Vulnerability and abuse: an exploration of views of care staff working with people who have learning disabilities.

In recent years there has been increased focus on vulnerability and abuse however greater attention has been paid to this in relation to children, elders and in domestic situations. Within learning disability service there has been increasing attention on physical and sexual abuse as well as attention being given to abuse as it is perceived by people with learning disabilities. The aim of this study was to explore the views of staff working within learning disability services regarding their views of vulnerability and abuse. A phenomenological approach was adopted, as this is a subject about which little is known and the lived experiences of care staff and the meanings that they attach to them were being explored. Semi-structured interview was the chosen method for data collection. Twenty informants shared their views in this study. The data generated were themed and the findings were presented in two different but complementary styles: case studies and themes representative across the entire sample. This research has highlighted a number of important issues. There is considerable difference in the meanings given to vulnerability by care staff and the range of meanings are further complicated when notions of risk are considered. A model is presented that illustrates experiences of vulnerability and confidence of the individual the impact of various experiences on those states. For example negative experience of bullying might increase vulnerability whilst positive family support might engender feelings of confidence. The study showed that staff are more influenced by personal and family values than by policy. Though this study focused on adult protection policy it was evident that this also applied in the case of other policy. The strong influence of personal values pervades all aspects of care. This was evident in the views of informants regarding abuse. Abuse is considered to range in severity from bullying, which is seen as prevalent but to an extent unpreventable, to sexual abuse which is considered by most to be taboo. Neglect and infringement of rights were in the main not seen as abuse with both being attributed to ignorance. Power, authority and/or control are felt to be essential in the management behaviour that challenges and is justified to that end. In the context of adult protection a model for safety planning is proposed that shifts the emphasis away from risk avoidance toward an enabling person centred approach that recognises the importance to the individual of excitement in life that also may involve risk