Explain the role of supportive relationships in reducing the risk of abuse and neglect and discuss the role of supportive relationships in reducing the risk of abuse and neglect (linked together)

In order for a vulnerable individual to feel confident and feel as if their needs are met, a supportive relationship is essential. A supportive relationship is a relation based on empathy and encouragement and based on the individuals supporting each other in different ways, in order to maintain happy and healthy, physically and mentally. Without a supportive relationship, individuals might not feel confident or they might feel withdrawn and neglected by the person who is taking care of them. Without a supportive relationship people might start feeling self-conscious or they might become depressed as they might feel as people do not want to be their friends or not even to communicate with them. Practitioners must build relationships and promote the rights of people using the services and they do this through a variety of different techniques and skills. There are core principles used that are vital throughout supportive relationships. The core principles of care are;

•Dignity - This ensures that individuals are being respected and have control.

•Equality - Encouraging equal opportunities and rights for everyone involved within supportive relationships.

•Respect - Admiration towards abilities and qualities of individuals within supportive relationships. Without having respect for one another, they will have no foundation of trust to build up from.

•Fairness - Being able to make judgements under no circumstances involve any discrimination but allowing people to speak up. For an individual who is vulnerable, within a supportive relationship they need to feel safe and able to speak up confidently.

•Privacy - Making sure people aren’t disturbed and keeping personal information confidential.

All of these core principles are vital, especially when working with vulnerable adults and focusing on appropriate supportive relationships. Without these core principles of care in place, individuals wouldn’t feel in control of their care and feel even more vulnerable.

Building effective relationships

Methods of communication - Communication should be used effectively and relevant to the individual's preference of communication. This could include; a signer for someone with a hearing impairment, an interpreter for someone whose first language isn’t English, or the use of makaton for people with learning and communication difficulties. It is vital to listen carefully to what people are saying and use active listening skills, such as focusing on body language, gestures and eye contact, as well as the words used. The more comfortable the individual feels when communicating, the likelihood of the communication being more effective is far higher. Better communication and the use of active listening can also help to reduce the risk of abuse and neglect. For example, if a service user’s first language is not English they may struggle and be unable to understand. In this situation, it is important to ensure that this individual feels comfortable and understands. The needs and requirements of the individual needs to be met to ensure that they are safe. By providing an interpreter, the individual will be able to explain and concerns they have and be understood fully. The individual's body language also needs to be taken into account so we can understand how the individual in feeling through their expressions and body language.

Adult at the centre of planning - Professional relationships differ from personal friendships in a variety of different ways. Moonie (2005) suggests that this difference is because;

•Professionals work within a framework or values.

•Professionals work always involves a duty of care for the welfare of individuals.

•Professional relationships involve establishing appropriate boundaries.

The development of trust between two people is an indication of the forming of an effective relationship. It is the professional’s responsibility to ensure that a relationship stays within the boundaries laid down in legislations and by professional bodies. Many professional codes of practice encourage a person-centered approach, which places the vulnerable adult at the centre of all interactions.

By ensuring that the individual is at the centre of the care, they will then feel involved within their care and feel a part of the team themselves and this will increase the likelihood of an individual opening up and explaining what has and is happening to them and in turn professionals can then support the individual appropriately.

Working practices

Person centered approaches - The individual is central to the care process and services and professionals should be working to meet the person’s needs and the individual should feel a partner in the process. For example; Lucy feels her needs are being taken into account and she is part of a process that treats her with respect and dignity. She does not feel isolated or ignored and she is encouraged to speak out about her feelings.

This shows how important it is for professionals to work together effectively as it increases the chances of an individual being protected from the risk of abuse.

Anti-discriminatory practice - Services aim to meet the diverse needs of the individual and ensure they do not receive a lesser service than others who are in a similar position. For example; When Lucy sees her GP, she feels listened to and her pain if fully investigated and never dismissed.

