Adult Protection Work in the Bradford District

1

Adult Protection Workin the Bradford District

Ruth Ingram - Adult Protection
Co-ordinator Jackie Hansford - APC/
lead BFHT John Heald -
WYP/training subgroup chair
.and - your PCT Adult Protection lead
2
This session

• What is adult abuse
• National and local framework for working together
  to protect adults
• What do I do if I suspect or know adult abuse is
  taking place?
• Help and support

3
The problem

• Not being fed Hit by staff grade 4 pressure
  sores
• Unexplained burn marks Evicted for having
  gay relationship

Sexually abused by brother in law Windows
smashed by local youths Weeks pension taken
from bag Called degrading names by
disabled husband
4
The problem

• Maria Caldwell
• Victoria Climbie

• Beverley Lewis
• Margaret Pantin

5
The three monkeys

Adult Protection Work
6
The problem
7

• Pressure groupsMENCAP, Respond, ACT, POPAN, AEA
• MediaMcIntyre Undercover, PanoramaCasualty, The
  Bill, the Archers
• Political pressureParliamentary Select Committee
  on Elder Abuse

8
The problemDynamics of abuse

• denying the elephant
• burnt out ostriches
• keeping the worms in their can
• startled rabbits
• heroic lions
• scaping the goat

Adult Protection Work
9
Recent Legislation

• Human Rights Act 1998
• Mental Capacity Act 2005
• Care Standards Act 2000
• Family Law Act 1996Protection from Harassment
  Act 1997Sexual Offences (Amendment) Act
  2000Domestic Violence Crime and Victims Act 2004
  
• Youth Crime and Criminal Evidence Act
  1999Achieving Best Evidence
• Crime and Disorder Act 1998Hate Crime,
  Anti-social behaviour

10
National Guidance

• Section 7 guidance to
• Local Authorities with Social Service
  responsibilities to
• . . . develop and implement multi-agency
  policies and procedures to protect vulnerable
  adults from abuse.
• No Secrets March 2000

Adult Protection Work
11
Vulnerable adults

• A personwho is or may be in need of community
  care services by reason of mental or other
  disability, age or illness
• and
• who is or may be unable to take care of him
  or herself, or unable to protect him or herself
  against significant harm or exploitation.
• Lord Chancellors Department
• Who Decides 1999

Adult Protection Work
12
Vulnerable or disabled?
Adult Protection Work
All disabled people, including those with
physical and sensory impairments, people with
mental health problems, people with learning
disabilities and carers who are family or
friends
13
Abuse definition
Abuse is a violation of an individuals human or
civil rights by any other person or persons

• Deliberate or unknowing
• Single or repeated acts
• In any relationship
• In any context

• Physical
• Sexual
• Psychological
• Financial or material
• Neglect and acts of omission
• Institutional abuse/ poor professional
  practice
• Discriminatory abuse

Adult Protection Work
14
National Guidance

• Figure out how to share information and work
  together then do it!

Adult Protection Work
15
Bradford DistrictAdult Protection Committee
16
Lead managers responsibilities

• To lead the implementation of adult protection
  work in their organisation- Prevention- Play
  their role in adult protection work (service
  delivery)- Reporting procedures
• - Integration into the day job
• - Monitoring- Information to staff and service
  users - Staff Training

17
Working together!

• Procedures multi-agency agreement This is how
  we will do it

Developing Frameworks
Adult Protection Work

• different roles
• different powers/tools
• different expertise
• different culture/language

• Information sharing agreement

18
What the procedures say
Developing Frameworks
Adult Protection Work
19
Who co-ordinates?

• 40 Adult Protection Risk Assessment Co-ordinators

• Situations 1 2Team leaders of care management
  teams (SSD and BDCT)
• Situations 3 4Adult Protection Unit

20
Najum - aged 71

• Najum had a stroke
• Daughter Meena told staff she could come and live
  with her
• Physiotherapist noticed Najum afraid of Meena
• Arranged clinic appointment
• Najum told nurse Meena shouting at her and
  keeping her locked in her room
• Najum asked for nephew Aflak
• Now living with Aflak, homecare package

Protecting People
Adult Protection Work
21
Hilda - aged 67

• Hilda had been living with her son.
• She moved to a residential home. Her son visited
  every week
• Care assistant noticed bruising on Hildas arms
• Senior care asked Hilda about the bruising, GP
  called
• Adult Protection Plan meeting SSD team manager,
  Care manager, Police, Womens Refuge, Care home

