Saafeguarding in Health and Social Care

What is Safeguarding?

(Introduction)

This assignment will explain the definition of safeguarding, by showing clearly how safeguarding links to health and social care. It will use examples of legislation to explain safeguarding policies and procedures which are created that are used in health and social care environments, and it will illustrate how mistreatment of others is reported correctly.

(What is safeguarding?)

Safeguarding means to prevent an accident, injury or maltreatment of other people. The term safeguard is used to describe the things we do to stop something from happening, and the actions we take to continuously stop someone from getting injured or abused. Safeguarding procedures are in place in a lot of industries where vulnerable people, such as young children or the elderly, are worked with. These procedures cover problems such as fires or slipping on wet floors, with solutions to put signs to warn of a wet floor in regards to slipping, and having common fire extinguishers with diagrams of how to use them in regards to fires. Safeguarding is a large factor in health and social care as the duty of caring for residents of different ages is to protect them from injuries and abuse. In care environments such as hospitals, there are many accidents that are able to occur if safeguarding policies are not followed. An example of a serious accident that can occur in hospitals is a mix up in medication, which could cause a patient being given medication that was meant for someone else. This could be potentially fatal in a worst case scenario, or the patient has a heightened risk of developing another issue adding on to the one they already suffer with. To prevent this, the list of medications and patients could be double checked to make sure that the right medication is given to the right patient. This is why safeguarding policies and procedures have to be in place so the chances of this happening are reduced drastically, and patients in a hospital, or residents in a care home, can be looked after properly.

(How legislation influences safeguarding)

The Care Act 2014 is distinct towards adults who are in need of care and support needs. This includes adults with learning disabilities and adults with joint pains, such as severe arthritis. It relates to safeguarding as it’s sole purpose was to develop clear safeguarding policies. It aspires to do this by listing clear definitions of abuse and neglect. It also developed policies to help with the safety of this group of individuals. This makes it easier for medical professionals to define when someone has been abused or neglected and to report this in a correct manner, and it makes it easier for a victim of either of these things to seek help and be brought of out those circumstances.

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The Health and Social Care Act 2012 is definite towards individuals accessing care services, such as care homes or hospitals. This piece of legislation also takes into account the workers within these services. The main aim of this act is to help individuals who access these services get the highest possible standard of care as well as helping to stop widespread issues such as abuse and neglect. Due to this Act, CCG’s have been appointed to stop maltreatment happening to individuals. This relates to safeguarding because a specific group of people, such as persons with learning disabilities or terminally ill individuals who are vulnerable, are being protected from harm.

The Data Protection Act 1998 is specific to a large group of individuals, as it regards people’s personal data, and it is aimed towards anyone who has personal data held by a company or a service, such as a hospital or a care home. The main reason for this act is to achieve higher security of people’s personal data, so there is a reduced chance of a data breach and no-one from the public can access another person’s details, such as their phone number or address. This relates to safeguarding as abuse is prevented because victims who escape abusive relationships can be confident that their personal details will not be able to be released to someone who has abused them in the past. Another act that relates to this one, and strengthens data protection is the General Data Protection Regulations 2018.

The Equality Act 2010 is definite towards any individual that may be discriminated due to a part of who they are, such as their gender, or their race. The purpose of this is to bring all past legislation regarding discrimination together into one piece. Also, it strengthens some parts of old legislation and adds new factors. The Equality Act 2010 covers disability, age, sex, gender reassignment, race, sexual orientation, religion, marriage and civil partnership and pregnancy and maternity. This relates to safeguarding as it helps create an equal society, so it protects people from being attacked because of their race. It also helps give young children a stronger voice, as children are found to have a smaller voice than older people. People with disabilities are often more vulnerable to abuse because they are often not believed when they try and speak to someone, but the Equality Act 2010 changes this. People of different genders also face less discrimination as they can sometimes face stigma for the jobs they go for, such as a female going into engineering or a male going into hairdressing.

