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Abuse, Neglect & Exploitation Policy

Intention

  • Each participant accesses supports free from violence, abuse, neglect, exploitation or discrimination
  • Protect the safety and best interests of clients by ensuring appropriate, effective preventative strategies are adopted and prompt responses to incidents of abuse, neglect or harm are implemented
  • Establish the responsibilities of the organisation and provide guidelines and procedures for the detection of and response to abuse, neglect or exploitation of people with a disability
Policy

Engedi Inc is committed to fostering a culture that promotes the prevention of and protection from abuse neglect or exploitation, of people with a disability. 

Scope
This policy applies to all Management Committee members, staff and volunteers across all programs of Engedi Inc. 

Principles

Engedi adopts the following safeguards in recognition and prevention of abuse neglect or exploitation of people with a disability:

  • Adhering to strict guidelines in relation to recruitment, including formal interview, criminal history checks, induction, ongoing training and supervision of staff 
  • Providing adequate support staff/ client ratio
  • Gaining individual information of clients and risk assessment to ensure adequate safeguards are in place
  • Respecting people’s gender and cultural beliefs where possible 
  • Forward planning to ensure compatibility of people in respite care

Keeping a watch brief
Engedi acknowledges that abuse and neglect can happen not only whilst the person is being supported by the service, but also in the home or in the community.

All Engedi staff will be alert at all times to identifying and responding to abuse and neglect. All staff will report any suspicions or incidents of abuse, neglect or harm to the manager.

Safeguards around personal finances
Where Engedi is responsible for the management or expenditure of finances for clients, fair and clearly documented processes are to be followed.

All records, processes and documentation are to be accessible to the person and/or their family and to any legally appointed or authorised person who has specific authority to make financial decisions on behalf of the person. This relates to:

  • Personal finances
  • Individualised funding packages. Funding applicable to participant NDIS Plan

Role of the Public Guardian
The Powers of Attorney Act 1998 and the Guardianship and Administration Act 2000 were enacted to protect people with impaired capacity from abuse, assault, neglect and exploitation. The Public Guardian, appointed under the relevant Act, has the responsibility for protecting the rights and interests of adults with impaired capacity where it has been demonstrated that they are at risk. This protective role extends to investigations into allegations of abuse and neglect, providing advocacy on behalf of the person with impaired capacity and providing legal representation. The Public Guardian may request information under s.22 of the Public Guardian Act (2014). 

Procedures
The following procedure is to be followed where abuse assault or neglect of any sort is known or suspected towards a person/s with a disability.

  • All incidents must be recorded and reported within the appropriate specified timeframe
  • Any high level or extreme level incidents, either witnessed or suspected, must be reported to the manager immediately. If the manager is the one suspected, then the management committee must be informed immediately.

If physical abuse or assault is witnessed by a staff member 

Staff at the scene must ensure:

  • The person (the victim) is safe from further harm and is protected from further contact with the person who is the source of the abuse or assault
  • The doctor and/or the ambulance is notified if the person is injured
  • The manager is advised of the incident immediately
  • Any evidence that may be required in the investigation is not disturbed. 

This includes delaying bathing in the case of sexual assault until it is established whether or not the person requires a forensic examination. The person’s clothing should be preserved after an assault of any sort until it is established whether or not a forensic examination of the clothing is required. The area where the incident occurred should be isolated to avoid contaminating evidence. 

  • A Critical Incident Report must be written fully documenting the incident.
    The report must be completed as soon as possible after the event and within 24 hours, and be an accurate and detailed record of the incident. It will include:
  • the nature and extent of the incident
  • a full description of the incident; being an exact record of the events including times; (when, where, what and who)
  • additional reports written by other witnesses or persons present at the time the incident occurred
  • the name, contact details and position of all those involved, particularly in relation to decisions that are made as a result of the incident
  • the response provided to the person making the allegation
  • the date and signature of the person making the report
  • the outcome of initial follow up

Role of the manager
The manager will ensure that all emergency procedures have been followed, that the appropriate emergency services have been called and that families or guardians are notified as soon as possible. 
The manager will:

