A personal touch: managing the risks of abuse during intimate and personal care

Abstract

This paper identifies considerations for managing the risks of abuse during intimate and personal care for people with learning disabilities and complex needs. Drawing on insights gleaned from research involving interviews with staff, policies and procedures in specialist day and residential services, and the development of a staff training resource, the paper identifies a framework for adult protection practice in this critical area of support.

The Identification of Environments and Cultures that Promote the Abuse of People with Intellectual Disabilities: a Review of the Literature

“…Cambridge (1999) reported how new staff were ‘set up to fail’, so that their competence could be challenged, confidence undermined and their ability to question practice and raise concerns diminished. Concerns have also been expressed about the use of agency staff, where little may be known about the quality of their work, and guidelines for working with agency staff have been suggested (Buckinghamshire County Council 1998; Cambridge & Carnaby 2000). These guidelines should include an introduction to the service, residents and expected standards.…”

“…These guidelines should include an introduction to the service, residents and expected standards. Guidelines should also recommend that agency staff familiar to the service are used and that new agency staff should not provide intimate care during initial shifts (Cambridge & Carnaby 2000). Similar guidelines could be applied when working with new staff, although the extent to which this occurs could be questioned.…”

“…It has been noted that concepts such as privacy, normally associated with good practice, may be misunderstood or misused by staff, again increasing the isolation of individuals and concealing poor or abusive practice (Sobsey & Mansell 1990; ARC/NAPSAC 1996). Privacy is a complex issue for services, with tensions noted in balancing privacy and homeliness, alongside safety and openness to external surveillance (Penhale 1999; Cambridge & Carnaby 2000). Characteristics of certain shifts also appear to contribute to isolation and abuse.…”

Risk and adult social care: Identification, management and new policies. What does UK research evidence tell us?

“…samples of predominately female carers). Although gender differences between staff were noted, especially with regard to adults with learning disabilities and views of sexual abuse (Brown et al 1994, Cambridge andCarnaby 2000), evidence on gender differences between staff in other areas of social care appeared to be absent. There was also very little specific research exploring perceptions of risk and its management by different ethnic and cultural groups of adult social care users, informal carers and practitioners.…”

Prevalence of disabled people involved in Spanish Civil Guard's police activity

“…They found that (although studies were few and the methodologically was poor) studies confirmed that this was the most vulnerable population. People with disabilities are more likely to be victims of crime are due to their: a) high dependency, b) lack of privacy caused by their need for care from others, c) lack of social skills especially communication skills, and d) ignorance of their rights (Cambridge & Carnaby, 2000;Cooke & Standen, 2002;Sobsey & Varnhagen, 1991;Tharinger, Horton, & Millea, 1990;Verdugo et al, 2002).…”