Safeguarding Adults Week: What have we learnt from abuse?

What we have learnt is that rather than being the result of a few ​‘bad apples’ (although there may well be an element of this), there is something about institutional care that may in and of itself create the potential for abuse like this to grow and thrive. Or to put it another way, some care settings may be a little like bad apple factories.

Learning about why abuse has gone on undetected is a critical component of preventing it being able to happen in the future, and what we do as advocates is crucial. 

Why might people not tell us they are being abused? 

• some people might not be able to 
• some people might not know that the experiences they are having are abusive 
• they may have told people and not been believed 
• they may be afraid that if they tell people it will make things worse
• they may have reported abuse that was investigated but was not upheld 

What we must do about this 

• listen closely to the people we are advocating for and take everything we are told seriously. Trust may take a while to build, but a good starting point is to show in action that we are independent and on their side
• take as much time as is needed to understand what life is like for those who would struggle to explain their experience to us 
• if a person cannot tell us what life is like then consider other ways we can find this out. This should include reading care notes (including daily notes), and contacting those who know the person well, including family members and friends
• make sure people understand that they have a right to expect good care from the people who support them. If their care is substandard, tell them that this is not normal
• provide information in a way that is accessible to the person you support 
• make sure people to know their rights and support them to uphold any rights that are being breached

You can’t just believe what you see or what you’re told

It may seem obvious, but people who know they are doing something wrong often hide it. Moreover, many people who work in a care setting can over time come to see poor care as normal.

Advocates, who may spend lots of time in a particular setting, are not immune to this process of becoming used to dysfunction. But resisting this, and keeping an alert, independent outsider’s perspective, is essential to keeping people safe from abuse. 

What must we do about this 

• be aware of changes in your own perception and discuss this in supervisions and team meetings - other people may be feeling this too so opening up the discussion can help everyone
• ensure you have regular meetings/​catch ups with colleagues, and arrange a catch up after a visit
• be conscious of your need to maintain independence. Remind yourself why you are there and who you’re there for
• be professionally polite but at the same time clear about the boundaries of your role

It can be difficult not to be affected by the environments we are in and we can find ourselves going with the flow. Swimming against the tide takes more effort but is a necessary part of preventing abuse and creating safer cultures.