Safeguarding of Adults at Risk

Welcome

31st March 2012

Neil Lee

Safeguarding of Adults at RiskHouse Keeping

Group Agreement

AimsTo explore personal values and beliefs

To enable staff to promote the safeguarding of all adults at risk

To establish a shared understanding of best working practice in offering support

To understand procedures when reporting abuse

ObjectivesExplain what is meant by the term “Adult at Risk”Describe what is meant by abuseList signs and indicators of abuseDiscuss how to differentiate between causes for concern and

safeguarding issuesDemonstrate how to respond appropriately Identify policy and procedure

IntroductionsEach person introduce themselves

Tell us where you work and who are the adults you work

Warm up exercise

True or False?Up to 10% of people over 65 are abused each year

TRUE – as far as we know

People who are abused may not know they are being abused

TRUECan you give some reasons?

True or False? In order of ‘most likely’ (1) to ‘least likely’ (3)

Woman 3 (25%)

Man 1 (45%)

Man and woman together 2 (33%)

Over 70% of elder abuse affects people over 70 years old

TRUE – in fact it is nearly 80%

True or False?Over 60% of elder abuse is experienced by women

TRUE – in fact it is nearly 70% -with earlier statistic – 52% of elder abuse affects women over 70

Some forms of abuse violate people’s human rights

FALSEALL forms of abuse violate human rights

True or False?Drug Users and alcoholics don’t count as vulnerable adults

FALSE

Most elder abuse occurs in care homes

FALSEMost occurs in people’s own homes

True or False?Abuse is another term for domestic violence

IT DEPENDSVulnerable adults can experience domestic violence but not all

domestic violence involves the vulnerable adults we are discussing

Most Community or District Nurses encounter elder abuse each year

TRUE88% reported so in a survey but this is only elder abuse

True or False?A fifth of older people living in care homes suffer from malnutrition

TRUEAny examples?

Nearly half of all nursing and care homes fail to reach national minimum standards for managing residents medication

TRUEAny examples?

True or False?Abuse is not always deliberate

TRUEAny examples?

“Grooming” is a term that only applies to paedophile offences

FALSE

No Secrets 2000Partnership

Prevention

Guidance – inter-agency policies, procedures and joint protocols

Communication

Adult at Risk “Adult at Risk” is a term used to describe a person who Is

an adult aged 18 years and over

AND

who is or may be in need of community care services by reason of mental or other disability, age or illness

AND

who is or may be unable to take care of him or herself or take steps to protect him or herself from significant harm or exploitation”

[No Secrets, DOH, 2000]

This Includes PeopleOlder peopleWith a Learning DisabilityWith a Physical DisabilityWith Mental Health problemsWith DementiaWith Brain injuriesWith Drug & Alcohol problemsWith a Sensory disability

Definition of Abuse ‘Abuse is a violation of an individual’s human and civil rights by any

other person or persons.

It may consist of a single act or repeated acts. It may be an act of neglect, or omission, or it may occur when a adult at risk is persuaded to enter into a financial or sexual transaction to which he or she has not consented or cannot consent’

[No Secrets, DOH, 2000]

Types of Abuse

Defining AbusePhysical Abuse – Including hitting, slapping, kicking, misuse of

medications, over or under feeding, restraint or inappropriate sanctions

Sexual Abuse – Through non- consensual sexual actions, rape, sexual assault / or pressured into consenting, sexual explicit conversations

Psychological/ Emotional Abuse – Through non-physical means, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, verbal abuse, isolation or withdrawal from supportive networks.

Defining Abuse (cont)Financial/Material Abuse – Including theft, fraud, exploitation of wills,

property, inheritance, possessions or benefits

Neglect – Ignoring medical and/or physical care needs, failure to provide access to health, social care or educational services, withholding necessities of life, e.g. medication, adequate nutrition, heating , lack of cleaning

Discriminatory – Based on someone's race, culture, faith, age, gender, disability, sexuality or capacity and other forms of harassment, slurs or similar treatment

Institutional – Harm or distress as a result of poor management, training or practice. Choice taken away, Care given at set times to make it easier for staff and the organisation

Indicators, Signs & Signals of AbusePhysical - Sleepy, Bilateral marks, injuries in various stages of

healing, hair loss, marks on hidden parts of the body, mouth ulcers, burns, bruises, brakes, scratches

