Supportive Relationships that help Reduce Risk of Abuse and Neglect

P6: Explain the role of supportive relationships in reducing the risk of abuse and neglect
M3: Discuss the role of supportive relationships in reducing the risks of abuse and neglect, using examples

In order for a vulnerable individual to feel confident and feel as though their needs are being met, a supportive relationship is essential.
A supportive relationship is a relation based on empathy and encouragement and involves the care and support from those around them such as, friends, and family and care workers.
Supportive relationships can affect an individual’s health and well-being in a positive way and by having the support of others around them can give the individual confidence and make the individual feel better about themselves. It also means that trust is built between the carer and the cared for, and when something goes wrong, the individual feels that they can go and report it someone who is close to them, who can then go on to resolve the situation.
For a new care worker this could prove difficult for them to create any kind of relationship with a client or service user, but they would need to consider both the nature of themselves, and the individual they are supporting’s role. Being a vulnerable adult leads them to being susceptible to various forms of abuse and/or neglect, and because of the very nature of what is happening they may have no idea as to how to respond to the abuse – finding it far easier to just let it continue, than fight it off.
The vulnerable individual needs to know there is somebody out there who is willing to support them, as not only does this allow for the individual to feel less alone, but it can also help minimise the risk of abuse to them in the near future, and being involved in care work is all about taking up that role. For example, a vulnerable adult who has to rely upon another to help them get washed, dressed, cook a meal and get ready for bed. When people are unable to be independent any longer, this tends to be an open invitation for other individuals to abuse them.
It is important to note that although the individual may need help looking after themselves, they do not lose their rights. They still have the right to be treated with dignity and respect; the right to be free from harm and supported in meeting his/her needs.
Individual’s rights can be respected in a supportive relationship with a care worker, as well as friends, family and other individuals like themselves which they may come into contact with. With these rights each individual will understand that they are being treated equally with all opportunities available, and they would learn to gain trust and work on their own independence, and this is where significant people can make a substantial difference to an individual’s overall health and well-being.
Supportive relationships encourage individuals to do as much for themselves as possible in maintaining their independence, and emotional state, it also encourages those with conditions or disabilities, for example an individual who has had a stroke, to maximise their potential and independence.
In order for adults to become resilient and empower their self-confidence, their self-esteem must be raised, and in order to allow this, a supportive relationship must be provided. For example if a care worker provides a supportive relationship to the vulnerable adult, they may feel that they are able to disclose episodes of abuse that are currently taking place. By feeling safe in the care workers presence, and trusting their motives because of the caring nature of the relationship that they provide, can lead to the abuse coming to an end, leaving the individual to feel safe once more, knowing that they are now being looked after by someone they can trust.
Without a supportive relationship, individuals may not feel confident or start to feel withdrawn and neglected by the one that is taking care of them; feeling self-conscious or depressed due to feeling that individuals may not want to be their friend or want to communicate with them.
When building a supportive relationship with a service user the carer should include the following elements: * If Helping – Help them with tasks, such as collecting prescriptions from their doctor. * If Enabling – Do things such as removing obstacles from their path (e.g. chairs). * If Making choices – Empower the individual to make the right choices and the carer to give them their own opinion on it. * If Maintain privacy – This can be done by ensuring that the individual has his/her own space, regardless of the circumstances. * If Advocacy – This can be done by speaking on behalf of the individual who cannot speak for themselves. * If Promoting rights – This can be done by ensuring that the individual’s rights are not compromised because of their support needs. * If Non-judgemental – Keeping an open mind and not judging a person because of their past or the way in which they choose to live their lives. * If Using preferred methods of communication – This can be done by communicating with an individual in their preferred method.
