Академический Документы
Профессиональный Документы
Культура Документы
personalised and
safe care.
There are known factors associated with institutional abuse17.
A closed inward looking culture and weak management at ward and locality
level
A poor institutionalised environment
Low staffing levels
High use of bank staff
Little staff development
Poor supervision.
Within such environments patients can become de-humanised and neglect and
abuse can
grow unrecognised or unchallenged.
Risks of neglect harm and abuse will be reduced where there is strong leadership
and a
shared value base where:
Whistle blowing
Inquiries into institutional abuse have repeatedly found that
Prevention
An A&E system identifies that a patient is developing a pattern of repeat
attendances and triggers a further assessment to determine if the person is
in need of additional support.
The admission assessment of a person with advanced dementia, flags the
need for additional support in eating and drinking.
An Acute Trust identifies a peak in numbers of patients with grade 1 & 2
pressure ulcers and uses root cause analysis to bring about improvement.
A mental health independent provider receives a series of complaints from
patients about staff attitudes on a secure ward and involves a advocacy
service in the investigation
A service specialising in care for people with autism notes an increase in the
use of restriction and restraint and carries out a review
A care home introduces dementia care mapping to understand and improve
staff interactions with residents
An ambulance service identifies particular problems arising from discharge
during early evening and liaises with the discharge coordinator.
liable if they are negligent in performing their caregiving duties, including leaving the consumer unattended. However, if
a worker's income and assets are low or modest, as is the case for many in this field, the worker may, in practical terms,
be "judgment proof." From this perspective, the risk of enforceable liability for negligent caregiving is a risk that is not
likely to materialize (Section II.A.1).
Negligence in non-caregiving matters. A worker may be found liable for negligence in non-caregiving activities, most
notably creating a hazard in the consumer's home. However, here, again, if a worker does not have sufficient income or
assets to pay the judgment in a damage action, this is a risk that is not likely to materialize (Section II.A.2).
Failure to report abuse or neglect. A worker may be a mandatory reporter under the state's adult protective services
(APS) law and may therefore be both civilly and criminally liable for failure to report abuse or neglect that comes to
attention of the worker. However, liability can easily be avoided by complying with the APS law (Section II.A.3.a). As a
practical matter, workers employed by the consumer or the consumer's representative, especially if the worker is a family
member, may have greater emotional or economic barriers to reporting, compared to agency-employed workers.
Liability for abuse or neglect. A worker may be criminally liable under the state's APS law if the worker abuses or
neglects the consumer. This is a low level risk because of the infrequency of encountering worker misconduct that rises to
the level of abuse or neglect. Of course, on the rare occasions when it does occur, the injury to the consumer can be
extremely serious (Section II.A.3.b).
Liability for injury to third party caused by the worker. The worker and the consumer are potentially liable for
injuries to third parties caused by the worker while acting within the scope of employment. The worker's liability is direct,
i.e., flowing directly from his or her own action or inaction, while the consumer's risk of liability is vicarious, arising from
the employer-employee doctrine ofrespondeat superior. Unless the worker and the consumer have sufficient income or
assets to pay the judgment in a damage action, this too is a risk that has a low probability of materializing (Section II.C).
Liability for injury to third party caused by consumer. A third party may claim that an injury inflicted by a
consumer was caused by the negligent care or supervision of the worker, thus making the worker liable for damages.
However, such claims are rare and are likely to be dismissed for failure to prove that the worker owed a duty of care to
the third party (Section II.C)
Reference
Achieving best evidence in criminal proceeding; Guidance on interviewing victims and
witnesses and using special measures; Criminal Justice System 2000
Care and Compassion; Report of the Health Service Ombudsman on ten investigations into
NHS care of older people; Parliamentary and Health Service Ombudsman 2011
Care Quality Commission; Our Safeguarding Protocol; The Care Quality Commissions
Commitment to safeguarding
Dr David Colin Thome Report: Mid Staffordshire NHS Foundation Trust; A Review of Lessons
Learnt; Department of Health 2009
Equity and Excellence: Liberating the NHS; Department of Health 2010
Heath H & Phair L; The concept of frailty and its significance in the consequences of care or
neglect for older people; an analysis International Journal of Older People Nursing 4, 120-
131;
2009
Health Professions Council Standards of Conduct Performance & Ethics; 2008
Information Sharing; Guidance for Managers & Practitioners; HM Government 2008
Mental Capacity Act 2005 Code of Practice; Dept Constitutional Affairs; 2007
National Framework for Reporting and Learning from Serious Incidents Requiring