This assignment looks at the importance of safeguarding and how practitioners and agencies should be involved to help prevent any risks when dealing with a vulnerable adult. The case study is about a 22 year old vulnerable adult called Andrew who has been diagnosed with autism. According to the Autism Society (2016), Autism is a complex developmental disability that usually affects children during early childhood. It is a condition that can affect communication, behavior, social interactions and how people experience and interact in the general word around them.
According to Social Care Institute for Excellence (SCIE) vulnerable adults are much more likely to be abused or neglected compared to others. This is usually because they are less likely to identify the type of abuse they are receiving therefore they are unable to report it. Scie, (2016) defines abuse as a single or repeated act or a lack of appropriate action that occurs which can cause harm or distress to the other person. Abuse can take place in a number of forms, some include neglect, bullying, and financial, physical, emotional and sexual abuse. The case study suggests that Andrew has fallen victim to a number of different types of abuse. Andrew grew up in the care of children’s services and has also lived in residential care. It is known that he has learning difficulties but he hasn’t been officially diagnosed with any other special need other than autism. This is clearly a result of care the system failing him which could be argued as institutional abuse, in which Hertfordshire.gov.uk (2017) defines as poor care standards and lack of positive responses to complex needs. Andrew would have shown signs of disorientation, agitation which are symptoms of autism when his routine was broken from the transition of moving from residential care to community care, therefore he should have had a number of professionals surrounding him that were be able to pick up on his signs of vulnerability and offer him support and the appropriate care.
The fact that he has some issues with his personal hygiene suggests he is unable to attend to his own basic hygiene needs, this is a sign of self-neglect. Medicent.net (2017) defines self-neglect with the inability to attend to one’s personal needs or hygiene. This could manifest in a number of ways such as not attending to one’s clothing, nutrition, hygiene and also being unable to act appropriately to care for medical needs and conditions. Andrew has a difficult relationship with his family and cut off all contact with them a couple of years ago. He is completely dependent on the professionals that surround him as he has isolated himself from anybody that has ever been close to him so perhaps he is feeling the effects of emotional abuse. It also implies that Andrew is a victim of physical abuse as well as cyber bullying. He has frequently attended Accident & Emergency on a number of occasion following recent assaults and is known face to the local police following a number of incidents in which he was physically threatened. He is now receiving threatening messages on Facebook which as a result is making him scared to go out of the house.
When there is evidence of suspected or actual abuse, action must be taken immediately. Every person that comes into contact with either children or adults in their everyday work has a duty to safeguard and raise concerns if abuse is suspected. According to Stretch & Whitehouse, (2010) there is a six stage process for safeguarding vulnerable adults if there is evidence of suspected or actual abuse; alert, referral, decision making, assessment, review & monitoring and recording. During this process there are of number of potential actions to take. Approaches to communication are essential when dealing with a vulnerable adult. If a service user chooses to disclose an allegation of abuse its essential to listen carefully to all details, show signs that you are interested, make notes of everything that was discussed, report the incident to the nominated safeguarding officer as soon as possible and most importantly praise the service user for choosing to disclose as it takes a great deal of courage to speak up. There are also a number of actions to avoid. You should never make a promise to keep a secret regarding abuse, you must ensure that the service user knows that any action that you take is to support them. Never ask any leading questions that could potentially jeopardize the litigation, try to avoid putting yourself in a position for a potential allegation against yourself and never assume that any action that need to be made is the responsibly of somebody else.
Safeguarding is the responsibility of everyone. According to Gov.uk (2014) safeguarding is a term used to describe how adults and children are protected from various types of abuse and neglect. It is a key responsibility of local authorities as well as a shared priority of many public services including clinicians, social workers, care managers, specialist safeguarding staff and the police. England.nhs.uk (2017) states that multidisciplinary working involves appropriately utilizing of knowledge, skills and best practice from service providers which include health & social care or voluntary and private sector providers to refine and improve health and social care delivery issues and reach solutions based on a collective understanding of complex patient needs. Communication between key agencies is a crucial requirement when dealing with vulnerable adults but in Andrews’s case the communication between multidisciplinary teams has been poor.
Due to the fact that Andrew grew up in the care of children’s services and also lived in residential care implies that he would have been appointed a named social worker who would be in regular contact with him. Care Quality Commission, (2014) states that social workers are responsible for identifying and raising concerns, building and managing safeguarding risks and benefits into care planning, reviewing care plans and leading support and enquires into abuse or neglect. The case study states that Andrew is unable to cope living alone as he is now living in a short stay hostel. This raises a concern as to whether Andrew was sufficiently risk assessed when leaving resident care to proceed to community care which is at the responsibility of his named social worker.
