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Safeguarding and Protection in Care Settings

Overview

This unit explores what safeguarding is and your responsibility to protect vulnerable individuals.

It looks at how to reduce the likelihood of abuse occurring and how to recognise and respond to suspicions of abuse as well as the national and local context of safeguarding.

There is also a section about safety online.

Contents

  1. Understand principles of safeguarding adults
    1. Explain the term safeguarding
    2. Explain own role and responsibilities in safeguarding individuals
    3. Define the following terms: Physical abuse, Domestic abuse, Sexual abuse, Emotional/psychological abuse, Financial/material abuse, Modern slavery, Discriminatory abuse, Institutional/organisational abuse, Self-neglect, Neglect by others
    4. Describe harm
    5. Describe restrictive practices
  2. Know how to recognise signs of abuse
    1. Identify the signs and/or symptoms associated with each of the following types of abuse: Physical abuse, Domestic abuse, Sexual abuse, Emotional/psychological abuse, Financial/material abuse, Modern slavery, Discriminatory abuse, Institutional/organisational abuse, Self-neglect, Neglect by others
    2. Describe factors that may contribute to an individual being more vulnerable to abuse
  3. Know how to respond to suspected or alleged abuse
    1. Explain the actions to take if there are suspicions that an individual is being abused
    2. Explain the actions to take if an individual alleges that they are being abused
    3. Identify ways to ensure that evidence of abuse is
      preserved
  4. Understand the national and local context of safeguarding and protection from abuse
    1. Identify relevant legislation, national policies and local systems that relate to safeguarding and protection from abuse
    2. Explain the roles of different agencies in safeguarding and protecting individuals from abuse
    3. Identify factors which have featured in reports into serious cases of abuse and neglect
    4. Identify sources of information and advice about own role in safeguarding and protecting individuals from abuse, including whistle blowing
    5. Identify when to seek support in situations beyond your experience and expertise
  5. Understand ways to reduce the likelihood of abuse
    1. Explain how the likelihood of abuse may be reduced by: working with person centred values, encouraging active participation, promoting choice and rights supporting individuals with awareness of personal safety
    2. Explain the importance of an accessible complaints
      procedure for reducing the likelihood of abuse
    3. Outline how the likelihood of abuse can be reduced by
      managing risk and focusing on prevention
  6. Know how to recognise and report unsafe practices
    1. Describe unsafe practices that may affect the well-being of individuals
    2. Explain the actions to take if unsafe practices have been identified
    3. Describe the actions to take if suspected abuse or unsafe practices have been reported but nothing has been done in response
  7. Understand principles for online safety
    1. Describe the potential risks presented by: the use of electronic communication devices, the use of the internet, the use of social networking sites, carrying out financial transactions online
    2. Explain ways of reducing the risks presented by each of these types of activity
    3. Explain the importance of balancing measures for online safety against the benefits to individuals of using electronic systems and devices

Study Guide

1.1 Explain the term safeguarding

Safeguarding is a term that describes the measures taken to protect the rights, health and well-being of vulnerable individuals so that they do not suffer from abuse, harm or neglect.

The Care Act 2014 says that safeguarding duties apply to individuals that:

  • have needs for care and support
  • are experiencing, or at risk of, abuse and neglect
  • are unable to protect themselves from abuse and neglect

1.2 Explain own role and responsibilities in safeguarding individuals

It is the duty and responsibility of all care workers to work in a way that helps to prevent abuse and, if abuse does occur, to promptly report it to the relevant person(s) or agency.

This means that staff should be trained to work in a person-centred way and be able to spot signs of abuse.

Staff should also read and be familiar with their organisation’s safeguarding policy and understand when and how to report suspicions of abuse.

1.3 Define the following terms: Physical abuse, Domestic abuse, Sexual abuse, Emotional/psychological abuse, Financial/material abuse, Modern slavery, Discriminatory abuse, Institutional/organisational abuse, Self-neglect, Neglect by others

There are ten types of abuse. Each of them are defined below:

