Nvq 3

BTEC Level 2 Certificate in Preparing to Work in Adult Social Care
Unit 4 Principles of safeguarding and protection in health and social care

Unit sector reference: HSC 024 Level 2 Credit value: 3
This unit introduces the important area of safeguarding individuals from abuse. It identifies different types of abuse and the signs and symptoms that might indicate abuse is occurring. It considers when individuals might be particularly vulnerable to abuse and what a learner must do if abuse is suspected or alleged.

BTEC Level 2 Certificate in Preparing to Work in Adult Social Care
Unit 4 Principles of safeguarding and protection in health and social care

Unit sector reference: HSC 024 Level 2 Credit value: 3
This unit introduces the important area of safeguarding individuals from abuse. It identifies different types of abuse and the signs and symptoms that might indicate abuse is occurring. It considers when individuals might be particularly vulnerable to abuse and what a learner must do if abuse is suspected or alleged.

Abuse is a violation of an individual’s human and civil rights by any other person or persons. It can be intentional OR unintentional.
Abuse is complex. Whereas some instances may be easy to identify, many are not and only come to light over a period of time. It is important that care workers work within the boundaries of their role – but are alert and aware of their responsibilities.
There may be considerable dispute over what is and is not abuse. This is an ideal opportunity for practitioners to work in groups to discuss good practice issues. Use the expertise of experienced practitioners – but be prepared to challenge.

Give a DEFINITION of the following types of abuse and describe signs and symptoms associated with each: (BTEC L2 U4 1.1, 1.2, QCF L2 U5 1.1, 1.2)
Physical abuse
, Injuries that are the shape of objects. Injuries in a variety of stages or injuries that have not received medical attention. A person being taken too many different places to receive medical attention. Skin infections, Dehydration or unexplained weight changes or medication being lost. Behaviour that indicates that the person is afraid or avoiding the perpetrator or Change of behaviour.

Sexual abuse
, Sexually transmitted diseases or pregnancy. Tears or bruises in genital/anal areas. Soreness when sitting. Signs that someone is trying to take control of their body image, for example, anorexia, bulimia, self-harm or sexualised behaviour. Inappropriately dressed.

Emotional/psychological abuse
Difficulty gaining access to the adult on their own. The adult not getting access to medical care or appointments with other agencies. Low self-esteem or lack of confidence and anxiety. Increased levels of confusion. Increased urinary or faecal incontinence. Sleep disturbance. The person feeling/acting as if they are being watched all of the time. Decreased ability to communicate. Language being used that is not usual for the service user. Deference/submission to the perpetrator.

Financial abuse

Sudden loss of assets. Unusual or inappropriate financial transactions. Visitors whose visits always coincide with the day a person's benefits are cashed. Insufficient food in the house. Bills not being paid A sense that the person is being tolerated in the house due to the income they bring in; sometimes with that person not included in the activities the rest of the family enjoys.

Institutional abuse treating adults like children. Arbitrary decision making by staff group, service or organisation. Strict, regimented or inflexible routines or schedules for daily activities such as meal times, bed /awakening times, bathing /washing, going to the toilet. Lack of choice or options, such as food and drink, dress, possessions, daily activities and social activities. Lack of privacy, dignity, choice or respect for people as individual’s unsafe or unhygienic environment. Lack of provision for dress, diet or religious observance in accordance with an individual's belief or cultural background.
Withdrawing people from individually valued community or family contact.

Self-neglect
Malnutrition, Rapid or continuous weight loss. Not having access to necessary physical aides. Inadequate or inappropriate Clothing. Untreated medical problems. Dirty clothing/bedding, Lack of personal care.

Neglect by others
Malnutrition, Rapid or continuous weight loss. Not having access to necessary physical aides. Inadequate or inappropriate Clothing. Untreated medical problems. Dirty clothing/bedding, Lack of personal care.

Some people are more at risk from abuse; describe factors which would make an individual more at risk than others: (BTEC L2 U4 1.3 QCF L2 U5 1.3)
• They may be less aware of their rights
• They may be socially isolated
• They may need help with personal care and daily living
• They may not be able to express themselves clearly
• They may have limited sex education
• They may have to share a home with people they have not chosen to be with
• They may live in poor housing
• They may need more care than their carer can give
• They may have difficulty understanding requests or actions
• They may not know how to complain
• They may receive support from several different carers
• There may be a history of substance misuse
• They may be in a relationship of unequal power
• They may be in unsuitable housing with no aids or adaptations
• They may have limited life experiences and so not recognise risky situations.

You suspect a person in your care is being abused, what action would you take? (BTEC L2 U4 2.1 QCF L2 U5 2.1)
Principles of safeguarding and protection in health and social care abuse.

Someone alleges that they are being abused, what actions would you take? (BTEC L2 U4 2.1 QCF L2 U5 2.1)
You should follow your company policies and procedures relating to suspected abuse, and the actions to take. These will inform you of the proper course of action, who to report it to, and what your responsibilities are as an employee of that company.

