Different Forms of Abuse and Ensuring Patient Safety

Introduction

An effective safeguarding framework in healthcare is important to protect vulnerable people from abuse and harm. Ther are different kind of abuse that service users can face such as physical, mental, emotional, financial and social abuse. This study will discuss three kind of abuse such as physical, emotional and financial abuse and their impacts on the patient, Andrew in the given case study. This study will demonstrate the action that are needed to take on suspecting or detecting an actual abuse. Then the study will discuss the roles of health and social care agencies in promoting safeguarding of staff and service users. The study will also explain the guidelines that are associated with safeguarding of people from abuse. Finally, the study will demonstrate the impacts of the accessible complaints in terms of reducing the cases of abuse.

Case study:

Andrew is 22 years old gentleman suffers from autism. He lives in a residential care home. From the given cases study, it is clear that Andrew is highly vulnerable to physical, emotional, psychological, social and financial abuse. Due to his learning disability, poor cognitive ability and lack of decision-making skill, Andrew faces several financial, physical and emotional abuse such as his mobile had been stolen, he has been bullied by peers at his office. All these abuses pose adverse impacts on his mental and physical wellbeing. He is more likely to show different signs of abuse such as depression, anxiety, sadness, loneliness and hitting or burning marks on skin. Therefore, Andrew needs proper safeguarding environment in the residential care home that will protect him from all these abuse and harm.

1.1 Three different kinds of abuse:

Physical abuse can be referred as the using physical forces against a person with an intention to cause injuries and harm to that person (Romeo et al. 2017). Vulnerable people with mental, physical and emotional disabilities are more likely to be affected by many kinds of physical abuse such as, biting, hitting, shaking, burning, suffocating, scalding, unwanted touch, pushing and force feeding. In the case study, Andrew is highly vulnerable to severe physical abuse that can interfere with his right to live a healthy and safe life. For example, he is vulnerable physical violence, hitting, burning of skin, suffocating, pushing, unwanted touch and force feeding.

Emotional abuse can be considered as the psychological distress that a person feels due to the unfavourable and unethical activities as well as behaviours of surrounding people towards the person (Zhao et al. 2017). There are different types of emotional abuse in the society such as, bully, devaluating self-esteem of a person, invoking fear or threats, swearing verbal abuse, threats, negligence towards individual, conveying feeling or worthlessness to a person, showing bias and discrimination to individual from accessing their rights. In the case study Andrew is highly vulnerable to all these emotional abuses which can impacts adversely on his psychological, spiritual and physical wellbeing. Andrew experience different emotional abuse such as verbal threats, neglect of people surrounding towards him, poor support from his family members, friends and neighbours and severe bullying and discrimination. All these abuses pose adverse impacts on his soft feeling, right decision making and positive thoughts.

Financial abuse can be considered as the financial fraud or maltreatment in which somebody conducts forceful controls on money and other assets of the victims (Cooper and Bruin, 2017). Financial abuse includes stealing money, taking legal authority of assets of victim by using forging signature and fake documents and interfere the with rights of victims to take effective financial decision. In the case study, Andrew suffers from financial abuse such as his mobile has been stolen. As he is autistic and having learning difficulties, he has high vulnerability to the risk of financial abuse. Therefore, safeguarding professionals in the care home must provide effective care and protection to Andrew to ensure that he is free from any kind of financial fraud. In addition to these safeguarding professionals need to train and empower Andrew in such way that he will develop the knowledge and skill in protecting his rights to his financial asset.

1.2 Signs and symptoms the three abuse:

Signs and symptoms of physical abuse are bite marks, biting marks, multiple bruising, burn marks, bed sores, fear, unexpected weight loss, changes in the behaviour and activities of the victim and depression (Mckendrick and Finch, 2017). NHS (2019) mentions that, UK is reported to have huge cases of physical abuse to the services users in the care homes which lead to poor physical and mental health of victims, even leads to death [NHS, 2019]. In the case study, the safeguarding staffs need to check that whether Andrew shows any of the above-mentioned signs and symptoms that would confirm the he experiences physical abuse. In his context, the care home authority conducts the physical examination of Andrew that can assist the safeguarding staffs to know that if there is any sign physical abuse on Andrew’s body.

