This is a solution of Icon College safeguarding in health social care organisation assignment, written on the basis of specific case of staffor hospital scandal.

Introduction

The assignment is based on the Stafford Hospital Scandal and Victoria Climbe Scandal. Both the cases are related to abuse. The Stafford Hospital scandal was based on abuse of vulnerable adults and the Victoria Climbe case is based on the child abuse. The assignment also has the details about the recent strategies and legislation designed to reduce the abuse of vulnerable adult and children.

Task 1A

1) Explain why particular individuals and groups may be vulnerable to abuse and relate it to your current case of abuse that you have researched.

The report is related to Stafford Hospital scandal. The scandal was related to the negligence of the hospital staff towards the treatment of elderly. This situation has led to the abuse and self-harm in the service users of the Stafford hospital. Adults are the most vulnerable in this kind abuse as they require the extra care and protection.

Preventing the vulnerable adults from abuse was not in the criteria of the hospital agenda. 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).

At Stafford Hospital they suffered the abuse in the form of neglect. This mainly happened because of failure to provide the access to the services for health and social care in the hospital. It leads to increase in the mortality rate in the hospital.

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 hospital staff (Bradshaw, 2000). But unfortunately, the patients were neglected terribly in the hospital and left them in a devastated situation. It damaged the trust of people in health care services and brokes the principles of health and social care.

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. 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.

2) Review risks factors that may lead to incidence of abuse and or harm in your case scenario and also in the community.

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

At Stafford hospital, the abuse was carried out by the nurses, unethical doctors, care providers and other hospital personnel. They did not provide the appropriate health care but charge for the same. They even overcharged the medical services. 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 Stafford case raised the alarms for poor care and services for the patients in the hospital. 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.

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Task 1B

Analyse the impact of social (i.e. health; housing, education; poverty, social exclusion and disadvantage, networks of support); and cultural factors (i.e. ethnicity; discrimination and religion) in general.

At the conference there was a discussion between the families of different communities of East London to discuss the Impact of Social and cultural factors on different kinds of abuse. Here is the report based on that discussion.

The social and cultural factors are the main reason behind the adult vulnerability. The various unwanted circumstances are the contributor to this situation. The discussion started with the types of abuse that an elderly person can suffer. These 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

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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.

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 this refrains themselves from the community and people.

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Types of Self Harm

Elderly abuse is related to the health inequalities. These are the result of unequal distribution of health facilities. People with lower socio economic status are more prone to health hazards and likely to get into the unhealthy behaviours like smoking, drinking, inadequate diet, dependency on drugs etc. (Aldana, 2001).

These habits are the self-harming and can cause the various other ailments in the elderly. The state of depression leads to these, but it will only worsen the condition of the adults. This can reduce their life span or make them even more dependent on the health care providers.

The different types of abuse and the impact of social and cultural environment is prevailing across Europe. There are severe negative impacts of these as it leads to abuse and involvement in self harming activities.

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Task 2

1) Analyse the strengths and weaknesses in current legislation and policy surrounding the type of abuse found in your case research.

Victoria Climbie case is related to child abuse. She was tortured and murdered by her parents in United Kingdom. Before her death the national Health Services also contacted her and reported the case of child abuse. She was hospitalised several times, but the care providers did not reported the case as it was home issue as per their understanding.

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). After the Children Act, 2004 various other Act and amendments took place. These are mentioned as follows:

The Children and Young Persons Act 2008

The Children and Adoption Act 2006

The Borders, Citizenship and Immigration Act 2009

The Apprenticeships, Skills, Children and Learning Act 2009

The Education Act 2011

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.

2) Explain the role of different professionals in protecting vulnerable service users to abuse

The different professional are:

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.

Primary care trust that is responsible for providing the primary health services to people. They have the dedicated team for preventive health care and promoting the health. They work towards reducing the health inequalities in the local communities (Marmot, 2005).

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.

Task 3

1) Explain existing practices and strategies designed to minimize abuse

As a social worker, I would like to safeguard the vulnerable adult abuse. There is a strict need for safe guarding the 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 health and social care institutions necessitate to work together efficiently in an association or partnership. Partnership and association can be used interchangeably. The Stafford case raised the alarms for poor care and services for the patients in the hospital. For recuperating the conditions, the partnership between the health and social care services are significant. With this 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 the adequate funds for residential services, home care services and nursing homes in order to control the access through care management and assessment.

The current legislations for the partnership include:

• Health Act 1999: This act comprises of the three flexible powers for the social and health 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.
• Children’s Trust: This is virtual in nature as compared to adult care trust. It emphasizes on assessing the common framework for children, information sharing and working with children and youth.
• Personal Health Budgets: This is basically meant for social care of adults. This policy permits the patients to receive the cash for the services they have taken from the health providers. This amalgamation is helpful for poor people to get the good health facilities.

