Staff understandings of abuse and poor practice in residential settings for adults with intellectual disabilities

Fyson, Rachel; Patterson, Anne

doi:10.1111/jar.12677

Cited by 14 publications

(11 citation statements)

References 23 publications

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“…Perhaps due to the sensitive nature of the topic, most researchers focusing on the abuse of adults with intellectual and other developmental disabilities have taken a qualitative approach to their research, including five studies that were rated a maximum of 5*. Authors of three of these studies conducted interviews with staff (Fyson & Patterson, 2019; Parley, 2010; Patterson & Fyson, 2016) and authors of one study recruited consumers identified as part of a class action lawsuit on behalf of adults identified as having ‘mental retardation’ and inappropriately residing in a state psychiatric hospital (Ahlgrim‐Delzell & Dudley, 2001). The final study rated 5* used secondary data to examine the conclusions and recommendations reported in executive summaries of adult serious case reviews to ascertain common and diverse themes using thematic analysis methodology (Aylett, 2016).…”

Section: Resultsmentioning

confidence: 99%

“…Policies and protocols should be followed, and immediate action taken by staff when abuse is reported, whereby information provided by alleged victims of abuse is documented, and relevant authorities are informed (Bigby et al, 2012; Ramsey‐Klawsnik & Teaster, 2012). Staff should receive regular unannounced visits by supervisors, regular clinical supervision and training (e.g., on topics including the relational dynamics of abuse, appropriate boundaries, patterns/signs of abuse and appropriate response to suspected cases of abuse) to ensure they feel both supported and empowered in their role (Allington, 1992; Furey et al, 1994; Fyson & Patterson, 2019; Hutchison & Kroese, 2016; Marchetti & McCartney, 1990; Ottmann et al, 2017; Ramsey‐Klawsnik & Teaster, 2012).…”

Section: Resultsmentioning

confidence: 99%

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Detection and prevention of abuse of adults with intellectual and other developmental disabilities in care services: A systematic review

Collins

Murphy

2021

Research Intellect Disabil

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Background: The abuse of adults with intellectual and developmental disabilities in care services seems to be relatively common, although there are anecdotal suggestions that abuse may be predictable and preventable.Method: Evidence related to how abuse is detected and prevented within services was reviewed. Database and ancestry searches were conducted, and the methodological quality of studies assessed using the mixed methods appraisal tool.Results: A total of 48 articles were reviewed. The characteristics of victims, perpetrators and organisations were summarised. Several recommendations for how abuse can be detected and prevented were made, including better staff training, supervision and monitoring of services. The quality of studies limits the reliability and validity of research findings. Conclusion:Risk and protective factors related to the abuse of adults with intellectual and other developmental disabilities remain largely consistent. Further research is required to support the implementation of recommendations aimed to detect and prevent abuse.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Detection and prevention of abuse of adults with intellectual and other developmental disabilities in care services: A systematic review

Collins

Murphy

2021

Research Intellect Disabil

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“…For service users with disabilities, this is of particular concern given that their requirement for support services extends to significant elements of their life needs. Furthermore, service users with capacity [1] constraints (due to an intellectual disability or otherwise) face increased barriers in representing their will and preferences when interacting with service providers, exacerbating the potential for poor service outcomes and, at times, abuse (Fyson and Patterson, 2020; Griffith et al ., 2013) and thereby undermining NPO mission realization. This is, or ought to be, a central concern for the management of organizations providing these services, as outcomes for service users are central to their mission objectives and consequently an important area of research.…”

Section: Introductionmentioning

confidence: 99%

Accountability logics in disability service NPOs – Incorporating the role of service user advocacy in accountability and management control systems

