Safeguarding Level 1 Adults For all non-clinical staff. START FINISH

Safeguarding Adults Law is part of the What is safeguarding? Safeguarding Adults Law is part of the Care Act 2014 The Care Act 2014 applies to those people over 18 years old: who have needs for care and support (whether or not the local authority is meeting any of those needs) and; are experiencing, or at risk of, abuse or neglect; and as a result of those care and support needs are unable to protect themselves from either the risk of, or the experience of abuse or neglect.’’. START FINISH

Who Abuses Adults? Anyone Who has POWER, over others, this can be by being a Social or Health Care Professional, a paid carer or an unpaid carer, a family member of friend. Think What have you seen in practice that has made you think Abuse may have taken place? Often it can be a feeling that things are not right, that service users are not getting treatment provided in a way we would accept, or that they are being exploited by others. START FINISH

Physical Abuse There are 10 types of adult abuse Includes hitting, punching, slapping, kicking, drowning, shaking, biting restraint, medication, lap belts, locked doors Possible Observed Signs and Symptoms Rough or inappropriate handling Hitting, Kicking, punching Force – feeding Misuse of medication Inappropriate use of restraint Inappropriate treatment regimes or sanctions, e.g. making someone sit in a corner Unexplained injuries, e.g. dislocations, fractures Unexplained bruising or abrasions Cowering and flinching Burns and scalds Possible observed practices START FINISH

Sexual Abuse Includes; rape, touching, innuendo, viewing sexual activity, or explicit materials, grooming to commit sexual acts Sexual acts the person hasn’t consented to, was pressurised into consenting to Touching inappropriately Penetration Indecent exposure Taking photographs Using inappropriate language Possible Observed Signs and Symptoms Incontinence/bed wetting Difficulty walking Repeated urinary tract infections Bruising, bleeding or unexplained soreness around genital area Unexplained “love bites” Sexually Transmitted Infection or pregnancy Self neglect or risk taking behaviour Possible observed practices START FINISH

Psychological Abuse Include; threats of harm or abandonment, isolation, humiliation, blaming, controlling or hostile behaviour Possible Observed Signs and Symptoms Shouting, swearing, name calling Bullying Insulting, humiliating, ridiculing Intimidating Controlling behaviour Control of access (family, friends, phone, post, pull cord, visitors) Disturbed Sleep or tendency to withdraw to room Loss of appetite / loss of weight Changes in behaviour Self abuse i.e. self harm, head banging, hand biting General resignation Extreme submissiveness Possible observed practices START FINISH

Neglect or Acts of Omission Possible Observed Signs and Symptoms Withholding of ‘necessaries’, e.g. nutrition, medication, healthcare, education, social stimulation Withholding assistance to use toilet, keep clean, warm and comfortable Failure to give access to appropriate services e.g. school, health, police or other Failure to safeguard and protect from harm or abuse Untreated physical illnesses Inconsistent or reluctant contact with health or social care agencies Lack of safety equipment / being used following recommendation Clear failure to ensure the taking of medication appropriately Dehydration/ weight loss / malnutrition Possible observed practices START FINISH

This is a criminal offence Financial or Material Abuse This is a criminal offence Includes :theft and fraud Possible Observed, Signs and Symptoms Exploitation of dependence for personal gain Prevention of necessary care options Misuse of funds, including lack of ‘best interest’ decisions Pressure or misappropriation of property, wills, bank accounts, benefits or assets Unexplained or sudden inability to pay bills Unexplained or sudden withdrawal of money Personal possessions of value go missing from home without explanation Someone has taken responsibility for paying bills, rent, buying food etc. but is clearly not doing so Possible observed practices . . . START FINISH

Discriminatory Abuse Oppressive attitudes towards a person motivated by race, gender disability, religion, culture, or sexual orientation. Possible Observed, Signs and Symptoms Direct or indirect discrimination based on race, gender, culture, disability, sexuality, religion, belief or values Harassment Incitements of others to commit abusive acts or make abusive comments Name calling Stereotyping Omitting services or activities based on preconceived ideas about someone’s age or condition Ignoring dietary requirements Possible observed practices . . . START FINISH

that is not addressed by the institution is abuse Organisational Abuse Includes Poor care standards, lack of positive responses to complex care needs, rigid routines, inadequate staffing or insufficient knowledge base within the service. Bad practice, that is not addressed by the institution is abuse Possible Observed, Signs and Symptoms The routine/ practice or management that is not responsive to or respectful to the individuals served Often described as “thoughtless” practice or “we always do it this way” or “this is how we do it here” Poor care planning Inflexible routines Little opportunity for outside activities Lack of privacy Poor staff morale, high turnover, high sickness rate Few visitors and/or staff insistent on notification before visits Possible observed practices . . . START FINISH

