Task 1

Overview to Case Study

The ECB College Safeguarding in health and social care assignment case study is about abuse, neglect of an elderly domiciliary care patient. The patient caught the care worker stealing cash from her purse. Mrs. Lynette’s care worker was Nadia Summers. Mrs. Lynette had doubts on her as she saw her money disappearing. She reported this to her family and for this they installed the camera worth £1000. Mrs Lynette was suffering from the neuron disease and that’s why she requires the social care worker for help. From the camera they cached Nadia stealing the money.

Q.1. Explain why particular individuals and groups may be vulnerable to abuse or harmful to self and others

Mrs. Lynette is 64 years of age and is suffering from a rare neuron disease. She requires the help from a care worker Nadia. This situation has led to the abuse and self-harm in the service users. Adults are the most vulnerable in this kind abuse as they require the extra care and protection. A vulnerable adult require the need of care because of age, illness and disability. They are generally unable to take self-care. A vulnerable adult has the mental and physical health needs with proper care and attention (Ansello, 2010).

People specially the vulnerable adults who are the users of the healthcare services have the right to get the proper treatment with dignity, compassion and respect by the care workers (Bradshaw, 2000). But unfortunately, the behaviour like Nadia’s damaged the trust of people in health care services.

Adults are more vulnerable and at the high risk of abuse due to the following reasons (Cambridge, 2000):

• They are generally isolated and don’t have the contact with the family, friends or neighbours.
• They have the memory problem
• They face the difficulty to communicate with others
• They are not able to get on with carer
• They get addicted to drugs and alcohol
• They require more emotional and financial support

They are more open to abuse due to the disability and mental illness. They are highly dependent on others and this increases their vulnerability towards the abuse. Taking care of a senior is quite difficult due to their different needs. It is very hard to understand their specific needs. Their demand and needs gives the rise to situation of abuse. The stress of caring the elderly makes the carer impatient and lead to abuse.

Q. 2. Using the given article, review the risk factors associated with the incidence of abuse and harm to self and others

The most significant risk factors of abuse in elderly are:

• Caregiver’s inability to adjust with them and cope with the stress.
• Depression among the caregivers
• Less support from the caregivers
• Substance abuse
• The intensity of dementia or illness among the elderly
• Social isolation
• Patient with the history of domestic violence
• The elder’s physical and verbal aggression

In the case of Mrs. Lynette, the abuse was carried out by the care providers Nadia. She misleads Mrs. Lynette and stole the money from her purse. All this caused the emotional abuse among the adults. This kind of abuse can lead to depression among the elderly and they can get into the harmful addiction of alcohol and drugs that can even worsen their conditions. The elderly neglect and the failure of care taking obligation constitutes the maximum number of reported cases about the elderly abuse.

The warning signs of the elder abuse include the changes in behaviour of elder and the frequent argument with the care providers. They become withdrawn and quite. They also become aggressive and look unkempt.

The physical signs of abuse include the wounds or bruises and the vulnerable adults become afraid of staying alone with particular individuals. The lack of training of the care providers also results in this kind of situation.

The case of Mrs. Lynette raised the alarms for poor care and services for the patients in the elderly domiciliary care. The vulnerable adults seek the emotional support, tangible support, problem solving assistance, social companionship and the support related to the self-esteem.

The emotional abuse may lead to even more loneliness and isolation among the adults as they already have relatively smaller social networks. The care givers must take the responsibility of helping the vulnerable adults to avoid these kinds of abuse and the related self-harm.

Task 2

Case Scenarios:

1. A newly qualified mental health nurse on the first day at work realises that a mental health patient with previous history of physical and verbal abuse towards staff member is refusing to take the medications
2. In a primary school a child has autism and finds it difficult to communicate with children. Child claims others at bullying and calling names.
3. One of the teenager tell you that another care worker comes to his room at night
4. A women with previous history of domestic abuse from her ex-husband has reported that she is three months pregnant She is now scared to live with him. She has the bruises all over her face and neck.

Q.3. Selecting the two scenarios explain how to minimise the abuse with reference to working practices and evaluate its effectiveness

The first scenario is of the mental health patient with the history of physical and verbal abuse.

Physical Abuse: It is a physical ill treatment that causes the physical injury. This can occur due to the withholding care, preventing an access to the health care and the use of inappropriate treatment and related techniques (Sobsey, 1994). It leads to the confinement and isolation among the vulnerable adults. This is also an evidence of under or over medication given to the patients.

