Safeguarding Adults P1 - Protection

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Safeguarding Adults P1 - Protection

• Practitioner Level
• May 2015

www.devon.gov.uk/index/socialcarehealth/ scwd/sc
wd-safeguarding-adults.htm
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Housekeeping
Fire Procedure
Smoking
Toilets
Breaks
Finishing Time
Mobile Phones / Devices
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Training Transfer

• Getting learning into practice
• 50 of learning fails to transfer to the
  workplace
• (Sak, 2002)
• The ultimate test of effective training is
  whether it benefits service users
• (Horwath and Morrison, 1999)

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Ground Rules

• Safeguarding is a dynamic world and we continue
  to learn about how to prevent people from being
  harmed on both a strategic / organisational level
  and as individual practitioners.
• Safeguarding is about partnership, it is not
  about blame. All agencies and individuals need to
  take responsibility, to reflect and learn to
  safeguard people who may be at risk.

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Ground Rules

• Confidentiality within the group will be
  respected but may need to be broken if a
  disclosure of unsafe practice, abuse or neglect
  is made during the course this will usually be
  discussed with you first.

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Introductions

• Name
• Place and nature of work
• What do you want to know by the end of todays
  session?

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At the end of the session you will

• be aware of the legal framework
• ask the right questions and gather initial
  information in order to undertake an initial risk
  assessment
• take any required protective action to promote
  the safety and well being of the person
• take or make appropriate safeguarding referrals
• recognise when other agencies may need to be
  involved e.g. the Police, CQC, and refer
  appropriately (preservation of evidence)
• have reflected on your practice in safeguarding
• be clear about your role in the safeguarding
  process

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Care Act

• Comes into force on the 1st April 2015
• Revokes, repeals and cancels many laws and
  guidance including No Secrets
• Clarifies and consolidates good practice
• Not just about health or social care promotes
  wider partnership working and responsibilities
• Promotes - Prevent, Reduce, Delay
• Many chapters relevant to SA Agenda

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14. Adult safeguarding
This chapter covers Adult safeguarding what
it is and why it matters Abuse and
neglect Understanding what they are and
spotting the signs Reporting and responding
to abuse and neglect Carers and adult
safeguarding Adult safeguarding
procedures Local authoritys role and
multi-agency working Criminal offences and
adult safeguarding Safeguarding enquiries
Safeguarding Adults Boards Safeguarding
Adults Reviews Information sharing,
confidentiality and record keeping Roles,
responsibilities and training in local
authorities, the NHS and other agencies
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Key Changes /points

• It changes the language of safeguarding adults
  NOT Vulnerable
• The guidance repeatedly highlights the importance
  of person centred practice, the Mental Capacity
  Act and Advocacy in individual cases.
• It also emphasises strategies for prevention at
  both operational and inter agency strategic
  levels of working.
• Commitment to Making Safeguarding Personal and
  Making Every Adult Matter

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Key Changes /points

• Includes more detailed and explicit references to
  carers, including the risks that they can face
  and support they may need as well as the risks
  that they can present.
• Roles and responsibilities of partner
  organisations
• Serious case reviews become Safeguarding Adult
  Reviews
• Roles and responsibilities of SA Board members
  and Safeguarding Adults Boards

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Safeguarding Duties

• The safeguarding duties apply to an adult who
• has needs for care and support (whether or not
  the local authority is meeting any of those
  needs) and
• is experiencing, or at risk of, abuse or
  neglect and as a result of those care and
  support needs is unable to protect themselves
  from either the risk of, or the experience of
  abuse or neglect.

Care Act 14.20
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Safeguarding Duties

• Local authority statutory adult safeguarding
  duties apply equally to those adults with care
  and support needs regardless of whether those
  needs are being met, regardless of whether the
  adult lacks mental capacity or not, and
  regardless of setting, other than prisons and
  approved premises

Care Act 14.60
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Make Enquiry

• Adult safeguarding means protecting a persons
  right to live in safety, free from abuse and
  neglect. The Care Act requires that each local
  authority must
• make enquiries, or ensure others do so, if it
  believes an adult is, or is at risk of, abuse or
  neglect (see paragraphs 14.36 to 14.75). An
  enquiry should establish whether any action needs
  to be taken to stop prevent abuse or neglect, and
  if so, by whom

Care Act 14.10
Mr A
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Categories of abuse

• Physical abuse
• Domestic violence
• Sexual abuse
• Psychological abuse
• Financial or material abuse
• Modern slavery encompasses slavery, human
  trafficking, forced labour and domestic
  servitude. Traffickers and slave masters use
  whatever means they have at their disposal to
  coerce, deceive and force individuals into a life
  of abuse, servitude and inhumane treatment.