  • Check that the right processes have been followed
  • Inform the appropriate authorities eg: the police are contacted as soon as possible if a person has:
  • died as the result of an assault or injury
  • has been sexually assaulted
  • has suffered a non-accidental injury whether or not it requires medical treatment
  • The local Sexual Assault Service is contacted if a person has been sexually assaulted
  • Inform the President of the management committee or their delegate
  • Ensure that families or guardians are notified of the incident as soon as possible, especially when consent to perform forensic examination is required following a physical or sexual assault.  A consent form to act according to what is necessary in the case of a critical incident is obtained prior to entry into Engedi’s care if the main carer is going away or is non contactable
  • Appoint a contact staff person to ensure that information is provided to the person, family or guardian through one coordinated source
  • Provide information in an understandable form, ensuring that an independent advocate is available, and communication aids or an interpreter are provided to assist the person to understand the process and make choices about receiving treatment, or services or legal or other support
  • Ensure that the person and their family know how to access debriefing or counselling services if that is their wish
  • Ensure all staff who were present at the time of the incident complete a critical incident report and send to manager within 24 hrs of the incident 
  • Arrange a debriefing session for staff within 24 hours of the incident occurring and offer counselling if required
  • Provide feedback as to status of investigation to all concerned within 48hrs
  • Review the risk profile of individuals involved in the incident to assess and manage the risk of further incidents
  • Assess the risk of further incidents happening and update any risk management plans relating to the event and the individuals involved
  • Inform Liability Insurers of the incident
  • Document in Incident register, gain feedback and evaluate process 

If the alleged offender is a staff member

The manager must be contacted immediately. If the manager is the alleged offender the management committee must be contacted immediately. 
The Manager or management committee member will:

  • Supervise any interactions
  • Depending on the seriousness of the incident or allegation, immediately suspend the person from duties
  • If incident is substantiated the person will be terminated immediately

Where the allegation involves financial abuse
All allegations of financial abuse must be reported to the manager.

The manager will:

  • Notify the client and or their family or where appropriate, their financial administrator
  • Report the incident to the police where theft or fraud is suspected
  • Ensure the adult guardian is notified in instances where the client is an adult and has an impaired capacity and there is no financial administrator or no family member, advocate or authorized attorney to act on behalf of the person

With all allegations or incidents of abuse neglect or exploitation Engedi will ensure:

  • That all allegations or reports are investigated 
  • The legal rights of the person their right to natural justice is not ignored
  • People’s right to privacy and confidentiality is respected
  • The person making an allegation or reporting an incident does not experience any retaliatory action as a consequence of making the allegation or report and that any report or allegation that is made is treated with sensitivity
  • Clients are provided the opportunity and supported to exercise choice over all stages of the process wherever possible
  • Information is provided to clients and/or their families in a format that meets their communication needs
  • Where appropriate and lawful, clients, their families, guardians, or significant others are provided with the information about the progress of the investigation
  • The management of the allegation does not compromise any investigation by the police or other authority

Regarding staff Engedi will ensure:
The legal rights of staff are not infringed, that the conditions of the awards/agreements are followed and that their right to natural justice is not ignored.

  • In addition to the requirements of this policy, employees’ rights to safety and security and the obligations of employers under the Workplace Health and Safety Act 2011 as amended and the Workplace Injury Management and Workers’ Compensation Act 1998 are honoured
  • If the offender is found to be criminally responsible but with no conviction recorded Engedi takes appropriate disciplinary action in accordance with their contract, Engedi employment policy and with the Industrial Relations Act 1999

This may include:

  • Additional training
  • Counselling
  • Increased supervision
  • Transfer of duties
  • Official warning
  • Dismissal

Following the completion of the process:
Engedi will:

