Introduction
As a part of Unit 7 : Principles of Safe Practice in Health and Social Care, I am
required to explore the various principles of safe practice that are in place in Health
and Social care environments. I will also be researching the importance of safe
working practices, safeguarding procedures and how to respond to emergency
situations in Health and Social Care settings. Furthermore, I be exploring the
professional responsibilities and legal duty of care that people who work in Health
and Social Care settings are required to follow. In addition, I will be examining types
of abuse and neglect that service users may experience and researching the signs
and symptoms of abuse. It is also important for me to learn about infection control
procedures and fire or evacuation drills in Health and Social Care environments. In
addition to the other areas that I will be researching, I will also be developing my
knowledge of safeguarding and the issues that come with it for many vulnerable
patients alongside the issues that staff may face when facing a complaint in a Health
and Social care setting.
Learning Aim A requires me to examine how a duty of care will contribute to safe
practice in Health and Social Care settings. For Learning Aim B, I will be required to
understand how to recognise and respond to concerns about abuse and neglect in
and Health and Social Care environment. Learning Aim C needs me to be able to
investigate the influences of health and safety legislations and policies on Health and
Social Care settings. For Learning Aim D I will need to explore procedures and
responsibilities to maintain health and safety and respond to emergencies in a Health
and Social Care setting.
Learning Aim A - Examine how a duty of care contributes to safe practice in
health and social care settings
AP.1 Explain the implications of a duty of care in a selected health and social
care setting
Duty of Care
Duty of care refers to the “legal obligation to safeguard others from harm whilst they
are under your care” (Collins English Dictionary, 2018). Typically a duty of care can
be met by: acting in someone's best interests, knowing ones competency limits,
protecting individuals, reporting incidents and follow the Code of Conduct. In different
professional roles, employers will have differing responsibilities that they must carry
out to meet their duty of care, however there is a general duty of care that must be
followed by all employers.
Duty of care is in place in every health and social care setting and is sometimes used
to “cover both legal and professional duties that healthcare practitioners may have
towards others” (Royal College of Nursing, 2018). In a healthcare setting, a duty of
care is only imposed in situations where it is foreseeable that harm may be caused to
a service user. The Duty of Care applies to all employees, regardless of their position
and exists when an employee has assumed some kind of responsibility for a service
1
,user. A Healthcare employee must uphold the rights of service users whilst also
promoting the interests of individuals, especially in cases where individuals
experience abuse or neglect. In a healthcare setting, a duty of care is enforced by
the Nursing and Midwifery Council which has published the ‘Code for nurses and
midwives’ which is applicable to any healthcare professional. Staff in health and
social care settings should always know their competency limits an not take on any
tasks that they cannot complete safely, they should also protect individuals
experiencing abuse or neglect as this their duty of care.
In the Merryvale Case Study, there was a clear disregard for Duty of Care as the
Residence was running below the legal limit in terms of care workers which would
clearly have negatively affected patients quality of care. As many of the patients are
vulnerable adults, they require assistance with personal care such as bathing and
washing, and due to the low staffing levels, they have to wait for long periods of time
without bathing or manage by themselves. If the patients had to manage by
themselves, there would be a high risk level due to the patients reduced mobility or
dementia, which could result in an injury due to the staffs neglect of duty of care. A
further issue with the illegal staffing levels (paired with the loss of the Residences full
time cleaner) is that there are health and safety risks in the environment such as
spilled food and drinks on work surfaces which breaches health and safety policies
and could result in the injury of residents which would mean that employees are not
acting to ‘safeguard others from harm’ (Collins English Dictionary, 2018). To properly
follow their Duty of Care, staff should have never allowed staffing limits to reach
below the legal limit and when this did occur, the best thing to do to protect the
residents would either be to temporarily close and move residents whilst new work
was found, another option would be to quickly find bank staff to cover the legal limit
whilst other employees were found.
