Transcript St HelensMulti-Agency Safeguarding Adults Policy

St Helens Multi-Agency
Adult Safeguarding
Procedures
January 2013 edition
Refresher Training
Updated November 2013
1
Programme for Today
Introductions
Key definitions
Types and Indicators of Abuse
What makes abuse more likely to occur?
Tea Break
How to make an alert
Key Reporting information
Roles and responsibilities
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Learning Objectives
By the end of the day participants will be
able to:
1.
understand key definitions
2.
describe the different types and indicators of abuse
3.
describe what makes abuse more likely to occur
4.
explain how to make a Safeguarding Alert in
St Helens
5.
understand key information to be included when reporting
abuse
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1. Key Definitions
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Multi Agency Adult Safeguarding in St
Helens
Partners agencies include Council, NHS, Police, Voluntary Sector
Partners believe that;
Everybody has the right to live in a safe and secure environment
without fear of abuse, harassment or injury.
Everybody should have access to relevant services for addressing
issues of abuse and neglect, including the civil and criminal justice
system and victim support services.
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Within St Helens Multi-Agency
Procedures
• “Adult Safeguarding” is taken to mean actions to
redress actual abuse or provide additional security
whilst an allegation is investigated”
•
A “Vulnerable Adult” is “An Adult who is in receipt of, or
may be eligible for community care services”
“No Secrets” (DoH 2000)
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Vulnerable Adults include;
• 18 – 64 years Physical illness / disability
Learning disability / mental illness
• 65 years plus as above and Frailty / Dementia
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Social Care needs are typically
met by Services such as;
- Domiciliary Care
-
Day Care
Careline
Occupational Therapy – aids and adaptations
Supported living/ sheltered accommodation schemes
Residential Care
Residential with Nursing care
Or other arrangements such as Direct Payments /
Personal Care Assistants
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All Adults:
BUT Vulnerable Adults
are:
- may experience abuse
- more likely to experience abuse
eg, Theft
Harrassment from
neighbours,
Domestic violence
- less likely to be able to recognise
and
resolve abuse without
specialist support
Mainstream support is
available
Specialist support is provided via
the
Adult Safeguarding Procedures
eg, Police
Community support
Domestic violence services
Victim
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2. Types and Indicators of Abuse
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Types of Abuse
•
•
•
•
•
•
•
Physical
Financial
Emotional/Psychological
Neglect
Sexual
Discriminatory
Institutional
Identified by No Secrets (Department of Health, 2000)
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Identifying the Indicators (signs and/or
symptoms) of abuse
GROUP EXERCISE
Make a table showing the types and
indicators of abuse following the example
below.
Type of
Abuse
Physical
Example
Hitting
Possible
Indicator of abuse
Bruising
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Physical Abuse
This includes:
•
hitting, slapping, pinching, pushing, hair pulling
•
inappropriate restraint or sanctions
•
Removal of necessary aids and adaptations,
eg.glasses and hearing aids
•
improper use medication
•
force feeding
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Indicators of Physical Abuse
This includes :
•
unexplained injury or injury
•
inconsistent with explanation
•
marks, bruises, burns, scalds
•
injuries at different stages of healing
•
appearing frightened of/avoiding physical contact
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Financial and Material Abuse
This includes:
•
Theft of money or possessions
•
money being borrowed by staff or volunteers who have a
responsibility for providing a service to that person
•
the use of money or property without the informed consent
of the Vulnerable Adult
•
pressurising or deceiving a person to alter their will
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Indicators of Financial and Material Abuse
•
Inability to budget and pay bills that is out of character with
previous behaviour
•
Large or frequent withdrawals from bank account for
unspecified reasons
•
Reluctance to buy essential food or clothing items and/or
excessive economies on heating and lighting
•
Refusal to produce bank statements/books or to allow the
holder access to them
•
Recent change of deeds or title of house
•
Care provision seen solely in terms of expense
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Psychological/Emotional Abuse
This can occur alongside other types of abuse and
includes:
•
•
•
•
•
•
•
Use of threats,fear or bribes
Intimidation by shouting, screaming or swearing
Withholding of necessary assistance
Denial of requests, choices and opinions or privacy
Denial of access to friends and family
Denial of religious or cultural needs
Radicalisation/recruitment to violent extremism
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Indicators of
Psychological/Emotional Abuse
Significant Changes ;
•
In behaviour – more withdrawn/more challenging
•
In sleep pattern – more sleep/less sleep
•
In Weight – weight gain/weight loss
Indicators of radicalisation/recruitment to violent extremism
include;
• Changes to faith
• Changes to appearance
• talk about another person who seems to have a lot of
influence
• Associating with a limited number of people
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Neglect
•
Neglect is where somebody has failed to something for the
Vulnerable Adult and this has caused harm
•
The carer maybe unable or unwilling to provide the care needed
or may not recognise the need for the care to be provided.