  • Physical abuse – where harm or injury is caused to an individual’s body e.g. an individual punching another individual
  • Domestic abuse – threatening behaviour, violence or abuse between individuals that are closely or intimately related such as family members or spouses e.g. an individual not allowing their spouse to leave the house
  • Sexual abuse – where an individual is involved in a sexual relationship or sexual activities that they do not want to do or do not have the capacity to consent to e.g. an adult having sexual relations with a child under the age of 16
  • Emotional/psychological abuse – where an individual loses all self-worth and confidence and feels unloved due to actions such as coercion, intimidation, bullying, threats or humiliation e.g. a group of individuals cyberbullying anther individual
  • Financial/material abuse – where somebody uses an individual’s money, finances or possessions without permission e.g. an individual making purchases on another individual’s bank card without asking
  • Modern slavery – human trafficking, forced labour and domestic servitude e.g. an individual being forced to work without pay
  • Discriminatory abuse – where an individual or group is treated differently because of a protected characteristic (as defined in the Equality Act 2010) e.g. a man not being allowed to do something because of their gender
  • Institutional/organisational abuse – where needs, wishes and preferences of the care organisation are put above those of the individual e.g. an individual only receiving support at times that it is convenient for the organisation rather than when they require it
  • Self-neglect – where an individual refuses or fails to take care of their own basic needs e.g. an individual having nowhere to sleep or prepare food because their house is full of junk (hoarding)
  • Neglect by others – failing to act on meeting the basic needs of an individual e.g. an individual withholding food from another individual

1.4 Describe harm

Harm is a deliberately inflicted physical injury.

This can be caused directly, for example by hitting or withholding medication or indirectly, for example, by neglect or spending all of an individual’s money so that they cannot afford to buy food for themselves.

1.5 Describe restrictive practices

Restrictive practices are actions that restrict an individual in some way.

This can include the use of restraints, medication or seclusion.

Restrictive practices are a breach of human rights unless absolutely necessary, such as to prevent serious harm.

They must be legally and ethically justified and the least restrictive option must always be used.

2.1 Identify the signs and/or symptoms associated with each of the following types of abuse: Physical abuse, Domestic abuse, Sexual abuse, Emotional/psychological abuse, Financial/material abuse, Modern slavery, Discriminatory abuse, Institutional/organisational abuse, Self-neglect, Neglect by others

The table below identifies possible signs and symptoms of different types of abuse:

Type of abuseSigns and symptoms
Physical
Cuts
Bruises
Fractures
Burns/scalds
Other unexplained/untreated injuries
DomesticAny of the signs and symptoms for the other types of abuse
SexualBloodstained underwear
Injuries on and around genitals, anus and inner thighs
Pregnancy
STD’s
Pain/discomfort when walking or sitting
Emotional/psychologicalAnxiety
Low self-esteem
Low confidence
Depression
Poor sleeping pattern
Fear
Financial/materialNot having enough food or clothing
Bills not being paid
Low standard of living
Assets disappearing
Modern slaverySigns of physical and emotional abuse
Signs of self-neglect/neglect by others
Seemingly under the influence of others
Fear of others, especially police
Having very few personal belongings
DiscriminatoryVerbal abuse
Disrespect
Exclusion
Needs not being met
Not being treated equally
Institutional/organisational
Inflexibility
Poor staffing
Poor staff training
Poor standards of care
Needs not being met
Self-neglectMalnutrition
Dehydration
Dirty clothes and bedding
Dirty living conditions
Neglect by others Malnutrition
Dehydration
Dirty clothes and bedding
Dirty living conditions

2.2 Describe factors that may contribute to an individual being more vulnerable to abuse

Some individuals may be more vulnerable to abuse than others. Several factors can influence this:

  • Mental capacity – not being able to make decisions about their own health and welfare
  • Low self esteem or self confidence
  • Past experience(s) of abuse
  • Communication difficulties
  • Isolation and social exclusion
  • Lack of education
  • Lack of access to information and support
  • Lack of independence
  • Not having others that care for them
  • Not receiving the right care and support
  • Having characteristics that could be discriminated against
  • Lack of money/assets or homelessness
  • Drug addiction
  • Mental health conditions
  • Culture, religion and traditions
  • Age – for example the very young or very old

3.1 Explain the actions to take if there are suspicions that an individual is being abused

If there are suspicions that an individual is being abused or an individual discloses to you that they have been abused, then you should report it immediately in line with your organisation’s agreed ways of working.

Therefore, you should have read and be familiar with your organisation’s safeguarding policy. If you do not have access to it, speak to your manager

Many organisations have a named person that deals with all safeguarding issues, however if your organisation does not, you should report a suspicion of safeguarding to your manager.

In an emergency situation, you must take action to remove the individual from harm as long as it does not put yourself in danger. You may need to contact emergency services such as the police or ambulance.

Injuries should be photographed and evidence, including the crime scene should be preserved as well as possible.

Abuse must be dealt with quickly and efficiently, so if you feel your manager is not treating it seriously you may be forced to escalate it further to senior management or even disclose what has happened to the individual’s advocate, social worker or the police.

3.2 Explain the actions to take if an individual alleges that they are being abused

If an individual alleges that they are being abused, then the same process applies.

Report it to your manager or your organisation’s safeguarding lead and follow your organisation’s safeguarding policy.

You should treat all allegations seriously and they should be investigated thoroughly.

