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Emotional/psychological abuse * Mental anguish caused by threatening or aggressive language/behavior, harassment, humiliation or neglect. * Verbal abuse – including threats, bullying, schism, sexism, intimidation or being shouted at. * Not allowing/restricting contact with family/friends. * Refusing to allow the individual to take part in favorite/any activities. Failure to respond adequately to emotional needs, such as security and affection. * Failure to protect from emotional or psychological abuse by others * Forcing a person to perform tasks, which are inappropriate or inhumane.

Financial abuse * Unauthorized use of service user’s money or assets * Failure to use a service user’s money and assets resulting in harm to the service user. * Willful use, withholding or disposal of a service users assets. Obtaining control of a service users money and assets by fraud, coercion or harassment, * Material exploitation – misuse of a person’s money, possessions, property, insurance, related documents, or preventing access to such material goods. * Theft – stealing a person’s money, possessions, property and/or insurance or related documents. Extortion of the above items through threats. Institutional abuse This could occur in an individual’s own home, a residential or nursing home, a hospital or day centre, and might include: * Enforcement of excessively rigid routines * Restrictions on personal possessions Lack of choice in everyday activities * Change in accommodation without consent * Infiltration of an individual (treating the individual as one might a young child) Self-neglect * Refusal to the extent that the individual’s health, development or general well being is affected. Refusal to access appropriate care professionals (e. G. Social services or medical staff) * Refusal to food, shelter, warmth and sleep Signs and symptoms of abuse When considering the following signs and symptoms, it is important to remember that there can also be perfectly innocent reasons for the majority f them; however all concerns must be reported immediately so that an investigation can be carried out. Bruising Bruises may be caused by slaps, pinches, rough handling or falls: any bruise requires both medical attention and an evaluation to determine its cause.

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Injuries to intimate areas Any bruising, cuts, redness, and rashes in the genitalia must be taken seriously and be investigated as indicators of sexual abuse. Sexually transmitted infections/pregnancy If there are concerns about the service user’s capacity to consent to sexual intercourse, the presence of infections or pregnancy would be indicators of buses requiring an immediate investigation. Sudden weight loss Sudden weight loss can be an expression of a service user’s distress or a result of neglect. Physical, emotional and sexual abuse can all cause loss of appetite in victims.

Poor care or a ‘can’t be bothered’ attitude from staff or management may mean that a service user’s needs are not met. Simply providing three square meals a day to a service user, doesn’t mean the meals are eaten, service Users may have difficulty feeding themselves, illness or medication may cause loss of appetite or problems with eating or swallowing or they may just not like he meal they have been given. Research has shown that the average nursing home resident takes 40 minutes to eat a meal, careers may be expected to provide support for between 5 and 20 people in an hour making it almost impossible to meet each service user’s needs.

Therefore care plans, risk assessments, policies, procedures and guidelines must be in place to ensure that the service users receive the highest possible quality of care possible. Dehydration Dehydration may occur as a result of service user’s being denied access to fluids or not being given the support necessary to be able to drink. Service users would have drinks available at all times and staff must be able to monitor fluid intake, special care should be taken for individuals suffering from sickness/ diarrhea and for all when the weather is hot.

Falls When a service user enters a home a care plan will be created for them. This should include an assessment of their risk of falling to determine what assistance they will need to get around. If appropriate procedures are not developed by managers and acted upon by staff then unnecessary falls will occur. The potential for falls occurring will always exist but negligence will increase their childhood. Factors such as lack of staff attention, wet floors, inappropriate seating, beds that are too high or too low and poor standards of moving and handling are avoidable but common.

Bedsores Bedsores are sometimes called pressure sores or deciduous ulcers. At first the skin appears red and turns white when touched, like sunburn. Stage two sores break the skin and if left untreated ulcers can crater and leave muscles, tendons and bones exposed. These sores are caused by prolonged pressure in individuals permitted to let too still for a long period of time. The bony prominences of the DOD are the most frequently affected sites. The ulcer is cause by diminished blood supply to the underlying structures of the skin, fat and muscles and are a result of the sustained and constant pressure.

Bedsores are very common in homes but this does not mean that are acceptable, they can be prevented by changing a person’s position frequently and by ensuring they have adequate nutrition, using a moisturizer would also help. Unusual behavior A service user that is being subjected to physical, emotional or sexual abuse may act differently, particularly in the presence of certain people; for example they Show signs of mental distress or upset as cries for help, crying etc. * may: Become quiet and over compliant. Get aggressive, destructive or paranoid. * Act in a flirtatious or sexualities manor Incontinence Incontinence in clients should always be investigated and never just accepted as a ‘normal’ part of the aging process. Failure to treat medical causes or to provide adequate toileting programmer would amount to neglect; emotional and physical distress caused by abuse may lead to incidents of incontinence. Financial changes Financial abuse can generally only be detected by those who have access to a revive user’s money or knowledge of their money.

