Barriers and Enablers to Safeguarding Children and Adults within a Disability Services Context: Insights from an Australian Delphi Study

Abstract

Research conducted in the 1990s revealed the tragic irony that exposure to the disability support system, and particularly to its institutional forms, was a major risk factor related to the neglect and abuse of children and adults with a disability. Subsequently, a range of policies have been introduced to minimize risk. However, recurring events of abuse and neglect in the disability services sector in high and middle income countries demonstrate that processes geared to safeguard children and adults with a disability from abuse and neglect remain insufficient. To establish the wider fabric of organizational factors that contribute to effective safeguarding practices within the Australian disability support sector, a modified online Delphi study was conducted, capturing the views of disability services staff and managers (n = 249) regarding barriers and enablers to effective safeguarding. This study identified issues concerning organizational culture, management practice, workforce development, client capacity building and contextual factors. During Round Two of the Delphi, participants were asked to rate the categorized enabler statements according to importance on a 10-point Likert scale, to ascertain the degree of consensus. A total of 262 of the statements were regarded as important or very important. The Delphi result highlighted the considerable gap between the wider systemic and cultural processes that, in the eyes of disability services staff and management, contribute to good safeguarding practice and the safeguarding measures currently in place. The article calls for a holistic approach to safeguarding that addresses procedural issues and to the transformation of the wider systemic and cultural fabric of an organization.

Detection and prevention of abuse of adults with intellectual and other developmental disabilities in care services: A systematic review

“…Other barriers included a lack of inter-professional collaboration and expert consultation, inconsistent approaches to investigations, delayed reporting of abuse, delayed investigations, biased and leading questioning of victims by untrained professionals, lack of time to conduct a thorough investigation and lack of resources (Ahlgrim-Delzell & Dudley, 2001;Fyson & Kitson, 2012;Ottmann et al, 2017;Ramsey-Klawsnik & Teaster, 2012;Zuckerman et al, 1986). Fyson and Kitson (2012)…”

Safeguarding in Australia’s new disability markets: Frontline workers’ perspectives

“…Multiple studies in high income countries have shown very high prevalence of physical, sexual or partner violence affecting people with disability (Hughes et al, 2012). In Australia, people with intellectual or psychological disabilities and those living in congregate care face particularly high risks (Araten-Bergman et al, 2017; Ottmann et al, 2017). People with cognitive or psychological impairments are three times as likely as people without disability to have experienced violence in the last 12 months (CRE-DH, 2021).…”

“…Such harms continue to be underpinned by complex, convergent factors, including ableist community attitudes; segregated living and working arrangements; poorly designed and enforced regulation; and barriers to change within organizations (Royal Commission, 2020). Antecedents of abuse and neglect have been explored through a relatively small body of scholarship, which has identified systemic basis of risks, which arise from the isolation associated with impairment; unequal power relations between people with disability and caregivers in formal services; tolerance of inequality; and normalization of harmful practices (Laing, 2017; Ottmann et al, 2017). Charlesworth et al (2020) implicate markets, noting that providers have responded to intensified competition and financial pressures in ways that compromise quality and safety.…”

“…Charlesworth et al (2020) implicate markets, noting that providers have responded to intensified competition and financial pressures in ways that compromise quality and safety. Yet despite growing recognition of the systemic nature of safety risks, responses have predominantly been reactive, compliance-based and behavioural (Araten-Bergman and Bigby, 2020; Ottmann et al, 2017; Robinson and Chenoweth, 2011). Abuse and neglect have been framed as individual transgressions and managerial indifference and cover-ups tolerated, undermining motivation among people with disability and witnesses – including carers and paid workers– to make reports or intervene, reinforcing cycles of harm (Ottmann et al, 2017).…”

“…Yet despite growing recognition of the systemic nature of safety risks, responses have predominantly been reactive, compliance-based and behavioural (Araten-Bergman and Bigby, 2020; Ottmann et al, 2017; Robinson and Chenoweth, 2011). Abuse and neglect have been framed as individual transgressions and managerial indifference and cover-ups tolerated, undermining motivation among people with disability and witnesses – including carers and paid workers– to make reports or intervene, reinforcing cycles of harm (Ottmann et al, 2017). As we show, such risks are perpetuated under the decentralised, provider-led attempts to regulate safety put in place under the NDIS.…”