Abuse in care homes: spotting it, tackling it and protecting your business

Posted: 17 December 2007

Author: Phillip Green

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Alan Boswell Group specialises in insuring care homes and works closely with leading insurers to put together insurance and risk management programmes for businesses in the care sector. Contact us for a free no-obligation report and quotation.

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Leading care home insurance broker, Alan Boswell Group looks at what care home managers can do to tackle the issues of abuse and finds that having the right care home insurance programme can play a part.

The BBC Panorama documentary "Please Look After Mum" which first aired in February 2007 showed a catalogue of abuse which took place at the Laurel Bank Nursing Home in Halifax. For many running homes, it made uncomfortable viewing. No matter how high the standards, no care or nursing home manager always knows what employees are doing.

What Constitutes Abuse?

Care home managers must be quick to spot abuse and realise it can take many different forms. These include:

  • Physical
  • Sexual
  • Psychological or emotional
  • Financial or material
  • Neglect
  • Discriminatory
  • Institutional

Once there is an understanding of what constitutes abuse, then the care home manager needs to be aware of how to spot it and take action if necessary.

Spotting the Signs of Abuse in a Care Home

So, what are some of the signs? Of course, it could be there are none and they will simply be supplied with information by an employee or family member.

Or people may show marked changes in their behaviour. This could include:

  • Being angry, tearful or depressed
  • Taking less care in their appearance
  • Being less welcoming to visitors
  • Being reluctant to go out
  • A loss of appetite

A home manager may spot an injury such as a cut, but the resident may seem unwilling to explain how this happened.

It is important not to draw conclusions if you suspect abuse. It could be that care home staff may not be to blame – it could be a visitor or volunteer has perpetrated the abuse or there may be some other cause.

Detailed Investigation and Clear Procedures

It is essential that the home manager makes a careful and detailed investigation and is prepared to bring in experts if necessary.

It is likely that care home staff will need to be questioned. Appropriate records must be made and staff treated with respect but it is essential that a full account is obtained.

If allegations are made, then the manager should ensure that another senior member of staff is present when details are taken. The manager must make sure there are clear procedures in place during an abuse investigation.

Background Checks

If it is found that a member of staff is responsible, the care home may face blame if they have not made thorough checks on that person's background. There is a scheme in place to prevent care workers abusing people such as the elderly and mentally ill.

Under the Protection of Vulnerable Adults (POVA) scheme , people who have abused, neglected or harmed vulnerable adults will be put on a register. Care home owners and care agencies in England and Wales must check those they employ are not on the list.

And, if a member of staff has acted wrongly, the care home manager should look to see what caused this:

  • Is training of care home staff to a sufficiently high standard?
  • Do carers know about restraint or other appropriate procedures and have they received training from an accredited provider?
  • Are care home staff members fit and proper to carry out the requirements of their role?

Care homes need a training budget and you can bring in external experts to help set up a training programme which meets the needs of all employees.

If the manager needs to take disciplinary action or dismiss an employee for example, they must ensure that their legal position is water tight. Being a small business is no excuse for not following the law and you should ensure that expert advice is taken at all stages.

Vicarious Liability

Care home owners should be aware that some solicitors are targeting people who may have been victims of abuse whilst in care. A case from 2001 - Lister v Hesley Hall - set a new precedent. The Law Lords found that the employers – who were owners of a boarding school - were liable. A school warden sexually abused children and it was found these were "within the scope of employment" hence vicarious liability attached to the school.

Get the Right Care Home Insurance

Having the right care home insurance in place to protect against abuse claims is crucial. Insurance is not an area where care homes should cut corners. Managers should ensure they use an insurance broker who understands the nursing and care sector and can advise on the ins and outs of the various care home insurance policies available. There are important variations and the cheapest care home insurance policy might not give you the best cover and could leave your business seriously exposed. If things do go wrong, your care home's reputation could be left in tatters – something insurance cannot repair.

Having the right insurance arrangement in place provides the care home manager with peace of mind. And your insurer may also be able to provide some guidance before there is a problem, for example in keeping proper records and with risk management measures. It is vital to have all the information readily available so that an insurer's legal team can provide the best possible defence. Some claims may be vexatious – but if innocence cannot be shown, then the consequences could be severe.

It will never be possible to totally eliminate abuse in the care homes industry, but the chances of it occurring are slim if care home managers are prepared to face up to the problem and ensure their business is run to the highest standards possible.

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