Organisational Abuse

What is Organisational Abuse/Neglect?

Organisational abuse (sometimes referred to as institutional abuse) is neglect and poor care practice within an institution or specific care setting such as a hospital or care home or relating to care in a person’s own home. This can range from a one off incident to on-going ill-treatment; neglect might also occur as a result of the structure, policies, processes and practice in an organisation.

Spotting the Signs of Organisational Abuse/Neglect

  • Run-down or poor facilities, including the standard of heating and ventilation
  • Over crowded facilities
  • Abusive and disrespectful attitudes towards people using services
  • Lack of respect for dignity and privacy
  • Not providing adequate food or drink or assistance with eating
  • No flexibility or lack of choice in relation to daily routines and diet
  • Not promoting independence
  • Misuse of medication
  • Tasks not being completed on time or correctly due to staffing pressures
  • Poor moving and handling practices
  • Failure to maintain moving and handling equipment
  • Inappropriate use of restraints
  • Lack of care plans
  • Poor record-keeping and lack of procedures
  • High staff turnover resulting in poor quality care
  • Failure to provide care with dentures, glasses and hearing aids
  • Failure to respond to abuse appropriately
  • Discouraging/refusing visits or involvement of relatives, friends or carers
  • Lack of personal items, clothing or possessions
  • Few social, recreational and educational activities
  • Not taking account of individuals’ cultural, religious or ethnic needs

What a Good Organisation Should Look Like

Leadership and Management

  • The manager of the service provides effective leadership, supporting, training, coaching and directing staff to do their jobs properly
  • The manager is visible, approachable and available
  • There are sufficient staff to meet the needs of service users
  • There are low levels of staff turnover
  • There is not a high reliance on agency staff
  • The service does not accept referrals for people who needs cannot be met
  • The manager informs commissioners when they are unable to meet a person’s individual needs
  • Policies and procedures are readily available and are followed correctly
  • Problems are proactively recognised and responded to effectively
  • High or low trends for Safeguarding Concerns, Complaints and Incidents are evaluated transparently and considered carefully
  • External incident reporting to the Police, Care Quality Commission and the Local Authority is robust, effective and open
  • Services are audited effectively and appropriately by the provider.

Staff Behaviour and Attitudes

  • Staff have up to date and good knowledge of the individual needs of the people they are supporting
  • Members of staff use appropriate and non-judgmental language about the people they support
  • Members of staff provide personalised care, providing the adult with choice and control
  • There is effective verbal and written communication between staff members
  • Any negative behaviour is challenged and there is a culture of zero tolerance towards abuse
  • Staff always treat people with dignity and respect
  • Best Interests decisions are made appropriately in line with guidance and documented effectively
  • Staff adhere to and proactively support the principles of the Mental Capacity Act.

Environment and Basics of Care

  • Support is provided to ensure the person’s personal hygiene and appearance is maintained
  • There are sufficient bathroom facilities provided to meet the personal care needs of the people who use the service
  • Personal possessions are treated with respect, and care is taken to ensure these are not lost or misplaced
  • The environment is always very clean and there are no unpleasant smells
  • The environment is well maintained and there are no health & safety hazards
  • There is a varied programme of activities and resources to help keep people active and occupied
  • Activities are provided in multiple locations offering options and choices
  • Staff are proactive in understanding and minimising the potential for conflict between service users
  • People are always dressed in clothing that is appropriate to their needs and or the weather
  • Staff promote independence and support the skills of the adult
  • Medication is always administrated with care using appropriate and up to date guidance.

Service Design and Delivery

  • People’s needs are being met in line with identified care plans
  • There are high quality care plans providing an accurate record of the individual’s needs
  • Care plans and risk assessments are updated and reviewed regularly to reflect any changes to personal circumstances
  • Staff carry out actions that are recommended by other practitioners from outside the service
  • The group of people using the service are compatible and have similar needs, helping to minimise the potential for conflict and pressure on staff/resources
  • Safeguarding policies and procedures are applied consistently and correctly.

Openness

  • There is regular and appropriate input from other professionals outside of the service
  • Individuals have frequent contact with family, friends and other staff not directly employed by the service
  • External appointments are met
  • Members of staff have a wide network of colleagues outside of the service
  • Appropriate referrals are made to Speech and Language Therapy, GP, Dieticians, Community Psychiatric and other Nurses
  • Management and staff create a relaxed environment that encourages and values professional challenge from outside the service, as well as transparency in relation to complaints from family members
  • The service facilitates appropriate, private consultations with professionals from outside the service
  • Family contact is proactively encouraged and supported.

Organisational Abuse Resources

Support

If you are concerned about a service you can talk to your Local Authority – Report Abuse. You call also contact the Care Quality Commission (CQC) if your concern is in relation to a registered care provider.