Concept of Safeguarding Vulnerable Adults - Research Paper Example

Concept of Safeguarding Vulnerable Adults In the current years the media and other human rights organizations continues to present child abuse under public awareness with high-profile cases related to neglect from child cares as well as catastrophic failure of systems producing shocking accounts related to children suffering. The issue attracts significant public concern where less is heard relating to vulnerable adults abuse. The society as a whole remains on the dark in understanding that abuse of vulnerable adults exists within the community (Parker, 2007, pg. 45). The society as a whole, in fact, remains uncomfortable with acknowledging that such a torrent of abuse exists. Adults constantly weigh the risks and benefits balance regarding the choices made. Safeguarding relates to a range of activities that aim at upholding every adult’s fundamental right that amounts to being safe and at the same time respecting individual’s rights regarding making of choices. Safeguarding involves empowerment, justice as well as protection. All persons within a society need to play a significant responsibility in relation to the role of vulnerable adults safeguarding. In a broader sense, safeguarding stems specialist services to everybody else within the society. Professionals, volunteers as well as the general public need to ensure they partake in safeguarding vulnerable adults. Effective safeguarding relates to four primary activities. The first safeguarding aspect refers to prevention and awareness raising. The action aims to improve everyone’s general wellbeing thereby encouraging communities to support one another in acting as in a manner where they look for one another. The action also aims at ensuring the public and all professionals as well as volunteers possess adequate information regarding actions they may take where they think that an individual is being abused or harmed. The second aspect refers to an inclusion that focuses on activities directly designed to make sure that providers of safety services within the community, as well as other services, remain alert. The operation also ensures inclusion of vulnerable adults from the communities, professionals as well as volunteers (Kingsley, J, 2009, pg. 411). The activity also encourages identification and support of individuals who are vulnerable to poor life for one reason or another through circumstances and outcomes of different services. The third activity refers to personalised management of both risks and benefits. The activity aims at attaining specific action essential in identifying and supporting people to ensure they make informed judgement as well as protect themselves. The activity assists individuals in making informed decisions relating to actions taken by suffering or situation where they are likely to suffer harm. The last consideration refers to specialist safeguarding approach. The review takes effect as a specific action aimed at ensuring that individuals who have experienced abuse or harm are assisted to protect themselves and i0f not so, involved in decision making designed to safeguarding them. LO2 Analysis and Definitions of Signs of Abuse A vulnerable adult refers to an individual aged eighteen years or above and who requires or is in need of care services from the community through a reason mental disability or any other disability. Other limitations may relate to age, illness affecting adults and thereby make them unable to take care or protect themselves from exploitation or any significant harm. These individuals include persons with learning disabilities, the older people, individuals suffering from health mental problems as well as individuals suffering from physical disability or any impairment. Consequently, there exists a need for additional support that may result from other factors that may complicate issues. These include chronic illness, sensory impairment, challenging behaviour as well as drug or alcohol problems among others. Understanding some of these disabilities proves essential to understanding how vulnerable these adults can get (Mezey, 2004, pg. 64). First consideration relates to adults with learning disabilities. Literature identifies individuals with learning difficulties as being prone to all kinds of abuse. These individuals possess poor social skills as well as poor judgement. They consequently possess poor communication skills and inefficient knowledge relating to defence against violence as well as inadequate education relating to appropriate sexual behaviour. These individuals are reinforced or educated to remain compliant thereby lacking practice that is essential while making independent decisions regarding everyday life. Other individuals like the deaf and the blind also remain vulnerable to sexual abuse as a result of learning to touch as a communication method (Townsend, 2005, pg. 76). The risk of ill-treatment also remains high during intimate as well as personal care for individuals possessing learning disabilities and other complex needs. Research indicates that individuals with learning disabilities remain at a higher risk of abuse when young, physically mobile or while engaged in self-injury. Majority of adults with learning disabilities will continue to be reluctant to respond to abuse where family members are responsible for a result of fear of losing their parents contact. The case is similar for disabled women who never reports abuse. Sexual abuse remains a high risk among adults with learning disabilities as mostly resulting from their peers. The next consideration relates to older adults. A lot of increased risk relating to older adults remains within the society deriving very similar factors. Most