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HSC CM3: Safeguarding in health and social care

Level: Level 3 Diploma
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1.1 Explain what is meant by ‘safeguarding’.

Safeguarding is the process of protecting people from harm. It involves ensuring that people are safe from abuse, exploitation, violence and other forms of harm. Safeguarding also includes protecting people from being exposed to risks that could cause them harm.

There are many different types of abuse and exploitation which can happen to anyone at any time. Abuse can occur in any relationship, including between family members, friends, partners, carers, professionals and strangers. It is important to remember that anyone can be a perpetrator of abuse, regardless of gender, age, race, religion or social status. There are a number of ways in which you can safeguard yourself and others from harm, including:

  • Identifying the signs and symptoms of abuse and exploitation
  • Knowing whom to contact for help and support
  • Reporting concerns to the appropriate authorities
  • Seeking professional help if you are experiencing or have experienced abuse or exploitation.

Safeguarding is everyone’s responsibility. If you are worried about someone’s safety, it is important to speak up and get help.

1.2. Explain how safeguarding:

Keeps individuals safe

Safeguarding is a term used in the United Kingdom and Ireland to denote measures to protect the health, well-being and human rights of individuals, especially children and vulnerable adults, from harm or abuse. Safeguarding includes a wide range of activities such as legislation, policies and procedures, training, inter-agency working, reporting and recording incidents, and investigating concerns.

Safeguarding is about protecting people from harm by creating a safe environment in which people can live and work and ensuring that they are treated with respect, and ensuring that people have access to the support and protection they need when they need it. Safeguarding creates a culture of safety where people feel able to speak up and report concerns, knowing that they will be listened to and taken seriously.

The safeguarding of children and vulnerable adults is of paramount importance. We all have a role to play in keeping children and vulnerable adults safe from harm.

Value individual needs

Safeguarding values individual needs by ensuring that their physical and emotional needs are met and that they are able to live safely and without fear and by promoting privacy and respect. Informed consent should be obtained before starting any safeguarding process. Individuals should be kept safe from violence and other infectious diseases.

Valuing individual needs means recognising that everyone is unique and has different needs. It is important to treat people as individuals and to tailor support to meet their specific needs. This includes making sure that they have a voice and are involved in decisions about their own lives.

Protects individuals

Safeguarding entails taking action to prevent harm or reduce the risk of harm occurring. It is about people and relationships and ensuring that everyone is able to live a life free from harm.

Safeguarding measures can include things like background checks, risk assessments and safety plans. They can also include training and education so that people are aware of the signs of abuse and know what to do if they are worried about someone. It is important to remember that Safeguarding is not just about protecting children and vulnerable adults from harm but also about protecting colleagues and everyone else from harm. We all have a role to play in safeguarding, and we all have a responsibility to keep ourselves and others safe from harm.

It aims to prevent harm in the first place, and it does this by raising awareness of the risks of harm and by promoting safe and healthy relationships.

1.3 Explain how Health and social care practitioners can take steps to safeguard themselves.

Safeguarding oneself as a health and social care practitioner requires vigilance and attentiveness at all times when working with patients. There are several potential hazards when working in close proximity to others, including the risk of contracting communicable diseases, being injured by a patient, or coming into contact with hazardous materials. In order to safeguard oneself, it is important to follow proper safety protocols at all times and to be aware of one’s surroundings.

When working with patients, always maintain good hygiene practices by washing your hands frequently and using personal protective equipment (PPE) when necessary. It is also important to clean and disinfect all surfaces that come into contact with patients. If you are working with hazardous materials, be sure to follow all safety protocols and wear the appropriate PPE. If you are working with patients who are known to be violent or have a history of aggression, take extra precautions to safeguard yourself and others around you.

In general, it is important to be aware of your surroundings and the people you are working with at all times. If you feel unsafe or uncomfortable for any reason, trust your instincts and take steps to remove yourself from the situation. Some specific steps that health and social care practitioners can take to safeguard themselves include:

  • Being aware of your surroundings at all times and being alert to any potential dangers
  • Avoiding isolated areas or situations where you could be vulnerable
  • Asking a colleague to accompany you when making home visits, if possible
  • Agreeing on a code word or signal with colleagues that you can use if you feel unsafe during a visit
  • Carrying a personal alarm with you at all times

2.1. Summarise current legislation in relation to safeguarding.

The Care Act 2014

The Care Act 2014 is the primary piece of legislation in England that consolidated and updated safeguarding laws. The intention of the Act was to provide a comprehensive framework to protect vulnerable adults from abuse or neglect, and it established a number of important new roles and responsibilities with regard to safeguarding.