Domestic Violence Incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse by someone who is or has been an intimate partner or family member regardless of gender or sexuality people being prevented from seeing family/friends, prevented from attending college/work/appointments, being followed or continuingly being asked where they are, accusations regarding other relationships unjustly, feeling scared of others, being threatened personally or threats against other family/friends, prevented from leaving the home, withholding finances, being forced to do something unwanted for their partner Possible Observed, Signs and Symptoms including psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence Female Genital Mutilation; Forced marriage Possible observed practices . . . START FINISH

Modern Slavery Encompasses slavery, human trafficking, forced labour and domestic servitude. Trafficking does not need to be through international borders, it is any movement of a person for exploitive gain Poor physical appearance, isolation, poor living conditions, few or no personal effects, restricted freedom of movement, unusual travel habits, reluctance to seek help Possible Observed, Signs and Symptoms Traffickers and slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment Possible observed practices . . . START FINISH

Self Neglect This covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding. Self-neglect may or may not be a safeguarding issue, however agencies must assess concerns raised under their statutory duties; having consideration for an individual’s right to choose their lifestyle, balanced with their mental health or capacity to understand the consequences of their actions. Dehydration, malnutrition, untreated or improperly attended medical conditions, and poor personal hygiene; hazardous or unsafe living conditions/arrangements (e.g., improper wiring, no indoor plumbing, no heat, no running water); unsanitary or unclean living quarters (e.g., animal/insect infestation, no functioning toilet, faecal/urine smell), lack of the necessary medical aids (e.g., glasses, hearing aids, dentures, walking aids); grossly inadequate housing or homelessness. Possible Observed, Signs and Symptoms Self-neglect generally manifests itself as a refusal or failure to provide himself/herself with adequate food, water, clothing, shelter, personal hygiene, medication (when indicated), safety precautions Possible observed practices . . . START FINISH

Physical and Financial Abuse Question A patient / service user tells you they are fed up of their grandchildren hitting them and demanding money. What type of abuse is this? Financial Abuse Physical Abuse Emotional Abuse Physical and Financial Abuse Continue START FINISH

Staff have a duty to seek advice and report any concerns . Some safeguarding issues apply to both children or adults as detailed below. Staff have a duty to seek advice and report any concerns . Additional Safeguarding Concerns Honour Based Violence This is a violation of a persons Human Rights . It is a collection of violent and abusive practices, which are used to control behaviour within families or other social groups to protect perceived cultural and religious beliefs and/or honour Forced Marriage This is a marriage in which one or both spouses do not or (in the case of some adults with learning or physical disabilities) cannot consent to the marriage and duress is involved. Female Genital Mutilation Removal of part or all of the female genitalia for non – therapeutic reasons If you suspect it report it ! START FINISH

Prevent and Safeguarding Violent Extremism PREVENT strategy Vulnerable adults and young people including those with mental health issues or learning disabilities may be susceptible to exploitation into violent extremism by radicalisers. Violent extremists often use persuasive rationale and charismatic individuals to attract people to their cause. PREVENT concerns can be reported under safeguarding as exploitation can be seen as abusive . . . .So if in doubt report under Safeguarding The Trust Safeguarding Team should be contacted if staff are concerned that a service user may be exploited into extremism. START FINISH

It is your responsibility to report any abuse wherever it is seen, suspected or reported and to take the necessary immediate actions to ensure the protection of any child or vulnerable person at risk. Your Responsibility Remember to discuss with your line manager or safeguarding team. You may be asked to complete a DATIX form. Record clearly what happened and provide information on why this is a situation of potential abuse START FINISH

Considerations If you are concerned about a persons welfare, always consider others who may also be at risk and ask yourself Are there children in the household? Are there any other vulnerable adults in the home? Is there a history of domestic violence? Is there a history of MH/Substance misuse/etc. Is the person at risk to others in the household? Are any other SEPT services involved? Are any other services involved? Has a referral been made to other services if risks are identified? THINK FAMILY These need considering and recording on the DATIX/Alert form, and in records as appropriate. START FINISH

Finally – Remember…………… You must tell – YOU HAVE A DUTY TO Ignoring abuse is not an option ZERO TOLERANCE OF ABUSE We all have a responsibility to challenge abusive practice (Whistle blowing policies) You must record accurately START FINISH

Remember, if you want to find more information / evidence about this subject or anything else which is relevant to your work or study, join your local healthcare library. For staff in Essex contact Basildon Healthcare Library. www.btuheks.nhs.uk library@btuh.nhs.uk 01268 524900 EX3594  It may be that you work in a different area, for example Luton. Details of all the Health Libraries in the East of England can be found at this site… You are welcome to join any of these. www.eel.nhs.uk START FINISH

Review of Objective(s) Before taking the end of course test, please ensure you have acquired the relevant knowledge against the modules objective(s) below: “At the end of this training, you should be able to identify: What abuse is and how different types of abuse might be identified Where abuse may take place Who abuses? Why abuse might occur and to whom What to do if you witness abuse” If not, please take this opportunity to revisit any of the content within the three presentations. Continue START FINISH

You now need to take the test! Remember to click the ‘home’ icon when you have finished the test to save your results! Example Course START FINISH