The common signs and symptoms of emotional abuse are depression, anxiety, loneliness, feeling of sadness, poor self-confidence, lack of self-esteem, changes in behaviour of victims such as victims may look threatened and helpless or they show aggression or irritation (Cooper and Bruin, 2017). PHE (2019) mentioned it its report that, in the UK, people with mental illness are more likely to suffer from the emotional or psychological abuse. In the case study, safeguarding staffs need to examine that if there is any behavioural change, mood swing or changes in the appearance of Andrew which will assist the staffs to determine what kind of emotional or psychological abuse have been experienced by Andrew.

In case of financial abuse, the signs and symptoms are the illegal withdrawal of money from bank of the victim, missing of belongings, unpaid bills, unexpected reduction of money, theft and fraud (Hood et al. 2017). In the case study, Andrew already experiences the financial abuse as his mobile had been stolen, which not only pose adverse impacts on his financial aspects but also develop psychological and emotional distress in him. Therefore, safeguarding staffs in the care home need to examine whether there is any further financial abuse that Andrew faces to provide him with proper protection against the financial abuse.

2.1 What actions need to be taken on suspecting any abuse or detecting actual abuse:

While suspecting or detecting the actual abuse the first activity is to listen to the victim carefully and then provide him or her with the right information regarding what to do next (Romeo et al. 2017). If there is emergency situation it is important to call to 999 to provide the immediate clinical support to the victim. Then it is important to record all the facts that is explained by the victim immediately and preserve all the evidence of the abuse. After detecting an actual abuse or suspecting any abuse, it is important to report it to the appropriate individual for initiating the further procedure of the safeguarding (Warren, 2018). For example, in the case study if the safeguarding staffs detect an abuse or a risk of abuse to Andrew, they must inform it to the line manager and other safeguarding officials. After detecting the actual abuse or the risk of abuse, it is important to stay with the victim or suspected victim to provide him or her with the mental, physical and emotional support at that time. While alerting to the management team or the administrative body of an organisation regarding the abuse, the safeguarding staffs must follow the legal and statutory guidelines to report and record the complaints of victims.

2.2 Roles of the agencies and safeguarding staffs:

While suspecting any abuse or harm, safeguarding staffs must provide the information to the concerned line manager or other safeguarding lead immediately. If there is concern that the line manager or any safeguarding official is involved in causing abuse, then the informer needs to inform this to the higher officials such as the senior managers of the healthcare organization (Manthorpe and Martineau, 2017). For providing the immediate information to the managers and the appropriate care agencies, safeguarding staffs must inform the abuse to the whistleblowing team, Trafford Council or contact the Community Screening team. If immediate medical support is required to the victim, then safeguarding staffs and managers first call for an ambulance or the emergency medical services to arrange immediate medical support to the victim (Stevens et al. 2018). The care manager must contact police if there is associated risk of crime with the abuse. The safeguarding staffs and care manager must ensure that all the evidence of the abuse must be preserved property for further evaluation of them. In case of Andrew, if any risk of abuse or an actual abuse is detected by the safeguarding staffs, they must inform the line manager for providing immediate support and protection to him. In this context, line manger will inform the higher healthcare authority of the care home to contact with the Multi Agency Risk assessment Team (MARAT) to make effective evaluation of the risk.

3.1. Legislation guidelines and policies in relation to safeguarding:

There are several local and national policies that safeguarding practitioners need to implement into their practices to safeguard the vulnerable people from any kind of abuse (Peckover and Appleton, 2019). National policies include the National Vetting and Barring Scheme conducted by the Independence Safeguarding Authority (ISA), ‘No Secrets’ national framework and codes of practice for health and social care (2000), safeguarding vulnerable group acts 2000, Common Assessment Framework (CAF), Human Right Act 1998 and Criminal records Bureau (CRB) (Preston-Shoot, 2020). This national safeguarding system in the UK is associated with ensuring that every vulnerable adult and child in the UK will be protected from unfair practices and abuse and they must be treated with proper respect and dignity in their society.

Local system for safeguarding includes Local Safeguarding Adults Boards (LSABs), Local Safeguarding Children’s Boards (LSCBs), Local Area Agreements (LAAs) and protection committee (Chinn et al. 2020). These local safeguarding bodies ensure that local vulnerable people and children must be provided with proper safeguarding environment in which they are protected from any kind of social malpractices and abuse and harm in the locality.

