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Safeguarding Adults

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Title: Safeguarding Adults


1
Safeguarding Adults
  • Mary Wynne
  • RBKC Safeguarding Adults Coordinator

2
Backround
  • In 1998 the Longcare Inquiry raised concerns
    about the protection of vulnerable adults in
    regulated settings
  • In 1998 the DoH embarked on producing an Adult
    Protection policy framework to offer greater
    protection to vulnerable adults.

3
No Secrets Guidance 2000
  • Local Authorities have a lead role to
  • make sure there is an effective policy in
    place to protect vulnerable adults at risk from
    abuse
  • To ensure there is a consistent and effective
    response where concerns, formal complaints and
    anxieties have been raised.

4
Underlying Principles of No Secrets
  • Primary aim is preventing abuse-training staff,
    CRB/POVA List checks, contracts, public awareness
  • Agencies to work together on the prevention,
    identification, investigation of alleged,
    confirmed or suspected abuse
  • Clear understanding of who does what
  • All staff and volunteers have a duty to act on
    any concern or suspicion
  • All agencies have a duty to act on an allegation
  • Management has a key role in setting standards of
    practice, taking decisions and fostering an open
    and supportive culture

5
No Secrets
  • There can be no secrets and no hiding place when
    it comes to exposing the abuse of vulnerable
    adults
  • No Secrets March 2000

6
Key Features of the RBKC policy
  • Local Policy launched Nov 2002-must be
    followed-signed up by partner agencies (health
    trusts,police,RBKC,housing)
  • Includes all agencies with an emphasis on
    achieving a shared approach
  • Includes all vulnerable adults in all settings
    and all forms of abuse
  • Sets out a clear process for responding to
    concerns

7
Who is a Vulnerable Adult?
  • A person aged 18 years or over
  • who 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.
  • (Who Decides Lord Chancellors dept 1997)

8
(No Transcript)
9
What is Abuse?
  • Abuse may consist of a single or repeated acts.
    It may be physical, verbal or psychological, it
    may be an act of neglect or an omission to act,
    or it may occur when a vulnerable person is
    persuaded to enter into a financial or sexual
    transaction to which he or she has not consented,
    or cannot consent. Abuse can occur in any
    relationship and may result in significant harm
    to, or exploitation of, the person subjected to
    it
  • No Secrets DoH March 2000

10
Forms of Abuse
  • Financial or material-theft, forced changes to a
    will, preventing access to money, loans between a
    VA and member of staff or paid carer, loans made
    under duress
  • Physicalhitting, slapping, pinching,hair
    pulling, pushing, kicking,inappropriate
    application of techniques (control restraint),
    misuse of medication, force feeding, involuntary
    isolation
  • Sexual-non-contact-inappropriate looking,
    photography, indecent exposure,
    innuendo,harassment, enforced witnessing of
    sexual acts
  • Contact abuse-inappropriate touching, forced
    masturbation of either or both persons, sexual
    assault, rape

11
Forms of Abuse
  • Psychological/emotional-prevention of using
    services, denial access to friends, lack of
    stimulation and meaningful occupation, verbal
    threats and humiliation, intimidation
  • Neglect or acts of omission- failure to provide
    food,shelter or clothing,failure to provide
    medical care,hygiene or personal
    care,inappropriate use of medication, denial of
    educational,social and recreational needs, lack
    of stimulation or emotional warmth

12
Forms of Abuse
  • Discriminatory-unequal treatment, verbal abuse,
    inappropriate use of language, derogatory
    remarks, harassment, deliberate exclusion
  • Institutional Abuse - occurs when the rituals and
    routines of a service result in the lifestyles
    and needs of individuals being sacrificed in
    favour of the needs of the institution

13
The Local Picture
  • Operational matters
  • Safeguarding Adult investigations are coordinated
    by the appropriate social work adult team.
  • There is good liaison with the Metropolitan
    Police and the Community Safety Unit whose
    safeguarding adults lead is a Detective Sergeant
    from that unit.

14
Strategic Structure
  • The RBKC Safeguarding Adults Management Committee
    meets
  • quarterly and is chaired by the Head of Adult
    Social Care. Membership
  • includes senior managers from the following
    agencies-
  • Housing
  • Social Services
  • Crown Prosecution Service
  • Community Safety Unit and Community Safety Team
  • Health-including PCT, Acute Trusts (Chelsea
    Westminster, Royal Brompton, Royal Marsden,
    Mental Health Trust)
  • Voluntary Sector (Equal People, MIND, Age
    Concern, London Cyrenians, ADKC, Migrant Refugee
    Forum)
  • Independent Sector (Care UK, Goldsborough Home
    Care)
  • Commission for Social Care Inspection

15
Making Links with Health
  • Much successful work has been undertaken with
    the statutory sector in order to try to raise
    awareness of the Safeguarding policy-
  • Chelsea Westminster Hospital developed
    internal procedures
  • PCT-there has been an agreement to introduce
    safeguarding adult questions to the Quality and
    Outcome Framework as part of the annual
    monitoring of GPs.
  • PCT Learning from Experience Group
  • The Central North West London Mental Health Trust
    (CNWL) now has a safeguarding adults steering
    group

