- Physical Abuse is when a person inflicts non-accidental physical force that results in pain, impairment or bodily injury.
- Sexual Abuse is direct or indirect involvement in sexual activities without consent, as well as being physically forced into sexual activity without consent.
- Emotional/Psychological abuse is when a person uses threats, bullying, tries to control another’s mind and makes them feel powerless. This type of abuse results in mental and physical distress and includes denial of basic human rights.
- Financial abuse is the unauthorised and improper use of funds, property and any other resources belonging to another person. Examples include forcing someone to change their will to include the abuser or preventing access to personal belongings or money.
- Institutional abuse occurs within an organisation where staff change routines systems and support they give clients to suit their needs rather than the clients’. This involves a system that is stretched beyond capacity causing maltreatment through lack of resources.
- Self-neglect occurs when a person fails to attend to their basic needs such as personal hygiene, feeding themselves, tending medical conditions they may have. It also means having the inability to maintain an accepted standard of care for oneself and surroundings. Self-neglect can be caused by many factors such as health problems, childhood problems, other forms of abuse and self-consciousness.
- Neglect by others refers to situations where a caregiver fails in providing adequate care for someone unable to care for themselves. This can be referred to as omission – failing to care for another. Neglect includes failure in providing medical care or sufficient nourishment/supervision among others
How can you identify the signs and symptoms associated with each type of abuse?
Physical abuse can often be identified by its signs and symptoms, although they may also be concealed by either the victim or the abuser. These signs and symptoms can include:
Abuse is:
- Bruises on any part of the body
- Clusters of injuries forming a pattern from the article used
- Different stages of healing
- Lacerations
- Burns
- Fractures
- Withdrawn behavior
- Scars
- Flinching when touched or approached too quickly/li>
- Telling lies to avoid answering questions about injuries/li>
- Covering up with long clothes, make-up, etc.
Signs and symptoms of sexual abuse include:
- Sexually transmitted disease or pregnancy
- Tears or bruises in genital/ anal area
- Sexualised behaviour
- Inappropriately dressed
- Withdrawn
- Depressed
- Poor concentration
- Self-harming behaviour
- Wetting or soiling
- Stressed appearance
- Urinary tract or vaginal infections
- Bruising
- Difficulty or sensitivity in walking or sitting
- Stained/ bloody clothes
- Emotional or crying
- Sleep deprivation
- Isolated
- Anti-social
- Less chatty
Signs and symptoms of emotional/psychological abuse include:
- Fear
- Depression
- Confusion
- Anti-social
- Isolation
- Crying
- Unusual behaviour
- Self- harm
- Taking anger out on others
- Loss of sleep or nightmares
- Covering up
- Low self- esteem , anxiety and lack of confidence
Signs and symptoms of financial abuse include:
- Sudden loss of assets
- Unusual financial transactions
- Visits on paydays
- Bills not being paid
- Lack of food in the house
- Change in will and testament
Signs and symptoms of institutional abuse include:
- Set meal times
- Lack of consideration for dietary requirements
- Name-calling
- Strict routines
- Inflexible and structured events
- Treating individuals as children
- Lack of privacy, dignity, choice or respect for individuals as unique beings
Withdrawal
(Note: The text seems incomplete at this point.) - Emotional distress caused by the aforementioned factors.
Signs and symptoms of self-neglect include:
- Self-harm
- Bruises
- Scars
- Withdrawn behavior
- Inadequate diet
- Unkempt appearance
- Poor social interaction skills
- Malnutrition
- Risk of turning to drugs and alcohol
Signs and symptoms of neglect by others may include:
- Malnutrition
- Rapid weight loss
- Lack of personal care
- Dirty clothing/household
- Inadequate clothing
- Lack of access to physical aids
- Untreated medical conditions and injuries
- Lying
- Potential substance abuse
- Bruises, cuts, scars, or marks on the body
- Social isolation or anti-social behavior
- Emotional distress
- Risk of self-harm
What are the factors that may contribute to an individual being more vulnerable to abuse?
