Confidently and disclosure

June 12, 2019 Nursing

This presentation is on working practice and strategies to minimise harm and abuse in health and social care
It’s all about the service users can reduce the harm and abuse.
Meaning of working practice and strategies are the policies and procedures to protect services from hurms and abuses
Working practices:
written and oral communication, use of ICT in sharing information between professionals, anti-oppressive practice, anti-discriminatory practice, thresholds, risk factors, risk predictions, framework of assessment, identifying children in need
working in partnership with users of health and social care services, between professionals and within organisations, decision-making processes and forums, safeguarding children boards, the ‘at risk’ register, area child protection committee, organisational policies and training
“Confidentiality policy”
“Whistle Blowing Policy”
“Physical Intervention Policy”
“Complaint Procedure in Care Home”
Confidently and disclosure
In this assignment i will be describing different strategies and working practices used in different health and social care settings to minimise abuse.

Looking at different characteristics of abuse is the fundamental part in trying to minimise abuse. There are different types of strategies i will be describing the following six: Written and Oral Communications
Anti-Discriminatory Practices
Use of IT
Needs Assessment
social workers will work to improve and safeguard the social wellbeing of
individuals, families and communities by promoting their independence,
supporting their social inclusion and participation in society, empowering
them to take control of their lives and helping them to keep safe.

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Personal Centred practices
Care planning Cycle
Needs assessment:
The needs assessment relates to an individual’s care and personal needs, the assessment centres on the activity for daily living and the care …show more content…
It involves in monitoring care and reviews from the service user in confidence to reduce the potential of harm. To enable that the care given to the individual in the right way the care worker should monitor the care given and keep other members of staff informed about any changes which will help minimise abuse in the care setting.
This is an example of the care planning cycle >>>>>
The care plan cycle is started off with the plan, the care worker then identifies the aims and goals. After a needs assessment is complete whilst they review it, they would also monitor the service user regarding if their aims and goals are met, the cycle is broken the care worker has to take a look at what went wrong and when it went wrong. Written and oral communication:
Communication between professions and service users help minimise abuse, as written and oral communications reduce abuse it helps improve the bond between the service user and the care worker. Reports made should be kept and information from service users should be dealt with in confidence, because if the information of the service user is under covered it could mean that they will be facing abuse. For example; if the service user is receiving abuse from a person but they are hearing impaired and can only communicate using sign language, then it will be best if the care worker knew how to talk in sign language as the service user may only feel…
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Key Principles for Social Work Practice
Social work practice and services should be based on professional principles and

These include:
? respect of the inherent worth and dignity of all individuals and the promotion
of their right to autonomy and self-determination;
? the right of vulnerable and marginalized individuals and groups to be assisted
and supported in overcoming barriers to inclusion in society;
? respect and protection of an individual’s rights while at the same time having
due regard to the rights and safety of others;
? the right of children and vulnerable adults to be protected from neglect, abuse
or exploitation;
? transparency and fairness in professional decision-making and in the
application of organization’s eligibility criteria for access to services; and
? respect for diversity and the promotion of social justice.

The practice continuum reflects the current emphasis on early intervention and
prevention both as a means of improving the quality of life and outcomes for people
but also in terms of reducing the need for more expensive targeted or specialist
services in the immediate or longer term.

Presenting social work in this way has its limitations and is not intended to suggest
that any stage or role along the continuum is mutually exclusive of the others. All
social workers, irrespective of their job or work context, will adopt elements of each
role in their day to day practice, reflecting their professional commitment to
empowering and promoting the self-determination and rights of those they work with
alongside their professional responsibility to safeguard and protect the most
vulnerable in our society.

Overarching statements of purpose are identified to indicate the primary focus and
desired outcome of social work practice against each specific role.

The importance of individualised person-centred care
Person-centred care means working together with the individual to plan their care and
support to meet their unique needs. This cuts down the risk of negative, unfair or harmful
treatment and neglect. The individual is put at the centre, able to choose and control how
they want their care and support to be.