  • Conduct a review of the incident, action and process to determine the effectiveness of the response
  • Regularly review the policy on a continual quality improvement basis
  • Provide regular training to all staff on this policy and procedure
  • Review of policy is a regular part of staff meeting agenda items
  • Ensure that information regarding the policy and practice is routinely provided to all new and existing management committee and staff as part of their induction
  • Ensure that information about this policy and practice is routinely provided to all clients and their families, guardians, or advocates in accessible formats
  • Ensure any employees involved in any incident of abuse neglect or exploitation are debriefed and offered counselling through one of the counselling services referred to on Counselling Services Mackay list

Definitions

Abuse is the violation of an individual’s human or civil rights, through the act or actions of another person or persons.
Assault is an intentional physical attack or beating that causes unlawful violence to another person. 
Neglect is a failure to provide the necessary care, aid or guidance to dependent adults or children by those responsible for their care. 
Exploitation is an act that exploits or victimises someone. 

Types of Abuse, Neglect and Exploitation

  • Physical abuse/assault
  • Psychological / Emotional abuse
  • Systemic abuse
  • Financial abuse and exploitation
  • Sexual abuse/assault and exploitation
  • Legal or Civil Abuse

Recognition of Abuse & Neglect

Types of Physical Abuse:

Types of Abuse

  • Non-accidental actions and assaults causing injuries, such as bruising, lacerations or welts, burns, fractures or dislocations 
  • Threats of violence 
  • Refusing people food because they have not done what they were asked to do 
  • Hitting, smacking, biting, shaking or kicking 
  • Pulling arms, hair or ears 
  • Bending back fingers or bending an arm up behind the back 
  • Placing hot substances in the mouth for swearing 
  • Leaving people in clothing or bedding that has been soiled 
  • Physically restraining a person which is not justified, authorised or excused by law 
  • Inappropriate use of medication including the unauthorised use of medication as a chemical restraint 

Physical Indicators

  • Unexplained cuts, abrasions, bruising and/swelling: on face, lips, mouth, torso, back, buttocks thighs in various stages of healing 
  • Unexplained burns or scalds: cigarette burns especially on soles, palms, back or buttocks, rope burns on arms, legs neck or torso 
  • Unexplained fractures, strains or sprains: to skull, nose, facial structure, dislocation of limbs in various stages of healing 
  • Bite marks 
  • Dental injuries 
  • Ear or eye injuries 
  • Ligature marks 
  • Welts 

Behavioural Signs

  • Avoidance of a particular staff member 
  • Fearfulness or fear of a particular person 
  • Bleep disturbance 
  • Obvious changes in behaviour 
  • Changes in appetite 
  • Changes in daily routine 
  • Unusual mood swings 
  • Withdrawal 
  • Unusual passivity
  • Out of character aggression 
  • Self-abuse 
  • Drowsiness 
  • Inappropriate or changing story of how an injury occurred 
  • Excessive compliance 

Psychological & Emotional Abuse

Type of Abuse

  • Humiliating people for losing control of their bladder or bowels
  • Shouting orders to people
  • Using humiliating names when speaking to people 
  • Treating adults as children 
  • Humiliation, emotional blackmail, blaming, swearing, intimidation, name calling
  • Isolation from friends and relatives 
  • The use of social isolation (ignoring people) 
  • Staff locking a person in their bedroom 
  • Using other clients to provide physical control over another consumer of a service
  • Harassing people to eat food they don’t want to eat 
  • Denying expression of cultural or religious beliefs 

Physical Indicators

  • Withdrawal
  • Speech Disorders 
  • In the case of a child, there may be lags in physical development or a non-organic failure to thrive 
  • Injuries sustained from self abuse or self destructive behaviours 
  • Suicide attempts 
  • Anxiety attacks 

Behavioural Signs

  • Self-abuse or self destructive behaviour
  • Challenging or extreme behaviours
  • Excessive compliance
  • Extreme low self esteem
  • Depression
  • Feelings of worthlessness
  • Lack of interpersonal skills necessary for adequate functioning
  • Extreme attention seeking behaviour 

Systemic abuse

Systemic abuse happens by the very nature of an environment, with failure to recognise, or provide adequate or appropriate services. The patterns and activities of everyday life are institutionalised, with services that are inappropriate to the person’s age, gender, culture, needs or preferences. A culture of abuse is heightened when people are grouped together without personalised assistance and with low staff ratios.

