Some interesting guidance out from the Association of Directors of Adult Social Services about tackling abuse of and by informal carers.
It suggests social workers are using the "rule of optimism" by overestimating families' capacity to care for service users - inability to cope being a risk factor for both types of abuse.
Adass is after some good practice examples on this (details in the story) so was wondering if anyone had any they could share.
one recent case i share. was working with an older person with advanced form of dementia. On the ph at the referall the eldest son disclosed to me he was worried about the mothers money -but had no evidence.
On my first visit to asses her needs to be rehoused the son and his wife further disclosed the uncertainty around the mothers finances- and were unclear what to do.
I think my approach was not to rush the family into making decisions but was mindfull of the mother being at risk of further finacial abuse.
In any case i had to run along side the housing assesment - doing a mental checklisit for signs of financial abuse.
i was looking for anecdotal signs from the mother but her dementia made clarifying money details diffcult. This made it difficult to build an evidence based appraoch as the evidence from her seemed non existent.
i sensitively asked the mother about how she spent her money for example asking did she have enough money from one week to teh next?, was she able to buy the things she wanted?, was it ever difficult getting access to her income? and did she know what was in her acc? this was hard as her dementia meant she was never sure and could not answer any of the questions fully as she had given over responsibilty to one of her "other" sons to manage her income. Mental capacity was considired but the presumption is based on the starting point that she does have capacity.
Observationally she appeared to have little food in cupboards and anecdotal eveidence from the son and his wife sugested she would when taken out on day trips not have enough money to buy food or clothing. The eldset son had tried to request bank statements but had been told by the "other" son that things were fine and had actually been reported to the social 3 months prior to my visit. But the eldest son had had no update on adult social care involvement. I thought (understanding that assesments were required to be carried out within 28 days by adult social care had been well breached ) that this was odd that no further action had been taken.
At this point I layed out to the son and his wife my advice about what their options were. The mother who was present in the living room was not engaging in the conversation ,but to summarise I had listened to their fears, and informally from that one meeting gathered clues that to me suggested there were enough concerns to raise with a referal to adult social care... again - giving benefit of the doubt to the "other" son who had reportededly raised concerns.
I respected the family dynamics and outlined to the family paraphrasing there concerns and with non directional counselling skills, outlined what might happen if this call were placed. it meant a long exchange exploring the family pride, the risks to the mother, lack of understanding of the situation. I advocated on her part that she needs to have her views supported -but when asked about the need to call the adult contact centre to report possible financial abuse she was indifferent, but allowed the decision to go ahead if all in room were agreeble.
the impact to her and to the family and the possibiltiy of involvement from social services, and police with a possible arrest were all outlined. The son and his wife were advised what my actions would be today of me advising my line management and raising an adult safeguarding concern which if up held would be forwarded onto adult social care (assuming a family member did not want to make that call) Also that i would keep them informed thorught the reporting stage untill adult social care could lead on the investagation.
We discussed the impact on the family and who would make that call and it was aggreed i would as a way of reducing the deviceness between family members make that call.
The family agreed to follow up cooperrating with any follow up action carried out by adult social care-whatever the consequences.
But its importaint to note the decision outcome was agreed mutually not cohersively, and the power of the family and the mother to be included in that proces as opposed to it being taken away from them perhaps made the difference.
Outcome of this identifying abuse from a family member, resulted in the mother having £22,000 pounds stolen idenetified, and enough evidence to secure a crown prosecution againt the "other" son.
Just to let you know we've done a feature looking at risk factors to look out for in cases where carers are being abused by the people they look after. It would be good to get some thoughts on this.
Bagheera44- you have said who you are and where you work and given a number of details about a specific case. Aren't you concerned about confidentiality?
Redana hopefully he hasn' t completely blown it- time will tell, I think we all sometimes assume we're talking in a v protected forum, of course we're not, probably better to have spoken to colleagues/manager, of course.
I agree I feel that was a bit too much information for my liking.