Adult Protection & Vulnerable Adults

The extent of the problem:

SCC AP referrals 2005-6SCC AP referrals 2005-6• 145 referrals went through AP process145 referrals went through AP process• >50% related to older adults –75+ with OPHM needs most at >50% related to older adults –75+ with OPHM needs most at

riskrisk• 60% victims female, 60% perpetrators male60% victims female, 60% perpetrators male• >50% cases –abuse occurs at home>50% cases –abuse occurs at home• 30% -abuse occurs in residential care –including hospital 30% -abuse occurs in residential care –including hospital

settingssettings• > 30% abuser is paid carer, >30% abuser relative or partner> 30% abuser is paid carer, >30% abuser relative or partner• 125% increase in referrals from previous year125% increase in referrals from previous year

Who is vulnerable?

• 18+ yrs old18+ yrs old• In need of community care servicesIn need of community care services• Mental or other disability –age or illnessMental or other disability –age or illness• Unable to take care of themselvesUnable to take care of themselves• Unable to protect themselves against harm or Unable to protect themselves against harm or

exploitationexploitation• Mental CapacityMental Capacity

What affects vulnerability?

• Social exclusionSocial exclusion• Dependency on others – mobility, access to Dependency on others – mobility, access to

information and services, control of finances, information and services, control of finances, ADLsADLs

• Social acceptability of low standards of careSocial acceptability of low standards of care• Social acceptability of domestic abuseSocial acceptability of domestic abuse• Dynamics of power within institutional care Dynamics of power within institutional care

settings –this includes hospitalssettings –this includes hospitals

What is abuse?

Violation of human and/or civil rightsViolation of human and/or civil rights Causing harm by someone in a position of power, authority Causing harm by someone in a position of power, authority

or trust –Harm may be:or trust –Harm may be: PhysicalPhysical PsychologicalPsychological EmotionalEmotional SexualSexual FinancialFinancial NeglectNeglect DiscriminatoryDiscriminatory InstitutionalInstitutional

Zero Tolerance

A multi-agency approach (No Secrets, A multi-agency approach (No Secrets, DoH 2000)DoH 2000)

All causes for concern should be All causes for concern should be reported – the ALERT systemreported – the ALERT system

Investigations should run in tandem with Investigations should run in tandem with complaints, Personnel, Professional complaints, Personnel, Professional Regulatory bodies (NMC, GMC)Regulatory bodies (NMC, GMC)

Institutional Abuse

Rigid routines and regimesRigid routines and regimes Lack of choice and consultationLack of choice and consultation Poor quality environmentPoor quality environment Staff focussedStaff focussed Low staff moraleLow staff morale Lack of staff trainingLack of staff training No evidence of effective policies and No evidence of effective policies and

proceduresprocedures

Who can abuse?

Anyone –Anyone – RelativesRelatives Informal CarersInformal Carers Paid CarersPaid Carers ProfessionalsProfessionals StrangersStrangers NeighboursNeighbours Other service usersOther service users

Adult Protection in SUHT

Adult Protection Alert Process piloted in Adult Protection Alert Process piloted in A&E since July 05 and now TrustwideA&E since July 05 and now Trustwide

Alert Forms revised to include guidance Alert Forms revised to include guidance notes and referral contact detailsnotes and referral contact details

Is now reconfigured as Adult Protection Is now reconfigured as Adult Protection Steering Group to monitor AP policy Steering Group to monitor AP policy implementation.implementation.

Progress to date:

Policy approved and launched July 06Policy approved and launched July 06 ALERT forms implemented across Trust –ALERT forms implemented across Trust –

download from Suhtranetdownload from Suhtranet Single point of access for ALERTS within Single point of access for ALERTS within

hours – 2 access points for OOHhours – 2 access points for OOH Training the Trainers completedTraining the Trainers completed Training programme devised for roll-out Training programme devised for roll-out

over next 12 months – MEC lead: Claire over next 12 months – MEC lead: Claire Rogers, Cancer Care, Nikki McKeagRogers, Cancer Care, Nikki McKeag

Key Principles

First Priority –ENSURE SAFETY OF First Priority –ENSURE SAFETY OF VULNERABLE ADULTVULNERABLE ADULT

Raise an ALERT –follow SUHT reporting protocolRaise an ALERT –follow SUHT reporting protocol Act on any cause for concernAct on any cause for concern Preserve evidencePreserve evidence Share your knowledgeShare your knowledge Joint workingJoint working Ensure you have had adequate trainingEnsure you have had adequate training Maintain accurate and up to date recordsMaintain accurate and up to date records