Adult safeguarding reflection

1. Think of a therapy session or event

·   Referral to review a patient’s swallow. The patient had cerebral palsy. He was found to be at risk of aspiration but did not aspirate on soft foods and thin fluids during a videofluoroscopy.

·   The patient’s mother refused to let me in to assess the patient. She reported that the patient was being seen by another SLT team (information which I verified). She also reported that it was not a good time to visit the patient since she had a monetary dispute with some other family and that she was his only carer and spoke to him in Portuguese. I handed over advice and wrote a letter to the patient’s GP explaining the situation and recommending a review.

·   Several months later an SLT from the learning disability team contacted me for information about the patient. She reported that the patient’s mother refused entry to a physiotherapist and to members of her team.

·   She reported that the patient was now PEG fed and that his communication had deteriorated. She agreed to contact the patient’s GP and to oragnise a professionals meeting regarding the patient’s care.

2. What did this make you feel?

·   I felt anxious that I could be at fault for not being more proactive about gaining access to the patient/ contacting the adult safeguarding team. I had felt that since the patient was being seen by another team and did not aspirate during his videofluoroscopy that I could handover advice and discharge.

What would you change and why?

·   I would contact the adult safeguarding lead to discuss the case.

·   I would ensure that I spoke directly to the patient’s GP to relay my concerns.

·   I would document my discussion with the patient’s mother in more detail and explain to her further the risks of withholding treatment. I would also try to be more persuasive and ask whether the patient had capacity to make a decision whether or not to accept a visit.

What has this taught you?

1.    To ensure that I speak to a safeguarding lead/ GP if I have concerns about a patient rather than just sending a letter.

2.    To document all discussions thoroughly including information on risks.

3.    To be more thorough when collecting information and to consider linking in with hospital/ other therapy teams further.