional/psychological abuse – Individual appearing afraid or worried, 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 Financial abuse – unexplained changes to spending pattern, family unwilling to pay for services, although individual has sufficient funds, sudden change of will. Institutional abuse – Individuals are not eating or getting dressed properly, being kept in their rooms and not interacting with anyone else, 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 – Individual gaining or losing weight, using drugs and alcohol. 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. Neglect by others – Neglect happens when the appropriate people fail to act, absence of food, water, and heat, poor personal hygiene including soiled clothing, dirty nails and skin, inappropriately dressed for cold or hot weather, bedsore, constant hunger, withdrawn, illness 3. Describe factors that may contribute to an individual being more vulnerable to abuse There are a number of factors which can contribute to an individual being more vulnerable to these types of abuse, including, no or little family contact, their personal communication skills and their past experiences. If the individual has learning disabilities or any other for that matter, this can also make them vulnerable as they may have communication problems and may not understand what is going on around them. This may cause them to not know that they actually need help or that what is happening is wrong.

Outcome 2: Know how to respond to suspected or alleged abuse 1. Explain the actions to take if there are suspicions that an individual is being 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 and 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 let my manager know what has happened immediately and pass this information on in private,my report being also confidential. 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. 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. 2. Explain the actions to take if an individual alleges that they are being abused. 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, 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 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. 3. Identify ways of ensuring that evidence of abuse is preserved. When a member of staff in a care setting believes a vulnerable adult is being abused it must be reported immediately to his/her Manager or senior, unless that person is himself under scrutiny, in such a case the matter must be reported to higher management.

The well being of the vulnerable adult is paramount and every effort should be made to make sure the victim knows their rights and how to report any issues. If the vulnerable person is in any immediate physical danger steps must be taken to remove them from this potential danger. In cases where a crime is suspected or has been committed, the police must be contacted. The consultation with the police will lead to a decision about how to/who will investigate if this is needed. Sometimes a care home manager will lead an investigation, this may also include the C.Q.C (Care Quality Commission). Any information given by either the victim or those who suspect the abuse is only shared with those who need to know.

Any actions/information received is always documented and must be done a.s.a.p, ideally within 24 hours (to be “safe” in terms of evidence for court if needed). Evidence must always be preserved, for example, physical abuse evidence may include body maps and photographs. Financial abuse evidence would include bank books/statements, any spaces in cheque books where an abuser may fill them in to falsely claim money from the client and sexual abuse evidence may include putting clothing into clean sealed plastic bags or in an instance of rape the room would need to be sealed off to preserve forensic evidence.

Outcome 3: Understand 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 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.

2. Explain the roles of different agencies in safeguarding and protecting individuals from abuse 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.

3. Identify reports into serious failures to protect individuals from abuse A report about Castlebeck Care Ltd which failed to ensure that the vulnerable living at Winterbourne View were adequately protected from risk, including the risks of unsafe practices by its own staff. Individuals in Winterbourne View which is a home owned by Castlebeck Care Ltd were pinned down, slapped, doused in cold water and repeatedly taunted and teased by staff in the home. Castlebeck Care Ltd failed to notify the Care Quality Commission of these incidents, injuries to individuals and of occasions when individuals had gone missing. A report about the murder of Steven Hoskin, a young man with

learning difficulties who was abused and murdered in July 2006.

In addition to being pushed over the railway and falling from a great height, it was also found that Steven had taken paracetamol tablets, had been drinking alcohol and had sustained recent injuries from cigarette burns. In addition he suffered appalling treatment from his abusers who took over his bed sit and he had neck bruises from having been hauled around his home by his own pet’s dog-lead and the backs of his hands had the marks of foot-prints. 4. Identify sources of information and advice about own role in safeguarding and protecting individuals from abuse Local Authority Adult Services Department like Social Services My manager, colleagues

My company’s policies and procedures on safeguarding

The internet

Care Quality Commission

Independent Safeguarding Authority

Books

Training and advice from training centres

Outcome 4: Understand ways to reduce the likelihood of abuse 1. Explain how the likelihood of abuse may be reduced by:

• working with person centred values

• encouraging active participation

• promoting choice and rights

Person-centred values include the individuality of the person, the rights of the individual, the individual’s choice, the individual’s privacy, the individual’s independence, the individual’s dignity and the individual being respected. If person centred values are taken into consideration when supporting an individual there is less likely to be abuse as all the staff will be working in the same way and will feel shamed if they abuse because of the way that they have been taught to work. If an individual is considered to have a say in what he or she wants and is at the centre of any decision, it will be more unlikely that there is abuse. The individual will know what suits him or her and will not get so frustrated. I always put the service users I work with, their families and friends at the centre of any decision about them and they are an active partner in their own care.