frail and dependent adults remain at a high likelihood of maltreatment. Majority of older adults at risk of abuse tend to stay quiet, disoriented as well as unable to communicate. Vulnerabilities within the older adults remain high even in social care services and hospitals. Neglect contributes to a significant risk factor in many countries with older adults from the age of eighty-five suffering neglect (Kempfer, 2009, pg. 116). These individuals end up of poor health or depression. Financial abuse risk remains on the rise among older adults living alone; they either lack financial support to cater for health services, as well as other essential services. Older women consequently suffer the risk interpersonal abuse with majority of them ending up with depressive symptoms. LO4 Factors That Inhibit and Assist partners working to Safeguard Vulnerable Adults and No Secrets Approach On the other hand, recognizing abuse becomes essential as the guiding principle of damage recognition is prevention. In situations where preventive strategies fail, professionals, agencies and the community need to ensure that effective procedures are in place to assist in dealing with abuse incidents. Under domestic situations, recognition of a number of indicators takes place. However, they should not be referred to as checklists or viewed in isolation from the emotional as well as social factors of vulnerable adult’s living situation and the carer. It remains essential to understanding that caring for vulnerable adults presents a lot of challenges. Majority of carers want to take care of their loved ones genuinely and to the best their ability allows (Mezey, 2004, pg. 212). However, possessing adequate knowledge to take care of vulnerable adults remains a significant challenge. Engaging in trainings, family support, friends as well as professional and advocates advice remains essential in ensuring a reduction of the risk of abuse. In health settings and social care services continued neglect instances or inadequate care proves an indication of what scholars refer to as institutional abuse (Gutman, 2010, pg. 123). The action manifests itself in single acts of continuous unconscious incompetence as well as unsatisfactory professional practice. At times, institutional abuse amounts to gross misconduct chargeable in a law court. Others refer the action as pervasive-ill-treatment mostly resulting from professional negligence. Examples of institutional abuse include: firstly, untimely response to constipation, distress and pain as well as other indignities. Secondly, humiliating the vulnerable adults or intimidating them. The third aspect refers to withholding either food or drinks for the vulnerable adults or in other circumstances, a complete lack of drinks or snacks opportunities. Next, leaving the vulnerable individuals unkempt or leaving them with inappropriate clothing. For example, giving vulnerable adults clothes meant for winter clothes during the summer season. The next aspect relates to locking doors with the intention of restricting the vulnerable adults from free movement or any form of physical restriction (Gutman, 2010, pg. 123). The next action amounts to restricting individuals through medication. For example, a sensitive person may be restricted from taking some medicines that remain essential to their health. The last aspect refers to professionals not maintaining dignity. A case example occurs in situations where professionals take advantage of the vulnerable individuals through trickery. The balance of power between vulnerable persons and the staff provides the central focus for adult protection. Every nurse possesses a potential to guide patients daily life. For example, the nurse decides for the patient on the best time to eat or when to respond to queries. The nurse also holds an understanding relating to the amount of knowledge to share with the vulnerable adult. Understanding the different capacity of knowledge these individuals possess helps in avoiding confrontations with them as well as ensuring that their behaviour is well guided. While to staff members some discussions or jokes seem healthy, to the vulnerable individuals they may take a different perspective and therefore leading to an imbalance of power between the vulnerable people and the staff. A practitioner holds a responsibility of maintaining professional boundaries within them and their clients. Where professionals make omissions at their place of work, inadequate care results and consequently become abusive to the patients. Example of acts of omission includes: first, taking away patients treasured possessions. Second failure refers to imposing restrictive regimes that may involve unnecessary bedtime restrictions (Lachman, 2006, pg. 88). Third aspect amounts to inappropriate language use or using gestures and inappropriate tone. Majority of investigations attribute institutional abuse to arise as a result of a number of factors that involve; management inadequacy, as well as poor communication. The next factor refers to unavailability of incident reporting for any concerns raised by the staff as well as clients. Another aspect relates to inadequate leadership within the organization that leads to abuse of power among the management and in return leading to the development of an adverse attitude among the staff members. Bad management practice also leads to the development of an adverse culture within the organization that destroys the working relationship. The last aspect refers to inadequate or absolute lack of training and development programmes for employees leading to work isolation. Currently, abuse of vulnerable adults recognition is becoming a societal role as well as policy thinking. The approach has ensured formation of