Factors that may contribute to an individual being more vulnerable to abuse include mental disabilities such as dementia or lack of mental capacity, isolation, previous abuse, low self-esteem, lack of sense of worth, substance abuse, old age, childhood, homelessness, inability to communicate verbally and medical dependence.
Individuals who lack protection are more susceptible to abuse. Predators target vulnerable individuals to exploit their weaknesses and make the act of abuse easier.
How to Respond to Suspected or Alleged Abuse and Preserve Evidence
If there are suspicions that an individual is being abused, it is important to take immediate action. The first step is to report the suspected abuse to the appropriate authorities, such as law enforcement or adult protective services. It is also important to document any observations or conversations that may support the suspicion of abuse.
If an individual alleges that they are being abused, it is important to listen carefully and take their allegations seriously. The next step should be reporting the allegations immediately and documenting any information provided by the victim.
To ensure that evidence of abuse is preserved, it is crucial not to disturb any potential evidence. This includes not cleaning up any physical evidence or altering anything in the environment where the alleged abuse occurred. It may also be necessary to take photographs of injuries or other evidence before they are treated or cleaned up.
If there are suspicions of abuse towards an individual, I would create a written report detailing my findings that have led me to believe that abuse has occurred or is occurring. As an alerter, I would report this information to my line manager and any other relevant departments. If my line manager fails to take action on the report, I would utilize the whistle-blowing technique and bring it to the attention of regulators or other agencies. All reports submitted by me will include body mapping to indicate where evidence of abuse has been observed and can be used as evidence.
If the client has any clothing that needs to be used as evidence, such as clothes with bloodstains, I would ask them to remain in those clothes until the relevant person comes to investigate the suspicions. This ensures that any evidence is preserved for the investigation and prevents contamination of the evidence.
As an alerter, I would not be responsible for investigating the case. However, if there was a situation where the evidence may be damaged or tampered with, I would try to preserve it by moving it to a safe place. In my written report, I would log where it was moved to, why and how. I would communicate with the client but not question them as this may make them feel more vulnerable. With the client’s permission, I would alert their family or friends about the incident.
Once the case had been investigated, care plans would be updated and I would make sure to follow any necessary changes to my job role.
If a client alleges abuse, I would follow the same procedures as usual. The only difference would be in my written reports, which would include a statement from the client about their version of events instead of mine. Additionally, the body mapping diagram would be different as the client would show me all areas where the abuse occurred rather than me reporting what I have seen. Nevertheless, I would still alert the same people and preserve evidence in the same ways.
It is important to preserve as much evidence as possible to allow for a quick investigation. Always prioritize the safety and needs of the client. Other ways to preserve evidence include requesting any CCTV footage that may show the abuse occurring or identifying factors involved in the abuse.
Can you explain the roles of different agencies in safeguarding and protecting individuals from abuse?
The police play a vital role in safeguarding adults, especially when the individual alleges that they are being abused. This is because abuse is a criminal act, and it becomes the responsibility of the police to investigate any allegations of such crimes. They have to preserve and collect evidence for further investigation.
If a crime is identified, the police will be the main agency responsible for directing any investigation within their policies and procedures.
The police have implemented policies and procedures to communicate with other services, enabling them to identify addresses where vulnerable people reside. They can now track the number of visits made to these addresses within a month, two months, and six-month period. This helps the police identify any patterns that may occur and enables them to safeguard and protect individuals effectively. Additionally, police officers are required to read serious case reviews that help them improve their policies and procedures further. The police have also received more problem-solving training that allows them to recognize abuse-related problems in their line of work.