Supportive practice

The Humanistic approach - This approach focuses on treating people with dignity, respect and as unique individuals, with diverse needs. This approach is used by professionals to support people and emphasises the importance of the individual regarding uniqueness and value. Carl Rogers identified core conditions that should be present in professionals relationships. These are;

•Empathy - the ability to see and understand the situation through the eyes of a person who is experiencing it.

•Congruence - to be genuine, transparent and real. Not acting as the expert but as an individual and working in partnership with the person.

•Unconditional positive regard - valuing and respecting an individual which also being non-judgemental towards the individual and appreciating them as a person.

Meeting the individual’s needs - Individuals may show a presenting problem or need. It is normally the one that they feel comfortable with. However, it often leads onto identifying less visible needs. We have a range of needs including;

•Physical

•Emotional

•Social

•Intellectual

•Cultural

•Spiritual

When doing a needs assessment, all aspects should be exploded with the individual's consent. Being responsive to their needs and concerns ensures that a person-centered approach is taken. Flexibility is of high importance when responding positively to the individual and their needs.

If working practices provide a supportive relationship through their care for service users and families, the possibility of reducing the risk of abuse will increase greatly For example, taking a person centred approach can build a supportive relationship due to the demand of which service providers have to make the individual feel involved, comforted and safe. By taking this approach in working practices, the individual should feel involved in the process which then allows respect and trust to be built. If a service user isn’t made to feel isolated and feels safe, this can help to reduce the risk of abuse. If a mutual partnership isn’t built and effective communication isn’t shown and the individual doesn’t feels involved, the lack of support the individual may feel will decrease the chances of them sharing information such as neglect. For example, if some service providers are not taking a person centred approach the individual will more than likely feel as though their needs aren’t being met this will lead to vulnerability and concerns towards care.

As a result the service user will feel less empowered to speak out and share any information. The role of supportive practices can also contribute to the reduce of the risk of abuse and neglect. The humanistic approach shows: “This focuses on treating people with dignity, respect and as unique individuals with individual needs.” (dport 2010). This portrays the focus of treating people equally regardless of anything such as abuse, race, age, gender. Equality should be shown in every situation.

D2 Evaluate the role of multi agency working to reduce the risk of abuse of adults

Multi agency working -

Multi-agency working is a strategy used by professionals from different agencies and professions. They bring their skills and knowledge together in order to meet the needs of the individual. Instead of working separately by bringing everyone together, this allows for close joint and focused working which encourages a sharing of people's ideas and a wider range of views whilst focusing on holistic needs.

Certain guidelines under the ‘sector guidance’, have been put in place to support workers and employers. A clear example of multi-agency work failing is the Victoria Climbie case where professionals didn’t work together in order to protect this individual and the outcome was extremely negative. This enhances the importance for professionals to use multi agency working to reduce the risk of abuse.

Support planning processes and single assessment processes, encourage greater inter-agency cooperation. This ensures that the individual’s needs are at the centre of the process. Rather than working with them alone, with each agency providing their own service without reference to each other, working together encourages and balance and shares the information, coordination of approach and less duplication of services. This type of work produces a multidisciplinary approach. For this to be effective, good communication and understanding is essential.

Working in partnership with adults using services, families and informal carers -

This encourages greater trust and empowerment of people using services. In turn, they are likely to feel more confidence in talking about worries, fears and also possibly abuse. The equality that is part of the partnership working should encourage the growth of self-esteem, self-confidence and the strength to stop accepting abusive situations and behaviour as a norm. It also ensures an agreed approach that all involved, including families and informal carers, are aware of and can monitor. Protection is provided by the clarity of the situation.

Certain guidelines under the ‘sector guidance’, have been put in place to support workers and employers.

No Secrets’ a Department of Health Guidance 2005

This sets out how providers of care services should and can protect vulnerable adults. It encourages different agencies to work closely together - multi agency working. It explains could be at risk and reasons why they may be at risk. By having this in place it encourages agencies and professionals to provide quality care by working together to reduce the risk of abuse.

For example, this sector guidance shows; ‘ Local agencies should collaborate and work together within the overall framework.’

It lists ways in which this framework can be implemented and steps than can be taken to do so. If this wasn’t in place, care services would struggle to protect vulnerable adults and may fail to reduce the risk of abuse.

