Safeguarding Adults for Provider Managers and Care Home Staff Vincent Docherty January 2018

Aims of the Course To provide care home managers and staff with a sound understanding of the need to protect adults from abuse. To encourage managers and staff to take proactive steps in recognizing signs and symptoms of abuse and to report it accordingly. To help managers and staff encourage safeguarding as a core skill within their teams, to promote safeguarding in their service. To update managers and staff with the most recent policy and procedures to enable them to address the increasing demands of safeguarding.

Care Act – Sect 42 Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse. Now statute this guidance empowered local authorities to act. The Local Authority were deemed to be the lead agency but all agencies must work together such as police, health, private and voluntary must work together to protect vulnerable adults from abuse

Principles of Safeguarding Empowerment – Presumption of person led decisions and informed consent. Protection – Support and representation for those in greatest need. Prevention – It is better to take action before the harm occurs Proportionality – proportionate and least intrusive response appropriate to the risk presented. Partnership – Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse. Accountability – Accountability and transparency in delivering safeguarding.

Role of CQC Safe Caring Well Led Five Enquiry Lines Effective Responsive

Safety + Safeguarding Medication Infection Control Safeguarding Physical Environment

Social Care Institute for Excellence. Social Care Institute for Excellence (SCIE) - Home page www.scie.org.uk/ - Cached - Similar UK resource of good practice and knowledge aimed at improvement of social care services with focus on central role of people who use services.

SCIE: Social Care Institute of Excellence Useful Guides and Reports Report 39 – Protecting adults at risk: London multi agency policy and procedures to safeguard adults from abuse. Guide 44 - At a glance guide of the procedures Guide 45 - Safeguarding and quality in commissioning care homes. Guide 46 – Commissioning care homes, common safeguarding challenges.

Preventive Practice Research - Abuse in Care – Caroline White, University of Hull 7 key areas that could indicate or promote abusive practice Leadership with Care Homes Actions, practices of staff, staff knowledge, skills and actions Behaviour of Service Users Isolation of service users ( out of borough) Defensiveness and lack of openness Service Design, Placement Planning and Commissioning Fundamental care and quality of the environment

Underlying Causes Recruitment difficulties Staffing levels Non adherence to policy and procedure – whistle blowing specifically mentioned Poor training Choice of Service Record Keeping – End of life and DOLS Dehumanisation

Common Safeguarding Issues Maladministration of medication Pressure sores Falls Rough treatment, being rushed, shouted at or ignored Poor nutritional care Lack of social inclusion Institutionalised care Physical abuse between residents Financial abuse

Common Record Keeping Issues Poor pre admission records/assessments Care plans Risk assessments Safeguarding referrals and investigations – link to Pan London MAR Sheets End of Life DNAR Referrals to outside agencies Staff handover records Staff supervision Complaints

Staffing Levels The low status and pay of care work Poor training and support for staff feeling stressed, rushed and overworked Leads to low morale, burnout and potentially poor standards of care High levels of sickness increasing pressure on the remaining staff in the workplace High staff turnover resulting in wasted training resources and high recruitment costs

Record Keeping Resident's care plans are person-centered and accurate. Care plans include risk assessment and risk enablement. There is evidence that staff adhere to care plans and they are regularly updated. All records are recorded clearly in a manner that can be easily understood by others. The home manager regularly monitors the standard of record-keeping.

Record Keeping cont. All records are accessible to those that need them while appropriate levels of confidentiality are maintained. Where the home manages any aspect of a resident's finances, either through resident choice or lack of capacity, the records are subject to robust and regular checks.

Record Keeping There is evidence that the home uses complaints to improve quality and practice. There are records of regular staff supervision and team meetings and evidence that actions are followed up All record-keeping practice is regularly reviewed, with input from frontline staff, as fit for purpose.

Dehumanisation Discriminated against or treated differently to others Isolated, dismissed or ignored Disrespected, mocked or belittled Deprived of dignity and privacy Deprived of choice and control Stripped of one's identity Deprived of basic needs (e.g. food) Abused physically, sexually or in any other way.

Identifying problem areas Can you identify any safeguarding areas that may need addressing in your organisation. Are there any common themes

Ten Challenges 10 10. Individuality 9. Independence choice and control 3. Alleviate loneliness and isolation 6. Expression 5. Right to Privacy 1.Respect 2. Zero tolerance 7. Confidence and Self Esteem 8. Engagement 4. Ability to Complain

Questions ?