•
It can include failing to undertake a reasonable assessment of
risk and allowing a person to harm themselves or cause harm to
others.
•
Neglect is a criminal offence (since April 2007) under the Mental
capacity Act (2005)
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Indicators of Neglect
•
Poor environmental conditions
•
Poor physical state of the person – weight loss,
dehydration, dirty or unkempt appearance, ignoring
medical or physical needs.
•
Failure to provide access to appropriate health, social
care or other relevant service
•
Attitudes of carers lack insight and appear uncaring
•
Carer is also a Vulnerable Adult and incapable of
meeting the basic needs of the person cared for
adequately
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Sexual Abuse
Involvement in sexual activities or relationships which:
•
•
•
individuals do not want or cannot understand and/or have
not consented to.
takes place within a family, care-giving or other relationship
of trust
Forced Marriage
This can include harassment, inappropriate teasing or innuendo,
indecent exposure, touching, penetration and being forced to
participate (actively or passively) in pornographic activity
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Indicators of Sexual Abuse
•
ill-health eg discharges and infections
•
inappropriate sexual behaviour eg overly seductive
•
Vulnerable adult appears withdrawn
•
pregnancy in a female who is unable to give consent
to sexual relations
•
fear /reluctance of person to be alone with an
individual known to them
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Discriminatory Abuse
Discriminatory abuse is a situation where a person or
group of people are treated differently due to
perceived differences.
This includes unfair or unequal treatment on the
grounds of disability, gender, race,sexual
orientation,age etc
Institutional abuse
This is abuse of any type that results from routines
and regimes within care settings which deny people’s
rights, choices and opportunities
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3. What makes abuse
more likely to occur?
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When is abuse or mistreatment more likely
to occur?
•
•
Long history of dysfunctional family relationships
where mistreatment of family members has been the
norm
Where paid carers experience the role very negatively
If the Vulnerable Adult:
•
Hits out at the carer
•
Has difficulty communicating
•
Disturbs the carer at night
•
Has odd and embarrassing behaviour
•
Is unhelpful or uncooperative
•
Is deliberately ungrateful
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When is abuse or mistreatment more likely to occur?
(Cont.)
If carers:
•
Do not feel supported
•
Habitually lose their temper – linked to stress
•
Perceive the vulnerable adult as being deliberately
awkward
•
Carer is physically or mentally ill, dependant on
alcohol or misuses drugs
•
Role reversal – child caring for a dependent adult
•
Carer is young/lacks maturity
•
The Vulnerable Adult has few/no social contacts
•
Have to cope with multiple problems
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Poor Practice versus Possible Abuse
Sometimes difficult to know where to draw the line!
POSSIBLE
ABUSE
POOR PRACTICE
RISK
SERIOUSNESS
HARM
CONTEXT
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Poor Practice
VA not given evening meal on one occasion
Possible Abuse
VA was not given evening meals over the weekend.
Said it had happened before.
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Poor Practice
Moving and handling procedures are not followed but VA is not
harmed
Possible Abuse
Identified moving and handling equipment is not available / VA is
badly bruised in transfer from chair to bed
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Good Practice
VA had a fall that could not be anticipated or prevented
All steps taken to provide medical attention
Possible Abuse
VA has a fall on a loose step in the garden / wearing slippers
that are too big
No medical attention sought until 3 days later when hip
fracture is established
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Poor Practice
One additional dose of medicine administered in error Pharmacy advised this would not have any impact
Possible Abuse
One additional dose of medicine administered for 9 days resulting
in hospital admission
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St Helens Safeguarding Adult Procedures
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4.How to make a Safeguarding
Alert in St Helens
Follow the Flow Chart !