In the Zebra Ward Case Study, although the intention to follow duty of care was
evident, and despite the patients’ initial physical injuries being tended to, duty of care
was not followed with regards the markings discovered on the children. A Doctor and
Nurse both failed to report or record the markings discovered on the children due to
being rushed, however being rushed is not an adequate excuse for failing to record
signs of physical abuse. The Nurse also failed to record the administration of a
sedative which disregards their duty of care towards the patients and puts them in
potential danger of having bad reactions to other medication or suffering an
overdose, both reactions which could potentially harm or kill them; this is not acting in
accordance of duty of care as the Nurse put both children in danger by failing to
record medication. The Ward Manager on Zebra Ward, refused to share information
with a Social Worker which although followed legal confidentiality policies, could
have endangered the children as if they returned home with their father, they could
be subjected to more abuse. To ensure Duty of Care was met, both staff that
witnessed the markings on the children should have immediately reported it to
another member of staff, and everyone working with the children should have been
made aware of the suspicion of abuse to ensure the children were safeguarded. The
Ward Manager should have asked to see identification from the Social Worker and
2
,informed Police of the possible abuse situation so that any appropriate professionals
could be involved in managing the case, unless the Social Worker was requested by
the ward, not sharing confidential information was correctly following policies in place
however could also have put the children at risk.
Daniel Pelka Case Study
On March 3rd 2012, Daniel Pelka was
pronounced dead after suffering at the hand
of abuse for years. He suffered sustained
abuse from his step-father and mother and
had several visits to A&E over the course of
his life for abuse related injuries. Despite
Daniel being frequently covered in bruising,
healthcare professionals were oblivious to the
abuse due to his mother's lies about the
incidents, and it was never fully explored.
Police were also called to his family residence
on “26 separate incidents involving domestic
violence and alcohol abuse” (BBC News,
2013), however professionals did not question that the abuse could also be
happening to Daniel. Daniel was under Social Services as an at-risk child however
his case wasn’t fully reviewed until after his death, when his two siblings were taken
away from the family home.
Professionals failed Daniel and his siblings on many occasions and ultimately their
ignorance led to his death. Although a Core Assessment was undertaken to explore
family relationships and identify possible risk factors, Social services did not identify
any issues at home and closed Daniels case. Daniel also had several GP and A&E
visits however none of the staff reported Daniels frequent injuries due to them being
“medically inconclusive” (Children’s Services,2013) and therefore failed their duty of
care as Daniel was left to suffer without any intervention. In the final review, the BBC
noted that had there been support for Social Services from other partner agencies,
Daniels case would never had become as severe and cases like is would be easier
to prevent.
Baby P Case Study
On August 3rd, Peter Connelly (Baby P) suffered death after being hit by his
stepfather and swallowing a tooth, effectively leading him to choke to death. Baby P
suffered abuse from his stepfather since birth and was known to Social Services from
early on after being taken to A&E for abuse related injuries. A Social Worker made a
pre-arranged visit to his household however failed to spot signs of abuse as bruises
and scarring had been covered up by his mother. In August, Baby P was taken to
hospital to undergo a paediatric assessment however the Doctor refused to continue
the assessment due to Baby P being “miserable and cranky” (BBC News, 2011).
3
, There were many cases where healthcare employees should have been able to spot
and report the signs of abuse, such as when Baby P was regularly visiting the GP for
abuse related injuries and should have had his case passed on to the Police or Child
Protective Services, however they did not manage to spot the signs or take any
further actions when abuse was suspected. Despite Baby P being placed under CPS
(Child Protective Services), no action was taken to prevent him from the harm that
would inevitably come to him. Due to healthcare workers not following the correct
duty of care when dealing with Peter’s case, he died, and although his case has had
a positive and long lasting impact on the future of Social Work and duty of care, it
should not have been allowed to happen.