As a health care provider, I would like to safeguard the vulnerable adult’s abuse. There is a strict need for safeguarding health of adults. Since the adults are more vulnerable to the health care related abuse, it is important to understand the existing practices and strategies for minimising the abuse. The current legislation for this are:

• Health Act 1999: This act comprises of the three flexible powers for the health and social care services providers: to group their budgets, to generate the incorporation of service providers and to expand the leading commission activities.
• Care Trust: It has around ten organizations and is considered as the closets model for a complete merger of social and health care in England.

These acts have the provision of safeguarding the people However as a nurse; I would try and bring the confidence back in the patient towards the health care services. By this the patient will start taking the medicines and his health condition can be improved.

The second case is of a Child who is suffering from the autism and finds it difficult to communicate with others. He is suffering from the emotional abuse.

Emotional Abuse: This occurs due to neglecting, rejection or humiliation. This kind of abuse can lead to depression among the children and they can get into the harmful addiction of alcohol and drugs that can even worsen their conditions. The Children’s neglect and the failure of care taking obligation constitutes the maximum number of reported cases about the child abuse

This case raised the alarms and lead to various legislations for the health care providers with the aim of reducing the child abuse.

• The Children’s Act 2004: The current child protection act is based on the Children’s Act, 1989. The act has the detailed rules and regulations for local authorities to protect the children from abuse. After the death of Victoria Climbie, government conducted the enquiry and introduced the new legislation for improvising the child protection in England (Laming, 2003).

The aim of this legislation is to keep the children safe. It is based on the principle of every child matters. There are number of changes made to the act by government for making the protection of children even more comprehensive. The act covers Wales and England in separate sections (Bainharm, 2005).

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Q 4. As a health care professional, discuss your recommendation for improvement on how to minimise the abuse

As a health care professional, I have to give the recommendations about the child abuse and physical abuse.  The Government every year publishes a paper to the concerned authorities about the guidance of offences against the children. It has the entire list of offences against children it helps the agencies to identify the person presenting the risk and the potential risk to the children. The agencies work closely with the vulnerable groups.

All the acts were made with the core of protecting the children against various abuse like child labour, physical abuse in form of punishment and sexual abuse among the children (Wallace, 2007). The child abuse is a shameful act, but still people are involved in this. The current legislations are successful in controlling the child abuse cases in Wales and England. The acts have imposed the criminal responsibility for the people involved in it. This has reduced the number of cases related to child abuse.

The emotional abuse may lead to even more loneliness and isolation among children as they already have relatively smaller social networks. The care givers must take the responsibility of helping the vulnerable children to avoid these kinds of abuse and the related self-harm.

For reducing the physical abuse the health and social care institutions necessitate to work together efficiently in an association or partnership. Partnership and association can be used interchangeably. For recuperating the conditions, the partnership between the health and social care services are significant. With this working partnership the staff of social service centre and general practitioner will act as a strong gatekeeper for other services provided in the health care institutes. General practitioners are responsible for controlling the access to health services of community through referrals from patients (Stevenson, 1996). Social care sector is responsible for managing  financial resources  (adequate funds) for residential services, home care services and nursing homes in order to control the access through care management and assessment.

The strategies for the health and social providers are very much achievable. Along with them the people with specific conditions and their respective carers should have the skills and knowledge to communicate effectively with the social and health care providers and at the same hand the staff of health and social care should also communicate with them effectively and try to resolve their queries. The providers should design the personalized care plans for the people with long term conditions with their best knowledge and expertise. The detail plan should be made and it should be discussed well with the patient. There should be integrated approach towards the designing of care plan and organizations should work together and closely with each other.

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Q.5. Analyse the impact of social and cultural factors and explain the professionals involved in protecting the vulnerable groups

The social and cultural factors are the main reason behind the vulnerability among different groups. The various unwanted circumstances are the contributor to this situation. The different kinds of abuse are:

Physical Abuse: It is a physical ill treatment that causes the physical injury. This can occur due to the withholding care, preventing an access to the health care and the use of inappropriate treatment and related techniques (Sobsey, 1994). It leads to the confinement and isolation among the vulnerable adults. This is also an evidence of under or over medication given to the patients.

