Safeguarding adults at risk of abuse or neglect
- 1. Safeguarding adults atrisk of abuse or neglect Level 1
- 2. Objectives 1. Recognise whosafeguarding 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 theright to live their life free from abuse...
- 4. Everybody has theright 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 adultsafeguarding • 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: • Ensurethat 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 underpinningprinciples 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 abuseand 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; anypain, 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 orpattern 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; wilfulinfliction 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; anyinstance 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 orpoor 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 toprovide 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 CapacityAct (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 ofbehaviour 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 Somebodysharing 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 eventof 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 eventof 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… Youare 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 atrisk 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 beinggenerated • 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 • Whistleblowing 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 thesafeguarding 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