When covering the heartbreaking case of Baby P, a BBC reporter quoted saying that
services “did not comply appropriately with their duties, and had they done so the
tragic death of Peter Connelly may have been avoided”. The BBC also stated that it
was the “incompetence and systemic failures” that led to Baby P’s untimely death,
and ultimately it was professionals disregarding their duty of care that allowed this
case, and will continue to allow cases like this to unfold.
Little Ted’s Nursery Case Study
In 2008, a nursery worker at Little Ted’s Nursery (Vanessa George) began sexually
abusing and sharing explicit images of her pupils. Vanessa “took pictures of herself
abusing toddlers and sent them” (BBC News, 2008) to Colin Blanchard, who
forwarded the images to Angela Allen. The three met online and shared disturbing
images of sexual abuse with each other for several months before each party was
arrested and sentenced to time in prison. The Nursery “operated as a relatively
'closed system' in many ways, selective in the persons or agencies with which it
communicated” (Rushforth,C ,2016), this allowed Vanessa to pick and chose policies
which led them to being made in her favour.In the Case Review, it is noted that there
was a general reluctance from agencies, schools and member of the public to
challenge the Nursery which led to behaviours such as those of Vanessa being
allowed to happen due to agencies ignoring their duty of care and not reporting
incidents or low childcare standards.
The case “dynamic is consistent with the behavioural and communication patterns
between families and professional safeguarding service” (Rushforth,C ,2016) due to
healthcare workers and services being avoidant of the situations unfolding before
them. One of the biggest issues with this case is the lack of a “whistleblowing policy
to support the reporting of K's escalating sexual behaviour” (Rushforth,C ,2018),
there was also no code of conduct which left staff unsure what may class as
inappropriate behaviour. There was also no policy on allegations against staff, no
safeguarding training for new employees and no supervision from anyone other than
Vanessa, who was using the Nursery for her own personal gain. In this Case Study,
although a duty of care was not followed which led to the continual sexual abuse of
pupils, there was also a lack of required legal documents in place which meant that
staff were left clueless and unable to raise their concerns.
4
As a part of Unit 7 : Principles of Safe Practice in Health and Social Care, I am
required to explore the various principles of safe practice that are in place in Health
and Social care environments. I will also be researching the importance of safe
working practices, safeguarding procedures and how to respond to emergency
situations in Health and Social Care settings. Furthermore, I be exploring the
professional responsibilities and legal duty of care that people who work in Health
and Social Care settings are required to follow. In addition, I will be examining types
of abuse and neglect that service users may experience and researching the signs
and symptoms of abuse. It is also important for me to learn about infection control
procedures and fire or evacuation drills in Health and Social Care environments. In
addition to the other areas that I will be researching, I will also be developing my
knowledge of safeguarding and the issues that come with it for many vulnerable
patients alongside the issues that staff may face when facing a complaint in a Health
and Social care setting.
Learning Aim A requires me to examine how a duty of care will contribute to safe
practice in Health and Social Care settings. For Learning Aim B, I will be required to
understand how to recognise and respond to concerns about abuse and neglect in
and Health and Social Care environment. Learning Aim C needs me to be able to
investigate the influences of health and safety legislations and policies on Health and
Social Care settings. For Learning Aim D I will need to explore procedures and
responsibilities to maintain health and safety and respond to emergencies in a Health
and Social Care setting.
Learning Aim A - Examine how a duty of care contributes to safe practice in
health and social care settings
AP.1 Explain the implications of a duty of care in a selected health and social
care setting
Duty of Care
Duty of care refers to the “legal obligation to safeguard others from harm whilst they
are under your care” (Collins English Dictionary, 2018). Typically a duty of care can
be met by: acting in someone's best interests, knowing ones competency limits,
protecting individuals, reporting incidents and follow the Code of Conduct. In different
professional roles, employers will have differing responsibilities that they must carry
out to meet their duty of care, however there is a general duty of care that must be
followed by all employers.
