The Social Care Institute for Excellence has made a short film about safeguarding on Social Care TV exploring what care home managers and their staff can do to safeguard residents from abuse.
One of its stars is Michaela Conoby, who is manager of a specialist dementia setting in Leeds called The Green care home.
Here she outlines her five top tips on safeguarding.
Tip one: Building relationships and establishing trust
Everyone needs to be free to express any safeguarding concerns. Staff, residents and relatives all need to know that anything can be up for discussion. But, just in case people are reluctant to come forward, we build in one-to-one time.
Take, for instance, any changes in personality, for instance if people go off their meals. This could be a sign that something’s wrong. The one-to-one sessions are an opportunity to find out what’s going on.
Obviously we adhere to Care Quality Commission safeguarding standards and outcomes that are expected for residents. We’re very comfortable with this and want to encourage a personalised, quality service; we have relative meetings and quality assurance questionnaires that can remain anonymous.
Relatives can come and see me in my office. I hold “surgery” times and I encourage them to approach me and other staff, so that they feel comfortable about approaching us.
Tip two: Having the right procedures in place
If a safeguarding issue arises, it’s vital that everyone knows what to do at what time. It needs to be dealt with promptly; but it also needs a similar level of urgency if it turns out that it isn’t a safeguarding issue.
This is important, so that residents, relatives and staff can have peace of mind. The way to do this is to inform people of all the stages of your activity; this provides reassurance.
In the film, we have some nice testimonials from relatives. One relative called Heather says: “The place is absolutely wonderful – it’s changed my life and my mum’s. Before, she was often on her own. Now, she’s made friends. I know that there are procedures in place. If I don’t understand anything, the door is always open.”
As staff, that makes us feel great. Our procedure-based approach means we are providing reassurance.
We have regular training and supervision. During supervision, safeguarding is brought up as a standing item. A staff member or team leader may not have anything to say or report, but the topic is brought up.
All staff at The Green go on safeguarding training. Safeguarding isn’t a taboo subject. Staff are very comfortable about discussing the issues. It’s not a swear word; we don’t cringe when we talk about safeguarding. The net result is that staff are very comfortable discussing care issues, which is the opposite to what some may expect. But we feel it works.
Tip three: Types of abuse
I’ve borrowed this tip from Hilary Paxton, who is our local head of safeguarding at Leeds Safeguarding Adults Partnership. In the film she goes through all the different ways that people are sometimes unable to protect themselves from abuse. It can be physical, sexual or emotional abuse. It can be psychological, discriminatory of neglectful abuse. It can include financial abuse.
Financial abuse is one big issue as people may not have the capacity to manage money, bank accounts and bills; and therefore may be more at risk. Checks and balances need to be in place, so that there’s no possibility of allegations being made of any misuse of funds.
Everything we buy is receipted, double-signed and monitored. Often we encourage relatives to bring an agreed amount of money in, but then we make sure that the resident gets to spend their money on whatever they want. Again, when we explain this to relatives, they’re mainly on board as they see exactly what we’re doing.
Tip four: Work with other agencies
Colleagues in other disciplines can support us to safeguard vulnerable adults and offer guidance.
For instance, in the film you’ll see me talking to a local GP about a particular case. We found unexplained bruising on a resident. We knew that it could well be because of medication.
But we looked at our procedures and acted accordingly, so that nothing was missed. Because some people bruise easily due to their medical condition, we can use the “body-mapping system”.
We mark the bruises on a diagram over a period of time. The GP or district nurse can then see if there’s a pattern to the bruising. And if it turns out to be a safeguarding issue, you’ve got your evidence there.
Tip five: Learning from incidents
When there has been a safeguarding incident, it’s important for us to all understand where things went wrong, how we’re going to put things right and what actions we’re going to take.
You can only do that by being open, by talking to other professionals and by using best practice from elsewhere. You need to be open-minded. We may not get everything right, but we will learn from any situations. And if you listen to our relatives, that sentiment provides them with the reassurance that anyone is looking for when their loved-one is entrusted into your care.
Further online reading
What do you think?Join the debate on CareSpace
Keep up to date with the latest developments in social care. Sign up to our daily and weekly emails