Unit 10 Safeguarding in HSC Assignment

Introduction:           

This Unit 10 Safeguarding in HSC assignment is aimed at understanding the concept of safeguarding and applying it in health and social care. A large number of people are at risk of getting abuse and are termed as vulnerable population and it is the duty of every health care service provider to protect these vulnerable adults and children from abuse or neglect. This safeguarding in HSC assignment would highlight the factors that contribute to abuse and self harm by identifying vulnerable population and major risk factors associated with abuse. Further the laws, legislations, policies and strategies that are designed to safeguard people in care settings would be identified and evaluated. Finally, the effectiveness of strategies used to reduce abuse cases in health care would be discussed along with suggesting improvements that can be made in current policies to further minimize such cases.

Task 1 a

1.1 Particular Individuals Vulnerable To Abuse and/or Self Harm:

Abuse can be explained as a process or action which is intentionally done to a person to harm or injure him. It can be either done in a physical way, emotional way or even in a financial way (Stevens, 2013). Almost every person irrespective of his age or gender can be abused by others, but still there are few people who are at more risk of getting abused. This is mainly because they are dependent on others for their day to day basic needs or require support from them, and thus, are can be easily taken advantage of. The groups of people or individuals who are usually considered vulnerable to get abused are as follows:

• Older people
• Young Children
• Females
• Disabled people
• Ethnic minorities

Older people comes under vulnerable population as they are majorly dependent over their family members and care takers for their daily chores and most of the times economically also. Additionally, their age and physical condition do not allow them to act much against the abuser, thus are physically, psychologically, financially abused and also suffer from neglect at times.

Young children also face similar problems alike older people as they need support and care from others and are not in a strong position to protect themselves, thus are at very high risk of physical, sexual or psychologically abused.

Females: females are very prone to get sexually abused at home or public places.

Disabled people or people with special needs are at very high risk of getting abused as their physical or mental state makes them dependent over others.

Ethnic minorities also come under vulnerable population and are abused by being discriminated, disliked or neglected by others. As they have different culture, language, different needs and requirements, they do not receive equal treatment at all places (Pimlott-Kubiak, & Cortina, 2003).In health and social care settings, several clients visit who are at high risk of getting abused and thus, it must be ensured that these people are well protected and safeguarded from any kind of abuse, discrimination or neglect. Every person has a right to live in a safe and secure environment and receive quality care services and therefore must be given equal treatment and care services with same respect and dignity. Health care professionals must be trained and educated to identify any abuse cases, whether at home or care centre and must take immediate action to protect these people by providing them required support (Carlson & Heth, 2010). 

A person can be abused in multiple ways as physical abuse, sexual abuse, psychological abuse, financial abuse, institutional abuse, discrimination or neglect. In the given case scenario, Mrs. JK is physically, psychologically and financially abused by her son as he is taking her money against her wish and is physically harming his mother making her emotionally weak. She is already 71 and little can she does to protect herself from his young son and thus, is at very high risk of getting abused. When she made complaint against her son, immediate action was taken to protect and safeguard her (Attwood, 2007). Similar actions need to be taken for other vulnerable people. Moreover, steps need to be taken to identify such cases early and prevent these kinds of abuse or neglect.

1.2 Risk Factors Leading To Abuse Or Harm:

As depicted above, few individuals or groups of people are vulnerable to be abused since they are dependent on others and seek support from them to successfully fulfill their daily basic needs but there are few risk factors associated with these people that make them even more vulnerable. These risk factors are as follows:

• Debilitating physical state: Compromised or debilitating physical states of a person like that of Mrs. JK that does not allow her to act against abuse or make them more dependent over others acts as a significant risk factor for abuse. This factor also plays a significant role in case of young children and disabled people.
• Compromised mental state: mental instability of a person acts as another major risk factor that makes him vulnerable to be abused. The person is not in his complete senses, many a times fails to understand abusive behavior done to him and thus, such cases go undetected.
• Fewer visitors: In a case when a person is not visited by family members or friends then the chances of abuse increases manifold. Elders, children or disabled people with not so frequent visitors are at high risk of abuse.
• Lack of adequate supervision by staff at care centers (Hawton & James, 2005)
• Poor socio economic factors: such factors increase the chances of discrimination or neglect.
• Negative experience of abuse disclose
• In addition to these risk factors, a child’s risk to get abused increases in cases when:
• He is having any physical or mental health
• conflicts or violence in family
• Lack of interaction or attention between parents and children
• single parent or non biological parents
• Sparse resources 