Care Act 14.17
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Categories of abuse

• Discriminatory abuse
• Organisational abuse including neglect and poor
  care practice within an institution or specific
  care setting such as a hospital or care home, for
  example, or in relation to care provided in ones
  own home.
• Neglect and acts of omission
• Self-neglect this covers a wide range of
  behaviour neglecting to care for ones personal
• hygiene, health or surroundings and includes
  behaviour such as hoarding

Care Act 14.17
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Patterns of abuse vary and include

• serial abusing in which the perpetrator seeks out
  and grooms individuals.
• long-term abuse in the context of an ongoing
  family relationship such as domestic violence
  between spouses or generations or persistent
  psychological abuse
• opportunistic abuse such as theft occurring
  because money or jewellery has been left lying
  around.

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Six key principles underpin all adult
safeguarding work

• Empowerment I am asked what I want as the
  outcomes from the safeguarding process and these
  directly inform what happens.
• Prevention I receive clear and simple
  information about what abuse is, how to recognise
  the signs and what I can do to seek help.
• Proportionality I am sure that the professionals
  will work in my interest, as I see them and they
  will only get involved as much as needed.
• Protection I get help and support to report
  abuse and neglect. I get help so that I am able
  to take part in the safeguarding process to the
  extent to which I want.
• Partnership I know that staff treat any personal
  and sensitive information in confidence, only
  sharing what is helpful and necessary. I am
  confident that professionals will work together
  and with me to get the best result for me.
• Accountability I understand the role of everyone
  involved in my life and so do they.

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What outcomes should individuals experience from
the safeguarding process?What can YOU do?

• Empowerment
• Prevention
• Proportionality
• Protection
• Partnership
• Accountability

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Because you said something...

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Small Group Discussion

• In groups have a look at the following scenarios
  -
• The man in the park
• The two brothers
• The couple in the conservatory
• What did you actually observe
• Whats the worst case scenario or possible least
  harmful
• scenario? What could / should / might be done
  (immediate
• short/long term)?

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Feedback the man in the park
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Hate Crime

• Any criminal offence, which is perceived, by
  the victim or any other person, to be motivated
  by hostility or prejudice based on a persons
  difference or perceived difference.
• CPS
• Police also record incidents which are not
  crimes.

Care Act 14.70
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Disability Hate Crime

• Better understanding of disability hate crime
• and of impact on victims
• Offender(s) often known to victim
• Likely to increase in severity or frequency
• EHRC / DoH / Home Office / Regional projects
• Neighbourhood harm register
• Enhanced sentencing

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Mate Crime
When someone befriends an adult at risk
(vulnerable) person in order to exploit them.
www.arcuk.org.uk/safetynet
Miss Y
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Grooming Process

• Choose an adult at risk (vulnerable) adult with
  whom they have (or can manipulate) a relationship
  of authority
• Develop a special relationship with the adult
• Get the victims support network to trust them or
  isolate the victim (threat, inducement,
  deception)
• Slowly introduce low level behaviour in order to
  desensitise or normalise
• Introduce the target behaviour

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Forced Marriage
www.forcedtomarry.com
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Radicalisation to Support or Commit Terrorism

• Nicky Reilly attempted to detonate
• an improvised explosive device at
• a restaurant in Exeter in May 2008.
• Was radicalised through contact
• with people on the internet. Known
• to have mental health issues and
• learning difficulties.

Building Partnerships, Staying Safe The health
sector contribution to the Prevent strategy
guidance for healthcare organisations
Police found weapons and explosives at the home
of Michael Piggin. He has Asperger syndrome and
had been repeatedly bullied at school. He had
become involved with a far right extremist
group, the EDL.
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Police involvement

• 101 OR 999
• http//www.devon-cornwall.police.uk/
• 112 is an emergency services number that crosses
  all telecom providers
• in poor signal areas for mobiles also in Europe
• PCSOs
• Police officers
• Neighbourhood beat managers
• Specialist officers public protection unit

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• Making Every Adult Matter MEAM Project is also
  creating ways of improving multi agency
  assessment and support provided to people with
  complex needs and chaotic life styles at risk
  from self neglect and other types of harm.

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Scams

www.thinkjessica.com www.stoploansharks.org.uk
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Trading Standards

• May be able to help
• If youve been misled by the trader into buying
  something you wouldnt have bought if you had
  been given all the information beforehand
• If the trader has made false claims about goods
  or services which you have found out not to be
  true
• If youve been sold fake or counterfeit goods
• If the trader has used aggressive selling
  techniques or persuaded you to buy something you
  wouldn't necessarily have bought if you had a
  free choice

scamsteamadmin_at_eastsussex.co.uk
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Feedback the two brothers
Miss P
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Domestic Abuse

• Incident or pattern of incidents of controlling,
  coercive or threatening behaviour, violence
• or abuse... by someone who is or has been an
  intimate partner or family member
• regardless of gender or sexuality
• Includes psychological, physical, sexual,
  financial, emotional abuse so called honour
  based violence Female Genital Mutilation forced
  marriage
• The Home Office 2013

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Devon Domestic Abuse Support Services

• www.new.devon.gov.uk/dsva

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Feedback the couple in the conservatory
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Carers and Safeguarding

• Carers are more likely to perpetrate abuse
  (intentional or not)
• if the carer
• Has unmet or unrecognised needs
• Is themselves vulnerable
• Has unwillingly had to change his or her
  lifestyle or feels unappreciated or exploited
• Is being abused by the vulnerable person
• Has little insight or understanding of the
  persons condition or needs
• Is feeling isolated, undervalued or stigmatised
• Has other responsibilities
• ADASS (July 2011)

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Woman in the hospital woman in the care home

• What might be happening (best
• Case Scenario / worst
• scenario)?
• What could / might be done
• (short/long term)?

