Whose Business Is It?

1
Whose Business Is It?
2
Housekeeping

3
Ground Rules

• Share experiences and views
• Recognise the sensitive nature of the subject
  matter
• Listen and respect what others have to say
• Note differing views as these may add to your
  knowledge
• Promote anti-oppressive practice
• Respect confidentiality unless it is necessary to
  address a current concern about the safety/risks
  to a vulnerable adult, if you do, talk this
  through with the trainer or a relevant person on
  the course
• Explain any jargon

4
Session 1Introduction

5

• A National Perspective
• There were 136,000 safeguarding alerts reported
  by 121
• councils in the 2011-12 reporting year, an
  increase of 44
• per cent (41,000 alerts) compared to the
  previous reporting
• year
• The 121 councils who provided information on
  both alerts
• and referrals, 60 per cent of the total alerts
  reported met

6

• A National Perspective cont
• The most common type of alleged abuse is
  physical, which
• accounts for 29 per cent of the total types of
  abuse
• reported. This is followed by neglect,
  accounting for 26 per
• cent of the abuse reported
• 19 per cent of the instances reported were about
  financial
• abuse, 16 per cent were related to emotional or
  
• psychological abuse and sexual abuse accounted
  for 5 per

7

• A National Perspective cont
• Referrals by client group
• Physical disability 63,955
• Mental health 32,580
• Learning disability 26,570
• Substance misuse 1, 750

8
Hampshire Figures 2012/13

• Number of referrals 2516 - an increase from 2145
  in 2011/12
• Overall referrals increased by a similar
  percentage in the 18-64 age group (17.4) and the
  65 age group (17.2).
• Mental health referrals rose to 18 from 13 in
  2011/12
• Most common types of abuse were neglect 34,
  physical abuse 30, followed by financial and
  material 17, psychological 9, sexual 5
• Sources of referral social care 38, health care
  17, self/friend/relative/neighbour 9, police
  6, housing 1
• Location of abuse residential or nursing home
  46, own home 33
• Hampshire County Council 2012/13 Abuse of
  Vulnerable Adults (AVA) Initial Report, 10th
  September 2013.

9
Safeguarding Adults
Safeguarding Adults is a term used to mean all
work which enables an adult to retain
independence, wellbeing and choice and live a
life that is free from abuse and neglect. The
Association of Directors of Adult Social Services
(ADASS), Safeguarding Adults October
2005 www.adass.org.uk
10
Who Is In Need of Safeguarding Services?
A Vulnerable adult is 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. No Secrets 2000 para 2.3
11
Who Is In Need of Safeguarding Services? cont

• Adult at Risk
• The Law Commissions review of Adult Social Care
  Legislation (2011)
• proposes revised definition for consultation
  based on
• Adults at risk should be those who appear to
• have health or social care needs including
  carers (irrespective of whether or not those
  needs are being met by services)
• (2) be at risk of harm and
• (3) be unable to safeguard themselves as a
  result of their health or social care needs.
• In addition, the statute should provide that the
  duty to investigate should apply
• only in cases where the Local Authority believes
  it necessary.
• The Law Commission (LAW COM No 326), 10 May 2011,
  Adult Social Care, p120

12
Safeguarding Children

• The revised statutory guidance Working
  Together to Safeguard Children (2013), clarifies
  the core legal requirements, making it clearer
  what individuals and organisations should do to
  keep children safe and promote their welfare. It
  strengthens the focus away from processes and
  onto the needs of the child.
• Retrieved from http//www.education.gov.uk/childr
  enandyoungpeople/safeguardingchildren/protection/a
  00210235/consultation

12
13
Government PolicyKey Principles of Safeguarding

1. Empowerment - Presumption of person led
decisions and consent 2. Protection -Support
and representation for those in greatest
need 3. Prevention it is better to take action
before harm occurs 4. Proportionality
Proportionate and least intrusive response
appropriate to the risk presented 5. Partnerships
- Local solutions through services working
with their communities 6. Accountability -
Accountability and transparency in
delivering safeguarding Retrieved from
http//www.dh.gov.uk/en/Publicationsandstatistics
/Publications/PublicationsPolicyAndGuidance/DH
14
Disclosure and Barring Service

