Unit 104 – Awareness of protection and safeguarding in health and social care Julie Stokes Jones

Reasons for this Unit?? http://www.youtube.com/watch?v=7dmjEYK_72k http://www.youtube.com/watch?v=uqg_UjWhmOM http://www.youtube.com/watch?v=ulazCKOsFz8 http://www.youtube.com/watch?v=X6mVGaSGrNc

What is a vulnerable adult What makes us vulnerable? Record your groups ideas about common factors on flip chart paper for feedback

Vulnerability factors could include: Limited or no verbal communication Lacking understanding Unaware of their rights Low self esteem/self worth Unable to protect themselves “Institutionalised” Institutional poor practice Violence, drug/alcohol misuse in relationships Disability Isolated family or individual Previous abuse has occurred If participants are working with CYP then it should be noted all children are vulnerable due to their age and dependence but there are other factors to consider. A person’s vulnerability will depend on his/her circumstances. Vulnerable adult is defined in Wales Interim Policy & Procedures for the Protection of Vulnerable Adults from Abuse 2011 and In Safe Hands 2000 as   A vulnerable adult is a person over 18 years of age 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 himself or herself, or unable to protect himself or herself against significant harm or serious exploitation. This definition may include a person who: has learning disabilities; has mental health problems, including dementia; is an older person with support/care needs; is physically frail or has a chronic illness; has a physical or sensory disability; misuses drugs or alcohol; has social or emotional problems; has an autistic spectrum disorder

“Safeguarding of Adults at Risk” Anyone over 18 To be protected from Danger Harm Abuse

Activity 3 What is acceptable? using your cards decide if you think this is abuse true or false Participants each given a true and false card. Statements are read by the facilitator appropriate for the learner group and individually people raise either true or false to the question is this acceptable or is this abuse

What do you think? A nurse feels that force feeding a patient is acceptable if that patient is malnourished, even if that means forcing the food down the patient’s throat. A daughter locks her father, who is prone to wandering, in his room, whilst she is out. She does this to prevent him leaving the house and possibly injuring himself or getting lost.

Is it Acceptable When…. A confused older person is drugged to keep them quiet? A mentally ill wife stops preparing food for her dependant husband when she stops eating? A relative takes some of the pension for all the help that they give?

Abuse of adults is defined as: a violation of an individual’s human and civil rights by another person or persons which results in significant harm. (In Safe Hands, National Assembly for Wales July 2000) For adults - Taken from Wales Interim Policy & Procedures for the Protection of Vulnerable Adults from Abuse 2010. A new definition is expected in 2014 and this slide will need updating.

Significant harm - adults ill-treatment (including sexual abuse and forms of ill-treatment that are not physical) impairment of, or an avoidable deterioration in, physical or mental health impairment of physical, emotional, social or behavioural development For adults - Significant harm may result from a series of incidents that, in isolation, may not seem significant but when repeated become serious. The impact of abuse on individuals is personal to them

“Safeguarding of Children at Risk” Anyone under 18 To be protected from Danger Harm Abuse

Definition of Child Abuse and Neglect A child is abused or neglected when somebody inflicts harm, or fails to act to prevent harm. Children may be abused in a family or in an institutional or community setting, by those known to them or, more rarely, by a stranger. (All Wales Child Protection Procedures 2008) A new definition is expected in 2014 and this slide will need updating. For CYP this definition comes from the AWCCP 2008.

Significant harm – children and young people ill treatment or the impairment of health and development the effects of sexual, physical, emotional abuse or neglect, or a combination of different types The Children Act 1989 introduced the concept of significant harm as the threshold that justifies compulsory intervention in family life in order to protect children. Local authorities have a statutory duty under the Children Act 1989 section 47 (1) (b) to make enquiries, or cause enquiries to be made, where they have reasonable cause to suspect that a child who lives, or is found in their area is suffering, or likely to suffer, significant harm.

Abuse: a single or repeated act, or multiple acts a lack of appropriate action a result of deliberate intent, negligence or ignorance an act of omission or neglect a child or vulnerable adult being persuaded or forced to enter into a financial or sexual arrangement to which they have not, or could not, consent can occur in any relationship and fundamentally is an abuse of trust, including failure to meet a duty of care This has been adapted to cover both adults and CYP. It may be of interest to the group that these factors apply across age groups.

