Preventing Abuse and Neglect
Scope of this chapter
Although the service has robust processes in place for identifying and responding to abuse and neglect, the aim is always to do everything within our power to prevent it from happening in the first place.
There are a range of ways in which we can work proactively to prevent abuse and neglect.
This chapter explains them all:
- Empowering people being supported;
- Reducing the risk of carer breakdown;
- Promoting an open culture;
- A learning culture;
- Quality assurance and monitoring processes;
- Safe care and treatment practices;
- Good record keeping and communication;
- Staffing, supervision and training;
- Robust recruitment processes.
Regulation 12: Safe care and treatment
Regulation 13: Safeguarding service users from abuse and improper treatment
Regulation 17: Good governance
Related Chapters and Guidance
Empowerment is about arming the people we support with information and helping them to use that information to stay safe at home and in the community.
- How to recognise when they may be at risk of abuse or neglect, and who from;
- That they always have the right to say no;
- What options are available to reduce the risk of abuse or neglect;
- How to make decisions about ways to reduce the risk of abuse occurring;
- How to get help and/or report concerns or incidents of abuse or neglect.
Some people may benefit from specific information about key risks. For example, how to stay safe online or how to recognise whether someone is a friend or not. If the person has a learning disability, specialist advice can sometimes be provided by a Community Learning Disability Nurse, particularly if it relates to their physical or sexual health.
The following 3 videos provide further information and guidance about empowering people to stay safe and protect themselves.
Safeguarding adults: helping people to protect themselves from crime
Safeguarding adults: looking out for each other to prevent abuse
If the person lives in the community and is also supported in any way by a family member or friend, that person is a carer under the Care Act 2014.
It does not matter whether the carer lives with the person or visits to provide support. It also does not matter whether they provide support through every day, or only now and again.
Some carers enjoy their role and can balance it well with other areas of their life. Some carers do not enjoy the role or find it more challenging to prevent the caring role from having a negative impact on other areas of their life, or on their own physical or mental wellbeing.
When a carer is struggling, the risk of abusive or neglectful behaviour towards the person being supported increases. Abusive or neglectful behaviour can often be a sign of carer breakdown. This is the point at which the carer can no longer care effectively or with compassion.
There are steps that we as a service can take to support carers and help prevent them from breaking down, reducing the risk of abuse or neglect towards the person:
- Listening to carers and acknowledging their challenges;
- Making sure carers know they have a legal right to an assessment from the local authority (with their consent, the carer may ask you to make a referral);
- Signposting carers to voluntary Carers Services, such as Carers UK;
- Signposting carers to specialist services, if the person they support has e.g., Alzheimer's Disease;
- Signposting carers to other charities and voluntary organisations that can offer information, advice and support e.g., Age UK.
As a service, we must promote an open culture. This is the exact opposite of a closed culture.
There is a separate chapter of this Handbook dedicated to reducing the risk of a closed culture and promoting an open culture.
As a service, we must promote a culture of learning and reflection.
There is a separate chapter of this Handbook dedicated to learning from incidents.
See: Learning from Safeguarding Enquiries, Safety Incidents and Complaints
Effective quality assurance and monitoring enables issues to be identified and addressed before there is an incident of abuse, neglect or harm to anyone.
The registered person is responsible for ensuring that the service has robust quality assurance and monitoring processes in place.
Quality assurance and monitoring processes should allow for evidence gathering from a range of sources, not just a review of records and other documentation.
- Online reviews;
- Questionnaires and surveys (staff and people using the service);
- Meetings with the people being supported and families;
- Commissioner's views;
- CQC inspections;
- Critical friends/peer reviews;
- Independent advisors.
If quality assurance and monitoring activity identifies issues or opportunities for improvement, these should be managed through an open, learning approach.
Safe care and treatment practices reduce the risk of errors, organisational abuse or neglect.
The following chapters explain a range of safe care and treatment practices:
Accidents, Injuries and Incidents
Infection Prevention and Control
Supporting People with Complex Needs and Specific Conditions
Good record keeping can help to pick up patterns and identify increasing or new risks before there is an incident of abuse or neglect of other harm.
Good records can also be used to evidence any additional support needs and access specialist services to help manage risks. For example, records of someone’s reducing mobility can help prioritise an Occupational Therapy intervention.
Good record keeping also safeguards against breaches of confidentiality.
Good communication is essential as it ensures that everyone that needs to know something does so quickly and in a way that they can understand.
Good communication also ensures regard for consent and confidentiality.
There is a separate chapter of this Handbook dedicated to communication.
The registered person must ensure that the service is always properly staffed, and that the number of staff available at any one time is sufficient to meet the needs of the people being supported in a safe, person-centred way, with full regard for dignity.
Any staff level issues are anticipated, they must be brought to the attention of the local authority (or other commissioning organisation). If done in a proactive way, it may be possible for a local resolution to be found for the affected period without putting people at any risk of abuse, neglect or other harm.
For example, the local authority may be able to source support from its internal provision, arrange short term support from another care provider or arrange for a person to spend time away from the service or home e.g., respite.
Effective supervision is a way that staff share their concerns in a private environment.
They can also talk about their own development and identify any gaps in skills, knowledge or competency, enabling these to be acted upon before any abuse, neglect or other harm occurs.
There is a separate chapter of this Handbook dedicated to supervision.
Safeguarding training is mandatory, and all staff and managers should attend training as part of their induction, and then routinely to refresh knowledge and skills.
Having up-to-date skills and knowledge ensures a whole service proactive approach to recognising and reducing risks.
Where specific risks are present, specialist training may be beneficial to fully understand the risks and strategies to reduce or manage them. For example, using moving and handling equipment safely.
For further guidance on training, see:
Learning, Development and Supervision
Example of a helpful training video
This video from the Papworth Trust provides examples of good and poor practices to prevent the risk of unintentional organisational abuse and breaches of human rights and dignity.
Recruitment processes must be robust enough to ensure that anyone who is not suitable to work in social care is not recruited.
- Those who have been found culpable in previous incidents of abuse or neglect;
- Those who do not possess the level of skills necessary for the role; and
- Those who do not have the correct disposition or ability to uphold our core values and principles.
Robust recruitment processes significantly reduce the risk of abuse, neglect or other harm occurring.
Recruitment processes must include:
- A Disclosure and Barring Service check (DBS);
- References from a current and previous employer;
- Where relevant, a medical check e.g., if the potential staff member has an existing condition that may affect their ability to work safely.
Within the realms of employment law, recruitment processes should also consider the needs of the people who are going to be supported, making sure that there is not likely to be a culture clash or any other issue to make the appointment unviable. One way to achieve this can be to involve people being supported in the selection process.
Skills for Care provide extensive guidance around recruitment for registered persons:
Last Updated: September 12, 2022