• The DBS was established under the Protection of
  
• Freedoms Act 2012 which amends the
  Safeguarding
• Vulnerable Groups Act 2006
• Merges the functions previously carried out by
  the
• Criminal Records Bureau (CRB) and
  Independent
• Safeguarding Authority (ISA)
• The primary role of the Disclosure and Barring
• Service (DBS) is to help employers make
  safer
• recruitment decisions
• A new test for regulated activity has been
  introduced

15
Session 2

• Rights and Responsibilities

16
What is the Mental Capacity Act 2005?

• A statutory framework to empower and protect
  people who are not able to make their own
  decisions
• Helps anyone over the age of 16, living in
  England and Wales, who lack capacity to make a
  decision for themselves
• Puts the needs and wishes of a person who lacks
  capacity at the centre of any decision making
  process

17
What is the Mental Capacity Act 2005? cont...

• Makes it clear who can take decisions, in which
  situations, and how they should go about this
• Enables people to plan ahead for a time when they
  may lose capacity
• Introduces new safeguards for people who lack
  capacity
• A Code of Practice

18
Whose Work is Affected by the Mental Capacity Act?

• YOU ARE ALL LEGALLY REQUIRED TO HAVE REGARD TO
  THE CODE OF PRACTICE
• People working in a professional capacity
• People who are paid to care or support adults in
  any setting
• Anyone with a Lasting Power of Attorney
• Anyone who is a deputy appointed by the Court of
  Protection
• Anyone acting as an Independent Mental Capacity
  Advocate (IMCA)
• Anyone carrying out research with people who lack
  capacity
• Anyone being paid for acts for, or in relation
  to, a person who lacks capacity
• GENERALLY anyone who looks after or cares for
  someone who lacks capacity

19
Principles of The Act

• Assume a person has capacity unless proved
  otherwise
• Do not treat people as incapable of making a
  decision unless you have tried all practicable
  steps to help them
• Do not treat someone as incapable of making a
  decision because their decision may seem unwise
• Do things for, and take decisions for, people
  without capacity in their best interests
• Before doing something to someone or making a
  decision on their behalf, consider whether you
  could achieve the outcome in a less restrictive
  way

20
What is Mental Capacity?

• Mental capacity is the ability to make a
• decision, by
• Understanding the information you are given
• Retaining the information long enough to enable
  you to make the decision
• Weighing up the information
• Communicating your decision

21
Best Interests Checklist

• 1. Do whatever possible to encourage the person
  to take part
• 2. Identify the things that you think the person
  would want you to take into consideration
• 3. Take into account the persons past wishes,
  values, religious and cultural beliefs and
  feelings
• 4. Do Not make assumptions about what someone
  wants because of their age, condition, race,
  culture or behaviour
• 5. Consider whether the decision has to be made
  now or could it wait until the person is more
  able to make it
• 6. Consult other people (if it is appropriate to
  do so) to get more information about the persons
  wishes, feelings , beliefs and values. This may
  involve family, friends, anyone engaged in caring
  for the person
• There are full details in the MCA Code of
  Practice p65 and 66.

22
The MCA and Safeguarding Adults

• Good practice in applying the principles
• of the MCA is also
• Good Safeguarding Practice

23
Deprivation of Liberty Safeguards (DOLS)

• DOLS were added to the MCA in 2008 to
  safeguard some of the most vulnerable people in
  our society, to ensure that any decision taken to
  deprive someone of their liberty is only made
  following defined processes and consultation. The
  safeguards apply to people aged 18 and over.