Categories of abuse There are 5 main categories: Physical Sexual Emotional Neglect Financial There are many ways in which a vulnerable individual may be abused. It is not unusual for an abused individual to suffer more than one kind of abuse. Accordingly, the impact of abuse and its seriousness for the individual must be evaluated in every case. These categories come from ‘In safe hands’ 2000 but are appropriate for CYP. Though financial is not always included it may well be a factor.

Signs and Symptoms of Abuse Discuss in a group the signs and symptoms of the 5 main categories of Abuse In a table list the signs and symptoms of the categories of Abuse, this table will be included in your assignment. Separate the signs and symptoms to adult and children

Real Case Studies (children) Baby P what could have been done differently? Victoria Climbie

Activity 7 - Case reviews Look at the summary of a case study you have been given. What do you think would have made a difference to prevent or stop the harm or abuse? Real case studies given to groups (appropriate to the learner group) to include key enquiries such as Winterbourne View Hospital, Vanessa George, Harold Shipman, Mid Staffordshire Hospital, Rochdale, Fiona Pilkington, Bichard enquiry, Steven Hoskins, and Victoria Climbie. These should challenge assumptions about who may be an abuser, where abuse might take place and who may be abused. Participants to read a selection of case summaries and asked what they think were key factors that would have made a difference to prevent and to stop the harm and abuse. Record on sheets given out and linked to each case study. Group asked to outline the case study/or studies they had and their thoughts shared. Contributions from the rest of the group are sought

Key agencies for adults include: Social Services (Local Authority) duty to assess & ensure that needs are met, investigate and to co-ordinate adult and child protection systems. Police - duty to investigate allegations of criminal activity CSSIW - notified of referrals in a regulated setting and monitor the service Adult Safeguarding Boards – a duty to investigate and report on cases and ensure partnership working Medical Professionals – duty to report and work as partners with other agenices You have a responsibility to report dangerous, abusive, discriminatory or exploitive behaviour & practice (Care Council for Wales Code of Practice for Social Care Workers) Roles of different agencies in safeguarding. Remind group they have a responsibility to alert and inform ‘whistle-blowing’ even if it is colleague or manager. Care Council for Wales Social Care workers code of practice: 3.2 Using established processes & procedures to challenge & report dangerous, abusive, discriminatory or exploitive behaviour & practice 3.3 Following practice & procedures designed to keep you & other people safe from violent & abusive behaviour at work

Key agencies for Children include: Children Social Care Services (Local Authority) duty to assess & ensure that needs are met, investigate and to co-ordinate adult and child protection systems. Police - duty to investigate allegations of criminal activity CSSIW - notified of referrals in a regulated setting and monitor the service Children's Safeguarding Boards – a duty to investigate and report on cases and ensure partnership working Medical Professionals – duty to report and work as partners with other agencies NCPCC – they are a charity organisation which offer Childline for children You have a responsibility to report dangerous, abusive, discriminatory or exploitive behaviour & practice (Care Council for Wales Code of Practice for Social Care Workers)

Essential Steps Believe that abuse can happen & never ignore a hunch If the person or child is in danger call 999 for police or medical help Report your concerns with your manager or other appropriate person Do not cover up for others Ensure that you know the Policy & Procedures Know the limits of your responsibility Report and record your suspicions as soon as possible Record the facts, what is said and what you have seen Do not tackle an alleged perpetrator yourself Inform the victim of your steps and what the process will be Taken from Wrexham Social Services

Do’s and Don’ts Go through hand-out of what you shouldn’t do and what you should do

Support for Adult who has been abused Where can they get support? CSSIW Social Services Adult Safeguarding Board Counselling GP Websites

Support for the adult social care worker Where can they get support? Manager or Senior Staff Counselling GP Websites

Support for child who has been abused Where can they get support? CSSIW or Estyn Children Social Care Services Children Safeguarding Board Counselling GP Websites

Support for the children social care worker Where can they get support? Manager or Senior Staff Counselling GP Websites Estyn Children Safeguarding Board

Revision Read examples and fill in what would you do?

Assignment Design a Guide for Staff