Individuals decide what to do, where to go, what clothes to wear and are treated with dignity, respect, confidentiality and are able to make their own choices. Individuals’ rights are promoted throughout the service. My service user has the right to do anything that they wish to do and if it is what they want as long as it is not dangerous; a risk assessment is then done to stop any abuse happening. I ensure that I promote service users’ rights and choices by allowing them to make their own choices and support them to have the rights of anyone else. 2. Explain the importance of an accessible complaints procedure for reducing the likelihood of abuse The complaints procedure gives the complainant the right to be heard and supported to make their views known.

An accessible complaints procedure is understandable and easy to use. It sets out clearly how to make a complaint, the steps that will be taken when the complaint is looked into. It also provides flexibility in relation to target response times. An accessible complaints procedure resolves complaints more quickly as the complainant feels that they are being listened to and their complaint taken seriously. This sets up an open culture of making sure that abuse will not be tolerated in any form and encourages the complainant to not accept this.

Outcome 5: Know how to recognise and report unsafe practices 1. Describe unsafe practices that may affect the well-being of individuals Unsanitary conditions can spread infection as cross-contamination can occur and can affect the well-being of the individual and others. Improper hand washing can also pose a risk. Dirty kitchen surfaces and equipment can spread infections, not covering hair when cooking can pose a risk to individual as can not reporting faulty equipment when working or not having cleaning materials can also be unsafe. In terms of health and safety not having risk assessments in place when a service user hurts themselves. Staff not checking when a service user is ill or unsteady on their feet. Staff not recording in care plans about a service user’s well-being and health and not monitoring them.

Other unsafe practices which also amount to abuse can occur such as leaving a service user on the toilet too long, ignoring or not listening to them. Marks on body not taken seriously and complaints not taken seriously can put them at more danger, harm and risk of abuse. I ensure that I keep to all the procedures for checking for abuse and the well-being of the individuals that I work with; by following these and the individual’s care plan I keep within the minimum standards of care and also work in a person centred way to make sure all individuals are happy and safe.

2. Explain the actions to take if unsafe practices have been identified If I identify unsafe practices then I must follow the whistle-blowing procedure and report to the appropriate person(s). I will report to my manager immediately or if it involves my manager then to another appropriate person(s). I will monitor all unsafe practices and make sure that I record and report in full all the evidence and then will talk to my manager because all unsafe practices are dangerous practices that could cause harm to the individual and others. For example, I talked to my manager last month about things being left on the stairs that may cause service users and others to fall over and hurt themselves. She has talked to the staff and now this has stopped.

3. Describe the action to take if suspected abuse or unsafe practices have been reported but nothing has been done in response If suspected abuse or unsafe practices have been reported but nothing has been done in response or if it has to do with my manager then I will report to the next level or manager. If it has to do with my manager then I will report to management, then to the social worker and safeguarding team and to the Care Quality Commission and even to the police depending on the response I get. When I worked in a nursing home there was some abuse of service users being left too long on the toilet and I talked to the nurse in charge and changes were made immediately. I had to record the information and give the nurse and manager a copy of my confidential report. If the nurse or manager had not done this then I would follow the whistle blowing procedure.


Safeguarding and protection in health and social care

Describe in your own words what is meant by the following types of abuse: Physical abuse: Physical abuse is when an individual is being physically harmed by the people who are responsible for their care Signs and symptoms of physical abuse: Unexplained bruising, cuts or burns. Unexplained injuries and falls. Restraining someone inappropriately without a reason. Malnutrition, ulcers, bed sore and being left in wet clothing. Inappropriate sanctions including deprivation of food, clothing, warmth and health care needs. Sexual abuse: Sexual abuse can be different types of abuse whether it’s sexual activities and the individual cannot consent to it and have been forced into it or whether it’s in a relationship. Sexual assault, rape and harassment are also types of sexual abuse. Risk of exploitation. Signs and symptoms of sexual abuse: Unexplained injuries to genitals. Inappropriate touching or use of sexualised language or behaviour.

Withdrawal and isolate themselves away from others. Sexual transmitted disease or pregnancy especially when the individual hasn’t or cannot give consent to sexual acts. Emotional/Psychological abuse: Emotional/Psychological abuse is when someone is causing emotional and mental distress to an individual. Signs and symptoms of emotional/psychological abuse: withdrawal and isolating themselves from social activities. Obsessive compulsive behaviour. Intimidation. Verbal abuse or depriving them of contact with other people. Loss of skills or abilities. Fearfulness and loss of self-esteem. Anxiety. Financial abuse: Financial abuse is something that can affect the welfare and wellbeing of an individual. Signs and symptoms of financial abuse: Exploitation or pressuring someone to make a will including property and possessions. Unexplained ability to pay bills. Unexplained withdrawal of money.