24
Agency responsibilities

• ALL AGENCIES have a responsibility to report
  concerns in accordance with the policy to ensure
  the most effective response No Secrets DH
  2000
• Adult Services have a responsibility, in
  partnership with other agencies, to co-ordinate
  safeguarding responses No Secrets DH 2000

25
All agencies

• Have the responsibility to
• ALWAYS involve service users in decision making
• Promote the safety of service users
• Promote the awareness of abuse
• Assure staff and service users they will be
  listened to
• Ensure staff are aware of reporting procedures
• Take appropriate action where abuse is suspected
• Call emergency services where there is immediate
  danger
• Provide training
• Work alongside other professionals
• Keep records
• Commission/provide safe services

26
Safeguarding Responses Should
Support me in making informed choices
Promote my independence
Keep me informed
Ascertain my views
Collaborate with others to promote my rights and
keep me safe
Nothing about me without me
Make use of opportunities
Enable me to learn from experience
Enable me to improve my life chances
Provide me with advocacy
Enable me to reduce my isolation
Make decisions in my best interest if I lack
capacity
Enable me to develop new skills
Support me if I have been abused
Protect me from significant harm
27
Session 3

• Recognising Abuse

28
Defining Abuse

• Abuse is the violation of a persons human and
  civil rights by any other person or persons
• Abuse is the harming of another individual
  usually by someone in a position of power, trust
  or authority over that individual
• The harm may be physical, psychological or
  emotional or may be directed at exploiting the
  vulnerability of the victim in more subtle ways
• The threat or use of punishment is also a form of
  Abuse
• Abuse may happen as a one-off or it may become
  a regular feature of a relationship
• Other people may be unaware that Abuse happening
  and for this reason it may be difficult to detect
• In many cases Abuse is also a criminal offence
• No Secrets DH (2000)

29
Types of Abuse

• Physical
• Psychological/Emotional
• Financial or Material
• Sexual
• Neglect and Acts of Omission
• Discriminatory

30
Context in which abuse might take place

• Institutional abuse
• Domestic abuse
• Abuse of trust
• Hate crime
• Mate crime
• Honour based violence
• Forced marriage
• Female genital mutilation
• Human trafficking
• Exploitation by radicalisers who promote violence
• Carers at risk of harm carers who cause harm
• Safeguarding concerns between persons at risk
• Prisons
• Personal budgets, direct payments and
  self-directed care

31
Who Abuses?
It can be any of us Relatives/Friends Other
service users Neighbours Paid carers Professionals
Strangers
32
Where Does Abuse Occur?
In the persons own home In the community In
nursing, residential or day care
services Hospitals Prisons It can happen
anywhere
33
Indicators of Abuse

• It is unlikely that any one indicator alone will
  conclusively prove abuse has taken place
• People will often experience more than one type
  of abuse
• Staff should be alert to patterns and clusters of
  indicators which may raise suspicions
• It is vitally important to report any concern/s
• Any report should be taken seriously
• Many of the indicators will feature similar
  elements in a number of different types of abuse
  e.g. Institutional abuse

34
Hate Crimes and Incidents

• A Hate Incident is defined as
• Any incident, which may or may not
  constitute a criminal offence, which is perceived
  by the victim or any other person, as being
  motivated by prejudice or hate
• A Hate Crime is defined as
• Any hate incident, which constitutes a
  criminal offence, perceived by the victim or any
  other person, as being motivated by prejudice or
  hate

35
Mate Crime

• Mate Crime is a newly recognised form of abuse
  which presents a risk to adults who may be
  vulnerable to being manipulated and exploited.
  Often the exploitation is financial but it can
  also be sexual, physical or emotional the
  exploitation may be a crime.

