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Resident-to-resident harm in care homes - a scoping review

This report Social Care Institute for Excellence (SCIE) aims to explore resident-to-resident harm in care homes, also referred to as resident-to-resident abuse.

However, there is an important distinction to be made between harm and abuse as abuse occurs within relationships where there is the expectation of trust. That expectation cannot be applied to the relationship between residents. Having highlighted this key distinction, this report reflects the literature and so refers to resident-to-resident abuse (RRA) throughout.

Specifically, this report aims to identify current research, policy and practice about resident-to-resident abuse in care homes. The report explores:

  • definitions and types of resident-to-resident abuse
  • prevalence & risk factors of resident-to-resident abuse
  • prevention of and interventions for resident-to-resident abuse
  • research gaps
  • potential case studies

Standout findings from this scoping review include:

  • that abusive behaviour was rarely documented or reported in some settings, with evidence that some care managers consider it an inevitable or predictable part of living in a residential setting. Some services allow harmful behaviours to be accepted and unchallenged
  • research regarding the prevalence of resident-to-resident abuse is limited, yet information from a variety of sources suggests it occurs fairly frequently
  • prevalence data is hard to compare across studies and settings due to very different methods being used
  • resident characteristics that are a risk factor for resident-to-resident abuse include dementia, mental illness, behavioural symptoms that may disrupt others and a history of aggressive or negative interactions with others
  • environmental characteristics that are risk factors for resident-to-resident harm include a crowded environment, inadequate staffing levels, lack of staff training, high numbers of residents with dementia, a lack of meaningful activities, crowded common areas and excessive noise
  • many incidents of resident-to-resident harm are not witnessed by staff.

This is an important piece of work for anyone working or visiting a care home.

Read the full report here.