Safeguarding and protecting of vulnerable adults – Unit 514
Safeguarding means to ‘safeguard’ an individual, to promote and prompt the safety of a vulnerable child or adult. Ensuring you have appropriate measures in place to maximise the safeguarding of others. Safeguarding is everyone’s responsibility that comes into contact with a vulnerable person and it is their responsibility to raise an alert immediately should anything be ‘out of the ordinary’
Protection is a central part of safeguarding and promoting welfare. It is the process of protecting an individual identified as either suffering or at risk of suffering significant harm as a result of abuse or neglect, you protect a vulnerable person when it is clear they are at risk or currently a risk.
It is vital that as an organisation we evaluate our policies and improve and develop them as new criteria and legislation comes into place and is to be followed. All staff will receive updates and changes as to when these become in place and receive yearly ‘safeguarding alerters training’ upon assessment service users are explained the complaints and compliments process and this is also available in print format in their provider file which stays in their home. It is explained that as our duty of care as a care provider, safeguarding is a huge role in our responsibility and that any signs or evidence that things are out of the ordinary will be reported to the necessary professionals. Service users are to sign an authorisation form upon assessment to agree with this process and that they consent to information sharing on a need to know basis. All staff are fully DBS checked and they are all trained to the same standard, this ensures that where reporting and whistle blowing is concerned everyone is familiar with the same policies.
Each member of staff will receive our ‘safeguarding vulnerable adults policy’ this includes explaining safeguarding, who a vulnerable adult is, different types of abuse, who may abuse, factors and indicators of abuse, the 4 point approach to abuse, our procedure as an organisation and what to expect and an easy to read flow chart on the stages of reporting. Each member of staff will sign to say they understand the guide and that they have received a copy. Each policies and procedures are reviewed and updated if necessary yearly. As on organisation there are certain national policies that we must abide by and some guidelines that have been recommended. For example – No secrets guidelines, influences us as an organisation that we have a duty to investigate and take immediate action whenever we believe a vulnerable adult is at risk or is at harm. That we have a duty to report it to the appropriate people and take their lead if necessary. It is also a national policy that each employee in the Health and Social Care setting must obtain a DBS check. And they will only be allowed to ‘loan work’ once a satisfactory check has been obtained.
There are many legislations and policies that relate to safeguarding and that care providers and other health professionals must follow. You must have legislations and policies in place to ensure the health and safety of those vulnerable people you are supporting. People working in care and in the health profession need to have clear, good knowledge of the safeguarding procedure and policies that are in place. They must feel confident about them and confident to follow them and put them into practice if need be. Some of the obvious ones would be legislations such as the – Health and Social Care Act, ADASS, Mental Capacity Act, Mental Health Act, Social Services Act, Safeguarding Vulnerable Groups Act, Discrimination and Equality Act and so on. The no secrets guidance is not legislation as such, No Secrets’ sets out a code of practice for the protection of vulnerable adults. It explains how commissioners and providers of health and social care services should work together to produce and implement local policies and procedures. This consultation paper is about learning. It is about how we as a society learn to empower people, both the public and the professionals to identify risk and manage risk. It is about how we empower people to say no to abusive situations and criminal behaviour.
It is about locating safeguarding in the wider agenda of choice and control. It is about recognising safeguarding as everyone’s business. It is about identifying the tools we need for better safeguarding. The guidance is for everyone such as social workers, housing officers, police officers, lawyers, service users, support workers and members of their families. The Human Rights Act protects all of us, young and old, rich and poor. Hopefully you will never need to rely on it, but every year hundreds of people do. Despite this, the Act is frequently misunderstood and misrepresented. The human rights that are contained within the law are based on the articles of the European Convention on Human Rights. The Act ‘gives further effect’ to rights and freedoms guaranteed under the European Convention. What this actually means is that it does two things: Judges must read and give effect to legislation (other laws) in a way which is compatible with the Convention rights. It is unlawful for a public authority to act in a way which is incompatible with a Convention right. The Mental Capacity Act 2005 (MCA) creates a framework to provide protection for people who cannot make decisions for themselves. It contains provision for assessing whether people have the mental capacity to make decisions, procedures for making decisions on behalf of people who lack mental capacity and safeguards. The underlying philosophy of the MCA is that any decision made, or action taken, on behalf of someone who lacks the capacity to make the decision or act for themselves must be made in their best interests. The MCA applies in England and Wales. It affects anyone whose mental capacity to make decisions is affected by (what the MCA refers to as) “an impairment of, or a disturbance in the functioning of, the mind or brain.” In some cases, a person’s capacity may be permanently affected, perhaps because they have a form of dementia, a learning disability or have suffered a brain injury.
But in others, the person’s capacity might be affected only for a temporary period, perhaps because they are confused or unconscious. It must be remembered that just because a person has a mental health diagnosis or is detained under the Mental Health Act 1983 does not necessarily mean that they lack capacity to make decisions for themselves. The MCA applies to people with mental health problems only when they experience a mental health problem that affects their ability to make a particular decision. For some people, the ability to make certain decisions is permanently affected as a result of their experience of mental illness.
