HSC024 PRINCIPLES OF SAFEGUARDING AND PROTECTION IN HEALTH AND SOCIAL CARE

There are different types of abuse that can occur within a healthcare setting: physical, verbal, sexual, emotional, psychological, and financial (Duggleby, 2014). The vulnerable populations who are at risk for being abused are women at any stage of their lives, persons with disabilities, of First Nations descent, the elderly, and anybody within a same-sex relationship (Chow, 2013). Abuse can occur in home, in public, and even within the healthcare setting. For the purpose of this paper, we are going to look at physical and verbal abuse within the healthcare setting.

Safeguarding Adults Boards – raises awareness and promotes the welfare of vulnerable adults by the development of an effective co-operative. This group of people come from a wide range of public and voluntary services and other organisations and is committed to ensuring that the work done effectively brings about good outcomes for adults. It is an organisation that draws on expertise and experience from a number of sources. The Police – their role is to safeguard vulnerable adults, investigate all reports of vulnerable adult abuse and protect and uphold the rights of vulnerable adults. Care Quality Commission (CQC) is the regulatory board and their role is to monitor and provide guidance on what all health and social care providers must do to safeguard vulnerable adults from abuse.

The duty that a setting has to safeguard its children, staff, parents carers & support its community and regulators in their inspection processes is paramount, this means that recommendations within serious case reviews offer the opportunity to examine current practice, what's happening and how it happens, within the setting and externally with other organisations, agencies and service providers.

It was brought to the attention of the CQC on May 12th 2011 that the television program called Panorama was going to be broadcast, showing video evidence from a undercover reporter going into Winterbourne View as an employee. The reporter exposed the psychological and physical abuse of the patients at the hospital.

Systems – Local authority Adult Services Dept (Social Services) – Safeguarding Team investigate and ensure safety Care Quality Commission – Inspect care providers Police to investigate/ prosecute Carers Direct Helpline

The report concluded that there was a systemic failure to protect people or to investigate allegations of abuse. The provider had failed in its legal duty to notify the Care Quality Commission of serious incidents including injuries to patients or occasions when they had gone missing.

The Care Quality Commission has published its findings following an inspection of services provided at Winterbourne View, owned by Castlebeck Care Ltd, in Bristol.

Findings from research and reviews are used within professional supervision, as serious safeguarding and possible loss of life can and have happened , by putting into supervisions a more emphasis on learning lessons and improving practice. Giving support to workers and building up a relationship that they feel they can talk about any issues they may have or seen. Giving example of case reviews where there has been a failing and informing of the importance of reporting, for example the undercover footage by the BBC by staff to residents with learning disabilities at winterbourne view hospital.By setting out a set and clear questions within the paperwork and within the discussions that policies and procedures need to be adhered to that all aspects are covered and are effective to ensure the safety of staff and clients.

Findings from a 2012 Study of Medical Negligence Claiming in Scotland revealed that patient support and advice groups find that when a complaint is made to the NHS in relation to a medical injury a defensive attitude tends to be adopted in response to such complaints. According to Professor Sir Ian Kennedy, Chairman of the Independent Parliamentary Standards Authority, this defensive attitude is what leads to claims being raised against the NHS. He stated that the current clinical negligence regime is what prompts defensiveness within the NHS and that this problem will persist as long as the fear of litigation and stigma of settlement remains. In the literature reviewed there seems to be a general consensus that the requirement for the claimant

The registered providers Castlebeck Care Ltd (Teesdale) had failed to ensure that those residing at Winterbourne View had adequate protection in terms of risk from harm by its own staff. Also there were no safeguards in place to prevent such incidents from occurring or resolving any concerns that might arise.

