Abuse in care? A research project to identify early indicators of concern in residential and nursing homes for older people

Purpose – The purpose of this paper is to contribute to the prevention of the abuse of older people in residential and nursing homes, through the identification of “early indicators of concern”. Such indicators support practitioners in identifying services in which older people are at risk of abuse, neglect and ill treatment. Design/methodology/approach – Semi-structured interviews were conducted with health and social care practitioners in two local authorities (in England and Scotland), who had visited services in which abuse or neglect had occurred. Practitioners were asked about the things that they had seen within the service which had caused them to become concerned. Findings – Over 90 early indicators of concern were identified. These indicators were grouped within six themes which identify key manifestations of service cultures which may promote the abuse of older people. Practical implications – Information and guidance has been developed to enable practitioners to recognise early indicators and identify services in which older people are at risk and in which actions are required to help prevent the onset of abuse. Originality/value – A range of studies have highlighted the importance of organisational cultures in promoting the abuse of older people. The early indicators identified through this research represent visible signs of such poor service cultures which can be observed by practitioners, enabling them to recognise services in which older people are at greater risk.