Under these above-mentioned national and local safeguarding policies, all the multiagency as well as the interagency workers such as doctors, nurses, health and social care staffs and the safeguarding staffs must perform their responsibilities in conducting effective safeguarding assessment and overseeing its outcomes in relation to ensure protection to all the vulnerable people from abuse (Peckover and Appleton, 2019). Under these policies, safeguarding staffs in the case study must ensure that Andrew must be treated with proper respect, care, dignity and fairness inside and outside the care home. On the other hand, safeguarding staffs must observe the behaviour activities and appearance of Andrews to determine whether there is any kind of risk of abuse thereby providing him with the overprotective environment to protect from any abuse.

3.2 Evaluating impact on the key requirement of the safeguarding:

Key requirements of safeguarding are an effective crisis management, transparent and effective information sharing system, conveying and sharing strategy meeting, agreement responsibilities, time scale and action of the leading safeguarding professionals, effective monitoring and coordination investigation system and well-trained safeguarding staffs (Chinn et al. 2020). These key requirements are essential for all the safeguarding staffs and leading safeguarding officials to share all the updates regarding the safety and protection of service users. Through using the transparent and automated information delivery system, safeguarding professionals report the serious failure to the higher authorities and board to take the immediate necessary action. Through conducting effective case review and following the systematic crisis management system, safeguarding professionals can report an incidence of actual abuse or develop an alarming system in case of suspecting any abuse (Appleton et al. 2020.). In case of safeguarding adults and children, there are several relevant and curate resources of the information that can be collected from websites, blogs, leaflets and online pages of governmental safeguarding policy. These information are useful for the vulnerable people to understand their rights to the confidentiality, four treatment and access to all the social and healthcare services irrespective of their mental and physical illness. The safeguarding staffs from the statutory and voluntary organisation must have the skill and knowledge in using the safeguarding resources effectively to ensure that all the vulnerable people are provided with the right care and support that are needed for their holistic development.

In the case study, the care home authority must ensure that there are all the key resources that are necessary to ensure safeguarding and overprotecting environment to Andrew. In this context, higher safeguarding officials will ensure that there are skilled and well-trained safeguarding staffs who can effectively determine the signs of abuse and harm to Andrew and provide him with the physical, psychological and emotional support that he needs to live a high quality and dignified life.

4.1. How likelihood of abuse can be minimized:

There are several ways to minimize the likelihood of abuse. Most effective way to minimize abuse is working with person centred values such as dignity, privacy, choice, rights, independence, fulfilments and self-esteem (Cooper and Bruin, 2017). Safeguarding professionals can reduce the likelihood of abuse, by enhancing the self-esteem, confidence level, decision making ability, self-management skill and self-defence approach in the vulnerable people. In the case study, safeguarding staffs must involve Andrew to make his choice and decision that will empower him in relation to increase his confidence level and self-management ability. Moreover, the care home authority must ensure that, safeguarding staffs will use the respectful words, empathetic communication, effective listening skill and supportive behaviour towards Andrew to reduces his vulnerability towards abuse. PHE (2019), mentioned that each people has his or her own rights to live a heathy and safe live in which he or she is free from any kind of harm, abuse or neglect. In the case study, safeguarding professionals need to ensure that they encourage active participation of Andrew into problem solving, decision making and train him to develop the intelligence and cognitive skill that are important to make effective self-defence.

4.2. Analysing type impacts that the accessible complaints can have on reducing the incidence of abuse:

Accessible complaints have potential impacts on reducing the likelihood of abuse. In this context, the health and social care organisations must have the transparent policies that will enable the victim to get the fair judgement against the abuse (Lewis et al. 2017). There must be proper implementation of each national and local safeguarding policy by the service users and safeguarding professionals that will develop an effective compliant system. Through an associable compliant system, it is possible for safeguarding staffs to report the incidences of abuse or risk of abuse to the appropriate person. There must be a clear and fair system for recording and reporting complaints against the abuse to concerned safeguarding officials which will take the necessary action to provide support and protection to the victim. The compliant system must be associated with the crisis management system which will provide protection to the victim and whistle-blowers from any kind of threats (Ng, 2020). Here the safeguarding staffs must ensure the they follow the legal procedure in receiving and recording complaints. Safeguarding officials must work with the voluntary and statutory organisations to evaluate whether the complaints is valid and then take the necessary actional to provide the protection and support to vulnerable adults and children.

In the case study, the care home must have effective accessible complaints system that will enable all the safeguarding staffs and higher care manager to ensure that the they record and report that complaints against abuse to Andrew. In this context the effective and systematic complaints system will provide assurance to Andrew to get protection, care and respect from people surrounding him. Through the accessible complaints system, the care home authority also ensure that all the safety needs, values and rights of Andrew are protected and respected.

