Month: November 2018

There are several unsafe practices that may affect the well-being of an individual. Examples include not documenting incidents or medical concerns, lack of good hand washing technique, not following health & safety guidelines, living in unsanitary conditions, poor diet and not having risk assessments in place but their are many, many more.

I ensure that all policies, procedures and good practices are followed to ensure the well-being of my clients. If I identify an unsafe practice, the first thing I do is make sure that my clients are safe from harm. I would then speak to my manager and offer suggestions about how the practice could be changed to make it safe. If I don’t feel comfortable approaching my manager (for example, if my manager is involved in the unsafe practice) or I do not feel that it has been dealt with correctly, I would address senior management with my concerns. If it is more serious, or still not dealt with to my satisfaction, I would whistle-blow and go straight to the local authority, CQC or the Police.

A good example is when I witnessed a member of staff encouraging a client to hug her on multiple occasions. Although I was fairly certain there was nothing sinister in her motives and there was no abuse, I felt it was unprofessional and crossed the staff-client boundary. I spoke about my concerns to my manager (with another manager present to act as witness) and was thanked for bringing it to their attention and assured they would speak with the member of staff concerned to stop it happening again. Had this not been dealt with properly by management, I would have been forced to report my concerns to CQC or local social services.

There are many ways to reduce the likelihood of abuse within an organisation.

Person-centred values is an approach to care work that all care staff should be encouraged to follow. It involves treating a client as an individual and including them in any decisions that need to be made regarding their care and support. A client’s person-centred values can be described as individuality, independence, privacy, partnership, choice, dignity, rights and respect. Not only do these values teach staff best working practices but also helps vulnerable people have a say in the support they receive and help them to feel empowered. This results in a staff team that has the mindset to support client’s best interests, reducing the likelihood of abuse. In addition, risk of a abuse is lowered when individual’s have active participation in their care provision because they are more likely to understand their rights and know when something might not be quite right. They will also be more likely to speak up if they have concerns. This goes hand-in-hand with promoting an individual’s rights and choices. Client’s should be free to make their own life choices and take calculated risks as long as it is unlikely to harm themselves or others or is illegal.

Personally, I treat everyone with the same level of respect that I would expect to receive myself, so person-centred values come naturally to me. I encourage all clients to take an active role in planning their activities and inform them of their rights in a manner that they understand when applicable. I also try to allow them the freedom and independence to be in control of their own lives, only stepping in to provide guidance if I feel that their actions may be detrimental to themselves or others.

Another way to reduce the likelihood of abuse is to have an accessible complaints procedure in place. This gives an individual a voice and a course of action should they feel they are being treated inappropriately.

All my clients are aware of the complaints procedure we have in place and know that they can have assistance in filling it out if they need to. Sometimes this results in false complaints such as when a client put in a complaint about a member of staff because he didn’t have enough money to buy a phone charger and failed to understand that it was not the member of staff’s fault but the fact that he had already spent all his money on something else but it is important that the system remains in place to catch any legitimate complaints. Our complaints procedure was used to great effect when a member of staff was permanently moved without warning to another service, resulting in the clients becoming upset because they had a great working relationship with said member of staff. The clients asked me what they could do about it and I informed them that although head office could put staff in whichever service they deemed fit, the client’s opinions could be passed on via a complaints form. I helped the clients to fill in their complaints (ensuring only what they said was documented and with another member of staff present to act as witness) and passed them on to head office. The client’s views were read by senior management and they made a u-turn on their decision.

There are a number of different agencies, policies and systems that have important roles to play in safeguarding vulnerable people.

On a national level, legislation acts as the framework within which all other groups can operate lawfully. This includes:

• The Care Act 2014 – makes safeguarding a corporate duty for local councils (supersedes No Secrets Policy Document 2000.
• Safeguarding Vulnerable Groups Act 2006 – helps prevent unsuitable persons from gaining access to vulnerable people through their work.

• Health & Social Care Act 2008 – regulations for the health and social care industry

• Public Interest Disclosure Act 1998 – protects whistle-blowers from victimisation

Several national agencies have sprung up as a result of the above legislation being passed. For example, the Disclosure Barring Service (DBS) was formed after the Safeguarding Vulnerable Groups Act came into force and it is their responsibility to keep a database of people that are deemed unsafe to work with vulnerable adults and children so that employers can make informed recruitment decisions. Also, the Care Quality Commission (CQC) came about following the passing of the Health & Social Care Act 2008. It is CQC’s responsibility to ensure organisations that provide care services are meeting national standards.

The Metropolitan Police are another national organisation that have a role to play in safeguarding vulnerable adults. It is their responsibility to investigate claims of abuse.

There are also agencies that operate on a local level to help safeguard vulnerable adults, including:

• In Warwickshire, the Adult Social Care Team can be contacted on 01926 410 410 during office hours.
• At other times, the Social Care Emergency Duty Service can be contacted on 01926 886 922.
• In more serious incidents, Nuneaton Police can be contacted on 02476 641 111

Despite the many policies and agencies involved in the protection of vulnerable adults, there have still been many cases of abuse occurring within a care setting. One example that was heavily reported in the news was the abuse that occurred at Winterbourne View Private Hospital. In 2011, a BBC Panorama investigation revealed that patients were routinely neglected, assaulted and restrained by care staff. Although various organisations were alerted to the malpractices, they were not followed through, resulting in local social services, police, the NHS and CQC being implicated for failing to do their duty. As a result of the investigation, several care staff at Winterbourne View were prosecuted and the hospital was closed down.

If I required further information or advice about safeguarding, I would probably go to my manager or consult with other members of my team in the first instance. I could also speak to other employees and look at the company’s vast library of policies and procedures, particularly the Safeguarding Policy, which is attached to this document. Other sources of information would include the local authority, CQC and my own independent research using books and the Internet.

If you suspect that an individual is being abused, it is imperative that you tell them of the reasons for your concerns and attempt to build a dialogue with them to try and establish what has happened. You should remain calm and listen intently to anything they may tell you without ‘putting words into their mouth’ and without pressing for information that they unwilling to give. If they ask you not to tell anyone, explain that you have a duty of care to report anything that is illegal or affects their well-being. Also explain that they have done the right thing by telling you and that you will take appropriate steps to resolve the problem and protect them from further abuse.

After speaking with the individual, you should preserve any evidence of abuse that is available and, at the earliest opportunity, make a written record of the conversation keeping only to the facts and the words that the individual used. It should then be reported to your manager, or, if your manager is implicated in the abuse, to the next manager up in the organisations hierarchy.

Depending on the circumstances, you may also need to report suspected abuse to the police, local social services and/or CQC (if your organisation does not respond appropriately), however confidentiality is paramount and you should work on a ‘need to know’ basis.

The same process should be used if an individual alleges to you that abuse has taken place. All allegations should be taken seriously.

As mentioned above, in some cases there will be physical evidence of abuse having taken place. It is very important to preserve this evidence. You can do this by sealing off the area where the abuse has taken place and leaving everything untouched, not washing soiled or bloodied clothing and discouraging the individual from washing (particularly if it is a case of sexual abuse). As well as recording the victim’s account of the abuse, you should also record any injuries they may have sustained.