A guide for individuals

Violence, threats and abuse of staff and volunteers are unacceptable. The Health and Safety Executive (HSE) defines work-related violence as: 

Any incident in which a person is abused, threatened or assaulted in circumstances relating to their work.

This includes sexual and racial harassment, and threats to family and property.

Violence and abuse are NOT part of the job, although incidents are still far too common.

Managing violence, threats and abuse is the responsibility of both the organisation and worker (employee or volunteer). Employers, managers, employees, volunteers and people who use services working together provide the best means to safer practice.

Your EMPLOYER has the primary responsibility

Your employer's responsibility includes providing you with:

• clear assessments of the risk to you from the individuals, families and groups you work with.
• a statement of the organisation's policy that sets out clear risk reduction procedures that fit your job and where you work.
• clear procedures about what to do when you think there is a risk, what to do if an encounter is escalating into a possible violent incident, what to do after an incident, what follow-up and support there will be.
• training that fits your job, including what responsibilities you have towards colleagues and to people who use services.
• a working environment that ensures your health, safety and well being and that of all employees and volunteers.
• support in dealing with your concerns about threats, abuse and violence.
• procedures for making sure precautions are working and can be reviewed.
• easily available support after an incident that fits what you and others who were involved need to recover from the experience.
• a commitment to action to be taken by the employer against the perpetrator including consideration of removal of service.

Skills for Care has published an updated employer's guide checklist, which provides detailed guidance and examples of all the above.

But you have responsibilities too

Familiarise yourself with:

1. Your organisation's procedures, and implement them. Where applicable this includes the procedures that cover working away from your base or with colleagues from other organisations. Whatever your job you need to be clear about how you should raise any concerns with colleagues and managers: your manager will be able to advise you and provide the relevant procedures.
2. What triggers violence and abuse. Violence or abuse are not considered part of your job, but even when measures are put place to reduce the risk it cannot be eradicated completely: your employer should have told you about this and arranged appropriate training.

Be prepared

• When you think there is a risk, discuss your concerns with colleagues and managers.
• Report all cases of violence and abuse.
• Use local systems to check whether other professionals have flagged concerns.
• Gather as much information as possible about people who use services where violence is threatened.
• Share information about potentially violent users of services with colleagues, your manager, other departments and other organisations, taking account of the Information Commissioner's Guidance.
• To attend training organised for you.

Use your employer's risk assessment procedures and keep re-assessing the risk of violence by asking questions such as:

• is there a history of violence?
• do you need to visit the person using services in their house or is there an alternative?
• should you be visiting in pairs?
• do you need to consider whether it is a man or a woman who works with a particular person?
• do you need additional support when making a visit to the home - e.g. line manager or a police officer?
• how might the person using the service interpret what you are doing, e.g. are they frightened, or under the influence of drugs or alcohol?
• are you limiting the choice of the person using the service or removing or restricting their freedom?
• are you withdrawing a service?
• are you saying 'no' to something they want to do or that they think will make a big difference to them?
• are you sharing information about people who use services and carers with colleagues to help keep them safe, having regard to the Information Commissioner's Guidance?
• are you recording thoroughly what the assessment is and the plan for managing the risks?
• is the risk of violence affecting your ability to assess or monitor risks to children or other adult members of the family?
• are you regularly re-assessing the risks to yourself and others with your manager and revising the assessment when required?

Plan what you and others will do. The plan should:

• result from discussions with your managers and colleagues, including those outside your organisation where they are, or may become, involved.
• include, whenever possible, people who use services and carers in the planning.
• have a strategy for coping with an incident where there is a known risk, covering for example:

  - your organisation's contact arrangements.

  - your colleagues and managers should know your movements and expected return time.

  - a safe place to meet.

  - who to involve.

  - ways of responding to violence, particularly the response to physical contact and what you think is a safe distance.

  - any equipment you may need (mobile phone/attack alarm/sim card alert) but do not rely exclusively on these as they are only additional preventive and protective measures to applied within the risk assessment process.
  
  - an exit strategy for you and others who may be at risk.
  

• recognise that safe practice is good for workers and for people who use services.

Be prepared for the rare, unpredictable and unexpected incident

Your employer should have procedures which staff and volunteers must follow in the event of an unpredictable or unexpected incident.

Your employer should tell you about these procedures and you should familiarise yourself with them and remind yourself of them from time to time. Preparation is never wasted.

Ways to reduce risk include:

• clear procedures are in place and followed if an alarm is raised (whether in an office, care setting or from a lone worker).
• workers are skilled in their work and have a confident, calm, professional approach that demonstrates understanding, empathy and respect.
• workers are appropriately dressed for the client group to prevent intimidation.
• people who use services, people who manage their own services and carers are:

  - well informed and given information that is jargon-free.

  - respected for their experience, expertise, history and culture.

     - involved in planning safe practice, environments and training.

• accurate and detailed records are kept and colleagues (within and outside the organisation) are kept aware of incidents and risks. NB data protection issue need to be addressed positively - please refer to the Information Commissioner's Guidance.
• staff and volunteers are trained to recognise the signs that indicate that a person is becoming agitated and that the situation is escalating into a violent one. (e.g. shouting, agitation, confusion, signs of alcohol or drug abuse).
• workers are adequately trained in the recognition of mental health issues which may result in violent or aggressive behaviour.
• workers are also trained to understand how their own behaviour can escalate or deescalate the situation. They should understand methods that might reduce the anxiety, distress or anger of the person using the service.
• workers know the procedures and how to use them when a situation gets out of control, including finding a way to leave.
• workers have access to adequate technology (alarms, panic buttons, etc) but these are not relied upon on their own to keep people safe.
• workers and managers review incidents, learning from them and re-planning for the future.
• systems to check that learning from incidents are used.
• support is provided in ways that staff feel comfortable with and are positive about accessing.

After an incident

What your organisation should do:

• implement the post-incident procedure, e.g. to gather information about the incident, ensure all staff are safe and inform the police.
• provide immediate appropriate support to you and others involved. This may include medical treatment.
• discuss with you:
• the sort of support you need to recover from the incident (we all differ in our reactions to incidents and so does the support).
• who else, if anyone, from your or other organisations, needs to be informed to keep them safe.
• the lessons for you, your colleagues, the organisation, and any other organisations involved.
• what will be done and how progress will be checked.
• review the risk assessment and make any changes needed in the procedures and support provided to reduce the risk of further violence or abuse.
• liaise with the police regarding possible criminal proceedings being brought against the perpetrator.
• where criminal proceedings are brought against the perpetrator you should be supported through the court process.
• consider the long term impact of the incident which may require possible re-training or redeployment if you are unable to continue in your current post.
• consider any wider changes required to your organisation's policy and procedures.
  

What you should do:

• be familiar with and use the organisation's procedures.
• know where you can get immediate support for yourself. It is your employer's responsibility to get support for others involved.
• don't be surprised if your reactions or other people's are different from what you expected, and be tolerant of your own and others' immediate reactions.
• take care of yourself and contact people who will offer the support you need.
• as soon as possible, record details of the perpetrator/s and the events and expect debriefing sessions for yourself and the perpetrator/s.
• record and report the incident to your employer.
• attend all further training sessions provided by your employer.
• remember nothing will change for the better unless incidents are reported.

Safe practice is part of best practice!

How to obtain your copy

To download a full copy of the guide for individuals please click here.  Alternatively if you require a hard copy of the guide please email marketing@skillsforcare.org.uk