Social Services play a vital role in safeguarding and protecting individuals who are victims of abuse. They have a ‘no secrets’ document that requires them to work together with other agencies to ensure the protection of vulnerable adults. Social services work in partnership with other agencies to develop policies and practices aimed at protecting vulnerable adults from abuse. They are responsible for providing a wide range of care and support for vulnerable adults, and when such individuals are at risk, social services will assess their needs to promote their wellbeing and protection.
Ambulance and NHS work together to provide the best care for vulnerable individuals by keeping in touch with other agencies. This is done to protect vulnerable people from safeguarding and protection issues. If a client is admitted into the hospital several times for the same reason, there are now systems in place to alert them of this. For example, if a client has been admitted several times with signs of any type of abuse, their computer systems will notify staff how many times the client has been admitted for similar issues; once in one month, twice in two months, and six times in six months.
Another example of identifying abuse or vulnerable adults is through a system introduced in some hospitals. This system helps identify if someone is being abused. If there is suspicion that a client is being abused, the hospital staff will ask the client to provide a water sample in a bottle from the toilet. In the toilet, there are different colored stickers to put on the pot to indicate if they are being abused.
If a client is unable to communicate with staff due to the presence of an abuser, they can use stickers on relevant bottles to indicate their situation. The staff will then be alerted and follow safeguarding and protection policies by attempting to move the client away from the abuser for their safety. The Care Quality Commission regulates and inspects care providers.
Over the years, there have been many serious case reviews that have prompted all agencies to review their policies and procedures. Nowadays, most agencies operate within the Multi-Agency Public Protection Arrangement (MAPPA) guidelines to enhance communication and information sharing.
How can we identify reports that involve serious failures to protect individuals from abuse?
During the serious case review of the 2008 murder of Stephen Hoskins, I discovered numerous failures by agencies that could have prevented his death. Additionally, there were policies and procedures in place that could have been implemented to safeguard and protect him.
Before his death, Stephen had reached out to many different agencies, including the ambulance, police, and social services. However, none of these agencies realized that he was being abused. Despite calling 999 on multiple occasions, there was no system in place to connect the calls and alert authorities of a pattern of abuse. Additionally, Stephen had stopped visits from social services. It is important to investigate why he no longer wanted them involved in his life; could he have been blackmailed into doing so? This lack of connection with social services may have given the abusers more power over Stephen.
A mental capacity assessment was not carried out on Stephen to determine if he had the ability to make the decision to stop his visits. During the investigation into Stephen’s murder, it was discovered that each agency possessed a small or large piece of information, but these pieces were never put together until after his death. The question remains: why did this happen?
At the time, the available procedures failed to protect Steven. Ensuring Stephen’s safety should have been a top priority. It is concerning that agencies only seem to communicate with vulnerable individuals after serious case reviews are conducted.
There are now systems in place to help protect future vulnerable individuals from the same problems that Stephen experienced. However, not all agencies can say they have solved the problems 100%. Social services stated that although their services have improved and they try to share as much information as possible, there is still training needed and more systems to be put in place. The NHS has said they are trying to work more closely with the police, but this has not yet been implemented. The ambulance service is working closely with all agencies, but there is still progress to be made.
Explain how the likelihood of abuse can be reduced:
When working with person-centred values, it is important to prioritize the individual’s needs and preferences. This approach focuses on creating a supportive and empowering environment that fosters independence, dignity, and respect for the person’s autonomy.
Encouraging Active Participation
Promoting Choice and Rights
It is important to work with person-centered values as this enables the client to be central to the care they receive. As a carer, you will build a relationship and trust with the client. If you have trust and a good relationship with your client, they are more likely to open up about any problems or abuse they may be experiencing. Working closely with your clients allows you to spot signs of abuse sooner than someone who does not have such close contact. You will learn about their routines, moods, and notice any changes in behavior that could raise suspicion of abuse. By detecting these signs early on, you can prevent harm from happening.
It is important to encourage active participation in order to empower the client to make decisions for themselves or with your guidance. For instance, you can ask the client whether they prefer a red top or a blue top. By doing so, you are giving them control over their care instead of making decisions on their behalf. This approach enables the client to feel in control and respected.
