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Safeguarding Adults Week: Shifting the balance of power

Kathryn Holland 15 November 2021

This article looks at how imbalances of power can increase the risk to abuse, and how advocacy can work preventatively by helping to redress power imbalances.

The Care Act 2014 puts empowerment’ front and centre of safeguarding. This means that people’s wishes and the outcomes that matter to them should be, wherever possible, leading the safeguarding enquiry. Empowerment can also help in the battle to prevent abuse happening in the first place. 

There are a number of ways in which power structures make us less able to see abuse. 

The normalisation of power structures

Most of us experience a degree of disempowerment in life and power structures are a normalised part of growing up - throughout our lives we have sometimes been obliged to accept things that we think are wrong. But this same tendency can mean that poor practice and even abuse go unchallenged. 

Professionals know best?

People who live within institutions may not challenge abuse because the people in charge aren’t challenging it. They may even be perpetuating it. People may think that if the professionals don’t see a problem, it’s because there isn’t one.

What does good care look like?

Some people may not have ever experienced really good care and degrees of poor care is all they know. Abuse can be an extension of poor care. 

Rights and entitlements

People who experience abuse in institutional settings may see themselves as lacking and at fault, rather than as having rights and entitlements that have not been upheld. 

Knowledge is power

Information may not be provided in a way that is accessible. This includes information about what abuse is, what you can do about it and what good care and treatment should look like. 

Some voices are louder than others

People may have spoken up about abuse before, but nobody did anything about it. It is not uncommon for harmful assumptions to be made about what a person with support needs says. For example, that they are just saying something to get attention or to get someone else in trouble. 

Advocacy has a critical role to play in addressing power imbalances

Helping people to recognise what abuse is

To help people know what abuse is and speak up about it we have co-produced a your right to good care’ easy read resource with Busy People, to help people know what they have a right to expect from the care they receive. 

Giving people a voice to speak up about abuse

Having someone who is independent, on your side and who can help you speak up is empowering and can help to reduce the risk of abuse. 

Helping people to know their rights

People have a right to live lives free from abuse and neglect. Abuse is always an abuse of someone’s rights. However, it is not always clear when a legal right is engaged by abusive practice.

Poor care may constitute an abuse of someone’s human rights. For example, the right to be free from inhuman and degrading treatment is likely to be engaged if a person is being supported/​treated in an environment that conflicts with their learning needs.

Not providing accessible information is a breach of the legal right, set out in the accessible information standard, the legal context of which is the Equality Act 2010. This places a legal duty on all service providers to make steps or take reasonable adjustments’ in order to avoid putting a disabled person at a disadvantage compared to someone without a disability.

Not providing information in an accessible format about what abuse is puts someone with communication needs at a disadvantage and may increase their risk of abuse. This is a right that is anticipatory not reactive. Therefore, health and social care organisations should not just be reacting to requests for accessible information but anticipating what the people they support may need.