Adult Protection Work
22
Good practice

• Seek advice, information and support
• Find a way to speak alone - Safety First!
• Tell the person
• why you are worried
• how you/others can help
• how the AP procedures work
• anything you have to do
• Actively support the person to decide
• What is right for them
• Refer to AP procedures or to other professional
  with their consent

Adult Protection Work
23
Belinda - aged 86

• Alzheimer's disease, no self-care skills, no
  clear communication
• Living with husband Philip
• District nurse sees Philip kick Belinda and shout
  at her. Domiciliary care workers report no
  personal care at night
• AP strategy meeting. SSD team leader and care
  manager, Police, GP, Nurse, Domiciliary care
  agency, advocate
• Care home - supervised visits

Adult Protection Work
24
Mental Capacity

• Mental capacity is judged on a functional basis
  i.e. has the person got the capacity to make
  this particular decision, and will include the
  person having
• access to the relevant information
• the capacity to understand and to retain the
  information relevant to the decision, including
  information about the reasonably foreseeable
  consequences of deciding one way or another or of
  failing to make the decision
• the capacity to weigh up the information and come
  to a decision
• the capacity to communicate the decision they
  have come toMental Capacity Act 2005

25
Good practice

• Communicate!
• Get support!
• Make a referral to AP procedures
• Attend multi-agency meetings
• Be prepared - take a report
• Participate
• Do what you agree to do in the time scale agreed
• Safety First!

Adult Protection Work
26
Hassan - aged 81

• Very frail, very hard of hearing
• Tells chiropodist that home care worker is taking
  his money
• AP referral
• AP telephone strategy meeting
• Worker suspended, police informed
• Other similar complaints
• Worker admits theft and is charged. Dismissed
  form work, referred to POVA index

Adult Protection Work
27
Terence - aged 74

• Emergency GP called by agency nurse to nursing
  home. Terence isolated, very dehydrated and in
  severe pain
• Died in hospital - grade 4 pressure sore
• Coroner requests police investigation
• AP strategy meeting
• CSCI, SSD joint visit. SSD suspend admissions,
  CSCI require up-to-date care plans
• SSD care managers and PCT nurses review all
  residents
• Care home employs new manager, DNs deliver
  training, CSCI and SSD review

Adult Protection Work
28
Good practice

• Communicate!
• Get support!
• Make a referral to AP procedures
• Attend multi-agency meetings
• Be prepared - take a report
• Participate
• Do what you agree to do in the time scale agreed
• Safety First!

Adult Protection Work
29
Making a referral

• Ensure immediate safety / medical attention
• Summon the emergency services if needed
• If a crime has just occurred call the police
• Preserve the evidence
• Record

Practitioner has concerns
Care Setting / Abuse by staff Tel 01274
434442 All other situations Tel 01274 -
431074 All Emergency situations out of office
hours Refer to Police (999) and SSD Emergency
Duty Team (01274 530434)
Make an Adult Protection Referral
Tell your PCT / Practice Adult Protection Lead
30
Making a referral

• You dont have to have proved abuse to make a
  referral
• Other people will also have part of the story/
• Its OK if there is no abuse!
• You are part of a team defining the problem and
  achieving a solution
• You have a unique role, skills and relationships
  that are needed in this work

31
Be Prepared

• Find out Who is your PCT lead?How do you
  contact the AP Unit? Where is your copy of the
  AP procedures?Who would you report abuse to?Who
  would support you?
• Decide who your practice lead is
• Attend/arrange AP training
• Give information to your colleagues and patients

Adult Protection Work
32
Help and support

• PACE guidance
• Information for staffNewsletterEasy Guide

33
Multi-agency training

• No Secrets- Level 1
• Multi-agency Adult Protection awareness training
• Key Messages
• Recognise abuse
• Tell your boss(unless they are the abuser or
  havent acted on what you have told them)
• Believe that something can be done

Adult Protection Work
34
In your PCT

• Lyndsey Longfield (City)
• Rob OConnell (South and West)
• Michelle Whitehead (Bradford
  North Airedale)

35
If you want more help

• Adult Protection Unit
• Telephone
• For general information 01274 431077
• About a specific situation01274 434442
• Fax [phone]
• E-mail adult.protection_at_bradford.gov.uk

Taking Action
36
Adult protection referrals
37
Alleged Victim
MH Mental Health PI Physical
Impairment P/TI Physical/Terminal Illness SI
Sensory Impairment LD Learning Disabilities
38
Where the abuse takes place
39
Which PCT Area?
40
Alleged Perpetrator