Conaty

Robbins

2023

AAAJ

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PurposeThe aim of this paper is to contribute to a greater understanding of non-profit organization (NPO) management control systems (MCS) and accountability in organizations providing support service for capacity constrained service users. Specifically, the paper examines the role of MCS and accountability in supporting mission realization in NPOs providing services to people with intellectual disabilities and reflects on this in the context of the COVID-19 pandemic.Design/methodology/approachThe research comprised a case study of four NPOs providing services to people with intellectual disabilities in Ireland conducted prior to the global COVID-19 pandemic. The study probed management's perceptions of stakeholders and examined the manner in which the design and use of MCS and accountability processes supported mission realization.FindingsService users were regarded as the least powerful stakeholder and consequently the least attended to in terms of MCS and accountability processes. The absence of relational and dialogical accountability with service users is not only central to maintaining this power asymmetry but also poses a threat to mission realization. These deficits can be addressed through the integration and monitoring of internal advocacy activities into MCS and accountability processes, which, on reflection, may also mitigate some of the negative consequences for service users of isolation from external support networks in times of crisis.Research limitations/implicationsThis research has opened up an area for enquiry – internal advocacy – heretofore not addressed in the management accounting literature, opening up a novel vein for future research. Such research could further examine the role of internal advocacy, drawing from and adding to the research in other support service domains. A number of objectives and questions might be considered: (1) probing the level of management recognition of the role of direct engagement in advocacy activities in supporting service user agency; (2) identifying with service users and management the nature and attributes of effective advocacy activities and practices; (3) questioning how such advocacy activities and practices might be reflected in MCS; (4) identifying what service user stakeholders regard as effective accountability to them in relation to their needs and objectives; and (5) assessing the impact on service user experience and on NPO mission realization of internal advocacy activities and the monitoring and review thereof through MCS. These suggestions for future research draw attention to aspects of support service delivery that have the potential to be profoundly influential on service outcomes.Practical implicationsA performance management model reflecting the identified need to incorporate internal advocacy mechanisms into organizational management control systems is proposed in an effort to increase accountability of NPOs to their core mission stakeholder – service users. This model may be of value to NPO management as they move from a medical-model of care to a rights-based model for service delivery in care settings.Social implicationsThe paper reflects the importance of listening to the voice of vulnerable service users in NPO care settings and proposes a mechanism for embedding internal advocacy in formal management control systems and accountability processes.Originality/valueIn proposing an “agency” supportive relational and dialogical accountability logic for such organizations, underpinned by “internal advocacy”, this research provides theoretical and practical insights for accountability processes and the design of MCS. The findings contribute empirically, not just to the NPO management and MCS literature but also to understanding the relational interaction of service users with service organizations, and what this means in supporting service user objectives and realization of organizational mission.

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“…Further, a lack of knowledge among professional caregivers about the sexuality of people with intellectual disabilities has been documented in several studies (Esmail et al, 2010 ; Lunde, 2014 ; Lunde et al, 2022 ; Saxe & Flanagan, 2016 ; Young et al, 2012 ). Fyson and Patterson ( 2020 ), interviewing staff from residential settings, found variations in staff's understanding of abuse and poor practice. Together, these studies indicate that professional caregivers are uncertain about how they can support people with intellectual disabilities regarding their sexual health.…”

Section: Introductionmentioning

confidence: 99%

People with intellectual disabilities and harmful sexual behaviour: Professionals' views on the barriers to prevent harm

Svae

Hassel

Søndenaa

2022

Research Intellect Disabil

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Background People with intellectual disabilities can be exposed to sexual abuse and they can display harmful sexual behaviour. This study aimed to identify barriers to preventing harmful sexual behaviour in people with intellectual disabilities within the support sector and the justice system. Method We conducted focus group interviews with 20 participants from hospital‐based habilitation centres, community residences, schools and the criminal justice system. Results The interviews identified a lack of education and guidelines for stakeholders or carers on regulating the sexual behaviour of people with intellectual disabilities. The criminal justice system faces challenges related to prioritising, understanding and communicating. People with intellectual disabilities may lack an understanding of the concepts of sexual consent and acceptable sexual behaviour. Conclusion There is a need to improve knowledge about intellectual disability and how to prevent harmful sexual behaviour for professional caregivers in the support sector and the criminal justice system.

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Staff understandings of abuse and poor practice in residential settings for adults with intellectual disabilities

Cited by 14 publications

References 23 publications

Detection and prevention of abuse of adults with intellectual and other developmental disabilities in care services: A systematic review

Detection and prevention of abuse of adults with intellectual and other developmental disabilities in care services: A systematic review

Accountability logics in disability service NPOs – Incorporating the role of service user advocacy in accountability and management control systems

People with intellectual disabilities and harmful sexual behaviour: Professionals' views on the barriers to prevent harm

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