a number of systems to support the vulnerable individuals and prevent abuse. The underlying aspect of these developments is to create care systems as well as social services where abuse and disrespect of sensitive individuals are unheard. Procedures vary across different nations with each country focused on achieving the best procedures for the best practices to enhance safeguarding of vulnerable adults. For example, in the United Kingdom (UK) different methods vary with a range of settings that ensures vulnerable adults receive the care they require. Although there are various institutions that remain on the front line in order to enhance social services and health care for the vulnerable adults in the UK, they derive their guidelines from No Secrets definitions and framework. No secrets give definition of abuse and provide a framework for numerous agencies to follow so as to develop local strategies essential to tackling the misuse. The framework enhances achievement of that practise through awareness raising and identification of prevention methods (Green, 2008, pg. 67). Agencies in the partnership include the National Health Service, social care services, regulators as well as service users. Incorporation of the police in the connection plays a significant role as the police possess the powers to prosecute and arrest wrongdoers. The police, therefore, assist through arresting and prosecuting those who abuse the vulnerable adults. However, achievement of the goal of safeguarding the vulnerable individuals rests with all the stakeholders mentioned. Where all the stakeholders play their part efficiently and equally coordinate and communicate with each other, the goal will be achieved. The social services serve as the lead agency responsible for coordination of local activities, but all organizations need to appoint a designated lead officer identifiable in every service. The basis of guidance formed by No Secrets falls into the following sections: First section refers to Protection of Vulnerable Adults (POVA). POVA represents a kind of a list working as a workforce ban in both England and Wales. The list works through check against as well as referral to care workers that have at an instance harmed a vulnerable adult or placed a vulnerable adult at a risk of injury. POVA ensures that such a carer is banned entirely from taking care of vulnerable adults in care positions. These rules remain applicable also to other employees in regulated care homes as well as adult placements schemes among other care facilities apart from the NHS. The second section No Secrets provides refers to Criminal Records Bureau (CRB). CRB enhances access to individual’s criminal records information when called upon to disclose such information. The information revealed play a significant role in ensuring that organizations get guidance while hiring employees through identification of unsuitable candidates for working in vulnerable adults services (Foreman, 2010, pg. 45). The disclosure service also includes the NHS. The third section refers to Safeguarding Vulnerable Group Act 2006. Although the act establishment occurred in 2006, its planned implementation occurred in 2008. The legislation constitutes a barring as well as a centralised system that enables employers to have ample time to check on their existing or potential employees through secured access to database systems. Provision of these database systems ensures provision of comprehensive as well as consistent protection measures for vulnerable people from a number of settings. The next section relates to Mental Capacity Act 2005. The law defines mental capacity as the ability of an individual to make reasonable judgements. Loss of function regarding decision making may take a temporally or permanent form. The legislation role is to empower individuals without capacity that may enhance them to remain centred during a decision-making process. The law also aims at safeguarding these individuals as well as professionals working with the patients . It clarifies persons who have the capability of making decisions through providing a clear structured legal framework. It goes further to explain how individuals making decisions need to go about the process. These guidelines ensure that those who lack capacity are protected from abuse. Consequently, the act provides a criminal offence arising from neglect that amounts to a charge subject to anyone who mistreats or has abused or neglected a person that lacks the capacity. The next section relates to Regulations and Standards that covers care homes, domiciliary care and NHS. The 2001 home care rules and the 2002 domiciliary care agencies regulations set out the training requirements for care staffs (Collins, 2009, pg. 93). The specific instructions were to ensure care personnel developed knowledge to limit causing harm or damage to vulnerable adults. The regulations and standards aim at providing care facilities conform to the set regulations as well as adhering to all the requirements of different regulators. Currently, further developments provide a mandatory unit by care services to protect vulnerable adults from abuse. The next section refers to safeguarding with medicines through ensuring care services uphold the national service framework set for old people. The set framework requires that all individuals aged seventy-five and above need to have a review of their medicine at least once a year. The measures also require recording the report and reviewing twice for older people taking four or more drugs. Other government authorised institutions also cover some guidelines in medicine that care facilities and the NHS need to observe. The next activity relates to a dignity in care campaign. The movement is also