Active participation describes a way of working that makes sure an individual can take
part in the activities and relationships of everyday life as independently as possible.

They are an active partner in their own care and support. Ensuring someone has the
right equipment that they need to get around or to eat and drink without help are good
examples of resources that support active participation.

Person-centred care should help the individual to make their own choices, assess and
take risks. It is important they understand the consequences of the decisions they could
make. For example, if a friend brings an individual food on a hot day that has been out
of the fridge for a while it is their right to weigh up whether it is likely to make them ill
and to decide whether to eat it. In this way those who receive care and support can
contribute to their own safeguarding.

In Adult Social Care alongside the Care Act 2014 is the ‘Making Safeguarding Personal’
initiative led by the Directors of Adult Social Services and the Local Government
Association. It introduced the phrase ‘no decision about me, without me’ and asserts
that safeguarding should be person-led and outcome-focused. It engages the person in
a conversation about how best to respond to their safeguarding situation in a way that
enhances involvement, choice and control as well as improving quality of life, wellbeing
and safety. Following the six principles above will help this to become a reality.

Multi-agency working
The main objective of a safeguarding adults board (SAB) is to assure itself that through
local safeguarding arrangements partners act to help and protect adults in its area who
meet the criteria set out in the Care Act 2014. These boards promote information sharing
between workers and organisations to make sure that the care meets all of the needs
of the individual. If a worker has concerns they must share these with other workers to
build up a full picture of the individual’s situation. You should find out from your your manager
what your local arrangements are and how they link to your workplace’s agreed ways of
working.Managers make decisions by following what is agreed locally and by their workplace
as the threshold, or the point at which something becomes a safeguarding issue. For
example, a one-off situation where a team is short of a worker on shift, despite efforts
to find a replacement, may not be seen as a safeguarding issue in that particular
workplace. In another situation where individuals have complex and multiple needs, or
in the community, this might be a seen as a risk to people’s health and wellbeing and a
safeguarding concern.

Managing risk
Risk enablement plays a natural part in self-directed care and support. It empowers the
individual to take control over their care, doing what they can to prevent themselves from
being harmed or injured and agreeing the care and support that they need. For example,
if an individual wants to go to the bathroom on their own but has mobility problems and is
also feeling weak due to being unwell, risk enablement would be used to ensure they have
the mobility equipment they need, and that they have a way of calling for help if they get
into difficulty. Being in control increases their self-confidence. As confidence grows they
are more likely to be open about reporting anything they are unhappy about. As a result
the risk of abuse and neglect happening is reduced.

Risk enablement
Involves supporting individuals to identify and assess their own risks, enabling them
to take the risks they choose. It is a key part of person-centred care and emphasisesthat the individual is the expert on their care.

An organisation that is active and positive about safeguarding adults will:
Be open and clear about how they look out for each individual’s wellbeing
Be open and clear about how they put into practice the CQC Fundamental
Standards and Code of Conduct for Healthcare Support Workers and Adult Social
Care Workers in England
Show how workers should look out for abuse and neglect by publicising signs and
indicators on posters or leaflets
Be responsible for providing learning and development for workers on
safeguarding adults
Treat all allegations of abuse or neglect seriously
Promote the values of person-centred care.

Managers make decisions by following what is agreed locally and by their workplace
as the threshold, or the point at which something becomes a safeguarding issue. For
example, a one-off situation where a team is short of a worker on shift, despite efforts
to find a replacement, may not be seen as a safeguarding issue in that particular
workplace. In another situation where individuals have complex and multiple needs, or
Adult abuse – What is it?
Abuse is mistreatment by any other person or persons that violates a person’s human and civil rights. The abuse can vary, from treating someone with disrespect in a way that significantly affects the person’s quality of life, to causing actual physical or mental suffering.