Closer working between professionals and within organisations -

This ensures that better communication and information-sharing takes place, This may take the form of discussions between staff, team meetings, communication via emails and the use of written records such as a daily log book. A sharing of concerns can result in early preventive action being taken. Patterns of behaviour can also be identified.

Decision making processes and forums -

If decision making is clear, everyone will understand what is happening. There is also less likelihood that a culture of secrecy will develop in which abuse could take place. The use of forums encourages a sharing of ideas and exchange of opinions, and provides an opportunity for individuals to gain confidence to speak out. They also have greater ownership of the decisions that affect their lives, such as being involved in interviewing new care workers. It provides an opportunity for procedures and guidelines to be explained, for rights to be emphasized and for individuals to increase their expectations of the care they receive.

Organisational policies and staff training -

Clear guidelines about expected behaviour from professionals are important to guided professionals and so that individuals know what is acceptable or not. Complaints procedures need to be understood and accessible to individuals, together with independent support when making a complaint. This could take the form of an advocate. Training must be provided when new procedures and policies are put into place in order for everyone to understand what is required. New staff need a formal induction, during which all policies and procedures are explained. This provides a foundation for the future behaviour and practice in the organisation and sets the tone for the future. Abuse is often a result of poor practice and a lack of understanding about the consequences of certain actions. Training is an important factor to this. The inclusion of role play and individuals talking about their experiences can give an insight into what it is like to be on the receiving end of care.

The role of the Care Quality Commision -

To ensure that organisations work in the best interests of individuals and follow the rules and regulations that apply to them, an independent regulator of health and social care services has been established. The Care Quality Commission took over the responsibilities previously held by the Commission for Social Care Inspection, the Healthcare Commission and the Mental Health Commissions in April 2009. In addition to its regulatory role, it is also responsible for protecting the rights of people detained under the Mental Health Act.

The Care Act 2014

This can positively support multi agency working. This legal framework show how professionals and agencies should protect adults at risk of abuse or neglect. The new legal framework states that it is required of local authorities to set up Safeguarding Adults Boards (SAB) in their area. It shows that the SAB must include local authority, the NHS and the police should meet regularly to discuss and act upon local safeguarding issues if needed(2014). It explains how hard it can be to pick up signs of abuse and the struggles professionals may face when monitoring this. This in turn then makes it harder for authorities to spot abuse and help people appropriately. However, by having this act in place, professionals can agree on how they should be working together and the roles that each member of the team should have in order to reduce the risk of abuse as much as possible. However, if professionals don’t agree in this there may be problems regarding communication and this can make the process longer and the focus on protecting an individual may be taken away. If this is the case professionals must remember their roles within the multi agency team and ensure that they communicate effectively and efficiently to ensure that the risk of abuse is reduced as much as possible.

Whistleblowing -

Since the Public Interest Disclosure Act 1998, staff have had the right not to suffer detrimentally or be dismissed as a result of disclosing certain information to an employer or regulator. This applies if a member of staff sees another staff member verbally abusing an individual.

All of these keys points enhance the effectiveness and importance for multi-agency working and show that without a strong team of professionals, the risk of abuse to adults would not be reduced as much and the individual wouldn’t be giving the necessary support and guidance to overcome abuse and reduce the risk of abuse.

References and bibliography:

•Person-centred approaches, available at: https://www.mencap.org.uk/about-learning-disability/information-professionals/person-centred-approaches, (accessed: 28/01/2016)

•0/Specification/Unit-11-Safeguarding-Adults-and-Promoting-Independence.pdf

•2015) Elder Abuse Prevention, available at: http://www.cdc.gov/features/elderabuse/ (accessed: 28/01/2016)

•http://qualifications.pearson.com/content/dam/pdf/BTEC-Nationals/Health-and-Social-Care/201

•No secrets: Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse -https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/194272/No_secrets__guidance_on_developing_and_implementing_multi-agency_policies_and_procedures_to_protect_vulnerable_adults_from_abuse.pdf