The Children Act 2004 is distinct to children with deteriorating emotional and physical health and is at risk of neglect or abuse. The first act for children was the Children Act 1989, which was specific to children at risk of harm. It aimed to put the child first in any case, and courts would not give orders unless to do would result in a better wellbeing for the child. It also introduced Section 47, which means a duty to investigate. This meant that any calls or referrals to Social Services would have to be investigated. The reason for the introduction of the Children Act 2004 was because of the death of 8-year-old Victoria Climbie, who was beaten by her Aunt and Uncle. She was never deemed as a child at risk from abuse because each time she obtained an injury, she would visit a new hospital or GP and there was a lack of communications between hospitals and the authorities. The Children Act 2004 was put together to ensure that all operations that are involved with a child abuse case would communicate with each other. Around this time, the government introduced something called ‘Every Child Matters’ which was a list of things that a child should be, such as staying safe and being healthy. It relates to safeguarding because it strengthens child protection laws and helps protect the physical and emotional wellbeing of the child, preventing further abuse or neglect from carrying on.

Today, it is debatable whether the Children Act 2004 served the purpose which it was created for, as since the date of its passing, there has continued to be cases where young children have been abused or neglected and ended up dying from this. In 2007, there was the case of Baby P, a one-year-old baby who died from his injuries inflicted by his mother and her boyfriend. His mother would cover his bruises with chocolate to be deemed unsuspicious by social workers. The doctors failed in adequate care as he was sent to hospital with a broken back, only for doctors to refuse to check him due to him being in a distressed state. On the 3^rd August he was pronounced dead after he was punched with such force that he choked on one of his teeth that fell out because of it. In 2012, there was the case of Daniel Pelka, a 4-year-old boy who died after being starved and beaten by his mother and stepfather. He often went to bins for food, yet this was never questioned properly by his school. Both of these cases question the ability of the Children Act 2004, as many opportunities were missed by social workers, police and schools to investigate efficiently.

(What is the relationship between legislation, policy and procedure?)

Legislation is a law or a set of laws that have been passed by Parliament. The word is also used to describe the act of making a new law. (Legislation, 2019). Legislation is suggested by the elected Government, and is passed through by a series of votes which occur until both the House of Lords and the House of Commons agree that the bill is good. After the legislation is passed, companies and services write policies to relate to the new law. Policies are the written standards that need to be followed so the legislation isn’t broken. Procedures are the criteria that is written within the policy to meet the requirements of the new law. They relate because it is a chain of reaction to a problem or event. This means that the initial reaction to the problem or event is legislation, such as the death of Victoria Climbie, which was reacted to by the release of the Children Act 2004. Because of this reaction, policies had to be made which is where the procedures are written down.

(What policies and procedures relate to safeguarding?)

In schools around the UK, they have the attendance policy, which sets out a list of instructions for members of staff to follow is a student is absent and they haven’t been notified. This was written due to the Human Rights Act 1998, which stated that people have a right to an education. The procedure members of staff follow if a student isn’t in and no one knows why, is to ring the student or the parents of that student and invite them to a meeting. There is also the Data Protection Act 1998, which caused confidentiality policies to be written in any service such as hospitals and schools, or companies that provide a service, such as care homes. In college, the procedures of this policy are to lock the classroom door when they are leaving, and to turn off computers when they are not being used. Another piece of legislation that influenced policies and procedures was the Equality Act 2010. This Act stated that everyone is to be accepted no matter their race, sex, gender assignment, disability, age, pregnancy and maternity, marriage and civil partnership, sexual orientation and religion. The policy that was made due to this Act was the anti-bullying policy, which was made to prevent bullying of anyone in relation to this Act. The procedure for anyone who was found bullying someone else was a meeting with a member of staff as a first warning, but if they persistently ignored the warnings, they could have a risk of being suspended or expelled. The statutory principles of the Mental Capacity Act 2005 aim to protect people who lack capacity and help them take part, as much as possible, in decisions that affect them. (Falconer, 2007) The policy created from this Act was to hold assessments that help professionals observe the adult’s ability to make choices, the procedure being to assess adults and determine the result by taking into account their circumstances, and the view point of others.

