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Clara lived with her husband until he died last year, she soon became socially isolated, and she began engaging with competition letters. These competition letters told her she had won the lottery and that she needed to pay an advanced fee to release her winnings. Clara played the competitions more and more regularly, the higher wins required Clara to solve puzzles and send more and more release fees.

A health care worker noticed Clara was losing weight, Clara told the worker about what she thought was her good fortune, Clara became upset when the health care worker suggested the situation sounded fraudulent

After a visit from the health care worker and a trading standards worker it became clear that Clara had sent a lot of money to the scammers and had nothing left to buy food.

Clara was spending all her pension on the scams convinced she would win large amounts, of money in the next few days. Clara was playing 15 competitions, sending off money to all of them. Moreover the phone rang constantly with calls from scammers who were fishing for information about fixed assets such as the house Clara lived in.

When asked why Clara had engaged with the scammers she said that it took her mind off the loss of her husband and it was something to do. Despite having full mental capacity Clara still only partially believed she was being scammed.

  • Describe the care intervention/s you have chosen, and then apply the careinterventions to the case 
  • Justify your reasons for using the interventions e.g. the Care Act 2014 and thepriorities and guidelines attached to the Care Act 2014.
  • Ensure you consider the requirement of the Care Act 2014 for safeguarding careinterventions to be user led.

Safeguarding

Vulnerable persons are regarded as those unable to make decisions and are at risk of harm by their own actions or exploitation. In the case study, Clara who is a widow has lost her husband and she uses negative coping mechanisms. According to Cramer (2012), negative coping mechanisms occur when one is unable to deal with life events such as death. After her husband dies Clara becomes isolated and is engaged in competitions. This becomes addictive and as she continues, she is required to pay more money. The key issue is Clara uses her hard-earned money to engage in competitions while she hardly gets any return. Clara is being conned. Clara is upset when she is advised that she is being conned.

Clara loses weight and this raises the attention of the healthcare workers. Clara is affected by this behaviour health wise but she doesn’t seem to notice its effects. According to Grun and McKeigue (2013), those who engage in lottery competitions slowly become addicted and it becomes excessive gambling leading to the likelihood of gambling disorders and health issues. Clara began developing health issues but is not happy when this is addressed that the competition may be fraudulent.

Clara spends her pensions engaging in the competitions to the point where she lacks food and this raises the attention of the health worker and the trading standards worker. The trading standards in the United Kingdom is a department involved in ensuring consumer protection against organizations. It is also involved in protecting vulnerable persons against scams and crime. Clara is also being asked for information about assets such as the house she lives in yet she continues to engage in the competitions despite the knowledge that she is being conned. Clara is a vulnerable adult and needs to be protected against the scammers.

Safeguarding is a term used in the United Kingdom to refer to protecting vulnerable adults who are at risk by harm to themselves or others. It is used to protect the rights of these people from abuse and neglect from family members, professionals, healthcare workers and other adults. According to the British Medical Association (2010) safeguarding refers to keeping vulnerable adults from harm by assessing their needs and collaborating with others to ensure their protection. The harm may be in terms of physical and violent abuse, mental, financial abuse. The vulnerable adults are unable to make decisions to protect themselves due to illness or incapability to decide due to various reasons.

Adult at Risk

According to Braye, Orr and Preston-Shoot (2012), safeguarding has six principles which govern it. The first is the principle of empowerment which states that the adult is in charge of their life and should be involved in decision making. The principle of protection states that the adult should be granted support to protect themselves where they are unable. The principle of prevention of harm states that there is a reduction of abuse where it is unacceptable. The principle of proportionality is ensuring a balance between the measures taken and the seriousness of the situation; less restriction. The principle of partnership is working together with individuals, communities and professionals to safeguard the adult. Finally, the principle of transparency and accountability is ensuring the actions taken are open and in communication with other agencies.