Involving the client in their care plan is also crucial as their wishes should be at the core of it for it to succeed. When all staff members work in this manner, it reduces the risk of abuse and gives clients confidence and self-esteem to speak up if there are any issues. Moreover, it helps create and maintain a professional relationship with your clients.
It is important to promote choice and rights so that the client has the freedom to choose the care they would like to receive and decline any suggestions they do not agree with. This allows clients to express their needs and wishes with confidence. For example, allowing clients to decide on what color top they would like to wear – red or blue, or letting them choose whether they want to eat in their room or in the dining area with other residents.
Why is an accessible complaint procedure important in reducing the likelihood of abuse?
A complaint procedure is a process for resolving issues. It is important to have an easily accessible complaints procedure so that clients, families, and staff know there is a procedure in place if they have a problem. This ensures that their problems will be dealt with in compliance with the established procedure. Additionally, having a complaint procedure helps clients, families, and staff feel less vulnerable and more protected. The complaints procedure also makes it less likely for people to be abused as any abuse is more likely to be challenged when there is an established complaints process in place. If abusers know there is a complaints procedure they are less likely to abuse a client.
A complaints procedure will encourage workers to maintain professionalism at all times, thereby reducing the likelihood of complaints being made against them. Additionally, clients have the option to make anonymous complaints about a worker without fear of repercussions. Without a proper complaints procedure in place, issues related to abuse and protection may go unrecognized and could potentially increase the likelihood of abuse occurring.
What are some unsafe practices that can negatively impact an individual’s well-being?
Unsafe practice occurs when policies and procedures are not followed correctly, resulting in harm or a risk of harm to individuals or others.
If medication is administered incorrectly, it puts the service user at risk of overdose or illness due to missed medication. For example, if someone has type one diabetes and you fail to give them their insulin, this could result in a hypo or hyper episode and lead to hospitalization. Giving a client the wrong dose of medication can also lead to overdose and hospitalization.
If the procedures for manual handling are not followed, the client is at risk of being hurt, bruised, falling, feeling embarrassed and helpless. If there is only one staff member available and two are required to complete manual handling tasks, it should never be done alone as it also puts the client at risk.
Not following infection control procedures can lead to illness or hospitalization, not only for yourself but also for others. Shortage of staff is a common issue in the workplace and can put extra strain on care workers. However, you should always assess the risk of completing each task to prioritize the client’s needs. Lack of resources and equipment can hinder your ability to complete necessary tasks, so it is important to ensure that these are regularly ordered and avoid carrying out tasks without proper resources or equipment. Lack of communication can also put your client at risk if you don’t understand a task or haven’t communicated with clients or staff. Always make sure to communicate clearly and ask questions if something is unclear. If needed, do not hesitate to ask for help.
What actions should be taken if unsafe practices are identified?
If you identify unsafe practices, you have a duty of care and should protect the individual to ensure they are not at risk of harm. Report this to the manager. If the manager does not act upon it, then report it to the Care Commission. Once you have done this, record your findings and make a report stating what is suspected as unsafe practice, who was involved, when it occurred, and why you think this is unsafe practice. Always preserve any evidence where necessary.
What should be done if suspected abuse or unsafe practices have been reported, but no action has been taken in response?
After reporting an incident, it is still your responsibility to provide care for your client. If the issue has not been resolved, you should speak with your manager again and inquire about why no action has been taken. If the manager has not addressed the situation, you can utilize the whistleblowing procedure to contact the regional manager or care commission. Additionally, other agencies may be able to intervene and prioritize the client’s needs. You can reach out to authorities such as the Police, Social Services, NHS or even family members in certain cases.
It is important to always keep records updated and preserve evidence. Additionally, it is crucial to continue reporting the incident until it has been properly addressed and the client is no longer at risk of abuse or harm resulting from unsafe practices.