However, there are some signs and symptoms which can be detected by anyone: * A depletion of the service user’s finances and misuse of their money or property. * A service users money being spent when they are unable to go out and spend it themselves. Unexplained withdrawals from their savings account, often in round figures and clustered at certain times. * The disappearance of an individual’s valuables from their room. Recognizing institutional abuse is very hard. Institutional abuse may be ignored because staff do not realism that there is anything wrong with their working environment or practices.

They may be unable to see that they way they are used to doing things may not be the best way for things to be done. Careers will be influenced by the attitudes of management and may be too focused on the physical element of the job at the expense of the emotional, social, spiritual and cultural needs of the service users. Lack of Flexibility It is fairly common practice for homes to have set times for service users to get up, go to bed, eat meals etc. If these are rigidly enforced the care of service users is likely to suffer and their needs are unlikely to be met.

If there are time limits for arraying out tasks such as getting service users out of bed it is possible that their careers will feel that they lack the time to encourage service users to do things for themselves. Careers may then take over, leading to increased risk and rapid loss of ability for the service user. Use of Restraints It is possible to use a variety of unsuitable means to deny freedom of movement to service users, for example they may be locked into their rooms, tied into chairs, sedated or left without access to walking aids.

Restraints must never be used to make life easier for staff or to punish/give a consequence to service users. A doctor must prescribe both chemical and physical restraints; a service user who is restrained must be very closely monitored and kelp in the restraint for a very short period of time. Proper use of restraints will involve the doctor, managers, social services, DOLs and service user’s family working together to achieve the service users best interests, there will be health or welfare reasons for the action taken.

Improper or even illegal use of restraints can seriously affect the service user’s physical and mental health. Warning signs include the use of improvised barriers such as wheelchairs position across doors, lack n monitoring of restrained service users and the use of one service user’s medication for another. Inappropriate Relationships There is a fine line between being too detached from service users and getting too involved with them and it is important for careers to find that line.

It is important to get to know service users, and on occasion develop a friendship with some but this cannot affect the professional responsibilities that careers have to the service users in their care. Service users can be dependent on careers in many ways, however this should never be exploited in any way including: sexual contact with a service user, accepting money from a service user, allowing a service user to make a career their beneficiary in their will or let a service user become so attached to a career that if the career left the home, it would seriously affect their health.

Other indicators of institutional abuse include: * Service users being denied the use of their hearing aids/glasses Restriction of access to facilities/phones or visitors * Lack of privacy, respect and dignity * Poor care of clothing and possessions * Lack of adequate procedures concerning medication, money handling etc. What to do if you suspect abuse Reporting any suspicions however seemingly minor is essential in ensuring the safety of those in your care.

The Social services provide a flow chart of instructions and outcomes on the reporting of abuse: An allegation of abuse has been made Report to homes’ manager Report to social services, they will process, guide and instruct any further investigations Investigation stage Outcomes of investigation If necessary, a safeguarding meeting will be held Implement any outcomes or changes requested from the safeguarding meeting Whilst ensuring that the above actions take place, it is also important to do the following: If there is an immediate danger or a crime may have occurred then call the emergency services. Keep the person involved safe. * Preserve any evidence * Support and reassure the person involved * Observe confidentiality as far as appropriate * Make written records. Do not, under any circumstances try and investigate the incident yourself or question anyone involved. Don’t put anyone at risk by confronting the alleged abuser and don’t promise to keep secrets as it may be important to pass on. Ensuring evidence of abuse is kept safe. It is important that when dealing with evidence to ensure that it does not come ‘contaminated’.

If you need to seal of an area then seal it off from everyone. If you are dealing with a physical piece of evidence, then ensure that it is kept away from others but it may not be possible to move it. If you are dealing with paperwork, then ensure that it is locked away. Evidence is a vital part of the investigation stage. Unlike humans, there is no room for error with evidence so it is the most important piece of information. It is also important however, to as far as reasonably practicable, to maintain confidentiality.

If abuse is suspected, it is to for other staff or other residents to know about it, so, although it is important to keep evidence ‘clean’ it is important to maintain confidentiality about it. If you are unsure what to do with the evidence, ask your homes’ manager as you report it who will give you further instruction. National policies surrounding safeguarding Safeguarding of adults is a legal requirement as well as morally right therefore there are laws and legislations surrounding safeguarding adults.