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Advocacy

• arrange, where appropriate, for an independent
  advocate to represent and support an adult who is
  the subject of a safeguarding enquiry or
  Safeguarding Adult Review where the adult has
  substantial difficulty in being involved in the
  process and where there is no

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New Statutory Advocacy

• The Act requires local authorities to involve
  people in assessments, care and support planning,
  and reviews.
• In order to facilitate the involvement and
  engagement of people who would otherwise have
  difficulty, it introduces a new requirement to
  arrange independent advocacy for people
• A) who have substantial difficulty in being
  involved/ engaged in these processes and
• B) where there is no one available to help
  facilitate this involvement and engagement.

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Substantial difficulty

• Where a person has substantial difficulty in
  engaging with the assessment process
• Is there anyone appropriate who can support the
  person be fully involved?
• Maybe a carer (who is not professionally engaged
  or remunerated), a family member or friend.
• If there is no one appropriate, then the local
  authority must arrange for an independent
  advocate.

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What is the purpose of making an alert?

• To support the person to keep them safe now and
  in the future and to lead the life of their
  choice
• To share information about risk so that others
  can decide on the next actions that might be
  needed
• To collect national information / data

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Practitioners Role
Responding in a regulated service 14.56
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(No Transcript)
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Asking the right questions

• Open
• Closed
• Specific
• Probing
• Hypothetical
• Reflective
• Leading

TED
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Gaining Consent

• You should seek consent to share
• Information unless doing so would
• Place a child at increased risk of significant
  harm
• Place and adult at increased risk of serious harm
  
• Prejudice the prevention, detection or
  prosecution of a serious crime
• Lead to unjustified delay in making enquiries
  about significant harm or serious harm

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Gaining Consent

• You can share information without consent
• In the best interest of a person lacking capacity
  (to understand the risks they face or capacity to
  understand the safeguarding process)
• In the public interest (You are trying to balance
  a persons right to privacy with their right to
  life, right to be free from torture, inhuman and
  degrading treatment, right to liberty and right
  to autonomy.)

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Objectives of an enquiry

• 14.78. The objectives of an enquiry into abuse or
  neglect are to
• establish facts
• ascertain the adults views and wishes
• assess the needs of the adult for protection,
  support and redress and how they might be met
• protect from the abuse and neglect, in
  accordance with the wishes of the adult
• make decisions as to what follow-up action
  should be taken with regard to the person or
  organisation responsible for the abuse or
  neglect and enable the adult to achieve
  resolution and recovery.

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When should an enquiry take place?

• 14.77. Local authorities must make enquiries, or
  cause
• another agency to do so, whenever abuse or
  neglect are
• suspected in relation to an adult and the local
  authority
• thinks it necessary to enable it to decide what
  (if any)
• action is needed to help and protect the adult.
• The scope of that enquiry, who leads it and its
  nature, and
• how long it takes, will depend on the particular
• circumstances. It will usually start with asking
  the adult their
• view and wishes which will often determine what
  next
• steps to take.

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Multi-agency Process

• Devon Care Direct on
• Torbay Single Point of Contact on 01803
• 219741 or safeguarding.alertstct_at_nhs.net
• Plymouth Adult Protection Team on
• 01752 668000 or adultpro_at_plymouth.gov.uk

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Process

• The Care Act becomes law on the 1st April 2015
• Until advised otherwise by the safeguarding
  adults board all processes remain the same

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Child Protection

• www.devon.gov.uk/childprotection
• If you are concerned about a child or young
  person in Devon contact the MASH on 0345 155 1071
  or email mashsecure_at_devon.gcsx.gov.uk and give as
  much information as you can.

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Prevention is Better Than Cure

• Keep the course in context. Whilst there are
  some very worrying situations occurring everyday
  there is also good practice.
• Remember to vigilant and deal with things at the
  earliest opportunity.
• Doing nothing isnt an option.
• What will you do now?

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Reference Sources

• www.devon.gov.uk
• https//www.gov.uk/government/uploads/system/uploa
  ds/attachment_data/file/366104/43380_23902777_Care
  _Act_Book.pdf
• http//www.careknowledge.com
• www.meam.org.uk
• www.scie.org.uk
• www.ripfa.org.uk
• www.careknowledge.com

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Final Questions?