3.3 Identify ways to ensure that evidence of abuse is preserved

Evidence of abuse can be preserved by:

  • keeping the scene of the abuse unchanged, perhaps by closing the doors to the room it occurred in and not entering until the police can see it
  • encouraging the individual to not remove clothing
  • or keeping soiled clothing/bedding unwashed in a plastic bag, especially in cases of sexual abuse
  • discouraging washing/bathing
  • taking photographs of injuries caused by abuse
  • securing any CCTV images
  • keeping evidence of suspicious transactions such as credit card bills, bank statements etc.
  • securing other items that may be used as evidence e.g. weapons, condoms etc.
  • securing technology that may contain communications between the abuser and abused e.g. laptops, phones etc.

4.1 Identify relevant legislation, national policies and local systems that relate to safeguarding and protection from abuse

Legislation, national policies and local systems are the framework for safeguarding and protecting individuals from abuse.

Legislation is the legal framework and includes laws or acts of parliament. The laws that relate to safeguarding are:

  • Safeguarding Vulnerable Groups Act 2006 – prevents people that may pose a risk to vulnerable individuals from having access to them through work (includes DBS checks)
  • Human Rights Act 1998 – sets out the rights and freedoms of all individuals including freedom from torture, discrimination and forced labour
  • Equality Act 2010 – protects individuals from discrimination
  • Data Protection Act 2018 – prevents personal information from getting into the wrong hands
  • Care Act 2014 – puts the onus on local authorities to investigate suspicions of abuse
  • Mental Capacity Act 2005 – protects and empowers people that do not have capacity to make their own decisions

National policies include:

  • CQC – its is the CQC’s responsibility to inspect and regulate care providers
  • Government Statement of Policy on Adult Safeguarding – list of principles for use by local authorities, healthcare, police etc. to develop their own local policies
  • Prevention in Safeguarding (SCIE) – guidance on the prevention of abuse

Local systems are those that are in place in your region and can include:

  • Local authority – this includes social services who must make enquiries about reports of abuse and safeguarding boards
  • Police – have a legal responsibility to protect vulnerable people
  • Health and social care – workers in this sector also have a responsibility to safeguard vulnerable people

4.2 Explain the roles of different agencies in safeguarding and protecting individuals from abuse

Several different agencies have roles to play in safeguarding and protecting individuals from abuse.

Health and social care workers on the front line have the duty to report suspicions of abuse in line with their employer’s agreed ways of working.

These should then be reported the local authority who have the duty to do welfare checks and investigate the allegations. This is usually performed by the Social Services department. The local authority also has the responsibility to set up safeguarding boards which look into cases of abuse and analyse how things could have been done better.

The police force have a duty to protect the welfare of vulnerable individuals and investigate abuse or suspicions of abuse where a crime has been committed.

The Care Quality Commission (CQC) inspect and monitor care providers to ensure that no abusive practices are being used.

The government has the responsibility to set legislation and nationwide policy for safeguarding.

4.3 Identify factors which have featured in reports into serious cases of abuse and neglect

Following serious cases of abuse and neglect, investigations will take place to analyse what had happened and identify if agencies could have done more to prevent them from happening. The findings are usually published in a report.

Some factors which have featured in such reports include:

  • an unacceptable number of individuals with autism and learning disabilities being kept in a hospital setting for long periods
  • Lack of accountability (e.g. directors not being criminally negligent)
  • Reports of abuse being ignored
  • Warning signs not being picked up on
  • Lack of unannounced inspections
  • Poorly trained staff
  • Ineffective policies and procedures

4.4 Identify sources of information and advice about own role in safeguarding and protecting individuals from abuse, including whistle blowing

You can information and advice about your own role in safeguarding and protecting individuals from abuse (including whistleblowing) from a number of sources.

Speaking with your manager will be, in most cases, the best option. They should have a good knowledge of your organisation’s agreed ways of working and the experience of using them.

Other colleagues and senior members of staff can also be a good source of advice, as can professionals from other agencies that may have seen the safeguarding process from a different perspective.

And, of course, reading your organisation’s policies and procedures particularly the safeguarding policy and whistleblowing policy will be a great source of information.

4.5 Identify when to seek support in situations beyond your experience and expertise

As soon as you find yourself in a situation that you believe is beyond your experience and expertise, you should reach out to others for support, particularly your manager.

Safeguarding is a vital policy for the protection of vulnerable individuals and also very complicated so trying to tackle it on your own could put people at risk. Always ask for help.

5.1 Explain how the likelihood of abuse may be reduced by: working with person centred values, encouraging active participation, promoting choice and rights supporting individuals with awareness of personal safety

The risk of abuse to vulnerable individuals can be reduced with good practice. This includes:

Working with person-centred values

The individual should always remain at the centre of the work we do, they should be respected, their opinions valued and their needs met. These are person-centred values.