Duty of care is in place in every health and social care setting and is sometimes used
to “cover both legal and professional duties that healthcare practitioners may have
towards others” (Royal College of Nursing, 2018). In a healthcare setting, a duty of
care is only imposed in situations where it is foreseeable that harm may be caused to
a service user. The Duty of Care applies to all employees, regardless of their position
and exists when an employee has assumed some kind of responsibility for a service
1
,user. A Healthcare employee must uphold the rights of service users whilst also
promoting the interests of individuals, especially in cases where individuals
experience abuse or neglect. In a healthcare setting, a duty of care is enforced by
the Nursing and Midwifery Council which has published the ‘Code for nurses and
midwives’ which is applicable to any healthcare professional. Staff in health and
social care settings should always know their competency limits an not take on any
tasks that they cannot complete safely, they should also protect individuals
experiencing abuse or neglect as this their duty of care.
In the Merryvale Case Study, there was a clear disregard for Duty of Care as the
Residence was running below the legal limit in terms of care workers which would
clearly have negatively affected patients quality of care. As many of the patients are
vulnerable adults, they require assistance with personal care such as bathing and
washing, and due to the low staffing levels, they have to wait for long periods of time
without bathing or manage by themselves. If the patients had to manage by
themselves, there would be a high risk level due to the patients reduced mobility or
dementia, which could result in an injury due to the staffs neglect of duty of care. A
further issue with the illegal staffing levels (paired with the loss of the Residences full
time cleaner) is that there are health and safety risks in the environment such as
spilled food and drinks on work surfaces which breaches health and safety policies
and could result in the injury of residents which would mean that employees are not
acting to ‘safeguard others from harm’ (Collins English Dictionary, 2018). To properly
follow their Duty of Care, staff should have never allowed staffing limits to reach
below the legal limit and when this did occur, the best thing to do to protect the
residents would either be to temporarily close and move residents whilst new work
was found, another option would be to quickly find bank staff to cover the legal limit
whilst other employees were found.
In the Zebra Ward Case Study, although the intention to follow duty of care was
evident, and despite the patients’ initial physical injuries being tended to, duty of care
was not followed with regards the markings discovered on the children. A Doctor and
Nurse both failed to report or record the markings discovered on the children due to
being rushed, however being rushed is not an adequate excuse for failing to record
signs of physical abuse. The Nurse also failed to record the administration of a
sedative which disregards their duty of care towards the patients and puts them in
potential danger of having bad reactions to other medication or suffering an
overdose, both reactions which could potentially harm or kill them; this is not acting in
accordance of duty of care as the Nurse put both children in danger by failing to
record medication. The Ward Manager on Zebra Ward, refused to share information
with a Social Worker which although followed legal confidentiality policies, could
have endangered the children as if they returned home with their father, they could
be subjected to more abuse. To ensure Duty of Care was met, both staff that
witnessed the markings on the children should have immediately reported it to
another member of staff, and everyone working with the children should have been
made aware of the suspicion of abuse to ensure the children were safeguarded. The
Ward Manager should have asked to see identification from the Social Worker and
2
,informed Police of the possible abuse situation so that any appropriate professionals
could be involved in managing the case, unless the Social Worker was requested by
the ward, not sharing confidential information was correctly following policies in place
however could also have put the children at risk.
Daniel Pelka Case Study
On March 3rd 2012, Daniel Pelka was
pronounced dead after suffering at the hand
of abuse for years. He suffered sustained
abuse from his step-father and mother and
had several visits to A&E over the course of
his life for abuse related injuries. Despite
Daniel being frequently covered in bruising,
healthcare professionals were oblivious to the
abuse due to his mother's lies about the
incidents, and it was never fully explored.
Police were also called to his family residence
on “26 separate incidents involving domestic
violence and alcohol abuse” (BBC News,
2013), however professionals did not question that the abuse could also be
happening to Daniel. Daniel was under Social Services as an at-risk child however
his case wasn’t fully reviewed until after his death, when his two siblings were taken
away from the family home.