A review by the department health following the winterbourne hospital scandal highlighted significant levels of abuse and poor care. A range of agencies failed to provide quality care from the operating company to commissioners and health regulators.(Department of Health,2012) Patients were reported to be slapped punched and restrained unlawfully for long periods. An emphasis on how poor quality care was delivered by the hospital included several patients suffering from dental problems(poor mouthcare), constipation and the giving of both antipsychotic and antidepressant drugs without a proper prescribing policy in place( HM Government,2012).Both the police and the emergency department encountered a significant number of patients from the winterbourne Hospital

Care Act 2014 is a monumental piece of legislation protecting and prioritising carer’s interests in an attempt to minimise the onset of health issues which compromise the ability to care (Taylor and Barling, 2004). However, the main incentive of the act is likely to reduce the risk factors, such as high levels of carer stress or strain, which are associated with maltreatment (Campbell Reay and Browne, 2001). Taking a preventative approach, the act gives carers newfound rights as early help through the initial delivery of high quality services is proven to generate better outcomes. The two main principles of the preventative approach is; providing early interventions which lessen or eradicate the need for future more costly services and; having facilities which promote integration and reduce isolation to enhance the overall well-being of the carer (ADASS, 2010). With this concept in mind, there are an array of resources available to assist carers to obtain 3 key concepts, namely ‘information, care and support’ (Rapaport et al, 2006). The role of a social worker is to help carers access their rights, provide information and advice, whilst manage and distribute services in accordance with guidance.

Care Quality Commission – are inspectors who inspect care providers this can be on a planned or unplanned visit.  “No Secrets” 2000 and “ Disclosure Act & Whistleblowing) were put in place by the government in order that local authority social services to work with other health and social care organisations to develop local multiagency codes of practice to help prevent and tackle abuse. Protection of Vulnerable Adults (POVA) Legislation introduced in England and Wales for Care Homes and Domiciliary Care agencies. POVA means registering people who are considered to be unsuitable to work with vulnerable adults. Employers have the responsibility to register the employees who have abused a service user. Police – the police investigate any allegations made and prosecute where required. The role of Criminal Records Bureau is to reduce the risk of abuse by ensuring that those who are unsuitable are not able to work with children and vulnerable adults. Commission for Social Care Inspection (CSCI) is the single, independent inspectorate for social care in England. Its role is to inspect the care home we work in. Aix Identify sources of advice, support and information to help social care workers understand their own role in safeguarding. A main source of support is through training (Safeguarding of Vulnerable Adults) provided by our employer or many local authorities run free, multi-agency, safeguarding

Legally nurses have a duty to act vigilantly when treating their clients, nurses are expected to achieve at least the minimum standard of care consistently. If a nurse fails this they will be judged as negligent (McHale and Tingle 2007). When analysing the scenario within our sessions, it was discussed that the nurse providing care was negligent, if so they would have been held accountable. Chitty and black (2005) inform the reader that negligence is ‘the failure to act as a reasonable careful practitioner would, in particular circumstances '. To assess how particular practitioner would act in a certain situation in relation to another is more complex and hard to resolve. The law simplifies this judgement using a tool called the bolam test. Simplified this dictates that a practitioner cannot be deemed negligent if the actions taken conform with that of another rational competent health care professional. (samanta 2004). The scenario can be related to adult nursing as well as the other

309). There must be contact between the patient and the health care system or nurse and that the patient has the ability to suffer (Bruggemann, Wijma, & Swahnberg, 2012, p. 129). If there is not any contact between two individuals, then abuse cannot take place. The abuse event is usually unintentional, and is preceded by an unhappy event between the caregiver (nurse) and the patient or other individual (Bruggemann et al, 2012). There are other factors that can put the victim at more of a risk of being abused such as “having a background of abuse in childhood, young age, high educational level, poor self-rated health, born in a foreign country” (Bruggemann et al, 2012, p. 129). Other factors that put someone at risk for abuse include “hierarchies, power assymetries, taboos” (Bruggemann et al, 2012, p. 129). Abuse in the healthcare setting does not discriminate against race, gender, income, social status, or so forth, it can occur between any two individuals that interact in the healthcare sector. After much research, we have been able to find a definition of abuse that is suitable for our