S(afeguarding has come  a long way in terms of legislation in the United Kingdom. The data protection act 1998 involves the use of personal data by obtaining, protecting and using personal data. Human rights act 1998 article provides that everyone has the right to privacy in his life or home but sharing of such information may be necessary to protect an individual. Children Act of 1989 states that local authorities have the right to investigate when a child is suspected to be undergoing abuse.

According to the Social Care Institute for Excellence (2011) the Care Standards Act, 2000 protects the persons at risk while ensuring the Secretary of State keeps a list of individuals who are unsuitable to work with people at risk. Safeguarding Vulnerable groups Act 2006 restrict contact between people at risk and potential perpetrators of harm. The latest act being Care Act of 2014 requires local authorities to make inquiries when an adult may be at risk of neglect and abuse. The authority should stop the abuse and set up safeguarding adults board. It should cooperate with other partners to ensure the protection of persons experiencing abuse and neglect.

According to Dunn (2013) an adult at risk is one above 18 years old and is a need of social care services due to illness, disability or other reasons rendering them incapable of taking care of themselves; is at risk of harm or exploitation. The term vulnerable adult is also used interchangeably but in the West Midlands and Birmingham adults at risk are preferred. The term vulnerable adult is contentious since it renders an adult as one who is unable to make decisions and may lead to stigmatization.

First Care Intervention

An adult may be considered at risk due to various factors such as being mentally ill, living with a person who abuses alcohol or drugs. Others include physical and learning disabilities and women due to cultural factors. Healthcare workers should be able to identify an adult at risk and work with other partners. Abuse and neglect are some of the issues the adult at risk encounter. According to the Department of health (2012), abuse consists of a single or repeated act, physical or verbal and inability to give consent. Physical abuse is being restrained or violence, sexual abuse is giving or receiving forceful sexual acts, financial abuse is fraud of assets, coercion of inheritance and theft.

The intervention chosen is making safeguarding personal for the adult at risk. Safeguarding is protecting the vulnerable person at risk. According to Lawson, Lewis and Williams (2014) making safeguarding personal refers to involving the individual at risk in making their own decisions while at the same time directing to improve their own safety. The professional in health and social care involve the adult in decision making and formal proceedings. The making safeguarding personal intervention involves planning outcomes with the person, supporting and empowering the person at risk to solve the circumstance putting them at risk. This approach is person-centred as it emphasizes the need for the adult to be in control. The individual is better informed on safeguarding and sets the outcomes they aim to reach. They set the guidelines they want to follow during the process.

In Clara’s case study Clara has enough mental capacity to judge that what she is doing is risky and it’s a scam. According to Manthrope and Samsi (2012), it is important to assess the mental capability of the adult at risk before commencing on safeguarding. There will be an assessment of the risk or financial abuse Clara is going through. Clara is taken through the process of safeguarding by Safeguarding coordinators who work together with the Adult Safeguarding Board. Clara is informed on why engaging in these competitions is dangerous for her in terms of health and addiction. The fact that she hasn’t received any of her money back should be reason enough to stop participating. Clara is given an opportunity to choose her willingness to quit participating and attend therapy to help her cope with the loss of her husband. She is involved in planning the outcomes such as replacing the urge to gamble with something better.

According to the Department of Health (2014), the Care Act 2014 safeguarding the adult at risk is among the aims set by the National Health Services. The guidelines stipulated include taking the reasonable steps, using assessment methods, evaluation of information and following the right policies and procedures. The Act also states the individual has the right to deny care being offered. The professionals ensure that they communicate fully to Clara on any upcoming updates regarding safeguarding her against further abuse while maintaining records on what is being done.

This intervention is positive in terms of ensuring Clara’s autonomy and deciding what she wants during the whole process of making safeguarding personal. There is nothing being done by force (Leino-Kilpi,2013). The problematic aspect is Clara may not fully adhere to the guidelines and she may continue participating in the competitions.