Sexual Abuse: This is a form of forced sexual activity from an adult (Brown, 1993). This includes the rape, inappropriate touching, incest etc. the sexual abuse can be done by a day care worker, residential worker, personal assistant or a social worker. This can lead to the sexually transmitted disease among the adults and can break the trust of the elderly in the carers.

Emotional Abuse: This occurs due to neglecting, rejection or humiliation. This kind of abuse can lead to depression among the elderly and they can get into the harmful addiction of alcohol and drugs that can even worsen their conditions. The elderly neglect and the failure of care taking obligation constitutes the maximum number of reported cases about the elderly abuse

Impact of Social factors:

The social factors include the health, education, housing, poverty, social exclusion or the low economic social status. These factors have the biggest impact on the person’s health. Among all, the low socio economic status have the biggest impact as it leads to inability to access the health care services and low education. The low socio economic status is very complex characteristic and encompasses the quality of health along with education and income. These inequalities are unfair and unnecessary (Carson et al, 2007). This has also taken people towards the long term impairments and illness. Ability to invest in the health is also directly associated with the individual’s health. The growing differences in the socio economic status have increased the health differences and lead to elderly emotional abuse. For such people health promotion is need of time

The poverty is also a reason that makes the adult vulnerable towards the abuse. As they become financially dependent, their self-esteem is highly affected and there are chances that they don’t get along with the carer and leads to the abuse.

Impact of Cultural factors

The cultural factors include the discrimination among the races. The discrimination between the colour, caste or creed makes the adults vulnerable. They are often discarded due to these factors by various health providers. The discrimination is the main reason behind the physical abuse and leaves the adults in isolation to deal with their own health issues.

The situation is prevailing in the East London and people with discriminated caste get the lesser access to the fundamental health services. As already they have the low social economic status, these factors have added to their problems and lead to the mental stress and other serious ailments. The immigrants from other countries to East London are also facing the same problems.

The racial discrimination is directly related to the blood pressure problems in the adults that further leads to the severe anxiety. The adults suffering from these, refrains themselves from the community and people.

The different professional helping in these are:

1. General Practitioners: They play an important role in providing the health services. They are generally the first point of contact for people. Every person in UK has the right to register with them
2. Primary care trust that is responsible for providing the primary health services to people. They have the dedicated team for preventive health care and health promotion. They work towards reducing the health inequalities in the local communities.
3. NHS Centre: They offer the quick access to the people. There are 66 centres in England at almost every convenient location. They offer the advice and information over the phone as well. They provide the self-care tips in particular health conditions.

Q.6. Analyse the strength and weakness of current legislations dealing with abuse

The legislations, policies, procedures and code of practices set the responsibility of employer in the regulation of social care worker. These standards are set at national level. They require the employer of the social care to adhere to those standards. The codes are a key step in the introduction of a system of regulation for social care in the four countries of the UK. They have to ensure that people who are working as social care providers must understand their responsibilities and roles. They should be provided with the appropriate training for handling the vulnerable groups who require the assistance from the social care providers. They must respect the rights of the service users and ensure that their behaviour must not harm them or their emotions. They should uphold the confidence and trust of public. Each patient should be treated individually and respectfully. The general social care council has laid down many codes of ethics for social workers.

These codes and policies are effective when practices in a prescribed manner. The vulnerable group are dependent on the social care providers. So they must work as per the policies and procedures.

References

• Aldana, S. G. (2001). Financial impact of health promotion programs: a comprehensive review of the literature. American Journal of Health Promotion, 15(5), 296-320.
• Ansello, E.F. and O’Neill, P. (2010) ‘Abuse, neglect and exploitation: considerations in aging with lifelong disabilities’, Journal of Elder Abuse & Neglect, vol 22, no 1, pp 105–30
• Bainham, A. (2005) Children: the modern law. 3rd ed. Bristol: Family Law.
• Bradshaw, R. (2000) ‘Preventing abuse of vulnerable adults’, The Journal of Adult Protection, vol 2, no 1, pp 35–38
• Brown, H. (1993). Sexuality and intellectual disability: the new realism. Current Opinion in Psychiatry, 6 (5), 623-8.
• Carson, B., T. Dunbar, et al ‘Eds’. (2007). Social Determinants of Indigenous Health.  Crow’s Nest, Allen & Unwin
• Cambridge, P. and Carnaby, S. (2000) ‘A personal touch? Managing the risks of abuse in intimate and personal care for people with intellectual disabilities’, Journal of Adult Protection, vol 4, pp 4–16.

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