16
Making Links with Crime Disorder
  • Safeguarding adults is linked into the Domestic
    Violence work -MARAC
  • Report to the Safer Surer Policy Board
  • Present to monthly Partnership Tasking Group
  • Working with the Community Safety Partnership
    Inspector to explore how we can make use of the
    Crime Prevention Design Advisors in safeguarding
    enquiries as they currently do in domestic
    violence cases.
  • Make better links with the Safer Neighbourhood
    Teams

17
Training Programme
  • Training budget funded by HHASC and PCT
  • Six courses run on a multi-agency basis
  • Training strategy is being reviewed with a view
    to developing a more comprehensive multi-agency
    training programme from a pooled budget
  • SAC undertakes briefings to agencies

18
Public Awareness
  • Public information booklet produced Nov 2005
  • More accessible version being developed for
    people with LD.
  • Elder Abuse Awareness Day on 15th June 2006
    2007-marked with a leafleting campaign, included
    all GP practices, libraries and CABs as well as
    leafleting members of the public on Kensington
    High Street
  • RBKCs Media and Communications Officer is
    assisting in developing a public awareness
    strategy on safeguarding adults

19
Equality Impact Assessment
  • Equality Impact Assessment completed in
    December06. The assessment revealed some
    negative impact in relation to the Asian
    community, older men and young people with mental
    health problems. This is being addressed in the
    action plan.

20
Prevention
  • Contract officers and commissioners of services
    ensure that provider agencies have clear
    expectations in relation to knowledge about the
    safeguarding adults policy and their role in it.
    Therefore all contracts for services working with
    vulnerable people include Safeguarding Adult
    requirements e.g. provider agencies must have
    robust recruitment practices and make Criminal
    Record Bureau POVA list checks.

21
Monitoring
  • The RBKC safeguarding adults monitoring system
    has been in place since the launch of the policy
    and enables us to look at trends e.g. where the
    safeguarding adult alerts are coming from, type
    of abuse, who the perpetrators are etc. The use
    of case monitoring information informs the
    prevention strategy.

22
Monitoring Figures
  • The number of safeguarding adult referrals to
    RBKC social work teams significantly increased by
    45 in 2006/7.
  • Suggests greater awareness of the policy than an
    increase in abuse
  • CSCI found that the median number of referrals
    among councils of adult abuse cases rose by 32
    from 2005-6 to 2006-7.

23
Monitoring Figures by Type of Abuse
  • Financial Abuse35
  • Physical Abuse25
  • Psychological Abuse20
  • Neglect9
  • Sexual8
  • Institutional1.4

24
Monitoring Figures for 2006/7
  • Total referrals for Older People 58 of all
    alerts.
  • Total referrals for People with Learning
    Disabilities 20 of all alerts
  • Total referrals for People with Physical
    Disabilities 13 of all alerts
  • Total referrals for People with Mental Health
    Problems 7 of all alerts

25
Alleged Perpetrators
  • Care Worker31
  • Relative21
  • Friend10
  • Spouse/Partner3
  • Health worker2.8
  • Other VA2.8
  • Stranger2.8
  • Neighbour2.2
  • N/K19

26
Outcomes of Enquiries
  • Outcomes of enquiries in terms of progressing
    them through the criminal justice system are
    extremely low. In the last 18 months few have
    been identified. This is a national concern. The
    recent Action on Elder Abuse Research report
    (March 2006) identified that out of 639 referrals
    to social services only 5 (0.75) resulted in a
    decision to precede with a criminal prosecution.

27
RBKC WCC Policy Review
  • The joint WCC and RBKC policy procedures were
    published 5 years ago and are currently being
    reviewed by a multi-agency task force.
  • Launch expected May 2008

28
Pan London Procedures
  • Representatives from the London Adult Protection
    Network met with the Social Care Institute for
    Excellence in Oct. Dept of Health policy leads
    are pleased for SCIE to go ahead with developing
    Pan London Procedures.
  • The DoH are also interested in using this project
    as a way to assist with the review of No
    Secrets.

29
Met Police- Vulnerable Adults Policy Review
  • Violent Crime Directorate heading this review
  • Police want to maximise the process and capture
    all allegations in whatever format is suitable
    for VAs.
  • Want to ensure non-crime reports are flagged to
    ensure intelligence is properly gathered
  • The policy will break down the issues into 3
    categories-
  • Domestic Violence-using the DV Standing
    Operational Procedures but include additional
    guidance for vulnerable adults
  • Hate Crime SOP (this will also include
    children)
  • Abuse in Care Settings (regulated and
    unregulated)

30
National Developments
31
Review of No Secrets
  • Commitment made by Ivan Lewis (Parliamentary
    Under Secretary of State for the Department of
    Health) on 14th June 2007 to-
  • To review 'No Secrets' guidance and to consult
    with other government departments that have an
    interest in this field . Legislation will be
    considered
  • Develop national reporting requirements so that
    each individual council can monitor abuse

32
Push for Legislation
  • The Association of Directors of Adult Social
    Services called for social workers to be given
    powers to enter the homes of vulnerable adults
    they believe are at risk of abuse.
  • Care workers would also be legally obliged to
    take appropriate action when they suspect a
    vulnerable adult is being abused, in the wake of
    recent abuse cases.
  • Action on Elder Abuse are also co-ordinating a
    national campaign to push for legislation

33
Elder Abuse Prevalence Study June 2007
  • Carried out over two years by independent
    researchers at National Centre for Social
    Research and Kings College, London,
  • Survey of around 2000 people aged 66 and over who
    live in their own homes (including sheltered
    housing).