Under the Act, local authorities have a duty to promote well-being and prevent abuse or neglect of vulnerable adults. Local authority social care services must take reasonable steps to ensure that they do not put any individual at risk of harm, including by providing support that meets their needs in a way that safeguards their rights and promotes their well-being.

If there are concerns that an adult has been abused or neglected, local authorities must carry out an assessment under section 42 of the Care Act 2014. This will help them determine whether there are grounds for believing that an adult is experiencing, or at risk of, abuse or neglect; whether they need any protective measures; what action should be taken by whom; and how long those measures should remain in place. If it is deemed necessary, local authorities can also impose conditions on providers of social care services – such as requiring them to make improvements to how they operate – under section 43 of the Care Act 2014.

The Protection of Children Act 1999

The Protection of Children Act 1999 sets out the legal framework for safeguarding and promoting the welfare of children in England. The act provides a number of mechanisms for protecting children from harm, including criminal background checks on individuals who work with children and powers for local authorities to intervene in cases where they believe a child is at risk of harm.

The act also established the post of Director General for Children’s Services within the Department for Education, which is responsible for overseeing all aspects of safeguarding policy and practice. The act was amended by the Safeguarding Vulnerable Groups Act 2006 to introduce a new system of vetting and barring for individuals who work with children.

The Data Protection Act 1998

The Data Protection Act 1998 (DPA) is a United Kingdom Act of Parliament which defines UK law on the processing of data on identifiable living people.

It was passed in 1998, replaces the Data Protection Act 1984 and implements parts of European Directive 95/46/EC. The DPA covers any information that could identify an individual, including but not limited to their name, address, date of birth or personal medical history.

Under the act, individuals have certain rights with regard to their personal data, including the right to know what data is being held about them and for what purpose, as well as the right to have inaccurate data corrected or destroyed.

Safeguarding Vulnerable Groups Act 2006

The Safeguarding Vulnerable Groups Act 2006 (the Act) came into force on 27 November 2007. The main purposes of the Act are to establish a new system for vetting and barring people who work with children or vulnerable adults and to make amendments to other safeguarding legislation.

The act established two new lists – the barred list and the vetted list. People on these lists are not allowed to work with children or vulnerable adults in regulated activity. The act also created a number of offences related to working with children or vulnerable adults without being registered, as well as making it an offence to knowingly employ someone who is not registered.

In order to be placed on either of the lists, an individual must first undergo a Disclosure and Barring Service (DBS) check. Once an individual has been placed on either of the lists, they can appeal their inclusion if they believe that there are grounds for doing so. The Act has been replaced by the Safeguarding Vulnerable Groups Act 2006 (the 2006 Act).

The Mental Capacity Act 2005

The Mental Capacity Act 2005 sets out a framework to protect and empower individuals who may lack the capacity to make certain decisions for themselves. It provides a way of working out whether an individual has the mental capacity to make specific decisions at a particular time. If they don’t have the mental capacity to make those decisions, the Act provides guidance on what should happen next. The Act also covers situations where people might need support in making some type of a decision, even though they have mental capacity.

2.2 Describe the relationship between legislation, policy and procedure.

There are three main types of legislation in the UK: primary, secondary and tertiary. Primary legislation is made by Parliament and includes Acts of Parliament (also known as Statutes), Orders in the Council and statutory instruments. Secondary legislation is made by Ministers under powers delegated to them by primary legislation and includes things like regulations, orders and rules. Tertiary or subordinate legislation consists of bye-laws, codes of practice and other similar measures that apply in specific circumstances or geographic areas.

Policy refers to the overall aims and principles that guide decision-making within an organisation. The procedure sets out how those policies should be carried out in practice. In theory, then, policies provide a framework for making decisions while procedure prescribes how those decisions should be implemented.

The relationship between legislation, policy and procedure can be summarised as follows: Legislation provides the broad framework within which organisations must operate; policy defines the organisation’s goals; procedure sets out how those goals will be achieved.