List the way how you would preserve the evidence of an abuse case. (BTEC L2 U4 2.3 QCF L2 U5 2.3)
You should write down details of the things that were said at the time, so that you have a reminder to relay information to your manager. Your manager may ask you to write an official document, explaining the conversation Between you and the person alleging abuse has occurred. This is a legal document so ensure that the information recorded is accurate, concise, and clearly written. This document needs to be dated, signed, and any errors Initialled, as this may be used in legal proceedings in the future. All Information received and recorded, must remain confidential.

Write a list of some of the national policies’ and local systems that relate to safeguarding and protection from abuse. (BTEC L2 U4 3.1 QCF L2 U5 3.1)

National and local policies relating to safeguarding and protection from abuse could include - * Safeguarding vulnerable adult’s policy * Safeguarding of vulnerable adults (SOVA) * No Secrets * In Safe Hands * Organisational safeguarding policy * Local authority policy * GSCC Codes of Practice

When an abuse situation occurs it requires many agencies to be involved, it is important to included multi agency and inter agency working. Explain who and what type of agencies would be involved in cases of abuse. (BTEC L2 U4 3.2 QCF L2 U5 3.2) No Secrets (2000) Principles of safeguarding and protection in health and social care In March 2000, the Department of Health and Home Office issued guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse. The guidance was aimed to prevent the abuse of vulnerable adults, including physical, sexual, psychological and financial abuse.

Safeguarding Vulnerable Groups Act 2006, currently an organisation wishing to employ someone to work with children or vulnerable adults must apply for a criminal record certificates issued by the Criminal Records Bureau (CRB disclosure) for any new job applicant.

CRB disclosures give employers information about an individual's criminal records history, which informs their assessments about the individual's suitability to work with children or vulnerable adults. Safeguarding of vulnerable adults list (SOVA).The list must be checked by all people recruiting in the social care sector when they carry out the CRB check. An employer has a duty to add a person to the list if they have been involved in any form of behaviour that harms a vulnerable person.

The person does not have to commit a criminal offence to be included on the list. The Secretary of State / Home Office ultimately takes decision for inclusion.

Every Child Matters was published in 2003. It was published at the same time as the government’s response to the report into the death of Victoria Climbié. Every Child Matters built on plans already in place to prevent the abuse of children, it focused on, and increasing the focus on supporting families and carers, ensuring necessary intervention takes place before children reach crisis point.

Addressing the underlying problems identified in the report into the death of Victoria Climbié, weak accountability, and poor integration ensuring that the people working with children are valued, rewarded and trained. Codes of Practice (GSCC) in a care context, codes of practice are sets of rules or guidelines that aim to ensure that care staffs implement specific policies, procedures and pieces of legislation.

Codes of Practice are drawn up by individual care organisations and by bodies such as the Commission for Racial Equality and the Equal Opportunities Commission as part of their remit under law. Codes of Conduct are guidelines for professional and ethical practice that are produced and issued by the regulatory bodies of the various care professions.

Car Standards Act 2000 (CSA) The Care Standards Act (2000) has had an enormous impact on everyone working in the social care sector. It created a new regulatory framework for all regulated social care and independent health care services. The Act has two fundamental aims, to protect vulnerable people from abuse and neglect Promote the highest standards of quality in the care that people receive.

Many people die each year because of abuse, neglect or because they were not properly protected by the health or Social care service. Some cases have been so severe that the government has held inquiries into why health or social care failed to protect these people. After the inquiry a report is written up to state why the health or social care service failed and what has to change as a result.
We have heard about some of these in the news. Can you list some of these? (BTEC L2 U4 3.3 QCF L2 U5 3.3)
. There have been many cases in the news, where laws and professional bodies have been found lacking in their protection of vulnerable people. I have given an example below of one case, but there are many to choose from.
The Soham murders were a high profile murder case in August 2002 of two Ten year-old girls in Soham, Cambridgeshire, England. The victims were Holly Wells and Jessica Chapman. The convicted killer was a local school caretaker, Ian Huntley.

The inquiry was announced on 18 December 2003, and Sir Michael Bichard was appointed as the chairman. The stated purpose was urgently to enquire into child protection procedures in Humberside Police and Cambridgeshire Constabulary in the light of the recent trial and conviction of Ian Huntley for the murder of Jessica Chapman and Holly Wells.

In Particular to assess the effectiveness of the relevant intelligence-based record keeping, the vetting practices in those forces since 1995 and information sharing with other agencies, and to report to the Home Secretary on matters of local and national relevance and to make recommendations as appropriate. The inquiry opened on 13 January 2004.

The findings of the Bichard Inquiry were published in June 2004. Humberside and Cambridgeshire police forces were heavily criticized for their failings in maintaining intelligence records on Huntley. The inquiry also recommends a registration scheme for people working with children and vulnerable adults, like the elderly. The development of this recommendation led to the Foundation of the Independent Safeguarding Authority. It also suggested a national system should be set up for police forces to share intelligence information. The report said there should also be a clear code of practice on record-keeping by all police forces.