Self harm and its risk factors:

Few people have a tendency to intentionally harm themselves by cutting, bruising, banging their head, medicinal overdose, suicidal attempts , etc. called self harm which is done as a reaction to overcome emotional distress situation (Royal College of Psychiatrists College, 2010). This is also as dangerous and harmful as abuse; health service providers should identify such cases and must take immediate actions to address them. Common Risk factors of self harm are as follows:

• Depression
• Abuse, neglect or discrimination
• Low self esteem
• Family problems or other social problems
• Financial difficulties’
• Unemployment

Mostly young females, prisoners, people with history of child abuse, lesbian/gay people and teenagers are the one who indulge in self harm activities and must be safeguarded through appropriate approach (Betts, et al 2014).

Task 1 b

1.3 Impact Of Social And Cultural Factors On Different Types Of Abuse/Harm:

There are several factors that make a person vulnerable to be abused by others in one or the other way but the social and cultural factors of individuals play a major role in depicting their risk of getting harmed. Social factors like physical or mental health, education, employment, access to resources, social exclusion and disadvantage and cultural factors like ethnicity, beliefs and religion of a person can majorly impact his vulnerability to get abused and also the way he manages abuse (Betts, et al.2014). First and foremost, health of a patient majorly determines his risk to abuse as poor mental or physical health make him dependent over others, compromises his state to act against abuse or stand for himself and thus, make him prone to get physically, sexually, emotionally or financially abused. Like in the given case scenario, where Mrs. JK has many health problems and her age makes her dependent over others, she was at high risk of abuse. Her son was abusing her by taking her money against her wish and beating her in case she refused to give it. Thus, this case makes it evident that social factor like compromised health state makes a person vulnerable to abuse. Additionally if a person is mentally ill, he can be easily abused physically or sexually and his abuse remains unnoticed many times as he cannot stand for himself (Gilbert, et al. 2009).

Other social factors like poverty also make a person vulnerable to abuse. Poor people usually face discrimination or neglect at public care services and are not treated with equality and respect. Poverty also makes a person irritated and increases his stress level provoking him to physically abuse his family members like wife or children or do self harm.

Poor education increases the risk of financial, emotional or discriminatory abuse or neglect. Less educated person is less likely to get employment or is usually unaware of available care services, thus, face stress and other mental illness that makes him vulnerable to abuse. They readily engage in self harming actions like suicide attempts, drug or alcohol abuse, etc.

Disadvantaged people and socially excluded people are at very high risk of suffering from discrimination, neglect, emotional or physical abuse. Moreover, these people have poor access to available services and service providers face several barriers in safeguarding them. Thus, it can be said that compromised social factors like poverty, poor education, unemployment, etc not only contributes to increase in risk of abuse but also prevent these abused people from being safeguarded or protected. Therefore, it is essential to take steps in a direction of creating a socially equal society where every person has equal rights and opportunities, is well protected from all kinds of harm and receive quality care services (Griffith, 2015).

In addition to social factors, cultural factors like ethnicity, religion and beliefs of individuals also play essential role in determining their risk of abuse. People belonging to ethically minor groups are at very high risk of getting abused. They face discrimination and abuse at several public places and facilities. Although several policies, laws and legislations have been made to give them equal treatment but still these ethnically minor population face discrimination and do not receive respectful equal treatment. Further, in few religions, it is considered normal to emotionally abuse females by considering them low or inferior to males. They do not have equal rights as males and thus, quite vulnerable to be abused in other ways like physical or sexual abuse as well. Thus, cultural factors, beliefs and perceptions have a major impact over person’s risk of getting abused and his strength or power to disclose it to seek support & help. In few cultures, children are taught right from their childhood that females are inferior and thus, these females keep on tolerating discrimination, neglect, emotional and physical abuse for years without disclosing it to anyone considering it as their fate (Frost & Robinson, 2007).

Task 2:

2.1 Strengths and Weaknesses In Current National And Local Legislations And Policies For Vulnerable To Abuse:

A large number of people face abuse; neglect or harm at their homes, public places or private centers and to protect these people from abuse government has many national, local and regional policies. Various guidelines have also been released to be followed at service delivery centers to be followed to ensure safety and security of service users along with set standards that need to be followed while delivering care services. Moreover, there are individual rights like right to live in safe and secure environment, right of get equal services, etc that further extend people’s safety and protect them from abuse or neglect.

