Organisational Abuse
Organisational Abuse includes neglect and poor care practice within a specific care setting. This could occur in a hospital or a care home, but also the care an individual receives in their own home from a domiciliary provider. Repeated instances of neglect or poor practice may be a sign of organisational abuse, when standards of care are so poor that residents or service users are put at risk.
Organisational abuse occurs when the routines, systems and procedures of a care provider result in poor or inadequate standards of care, and when the organisation fails to address problems that are brought to its attention. While it is not always easy to tell the difference between poor practice and ongoing organisational abuse, you should look out for things like:
- Failure to provide care, inadequate provision of care or acts of omission;
- Inappropriate use of power or control;
- Inappropriate confinement, restraint, or restriction;
- Lack of choice or provision – in nutrition/hydration, in decoration, in lighting and heating, and in other environmental aspects;
- Lack of respect for independence, dignity or privacy;
- Lack of personal clothing or possessions;
- No flexibility of schedule;
- Financial abuse (it could also be helpful to read up on Lasting Power of Attorney, Power of Attorney, and Next of Kin );
- Physical or verbal abuse;
- Lack of leadership, supervision and governance; and
- Failure to respond to concerns about abuse or neglect appropriately.
If you think Organisational Abuse is happening near you, you can contact The Care Quality Commission (CQC), the regulatory body for providers, who will be able to advise you on the best course of action to take. If you have any concerns, you must raise them. It is better to raise and be wrong, than not act.
Concerns in relation to Organisational Abuse should also be raised with the Telford & Wrekin Council Adult Safeguarding Team, who will decide whether to conduct a Safeguarding Enquiry. On occasions this may lead to providers being taken into the Organisational Safeguarding Process to obtain a commitment to improvements and support them to make changes. Alternatively regulatory action may be taken if improvements are not consistently demonstrated over a period of time and the safety of service users cannot be guaranteed.
Over recent years the Telford & Wrekin Council Adult Safeguarding Team have strengthened their relationship with the Telford & Wrekin Council Procurement (Vulnerable People) Team, to further enhance additional Quality Monitoring support, to achieve greater alignment in addressing Provider concerns.
The Procurement (Vulnerable Team) Team become involved where concerns reach the threshold of becoming contractual matters, whereby a Providers may not be consistently delivering as per the agreement they have in place with Telford & Wrekin Council. Information is shared frequently between both teams and also through Information Sharing Meetings with partner agencies involved in working with providers, to raise awareness of current and rising issues. Conversations take place regularly to ensure that everyone is kept informed and up to date on developments.
This combined approach allows Telford & Wrekin Council to move quickly in supporting Providers to make the improvements that are required, or understand where there are deeper problems that need to be addressed in detail as soon as possible. It also demonstrates a greater level of strength as a Local Authority, in that there is engagement across teams who require the same outcome of improved standards, and united in any Organisational Failure process or contractual action deemed necessary.