Financial Abuse & Exploitation

Type of abuse

  • Denying access to or control over their money and personal finances when they have ability to do this
  • Taking money or other property without the person’s consent (which is likely to also constitute a criminal offence) or where their consent is fraudulently obtained
  • Misappropriation of money, valuables or property
  • Changes to wills or other legal documents, by coercion, misrepresentation or where consent for changes was fraudulently obtained
  • Denying access to information or documentation concerning their personal finances or individualised funding package
  • Personal use of a client’s telephone by staff which is not recorded or reimbursed, leaving the consumer to pay the cost of the calls
  • Staff borrowing a client’s possessions even for a brief period, eg CDs, lawn mowers etc
  • Staff purchasing a client’s possessions at grossly below the real and accepted value of the item
  • Staff using a client’s vehicle for their own purposes 

Physical Indicators

  • No access or unwarranted restrictions to personal funds
  • No control over personal funds or bank accounts
  • No records or incomplete records kept of expenditure and purchases
  • No inventory kept of significant purchases
  • Person controlling the finances does not have the proper legal authority
  • Misappropriation of money, valuables or property
  • Forced changes to wills or other legal documents
  • Persistent failure to produce receipts
  • Receipts indicating unusual or inappropriate purchases

Signs

  • Person has insufficient money to meet normal budget expenses
  • Person is persistently denied outings and activities due to a lack of funds 

Sexual Abuse and Exploitation

Types of Abuse

  • Any sexual contact between an adult and child 16 years of age and younger
  • Any sexual activity with an adult who is unable to understand, has not given consent, is threatened, coerced or forced to engage in sexual behaviour
  • Forcing someone to take part in sexual activity against their will
  • Forcing someone to take part in sexual activity through threat or coercion

Physical Indicators

  • Direct or indirect disclosure of abuse or assault
  • Difficulty in walking or sitting
  • Pain or itching in genital and/or anal area
  • Vagina or penile bruising, bleeding or discharge
  • Self-abusive or self destructive behaviour
  • Attempts at suicide
  • Torn, stained or blood stained underwear or bedclothes
  • Sexually transmitted diseases
  • Trauma to the breasts, buttocks, lower abdomen or thighs
  • Unexplained accumulation of money or gifts
  • Pregnancy 

Behavioural Signs

  • Sleep disturbances
  • Changes to eating patterns
  • Inappropriate or unusual sexual behaviour or knowledge
  • Changes in social patterns
  • Sudden or marked changes in behaviour or temperament
  • Anxiety attacks
  • Refusing to attend usual places eg, work, school, respite
  • Depression
  • Going to bed fully clothed
  • Excessive compliance of staff 

Legal or Civil Abuse

When abuse is known or suspected to have happened, the person is denied of access to justice or legal systems that are available to other citizens.

Neglect

Type of Neglect

  • Physical Neglect
  • Passive Neglect
  • Wilful Deprivation
  • Emotional Neglect 

Indications

  • Failure to provide adequate food, shelter, clothing or basic personal health care
  • wilful deprivation of necessities of life
  • Staff assisting people to eat and drink in an incorrect or hurried and rushed manner, causing physical discomfort, illness, injury or resulting in or contributing to death
  • Staff giving one person another person’s medication
  • Staff giving over the counter medication to a person without first checking with the family or doctor for appropriateness or any potential harmful side affects
  • Staff continue to administer medication after the use by date has expired
  • Staff not utilising a communication device to allow the expression of needs, choices or preferences
  • Failure of staff to recognise or acknowledge non-verbal messages conveyed by people who have limited communication abilities
  • Staff leaving people alone in a vehicle for extended periods
  • Staff not obtaining or seeking the appropriate medical, specialist, therapy or other allied health support for a person based on the identified individual need
  • Staff not ensuring that a client has access to regular medical support including assessments for medication blood levels, blood pressure, diet and nutrition or access to regular health screening tests
  • Supervision of medical or dental care that places people at undue risk through unsafe environments or practices