However, many people who experience mental health problems are capable of making all of their own decisions. For others, the ability to make some decisions is affected occasionally and only for short periods. Individuals that have been diagnosed with mental health would have undergone an assessment, or several. This would determine whether they have the capacity to make decisions. If it has been decided that they have not, a best interest meeting would take place. Where professionals will meet (often GP’s and care coordinators ECT) that personally know the individual and come to a decision on the individual’s behalf. This safeguards the individual from making a possibly unwise decision. Especially if they are not fully aware of the outcome or consequences of the decision. 1.4
Unfortunately sometimes local authorities, care providers and other health professionals only tend to put severe measures into place when something previously has gone very wrong E.G a big safeguarding issue. In 2011 it became apparent that there was a scandal of abuse going on at a care home in Bristol. Under cover panorama had been it to secretly film and it was shown on British television. South Gloucestershire Council, CQC and the management of the privately owned home had ignored and not seriously acted upon, complaints and reports / concerns previously to this. The home was shortly after shut down and many members of staff were suspended. The members of staff were all punished, some receiving prison sentences after being found guilty of physical, emotional and verbal abuse. Since this has happened, South Gloucestershire Council have made big changes, especially around its safeguarding policy and procedures and have a large team which deal with any safeguarding issues or concerns. They are acted upon almost immediately. There was also a case in Cornwall back in 2004. Budock hospital, which was part of the NHS. It was brought to light that members of staff working at the hospital had been suspended and were pending investigation due to allegations of abuse. It became apparent that severe institutional abuse had taken place. Residence that had been staying at the hospital, got removed from the premises into a ‘safe place’ and investigations took place. When an undercover investigator went in, it was found that service users were being tied to wheelchairs, being forced medication due to ‘bad behavior’ and some
were locked in their rooms for 16 hours a day. Some service users did not have assessments or plans that would be person centered to them. However from this case, a lot of policies, procedures and expectations got put into place. The word ‘safeguarding’ came into place and guidelines were expected to be followed. Service user’s plans were to be person centered and individual to them. Staff undertook specific training for those service users they were working with. Any domiciliary or health care agency / bodies that would be carrying out personal care tasks would HAVE to register with the regulating body. (At the time CSCI, which is now CQC) this would make potential abuse harder for a perpetuator as there were more stricter policies and guidelines in place, as along with all the new strategies in place, residential and domiciliary care were also reviewed and were expected to follow suit. Unfortunately sometimes it will take something drastic to happen for them to review their policies, procedures and guidelines to put stricter guidelines and rules into place. CQC inspections have become more intense and thorough, making it more difficult for care providers that are slack on their guidelines to ‘fall through the net’
A safeguarding alert can be made by anyone, whether it maybe a service user, a support worker, a family member, a colleague, a friend, a neighbor or a member of the public when any harm, abuse or something concerning which is out of the ordinary is suspected it is important to act upon immediately. If the person is in immediate danger, a crime has been committed or they are at harm then the police will need to be informed ASAP and try to ensure the person is safe, however ensuring you are safeguarding yourself also, EG if the perpetrator is still there, they could turn towards you as you are ‘helping’ the victim. The member of staff would then need to contact there line manager so they are able to contact the Local Safeguarding Authority. If the concern is not a police matter, it is still vital to act upon ASAP, by informing your line manager for them to again, inform Local Safeguarding Authority so they are able to screen the concern and decide what to do. The Police / Safeguarding authority will gather evidence. This will probably involve asking for record keeping about the victim and a statement from the reporter / whistle blower on what they have witnessed or been told. In most
circumstances the Safeguarding Authority will ask you to complete an alerters form, which asks you information about the victim, what you have been told or witnessed and any physical marks or appearance changes you have noticed. A copy of the averter form will also need to be sent to CQC as a regulating body for the services being provided. There will be a strategy meeting, where professionals such as social workers, safeguarding team managers, OT’s, GP’s, Care managers and the police if relevant can attend. This is a meeting to discuss the way forward. It will discuss what is going to happen, any input anyone has and what will happen next. It some cases there will be a strategy discussion, which is less formal, and can be held over the telephone. A risk assessment to reduce the risk of it happening again and what has been put into place to reduce the risk will be put into place. A safeguarding meeting will take place to discuss the outcome and what will be happening. A plan will be put into place along with the risk assessment, this should be person centered to the individual and each person involved in that persons care should adhere to it and follow it. There should be close monitoring and reviews after this has all taken place. The victim’s behavior needs to be monitored, they may need support or counciling. There should be regular reviews and spot checks to ensure the victim is feeling safe and happy with things that have been put into place. If it was found that the concern was not a safeguarding matter. The care plan should still be reviewed as appropriate. If there has been a change in the service user’s needs, or a change in family life / home life. The care plan is to updated accordingly so that it is clear to other people that it is not a concern and that it is now part of ‘the ordinary’