204Answers

Unit 204 Ai Physical abuse is the use of physical force that may cause bodily injury, pain or impairment. This can include acts of violence such as slapping, punching, kicking, shaking, pushing and pinching. Other forms of physical abuse include using restraints, force feeding or inappropriate use of drugs. Sexual abuse is sexual contact of any kind with another person who has not given their consent whether they are capable or incapable of doing so. This can include touching someone inappropriately, i.e. genitals, breasts, bottom or kissing. Emotional or psychological abuse is subjecting a person to a behaviour that may cause distress or trauma. This can include actions such as making negative comments, depriving of someone with interaction with family or friends, or gaining trust in order to exploit. Financial abuse is to misuse a person’s funds or assets. This can include taking money from their bank or home, using their money to buy items for yourself or others, short-changing or using store cards to earn extra points for your own account. Institutional abuse can occur in care/nursing homes, hospitals or where vulnerable people are at risk. This mainly refers to forcing actions upon people without their consent such as getting people up and dressed at a specific time, toileting and meals at set times and treating everyone with the same actions without taking their individual needs into consideration. Self neglect is when a person neglects their basic needs such as personal hygiene, not eating, or failing to keep appointments with Doctors or at hospitals. All of these have a detrimental impact on their health and wellbeing. Neglect by others is failure of another to support or assist with a person’s needs. This can be in the form of meals not being given, medication not being administered or lack of assistance with basic and emotional needs. Aii Physical Abuse: Unexplained injuries such as bruising, cuts, marks or burns. A person may be withdrawn or nervous when approached. Sexual Abuse: A person may be withdrawn or overly friendly in a sexual way and may also have painful or injured genitals and avoid any physical contact. Emotional/Psychological Abuse: Signs of this may be depression, lack of interest or concentration, they may become agitated or anxious and have low self-esteem. Financial Abuse: Unable to pay bills or purchase items, unexplained lack of money or withdrawals from account. They may appear distrusting or over-protective about financial matters. Institutional Abuse: No support or care plan in place, shared possessions in a residential setting, expected to use toilet facilities at a set time or inadequate or broken equipment being used. Self Neglect: Medication not being taken, low self-esteem, clothes not clean, personal hygiene not being carried out and isolating themselves from others. Neglect by Others: Depression or withdrawal, malnourished or dehydrated, lack of confidence or trust. Aiii If you suspect that someone is being abused you should speak with them directly in the first instance. It is important that you gather all facts and don’t ask leading questions. You must have their consent wherever possible before reporting any abuse. If a person does not have the mental capacity to agree to this then you must assess if it is in their best interest to report it. You must inform the person of your intentions before you carry them out and give reassurances of confidentiality. If you are in any doubt then you should report it to your manager. Aiv If someone discloses they are being abused you must stay calm and listen to what they tell you. This must be taken seriously and record should be made of the conversation. Offer them support and explain that you must report what they have told you. You should then report all information to your manager or social services. You should never approach the alleged abuser or assume that someone else will report it. You must never push the person for more details. Av Following an alleged incident of abuse you must try to preserve evidence by not moving anything, resisting the temptation to tidy or clean, lock the room so others cannot interfere with evidence, lock documentation and reports in a secure place. It is also important that the victim does not wash or dispose of any items that may be used as evidence, e.g. clothing. Avi The Association of Directors of Adult Social Services (ADASS) have published a National Framework for the safeguarding of adults. There is also legislation to ensure employers do not employ people who are barred from working with vulnerable adults (Safeguarding Vulnerable Groups Act - 2006), this is enforced by the Independent Safeguarding Authority (ISA). Avii Brighton and Hove City Council have published a Safeguarding Adults at Risk framework which every employee is required to understand. This is based on the recommendations of the ‘Safeguarding Adults’ policy published by ADASS. Aviii National Agencies: Central Government and national agencies such as CQC and ADASS are responsible for publishing guidance on safeguarding policies and ensuring these are implemented. Local Authorities: LA’s must ensure that all care organisations in their region are following the correct codes of conduct. Centre Managers: Managers of care providers are required to ensure all line managers