Pointers for Practice: Professional concerns

There are a number of barriers to recognising professional abuse or neglect.

In a thematic assessment completed by NCA's Child Exploitation and Online Protection (CEOP) Command the following were identified. Whilst they focused on children their findings are relevant to practitioners working with adults at risk:

adults at risk in institutional settings are not only at risk from abusers but from adults who fail to notice abuse or, if they do notice it, fail to report it
management structures may discourage junior practitioners from reporting suspicions
organisational structures may allow offenders to gain the trust of their victims and those who should be protecting them
for some staff protecting the organisation's reputation may take precedence over reporting abuse.
Practitioners under a "false perception" that institutional abuse no longer happens, because of the historic nature of cases and recent developments in safeguarding.

A study completed by Welsh researchers Featherstone and Northcott¹ of patients with dementia found that behaviour that is well-intentioned can be abusive. They cite examples from their study of nurses and healthcare assistants raising bedrails on beds, tucking patients in very tightly so they cannot move; preventing others from getting up out of bed by removing walking frames and in some case sedating patients. The rationale behind these actions was a fear of dementia patients falling if they were allowed to move around freely. In these situations, the patients were being both physically and psychologically abused as they were experiencing a loss of liberty, rights and freedom of movement.

Other examples of possible risk of harm by staff include:

Insulting, shouting, belittling
Failing to ensure an individual in their care receives the necessary help to drink, eat, get to the toilet
Lack of attention paid to changing incontinence pads, or attention given to management of pressure sore plans
Inappropriate use of medication that does not meet the person’s needs
Moving and handling that is likely to injure or harm
Exploitation related to benefits, income property etc.

¹http://www.storiesofdementia.com/2018/04/research-report.html