When individuals are given choice and their voices are heard, they are far more likely to speak out if they witness or are a victim of abuse.

Encouraging active participation

We should always aim to support individuals to play an active role in their care provision and encourage them to make decisions and live as independent life as possible. This is active participation.

Independence increases an individual’s confidence and self esteem and empowers them to challenge things that they do not think are right.

Promoting choice and rights

When we work in a way that promotes an individual’s rights, including their right to make their own choices, they will be better able to understand what is right and wrong and stand up to things they feel will affect them negatively.

Supporting individuals with awareness of personal safety

Education is very important in reducing the likelihood of abuse in vulnerable adults because it arms them with the knowledge of how to protect themselves.

5.2 Explain the importance of an accessible complaints procedure for reducing the likelihood of abuse

Abuse is much less likely to occur if systems are in place to empower individuals to challenge the care and support they receive.

Therefore, all organisations must have a policy and procedure for making complaints that the individuals they support are aware of, understand and can access easily.

5.3 Outline how the likelihood of abuse can be reduced by managing risk and focusing on prevention

Managing risk and focusing on prevention can also reduce the likelihood of abuse to vulnerable individuals.

Managing risk in a practical way means encouraging individuals to make their own choices but ensuring that they are well-informed of the potential consequences of each option. This helps to minimise the associated risks as much as possible.

6.1 Describe unsafe practices that may affect the well-being of individuals

Unsafe practices in the care industry usually come from not following employer’s policies and procedures, employer’s not having adequate policies and procedures and staff not being trained properly.

Anything that needlessly jeopardises the safety of an individual is an unsafe practice and this, of course, can negatively affect their well-being.

Examples include:

  • Not keeping accurate medication records – could lead to an individual underdosing/overdosing
  • Not involving an individual in their care planning – could lead to low self-esteem and lack of confidence
  • Poor hygiene e.g. not washing hands – could lead to the spread of infection
  • Keeping an untidy work environment – creates hazards that could lead to a variety of trips/falls and make evacuation due to fire more difficult
  • Staff undertaking tasks that they are not trained or qualified for – could lead to mistakes being made

6.2 Explain the actions to take if unsafe practices have been identified

If an unsafe practice is identified, it is important to report it immediately to the responsible person(s). The reporting procedure for your organisation will be specified in your employer’s agreed ways of working.

If you can do so safely and proficiently, you should remove the hazard or make it as safe as possible. For example, if it is a spill, you could mop it up but if it is exposed live electrical cable, you would have to report it to your employer and either they or someone else would instruct a qualified electrician to resolve it. You may put up a sign to warn others of the danger.

6.3 Describe the actions to take if suspected abuse or unsafe practices have been reported but nothing has been done in response

If you have reported unsafe practices or suspected abuse to your manager and feel nothing has been done in response, you could follow-up with them to find out the current situation.

If they are not dealing with it correctly or not treating it serious, you should escalate it to senior management.

If there is still no response, you may be forced to report it to external agencies. This is known as whistleblowing.

External agencies can include the local authority, social services, CQC and the police.

7.1 Describe the potential risks presented by: the use of electronic communication devices, the use of the internet, the use of social networking sites, carrying out financial transactions online

Modern technologies can pose additional risks to vulnerable adults.

Electronic communication devices

Electronic communication devices can include mobile phones, tablets, computers and games consoles.

Internet use

Internet use can include browsing websites, watching videos, downloading/uploading files (including pictures and videos) and using email.

Social networking sites

This includes Facebook, Twitter, Instagram, Pinterest and Linkedin.

Online financial transactions

Online banking allows people to send/receive money over the internet as well as set up direct debits, standing orders etc. As well as apps provided by high street banks, there are other money management providers such as PayPal.

Products and services can also be bought/sold online.

Safeguarding risks

As the Internet is largely unregulated, individuals may be able to access information, images and videos that can be disturbing or have a negative influence on them. Examples include illegal pornography, death, violence and propaganda. Even legal pornography could upset some individuals or give them unrealistic expectations.

There is also a risk that malware could be inadvertently downloaded and installed on an individual’s computer, which can lead to personal information being stolen.

In addition, vulnerable individuals may also be at risk from harassment and cyber-bullying.

Unscrupulous people could take advantage of vulnerable adults by influencing them over the Internet using chatrooms or social media.

Usernames and passwords

7.2 Explain ways of reducing the risks presented by each of these types of activity

7.3 Explain the importance of balancing measures for online safety against the benefits to individuals of using electronic systems and devices

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