Safeguarding adults at risk of abuse or neglect

1. Safeguarding adults at risk of abuse
or neglect
Level 1

2. Objectives
1. Recognise who safeguarding duties apply to
2. Recognise categories of abuse or neglect
3. Recognise factors associated with abuse or neglect
4. To know how to report concerns about abuse or neglect using
appropriate systems.
5. To reflect on own practice to ensure that it minimises the risk
of abuse or neglect to an adult
6. Understand the principles and values which underpin all
safeguarding adults activity.
7. Recognise the impact of legislation on own practice.

3. Everybody has the right to live their life free from
abuse...

4. Everybody has the right to live their life free from
abuse...
Every adult has the right to self-determine what happens to their bodies,
therefore practitioners need consent to deliver care or treatment to a person.
This legislation is the Mental Capacity Act an important legal framework which
goes hand in hand with the safeguarding agenda.
Mental capacity act has been in force since 2007 and it promotes the rights of
vulnerable adults to self-determine on decisions that they are able to and in the
absence of capacity for a decision provides a best interest checklist for health
and social care staff to follow when making decisions on behalf of that person.

5. The Care Act (2014) sections 42-46
• Replaces the ‘No Secrets’ guidance
• Safeguarding duties apply to an adult who;
Has the need 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

6. Aims of adult safeguarding
• Stop abuse or neglect wherever possible
• Prevent harm and reduce the risk of abuse or neglect to adults
with care and support needs
• Safeguard adults in a way that supports them in making choices
and having control about how they want to live
• Promote an approach that concentrates on improving life for the
adults concerned
• Raise public awareness so that communities as a whole,
alongside professionals, play their part in preventing, identifying
and responding to abuse and neglect
• Provide information and support in accessible ways to help
people understand abuse and what to do to stay safe and raise
concerns about the safety of an adult
• Address what has caused the abuse or neglect
Intentional abuse disciplinary process if upheld and dismissed from
a service requirement to report to Disclosure and Barring service

7. Necessary to:
• Ensure that everyone, individuals and organisations are clear
about their roles and responsibilities
• Create strong multi agency partnerships that provide timely
and effective prevention of and response to abuse
• Support the development of a positive learning environment
across partnerships to help break down cultures that are risk
adverse and seek to scapegoat
• Enable access to mainstream community resources e.g.
leisure facilities that can reduce social isolation
• Clarify how responses to safeguarding concerns deriving from
the poor quality and inadequacy of service provision,
including patient safety in health sector, should be responded
to

8. Six key underpinning principles
1. Empowerment: people being supported and encouraged to
make their own decisions
2. Prevention: better to take action before harm occurs
3. Proportionality: the least intrusive response appropriate to
the risk
4. Protection: support and representation for those in greatest
need
5. Partnership: local solutions through services working with
their communities
6. Accountability: accountability and transparency in delivering
safeguarding

9. Making safeguarding personal
• Broad community approach to establishing
arrangements
• Organisations recognise that arrangements are there to
protect individuals
• Different preferences, histories, circumstances and life-
styles
• Unhelpful to prescribe a process that must be followed
• Person-led and outcome focused
• Enhances involvement, choice and control
• Improves quality of life, well being and safety

10. Types of abuse and neglect
• Physical abuse
• Domestic violence
• Sexual abuse
• Psychological abuse
• Financial or material abuse
• Modern slavery
• Discriminatory abuse
• Organisational abuse
• Neglect and acts of omission
• Self-neglect

11. Physical abuse; any pain, suffering or injury that
is wilfully inflicted
• Rough handling
• Forcing people to do things against their wishes
• Forced medication/ hiding medication in food
• Inappropriate use of medication i.e. over/under sedation
• Cuts, scratches, bruises, bite marks
• Scalds, burns, any un reported fractures
• Pressure ulcers or poorly managed skin conditions
• Hypothermia
• Loss of weight (malnutrition)
• Omission or failure of care if leading to deterioration or
distress

12. Domestic violence
‘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’ (Home Office 2013)
• Psychological
• Physical
• Sexual
• Financial
• So called ‘honour’ based violence
• Female Genital Mutilation
• Forced marriage

13. Sexual abuse
• Rape
• Indecent exposure
• Sexual harassment
• Inappropriate looking
• Inappropriate touching
• Sexual teasing or innuendo
• Sexual photography
• Sexual assault
• Sexual acts to which the person has not consented to

14. Psychological abuse; wilful infliction of mental
suffering by a person in a position of trust
• Threats of harm or abandonment
• Controlling
• Intimidation
• Coercion
• Shouting, blaming, insulting or swearing
• Verbal
• Bullying, ridiculing
• Denial of access to people
• Denial or failure to acknowledge different religious needs
• Lack of personal space or privacy
can also include wilful failure of a person in a position of trust to
prevent mental suffering inflicted by a third party

15. Financial
• Theft
• Fraud
• Internet scamming
• Financial coercion i.e. wills, property
• Misuse or misappropriation of property, possessions or
benefits
Potential indicators:
Change in living conditions
Lack of heating, clothing etc.
Inability to pay bills/unexplained shortage of money
Unexplained withdrawals from an account
Unexplained changes to wills