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Reference list:

Appleton, J.V., Harrison, J. and Mumby-Croft, K., 2020. Safeguarding children: a public health imperative. Community Public Health in Policy and Practice E-Book: A Sourcebook, p.263.

Chinn, D., Klier, J., Stern, S. and Tesfu, S., 2020. Safeguarding Europe’s livelihoods: Mitigating the employment impact of COVID-19. McKinsey. Retrieved May, 31, p.2020.

Cooper, A. and Bruin, C., 2017. Adult safeguarding and the Care Act (2014)–the impacts on partnerships and practice. The Journal of Adult Protection.

Cooper, A., Cocker, C. and Briggs, M., 2018. Making safeguarding personal and social work practice with older adults: findings from local-authority survey data in England. British Journal of Social Work, 48(4), pp.1014-1032.

Flynn, S., 2021. Safeguarding Adults at Risk: Critical Commentary on the Construction of the Adult at Risk in Ireland. Irish Journal of Applied Social Studies, 21(1), p.3.

Hood, R., Price, J., Sartori, D., Maisey, D., Johnson, J. and Clark, Z., 2017. Collaborating across the threshold: The development of interprofessional expertise in child safeguarding. Journal of interprofessional care, 31(6), pp.705-713.

Kwan, C.K., Ling, H.W.H., Cheung, J.C.S. and Chui, E.W.T., 2021. Safeguarding health equality for the disadvantaged during the COVID-19 pandemic: Lessons learned for the social work profession. Qualitative Social Work, 20(1-2), pp.463-469.

Lewis, N.V., Larkins, C., Stanley, N., Szilassy, E., Turner, W., Drinkwater, J. and Feder, G.S., 2017. Training on domestic violence and child safeguarding in general practice: a mixed method evaluation of a pilot intervention. BMC family practice, 18(1), pp.1-13.

Lonbay, S.P. and Brandon, T., 2017. Renegotiating power in adult safeguarding: the role of advocacy. The Journal of Adult Protection.

Manthorpe, J. and Martineau, S., 2017. Engaging with the new system of safeguarding adults reviews concerning care homes for older people. British Journal of Social Work, 47(7), pp.2086-2099.

McKendrick, D. and Finch, J., 2017. 'Downpressor man': securitisation, safeguarding and social work. Critical and Radical Social Work, 5(3), pp.287-300.

Ng, W., 2020. Focus: Sex & Reproduction: Safeguarding the Health and Rights of Sex Workers: An Interview with Beatrice Codianni, New Haven Community Activist and Founder of Sex Workers and Allies Network. The Yale Journal of Biology and Medicine, 93(4), p.615.

Peckover, S. and Appleton, J.V., 2019. Health visiting and safeguarding children: A perfect storm?. Journal of Health Visiting, 7(5), pp.232-238.

Preston-Shoot, M., 2020. Safeguarding Adults Together under the Care Act 2014: A Multi-Agency Practice Guide, Barbara Starns. The British Journal of Social Work.

Romeo, L., Lawson, J., Stanley, T., Taylor, M., Tapper, L., Gunner, J., Carr, S., Hafford-Letchfield, T., Baker, D., Bateman, F. and Manthorpe, J., 2017. Safeguarding Adults under the Care Act 2014: Understanding Good Practice. Jessica Kingsley Publishers.

Romeo, L., Lawson, J., Stanley, T., Taylor, M., Tapper, L., Gunner, J., Carr, S., Hafford-Letchfield, T., Baker, D., Bateman, F. and Manthorpe, J., 2017. Safeguarding Adults under the Care Act 2014: Understanding Good Practice. Jessica Kingsley Publishers.

Stevens, M., Woolham, J., Manthorpe, J., Aspinall, F., Hussein, S., Baxter, K., Samsi, K. and Ismail, M., 2018. Implementing safeguarding and personalisation in social work: Findings from practice. Journal of Social Work, 18(1), pp.3-22.

Warren, L., 2018. Role of leadership behaviours in safeguarding supervision: a literature review. Primary Health Care, 28(1).

Zhao, F., Hämäläinen, J. and Chen, Y.T., 2017. Medical social work practice in child protection in China: A multiple case study in Shanghai hospitals. Social work in health care, 56(5), pp.352-366.