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Experienced Social workers

The following illustration may help:

I was asked to review evidence regarding an 86 year-old woman in residential care who had apparently been assaulted. I was provided with a medical report which showed that she had bruises to her face and forearm that were a couple of days old. The medical opinion was that it was impossible to determine whether these injuries had occurred deliberately. The police had interviewed the service user who had been unable to tell them how the injuries had occurred. They had also interviewed the other residents and staff but no further information had been forthcoming. The home had been described as Good in a recent inspection and no local information was available regarding increased numbers of complaints or other indicators which might contradict this assessment. I asked the service user's GP for an opinion, since I was aware that following a stroke, Warfarin had been prescribed. I knew this was an anticoagulant and that consequently bruising might be more likely. The GP confirmed that it was possible that the Warfarin might be responsible but could not provide a conclusive judgement. Given the available evidence, my thoughts were that the medication was the most likely cause but, nonetheless, I asked the owners of the residential home to review all of their procedures for logging incidents, since whatever the cause, the service user was clearly not observed closely enough by staff. In addition, I also requested that the social worker should work more closely with service user's family who, although not regularly involved, did visit her. Their continued oversight would also lend a protective factor to safeguard her health. Thinking about it later, I also recognised that there were limitations in terms of relying on logs, etc. and that there was a need for all social workers to be observant as to how care was provided during their visits.

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