16. Modern slavery
• Slavery
• Human trafficking
• Forced labour
• Domestic servitude

17. Discriminatory abuse; any instance when a
person, discriminates against an individual
because of their difference
• Age
• Disability
• Gender reassignment
• Marriage and civil partnership
• Pregnancy and maternity
• Race
• Religion or belief
• Sex
• Sexual orientation
Protected characteristics under the Equality Act (2010)

18. Organisational; neglect or poor professional practice
as a result of the structure, policies, processes and
practices within an organisation.
• Little or no choice in respect of what time to retire or get up
• Lack of choice or consultation about meals.
• Lack of individualised procedures for maintaining cleanliness
• Clothing being shared with other people being supported
• Group routine toileting procedures
• Poor handling of current or acquired medical illness
• Failure to receive medication at optimum times

19. Neglect; failure to provide the degree of care
which a reasonable person in that position of
responsibility would
• Failure to assist in personal hygiene, provide warmth, food
and shelter
• Failure to provide or maintain social contact
• Failure to provide medical intervention when needed
• Failure to protect a person from health and safety hazards
• Confining or restricting someone
• Infantilisation
• Denial of access to services, refusal of transport
• Failure to provide regular nutrition and ensure it is eaten
• Failure to provide correct pressure relief thus preventing
injury

20. s.44 Mental Capacity Act (2005)
• Introduced a criminal offence of ‘ill treatment’ or ‘wilful
neglect’ of a person who lacks capacity
• Remember ...wilful action and bad practice, bad practice
could be abusive related to harm
• A person found guilty of such an offence may be liable to
imprisonment for a term of up to five years or a fine up to
£5000

21. Self-neglect
wide range of behaviour neglecting to care for one’s
personal hygiene, health or surroundings and
includes behaviour such as hoarding
What is the challenge?

22. Risk management & prevention
Patterns of abuse vary and include serial abusing (where
perpetrator seeks out and grooms individual), long term i.e.
within on-going family relationships or opportunistic
Abuse may be perpetrated as a result of deliberate intent,
negligence or ignorance
Alerters play a key role in helping to prevent abuse and manage
risks associated with abusive situations or environments
It is good practice to:
• Acknowledge that abuse could happen here
• Be alert to signs of distress or intimidation
• Report concerns and incidents straightaway

23. Risk management & prevention
Be prepared to recognise abuse and report
If concerns are not initially addressed don’t give up
Take up opportunities for personal training to keep up to date with
good practice
Follow guidance about intimate care and managing challenging
behaviour
Be prepared to ask for support if feeling out of depth with a
particular situation

24. Dealing with disclosures
Somebody sharing with you that abuse has taken place
Somebody sharing with you that they feel at risk of abuse
The abuse may be recent or historical event
It might be very sketchy with minimal information
Irrespective, it should be taken seriously
Alleged victim and alleged perpetrator should be kept separate
Any evidence preserved i.e. photographs or body mapping
Consider if any child protection issues

25. In the event of a disclosure
 Stay calm and allow adult to speak at own pace
 Clarify what has been said to you
 Be aware that medical evidence may be required
 Ascertain the facts without leading the adult
 Seek the persons consent to share the information
 Write down what has been disclosed
 Report what has been disclosed to appropriate person

26. In the event of a disclosure
X Laugh or joke about what has been said
X Rush in with comments or opinions
X Bombard the person with questions
X Change the subject
X Ignore what you have been told or dismiss what you have heard
X Share information with those without a legitimate need to know

27. Being an alerter…
You are not being asked to verify or prove that the
information is true
You are being asked to log the concerns and report them
appropriately
Alerting is the first stage in safeguarding adults at risk of
abuse or neglect

28. Safeguarding adults at risk of abuse or neglect Policy G62
• Found on Trust Intranet site either in policy section or
Safeguarding Adults site
• Following identification of concern alert required within 1
working day
• If not sure seek advice from Ward/Department Manager or
Clinical Matron for Centre
• Safeguarding alert to be faxed to the relevant Local Authority
• Centres Clinical matron to be informed of the alert
• Completion of a datix required

29. Following alert being generated
• LA have 1 working day to make the decision as to whether
alert should be dealt with through safeguarding procedures
• Fax through copy of referral to Police Safeguarding Unit
• Care Quality Commission (CQC) notified if referral concerns a
regulated facility
• Allocation of Safeguarding Officer
• Strategy meeting within 5 working days
• All agencies to work in partnership for the implementation of
safeguarding plan

30. Whistle blowing
• Whistle blowing is a method of informing on your
organisations failings to deal with issues.
• It is the last step and not the first step.
• South Tees P39 Reporting concerns at work (Whistle
blowing) policy
• Designed to support and assist staff to bring genuine
concerns to the attention of the appropriate people, who can
take the relevant action.

31. Dignity and respect
• Part of your professional body’s /STEES required practice
• Have a zero tolerance of all forms of abuse
• Support people with the same respect you would want for
yourself or a member of your family
• Treat each person as an individual by offering a personalised
service
• Enable people to maintain the maximum possible level of
independence, choice and control
• Listen and support people to express their needs and wants
• Respect people's rights
• Ensure people feel able to complain without fear of retribution
• Engage with family members and carers
• Assist people to maintain confidence and a positive self-
esteem
• Act to alleviate people's loneliness and isolation

32. This concludes the safeguarding adults at risk of abuse and neglect
training presentation. If you haven't already, please complete the
quiz below to test your knowledge and record your participation.
For more information or practical advice please contact the clinical
matron for your centre.
Thank you