In practice, however, the distinction between these three concepts is not always clear-cut. For example, many Acts of Parliament delegate powers to Ministers to make secondary legislation that will set out the detailed procedures for implementing the policy enshrined in the primary legislation. Similarly, an organisation’s policies may be informed by or even directly derived from relevant legislation. In such cases, it can be difficult to disentangle the relationship between legislative requirements, organisational policy and operational procedure.

2.3. Identify policy and procedures in relation to safeguarding.

The safeguarding policies and procedures are designed to protect vulnerable individuals from harm. These policies and procedures should be followed by all staff, volunteers, and other professionals who work with or come into contact with children, young people, and adults at risk.

Safeguarding policy: All organisations that work with or come into contact with children, young people, or adults at risk should have a safeguarding policy in place. This policy should set out the organisation’s commitment to safeguard its clients and explain what actions will be taken if there are concerns about a client’s welfare. The policy should also make clear that any suspicions or allegations of abuse will be taken seriously and responded to promptly in line with the organisational procedure.

Procedures: Organisations should have clear procedures in place for dealing with safeguarding concerns or allegations of abuse. These procedures should include reporting mechanisms for staff members who have concerns about a client’s welfare, as well as guidance on how to respond if an allegation of abuse is made against someone working within the organisation. All staff members should be aware of these procedures so that they know what action to take if they have any concerns.

Organisations should also have procedures in place for dealing with clients who may pose a risk to others. These procedures should include assessments of the risks posed by individual clients, as well as measures that can be taken to mitigate these risks. Staff members should be trained on how to identify and deal with potential risk factors so that they can take appropriate action if necessary.

Furthermore, organisations should have procedures in place for supporting clients who have been subjected to abuse. These procedures should include information on how to provide emotional and practical support to clients, as well as guidance on when and how to refer them to specialist services if necessary. Staff members should be aware of these procedures so that they can provide appropriate support to any clients who disclose abuse.

It is important that all staff members receive regular training on safeguarding issues. This training should cover topics such as identifying signs of abuse, dealing with disclosures of abuse, and the organisation’s safeguarding policies and procedures. By ensuring that all staff members are up-to-date with best practices in safeguarding, organisations can help to create a culture where protecting vulnerable individuals from harm is a priority.

Lastly, it is important to note that safeguarding is an ongoing process and not something that can be achieved once and then forgotten about. Organisations should regularly review their policies and procedures to ensure that they are fit for purpose and up-to-date with best practices. They should also create an environment where staff feel able to raise concerns about safeguarding issues without fear of reprisal so that any potential problems can be identified and dealt with swiftly.

3.1 Explain factors that may contribute to an individual being vulnerable to harm or abuse

There are a number of factors that may contribute to an individual being vulnerable to harm or abuse. These include individual and environmental factors: age; physical disability, mental health issues; substance misuse; social isolation; and financial hardship. Individuals who are vulnerable may be less able or less likely to protect themselves from harm, and as such, they may be more susceptible to abuse.

Age

Age is often a significant factor in vulnerability to harm or abuse. The elderly are generally more vulnerable than the general population due to frailty, illness and cognitive decline. This can make them less able to protect themselves from harm and more reliant on others for care and support. Young children are also particularly vulnerable as they are small, powerless and lack the ability to understand or communicate what is happening to them. They may also be isolated from family or friends who could provide protection.

Physical disabilities

Individuals with physical disabilities are often seen as easy targets for harm or abuse. This is because they may be unable to defend themselves properly or may not be able to communicate effectively if something is happening to them. Additionally, individuals with physical disabilities may be more reliant on others for help and support, which can make it difficult for them to report abuse if it does occur. Finally, societal attitudes towards people with physical disabilities can also contribute to their vulnerability; negative attitudes can make it harder for people with disabilities to get help when they need it and can also increase the likelihood that they will be targeted in the first place.

Mental health issues

Individuals who suffer from mental health issues are often considered to be vulnerable to harm or abuse. This is because mental health problems can make it difficult for individuals to take care of themselves, communicate effectively, and make decisions in their best interests. As a result, people with mental health issues may be more likely to fall victim to exploitation or violence. Additionally, mental illness can also make it difficult for individuals to seek help when they are being abused or exploited.

