Responding to Allegations of Abuse
: A Qualitative Study of the Influences Upon Decisions made by Nurse and Social Workers in Community Learning Disability Units in South Wales

  • Zoë Hodges

    Student thesis: Doctoral Thesis


    Background: The abuse of adults with a learning disability has been increasingly monitored and recorded in order to prevent abuse and to intervene when it occurs. What has received less attention is why the incidents that are identified and recorded as abuse are recognised and defined as abuse. Whilst little is known about how the abuse of adults with a learning disability is defined, even less information is available to discuss the influences that nurses and social workers in a Community Learning Disability Team experience in defining and responding to potential abuse. Exploring these influences and the decisions that follow from them is the focus of this study.

    Purpose: This research investigates, explores and recognises the choices, decisions and conflicting priorities that nurses and social workers experience in identifying and responding to potential abuse. This study also recognises how registered nurse and social work professionals in a Community Learning Disability Team arrive at a decision as to what action is required to respond appropriately to the potential abuse that they are aware of.

    Method: This study follows a qualitative paradigm and symbolic interactionist perspective to value and explore participant interview data. The grounded theory approach of Situational Analysis (Clarke, 2005) – a constructivist method that extends the original grounded theory method – is used to analyse information from 25 semi-structured interviews.

    Findings: The findings identify four theoretical categories emerging from participant data. These are; the official line, expectations and perceptions, nonvulnerable adult process responses and lastly confidence and competence. New theory is presented using a project map a unique and disciplined feature of Situational Analysis (Clarke, 2005).

    Participants expressed that recognising and responding to abuse was not a clear, linear or straightforward process. Characteristics of each of the theoretical categories may overlap with, or be challenged by, another category. Examples of this included that there was a discrepancy between the clarity of the available
    guidance and how it was applied to practice within individual Community Learning Disability Teams. Filtered through the priorities that nurses and social workers identified, the four categories contribute to establishing the theoretical statement the ‘tipping point – practitioner discretion, management decision’.

    Conclusions: Policy guidance suggests that the consistent application of single point or threshold at which abuse is defined and action taken is both positive and possible (SSIA 2010, Wales, 2014). This research proposes that there are a number of influences upon practitioners which prompt them to exercise a discretion as to how abuse is defined that may include re-framing incidents so that they that they do not constitute abuse. Where abuse is identified by participants it is likely that a manager – usually a social services manager- will direct or instruct the action that the practitioner should take to respond to the incident.
    Date of AwardMar 2016
    Original languageEnglish
    SupervisorRuth Northway (Supervisor) & Michelle Culwick (Supervisor)

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