Andrew is a frequent attender to Accident & Emergency which should have raised concerns amongst the clinical practitioners. The fact that his repeated visits show signs and symptoms including emotional distress and physical harm would surely raise an urgent concern that he was a victim of physical abuse. All professions must follow a code of conduct and code of practice to ensure the appropriate level of care is offered to look after service users. (CQC) states that clinicians must report incidents of abuse, neglect or undignified treatment and lead and support enquiries into abuse or neglect where there is need for clinical input. Andrew is also known to the police for a number of incidents in which he is either the victim or the perpetrator. These incidents show confusion and vulnerability on Andrews behalf and could also imply a cry for help. Police officers have a duty of conduct to investigate possible crimes and achieve the best protection along with support for individuals suffering from neglect or abuse which in Andrews’s case has hasn’t been carried out effectively (CQC, 2014). Andrew is completely dependent on all of these professionals therefore they all have the duty and the opportunity to raise an urgent concern on behalf of Andrew to ensure the correct action is taken to reduce the potential risk or further harm.
In regards to safeguarding, there are a number of policy, guidelines and legislations that have been put in place to help reduce the likeliness of abuse and neglect. The following laws have been developed over a number of years following the response to various cases which have been brought to court and highlighted in various aspects of the media; Protection of Vulnerable Adults (POVA), The Care Act (2104), Mental Capacity Act (2005), Safeguarding Vulnerable Adults Act (2006). The POVA scheme provides a list of people who are considered unsuitable to work with vulnerable adults and acts as a work force ban. It protects vulnerable people aged 18 and over in care setting in England and Wales. POVA checks are requested as part of disclosures from the criminal records bureau in which ensures employers are unable to employ individuals who appear on the list within a care settings vacancy. The Mental Capacity Act (2005) aims to help protect vulnerable adult who lack the capacity to make important decisions for themselves. This legislation also established the Independent Mental Capacity Advocates Service (IMCAS) which according to (SCIE) promotes equity and social justice and allows people to become more aware of their rights and exercise these rights.
Within safeguarding there are key requirements that are essential to maintain standard levels of care. In a health care settings the recruitment process plays an important to the high quality of care that is offered to service users and ensures organizations recruit individuals who possess the relevant skills and qualities required to fulfil a specific role. When applying for a job in the health and social sector it is required for a Disclosure Baring Service (DBS) check to be carried out. According to Child Protection Company (2017) DBS checks are required for all unsupervised volunteers and employees that have direct access to or work with adults and children at risk. Various other methods are also required during the recruitment process such as interviews, employment history checks and references.
The likelihood of abuse occurring within health and social care settings, can be reduced by a number of factors. Stretch & Whitehouse, (2010) states that abuse is often the result of poor practice and a lack of understanding the consequences of certain actions. Adequate training must be provided for all colleagues when new procedures and policies are introduced to ensure appropriate measures and actions are taken when abuse is suspected. Employees should treat service users with a kind and approachable manner which could result in the service user gaining trust and opening up to any issues that could potentially be taking place. Whistle blowing policies have been introduced across all workplaces. All providers within a health and social care setting must have a clear whistleblowing policy that is understood by all employees. CQC, (2013) states that whistleblowing is a term used for employees to raise a concern regarding malpractice, patients at risk or any wrongdoing or possible criminal activity. Whistleblowers are completely protected by the law, can’t be treated unfairly or risk losing their job. Concerns can be raised at any time regarding incidents that have either happened in the past, are happening now or may even happen in the near future.
It is essential for all service providers to provide a clear and accessible complaints procedure and any complaints that are made should be treated in a sensitive manner without prior judgement or preconception and should be thoroughly investigated using prescribed procedures. It is believed that the higher the level of vulnerability within an adult, the less likely they are to complain
If Andrew was given an adequate social worker, they would ensure that he understood the complaints system clearly which would encourage him up raise a concern and make any changes that would be beneficial to him and his needs. Anyone making a complaint cannot be intimidated or victimized for speaking up. (Lowvisionary, 2013) states that complaints procedures allow organizations to highlight any weaknesses within their patient care, which would eventually result in improving the standards of care that was offered to service users. Effective complaints procedures could encourage vulnerable individuals to feel protected and empowered which would also result in them being less likely to accept the abuse in the first, additionally abusers would feel less likely to abuse an individual if they believed that their behavior and actions would be challenged. This would result in the likelihood of abuse in vulnerable adults to reduce.
Andrew would clearly benefit from adequate safeguarding measures from all of the public services stated in this assignment.