Safeguarding Flashcards
What is adult abuse?
Adult abuse is defined as a single or repeated act or lack of appropriate actions, occurring within any relationship where there is an expectation of trust, which causes harm or distress to a vulnerable person.
Who is a vulnerable adult?
The Department of Health defines a vulnerable adult as a person aged 18 years or over who is or may be in need of community care services by reason of mental or other disability, age or illness, and who is or may be unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation.
What are the risk factors for adult abuse?
Lack of mental capacity. Increasing age. Being physically dependent on others. Low self-esteem. Previous history of abuse. Negative experiences of disclosing abuse. Social isolation. Lack of access to health and social services or high-quality information.
What are the types of abuse?
Physical abuse may involve physical violence, misuse of medication, inappropriate restraint or sanctions.
Sexual abuse.
Psychological abuse, including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, harassment, verbal abuse.
Financial or material abuse, including theft, fraud, exploitation, pressure in connection with wills, property, inheritance, or financial transactions, misuse or misappropriation of property, possessions, or benefits.
Neglect and acts of omission, including ignoring medical or physical care needs, failure to provide access to appropriate health, social care, or educational services, withholding medication, adequate nutrition, and heating.
Discriminatory abuse, including racist, sexist or abuse based on a person’s disability.
Domestic abuse - including psychological, physical, sexual, financial, emotional abuse, so-called ‘honour’-based violence.
Modern slavery - includes slavery, human trafficking, and forced labour and domestic servitude.
Organisational abuse - including neglect and poor care practice within an institution or specific care setting such as a hospital or care home.
Self-neglect - includes a wide range of behaviour neglecting to care for personal hygiene, health or surroundings and includes behaviour such as hoarding.
What are the six principles of good safeguarding practice?
The primary aim of safeguarding is to keep an individual safe and prevent further abuse from occurring. The Department of Health for England and Wales states six principles of good safeguarding practice:
Empowerment: presumption of person-led decisions and informed consent.
Protection: support and representation for those in greatest need.
Prevention: it is better to take action before harm occurs.
Proportionality: proportionate and least intrusive response appropriate to the risk presented.
Partnership: local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse.
Accountability: accountability and transparency in delivering safeguarding.
How are adults safeguarded?
Interventions should be aimed at making life easier, such as providing mobility aids or treating physical and mental illness to help individuals maintain independence. Such actions reduce barriers to patients making their own choices and reduce their reliance on others.
In all cases of possible abuse, doctors must assess the risk to the individuals and whether there is a need for immediate intervention. Circumstances that would require immediate action would include when someone’s life is in immediate danger or there is significant risk of serious harm. Then you should ring 999/112/911.
Doctors assessing risk should also think about any risk posed to adults at risk other than the patient, to members of the public, or to children.
All concerns regarding significant risk of abuse should be reported to the local services responsible for safeguarding. If unsure, doctors should always make a referral for investigation. All responses depend on the circumstances of the case.
How does abuse present in healthcare settings?
When assessing abuse, doctors should seek to establish the circumstances surrounding the concerns. The abused person may have difficulty in reporting abuse. The person may be frightened that the abuse will become worse if it is revealed and may be worried that it may leave them even more vulnerable.
An abused adult may seem withdrawn, unkempt, lose weight, and have poor skin care. This may be due to illness or may be due to neglect. It is important to establish whether the person can reach a drink, can feed him or herself and is able to ask for help.
Unexplained injuries may be discovered on examination or reported. These should be followed up and the cause of injury clarified to understand whether abuse may have occurred.
The distress caused by abuse may cause the person to have behavioural change, such as becoming withdrawn, aggressive, irritable or emotionally labile.
What is NHS continuing healthcare?
NHS continuing healthcare is free care outside of hospital that is arranged and funded by the NHS. It is only available for people who need ongoing healthcare and meet the eligibility criteria.
How is eligibility for Continuing healthcare assessed?
There are 2 parts to assessing eligibility for NHS funded continuing health care - in the first instance the local team looking after the patient complete a checklist to see if a person may be eligible. This checklist contains a scoring system which determines if a person may need a full multidisciplinary continuing healthcare meeting that is chaired by a specialist assessor.
What is included in the checklist for continuing healthcare?
The checklist contains 11 domains against which a person is assessed. These are similar to the domains that are used in a comprehensive geriatric assessment.
Each domain is assessed as being;
A (high need)
B (medium need) or,
C (low need)
A total score is then calculated.
A full continuing healthcare meeting is required if a person is assessed as having;
- Two or more domains selected in column A;
- Five or more domains selected in column B or,
- One selected in A and four in B or,
- One domain selected in column A in one of the boxes marked with an asterisk.
What are the main types of care homes in the UK?
There are 3 main types of care home in the UK. Before admission a person’s needs should be assessed so they can be appropriately managed in the correct environment.
It is also appropriate to consider if a person should have a period of rehabilitation or ongoing assessment before making a final decision about a move to a care home.
The 3 main types of care home in the UK are:
- A care home without nursing – this provides assistance with personal care on a 24-hour basis (often referred to as a residential home)
- A care home with nursing – provides the above but with 24-hour nursing staff available as well to manage nursing needs (for example Mr Bakers grade 4 pressure area which requires regular dressings)
- A specialist care home for dementia – these specialist units are usually for people who have prominent behavioural or psychological disorders associated with their dementia. Dementia is very common in care home residents and most do not require specialist homes.
Some care homes may offer a combination of the above services.