An abuser could be anyone, it can be someone you know or someone you work with. It could be the people who care for the person or even their family and friends. It could be a stranger or a
paid care. Sometimes harm occurs even when abuse has not happened on purpose. It could happen because of poor training or because the person does not know how to care for someone.

Abuse is often a crime, for example theft or assault. This could take place in the street, someone’s own home, a residential or nursing home. A day center or hospital – it can take place at any time, day or night.

Abuse can happen anywhere:
in a person’s own home
in a residential or nursing home
in a hospital
in the workplace
at a day centre or educational establishment
in supported housing
in the street
The person responsible for the abuse is often well known to the person being abused, and could be:
a paid carer in a residential establishment or from a home care service
a social care worker, health worker, nurse, doctor or therapist
a relative, friend, or neighbouranother resident or person using a service in a shared care setting
someone providing a support service
a person employed directly by someone in their own home as a carer or a personal assistant
Others are strangers who:
befriend vulnerable people with the intention of exploiting them
deceive people into believing they are from legitimate businesses, services or utility providers
intimidate vulnerable people into financial transactions they do not want or cannot understand
Types of abuse
Types of abuse can include:
Physical – for example, hitting, slapping, burning, pushing, restraining or giving too much medication or the wrong medication.

Psychological – for example, shouting, swearing, frightening, blaming, ignoring or humiliating.

Financial – for example the illegal or unauthorised use of a person’s property, money, pension book or other valuables.

Sexual – for example, forcing a person to take part in sexual activity without consent.

Neglect or acts of omission – for example, where a person is deprived of food, heat, clothing, comfort or medication.

Discrimination, including slurs or similar treatment on the ground of a person race, gender and gender identity, age disability, sexual orientation or religion.

Domestic abuse is when someone you are in a close relationship with behaves in a way that causes you physical, mental or emotional damage and through coercive and controlling behaviour.

Modern slavery includes human trafficking, forced labour and domestic slavery.

Organisational abuse includes neglect and poor practice within an institution, care setting or care provided in your own home.

Self-Neglect – an adult at risk may also neglect themselves.

Any of these forms of abuse can be deliberate, or be the result of either ignorance, or lack of training, knowledge or understanding. Often if a person is being abused in one way they are also being abused in other ways.

An adult at risk means a person who is at risk of abuse or neglect. This is usually an adult who has care and support needs, and who is unable to protect themselves from abuse or neglect because of their care and support needs. It doesn’t matter whether they receive help for these needs or not.

Sometimes harm occurs even when abuse has not happened on purpose. It could happen because of poor training or because the person does not know how to care for someone.

Mr. Manu vulnerable to harm self or others and abuse
Due to schizophrenia, he has lost the patterns of social norms that lead to self-neglect. The main characteristic of schizophrenia is slow deterioration of functions, his condition worsens over the period of time (McDonald et al., 2004).
It expands on the function within the society as people with the symptoms of schizophrenia are tend to be isolated. It roots in the fouls of wrongly expressed feelings for instance, they share a sad story but they are laughing in the same time (McDonald et al., 2004).
Social isolation leads to depression, which is worsen if one doesn’t have somebody to share his feelings (McDonald et al., 2004).
Schizophrenia also increases the chance for hallucinations and delusion. For instance, the individual believes in certain things that is not based on reality or hears voices that can instruct what he has to do. The person is not able to distinguish between reality and believed or heard things, therefore the perception of reality is subjective and the person becomes vulnerable to harm self or others or even being abused by others without recognise it (McDonald et al., 2004).
Due to hallucination he can feel frightened and harm herself or others in surrounding. Mr. Manu is unable to understand the incoming information at the same pace as people who don’t suffer from schizophrenia. It can cause serious problem in daily routines such as taking the medication in the right time and in the right moment, as her memory is not functioning in the adequate level.
These factors contribute in her vulnerability, as he is not able to recognise if the intention of others are inappropriate and want to abuse his either financially, physically or emotionally.