36
Institutional Abuse

• Routines and regimes
• Lack of choice and consultation
• Poor quality environment
• The service revolves around the staff
• Low staff morale
• Lack of staff training
• Lack of personal belongings
• No evidence of effective policies and procedures

37
Abuse of Children

• Children and young people may be
• abused in a family or in an institutional or
• community setting by those known to
• them or, more rarely, by a stranger

• All abuse and neglect are forms of
• maltreatment a person may abuse or
• neglect a child by inflicting harm, or by
• failing to act to prevent harm

38
Session 4

• Responding

39
Responding

• All allegations/disclosures must be treated
  seriously
• The safety of the person is paramount
• Stay calm, listen and reassure
• Demonstrate a sensitive approach
• Be aware of the possibility of the existence of
  forensic evidence
• Explain the you are required to share that
  information with your manager but not with other
  staff or any other service users

40
Responding cont

• Reassure the person that any further response
  will be taken sensitively and with their full
  involvement, whenever possible
• Reassure the person that the service will take
  steps to support and where possible, protect them
  in the future
• REPORT
• MAKE A WRITTEN RECORD

41
Session 5

• Reporting

42
No Secrets (2000)

• ALL AGENCIES have a responsibility to report
  concerns in accordance with the policy to ensure
  the most effective response
• ALL KINDS OF ABUSE HARM THE INDIVIDUAL WE MUST
  NOT IGNORE IT

43
Confidentiality

• A persons right to confidentiality is not
  absolute and may be overridden where there is
  evidence that sharing information is necessary in
  exceptional cases to prevent
  
• Serious crime
• Danger to a persons life
• Danger to others
• Danger to the community
• Danger to the health of the person
• IF IN DOUBT ALWAYS REPORT
• - in line with your organisations policy

44
Enablers To Reporting

• Service users awareness of what to expect from
  staff and the service
• Knowing how to recognise indicators of abuse
• Open organisational culture
• Staff training
• Staff support

45
Enablers To Reporting cont...

• Accessible complaints procedures
• Supervision and staff appraisal
• Effective management role modelling of good
  practice
• Good working relationships with professionals,
  families and carers

46
Barriers to Reporting

• Failure to recognise the abuse
• Will not be believed
• Fear of reprisals
• Fear of heavy handed responses
• Breaching confidentiality
• Not sure if concerns are valid
• Lack of clarity about reporting procedures

47

• Barriers To Reporting cont...
• Impact on relationships with colleagues/service
  users/families
• A workplace culture of non reporting
• Increased tolerance levels (accepting certain
  behaviours)

48

• Whistleblowing
• There are times when staff feel that their
  concerns about abuse have not been taken
  seriously, or when they have felt that they risk
  being victimised in the workplace if they report
  their concerns or where staff genuinely feel
  that the manager is the abuser or is condoning
  abuse
• All agencies whether, statutory, voluntary or
  private should have their own procedures to
  enable staff to express their concerns outside of
  their organisation/line-management

48
49
Childrens Safeguarding Concerns Be familiar
with and follow your organisations procedures
and protocols for promoting and safeguarding the
welfare of children in your area, and know who to
contact in your organisation to express concerns
about a childs welfare.
50
Session 6

• Recording

51
Guidance for Making a Written Record

• Make a note of date, time and setting
• Make a note of anyone else who was there at the
  time
• Record what was said using the persons own words
• Separate factual information from any opinions
  expressed
• Use a pen or ballpoint with black ink if you can

52
Guidance for Making a Written Record cont...

• Make sure your writing is legible and do not use
  tippex and initial any changes
• Date and sign your report
• Remember that your report may be required as part
  of any legal action or disciplinary proceedings
• Keep a copy for future reference which is filed
  securely

53
Session 7

• What Next?

