Service users with dementia and autism most likely to assault social care staff

A report from Skills for Care finds one in four workers in adult social care have experienced physical abuse in past year

Social workers and carers working with people with dementia and autism are most at risk from physical attacks, according to research from Skills for Care.

A literature review, combined with a survey of 1300 frontline staff in both public and independent adult care settings, found those working with dementia were most likely to be physically assaulted. It also found their employers were least likely to have a policy in place around dealing with abuse or violence.

Although staff working with those suffering mental illness were more at risk from abuse or violence, most incidents in the past year related to verbal abuse.

Meanwhile, those working with people with autism were less likely to suffer abuse but when they did the abuse was more likely to be a physical assault.

The survey found a quarter of frontline staff in adult social care had experienced a physical assault in the last year and the same number had experienced verbal abuse on a daily or weekly basis.

While most physical assaults did not require medical attention, 6% needed first aid while others reported sexual abuse, being spat on, urinated on or being imprisoned. More than a third of respondents said they were working on their own when the incident happened.

Disturbingly the survey also found that nearly one in 20 incidents of abuse and violence in the past year came from other staff members.

Although the majority of incidents were by service users, one fifth were by friends and family of service users. The literature review found abuse has been increasing in this sector in past years, most likely because of budget cuts and staff being forced to refuse services. The most common reasons for service users to attack was because of frustration or misunderstandings.

In line with Community Care’s recent survey on violence, most incidents were not reported to management. Less than 30% brought it up in discussions, and of that number more than half said no help was forthcoming.

Survey respondents spoke of the emotional toll the abuse is taken. One said: “I ended up having to take sick leave as I could no longer cope- my manager did nothing to support me.”

Another said: “Feeling I have to put up with verbal abuse as part of my job has made me want to leave social work.”

A third said: “This episode of verbal abuse and threatening behaviour is not rare – it is something that happens every day. So far, I have a broken tooth, deep bite wounds to my arms and cuts to my face. This incident escalated to a dangerous level but was dealt with because staff are skilled in intervention work.”

The authors said employers needed to have a range of mechanisms to support staff. These should include effective management and supervision, clear systems for reporting incidents, structured training programmes (especially for those working with people with autism, dementia and learning disabilities) and practical help when incidents occur- ranging from time-out, a break to recover, counselling or further training.

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5 Responses to Service users with dementia and autism most likely to assault social care staff

  1. Nick Johnson November 12, 2014 at 10:43 am #

    It would be good to examine the circumstances of abuse of staff in more detail. Some may come ‘out of the blue’ and some may be driven be disappointment or desperation at refusal. It is important to remember that many people only come to Social Services when all other options have been tried, so failure here is the end of the line and desperation is a common response.
    Where a service user strikes out, it may be that we cannot comprehend their wishes or do not know them well enough and the triggers which might spark a violet reaction.
    I would expect people to review these events and begin to understand why an event happened and what might be done to make it less likely in future.
    As to manager support, I have been shocked in recent days with the phenomenal number of managers and senior managers who are interim or on temporary contracts. This may give them little security or limited interest – in one case 5 out of 8 of the senior management teams were ‘temps’.
    We clearly need to do more than count.

  2. Viv Eden November 12, 2014 at 10:53 am #

    Have there ever be any surveys about the staff that experience abuse? I realise potential for abuse is present but I am concerned about the negativity we are creating towards certain groups. It is my view that if staff were more aware of person centred approaches and communication needs, attacks would be reduced. I have known staff who have been attacked more than once and feel it is more to do with their practice than the label of the person.

    • Jambon November 20, 2014 at 8:52 pm #

      I do share you’re view about poor practice (intended or not) often being the cause of attacks, however I think it’s a bigger issue then just blaming individuals. Have a look at the salaries offered to people who support people with autism or dementia (2 of the most complex service user groups)- its shockingly low in comparison to more housing related support worker roles and more often then not minimum wage or just above I live in the home counties just outside of London and 2 large well know providers pay in the region of £13-14k to support workers who support some of the most complex people within services.

  3. chesters November 12, 2014 at 4:34 pm #

    I have experienced frequent denial by mental health professionals, and many social workers, about the capacity of dementia sufferers to exhibit unprovoked aggression and physical assault, to those nearest, whether staff in residential/nursing homes, fellow residents, or family members. I have the utmost sympathy for staff (and families) having to cope with this. I am not surprised to read that there has been a significant increase in the number of times the Police have been called out to residential/nursing homes in order to restrain a violent resident. Granted, many staff could be better trained and supported to understand and respond to dementia, but they are often overworked, understaffed, and know they could be up for assault if they tried to manhandle a person. The furore over the alleged over-prescription of sedatives and psychotropic medication for dementia sufferers in care, has made many heads of homes, and GPs, reluctant to use medication. Being ‘nice’ and more person-centred, in the face of sustained aggression and assault from individuals who are themselves vulnerable, may not get very far in maintaining a safe environment. it may be unpleasant to say so, but physical restraint might occasionally be an essential aspect of
    the caring role in this situation

  4. Hodgson November 16, 2014 at 4:25 pm #

    Their is enough stigma against service users within the mental health services & Autism services as it is and it isn’t the case that you say that Most abuse comes from adults with Autism & dementia..I Think you have got your wires crossed ..Not all adults are violent Who have autism their is also a lack of community care for these individuals as it is .Care in the community is a complete failure due to Margaret Thatcher closing all the NHS Victorian mental hospital, s they where once in..A future promice by the previous conservative government That these individuals would be cared for in the community wasn’t enough due to lack of funding & resources that many adults in the community are living with no support or unsuitable care..Some have Tried it and it’s been a susssesful. But others The placements have failed . leaving These individuals with no support often they end up in prison or homeless hostels and some even get killed for fun..This country is a total disgrace. It seems You obviously don’t watch the news You see more social worker, s than ever before Locked up for SEXUAL abuse in prison or assaulting service users or misleading other proffesinals about a particular individual or Falsifying Their medical records. .yes some service users have attacked social worker, s but not all service users have attacked Social worker, s or carers .You Here more on the BBC News of social workers being arrested for assault more than you hear of service users being arrested for assault. . Not all adults with dementia hit out either. Maybe some but not all of them..It’s like adults with learning disabilities some do hit out but it’s due to their condition they are born with ..But not all adults with any type of disability they are not all violent or aggressive ..Maybe some but you can’t word it that Adults who have Autism or dementia our all violent because you are infact wrong and this above article is very misleading ..Most abuse comes from the very proffesinals Like care workers & social worker, s as these are the ones you hear about being arrested & charged with a crime more so than a service user. .more so like winter born view and care in the community from dolmicary care and and a few care homes..Obviously they are not all bad ..But their is now strong evidence that more abuse happens more so in the community than it does in a care home falicity. .We need to stamp out the stigma of adults with disabilities it’s unfair & it’s wrong