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Conclusions
What seems to be clear from the review of the studies is that staff who attends
adult safeguarding training do increase their knowledge and confidence in their
ability to recognise abuse and respond appropriately to incidences of neglect or
mistreatment of adults living in long term care homes. How much of a
difference safeguarding training makes has not been widely researched and
currently there was no research found on the topic of staff competencies within
Northern Ireland. However, training is not the only factor that can make a
difference to the way that staff responds to adult abuse.
The review has found that organisational issues such as; understaffing in care
homes, staff values and whether or not there is a safeguarding culture within
organisations, can all play a role in prevention of adult neglect and
mistreatment. These factors also affect the response made by staff when
abuse does occur. Particularly within the adult care home sector, staff
responding to incidents are faced with distinguishing between; what are poor
standards of care, poor practices due to inexperience or staffing issues, human
errors leading to mistakes and accidents, and reckless practice - and deciding
which of these meet the threshold for reporting or raising a safeguarding alert.
Quality improvement initiatives have been attempted on a small scale to raise
awareness of adult safeguarding and human rights and there are more lessons
to learn about how care homes and statutory agencies could work together to
prevent adult abuse and also improve how staff respond when neglect and
mistreatment does occur.
Evaluations of staff training have helped to show what difference educating
staff about adult abuse has made to staff knowledge and confidence. Skills are
developed through practice experience and therefore some staff more than
others will encounter adult abuse more often. Through having more experience
these staff will self-report a higher level of competence compared to those who
have less experience and who have not completed training. The review also
identified that there is a need to evaluate the training programmes taking into
consideration 'multi-modal' delivery that includes classroom based teaching,
the use of case scenarios, online resources, supervised practice and refresher
courses. The delivery and effectiveness of adult protection and safeguarding
training within Northern Ireland is potentially a topic for further research.