54
Information To Be Given When Making a Referral

• Your details
• Details of the alleged victim
• Details of alleged perpetrator (if known)
• Details of any witnesses (if known)
• Name and contact details of GP
• Reasons for the concerns
• Any relevant background information
• Whether the person is aware of the referral
• Action already taken

55
Safeguarding Children Referral Processes
Hampshire During office hours (8.30am 500pm) -
you should contact Children's Services 0845 603
5620 At all other times you should contact the
Out-of-hours Service 0845 600 4555 Professional
Line 01329 225379 Details are found on the
Hampshire County Council website. Portsmouth Port
smouth residents and practitioners should contact
the Child and Family Enquiries (CAFE) service for
advice if they are unsure whether or how to refer
a child or family they are worried about.
Email CAF.Enquiries_at_portsmouthcc.gov.uk or
phone [phone] Detail are found on the
Portsmouth City Council website. Isle of
Wight The Referral and Assessment Team is the
central team that handles all initial enquiries
to Children and Family Services. The team
operates a duty system based at the Childrens
Service Centre, Atkinson Drive, Newport
(Telephone [phone]).
56
Safeguarding Adults Referral Processes
Referral to Adult Services as the Co-ordinating
Agency Refer to the Adult Services Contact
Centre - Professional Line 01329 225378 The
Patient/Service User can self-refer to Adult
Services Contact Centre Hantsdirect Public
Line 0845 603 5630 or 01329 225398 Out of Hours
Service 0845 600 4555 Your referral will be
screened by the contact centre and passed to our
social work teams who will assess the
Safeguarding concern raised. Consultation/Advice
only A Safeguarding Co-ordinator is available
daily 08.30-17.00 for specialist advice and the
Professional Line for consultation/advice only
01962 847214. You can e-mail a safeguarding
co-ordinator for specialist advice to our Adult
Safeguarding Unit shared inbox
Adult.safeguarding.unit_at_hants.gov.uk Visit our
safeguarding website at http//www3.hants.gov.uk
/protection-from-abuse.htm
57
Safeguarding Adults/Domestic AbuseCentral
Referral Unit (CRU)
Hampshire Constabularys Central Referral
Unit will receive and grade all referrals to
ensure that the right level and consistency of
response is given to agencies. Referrals can be
sent by email or phone  the unit is open 7.30am
- 8pm Monday to Friday and 8am - 4pm Saturday and
Sunday. Outside of these times, if it is
an emergency, the police can be contacted via 999
or via 101 for issues that require a less urgent
response.The Central Referral Unit contact
details are as followsE-mail
cru_at_hampshire.pnn-police.police.ukPhone 02380
745399Fax [phone]  
58
What Do I Need To Know?

• How to recognise abuse and where to report my
  concerns
• Where to find my workplace Policy and Procedure
  and make sure I have read and understood it
• That abuse is not an isolated problem, but a
  significant social concern
• That abuse can be a crime
• That anyone can potentially cause harm to a
  vulnerable adult, intentionally or
  unintentionally
• The rights of the people I provide a service to
• That I will be supported if I report a concern
• My rights as an employee
• What training I can expect to ensure I provide
  quality care
• That Adult Services have a responsibility, in
  partnership with other agencies, to assess and
  respond

59
Prevention

• Acknowledge that it COULD happen here!
• Report any concerns in whatever way necessary
  to be heard
• Do not tolerate poor practice
• Be aware of possible indicators of abuse
• Promote self advocacy and advocacy
• Follow policies and procedures for intimate
  personal care, physical interventions and
  sexuality
• Attend training when given the opportunity
• Make use of supervision opportunities
• Good record keeping
• Use Whistleblowing Procedure

60
People have
Safeguarding Outcomes

• Been kept physically safe
• Been safer in their community
• Been safer in their services
• New assessments/care packages
• Seen prosecutions (criminal and civil)
• Seen action taken against staff (Human Resources
  /DBS)
• Seen action taken by regulators (CQC)

• Been listened to
• Taken seriously
• Learnt new skills
• More money
• Greater independence
• Received improved care
• Better relationships
• Better trained staff

61
What Have I Learnt?
Stop Start Keep
62
Visit the new Making Connections website at
www.making-connections.co.uk for more
informationMaking Connections (IOW) Ltd. 2013
Safeguarding News

• Practice Guidance
• Research
• News

• Updates
• Documents
• Useful Links

62