Substance misuse

Substance misuse can lead to a person becoming more vulnerable to harm or abuse as it can impair their judgement and make them more likely to take risks. They may also be more likely to socialise with people who are harmful or abusive and less able to defend themselves if they are attacked. Substance misuse can also make it difficult for someone to keep a roof over their head or maintain healthy relationships, making them more isolated and, therefore, at greater risk of harm.

Social isolation

Social isolation is one of the main factors that can contribute to an individual being vulnerable to harm or abuse. When a person is isolated, they are cut off from their support system and may become more trusting of strangers. Additionally, they may be less likely to report abuse if it does occur. Isolation can also lead to feelings of loneliness and despair, which can make a person more susceptible to exploitation. Individuals who are isolated may be less likely to have access to information about how to protect themselves from abuse. Social isolation can make it more difficult for people to seek help if they are being abused.

4.1 Describe signs, symptoms, indicators and behaviours that may cause concern relating to:

Neglect

There are many signs, symptoms, indicators and behaviours that may cause concern relating to neglect. Some of these include:

  • Persistent hunger or malnutrition
  • Untreated medical needs or illnesses
  • Lack of proper clothing for the weather/dirty clothes
  • Lack of personal hygiene/poor hygiene habits
  • Excessive tiredness or fatigue
  • Listlessness or apathy
  • Withdrawal from others or social isolation

Self-neglect

There are many signs, symptoms, indicators and behaviours that may cause concern relating to self-neglect. Some of these include:

  • Unkempt appearance – neglecting personal hygiene or not caring about one’s appearance
  • Living in squalid or unsafe conditions – hoarding, filthy living quarters, unsanitary conditions
  • Isolation and social withdrawal – withdrawing from family, friends and community; avoiding contact with others; appearing lonely or depressed.
  • Neglecting basic needs – not eating correctly or nourishing oneself, not taking medications as prescribed, failing to pay bills or take care of property resulting in utility shut-offs or eviction notices.
  • Unattended physical injuries or bruises
  • A home that is cluttered, dirty or in disrepair
  • Bills or important documents that have not been taken care of
  • Pets that are neglected or appear to be starving

Institutional abuse

Signs and symptoms when an individual is undergoing institutional abuse can include:

  • Withdrawal or regression
  • Unexplained changes in behaviour or mood
  • Sudden onset of anxiety or depression
  • Self-harming behaviours
  • Displays of fear or distress around certain individuals or in certain situations
  • Reluctance to be left alone with certain staff members or in particular areas of the institution
  • Repeated unexplained injuries or bruising
  • Sexually inappropriate behaviour
  • Fear of certain places or people
  • Sudden weight loss or gain
  • Rocking, self-soothing behaviours

Financial abuse

Some signs that a person may be experiencing financial abuse include:

  • Unusual or unexplained changes in their finances or banking activity
  • The sudden acquisition of new debts or maxing out of credit cards
  • Having no access to cash, credit cards or bank accounts
  • Being given an allowance and having to account for every penny spent

Other symptoms and behaviours which may be indicative of financial abuse include:

  • A rapid change in spending patterns
  • Increased secrecy around money matters
  • Appearing anxious or stressed about money
  • Suddenly not being able to pay bills or meet financial commitments.

If you are concerned that someone you know is experiencing financial abuse, it is important to talk to them about it. Try to create a safe environment where they feel comfortable talking openly about what is going on and look for support from organisations that can help.

Sexual abuse

Indications for sexual abuse include:

  • Bruises or bleeding in the genital area
  • Pain or discomfort when urinating or defecating
  • Sexually transmitted infections
  • Unexplained pregnancy
  • Changes in behaviour, such as becoming withdrawn, aggressive or disruptive
  • Changes in sleeping patterns, such as difficulty sleeping or nightmares
  • Self-harming behaviours

The child may exhibit behavioural indicators such as:

  • Sexually explicit behaviour or language
  • Seductive behaviour towards adults
  • Withdrawing from friends or activities they used to enjoy
  • Sudden changes in mood, such as depression, anxiety or irritability

5.1 Explain the boundaries of confidentiality in relation to the safeguarding, protection and welfare of individuals

Confidentiality is a complex issue, and there are no definitive answers. In general, confidentiality should be respected unless there are overriding safeguarding concerns. This means that information about an individual should not be shared without their consent unless there is a good reason to do so.

