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3.3 Carers


If family, friends and or other unpaid carers are implicated in the allegation of abuse, decisions about when and how to inform them should be made as part of the Strategy Meeting / Discussion.

It should not be assumed that abuse within a family is unintentional or due to carer stress. Where there is an allegation of domestic abuse and the alleged victim is an Adult at Risk, the Safeguarding Adults process should be followed (see Part 2: Safeguarding Framework).

Research commissioned by Women's Aid in October 2007 reveals that people with disabilities are more vulnerable to domestic violence and will often face additional difficulties in attempting to access support. (See Domestic Violence London, Domestic Abuse Perpetrated Against People with Disabilities).

Most victims of elder abuse are older women with a chronic illness or disability and the most typical abusers are partners, adult children, or family members. (See Domestic Violence London, Elder Abuse).

However, it is necessary to exercise professional judgment throughout the safeguarding process to discern where alleged Abuse or Neglect by a carer may be due to lack of knowledge or where the carer’s own needs make them unable to care adequately for the person at risk. A distinction should be made between harm caused inadvertently and abuse or deliberate omission / neglect. In these situations, a decision may be taken that the aim of the Safeguarding Adults process is to reduce harm through protective measures such as offering support for the carer.

Circumstances

Circumstances in which a carer (for example, a family member or friend) could be involved in a situation that may require a safeguarding response include:

  • A carer may witness or speak up about abuse or neglect;
  • A carer may experience intentional or unintentional harm from the adult they are trying to support or from professionals and organisations they are in contact with; or
  • A carer may unintentionally or intentionally harm or neglect the adult they support on their own or with others.

Assessment

Assessment of both the carer and the adult they care for must include consideration of both their wellbeing. Section 1 of the Care Act includes protection from abuse and neglect as part of the definition of wellbeing. As such, a needs or carer’s assessment is an important opportunity to explore the individuals’ circumstances and consider whether it would be possible to provide information, or support that prevents abuse or neglect from occurring, for example, by providing training to the carer about the condition that the adult they care for has or to support them to care more safely. Where that is necessary the local authority should make arrangements for providing it.

Speaking up/disclosure

If a carer speaks up about abuse or neglect, it is essential that they are listened to and that where appropriate a safeguarding enquiry is undertaken and other agencies are involved as appropriate.

If a carer experiences intentional or unintentional harm from the adult they are supporting, or if a carer unintentionally or intentionally harms or neglects the adult they support, consideration should be given to:

  • Whether, as part of the assessment and support planning process for the carer and, or, the adult they care for, support can be provided that removes or mitigates the risk of abuse. For example, the provision of training or information or other support that minimises the stress experienced by the carer. In some circumstances the carer may need to have independent representation or advocacy; in others, a carer may benefit from having such support if they are under great stress or similar; and
  • Whether other agencies should be involved; in some circumstances where a criminal offence is suspected this will include alerting the police, or in others the primary healthcare services may need to be involved in monitoring.

Other key considerations in relation to carers should include:

  • Involving carers in safeguarding enquiries relating to the adult they care for, as appropriate;
  • Whether or not joint assessment is appropriate in each individual circumstance;
  • The risk factors that may increase the likelihood of abuse or neglect occurring; and
  • Whether a change in circumstance changes the risk of abuse or neglect occurring. A change in circumstance should also trigger the review of the care and support plan and, or, support plan.

End