Define the following types of abuse: Physical abuse

Hitting, slapping, pushing or kicking, forcing people to eat or take medication, leaving people to sit in urine or faeces.

1.1b – Define the following types of abuse: Sexual abuse

Unwanted advances, indecent exposure or harassment, rough washing or touching of the genital area, rape, being forced to watch or participate in sexual acts. 1.1c – Define the following types of abuse: Emotional/psychological abuse Intimidation, not being included, being ignored, threats, bullying, humiliating and blaming. These include discrimination that relates to age, race, gender, sexuality, culture, religion etc.

1.1d – Define the following types of abuse: Financial abuse

Using an individual’s money without their permission or on items they have not requested, not giving correct change, taking store card points, taking the free item of “buy one get one free”. Not giving individuals enough money for food and essential items. 1.1e – Define the following types of abuse: Institutional abuse Poor care to people in group environments, for example, in a residential care home or in a day centre.

Food choices not provided for individuals with different dietary needs or requirements. The individual’s room and clothing not being kept clean. 1.1f – Define the following types of abuse: Self neglect

Individual not eating, washing, dressing properly. Not looking after themselves. 1.1g – Define the following types of abuse: Neglect by others Inadequate care or denial of an individual’s basic rights. 1.2 – . Identify the signs and/or symptoms associated with each type of abuse. These are the main types of abuse with some examples of signs and symptoms:

Physical – Unexplained bruises, scratches, cuts, fractures, broken bones, broken teeth.

Sexual –Bruises around genital area. Individual becomes particular about washing genital area or wanting to hide themselves. Emotional / psychological – Abnormal behaviour or moods. Talking a lot and very fast or being unusually quiet. Appearing afraid or worried. Being concerned that care and support may not continue Financial – Shortage of money, reluctance to pay for things, complaining about price increases, unusual interest or lack of interest in their personal finances. Institutional – Individuals not eating properly, not dressing properly, not participating, staying in their rooms, not getting required attention and support, complaints from residents or family members. Dirty rooms and communal areas. Health and safety being ignored. Self-neglect –Individual gaining or losing weight, looking dirty or dishevelled. Not washing and smelling. Not caring about themselves. Medical issues not being taken care of. Lack of confidence and self-esteem.

Lack of social network, family and friends. Staying at home when they could get out and about. Neglect by others – Any of the above symptoms could be neglect or lead to neglect by others if left and not resolved. If you do not take action to report or resolve a situation where you believe abuse is taking or has taken place, you could be accused of neglect yourself. 1.3 – Describe factors that may contribute to an individual being more vulnerable to abuse. Some individuals are more vulnerable to harm or abuse than others. These are some of the reasons why: Individuals with a sensory impairment, for example, poor or no hearing or sight that might lead to communication difficulties. Individuals may lack the capacity to understand what is happening or that it is wrong. Lack of capacity could be for a number of different reasons and could be long term or short term. Individuals may be severely disabled.

Individuals may be physically or emotionally weak and rely on others for care. Individuals may have suffered brain injury and may not be able to communicate. Individuals may be unconscious.  Individuals who do not have good support networks around them. Individuals being cared for at home who are reliant on another person for care and support.

204 Cert.2 – Know how to respond to suspected or alleged abuse.

2.1 – . Explain the actions to take if there are suspicions that an individual is being abused.

The actions to take constitute the employee’s responsibilities in responding to allegations or suspicions of abuse. Always follow policies and procedures and report to the appropriate person(s), record the facts on appropriate paperwork, listen do not judge, stay calm and collected, and do not tamper with evidence.

2.2 – . Explain the actions to take if an individual alleges that they are being abused.

The key things you MUST do if an individual discloses abuse to you: Assume the individual is telling the truth. Speak to them in a calm and sensitive way. Listen carefully and make sure you record what was said including date, time and place. Reassure the individual and tell them that you have to pass this information on. Always follow your policies and procedures.