Where would you go as a care worker to find information and advice about safeguarding and protecting individuals from abuse? (BTEC L2 U4 3.4 QCF L2 U5 3.4)
It is your responsibility to report any unsafe practices, straight away, to your line manager. To Blow the Whistle on somebody or something means to report somebody for doing something wrong or illegal, especially within an organisation.
If you feel nothing is being done about your report of unsafe practices, you can contact - * Local authority/Council Safeguarding team, * The Police, * CQC. (Care Quality Commission)

NOTE -
Active participation is a way of working that recognises an individual’s right to participate in the activities and relationships of everyday life as independently as possible; the individual is regarded as an active partner in their own care or support, rather than a passive recipient
Unsafe practices may include: * Poor working practices * Resource difficulties * Operational difficulties

Imagine you have been asked to write a leaflet for new carers in your workplace to help them understand how the likelihood of abuse may be reduced by: * Working with person centred values * Encouraging active participation * Promoting choice and rights * The importance of individuals being able to make a complaint
What information would you write down for each point? (BTEC L2 U4 4.1, 4.2 QCF L2 U5 4.1, 4.2) * Working with person centred values: By using person centred planning values, you get to know the service user in detail, knowing their preferences, their character, their family circle and contacts, therefore you are aware of any changes in them. You can pick up on risks, before they happen. * Encouraging active participation: By doing this you are involving the service user, and building up a trusting relationship. You are encouraging the individual to express their needs, and therefore the individual is more likely to confide in you of any problems they are experiencing. * Promoting choice and rights: By doing this with the individual, you are encouraging them to ‘speak up’, and voice their concerns. You are also informing them of their rights, empowering them to say ‘no, to anything they deem as wrong or unacceptable.

By having an accessible complaints procedure, you are encouraging the individuals in your care to ‘speak up’, about any issues they may have. They will not feel threatened, inadequate, or guilty, about making a complaint, with no fear of repercussions if they do complain. If the complaints procedure is easily accessible, the individual will be aware of what to do in the event of a complaint, who to complain to, and what will happen next.

GSCC Code of Practice
Look at the scenario below and list the actions that showed how the care worker was following the Code of Practice.
“Promote the independence of service users whilst protecting them as far as possible from danger or harm”
“Mrs W has just arrived from hospital, but she is quite clear in her mind and always refuses to be lifted using the hoist. Several of the staff tried to move her themselves rather than cause her any upset. She is very heavy and the risk assessment is quite clear that until she can weight bear again the hoist must be used.
“When Jane and I were on shift I asked her if she would mind using the hoist because I had recently been trained to use it and wanted her to tell me if she felt safe with me, I also explained that I was afraid we may hurt, her or ourselves, if we moved her without it and that there was a risk assessment that gave us a clear plan of how we should help her to move until she was well enough to manage herself.
“I think that because we gave her plenty of time and asked her to do as much for herself as she was able she agreed. We moved her into bed with far less effort and even had some fun doing it because she was more in control and relaxed. We decided it was important for us to report this at the shift handover so that everyone would follow the same procedure.”
How did the care worker follow the code of practice?

Describe unsafe practices that may affect the wellbeing of individuals: (BTEC L2 U4 5.1 QCF L2 U5 5.1) * Poor working practices: This could include not having proper policies to protect the service users, not have correct equipment to perform their role (hoists, p.p.e, etc). Not working to the current standards, therefore putting service users at risk. * Resource difficulties: This could be that staffs are not trained correctly to perform the tasks their role involves. It could be that the home is understaffed, as the budget is not there to employ more staff. The staff group may use agency staff, due to sickness, vacancies etc, and the agency staff are not aware of the needs of the individuals. Necessary facilities / equipment is not purchased due to lack of funds, (wheelchairs, disposable gloves, and correct diet for healthy living, utilities (heating and lighting restricted). * Operational difficulties: This could be because of staff shortages, so recommended ratio of staff to service users, and are not maintained. The staff group may not work as a team, therefore a continuous service is not maintained, and the service delivery suffers. Inexperienced staff acting up in a senior role that may not have the knowledge to perform the role.

Explain the actions to take if you have been asked to do something within your workplace which you know is an unsafe practice: (BTEC L2 U4 5.2 QCF L2 U5 5.2)
It is your responsibility to report any unsafe practices, straight away, to your line manager. To Blow the Whistle on somebody or something means to report somebody for doing something wrong or illegal, especially within an organisation.

Imagine that you have reported some abuse or unsafe practice, but you know nothing has been done since you reported it. What would you do? (BTEC L2 U4 5.3 QCF L2 U5 5.3)

If you feel nothing is being done about your report of unsafe practices, you can contact - * Local authority/Council Safeguarding team, * The Police, * CQC. (Care Quality Commission)