(What are the signs of abuse?)

The definition of physical abuse is anything that has been inflicted on the body that could leave potential marks of any kind. Examples of physical abuse include smacking, pulling of hair and punching. Someone may be physically abused if they have deep, infected leg ulcers, burn marks on the back of their legs and cigarette burns on their forearms. Bruises on the body is also a big sign of physical abuse, as it is something that is abnormal on the body. Victims of physical abuse also have a change in personality, as they may appear more scared than other people, showing this by flinching whenever someone is near them. They may also be isolated more, and they could often apologise frequently for harmless things as they think that they won’t be harmed anymore if they say sorry. They may also have an increase in anger, or wear clothes that don’t reveal much skin in hot temperatures. Elderly people may also get water infections frequently if they aren’t being cared for properly, or they may suffer with bed or pressure sores.

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The definition of emotional abuse is to inflict pain in a way that affects the victim’s psychological wellbeing, and causes them to suffer a lowered self-esteem, which could lead to mental health issues such as anxiety or depression. Examples of emotional abuse include bullying, coercive control, constant rejection and isolation from family, exploitation, stalking and persistent name calling. Signs that someone is being emotionally abused range from feeling unable to eat due to overwhelming nerves which can create a feeling of nausea, this is often known as anxiety. Due to this nausea, and the inability to eat, they may find themselves feeling ill as well as being unable to have a restful sleep. Personality changes also happen in people who have been emotionally abused, as they become more upset and often have a lowered self esteem. Elderly people may become more withdrawn from others, and feel drained of any positive energy which they may have had. This causes them to appear more quiet, especially when the person abusing them enters or is already in the room. Physical signs to emotional abuse range from insomnia to weight loss. They may also partake in strange behaviour, such as sucking, biting or rocking. (Effects of Emotional Abuse, 2019).

The definition of sexual abuse is any unwanted advances made in a manner that has a sexual purpose. Examples of sexual abuse include having nude pictures taken of you without consent, non-consensual sex, proximity, harassment or prostitution. A list of signs of sexual abuse include pain and bruises around the thighs, breasts and genital area and unexplained bleeding. (Wyatt et al, 2017). Indicators that someone has been sexually abused are serious illnesses such as sexually transmitted infections. Some younger women may even end up pregnant as a result of sexual abuse. Elderly people who have been sexually abused could suffer with problems regarding their pelvis, due to their bones being weaker than a younger person’s. They may also sustain bruising around their upper thighs or hips. They may also become socially and emotionally withdrawn from others, or engage in aggressive, unusual sexual behaviours. (The Nursing Home Abuse Center Team, 2019).

The definition of financial abuse is any money taken from a person without their consent. This means that money could be taken off a person who is offering it to someone, yet fails to have the mental capacity to understand what they are doing. Or, it could be taken off someone who thinks that they are sending it elsewhere. There are many ways that financial abuse occurs. It is often found that the elderly, people with learning disabilities, and young children are particularly vulnerable to financial abuse because they are more naïve to the dangers of the world. Signs of financial abuse is someone who always appears to have a lack of money, which can sometimes lead to them not having enough to pay bills. If someone was to look at the bank statements of someone who is or have been financially abused, it would be easily noticed that large amounts of money, sometimes thousands, are leaving their bank at one time. They may also feel distressing amounts of anxiety. Elderly people, especially those with dementia, can have their lives changed for the worse by financial abuse as they are unable to get the money back. This can cause them to be arguably more distressed than a younger person, which could cause health problems.

The definition of neglect is to deprive someone of basic necessities. It is usually found that someone who is being neglected will often be unclean and malnourished. Other examples of neglect include no attention, not feeding and not taking them to the doctor’s when it is necessary for them to go. People who have been neglected will often appear as bewildered or unclean. They may often appear to be needing a drink, as they are dehydrated. They may usually be isolated from other adults or children around them. Elderly people may live in unsafe and dirty conditions, such as having no working heaters in the winter or bedding stained with urine. They may be left dirty as a result of not having a wash as their main carer refuses to help them. Their main carer may even leave them out of sight in public places, making them find a way on their own.