Few of the important government legislations set to empower and safeguard vulnerable population from abuse are as follows:

• Care Act 2014 (Department of Health 2014): this act ensures that NHS and other local authorities deliver quality services to their clients, treat them with respect and dignity and provide them safe and secure environment free from any kind of abuse (Mandelstam, 2008).
• Safeguarding Vulnerable Groups Act (2006): by this act, vulnerable groups are protected as only right and suitable people are allowed to take care of them at care centers. The authorities and key agencies make sure that any kind of harm is not done to their clients by unwanted behavior or procedures.
• Sexual Offences Act 2003:  to protect sexual abuse of people with mental disorders, this act prohibits any sexual activity between paid/unpaid care worker and the person requiring car without his permission or consent.
• Ill Treatment or Willful Neglect: this act protects service users especially individuals who lacks capacity to make  decision making , in health and centers from being poorly treated or neglected. Ill treatment involves activities like hitting, humiliating or verbally abuses a service user and is a punishable offence.
• Public Interest Disclosure Act 1998: this law empowers a person to take action against any harmful, abusive or discriminatory action or prevent such incidence in their workplace by identifying and reporting cases to senior authorities.

These and many other similar acts and laws along with set guidelines and recommended policies are quite effective in protecting vulnerable adults, children, disabled and other people from all kinds of abuse or neglect. These laws and policies help in identification of abuse activities and protect people by punishing the offender. They also help in recruiting right people as care takers and prevent recruitment of unsuitable people that may harm service users in one or the other way. Thus, empowers and safeguard vulnerable people from abuse.

Although there are these many laws, guidelines and polices but still a large number of people face abuse because there are certain limitations and weaknesses in the system as follows:

• Abuse is a vast term and thus, current laws and legislations may fail to cover all the possible ways and incidences of abuse/harm.
• Some legislation acts only against paid care workers and fail to cover abuse done by some relative or unpaid care worker.
• A large number of abuse cases remain undisclosed (Gunnell & Bennewith, 2005)
• People face difficulty in proving abuse cases in case of absence of solid evidences
• In case of minor offences, the offender is not punished and just left with warnings. But these things may even provoke them to do more harm to their victim or the one who lodged complaint against them

2.2 Range Of Professionals That Protect Vulnerable People from Abuse:

To protect vulnerable people from getting abused at care services, various professionals and agencies play essential role such as social services, health services, community services, general practitioners, hospital administration, education services, day care centers, mental health services, pediatricians, police ,local councils, etc. These government and non government agencies and professionals help in one or the other way in identifying, reporting and controlling abuse cases and protect people from getting harmed (Jacques, 2011).

Health Professionals like GP, pediatrician, nurses, midwives, mental health service providers, etc are supposed to deliver their services in a way to do no harm to the users and provide maximum possible benefit to them. They are supposed to deliver high quality services with a patient centered approach and give equal respect each patient irrespective of his social, economic or cultural factors. They are also specialized in identifying abuse or harm symptoms, help in early identification of abusive activities and thus protect people by reporting it immediately and taking action against the offender.

Local health boards assist in safeguarding by identifying the needs and requirements of local people and then designing strategies and setting guidelines in a direction to effectively meet those needs. They also ensure that recommended policies, legislations and guidelines are being followed at service centers to protect local people from all kinds of harm.

Care quality commission act to make sure that every individual’s rights are protected and people are getting high quality services in a secure environment. They work with local and national agencies to regularly inspect health care centers and check whether people are getting services as per recommended standards or not (Davies & Ward, 2011).

Social services and other public agencies work together to ensure that vulnerable or needy people are receiving care and other services on time. They also play essential role in identifying people who are facing abuse, provide them required support and protect them from further harm by taking action against the offender (Resnick, et al. 1997).

Care standards inspectorate: CSIW majorly help abused people and protect them by regular inspections of care centers to ensure quality care services are delivered, taking feedbacks, managing complaints and handle registrations of service centers based on guidelines and standards.

Victim support organization: the organization work with the aim of providing required support and help to abused people, witnesses and their family members. It is an independent organization that gives essential information on how to report or get help in case of being abused, provide emotional help to victims and families and also help them to recover from these painful incidences (Brandon & Thoburn, 2008).