The main principles of supportive relationships are:
Core principles of care – Previously referred to as the “care value base”, the core principles of care are a set of principles, values and guidelines to be followed by all health and social care workers. These principles are: * Promoting equality and diversity of individuals * Promoting the rights and responsibilities of individuals * Maintaining confidentiality of information
These are the three key principles that guide workers on how to treat vulnerable individuals. However the vulnerable individuals should also be treated with: * Dignity and respect * Equality – this refers to the individual being treated the same as any other individual, but based upon what their needs are * Fairness – meaning that the individual’s rights should be respected, regardless to the support they need * Privacy – referring to the individual being able to have their own private space
The core principles of care are the first basic steps when creating a supportive relationship. Without respecting these principles, no one person would be able to create a supportive relationship with a vulnerable individual.
Building effective relationships – When building a supportive relationship with a vulnerable individual, the carer must not be confuse it for a personal friendship, as a supportive relationship and a friendship differ in a number of ways. According to Neil Moonie (2005) these differences are that: * Professionals work within a framework of values * Professional work always involves a duty of care for the welfare of individuals * Professional relationships involve establishing boundaries.
It is important that the professional ensures that the supportive relationship stays within the boundaries laid down in legislation and by professional bodies. Many professional codes of practice encourage a person-centred approach, where vulnerable people are at the centre of the interaction, this allows the individual to make decisions for themselves or participate in making the decisions if they lack the mental capacity.
Methods of communicating and listening – When developing a supportive relationship with a vulnerable individual the carer must use the preferred method of communication when available, this will make the individual feel more comfortable and would in-turn make the supportive relationship work more smoothly, as everyone will understand each other.
If an individual is deaf, they would require a signer for communicating with them; if an individual does not speak English they might require an individual to translate in their language. It is important that the vulnerable person uses their preferred method of communication, as it would make it easier for the individual to express themselves.
Respect for culture, beliefs and lifestyle – For a supportive relationship to be effective, it requires the professional to respect who the individual is and their beliefs, culture lifestyle and their choices in life. When a professional shows interest and respect for the individuals culture and beliefs, then the individual would feel more trusting and comfortable towards the professional.
It is important that the professional provides the necessities in order to support the individual’s beliefs (e.g. if an older individual from a residential care home was a vegetarian, then the professional must assure that a vegetarian meal is served to them).
Often in residential care homes, some residents do not wish to be treated by a worker of the opposite sex, this means that the professional must take their opinion into consideration.
Recognition of needs and preferences – It is exceedingly important for professionals to recognise the needs and preferences of an individual. By doing this, a supportive relationship will be more effective. If the professional knows how the service user likes to communicate or be treated then it would be easier for the two individuals to create an effective supportive relationship. This also helps the professional to notice any changes in the service user’s behaviour, this could help prevent or stop abuse.
Empowerment – Empowerment involves respecting the service users and their individual rights. This means allowing them to have as much power and control over their own lives as possible. Empowerment can reduce the risk of abuse and neglect by the individual being open, as they would feel like they will be listened too, due to the individual having the power to make their own decisions and knowing that they will be supported.
Confidentiality – Confidentiality is important when working on a supportive relationship. A professional must make sure that they do not share any personal information about the service user with anyone that isn’t supposed to know about it; For example, when a professional wants to talk to the service user with anyone that isn’t supposed to know about it. When a professional wants to talk to the service user about a personal matter, they must make sure that they do it somewhere private where other individuals are unable to hear them (e.g. bladder problems).
Although confidentiality is one of the key aspects of a supportive relationship, a professional has to share certain information with other professionals or the service user’s family, in order to benefit the individual. Maintaining confidentiality is very important in a supportive relationship as it would boost the service user’ s confidence, thereby making them feel respected. Keeping confidentiality of the service users can also make them feel safe and protect them from abuse.