You must familiarize yourself further with a minimum of a basic understanding of the following pieces of legislation and national policies. * White paper addressing Social Services (1998) – Stressed the importance of improving the protection for adults needing care and d support. * Public Interest Disclosure Act 1998 – An Act to protect individuals who make certain disclosures of information in the public interest; to allow such individuals to bring action in respect of visitation; and for connected purposes. Human Rights Act 1998 – placed a positive duty upon ‘public bodies’ to act compatibly with the 1950 European Convention on Human Rights. This includes a duty to intervene proportionately to protect the rights of citizens. Article 2: The right to life’, Article : ‘Freedom from torture’ (including humiliating and degrading treatment), Article 8: ‘Right to family life’ (one that sustains the individual). * The Disability Rights Commission Act 1999 – led to the establishment of the Disability Rights Commission (DRY) in April 2000.

This Act sets out the Dry’s statutory duties. No Secrets (2000) – Guidance published by the Department of Health builds upon the Government’s respect for human rights and highlights the need to protect vulnerable adults through effective mufti-agency teamwork. * National Care Standards Commission then became the Commission for Social Care Inspection, owe known as Care Quality Commission (ICQ) – The governing body over all types of care services created to ensure the well being of vulnerable people.

Sexual Offences Act 2003 – An Act to make new provision about sexual offences, their prevention and the protection of children and other vulnerable individuals from harm from other sexual acts, and for connected purposes. * Disability Discrimination Act 1995 – An Act to make it unlawful to discriminate against disabled persons in connection with employment, the provision of goods, facilities and services or the disposal or management of premises; to make revision about the employment of disabled persons; and to establish a National Disability Council. Disability and the Equality Act 2010- From 1 October 2010, the Equality Act replaced most of the Disability Discrimination Act (DAD). However, the Disability Equality Duty in the DAD continues to apply * Mental Capacity Act 2005 – An Act which aims to protect people who cannot make decisions for themselves due to a learning disability or a mental health condition, for example Alchemist’s disease, or for any other reason. It provides clear guidelines for careers and professionals about who can take decisions in which tuitions. (Note: it is important that you learn the 5 key principles of this Act). Safeguarding Adults (2005) – National Framework of Standards was issued by the Association of Directors of Social Services (ADDS). The national framework is comprised of 1 1 sets of good practice standards in safeguarding adults. It makes a distinct shift in language from ‘vulnerable adult’ as used in No Secrets to ‘safeguarding adults’. * Mental Health Act 2007 – an amendment to Mental Health Act 1983 which is largely concerned with the circumstances in which a person with a mental disorder can be detained for treatment for that disorder thou his or her consent.

It also sets out the processes that must be followed and the safeguards for patients, to ensure that they are not inappropriately detained or treated without their consent. The main purpose of the legislation is to ensure that people with serious mental disorders which threaten their health or safety or the safety of the public can be treated irrespective of their consent where it is necessary to prevent them from harming themselves or others. Local and Organizational Systems for Safeguarding Surrounding your workplace will be a set of local and organizational systems to ensure the safeguarding of adults in your care.

Depending on where your company is based, there are a number of local authorities that you can turn to. This is area specific and will therefore require research, for example, in Bassoonists, for advice and guidance and for further information; there are three local bodies which can help: * Lowdown Alliance * The Highlighted centre * Alton family centre The company you work for, your organization will also have their own internal systems for safeguarding adults. For example, they will have their own policies and procedures, provide training and will also enforce their systems in your irking practices.

They may also complete supervision sessions in which you will have time with a senior member of staff to express and concerns or ask any questions which you may have. It will also be a chance for your senior staff to speak to you about your practices to improve your ability and develop your knowledge of the job. Your role and the roles of others It is everyone’s job to ensure the safety and well being of service users. It your work role, you must ensure that you are not committing knowingly or unknowingly abuse practice and to watch for signs and symptoms of abuse occurring and most importantly, to report it.

It is the role of your manager to do what you must do, as well as take any concerns or reports raised with the most importance and take appropriate further action. It is also their job to ensure that their staff team is not committing any abuse practice. It is the role of the service manager, to do what they manager is doing, but also watch for the manager as well. This is internal people who are caring for someone, and every person who is involved must ensure safe practice. It is the role of social services to ensure the company are reporting any allegations of abuse and that the company is abiding by legislation and policies.

It is the role of the ICQ to ensure that the company are reporting allegations of abuse and that the company is abiding by legislation and policies. It is also the role of the ICQ to inspect care settings in all aspects of a person’s care to ensure that all correct working practices are being carried out. When working in a care setting, you will end up working with other professionals such as occupational therapists, behavior nurses, clinical nurse specialists, speech and language therapists, psychiatrists etc.

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