are competent at delivering safeguarding training to their staff. Line Managers: Managers of staff need to ensure all new staff complete the relevant safeguarding training and carry out refresher training during the course of their employment. They must also supervise staff to ensure codes of conduct are being followed. Care Workers: Care workers must ensure they understand the Safeguarding policies of their company and report any safeguarding issues or any breaches of codes of conduct. Aix Care workers can refer to documentation on their employer’s safeguarding policies. They can talk to their managers for advice and guidance. There is a lots of guidance online such as websites for CQC, local authority safeguarding pages and ADASS. Task B Winterbourne In July 2011, CQC published a report on Winterbourne View care home following a BBC Panorama documentary which showed months of secret filming of incidents of abuse. The CQC investigation found there was a ‘systemic failure to protect people or to investigate allegations of abuse’. The report states that the providers of care, Castlebeck Care (Teeside) Ltd., failed to notify CQC regarding serious incidents of abuse, therefore misleading the commission about the quality of care being provided. Winterbourne did not have sufficient assessment procedures in place to enable them to understand the needs of vulnerable adults in their care which meant individual needs were not being met. CQC also found that staff recruitment and training was inadequate, by recruiting staff that had no prior experience of caring for vulnerable people, failing to train staff on the correct safeguarding and care procedures and failing to monitor and evaluate staff performance. One notable indicator of this was staff’s excessive use of restraint. Castebeck Care Ltd. also failed to ensure there were robust monitoring procedures in place to ensure quality of care. Complaints about the quality of care being provided were made but were not listened to, and the company failed to investigate allegations of abuse. Orchard View In June 2014, CQC published a report following a Serious Case Review detailing a series of failures at Orchard View care home. The home was originally rated as ‘Good’ by CQC in 2010 but was re-inspected in June 2011 following a series of investigations by the local authority into allegations of safeguarding failures including serious injuries and medication errors. The inspection only found minor failures such as inadequate staff training, residents being treated without dignity or respect, medication management failures, and failures to meet resident’s nutritional requirements. After further allegations of incidents of abuse, QCQ returned in September 2011 and found that residents were left at risk of serious neglect including poor continence care, poor pain management, a failure to support people with eating and drinking, insufficient administration of medication, poor staff training and a shortage of available staff. Southern Cross closed the home shortly after the publication of this report and a coroner’s enquiry was launched into the deaths of 19 people at the care home. It concluded that five of the deaths were attributed to neglect and the others to ‘sub-optimal care’. Failings were attributed to staff, the care home’s managers, the owners Southern Cross, and also to CQC themselves due to their inaction following the allegations. Task C Ci The care worker should call emergency services if there is immediate danger or if there has been an alleged crime, this must be reported at once. The person must be kept safe and given support and reassurance. Evidence should be preserved and confidentiality should be observed. Written records should be made and an alert form should be completed. Cii Go to another manager or HR department, contact CQC or local adult safeguarding services. You may also contact the police or follow whistleblowing procedures and use the whistleblowing help line. Ciii Elderly and infirm people are more vulnerable due a diminished physical and mental capacity to defend their rights. Those suffering from poor mental health may not have the capacity to understand or identify abusive actions. This may leave them more open to manipulation in particular. Seriously or terminally ill people may not have the physical or vocal capacity to challenge abusive behaviour. They may also be more likely to be passive and accepting of ill treatment. Civ A person-centred approach to care empowers an individual to voice their will and challenge unfair or abusive treatment. This approach increases self confidence and self assurance and supports mental wellbeing. Cv Active participation gives individuals choice in how they live their lives and allows them to contribute to the care they require and receive. It gives the person an equal share of control which promotes confidence and individuality. This approach also allows the care worker to see the individual's personality, allowing them to cater for their individual needs. Cvi A clear, simple and accessible complaints procedure promotes equality and inclusion by allowing all individuals to use it. The easier a complaints procedure is to use, the more likely individuals will engage with it, staff should ensure all people in their care are aware of the procedure and how to use it.