Working Practices – It is well known that the way in which a professional works can sometimes help in minimising the risk of abuse. If a professional follows the Core Principles of Care, and if he/she stays focused on the needs of the service user’s, then that can have a significant impact on the individual’s development and welfare. Some examples of good working practices that can help minimise the risk of abuse are: * Needs assessment – This helps to identify the individual’s needs and informs the support plan and other professionals involved. This process also involves the individual’s themselves, therefore allowing them to feel empowered, along with not feeling as though they are being left out of the decision making process. * Support planning cycle – This is a plan that sets the needs of an individual’s themselves, so that they feel empowered, and so that they do not feel left out. * Person-centred practices – This enables the service user to be at the centre of the provision, in order to meet all their needs. * Record and method of communication – The purpose of this work practice is to record the communication between workers, families and service users, so that everyone is aware of what is happening. The language used is understood by all. * Anti-oppressive practice – The purpose of this is that by adopting a person-centred approach it ensures the focus is on the needs of the service user, and that the professionals are not forcing their ideas or agendas on the service user. * Anti-discriminatory practice – This enables service users to be treated the same as others based upon their needs, without being discriminated inclusive practice. Inclusive practice is the action of getting the service user involved in decision-making, in order to provide a better health and social care service, in order to benefit their welfare.
The working practices above show a clear example of inclusive practice.
Protocols of sharing information – Every organisation should have a clear understanding of confidentiality and the sharing of information with other professionals. A service user’s information must be kept confidential at all times, and the only time a professional should share that information is if it affects the overall health and well-being of the individual. For example, if an individual has certain allergies, then the professional should notify the chef of these; however the professional should not give any other personal information about the service user, unless it is absolutely necessary.
Providing a safe and secure environment – According to McKie (2010) Health and Social Care organisations must ensure that both the physical as well as psychological environment is safe for all information pertaining to the service user, and the service users themselves. Neither of the groups should be put at risk due to organisational shortcomings and a sufficient number of staff members should be on duty to make sure that the environment is safe for the service users.
Advocacy – Advocacy aims to ensure that individuals, particularly those who are the most vulnerable in society are able to be heard with regard to issues that may be affecting them. Advocacy allows vulnerable people to defend and safeguard their rights.
Advocacy is usually enforced by the use of an advocate who provides support and can speak on behalf of an individual, offer information and help in needed. Advocacy can therefore reduce the risk of abuse and neglect, as though the vulnerable individual may not be able to physically speak and give information of abuse or neglect, they can get an advocate to do so in their stead. This reduces the risk of abuse and neglect as an advocate can provide the vulnerable adult information in a supportive role to support them, and help them in the situation they may be in.
Access to information – Under the Data Protection Act (1998) Access to Personal Files Act and Access to Medical Records Act, it st6ates that the service users have rights to access their own personal information for whatever reason they may require it, however a doctor can deny such access if it is thought that it might be in the benefit of the service user. This working practice encourages a positive environment, which can make the service user feel more valued and respected.
Supportive Practice – When building a supportive relationship with a service user, the care professional must ensure that they focus on the humanistic approach. The humanistic approach is when a person is treated with dignity, respect and as a unique individual with their own individual needs. This approach can make the given individual feel valued and important.
According to Mckie (2010), Carl Rogers identified that the core conditions of an effective supportive relationship are: * Empathy – The ability to understand the situation through the eyes of the individual who is experiencing it. By showing the service user empathy, they will see that the worker cares about them and would thereby feel more comfortable with the worker. * Congruence – To be genuine, transparent and real; not acting as an expert but as an individual, working in partnership with the individual. This can help a supportive relationship as the service user would feel more comfortable if the care worker is friendly and as genuinely towards them as possible. * Unconditional positive regard – To value, respect and not judge the individual, and experiencing them as a person.
Meeting the individual's needs – As an individual we all have our own needs, and in some cases the needs of vulnerable people can be greater than those of other individuals. The needs that all professionals should meet when building a supportive relationship include: * Physical * Intellectual * Emotional * Social * Cultural * Spiritual
It is imperative that all these needs are meet when working with a vulnerable person, as it would help in developing the supportive relationship by boosting their confidence and empowering them to help make their own decisions.
Meeting their needs could potentially mean that they could come to trust the carer more, feel more comfortable around them, and also rely on them when they have to. These are all work practices that lead to an effective supportive relationship.