If the individual needs medical attention, call the emergency services or call a doctor as appropriate and inform your supervisor / manager immediately or another available senior person. If this is a criminal matter, for example, an alleged assault, rape or indecent exposure, you will need to call the police and if in any doubt consult your policies and procedures or contact your supervisor / manager immediately or another available senior person.

2.3 – Identify ways to ensure that evidence of abuse is preserved. In most circumstances you may not need to do anything except record the events that have given cause for concern. The best way to preserve evidence is to report the matter as quickly as possible. When needed you should: Make a written record of messages (e.g. answer-phone) to ensure they are not lost. Include the date and time and sign them Ensure written records (notes, letters, bank statements, medication records etc.) are kept in a safe place Don’t tidy up, wash clothes, bedding or other items.

Do not try to clear or tidy anything up
Try not to touch anything unless you have to for the immediate wellbeing of the victim – if you have to try to make a record of what you have done If any sexual offence is suspected try to discourage the victim from washing, drinking, cleaning their teeth or going to the toilet until the police are present Preserve anything used to warm or comfort the victim e.g. a blanket Try to ensure that no one else enters the premises or alleged scene of crime until the police arrive If you can, try and ensure that the alleged perpetrator does not have any contact with the victim Record any physical signs or injuries using a body map (click here) or hand drawing. Write a description of any physical signs or injuries including size, shape, colour etc. Always remember to sign and date your notes and any other records you have made

204 Cert.3 – Understand the national and local context of safeguarding and protection from abuse.

3.1 – Identify national policies and local systems that relate to safeguarding and protection from abuse.

The Care Quality Commission (CQC) regulates care homes and inspects every care home it registers. The CQC also registers home‐care or domiciliary care services. Any registered care provider must, by law, have a complaints procedure. Services have rules about the staff they employ and the standards of care they provide.

Everybody working with vulnerable adults and children has to complete a criminal record check by the Disclosure and Barring Service (DBS). The DBS helps employers to make safer recruitment decisions and prevent unsuitable people from working with vulnerable groups, including children. It replaces the Criminal Records Bureau (CRB) and Independent Safeguarding Authority (ISA).

The Deprivation of Liberty Safeguards (DOLS), implemented April 2009, provide a legal protection for those vulnerable people who are, or may become, deprived of their liberty. Safeguards exist to provide a proper legal process and suitable protection in those circumstances where deprivation of liberty appears to be unavoidable, in a person’s own best interests. These safeguards can apply to people who have a mental disorder and lack capacity to consent to the arrangements made for their care or treatment, but for whom receiving care or treatment in circumstances that amount to a deprivation of liberty may be necessary to protect them from harm and appears to be in their best interests. 3.2 – . Explain the roles of different agencies in safeguarding and protecting individuals from abuse.

Care Quality Commission (CQC): They have a role to play in safeguarding. If you have followed policies and procedures and reported a situation of abuse and you are not getting reasonable feedback about what action is being taken and you do not believe your complaint has been acted upon, or you suspect that your supervisor / manager is involved, and there is no-one else internally in your organisation you can talk to, you should contact CQC.

Disclosure and Barring Service (DBS): The DBS helps employers to make safer recruitment decisions and prevent unsuitable people from working with vulnerable groups, including children. It replaces the Criminal Records Bureau (CRB) and Independent Safeguarding Authority (ISA). The DBS are responsible for:

Processing requests for criminal records checks
Deciding whether it is appropriate for a person to be placed on or removed from a barred list. Placing or removing people from the DBS children’s barred list and adults’ barred list for England, Wales and Northern Ireland

3.3 – Identify reports into serious failures to protect individuals from abuse. In cases where suspected abuse or neglect has resulted in death, or abuse or neglect is known or suspected to be a factor in the death (including death by suspected suicide), or for cases of serious and significant harm, a Serious Case Review (SCR) will be undertaken 3.4 – Identify sources of information and advice about own role in safeguarding and protecting individuals from abuse.