Positive risk-taking is the second intervention taken to apply in Clara’s case study. Positive risk-taking refers to balancing the likely risks and benefits of a choice. It involves assessing the risks involved and taking the measures to manage the risks. The individual is at the centre of the positive risk taking. It involves empowering the individual on potential risks on the plan to manage the risk, evaluating into detail the different services involved in potential courses. It also involves making rational decisions based on the available information. Positive risk-taking is an ongoing process that involves assessment, decisionmaking and reviewing the various steps made. According to Banks (2012) identification of the risky behaviour is done, stages in the plan and the various challenges that may be encountered in the process to reduce harm.

In this situation, Clara is given the right to make her own decision regarding her financial state. The risks involved in Clara’s situation is her health is jeopardized due to gambling and the scammers are asking for information on her fixed assets. According to Morgan (2014), positive risk-taking involves directing the adult at risk on the consequences of their various actions. Clara is guided on the risks of continuous participation in the competitions and spending her pension in the puzzles. The professional emphasizes the need to save the money rather than spending it while she attends therapy for her complicate grieving. Clara is made to understand the need to stop engaging in the competitions as there are more potential benefits and minimize harms.

The positive risk-taking is important because it teaches the importance of making the right decisions while at the same time allowing the individual to make their own choices. It demonstrates the consequences of a certain action if the adult at risk goes ahead to perform the action. According to Morgan and Andrews (2016), the benefit of positive risk-taking applies to rational decisionmaking. As the Care Act, 2014 states the principle of empowerment states the individual should be given the ability to make their own choices while that of the partnership is ensuring all the key players play their role including the legal advocates.

The positive risk-taking intervention has several benefits including granting the individual at risk the autonomy to make decisions and indicating the various disadvantages. This would be really positive for Clara since she will have the willpower to stop participating in competitions and address the underlying issues. The disadvantages include the difficult process of engaging various key holders in the risk assessment such as the therapist and the legal advocates.

The first intervention which is safeguarding to protect the adult at risk against financial abuse. Making safeguarding personal focuses on the individual and giving them the ability to make their own choices on the safeguarding process. The first drawback regarding this intervention is low support from Clara regarding attending her therapy on complicated grief. Despite the knowledge that she is being scammed and she needs to find a healthy coping mechanism to deal with her grief she rarely attends therapy. According to Worden (2018), therapy is important when one is grieving especially if they are stuck in denial and anger. Clara needs to see a therapist because she is engaging in addictive behaviours such as gambling to escape the harsh reality of her husband’s death.

The second drawback is that Clara is still engaging in the competition despite being informed about the effects of the competition on her health. The competitions have adversely affected her health and the scammers are using her state to manipulate her financially. According to Broda et.al (2013) those willing to place huge amounts of money on the lottery more often than not experience poor outcomes. Clara has experienced poor outcomes and has not won despite the knowledge that she is being scammed and continues to participate.

The second intervention is positive risk-taking where the balance between potential benefits and minimizing harm. Attempting to contact the legal team for Clara to have her pension and fixed assets to be overseen by an advocate is difficult. This is mostly because of the high costs and lengthy procedure to complete the procedure successfully. The financial cost of having a solicitor is about 100 Euros per hour and Clara has already used most of her money in the competition. Most are not willing to take up her case pro bono and therefore delaying the legal procedure to ensure that she still owns her home. The scammers are calling to inquire and might use the information to have her home.

The second challenge is that risk assessment and management is a lengthy procedure which requires collaboration with various stakeholders. According to Mittal and Ross (2012), positive risk-taking involves various steps and there is a need to ensure that they are all considered. This leads to time consumption as the whole process is being completed.

The two care interventions have similarities since both of them are person-centred. They both aim at the wellbeing of the adult at risk while ensuring the autonomy of the person. The adult at risk is left to make the decisions they prefer and the choice is left to them to decide; both allow the individual to refuse the offers and processes being made by the social care.

However, there are various differences while the making safeguarding personal aims at ensuring that the abuse doesn’t continue the positive risk-taking aims at reducing the risks involved while maximizing on the benefits. The positive risk-taking educates the individual on the consequences of the action while safeguarding mainly focuses on ensuring the financial abuse such as in Clara’s case stops.

