Transcript Safeguarding Vulnerable Adults & Dementia

Safeguarding Vulnerable
Adults & Dementia
“Every adult has a right to respect, dignity,
privacy, equity and a life free from abuse”
Joint committee on Human Rights
The Safeguarding Team aims to support all Trust
staff in contact with patients to recognise, report and
prevent the abuse of vulnerable adults, children and
staff, through raising awareness, providing
appropriate training and investigating all allegations
of abuse.
The Team comprise of Senior Acute Care Health
Professionals with experience in Midwifery,
Paediatrics, Surgery, A&E, Critical Care and Elderly
Care. The team act both strategically and
operationally in preventing and investigating abuse in
order to safeguard both patients and staff.
Our Mission statement
Director of Nursing & Midwifery / Executive
Lead for Safeguarding
Jill Galvani
LEAD NURSE FOR SAFEGUARDING
Mandy McDonough
SAFEGUARDING
CO-ORDINATOR
Matt O’Neill
ADULT
PROTECTION
TEAM
Carl Griffiths
Named Nurse for
Adult Protection
Karolyn Shaw
Named Nurse for
Adult Protection
DOMESTIC
ABUSE
Sheila Oakley
Domestic Abuse
coordinator
CHILD PROTECTION
TEAM
Behaviour
Management
Maggie Chessall
Named Midwife for Child
Protection
Barry Smith
Behaviour
Management
Specialist Nurse
Sue Fogarty
Named Nurse for Child
Protection
Sue Hess
Safeguarding Practitioner
Safeguarding Structure
A Government Response
House of Commons Health Select Committee
April 2004
Abuse of adult /elderly people is a hidden, and often ignored,
problem in society. The profile of child abuse has been
dramatically raised in the past few years and the Government
has acted to introduce controls and measures to identify and
tackle that problem; but abuse of older people remains in the
background.
It has been put to us that 500,000 older people in England are
being abused at any one time, yet many people are unaware of
the problem and few measures have been taken to address it.
Often care staff take no action because they lack training in
identifying abuse or are ignorant of the reporting procedures.
Equality and Human Rights Commission
23 November 2011
The Commission's inquiry into the home care system in
England reveals disturbing evidence that the poor treatment
of many older people is breaching their human rights and too
many are struggling to voice their concerns about their care
or be listened to about what kind of support they want.
The final report of the Commission’s inquiry says ‘hundreds
of thousands of older people lack protection under the
Human Rights Act’.
Mid Staffordshire NHS Foundation
Trust Public Inquiry
6th February 2013
The report into the care provided by Mid Staffordshire NHS
Foundation Trust concluded that for many patients the most
basic elements of care were neglected.
Robert Francis QC said: "I heard so many stories of
shocking care. These patients rightly expected to be well
cared for and treated. Instead, many suffered horrific
experiences that will haunt them and their loved ones for the
rest of their lives."
Physical
Psychological
Sexual
Neglect
Discrimination
Financial
Institutional
Domestic Abuse
Deliberate Self Harm
Categories of abuse
• Assumptions are easier to make.
• Older adults tend to have a negative
stereotype, we tend to focus on inability
rather than ability
• Older adults have money, possessions and
property to exploit.
• Older adults can refuse a service
• Agencies have less power to intervene.
• Identification of mistreatment is more
difficult due to less contact.
Does age make a difference?
• Hitting, slapping, scratching and kicking
• Pushing or rough handling
• Misuse of medication
• Deprivation of food, drink, warmth
• Inappropriate restraint
Physical Abuse
Mental Capacity Act 2005 creates a new
offence of ill treatment and neglect.
• Applies to all - Carers and Professionals
• Punishable by up to five years in prison
Mental Capacity Act 2005 Morris & Taylor
The Law Society
Neglect
When you pay too little attention, or
no attention to the individual.
To fail to take proper care of
someone
Or omit to do
Fenella Morris
Barrister
(specialist in mental health) 2005
Neglect
13th June 2013
FIVE members of staff at a Merseyside care home were accused of
leaving elderly dementia patients covered in their own filth after
“downing tools” and are being charged with 11 counts of willful neglect of
a person lacking capacity.
The prosecution stated when the night shift arrived at 9pm they found 11
elderly patients caked in their own waste, with many of them having not
been put to bed, changed, or given incontinence pads. One of the
residents was also found to have gone to the toilet in a kitchen bin.
It is the Crown’s case that each of the 11 residents named in the
indictment were sorely neglected by each of the defendants, who were
responsible for their care, to the extent that all had been left uncleaned
and unchanged for such a significant period of time that each of the 11
was in a state of obvious significant discomfort and in immediate need of
cleaning and changing.
Examples of institutional abuse are:
Observed lack of dignity and respect in the
care setting.
Rigid routines, processes and tasks organised
to meet the needs of the staff and not the
person.
Disrespectful language and attitudes which
lead or may lead to harm.
Institutional Abuse
Named Nurse interviews alleged victim, ascertains
capacity and ensures victim is safe
Gathers information and liaises with other agencies to
see if the threshold for referral has been met.
Strategy Meeting is held and safety plan is approved
Lead Agency Appointed for investigation
Investigation proceeds
Case conference held and is either closed or identified for
review
Process for alert
• Did the adult give consent to the activity
that is deemed abusive?
• Was the adult coerced?
• What harm was sustained?
• What is the standard expected?
• Has a crime been committed?
• Do we have a duty under law?
• Do we have a duty to care, either for the
individual or for others which overrides the
persons consent (nature and severity of
abuse will determine as well as the setting)
Process for alert
……a person who is CAPABLE of making
his/her own decisions has the right to
decline the authorities help and protection,
even if this means that he / she is left in an
environment which is harmful to him/her.
The worker should make clear the available
options but their rights to refuse intervention
should be respected……..
Law Commission 2002
Refusing Help
Liaises with
Central Advice
and Duty Team
Case opened
with DASS,
Social Worker
identified
Appropriate agency
identified as lead
i.e. Police
Investigation
commences
Professionals /
Strategy
meeting
Protection plan
agreed and
implemented
Review
Adult Protection team
review and decide if
appropriate for referral
Adult Protection team
receives referral
Self Neglect is an umbrella term that
covers a wide range of behaviours
- Neglect of self
- Neglect of environment
- Risky lifestyle behaviour
Self neglect may arise from an inability
or unwillingness to care for oneself or a
combination of both.
Self Neglect
Emerging themes from a small body of
research indicate:
Pride in self sufficiency
Sense of connectedness to a
place and possessions
A drive to preserve a sense of
identity and control
Traumatic life events that have
had a life changing effect.
Self Neglect
Both the Named Nurses in Adult
Protection and the Behaviour
Management Specialist Nurse are
qualified Best Interest Assessors for
Deprivation of Liberty Safeguards (DoLS)
We regularly advise Trust and external
agency staff on the appropriate use of the
Act in relation to medical treatments,
discharge destination and behaviour
management.
MCA 2005
Thank you