If a professional follows these practices, then the service user should be more accepting of the supportive relationship, thereby allowing them to become more trusting and more confident in the professional.
Although the service user needs a positive attitude and help from the professional, he/she must remember to keep the relationship within the boundaries and ensure that the service user does not become dependent upon the professional.
D2: Evaluate the role of multi-agency working to reduce the risk of abuse of adults, with reference to legal frameworks, regulations, working strategies and procedures

In this part of the assignment I will be evaluating how multi-agency working could help investigate the case of John, (a man with learning disabilities below,) and how this would minimise the risk of suspected abuse to him by identifying agencies that would be able to work together on his behalf.
Case Study:

“John lives in a supported housing, run by a private organisation, for people with learning disabilities. He attends college three times a week and a day centre for two days. He has a good relationship with a volunteer who visits him at weekends and takes him on trips. A friend from college has started turning up at the day centre and at home. John seems reluctant to see him at times but will not say why. He has started to spend more money than usual on CDs and electrical gadgets, which he then gives to his friend as gifts. He is not his normal cheerful self. The volunteer feels that John is being taken advantage of by his new friend and that financial and verbal abuse (threats) may be taking place.”
Multi-agency working is a variety of different company’s coming together for a meeting and discussing what the best thing to do would be, which would in turn benefit each individual and to save time on things with all of the company’s. By multi-agency it means that all of the companies that are involved are saving money and getting the job done together, and saving time by organising when to do the job and when it is suitable for each individual. Multi-agency working brings together practitioners from different sectors and professions to provide an integrated way of working to support children, young people, vulnerable adults and families.
“Multidisciplinary teams consist of staff from several different professional backgrounds that have different areas of expertise. These teams are able to respond to clients who require the help of more than one kind of professional. Multidisciplinary teams are often discussed in the same context as joint working, interagency work and partnership working” Drinkwater (2008)
This approach become more focused after the publication on the ‘No Secrets’ guidance in 2000, with the main aim being to prevent abuse to vulnerable adults. The document provides guidance to local agencies that have a responsibility to investigate and take action when a vulnerable adult is deemed to be at risk of harm, abuse or neglect.
When working with vulnerable adults who have been abused or who are potentially vulnerable to abuse, multi-disciplinary working can be key to detection and protection and in reported cases of abuse it has often been found that it has remained undetected because professionals failed to work together to minimise risk and highlight concerns.
All agencies that come across vulnerable adults in their line of work have a legal framework for which they must follow in implementing multi-agency working. In the case of John, there are many agencies involved with his care and day-to-day living that may notice signs that he is suffering from some form of abuse, (financial and/or verbal). These would include a member of staff at his supported housing, his tutor at college, a support worker from the day centre in which he attends, the volunteer who visits him, and possibly his GP.
A professional who comes into contact with a vulnerable adult should be able to determine immediately whether other agencies need to be involved and they have a duty to share concerns with individuals that need to know.
However in reference to the case study, the majority of these agencies may have problems in detecting changes in John, but have not attempted to follow the issue up because they may feel that they are the only ones who have noticed these changes. By multi-agency working this would allow good quality care to be given in an appropriate way which is suitable to the individual’s needs. Therefor if all of these professionals were to come together, they would be able to share their views about Johns change in attitude and behaviour, and discuss ways in which to overcome them in order to prevent any further abuse from taking place.
When professionals work together, it creates a platform where vulnerable adults can have their individual rights fought for and protected. It is John’s rights to be protected from harm and exploitation, however the job of the professionals working with him, is to ensure that this happens. While it is suspected that John may be suffering from abuse, steps need to be taken in order to resolve this situation.
When the service user is accessing a number of different services, like John is, multi-agency working becomes even more imperative. Effective communication between professionals and organisations is vital, in order to ensure that the service user is protected.
Communicating information about significant changes, events and actions ensures that all those involved with supporting the service user are monitoring their well-being. Lack of communication can lead to irregularity as well as misinformation and allegations, none of which are in John’s best interests.