(How do you report mistreatment of others?)  

When an issue regarding abuse is disclosed, it means that someone witnessed the abuse of someone else, or was told about it by the victim. When something is being disclosed, it is important to remember certain details such as the the time and place of the incident. It is essential to report any disclosed information to a line manager right away, as if it is delayed abuse can continue to happen. It is important to not overwhelm the victim with questions, as it is the line manager’s job to take action regarding the disclosure. When a child discloses something, it is good to help them open up by making yourself look more approachable. This could be by changing your body language to something that is more friendly looking and open, rather than something that is stern or closed off. It is important to listen to the child and put away any items that could possibly be a source of distraction. When a child discloses something, you need to let them explain what occurred at their own pace as it could be incredibly difficult and traumatising for the child to talk about. At the end of the discussion, it is good to show that you have truly listened and understood by taking time to reflect back on what they have said. If something has gone on or been disclosed and it’s not an immediate threat, members of staff need to find a DSP, which stands for Designated Safeguarding Person. They are the first contact for staff to go to if they need to talk about an abusive event which they have been told about. This is called a referral, which is where someone tells you about something that has happened to someone else. The Designated Safeguarding Person is responsible for updating the safeguarding policies and procedures as necessary. They are also responsible for promoting a safe environment, supporting staff with concerns about a person and deciding whether the disclosure is plentiful enough to be referred to Social Services. In other cases, such as if a victim seeks medical attention, you need to call 999. If the abuse is life-threatening and taking place at that moment, then you need to call the police and ask for assistance. If you are concerned about someone, but you are uncertain over if there is a serious problem, then you can refer it to Suffolk County Council. Someone can unintentionally cause something to happen due to not understanding or having a lack of awareness and no or minimum staff training. This is referred to as an Act of Omission. Sometimes, there are extreme cases where everyone at an organisation, including the managers, are ‘in on’ the abuse happening to someone. This means that when professional bodies such as the Care Quality Commission come to inspect the organisation, they cover up the abuse which occurs to get good ratings from them. In this case, the correct line of reporting is an act called whistleblowing. Whistleblowing is where you report an issue regarding certain areas such as health and safety. You can inform your employer of the wrongdoing, but if they have not listened or you feel nervous to do so, you can go to a professional organisation, such as the Care Quality Commission if you work in a care home, to report it. If the information is about possible harm or abuse, a safeguarding alert is made to the local authority. In support of the investigation an inspection may be carried out, and other regulator official body may be notified if it is appropriate for them to look into the concern as well. (Raising a concern with CQC, 2019)

References

• Page 53. CACHE Technical Level 3 Extended Diploma in Health and Social Care. Linda Wyatt, Pete Wedlake, Maria Ferreiro Peteiro, Elizabeth Rasheed. Hodder Education- London.
• Effects of Emotional Abuse (2019) [ONLINE] Available at: http://www.nursinghomeabuseguide.org/emotional-abuse/effects [Date accessed: 30/09/2019]
• Falconer (2007) [ONLINE] Available at: http://www.hampshiresab.org.uk/wp-content/uploads/Mental-Capacity-Act-2005-Code-of-Practice.pdf [Date accessed: 25/09/19] (Page 20)
• Legislation (2019) [ONLINE] Available at: https://www.parliament.uk/site-information/glossary/legislation/ [Date accessed: 25/09/2019]
• Raising a concern with CQC (2019) [ONLINE] Available at: https://www.cqc.org.uk/sites/default/files/20160108_Whistleblowing_quick_guide_final_update.pdf [Date accessed: 30/09/2019] (Page 4)
• The Nursing Home Abuse Center Team (2019) [ONLINE] Available at: https://www.nursinghomeabusecenter.com/elder-abuse/types/sexual-abuse/ [Date accessed: 30/09/2019]