Task 3:

3.1 Existing Working Practices and Strategies To Minimize Abuse

For minimizing abuse cases in health and social care, several working practices have been adopted and strategies have been designed by both government and non government agencies. Government has made laws and legislations, set standards of care services and has a code of conduct to be followed at national and local level health care centers to ensure protection of right of service users (Leckie and Pickergill, 1999).

The laws and legislations like care protection act, data protection act, sexual offence act, safeguarding vulnerable population act, etc ensure that people are protected against abuse by identifying abuse symptoms and punishing the offender on being found guilty.

Other practices that are adopted to minimize abuse are predicting risk for a person by identifying risk factors of abuse. Risk factors like compromised health state, poor socio economic factors, children with non biological parents, etc are identified and assessed and if it seems that the person is vulnerable, he is provided with extra care and protection. Moreover, right people as per set recommendations are recruited in care centers to prevent harm or abuse cases. Further health professionals like nurses, midwives, care takers, GP, Pediatricians , etc are taught about warning signs of abuse or self harm that help them to early detect such cases and take required action against them. Several seminars and training sessions are organized regularly to keep them further updated about any reforms or new policies and thus, ensure overall wellbeing of service users. Responsible agencies work together with service users, keep communicating with them and involve them in decision making process to empower and safeguard those (Limber & Small, 2003).

3.2: Effectiveness Of Existing Working Practices And Strategies:

The current working practices and strategies like effective communication in health care, complaint policy, safe handling of all information and data, whistle blowing policy, adoption of procedures and practices as per set recommendation, recruiting right employees, etc are very effective in protecting vulnerable people from abuse of all kinds. Training sessions, seminars and regular inspection by higher authorities further ensure that people are receiving high quality services in a safe and secure environment. However, these practices and strategies have few limitations and weaknesses as well and few improvements are still required to make them more effective (Peate & Potterton, 2011).

Current strategies do not cover all kinds of minor and major abuses as it a vast term. Several offenders go unpunished as their offence is difficult to prove while many other cases remain undisclosed as people are scared of disclosing. Many people still suffer from discrimination or neglect behavior at care service centers due to their compromised socio economic factors or different cultural factors. The policies are still ineffective in protecting females, children and adults facing abuse at their home. Thus, it can be said that although health professionals and other service providers have adopted working practices and strategies to safeguard and empower their service users but still changes and reforms are needed in the system to improve the overall effectiveness.

3.3 Possible Improvements in Existing Working Practices And Strategies:

For increasing the effectiveness of existing practices and strategies to protect vulnerable people from getting abused at health and social care centers, following steps may be adopted:

• Changes need to be made in current business law and legislations to give a common definition of term ábuse’ and ensure that all major and minor activities of abuse or harm to others are covered.
• Installing CCTV cameras in wards, private rooms, reception area, etc must be made compulsory so as to have solid evidence against abuse or neglect
• 24 hour call service must be initiated that would allow vulnerable people or their family members to lodge their complaint and receive support, help and protection (Welbury, et al. 2012).
• It must be made compulsory to keep a record of all the people found guilty of abusing so as to protect people and prevent him from getting recruited and get any such opportunity again.
• Laws regarding protection from domestic abuse need to be reformed and strengthened (Arthur, 2005).
• Special and exclusive team need to be made who would only manage and handle abuse cases and would work to safeguard vulnerable people
• Investigation and inspection frequency and patterns need to be improved to enhance efficiency.
• Hearing related to abuse or harm cases must be more seriously considered and it must be ensured that the offender is well punished.
• All health care centers should develop a system of making annual reports of all the abuse cases, their patterns and the action took against them so as to review these cases and identify weak areas needing improvement.
• The minimum qualification and experience criteria set for recruiting direct support staff needs to be reconsidered. 

By making these improvements or reforms in current practices and strategies, their effectiveness can be increased manifold and people can be provided with even more safe and secure environment free from risk of abuse (McGrath, 2006).

Conclusion:

It can be concluded that there are certain group of people like elderly adults, young children, females, disabled people, etc who are at high risk of getting physically, mentally, sexually or financially abuse in  health and social care  or some private places. It is the duty of government and other responsible agencies to safeguard these vulnerable people by ensuring provision of safe and secure environment to them. Various laws, policies, guidelines and strategies have been designed in a direction to empower these people but still a lot needs to be done to protect people from getting abused, discriminated or neglected.

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