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How to Make a Safeguarding Alert in St Helens
BE ALERT: suspicion, allegation, observation or disclosure of abuse
Deal with immediate danger (if any)
Call 999 if appropriate
Support and make Vulnerable Adult as safe as possible
Preserve the evidence (if any / appropriate)
Report the Abuse
Inform Line Manager / Agency’s Designated Person who must telephone
St.Helens Council Contact Centre within 1 hour to make a Safeguarding Alert
If Line Manager is likely to be unavailable for more than 1 hour - YOU MUST telephone
the Alert through yourself
Telephone
St.Helens Council Contact Centre - 01744 676600
(9.00am to 5.00pm - Monday to Friday)
or Emergency Duty Team (EDT) - 0845 0500 148
outside of the above hours
Make a Record
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Be Alert
•
•
Think about what you see and ask is it acceptable practice
Always take seriously what you are told
Deal with immediate Danger, if any
•
Call 999 for Police or an Ambulance
Support and make the Vulnerable Adult as safe as possible
•
Explain that you will inform your line manager, unless you believe
this will cause the Vulnerable Adult further distress
Preserve the Evidence
•
•
•
Evidence can be anything (PPP)
–
Person – blood, scratches, dirt, clothing
–
Place – a room, the garden, a car
–
Property, chequebook, purse, jewellery box, medication,
documents
Don’t touch, remove or clean any PPP unless absolutely necessary
Be supportive but don’t interview the person
Report
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Duty to Report Abuse
•
Applies to all St Helens Council employees, staff and
volunteers in all Agencies that are signatories to
Multi-Agency Procedures or contracted by them to
provide a service
•
Report suspicions/ allegations/disclosure/observations
of abuse to your Line Manager/Agency/Designated
Person
•
If the Line Manager/Agency Designated Person is
likely to be unavailable for more than one hour, YOU
MUST report directly to St Helens Council Contact
Centre
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An Alert must have…..
An Alleged
Perpetrator
(Who)
An Alleged
Abuse
An alleged
Victim
(Did what)
(To Who)
Or in the case of Neglect…
(Who)
(Failed to do what)
(To Who)
Line Manager/Agency’s Designated Person
MUST check initial facts and consider context
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Consider Context
WHO
Perpetrator
Intention
WHO
Victim
Impact
WHAT
Act or Omission
Common
themes/sequence
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5. Key Information when
reporting adult abuse in
ST Helens
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Key Information When Reporting Adult Abuse in St Helens
WHO
- is the alleged victim?
- is the alleged perpetrator?
WHAT
- is the allegation, i.e. what did alleged perpetrator do or fail to do to victim
- is the relationship between the alleged victim and alleged perpetrator?
- type of alleged abuse is this, i.e. financial, sexual, physical,
emotional/psychological, discrimination, neglect or institutional?
WHERE
- does the alleged victim live?
- does the alleged perpetrator live?
- did the alleged abuse occur?
WHEN
- did the alleged abuse occur - what date / time?
Remember - WHO, WHAT, WHERE, WHEN
Telephone
St.Helens Contact Centre - 01744 676600
(9.00am to 5.00pm - Monday to Friday)
or Emergency Duty Team (EDT) - 0845 0500 148
outside of the above hours
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Make a Record
•
Any allegations or suspicions of abuse of a Vulnerable
Adult must be recorded the same day/shift within the
organisation’s/agency’s recording system that holds
the Vulnerable Adult’s personal file/case file/contact
records.
•
Opinions should not be recorded. If necessary,
opinion will be taken as a witness statement later on
in the investigation by persons qualified to do so.
•
The record must be signed and dated (in black ink, if
possible) bearing in mind it may be required later as
part of evidence in legal proceedings
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Response to Adult Safeguarding
Alerts
Actions to establish facts, as far as is reasonable and
proportionate to the allegation of abuse, will be taken.
•
Criminal Procedures
•
Disciplinary Procedures
•
Serious Untoward Incident Reviews e.g. NHS organisations
(Trusts)
Also changes to the Care Plan maybe made to
Protect the person
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(Cont)
Responding to an Adult Safeguarding Alert is the responsibility of;
•
“Investigating Managers”/ ”Investigating Practitioners” – these
are from care management, ASCH
•
Safeguarding Coordinators - these are specialist staff form the
Adult Safeguarding Unit, ASCH
•
Others were appropriate include the Police, Specialist nursing and
health professionals, Community Safety or Domestic Violence
Support
•
Managers of Provider Services when employees are involved and
Disciplinary Procedures are appropriate.
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Response to a Safeguarding Alert in St Helens
Initial Strategy Discussion
Not appropriate to
continue with
Safeguarding process
Initial Safeguarding Visit
Additional Strategy Discussion
Strategy Meeting to identify and agree:
Protection Actions
Investigation Actions
Consideration of HR Procedures
Implementation and Monitoring Meeting to monitor and review:
Protection Actions
Investigation Actions
Closure Meeting
Feedback to Vulnerable Adult and others as appropriate
Closure Summary
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