Understanding Personal Safety and Lone Working

Since 1984 in this country, 19 workers involved in community-based roles have been murdered while visiting clients in their own homes.   Each one of these workers had their own story, a family who loved them and an organisation behind them, supporting them in their work.

Nevertheless, because of the wide diversity of people now accessing services in the community - some with mental health or substance dependency issues - and who require visits from a variety of services in their own homes, staff who work in the community face particular risks.

When examining the most recent incidents of violence against community workers, it becomes strikingly clear that certain indicators - in some cases even clearly documented information - were present, which may have warned of the danger to the worker who was killed.

Research into violence prediction indicators shows that the number one predictor of possible violence is in fact a person’s history of violent behaviour.  Such common sense may appear so straightforward as to sound patronising, however this one key principle is possibly the most important in keeping staff safe.

The tragic case of Ashleigh Ewing serves as a chilling example of how, when available  information is not shared between agencies, the results can be fatal.

Pre-Incident Indicators

Ashleigh’s killer had a history of violent and threatening behaviour, including attacking his parents with a hammer and admitting to having murderous voices in his head.   In the time leading up to the killing, he had been refusing to take antipsychotic medication, was drinking alcohol and had become distressed by mounting debts. He was showing signs of slipping into a psychotic state.

An eminent consultant and author on the prediction of violence, Gavin de Becker, advocates awareness of what he terms “Pre-Incident Indicators”.   These pre-incident indicators are events or actions which occur during the time leading up to a violent incident.  These signs of an impending violent act are ‘as observable, and often as predictable, as water coming to the boil’.

Threats, Intimidation, Manipulation and Escalation are some of the more obvious signs that a client is rising along an aggression curve, building up to a possibly more violent act. 

Other signs may be less obvious, such as a loss of hope, a feeling of persecution or even receiving encouragement from stories in the media about other people in their situation who have used violence.  Sometimes incidents occur in clusters because of this last element - people feeling emboldened by the acts of others.

Collective intuition

A common but often under-utilised resource is when staff, or others who deal with the client, have developed a ‘feeling’ about changes in their client’s behaviour.  If staff, who deal with varied clients all day, every day, get a feeling of fear about just one of them, then the organisation should sit up and take notice, rather than risk the after-effects of apathy and denial.

De Becker advises that when risk-assessing an individual for the potential for violence, we must take advantage of the collective intuition of the ‘experts’ we employ to interact with them.  Indeed the Health & Safety at Work regulations in the UK state specifically that employees must be consulted on issues relating to their safety.  It would seem appropriate to take into account their instinct and intuition about the hazards of their jobs.

Furthermore, if there is information about a potential hazard in the workplace, such as a client with a history of violence, or whom staff report having concerns about, or whose mental condition is deteriorating, then the organisation has a clear obligation under Health & Safety law to inform staff about the nature of the hazard and about the steps they should take to protect themselves from it.

Sometimes, the issues of data protection and information sharing throw up some concerns about client privacy, however there are clear directives which should allow certain critical information about hazards and risks to be shared with staff and management both within and between agencies in order to keep staff safe.

Risk Awareness and the 3-Tier model.

Organisations should always try to win at Round 1, where risk awareness and avoidance strategies can be employed to keep staff safe and away from danger.    Failing that, staff need to be empowered and enabled to analyse a particular scenario for its danger and to act appropriately to remove themselves from it in a timely manner, before it escalates and before they are at risk of violence.  That can be likened to winning in round 2, where round 1 has not eliminated the risk.

We like to call the people employed by public services organisations to visit clients and deal with them on an every-day basis ‘contact professionals’ and therefore ‘the experts’.  In our experience, these workers are experts in their field, whether mental health officers or domestic support staff, because they know their clients, their environments and the associated dangers better than anyone else.

They also develop crucial experience in dealing with angry, frustrated, fearful and worried people.  For the most part, with experience comes an approach to resolving conflict which is generally very fit for its purpose and helps them to de-escalate and defuse situations successfully almost all of the time.

However, there are exceptional times when circumstances reach a level of risk and unpredictability when their experience and professionalism is overwhelmed.   For example, in our work in training groups of staff from Local Authorities, NHS Primary Care, Voluntary Organisations and Social Housing around the country, it is perfectly normal for several of the group to have been:

1. - barricaded in a property by a client demanding action on an issue.
   

2. - made aware of a client’s violent history, while sitting alone with them in their front room.
   

3. - overwhelmed by a prolonged and highly aggressive outburst by a client.
   

4. - assaulted or threatened by another person in the client’s house.
   

5. - approached or felt threatened when en-route to a client meeting.
   

Unfortunately, despite risk-reduction measures and the skills of staff in de-escalating and defusing conflict, there may be the extremely rare occasion when a community worker has unknowingly walked into the presence of real danger, has tried to de-escalate and defuse but failed.  

This is the critical moment.  We would hope that they can realise the danger they may be in, and must then use all their resources - physical, psychological and emotional - to disengage from a motivated attacker.  That’s Round 3, and while nobody ever wants to fight it, if staff reach this point, then the formal risk assessment is a null point and the stakes are very high indeed. 

“I can’t emphasize training enough. There are ways of assessing and handling clients in distress or who are personality disordered. Ultimately it is these kinds of skills that keep social workers safe.”

Social Worker

Emergency Duty Team