When evaluating the extent to which multi-agency working could help to minimise the risk of suspected abuse to John, requires taking a look at the bigger issue concerning this strategy. The benefits of this strategy to John would be quite self-explanatory – he would ultimately be free from his abuser once the agencies had come up with a suitable plan of action. Each agency would be able to share their views detailing the changes they had noticed, but is it always in the best interests of the service user?
The effects of multi-agency working can leave the individual concerned (John, for example), feeling out of control with their decisions, may feel that everyone is making choices on his behalf, and that he is unable to have his say, much like the attitude his abuser is showing him currently.
Multi-agency working also has a variety of issues which could make the situation worse for John, as many agencies show a serious lack of commitment to partnership working, with no one individual outlining the roles and responsibilities of each agency, of which results in insufficient information being shared.
Another point to note in this case is that many agencies have different priorities in relation to adult protection, which in turn can create delays in decision making, causing the problem to continue on without a clear, definitive strategy in place. In John’s case all agencies have a priority of keeping him safe; however that priority is always at different levels. For example, his college tutor may be less worried about John because he has to deal with a number of other students also, whereas the volunteer is there to just support John, and would be very concerned by any changes in his behaviour and would want to implement a strategy as soon as possible.
The advantages of working in a multi-agency is that there are a lot of different ideas from everyone involved, and when these ideas are pooled together, they can create a strong plan on how to proceed. This means that John would be able to receive the best care tailored to his needs, and build a better relationship with other individuals. When in multi-agency working there is also a case conference and liaison meetings, where professionals are able to attend a meeting about a specific individual; this is an opportunity for professionals to share information and noted to be taken. This in-turn allows for decisions to be made in which the best care can be provided for the individual.
However when it comes to multi-agency work, communication isn’t as strong as it could be, which leads to problems and messages not being sent to the appropriate parties. This sometimes means that task for the individual aren’t completed and the care provided isn’t the as good as it could be.
Another advantage would be that more support is given to family’s that need it and are providing them with a range of different types of support, for example, counselling, family support workers and social workers. However, a disadvantage of multi-agency would be not sharing information with one another so that everything is covered.
Multi-agency working alongside supportive relationships, when used effectively can solve situations that could have potentially, at one stage resulted in horrific circumstances. If it was used to investigate the case of suspected abuse in regards to John, it could create an outcome which prevented any more abuse from occurring, leaving John to feel secure in his trust of the agencies looking after him, and feeling positive that he is now protected from harm.

References:

Stretch B. and Whitehouse M. –Health and Social Care Level 3 Book 1 BTEC National. London: Pearson Education Limited, 2010
N.p., 2015. Web. 8 May 2015.
Columbia, Province. 'Abuse And Neglect Of Older Adults: Information For Family Caregivers - Healthlink BC File #93B'. Healthlinkbc.ca. N.p., 2015. Web. 8 May 2015.
Consent And Confidentiality When Sharing Information. 1st ed. 2015. Web. 10 May 2015.
Corecarestandards.co.uk,. 'Principles'. N.p., 2015. Web. 8 May 2015.
Google Books,. 'Health And Social Care (Adults)'. N.p., 2015. Web. 10 May 2015.
Helpguide.org,. 'Effective Communication: Improving Communication Skills In Your Interpersonal Relationships'. N.p., 2015. Web. 10 May 2015.
Protecting Vulnerable Persons From Abuse And Neglect: Reporting Requirements For Direct Service Providers. 1st ed. 2015. Web. 18 May 2015.
Safeguarding Vulnerable Adults: A Shared Responsibility. 1st ed. 2015. Web. 11 May 2015. uk, dpro. 'Centre For Confidence And Well-Being, Resources, Diversity And Type, Type Resources (MBTI), Section 3: Applications - Personal Development, Relationships, Teams, Management ..., Team Development'. Centreforconfidence.co.uk. N.p., 2015. Web. 10 May 2015.