Sources of information and advice include:
Care Home manager
Care Plans
Mandatory Training
Deprivation of Liberty Safeguards (DOLS)
Quality care Commission (CQC)
Citizens advice Bureau
Social Services
Health Services

204 Cert.4 – Understand ways to reduce the likelihood of abuse.

4.1a – Explain how the likelihood of abuse may be reduced by: working with person centred values

This ensures a carer can:

1. Define care values and explain the principles of care
2. Explain the importance of rights, privacy, respect and dignity in ensuring choice and independence 3. Explain the principles of delivery for a person centred approach to care delivery 4. Know how to use a care plan to help in delivering person centred care 5. Explain the responsibilities of the organisation and care worker in care delivery 6. Define the role of the care worker in establishing and maintaining effective work relationships 7. Explain how to utilise support and supervision to ensure effective practice 8. Explore ways to develop the knowledge and skills required to promote continual development of the care worker 9. Promoting empowerment

In using person centred values you can manage risks associated with:

Person centred approaches
Determining needs
How needs develop
Language preferences
Significant others
Eating problems
Supporting that development
Supporting the individual
Care values
Care planning
The care (service) setting
Working safely
Managing risk
Dealing with emergencies
Personal care
Dying, death
Mental health
Promoting independence

4.1b – Explain how the likelihood of abuse may be reduced by: encouraging active participation Active participation is an approach that empowers individuals in the activities and relationships of everyday life leading to them living as independently as possible. The importance to the individual as an active partner in their own care or support is that it brings physical, psychological, relational and over all wellbeing benefits. The likelihood of abuse is decreased as the individual engages positively by actively participating is area of their life, such as in personal care, the scope for abuse by others is reduced. 4.1c – Explain how the likelihood of abuse may be reduced by: promoting choice and rights An important feature of empowerment is to offer people genuine choice when it comes to the services and supports on offer.

This issue was highlighted by SCIE’s Service User Advisory Group on Safeguarding Adults. Without choice and the ability to exercise choice, the potential for abuse can become greater and the opportunity to escape it become harder. 4.2 – . Explain the importance of an accessible complaints procedure for reducing the likelihood of abuse. Every employer should have a procedure in place for raising any concerns or a complaint about abuse so that it is a simple process and encourages people to raise their concerns, however small they might appear to be. Complaints are very important as they often lead to an improvement in the service(s) provided. The complaints procedure can usually be found in the Safeguarding Adults policy and procedures. You will also need to be aware of the contact details for your Local Authority’s Safeguarding team.

204 Cert.5 – Know how to recognise and report unsafe practices.

5.1 – . Describe unsafe practices that may affect the well-being of individuals.

Unsanitary conditions can spread infection as cross-contamination can occur and can affect the well-being of the individual and others. Improper hand washing can also pose a risk. Dirty kitchen surfaces and equipment can spread infections, not covering hair when cooking can pose a risk to individual as cannot reporting faulty equipment when working or not having cleaning materials can also be unsafe.

In terms of health and safety not having risk assessments in place when a service user hurts themselves. Staff not checking when a service user is ill or unsteady on their feet. Staff not recording in care plans about a service user’s wellbeing and health and not monitoring them.

Other unsafe practices which also amount to abuse can occur such as leaving a service user on the toilet too long, ignoring or not listening to them.

Marks on body not taken seriously and complaints not taken seriously can put them at more danger, harm and risk of abuse. 5.2 – . Explain the actions to take if unsafe practices have been identified. If I identify unsafe practices then I must follow the whistle-blowing procedure and report to the appropriate person(s). I will report to my manager immediately or if it involves my manager then to another appropriate person(s). I will monitor all unsafe practices and make sure that I record and report in full all the evidence and then will talk to my manager because all unsafe practices are dangerous practices that could cause harm to the individual and others. For example, I talked to my manager last week about things being left on the stairs that may cause service users and others to fall over and hurt themselves. She has talked to the staff and now this has stopped.’

5.3 – . Describe the action to take if suspected abuse or unsafe practices have been reported but nothing has been done in response.

If suspected abuse or unsafe practices have been reported but nothing has been done in response or if it has to do with my manager then I will report to the next level or manager. If it has to do with my manager then I will report to management, then to the social worker and safeguarding team and to the care quality commission and even to the police depending on the response I get.