Disparity between assets and satisfactory living conditions. Missing personal possessions. Institutional abuse: Institutional abuse is created or sanctioned by the systems, policies and procedures of an organisation. Signs and symptoms of institutional abuse: Regular admissions to hospital. No care or support plan. Could also include any work action or regime which destroys the dignity and respect to which every person is entitled to. Individuals possessions being shared in a residential setting. Self-neglect: Self-neglect is when an individual isn’t looking after themselves which could lead to self harm and neglect. Signs and symptoms of self-neglect: Dirty or unkempt appearance. Unhygienic. Not eating or drinking which leads to malnutrition. Misuse of medication.

Unexplained cuts and marks on skin. Neglecting your house e.g. no heating or lighting. Neglect by others: Neglect by others is when someone is in a position of trust that doesn’t provide the care as stated in the care plan. Signs and symptoms of neglect by others: Dirty or unkempt appearance. Not assisting with personal hygiene. Malnutrition not providing food fluids and warmth. Deteriorating health. Unexplained weight loss. Not giving individual prescribed medication. Not respecting the individuals privacy and dignity

Explain the correct actions to take if you suspect an individual is being abused. If you suspect an individual is being abused you would follow organisational procedures. You would make a note of the disclosure and date and sign it but when noting you have to make sure you document what the individual has said, using their own words and phrases. You would document the setting and anyone else who was there at the time and report it to your manager. You don’t break confidentiality by talking to people about the abuse. Explain the correct actions to take if an individual tells you they are being abused. If an individual tells you that they are being abused you would reassure them that they are going to be safe and that it is not their fault this has happened and that you are taking the information seriously and that you are going to tell the appropriate person and why. You would stay calm and try not to show shock or disbelief.

You would listen carefully to what they are saying. You would tell them that the service will take steps to protect and support them. You would preserve evidence. Identify how to ensure that any evidence of abuse is kept safe. All evidence of abuse should never be moved and should be left in the same place and position as before. If the individual agrees and the evidence is crucial photographs may be taken. Try and get the individual away from the scene of abuse and tell them not to touch or move anything relevant. Identify the national policies that set out special requirements for safeguarding individuals Safeguarding Vulnerable Group Act 2006. Independent Safeguarding Authority (ISA) criminal Records Bureau. Human Rights Act 1998. Identify the local and organisational systems for safeguarding. Safeguarding Adults Board. Safeguarding policies and procedures for vulnerable adults.

Employer/organisational policies and procedures. Explain the roles of different agencies and professionals that are involved in safeguarding adults. Police- their role is to safeguard vulnerable adults. They would investigate all crimes and reports of abuse and then will take action to prosecute if they have the evidence that is needed. They can provide support for vulnerable adults that have been abused. Criminal Records Bureau- this allows the employers to do checks on possible employees previous convictions. Social Workers- they are responsible for accessing different services that can support and protect individuals. Identify sources of advice, support and information to help social care workers understand their own role in safeguarding. Specialist workers in other agencies. Relevant websites. Books and leaflets. Speak to more experienced staff.




Safeguarding and Protection

1.1 In your answer from the workbook you completed, you described the following terms instead of defining them. Please review this section by defining each of the terms outlined below:

* Physical abuse

* Psychological abuse

* Sexual abuse

* Finance abuse

* Self neglect

* Institutional abuse

1.2 Identify the signs and symptoms associated with physical abuse SHC 024: Duty of care in a health and social care setting 1.1 Explain how a working relationship is different from a professional relationship. 1.2 Describe the different working relationships in your organisation where you work. 3.1 Describe why it is important to work in partnership with others. 3.3 Identify the skills and approaches you need to resolve conflicts HSC026: Implement Personal centred approach in health and social care settings 1.3 Explain why risk taking can be part of a person centred approach? 3.3 Explain the steps to take if consent cannot be readily established. 4.1 Describe how active participation benefits an individualS HSC2015: Support individuals to Meet personal care needs

1.3 Explain how you report concerns about safety and hygiene of equipment or facilities used for personal care. 1.4 How do you ensure safe disposal of waste material? HSC027: Contribute to Health and Safety in Health and Social Care 1.3 Outline the main health and safety responsibilities of:
Employee

Employer

Others in the work place

2.1 Explain why it is important to assess health and safety hazard posed by the work setting or by particular activities. 2.2 Explain when and how to report potential health and safety risks that have been identified 2.3 Explain how risk assessment can help address dilemmas between rights and health and safety concerns. 3.1 Describe different types of accidents and sudden illness that may occur in your own work setting.