Title__How_Do_Unsafe_and_Abusive_Practices_Become_Routine_in_Some_Workplaces_

Title: How do unsafe and abusive practices become routine in some workplaces' Given that the majority of care work is of a personal nature, involves looking after those who may have difficulty in communicating, is physically hard, demanding and dirty and is carried out by the newest and lowest status of the workers, I will show that, by using examples from K101 (Unit 17) and Understanding Health and Social Care (Chapter 14), abusive and unsafe practices can occur in the workplace due to inadequately trained or prepared staff, the lack of appropriate guidelines or policies and safeguards and the embedding of ethos and habits becoming routine in the workplace. Abusive care takes many forms and is not solely concerned with those who are ill intentioned and wish to harm others. Abusive and unsafe care can be a solo or series of acts that results in the harm or exploitation of a person and can be of a physical, sexual or psychological nature and includes acts of omission or neglect. One of the most common ways for abusive and unsafe practices to become routine is that staff are inadequately trained or prepared for the work that they will be asked to do. Intimate care requires care assistants, normally the most junior staff, to carry out tasks that involve direct physical touch and nakedness. K101 (Unit 17,p 20), gives examples of the type of care offered, the lack of training and support given to new members of staff at Millstream Court. It is evident from the case study that Maria has received no training or preparation during her induction for what she will be asked to do or how to react when dealing with these tasks. Because of this Fakhra, Richard and Marie all had experiences which were unpleasant, embarrassing and frightening and could have resulted in death or severe distress or harm to the service user. The lack of training and preparing Marie for such tasks could have led to her not only losing confidence in her abilities and becoming traumatised by her experiences but also acting insensitively to both patients. The lack of supervision by senior and more experienced colleagues also lead to unsafe and abusive practices, for instance if Maria had continued to deal with other patients as she had dealt with Fakhra and Richard, practices and habits which not only had the potential for abuse but could also become the norm therefore being insensitive and ignoring the patients needs and feelings. These practices could also be passed on to junior staff. As these tasks form a major part of intimate care, failing to provide training or discussing such issues can have the potential for abuse if they are left to someone without experience or feels awkward not only in carrying out the tasks but discussing the tasks with other appropriate adults. Using the same scenarios described in K101, Unit 17 and Geraldine Lee-Treweek in her study of Cedar Court nursing home (Understanding Health and Social Care, Chapter 14)there is little evidence to support the fact that appropriate guidelines or Codes of Practice are in place or that staff are aware of such policies. Policies such as the one given in K101 (Chap 17, p54) ensure that staff are properly trained, supported and informed and that patients are not treated in an abusive or unsafe manor therefore providing safeguards for both the service user and care provider, although service users are not normally involved in the creation of safeguards and guidance so they tend to focus on what is important and convenient rather than what is needed. However, codes of practice have another use and that is that they give staff a clear indication of what bad practice is and that they have a responsibility to report any such practice. As care workers are responsible for working within a framework, so they become accountable for their actions, which can take the form of explicit statements, procedures or investigations. Having codes of practices and standards ensures that staff do not introduce cultures which are unsafe or harmful but also have a way of reporting them. K101, Unit 17, Section 4 also states that poor care practice can be embedded in the ethos and habits of a workplace’ and this is further supported by the evidence from Geraldine Lee-Treweek in her study of Cedar Court nursing home (Understanding Health and Social Care, Chapter 14) which states ‘Physical care was attained at Cedar Court through practices of daily mistreatment’ (Chap 14, p111). In the chapter it is explained that the auxiliaries view their jobs as servicing the residents and they need to do this quickly and efficiently. However in ‘doing their job’ they are treating the patients as objects and depersonalising them by ignoring their needs and rights, in fact staff see the patients as problems and give examples of how these problems of are dealt by telling off, ignoring and constraining patients rather than trying to understand the reason for the challenging and aggressive behaviour. In failing to try and understand the reasons behind the behaviour, the staff are actually creating a cycle of triggers that enforce the behaviour and subsequent ‘no nonsense approach’ from the staff. The evidence presented highlights the abusive practices in place at Cedar Court, not because the auxiliaries wish to harm patients but rather that their workload and performance is being judged on ‘presenting the patients’, allowing little time for developing caring attitudes towards patients. It is also evident that there is very little training or supervision therefore allowing the abusive practices of containment, punishment and mistreatment to become the norm and worse still difficult to disapprove of or comment on by colleagues due to the fact that the practices have become engrained in the values and ethos of the staff. In summary, unacceptable care practice is only partly about badly performed tasks or individuals. It is also to do with, the care environments where inappropriate ethos and practices have developed over time and have become part of an organisations culture and values. It is also to do with undermining people, physically and emotionally, by depersonalising them and failing to relate to them as people and humiliating them. In conclusion unsafe and abusive practices can become routine in the workplace due to lack of staff training and preparation for what is involved, the lack of or incorrect policies, strategies and safeguards being in place and the fact that such practices have become engrained in the values and beliefs of those who work there. However management levels at care organisations and individuals within that organisation must take responsibility for such practices and ensure that safeguards are in place to prevent them from causing any further harm to patients. Word Count: 1109 References The Open University (2010) K101 An Introduction to Health and Social Care, Unit 17 ‘Unacceptable care’, Milton Keynes, The Open University. Lee-Treweek, G., (1994) ‘Bedroom abuse: the hidden work in a nursing home’ In Johnson, J., De Souza, C., (2008) Eds Understanding health and Social Care; An Introductory Reader. (2nd edn), London, Sage