Homes with abusers? Let us address that now | Katherine O’Neill

by Katherine O’Neill

The dangers we carry for failing to protect carers from the physical abuse and sexual assault they face in their work are often hidden from view. Research on the abuse of older people shows the extent to which issues around discrimination, bullying and victimisation in care homes can make carers feel isolated, and change their decision-making skills.

Care workers work from the longest day of the year. They are among the most exploited and vulnerable people in our society. Faced with abuse and harassment on a daily basis, they are particularly at risk of depression and anxiety.

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But our public policies allow those figures to rise. Those at risk are silenced and we have failed to learn from the public example of restaurants, schools and other organisations that have faced public outcry following an attack or miscarriage of justice. These are the cases that highlighted to us the implications for service users and their families of such serious harm. And while the latter issue is raised again and again by the media, the conversation on the prevalence of abuse within residential care homes is often relegated to second place.

In nursing homes, carers face the frightening knowledge that they are being abused and sexually assaulted, yet are often only learning about this from media reports, or quietly suffering from their own stress. From 2011 to 2017, half of the 121 victims reported serious sexual or physical abuse by staff in 21 of the UK’s largest adult social care providers. Repeated unlawful acts including assault and rape made up 19% of abuse claims.

Staff deployed to new places and facilities face an increased risk from sexual or physical abuse and should be notified of this. The consequence is that some have difficulty trusting care workers – particularly carers unfamiliar with their needs. And all staff within one organisation are unable to learn from their neighbour’s experiences without first learning about it from the media. Despite repeated warnings from local authorities that there is a problem, the issue was not considered sufficiently important for the Care Quality Commission to report it out as a significant incident until 2006.

The huge national and local authority funding difficulties faced by care providers has meant the maximum amount of training given to care workers on workplace safety and safeguarding has not kept pace with the increase in the size of the sector. Five years ago, employers were told to provide training to 656 workers on sexual misconduct and harassment. Last year this number rose to 21,523. Yet research has shown a shockingly low rate of staff who take up training. One provider reported on a tactic that some abusers use in order to get information about other care workers – they show vulnerable carers a picture of a friend or family member in an attempt to gain their trust.

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A number of scenarios are possible if the perpetrators in abuse cases are not brought to justice. The possibility that victims will not press charges is a key concern. Should they feel they are not receiving the right level of support to make this happen, they may give up. This lack of confidence is most detrimental to the services they receive, the providers they work for and our society as a whole.

This was the subject of a recent BBC Five Live public affairs programme called Care Aware. As part of the programme, care workers shared their experiences and knowledge of violence within the sector. One care worker described being sexually assaulted, but not reporting it to the police for more than a year. She was “too scared”.

Care workers – and care recipients – deserve much better. Our public policies must develop safeguards to protect carers from unnecessary stress, and we need to have a renewed focus on staffing and funding increases to put an end to the injustices we see every day.

Katherine O’Neill is an editor at Nursing Times.

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