There are some circumstances where confidentiality may need to be breached in order to protect an individual from harm. For example, if someone tells you they are planning to hurt themselves or someone else, this information cannot be kept confidential and must be shared with the relevant authorities in order to protect the individual concerned.

Similarly, if you believe that a child is being abused or neglected, then you have a duty of care to report this to the relevant authorities, even if the child has not given their permission for this information to be shared. In these cases, it is more important to safeguard the welfare of the individual than respect their right to confidentiality.

However, there are many other situations where the line between confidentiality and safeguarding is less clear. For example, if an adult tells you about their history of abuse, this information should usually be kept confidential unless they specifically ask for it to be shared with someone who can help them stay safe.

It is always best to err on the side of caution when deciding whether or not to share information. If you are unsure whether or not to share something, it is always best to seek advice from a supervisor or another professional who has experience in safeguarding and child protection.

6.1. Evaluate the role and responsibilities of the health and social care practitioner in relation to safeguarding individuals.

Individuals must be protected from abuse, neglect, and exploitation by health and social care practitioners. They should promote and preserve the individual’s welfare and well-being.

Healthcare personnel should be aware of the signs and symptoms of abuse, neglect, and exploitation, as well as how to respond if they feel someone is in danger. They should also be familiar with appropriate safeguarding legislation, policies, and procedures.

To ensure that persons are protected from harm, the practitioner should collaborate with other organisations involved in safeguarding, such as social services or the police. They should also notify the proper authorities if they have any concerns about an individual’s well-being.

In terms of safeguarding, the practitioner must respect confidentiality and should only communicate information with those who need to know in order to protect the individual. They should be willing to participate in frequent safeguarding training and development in order to stay current on best practices. The health and social care practitioner should:

  • Promote the individual’s right to safety, dignity and respect;
  • Empower the individual to make choices and decisions about their life;
  • Advocate on behalf of the individual where necessary;
  • Provide support and guidance to other professionals involved in safeguarding.

References:

Turner, Sarah. “Safeguarding Children Training in Adult Mental Health Care.” Mental Health Practice, vol. 12, no. 9, RCN Publishing Ltd., June 2009, pp. 28–32. Crossref, https://doi.org/10.7748/mhp2009.06.12.9.28.c7093.

“Safeguarding Adults – Signs and Symptoms of Abuse.” Safeguarding Adults – Signs and Symptoms of Abuse, www.tameside.gov.uk/AdultServices/Safeguarding-Adults-Signs-and-Symptoms-of-Abuse.

“NSPCC Learning Homepage – Safeguarding Training and Resources.” NSPCC Learning, learning.nspcc.org.uk.

Davies, Liz. “Safeguarding Children in Primary Health Care.” Health & Social Care in the Community, vol. 18, no. 3, Wiley, Apr. 2010, pp. 330–31. Crossref, https://doi.org/10.1111/j.1365-2524.2010.00915_6.x.

“What Should a Safeguarding Policy Include? | iHASCO.” What Should a Safeguarding Policy Include? | iHASCO, 16 Feb. 2021, www.ihasco.co.uk/blog/entry/1626/what-should-safeguarding-policy-include.

“Writing Safeguarding Policies and Procedures | NSPCC Learning.” NSPCC Learning, 28 Feb. 2022, learning.nspcc.org.uk/safeguarding-child-protection/writing-a-safeguarding-policy-statement

Owen, Jennifer, et al. “Adult Safeguarding Managers’ Understandings of Self‐neglect and Hoarding.” Health & Social Care in the Community, Wiley, May 2022. Crossref, https://doi.org/10.1111/hsc.13841.

“Safeguarding Adults: Sharing Information | SCIE.” Social Care Institute for Excellence (SCIE), 1 Jan. 2019, www.scie.org.uk/safeguarding/adults/practice/sharing-information#:~:text=Confidentiality

“Writing Safeguarding Policies and Procedures | NSPCC Learning.” NSPCC Learning, 28 Feb. 2022, learning.nspcc.org.uk/safeguarding-child-protection/writing-a-safeguarding-policy-statement.

Collier, Ellie. “Caldicott Principles | 7 Principles of Health Care.” The Hub | High Speed Training, 19 Apr. 2019, www.highspeedtraining.co.uk/hub/7-caldicott-principles.

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