Individuals who particularly suffer from depression tend to seek love and attention to satisfy the need of love, but in most cases, due to their vulnerability, they are seeking from the wrong person (McDonald et al., 2004).
According to Abraham Maslow`s pyramid of needs, human have different types of needs with different priorities. Physiological needs are taking the most important place in one`s life. If shelter, food and drink are not provided adequately, the rest of the needs are not satisfied such as safety, belonging, self-esteem and self-actualization. In the case of Susanne, the physiological needs are not satisfied, therefore she is not stable regards the rest of them (Maslow, 1970).

The physical risk factors are varying. For instance, due to the condition of schizophrenia, self-neglect is already noticed by the mental health nurses, family members and neighbors. Due to self-neglect, the environment where she lives is unsuitable for a healthy lifestyle. Infection is a big risk as vermin are occupying in the property already, the house is unclean and full of rubbish.
Apart from the housing condition, during cold weather she can catch cold or being sick easily or even there is a significant risk of freezing.
On the other hand, as she lives alone, nobody is there to help her if she might harm herself due to schizophrenia. However, even if is still there somebody, she might harm the person who tries to help her as she is not aware at that time of her behaviour.
There is also a significant risk of proliferate of vermin to the surrounding area.
Due to her malnutrited physical condition, her immune system is weaker then someone who is well nurtured, therefore she is more prone to be sick.
She lives isolated from society and according to Maslow`s pyramid of needs, her basic physiological needs are not satisfied, therefore she is not able to build self-esteem or feel beloved. This factor can lead to chronic depression, more alcohol consumption and the risk of suicide as she can`t see the solution to solve her problems alone and she is unable to share her feeling with anybody. This also can lead to abuse by others who are aware of her mental condition and the need of being loved, these individuals can include her family members, mental nurses, neighbours or anybody who know her.

There is a significant risk of taking the medication in the wrong time or wrong amount due to memory impairment. Memory impairment can lead to domestic accidents, such as a forgotten gas or electricity.
Cultural and social factors that impact on harm, self-harm and abuse:
Every individual coming with their own background, the culture they are brought up in, therefore everyone carries different social norms as a base of behaviour. These factors of personality form the way how one is thinking, acting and reacting about certain things. Cultural and social factors therefore contribute in making one vulnerable and others abuse people as everybody has different view of how to behave. For example, a man or woman from a Muslim country might behave withdrawn in the society as they see this as normal due to their culture in contrast with a lady from other religion that don’t have restriction on how to dress (James, 1950).
However, the cause of every abuse is different and complex. The culture plays a significant role in every family`s life and indirectly forms the way how kids will be brought up. Due to the culture, in every family there is a particular role is being appareled on family members. For example, who is the head of the family, who needs to earn the money or what type of responsibility women have. Coping with stress within the family is also a key factor in one`s life for example, if they cope co-operatively or only one person is responsible always for everything (James, 1950).
However, these cultural and social factors mentioned above clarify the importance of different backgrounds and help to understand that every individual no matter with what kind of background should be respected. Once careers are able to understand the essence of how culture and social factors impact on one`s behaviour, will be able to understand how people might become vulnerable to harm or abuse and will use this knowledge for successful safeguarding.
In Mr. Manu`s case the background is not clarified adequately, therefore the culture is unknown where she has been brought up in. However, social factors include health and the level of health care. According to Susanne`s mental disorder, her health state is not suitable to live her life alone. However, the health care system is able to support her wills that she does not want to go into a day care home, she rather stays in her own property even though it is not suitable to live a healthy lifestyle. In England it is essential to put the person in the center of his care, even if it involves some risk factors.
However, the network of support is varying in Mr. Manu`s case, as not only his family but also mental health nurses visit him occasionally. However, these occasional meetings are not enough for him to build self-esteem or make a big step to change his life towards a healthy lifestyle. Even though his mental disorder includes the chance that being self-neglected, but regular visits from his family and social workers would give him the initial courage to start to think about to giving up the alcohol addiction.


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