34
Elder Abuse Prevalence Study
  • The findings of the study show that
  • - 2.6 or 227,000 people were neglected or
    abused by family, close friends and care workers
    in the last year.
  • - 4 or 342,400 people were neglected or
    abused in the last year by family, close friends
    and care workers, neighbours and acquaintances
    (i.e. a broader definition of those who might
    abuse).
  • - Mistreatment is broken down into neglect
    (1.1), financial abuse (0.7), psychological and
    physical abuse (both 0.4) and sexual abuse
    (0.2).
  • -The majority of the incidents involved a
    partner (51) or another family member (49)
    followed by a voluntary or paid care worker (13)
    and close friend (5).

35
Elder Abuse Prevalence Study
  • The full Cominc Relief Report can be found
  • at -
  • http//www.comicrelief.com/elderabuse.

36
New Joint Commission - 2009
  • The Care Quality Commission, a forthcoming merger
    of the Commission for Social Care Inspection, the
    Healthcare Commission and the Mental Health Act
    Commission, will extend existing enforcement
    powers over local authorities, independent
    providers and the NHS where service users are
    being put at risk, the government announced.
  • The commission will be able to close orgs, issue
    statutory warning notices requiring improvement
    within a specified time, impose fines in lieu of
    prosecution, increase frequency of
    inspections . The powers of the commission will
    be included in the new health and social care
    bill due to be introduced in parliament this year.

37
New Vetting Barring Scheme
  • The Safeguarding Vulnerable Groups Act 2006
    provides the legal framework for the new vetting
    and barring scheme. The Act is a major element of
    a wide-ranging and ambitious programme of work
    established across government to address the
    systemic failures identified by the Bichard
    enquiry into the Soham murders. The DfES, DoH and
    the Home Office are drafting the Regulations
    Guidance that will underpin the scheme. The
    scheme is expected to affect 11 million workers.

38
Dignity in Care
  • Dignity in Care Campaign-update
  • Care Services Minister Ivan Lewis announced there
    are now 1000 individuals who have been recognised
    as 'Dignity Champions' and been rewarded for
    going that extra mile in improving the service
    that older people receive.

39
Joint Committee on Human Rights Aug07
  • This report focuses on The Human Rights of Older
    People in Health Social Care settings.
  • Argues elder abuse is a serious and severe human
    rights abuse and in certain circumstances, amount
    to a criminal offence.
  • Argues HRA gives legal force to the concepts of
    dignity, respect, equality and fairness.
  • The HRA functions to provide a legal framework
    for service providers to abide by and empower
    service users to demand that they be treated with
    respect for their dignity.

40
Human Rights Gap
  • The House of Lords ruled in June that the Human
    Rights Act 1998 did not apply to the residents of
    private care homes. This has raised concerns that
    as the ruling is based on the legal proposition
    that private care homes do not provide functions
    of a public nature this leaves residents without
    recourse to challenge human rights abuses.
    Baroness Ashton-Minister for Human Rights has
    pledged to plug the loophole as a matter of the
    utmost urgency.

41
New Criminal Offence of Neglect Mental Capacity
Act 2005-
  • Recent Prosecution for Neglect-Oct07
  • The Managing Director of a care home company and
    other members of staff have been prosecuted on
    the basis that they had neglected residents at an
    old peoples home in Gloucestershire.
  • Residents sleeping beside their own waste
  • Mouldy faeces found in one of the rooms,
  • Filthy toilets
  • Lack of any stimulating activities for the
    patients.
  • The prosecutions follow a joint operation between
    the local police and CSCI.

42
CPS Consultation Crimes Against Older People-
  • The CPS published a public consultation on its
    draft policy for prosecuting crimes that are
    carried out against older people. It sets out how
    the CPS prosecutes these cases and supports
    older people who are victims witnesses
  • www.cps.gov.uk

43
Recent CSCI Publications
  • Better Safe Than Sorry -Improving the system
    that safeguards adults living in care homes Nov
    2006
  • Safeguarding Adults-CSCI Protocol-Feb 2007
  • In Safe Keeping - supporting people who use
    regulated care services with their finances-May
    2007
  • Rights, Risks Restraints-an exploration into
    the use of restraint in the care of older people
    Nov 2007
  • Social Care-Choosing the Right Service for You
    Jan 2008- guidance and advice for the public

44
Helpful Websites
  • Action on Elder Abuse-www.elderabuse.org.uk
  • Voice UK- www.voiceuk.org.uk
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