P4- Abuse, neglect and vulnerability

P4- Explain the likelihood of abuse and neglect for service users in health and social care

Write the correct type of vulnerability in the left hand column.

• Physical Vulnerability
• Cognitive impairment
• Emotional vulnerability
• Social vulnerability
• Staffing issues may lead to institutional abuse and neglect.

	A condition ranging from mild to more severe, in which an individual has trouble remembering, concentrating and learning, or in making decisions. A person with cognitive impairment may have difficulty protecting themselves from abuse, exploitation or neglect. Causes of cognitive impairment can include head injury or being born with learning disabilities. The extent of the cognitive impairment will have an impact on how they are able to protect themselves from abuse. Each service user is an individual and their circumstances are unique.
	Elderly people may outlive their friends and relatives and lose confidence in making new friends. They may fear going out or have problems accessing support that may be available. People may be lonely for all sorts of reasons. New mothers who are coping with a baby may feel socially isolated and vulnerable, as may children in care who are moved from one home to another. Social vulnerability may also affect those who cannot afford to engage in social activities.
	Sometimes health and social care services let service users down. To deliver an exceptional level of care, correct numbers of staff must be employed, trained and on duty. Staff disputes, low morale and sickness can impact on a care team’s performance. Workers should be treated fairly, their views should be heard and they should feel part of a team. If you have concerns about staffing levels or other issues that may affect your ability to deliver an acceptable level of care. If you notice the staffing levels are low you may need to take your concerns to the CQC. This may also be your course of action if you are concerns about the quality of leadership. For other shortcomings, such as lack of training for new or established staff, you should first take your concerns to your manager.
	There are many reasons that your service user could be physically vulnerable these may contribute greatly to the risk of abuse or neglect. A service user may have a chronic medical condition (a long lasting disorder), such as arthritis. Their physical frailty increases and their strength may diminish. This can make them more vulnerable to physical abuse and more susceptible to neglect. Younger children may also be more vulnerable to physical abuse as they are often smaller than their abuser.
	Emotional vulnerability can impair an individual’s judgement. A person with depression, anxiety or phobias may react differently to the dangers around them or may not even perceive a danger at all. They may be more vulnerable to persuasion or coercion. You need to be alert to the signs and symptoms of abuse or neglect as individuals may be unwilling or unable to complaint about what is happening to them.

Case Study

Adam is 36. He has Down’s syndrome and he used to live with mother. When his mother became too frail to look after him he moved in with his brother, Ben, who lives eight miles away. Adam can use the bus to go and see his mum, but Ben is scared that Adam will get lost and has asked him to not go on his own. Ben and his wife both work full-time and Adam is often alone. Adam is well fed and his clothes are clean. Adam’s old friends miss him, but Adam has told them he now has new friends where he lives so they do not need to worry about him. Adam has not joined any groups. He does not go out and he feels very lonely and isolated. Sabrina, Adam’s new social worker, wants to help Adam meet new people.

1. Is Adam neglected? _______________________________________________
2. What could Sabrina do to improve the quality of Adam’s life? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3. How can Sabrina support the rest of Adam’s family? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4. What could happen to Adam if his social needs are not met? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5. Why is it important for Sabrina to document all of her interventions and keep a check on Adam’s progress? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________