Title: Safeguarding Adults
1Safeguarding Adults
- Mary Wynne
- RBKC Safeguarding Adults Coordinator
2Backround
- 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.
3No 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.
4Underlying 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
5No Secrets
- There can be no secrets and no hiding place when
it comes to exposing the abuse of vulnerable
adults - No Secrets March 2000
6Key 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
7Who 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)
9What 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
10Forms 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
11Forms 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
12Forms 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
13The 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.
14Strategic 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
15Making 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
16Making 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
17Training 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
18Public 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
19Equality 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.
20Prevention
- 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.
21Monitoring
- 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.
22Monitoring 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.
23Monitoring Figures by Type of Abuse
- Financial Abuse35
- Physical Abuse25
- Psychological Abuse20
- Neglect9
- Sexual8
- Institutional1.4
24Monitoring 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
25Alleged Perpetrators
- Care Worker31
- Relative21
- Friend10
- Spouse/Partner3
- Health worker2.8
- Other VA2.8
- Stranger2.8
- Neighbour2.2
- N/K19
26Outcomes 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.
27RBKC 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
28Pan 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.
29Met 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)
30National Developments
31Review 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
32Push 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
33Elder 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).
34Elder 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).
35Elder Abuse Prevalence Study
- The full Cominc Relief Report can be found
- at -
- http//www.comicrelief.com/elderabuse.
36New 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.
37New 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.
38Dignity 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.
39Joint 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.
40Human 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.
41New 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.
42CPS 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
43Recent 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
44Helpful Websites
- Action on Elder Abuse-www.elderabuse.org.uk
- Voice UK- www.voiceuk.org.uk