Professionals failed Daniel and his siblings on many occasions and ultimately their
ignorance led to his death. Although a Core Assessment was undertaken to explore
family relationships and identify possible risk factors, Social services did not identify
any issues at home and closed Daniels case. Daniel also had several GP and A&E
visits however none of the staff reported Daniels frequent injuries due to them being
“medically inconclusive” (Children’s Services,2013) and therefore failed their duty of
care as Daniel was left to suffer without any intervention. In the final review, the BBC
noted that had there been support for Social Services from other partner agencies,
Daniels case would never had become as severe and cases like is would be easier
to prevent.
Baby P Case Study
On August 3rd, Peter Connelly (Baby P) suffered death after being hit by his
stepfather and swallowing a tooth, effectively leading him to choke to death. Baby P
suffered abuse from his stepfather since birth and was known to Social Services from
early on after being taken to A&E for abuse related injuries. A Social Worker made a
pre-arranged visit to his household however failed to spot signs of abuse as bruises
and scarring had been covered up by his mother. In August, Baby P was taken to
hospital to undergo a paediatric assessment however the Doctor refused to continue
the assessment due to Baby P being “miserable and cranky” (BBC News, 2011).
3
, There were many cases where healthcare employees should have been able to spot
and report the signs of abuse, such as when Baby P was regularly visiting the GP for
abuse related injuries and should have had his case passed on to the Police or Child
Protective Services, however they did not manage to spot the signs or take any
further actions when abuse was suspected. Despite Baby P being placed under CPS
(Child Protective Services), no action was taken to prevent him from the harm that
would inevitably come to him. Due to healthcare workers not following the correct
duty of care when dealing with Peter’s case, he died, and although his case has had
a positive and long lasting impact on the future of Social Work and duty of care, it
should not have been allowed to happen.
When covering the heartbreaking case of Baby P, a BBC reporter quoted saying that
services “did not comply appropriately with their duties, and had they done so the
tragic death of Peter Connelly may have been avoided”. The BBC also stated that it
was the “incompetence and systemic failures” that led to Baby P’s untimely death,
and ultimately it was professionals disregarding their duty of care that allowed this
case, and will continue to allow cases like this to unfold.
Little Ted’s Nursery Case Study
In 2008, a nursery worker at Little Ted’s Nursery (Vanessa George) began sexually
abusing and sharing explicit images of her pupils. Vanessa “took pictures of herself
abusing toddlers and sent them” (BBC News, 2008) to Colin Blanchard, who
forwarded the images to Angela Allen. The three met online and shared disturbing
images of sexual abuse with each other for several months before each party was
arrested and sentenced to time in prison. The Nursery “operated as a relatively
'closed system' in many ways, selective in the persons or agencies with which it
communicated” (Rushforth,C ,2016), this allowed Vanessa to pick and chose policies
which led them to being made in her favour.In the Case Review, it is noted that there
was a general reluctance from agencies, schools and member of the public to
challenge the Nursery which led to behaviours such as those of Vanessa being
allowed to happen due to agencies ignoring their duty of care and not reporting
incidents or low childcare standards.
The case “dynamic is consistent with the behavioural and communication patterns
between families and professional safeguarding service” (Rushforth,C ,2016) due to
healthcare workers and services being avoidant of the situations unfolding before
them. One of the biggest issues with this case is the lack of a “whistleblowing policy
to support the reporting of K's escalating sexual behaviour” (Rushforth,C ,2018),
there was also no code of conduct which left staff unsure what may class as
inappropriate behaviour. There was also no policy on allegations against staff, no
safeguarding training for new employees and no supervision from anyone other than
Vanessa, who was using the Nursery for her own personal gain. In this Case Study,
although a duty of care was not followed which led to the continual sexual abuse of
pupils, there was also a lack of required legal documents in place which meant that
staff were left clueless and unable to raise their concerns.
4