referred to as (DH 2006) relating to a campaign throughout England and Wales that emphasizes on the quality of the residents experience of care and the manner of provision of the care staff as well as how the staff can make considerable differences. The activity ensures that upholding dignity remains mandatory and no toleration of abuse (Feldman, 2005, pg. 210). The structured development takes the form of ten points that individuals learn about what to expect from services that respect dignity. Among the ten points, each point possesses a series of tests that evaluates whether staffs meets the dignity challenge. The initial aim of the campaign focused on only older people but is currently being extended to all vulnerable adults receiving care in care facilities. The other aspect that No Secret observes refers to the Nursing and Midwifery Council that regulates the professional conduct of nurses and midwives. These health practitioners need to adhere to the professional code of conduct that guides their action while performing their duties. They possess an obligation of identifying any risks with clients and consequently act upon to protect them. LO3 Policies Underpinning Individuals Roles in Recognition and Response to Abuse When dealing with vulnerable adults, the first priority should be to ensure that they act on any suspicion or evidence of abuse or neglect by reporting the incident. There are some states and localities where forms are recorded highlighting the issues and concerns that one might have. There are however others that the regions order one to file a statement without necessarily having to fill in forms however they have to sign and swear to the recorded statement. It is important to assess the position that one occupies in the organization and the organizational procedures so that one can determine to whom one should report any cases and forward any complaints or issues (Maas, 2001, pg. 159). It is important for one to establish the set protocols that control that control the organization so as to establish the procedures and not to overrun any form of authority due to a breach of the guidelines established by the organization. It is implicit for one to seek professional and specialist opinion for particular groups of people that have suffered abuse. For instance in the case of the old people the injuries sustained need to be assessed properly since they do not heal as first as the young people (Blais and Hayes, 2011, pg. 219). The persons with mental health needs and disabilities also need proper and specialized care. It is also important to keep into consideration that the clues for someone that has been abused are not straightforward, and one should establish with certainty if a person has been abused. It is therefore important to establish the facts and determine when to raise an alert. In this regard, there are questions that one may ask the victim such as how many times have the acts of abuse occurred? How many concerns are there? To what degree of harm is the vulnerable individual at risk? One needs to establish the difference between harsh and moody behaviour on the part of the nurse due to problems that one may have. It is, therefore, essential to distinguish between the two before reporting since one may misinterpret a situation and end up reporting an individual unnecessarily. One of the ways to establish and differentiate between the two different cases is discussing the issue and articulating objectively the cause of the behaviour and the attitude of the nurse towards the patient. It resolves the problem that may arise from misjudging a situation and erroneously reporting an unintentional act. When responding to acts of violence one needs to assure the vulnerable adults that their matters will be taken seriously, and the situation will be treated fairly. It encourages reporting of the incidents by the victims. Additionally, there needs to be an assurance that the situation will be handled confidentially and, but may however be shared only if there are others at risk of the same (Reed, 2012, pg. 129). There is also a need for a guarantee of safety of risks of reprisals or intimidation from the people that the victim may have reported. There is also need for a guarantee of protection against the backdrop of reporting such as losing one’s job and that the cases will be dealt with in a fair and equitable manner. It enhances in reducing the frivolous claims that some people may have against others as an act of revenge and a reassurance for fairness and equitability reassures all. The local adult protection team is responsible for deciding on the agencies that may be involved and might be contacted and investigate the situation. The investigation that is made seeks to establish the facts and also assess the needs of the vulnerable adult for protection, support and redress. Decisions as to what actions need to be taken for the perpetrator also need to be investigated to find out if they are culpable or not. It is important to understand the different dynamics that are in a given social setting that help in the recognition and collection of information on vulnerable adults. These may include the cultural, religious and racial backgrounds in a particular locality. There are victims that may be against the assistance offered and if they have the mental capacity to make these decisions it limits the help that one can offer and derails helping others that may be affected by a similar problem. The responsibilities that one is designated are to ensure that they co-operate with the investigations, preserve evidence, maintain accurate records and attend case conferences (Davis, 2001, pg. 254). It is paramount that when collecting the information one takes into consideration