Responding to disclosures

Responding to Disclosure

Some incidents of abuse only come to light because the abused person discloses

the information himself or herself.

The abused person may not understand that they are being abused and so not realise

the significance of what they are telling you. Some disclosures happen many years after

the abuse. There may be good reasons for this for example the person they were afraid

of has left the setting. Therefore, any delay in an individual reporting an incident should

not cast doubt on its truthfulness.

When someone discloses to you, remember you are not investigating.

Do:

· Stay calm and try not to show shock.

· Listen very carefully.

· Be sympathetic.

· Be aware of the possibility that medical evidence might be needed.

· Tell the person that:

o They did a good/right thing in telling you.

o You are treating the information seriously.

o It was not their fault.

· Explain that you must tell your Line Manager and, with their consent, the manager will

contact Adult Services, Health and/or Police. The manager will, in specific

circumstances, contact Adult & Community Services or Torbay Care Trust without their

consent but their wishes will be made clear throughout.

· If a referral is made but the vulnerable adult is reluctant to continue with an investigation,

record this and bring this to the attention of the Safeguarding Co-ordinator. This

will enable a discussion of how best to support and protect the vulnerable adult.

However, a professional case discussion will still need to take place and should be

recorded appropriately.

Do not:

· Press the person for more details.

· Promise to keep secrets (you can never keep this kind of information confidential).

· Pass on the information to anyone other than those with a legitimate “need to know”,

such as your Line Manager.

· Make promises you cannot keep (such as, "I will never let this happen to you again").

· Contact the alleged abuser.

· Be judgmental (for example, "Why didn’t you run away?").

· Gossip about abuse.

· Stop someone when they are telling you what has happened to them, as they may never

tell you again.

You must

· Make a note of what the person actually said, using his or her own words and phrases.

· Describe the circumstance in which the disclosure came about.

· Note the setting and anyone else who was there at the time.

· When there are cuts, bruises or other marks on the skin use a body map (see following

pages) to indicate their location, noting the colour of any bruising.

· Make sure the information you write is factual. You may wish to indicate your own

opinion or a third party’s information. If you do, ensure the separation is made very clear.

· Use a pen or biro with black ink so that the report can be photocopied. Try to keep your

writing clear.

· Sign and date the report, noting the time and location.

Be aware that your report may be needed later as part of a legal action or disciplinary

procedure

Vulnerable groups

When understanding abuse and neglect in the context of health and social care, you will need to understand human vulnerabilities. Groups of individuals may be targeted for abuse for several reasons but mainly due to their capabilities and understanding of right and wrong.




Below are links that will allow you access further information on the most common groups affected.




Vulnerable adults


Adults can be classed as being vulnerable due to disability, old age, alcoholism, drug use, homelessness and lack of educational support. Without the correct social or health support given to them, they can often be taken advantage of by others through various forms of abuse. Self esteem plays a huge role in the abuse cases in adults, for example due to a lack of education/information some adults may trust in other adults to provide them with guidance , however this can lead to financial and emotional abuse, due to the amount of trust and power given to an unreliable advocate.




http://www.nhs.uk/Conditions/social-care-and-support-guide/Pages/vulnerable-people-abuse-safeguarding.aspx




Vulnerable children


Due to their age and worldly knowledge, children can be subject to various forms of abuse. Abusers usually rely on the fact that children are trusting of adults and can be easily threatened into silence. Abuse often comes from those closest to the child e.g. parents, relatives and care workers.


https://www.nice.org.uk/advice/lgb19/chapter/Introduction






Legislation protecting vulnerable people from abuse


http://www.scie.org.uk/publications/guides/guide15/legislation/otherlegislation/vulnerablepeoplelegislation.asp

Human rights

If PDF document cannot be viewed a the bottom of this page, click on the link below to access information regarding human rights and key terms when dealing with abuse, neglect and vulnerable individuals.


https://drive.google.com/file/d/0B74RpHNIBV7mQVVUcnRIX05jQzA/view?usp=sharing

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? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Complaints procedures

P5: http://www.bbc.co.uk/news/uk-13700532

•Victims in the care home made complaints of they had allegedly been teased, forced to swallow medication… How should staff have responded to the disclosures? How should they record and report their data? (Data Protection Act 1998).

•Workers complained to their manager who sent an email to Safeguarding Board- who are these people?

•Nurse whistleblows to the BBC. What is whistle blowing?

M2: http://www.rcpsych.ac.uk/pdf/case%20review%20easy%20read.pdf

•Why is it important to recognise and respond to the evidence/concerns?

•Reduce the likelihood of abuse and neglect from happening again- how can they do this? Which method would be the most important in a care home like Winterbourne View? What lessons can be learned?

•

D2: http://www.bbc.co.uk/news/uk-england-bristol-20078999

Justify the procedures. The procedures made changes to how vulnerable adults are cared for in the UK. Whistleblowing seemed to have the biggest effect.

Results of the serious case review included:

ØWinterbourne view closed (no more abuse)

ØProsecution of abusers

ØCouncil managers sacked

Ø“fundamental changes are needed in how care of vulnerable adults is commissioned”

ØGovernment plans a reduction in the number of people with learning difficulties in these hospitals. http://www.bbc.co.uk/news/uk-20669741

Øhttps://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213221/4-page-summary.pdf

Task 1 assignment example introduction

A duty of care is the expectation and legal obligation of all service providers working within the health and social care sector. The duty of care is important because it protects the safety of both the service providers and the service users. All care workers must follow 7 aspects to ensure that they are caring for all service users effectively and I will be reporting on the duty of care shown in both a child and adult health and social care settings. (Add more detail about the duty of care)

 

The focus of my investigation into child care will be the paediatric Zebra Ward at the Prince Oswald Children’s Hospital. The Zebra ward provides care to children with ranging medical conditions between the ages of six months to two years old.  (Add basic information for the service provided and a brief introduction to the service users that you will be discussing in more detail throughout your assignment) {REPEAT THIS PARAGRAPH FOR YOUR ADULT CARE SETTING}

 

 

The duty of care can be separated into seven distinct categories including the legal obligation to protect wellbeing and prevent harm.  This aspect of the duty of care requires service providers to understand and apply the key health and social care laws to their everyday practice…. (explain the 7 aspects in detail and link to relevant information in your case study)

P1 - Practice Task

P1 Task. Word Document:

Complete a practice assignment case study review, referencing one of the three case studies discussed and using the following structure below:

A Duty of care is…

It is important because…

All care workers must follow 7 aspects that are… to ensure that they are caring for all service users proficiently.

Case Study 1- Call me Joe.

https://www.youtube.com/watch?v=Bd8dywHjwMQ

•In Joe’s case it could be viewed as a case of neglect because…

•The care workers have a legal obligation to protect wellbeing and prevent harm, they could do this by…

•Care workers also have a legal obligation to uphold the rights and promote the interests of individuals experiencing abuse or neglect, Joe is experiencing neglect because… to prevent this from escalating care workers may want to…

Case Study 2- 28 weeks.

https://www.youtube.com/watch?v=_zhn7zXrBH4

Case Study 3- Doing our best.

https://www.youtube.com/watch?v=pFs6Y07wwNY