The partnership for safe guarding the adults must have

• The established authority
• Membership from entire statutory organisations
• Membership from independent and voluntary service providers
• Representation from carers’ and service users’ organisations
• Executive management for supervision
• A strategic plan.

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Preventing the elder abuse is also based on the three main things: listening to them and their care givers, intervening in the suspicious events, educating others to recognise and appropriately report the abuse. This can also be done through:

• Developing the adult day care programs
• Developing the local respite care agencies
• Providing the appropriate medical care
• Providing the counselling to the depressed elders
• Help them in quitting the self-harming activities like smoking or drinking.

It is also important to educate the family and friends to recognise the abuse in vulnerable adults.  They should be able to identify the warning signals that indicated the elder abuse of any type and reporting it immediately to save them. The medicines must be looked regularly for checking the expiration date. The friends and family must watch for the financial abuse. They also must ensure that the elders are left isolated. They must keep in touch with them regularly. All this must be informed to the family and friends by conducting some local seminars. This will help them the elderly to save the potential abuse.

After educating the family and friends, the elderly must also be counselled for various things to avoid the abuse. They must protect themselves from the financial abuse. They themselves must make an effort to be in t ouch with friends and family so that they don’t feel isolated. They should speak up if they are ill-treated by the health care providers.

2) Evaluate the effectiveness of working practices and strategies used to minimise abuse in health and social care setting.

All these practices will be very helpful for minimising the adult abuse. The legal partnership legislations also have the positive outcome in the form of reduction in the cases of abuse in the last decade. Over the time the health and social care working are becoming comprehensive and more refined in the form of services provided to the people. These partnerships have helped in:

• Building the shared principles and values
• Agreeing to the specific shifts in the policies
• Readiness in exploring the new options for services
• Determining the agreed boundaries
• Agreeing to the roles in regard to providing, purchasing and commissioning
• Identifying the agreed pools of resources
• Ensuring the effective leadership
• Providing the capacity for sufficient development
• Paying extra attention to attitude and mutual trust.

The successful partnership is dependent on the main reason behind it, provision of adequate resources for organizational and development support and matching the activities for the staff and attaining their support

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3) Discuss in your report what possible improvements to working practices and what strategies exist to minimize abuse in health and social care

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.

If the above strategies get implemented the barriers to partnership can be easily removed and the society can be saved from the scandals like Stafford Hospital which mounted to large number of deaths and causalities. This will enable the providers to ensure the best services and care to people and people on the other hand can get the personalized care plan. The road to success for these partnerships is not tough; just it requires bit more personalized approach and care. There is a need to realize the fact that social and health care providers should work jointly to cater the complex need of people and should work harder to serve them to their satisfaction.

Task 4

Self-Evaluation

The entire assignment is based on the abuse related to health care services.  From the Stafford hospital scandal, the vulnerable adults and their potential abuse came in light. 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. 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 hospital staff. At Stafford hospital, the abuse was carried out by the nurses, unethical doctors, care providers and other hospital personnel. They did not provide the appropriate health care but charge for the same. They even overcharged the medical services. All this caused the emotional abuse among the adults.

Adults suffer from different kinds of abuse – physical, emotion, sexual and financial. There is a direct impact of social and cultural factors on the adult’s health. The social and cultural factors are the main reason behind the adult vulnerability. The various unwanted circumstances are the contributor to this situation. The social factors include the health, education, housing, poverty, social exclusion or the low economic social status. The cultural factors involve the racial discrimination that leads to the situation of isolation among the adults.

The problems of the vulnerable adults are clear from the above all mentioned points. The nest important thing is to safeguard them from the abuse. For this there are many ways, the first one is the legislative framework where in the health care providers and social care agencies come in partnership. They both ensure the proper care for the vulnerable adults. Along with this, the family, friends and other carer must be educated about the care practices for them. The adults should also take the step to safeguard them from the abuse.

Another case mentioned in the assignment is of Victoria Climbe which relates to the child abuse cases. This case raised the alarms and lead to various legislations for the health care providers with the aim of reducing the child abuse. After the death of Victoria Climbie, government conducted the enquiry and introduced the new legislation for improvising the child protection in England. 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.

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.

It is critical to safeguard the vulnerable adults and the children from potential abuse as these groups require the extra care from the society due to their dependency.

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References

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 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. 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. Bainham, A. (2005) Children: the modern law. 3rd ed. Bristol: Family Law.

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