addressing facts such as did I hear, witness or if told who said the information. Since the health and well-being of the patient are the most important aspect one needs to maintain continuity of care for the vulnerable person and seek medical opinion for the physical examination of the individual. There are various cases that act as the primary motivations for different nurses to abuse the vulnerable people since the nursing profession is supposed to be caring but there are some factors that trigger the inadequate care, neglect and abuse occur. One of the factors is the organisational or management inadequacy, lack of communication and role conflict or poor staff relationships. Pressure on the service and frustrations about work or working conditions, low staff morale and burnout are also contributing factors to the change in attitude (Street, 2002, pg. 67). The lack of training, support or supervision and working in isolation are also factors that lead to the changes in the nursing perspectives and emotions that eventually turn out to be violent behaviour. There are conflicts that are perpetrated as a result of a split in personality between the nurse and the vulnerable person making it a challenge for the investigators to comprehend between the person making the mistake and the one that does not due to the interference and the nature of the two conflicting parties. It is, therefore, necessary for all the nurses and volunteers to receive training on the policies and the procedures that can make it easier for them to conduct their services commensurate with their responsibilities in the protection process. Policies and guidance on health safety, risk assessment, use of equipment, use of restraint, and patient choice should be well structured and highlighted for all the members of staff to go through. Procedures for reporting incidents accidents or falls are also highly necessary to ensure that the vulnerable people and the nurses in particular are aware of the systems and the procedures that ought to be followed. Procedures dealing with money and the patient’s legal transactions are essential to the understanding the procedures and mechanisms that need to be used in the processes (Collins, 2009, pg. 79). The medicine and maladministration management is also a critical area since some of these resources may be poorly utilised and there need to be proper guidelines governing these aspects too. The standards for infection control and consent to resuscitation should be implemented in all areas. The rules for raising patient experience are also necessary since the patients need to have the best care to ensure that they feel satisfied with the care that the nurses give. The local adult protection teams have an obligation and need to be able to advice on all aspects of safeguarding vulnerable adults. The Staff also needs to have an open and empowering environment that is created through interacting and advising them accordingly. The Help lines are also open for any emergencies and reporting by the vulnerable adults that are run by the Elder Abuse and Counsel and Care providing central points through which vulnerable adults discuss concerns and receive support. There are also leaflets that are given to the vulnerable adults to give those guidelines and procedures in case of any eventualities are essential in passing information to the members of the community and other support staff that may help in those situations (Miller, 2009, pg. 394). There have however been efforts to assist the people settle their disputes informally or through an arbitrator if the case requires one. This is to reduce the number of lawsuits and formal cases that have been on the rise with the streamlining of the reporting structures and procedures. The arbitrator ensures that the parties come to an understanding and are able to deliberate on their issues without involving any form of formal process that may require the use of resources to ensure that they have successfully been solved. However, in case the informal measures do not work there is support for the people who wish to make a formal complaint who are advised accordingly on the steps to take and the different criteria used to achieve their goals. It is necessary therefore for the patients and clients who are vulnerable to be well-equipped with the clinical and assessment skills that can help to provide care for the vulnerable people. The nurses also need to be fully equipped with the information and tools that are essential to the provision of care for the members of the society that are vulnerable and understand the guidelines that should be followed in this case to ensure that they serve their patients and give them top-notch care. With the growth in the ageing population witnessed in recent years the number of old people that need the health and social services care will only grow necessitating better and more equipped facilities to tackle this problem (Maas, 2001, pg. 169). The nurses should be at the forefront in administering the care and are not expected to be involved in any form of a lawsuit against them for malpractice of any kind. However, the guidelines and procedures in case arises are clearly stipulated, and the members need to learn and internalize the information in order to follow the proper procedure if faced with the problem. The guidelines and procedures set in place can eradicate the problem of having improper procedures when there is any form of lawsuit or report against an individual thereby making the vulnerable people feel safe and secure even after reporting. References Best practices: Evidence-based nursing procedures. (2nd ed.). 2007. Philadelphia: Lippincott Williams & Wilkins. 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