NICE guidelines call on staff and visitors to identify care home abuse and neglect

The National Institute for Health and Care Excellence (NICE) has published draft guidelines setting out how to recognise the warning signs of abuse, and what actions to take if abuse or neglect is suspected.

Health and social care practitioners are being asked to also provide information on signs of abuse and neglect to residents and their families and carers.

Abuse may be physical, sexual, psychological and financial. In 2018/19, 415,050 safeguarding concerns of abuse and neglect of adults were raised in England, an increase of 5.2% on the previous year.

The guidelines differentiate between subtle signals, which should lead people to look carefully at the situation, and stronger signals that should lead people to suspect abuse and take immediate action.

Staff and visitors should ‘consider’ abuse or neglect in situations where there may be an alternative explanation, such as behaviours associated with dementia, autism or a learning disability. Judgements should be made based on personal experience with that resident’s behaviour.

Abuse should be considered if a resident:

  • has lost or gained weight unintentionally
  • uncharacteristically refuses or is reluctant to engage in social interaction
  • does not have opportunities to do activities that are meaningful to them

NICE guidelines also describe circumstances where people should ‘suspect’ abuse or neglect, where there is no clear alternate explanation. These markers should not be seen as absolute proof of abuse, but immediate action should be taken.

These include when a care home resident:

  • lives in a dirty, unhygienic or smelly environment
  • is malnourished or dehydrated
  • is denied independence aids (such as hearing aids, glasses or dentures), contrary to their care and support plan

“This new set of NICE guidelines for safeguarding adults in care homes should help to clarify roles and improve understanding of the actions one can take against recognised abuse, and the various processes involved in addressing concerns” says Dorothy Hodgkinson, practitioner at Finding Perspectives UK.

The guidelines also includes recommendations on policy, training and care home culture so staff are aware of safeguarding and are willing to report concerns.

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