Conclusion

The vulnerable adult faces various risks such as physical abuse, sexual abuse, financial abuse, verbal abuse and discrimination. It is important to be careful to pick up some of the signs such as loss of weight, lack of food, bruises and social isolation. The perpetrators of this abuse could be family members, health professionals, caregivers and even friends. For Clara, there was evident weight loss and this caused an alarm. The policies set in the United Kingdom provide for the protection of vulnerable adults and if followed to the latter would cause a reduction in the abuse cases.

References

Banks, S., 2012. Ethics and values in social work. Macmillan International Higher Education.

Braye, S., Orr, D. and Preston-Shoot, M., 2012. The governance of adult safeguarding: findings from research. The Journal of Adult Protection, 14(2), pp.55-72.

British Medical Association, 2012. The medical profession and human rights: handbook for a changing agenda. Zed Books.https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=The+medical+profession+and+human+rights%3A+handbook+for+a+changing+agenda.+Zed+Books.&btnG=

Broda, A., LaPlante, D.A., Nelson, S.E., LaBrie, R.A., Bosworth, L.B. and Shaffer, H.J., 2013. Virtual harm reduction efforts for Internet gambling: effects of deposit limits on actual Internet sports gambling behavior. Harm reduction journal, 5(1), p.27.

Cramer, P., 2012. Coping and defense mechanisms: What's the difference?. Journal of Personality, 66(6), pp.919-946.

Department of Health, 2012. Safeguarding adults: report on the consultation on the review of ‘No Secrets’. https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Department+of+Health%2C+H.O.A.T.H.M.O.F.J.%2C+2012.+Safeguarding+adults%3A+report+on+the+consultation+on+the+review+of+%E2%80%98No+Secrets%E2%80%99.&btnG=

Department of Health, 2014. Care and Support Statutory Guidance Issued under the Care Act 2014. https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Department+of+Health%2C+2014.+Care+and+Support+Statutory+Guidance+Issued+under+the+Care+Act+2014.&btnG=

Dunn P No secrets,2013: Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse. Department of Health, https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Dunn+P+No+secrets%2C2013%3A+Guidance+on+developing+and+implementing+multi-agency+policies+and+procedures+to+protect+vulnerable+adults+from+abuse.+Department+of+Health%2C+&btnG=

Grun, L. and McKeigue, P., 2013. Prevalence of excessive gambling before and after introduction of a national lottery in the United Kingdom: Another example of the single distribution theory. Addiction, 95(6), pp.959-966.

Lawson, J., Lewis, S. and Williams, C., 2014. Making Safeguarding Personal.(Vol.26).pp 789-790

Leino-Kilpi, H. ed., 2013. Patient's autonomy, privacy and informed consent (Vol. 40). IOS press.

Manthorpe, J. and Samsi, K., 2012. ‘Inherently Risky?’: personal budgets for people with dementia and the risks of financial abuse: findings from an interview-based study with adult safeguarding coordinators. British Journal of Social Work, 43(5), pp.889-903.

Mittal, V. and Ross Jr, W.T., 2012. The impact of positive and negative affect and issue framing on issue interpretation and risk taking. Organizational behavior and human decision processes, 76(3), pp.298-324.

Morgan, S. and Andrews, N., 2016. Positive risk-taking: from rhetoric to reality. The Journal of Mental Health Training, Education and Practice, 11(2), pp.122-132.

Morgan, S., 2014. Positive risk-taking: an idea whose time has come. Health Care Risk Report, 10, pp.18-19.

Social Care Institute for Excellence ., 2011. Has service user participation made a difference to social care services?. Social Care Institute for Excellence. https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Social+Care+Institute+for+Excellence+.%2C+2011.+Has+service+user+participation+made+a+difference+to+social+care+services%3F.+Social+Care+Institute+for+Excellence.&btnG=

Worden, J.W., 2018. Grief counseling and grief therapy: A handbook for the mental health practitioner. Springer Publishing Company.

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