If an accident is an unintentional event leading to injury. An incident damage to premises or equipment and a Near Miss where no injury or damage occurs where does Violence and Aggression (V&A) fit in?

I am particularly relating this question to people with learning difficulties in a day centre, support in the home and shared lives (adult guardianship).

As violence and aggression is intentional, even if considered (sometimes) a way of communication by adults with learning difficulties, how do H&S practitioners in this field report such events? At the moment we report them using the proverbial Accident Report. V&A (or Assault) is reportable if it occurs in the work place. Of course I am referring to physical and verbal abuse. But .........

As V&A is an intentional act how can it be classed as an accident (which is an unintentional event)?

All answers gratefully received.

People with mental health issues are some of the most vulnerable People you are likely to come into contact with and thier frustrations can manifest themselves in several different way including violence to the care giver.

There is some Background Information here: http://www.nrls.npsa.nhs...ression/?entryid45=59801

I do have more but will have to dig it out...I will post when I can

Hi

Agree with previous posters in that it should be recorded as an 'incident'.

Acts of V&A in this field are not always intentional in that respect i.e. a need/aim to cause harm, but as others (and you) have said may be a method of communication. Recording is key as it can assist in identifying triggers for behaviour, identify any particular patterns such as time of incident, against whom, nature of incident (physical, verbal, sexual etc) and help identify controls and interventions. This can be challenging, especially if you have individuals whose behaviour patterns manifest themselves in repeated V&A-related events.

On a side note & without being overly pedantic, there is a big difference in support needs and other issues affecting those with learning difficulties and those with mental health issues - something to bear in mind when reviewing incidents and supporting this particular group.

what U should also do is monitor just who is violent to who and under what circumstances as some surprising facts can come out? ---------- in one case I was involved with it was discovered that a large and strong individual was allowed to go to a day care ctr as an experiment to see how they would react as they were very violent their whole life and in their specialist care ctr but had had treatment to reduce this violence ---------- the SS people were most upset when I found out about this persons history and continued aggression to people as I put my foot down and after much case history discussions it was agreed [and they privately admitted] that the treatment had not worked so the person was removed to a safer place for both them and the majority

S-Service's people / carers etc. will not like this approach but U need to stand your ground and try to ensure that staff are made safe and if specific negative evidence is gathered about certain individuals then action should be taken to make the area safe for the majority.------ An additional problem is the fact that many staff in these work areas just accept that violence against them & others is part of the job and it is acceptable so staff will need educating

best of luck as this is a tricky area

If you are worried about definitions you can describe it as “an accident is an unintentional (or unplanned) event leading to injury” as you the employer did not plan or intend for the violence and aggression to take place, any more than you might plan for the wheels to fall of a trailer or someone to fall off a scaffold.

I advise that u do as Toe suggests

I first came across this dilemma some 20 years ago now when I was working for an LD charity. We used to record V&A as an accident, because as AK hints, it indicates risk that need to be controlled. If you step back a bit and ask yourself why you record it starts to make sense. Nobody collects accident/incident stats as a hobby (well, nobody I know anyway), we do it to indicate risk and to prioritise effort in risk control. V&A, whether intentional or not, can be a high risk in some settings if it is not properly controlled, so record your V&A. Whether you use 'accident' or 'incident' is a bit of a moot point.

The issue seems to be about nomenclature; bear in mind that most H&S literature and theory is based on settings where an accident is likely to be a falling hammer or a descending press; it is not a good fit with 'softer' service industry or care settings. So use it in a way that gets the results you're looking for, which in this case is risk control. In LD that's often about being better at meeting somebody's care and support needs, so everybody wins,

John

OK, for the sake of continuing an interesting discussion :-)

That could depend on how much the person with learning difficulties was responsible for their actions, i.e., how conscious/knowing, they were that they were going to inflict harm on the other person. There are many 'normal' people who occasionally 'lose it' and kick/hit the sofa etc., and after come to their senses about what they did.

I think if a person is fully in command of their emotions and senses etc., when they are going to 'hit' someone then on their part it is clearly deliberate whereas if they are not then it could easily be an 'accident' also on their part. From the receivers point of view, unless they are in a boxing match :-), they are not intentionally receiving the 'hit'.

Of course I think the key thing is to report it, have the 'injury' checked by a competent person and for the employer/team to look at how to reduce the risks.

I am not challenging your post, by the way, and rather am just adding a different perspective for the sake of discussion.

Regards

I work for an organisation where violence can and does occur (the people attending in general do not want to be there and can include children, those with mental health issues, alcohol or drug addiction etc so meetings can be extremely volatile).

When I first joined the organisation incidents involving aggression were not recorded. Our Incident Form now records violence (both verbal and physical). When recording I also note if the violence is aimed towards staff or those attending our premises as asked each year under the Freedom of Information Act for number of incidents involving assaults on staff.

Thankfully the numbers are low - generally one or two a year at max and usually it's a case of the person being in the wrong place at the wrong time rather than aimed towards the individual person e.g. they were blocking the person's exit and were moved physically out of the way!

As a direct result of recording incidents, was able to argue to management the need to provide conflict handling training for staff so they could deal effectively with incidents as they occurred (and learnt how to recognise the trigger factors / body language / calming steps etc to take).

We offer counselling to staff if they are involved in an incident (even if it's verbal - if they need to speak to someone they can). All incidents are also recorded on file so if the person involved attends again, there is the option to have a police presence requested. It means we can provide evidence to the police that there is a higher potential for violence as they've been verbally abusive on the last 2 visits and threatened staff on the last visit etc. There is space on the incident form to record police attendance details as well and can update if person has been charged etc.

I'm not going to claim that ALL incidents are reported (one person's verbal abuse is another persons banter) but I try and quantify it by telling staff if they feel threatened or intimidated and believe they may have been assaulted, then they should report. I'd rather they did and it be recorded than something happening later on and there not have been any mention of the potential for violence.

As far as reporting to the HSE - only if the person suffers injury as a result of an assault and is signed off work (normally anyway!). Again, thankfully there hasn't been any really serious incidents e.g. involving firearms or knives etc though there is a very small possibility of this [we've had a couple of instances whereby we've been alerted by the local police that a person known to us has threatened violence and been apprehended with a knife, and in one case, a gun]. As those attending can be very young children we try to balance between keeping staff and those attending safe but not turning the premises into prisons with bars on the windows and staff in uniforms which could be frightening for small ones and intimidating for those with mental health issues.