Sexual – Difficulty in sitting/walking, use of sexual words/gestures, body fluids, pregnancy, blood stains, difficulty in going the toilet, STIs

Psychological/Emotional – Hesitation to talk openly, emotional agitation, unusual behaviour such as sucking thumbs, biting, rocking, confusion, unexplained fear

Indicators, Signs & Signals of abuse (cont)Financial – Lack of heating, lack of food in the cupboards, referral to

another person for money related matters, borrowing money, unexplained bank withdrawals

Neglect/Environmental – Dehydration, malnourishment, weight loss without illness, pressure sores, lice, dirty, mouth rashes, smells, doors left open/locked, unable to use mobility aids, glasses, hearing aids

Institutional- Restricted visiting, no stimulus, lack of bedding/clothing, no privacy for visitors

Consider what might you see/hear/feel/smell

Who Can Be An Abuser?Partner Other family memberHealth care workerVolunteerSocial care staffOther vulnerable adultNeighbour/ friendStrangerOther

Relationship Figures 2010/ 11Partner Other family memberHealth care workerVolunteerSocial care staffOther professionalOther vulnerable adultNeighbour/ friendStrangerNot known Other

7%18%3%0%25%3%13%6%2%14%8%

This is only what we know from what is reported. The true figures could be double, triple.........

Break

Signs & SignalsShare out the cards and in turn

read your situation, discuss as a group

and decide where you place it

Case StudyFollowing an allegation…

Dealing With A Concern/Allegation Of AbuseDO- Inform a Line ManagerTake what the person says seriously Stay calm, try not to show shockListen carefully & allow them to share informationSupport & reassure the person throughout, it’s not their faultProtect evidenceTell the person you must discuss with a managerEnsure the person is safeWrite down what was said Inform police if it’s a crimeMaintain Confidentiality

Dealing With A Concern/Allegation Of Abuse (cont)DON’T-Promise to keep secretsPress the person for more informationMake promises you cannot keepDon’t interrupt Do not be judgemental or ‘explain’ the situation awayDo not contact the alleged abuserDon’t be persuaded to keep quietDo not attempt to investigate yourself

Failure to report known or suspected abuse is an act of omission and a failure under duty of care – making the failure abuse itself

Writing a ReportMake a note of what has been disclosed to you as soon as possibleEnsure that you state the facts and not opinion Date and sign your report, clearly stating your nameWrite down what was said using the exact words if possible or what

you observed, including dates and timesDescribe the circumstances in which the disclosure was made, what

you observed concerning actions and behaviourSay where it happened and who else was there at the time, stating

full names if possibleConsider who, what, when, where, why Any immediate action that has been taken

Public Interest Disclosure Act [1998] ‘Whistleblowing’

Aim:Last resort optionProvides an avenue to raise concerns and receive feedback on any

action takenYou will be protected from reprisals or victimisationEncourages employees to raise serious concerns Identity will be kept confidential for as long as possibleAn investigation or court case may reveal a persons identity

Mental Capacity Act 2005 Key 5 Principles 1. A person must be assumed to have capacity unless it is

established that he lacks capacity’2. ‘A person is not to be treated as unable to make a decision unless

all practicable steps to help him to do so have been taken without success’

3. ‘A person is not to be treated as unable to make a decision merely because he makes an unwise decision’

4. ‘An act done, or decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made in his best interests’

5. ‘The act or decision is to be achieved in a way that is less restrictive of a person’s rights and freedom of action’

Useful Telephone Numbers Independent Safeguarding Authority – 01325 953 795 Office Public Guardian - 0300 456 0300 Police Call Centre – 101Police Emergencies – 999NHS Whistleblowing Hotline – 08000 724 725Care Quality Commission (CQC) – 0300 061 6161Public Concern At Work 020 7404 6609

How Safe are our Services?

What can you do

as an individual,

team or organisation

to help create a safer

environment for the

people you support

‘Abuse results in significant harm,

exploitation of, the adult at risk.

It may be perpetrated by anyone who

has power over the person whether

they are a carer, relative, a paid

Member of staff or professional, or as

a result of persistently poor care or a

rigid and oppressive regime.’

Steven Hoskins Video

Safeguarding Of Adults At RiskAny questions

Evaluations & Certificates

“The great end of learning is not knowledge, but action”Peter Honey

Thank you

Neil Lee07753283048neilleetraining@gmail.com