Safeguarding 2016 Level 2 Adults Navigation Toolbar

Safeguarding Adults Law is covered by the Care Act 2014 What is Safeguarding Adults? Safeguarding Adults Law is covered by the Care Act 2014 It applies to those people over 18 years of age : Who have needs for care and support (whether or not the local authority is meeting any of those needs) and; is experiencing, or at risk of, abuse or neglect; and as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect.’’. Also a carer may experience intentional or unintentional harm from the adult they are trying to support or from professionals and organisations they are in contact with Navigation Toolbar

Consider each principle in all aspects of safeguarding adults Safeguarding Adults Principles There are six key principles defined by the Care Act 2014 Empowerment: Presumption of person led decisions and consent Protection: Support and representation for those in greatest need Prevention: Prevention of neglect, harm and abuse is a primary objective Proportionality: Least intrusive response appropriate to the risks presented Partnership: Local solutions through services working with communities Accountability: Accountability and transparency in delivering safeguarding Consider each principle in all aspects of safeguarding adults Navigation Toolbar

Who Abuses Adults Anyone Who has POWER over others, this can be by being a Social or Health Care Professional, a paid carer or 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. Navigation Toolbar

There are 10 different categories of abuse Think about the Ten types of abuse that can take place; Physical Abuse These are often ones you would recognise easily as abuse Hitting, Punching, Slapping, Kicking, Drowning, Shaking, Biting Restraint, Medication, Lap Belts, Locked Doors I These are not so obvious but can be associated with abuse if not used properly I Navigation Toolbar

Possible Observed Practices Sexual Abuse Direct or indirect involvement in sexual activity without consent or ability to give consent, this includes rape, indecent assault, indecent exposure or exposure to explicit sexual behaviour, material or images. Possible Observed Signs and Symptoms Possible Observed Practices Sexually transmitted diseases or pregnancy New tendency of withdrawn behaviour Tears or bruises in genital/ anal areas Soreness when sitting Sexualised behaviour Deliberate Self Harm Incontinence and bedwetting Excessive washing Sexual acts the person hasn’t consented to, was pressurised into consenting to Touching inappropriately Penetration Indecent exposure Taking photographs Using in appropriate language Think: Preserving evidence can include supporting the victim not to wash/shower before evidence is collected Navigation Toolbar

Possible Observed Practices Neglect or Acts of Omission Failure to provide access to Health, Social or Educational Services, withholding daily necessities or basic care i.e. nutrition, clothing, shelter and warmth. Possible Observed Signs and Symptoms Possible Observed Practices 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 Withholding of ‘necessaries’ e.g. nutrition, medication, healthcare, education, social stimulation Withholding assistance to use toilet, keep clean, warm and comfortable Avoidable Pressure Ulcers Repeated Falls Failure to ensure privacy and dignity in living conditions Navigation Toolbar

Possible Observed Practices Psychological Abuse Acts or behaviour affecting the emotional health causing distress or anguish to individuals including threats of harm or abandonment, isolation, humiliation, blaming, controlling or hostile behaviour. Possible Observed Signs and Symptoms Possible Observed Practices Deprivation of privacy, dignity or choice Difficulty gaining access to the adult on their own Low self-esteem, lack of confidence and anxiety Sharp changes in behaviour in the presence of certain persons Self abusive behaviour – self mutilation, head banging Loss of weight Disturbed sleep Shouting ,swearing, name calling Bullying Insulting, humiliating, ridiculing Intimidating Controlling behaviour Control of access (family, friends, phone, post, pull cord, visitors) Navigation Toolbar

Possible Observed Practices Financial or Material Abuse Includes theft, fraud, exploitation, pressure in connection with wills or estates, misuse or appropriation of property and possessions or benefits. Possible Observed Signs and Symptoms Possible Observed Practices 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 foot etc. but is clearly not doing so 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 Navigation Toolbar

Possible Observed Practices Discriminatory Abuse This abuse is motivated by discriminatory and oppressive attitudes towards a person due to their race, gender, cultural background, religion, physical and/or sensory impairment, sexual orientation and age. Discriminatory abuse manifests itself as any of the other categories of abuse. Possible Observed Signs and Symptoms Possible Observed Practices Omitting services or activities based on preconceived ideas about someone’s age or condition Cultural or religious needs are not being met Direct or indirect discrimination based on race, gender, culture, disability, sexuality, religion, belief or values Harassment Incitement of others to commit abusive acts or make abusive comments Navigation Toolbar

Organisational Abuse Abuse by an organisation imposing rigid and insensitive routines; unskilled, intrusive or invasive interventions; or an environment allowing inadequate privacy or physical comfort. Possible Observed Signs and Symptoms Possible Observed Practices 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 Inadequate staffing or insufficient knowledge base within the service. 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” Home care workers not providing care that has been assessed for Bad practice that is not addressed by the institution Navigation Toolbar

Possible Observed Practices Domestic Abuse 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 Possible Observed Signs and Symptoms Possible Observed Practices including psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence Female Genital Mutilation; Forced marriage 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 Navigation Toolbar

Possible Observed Practices 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 Possible Observed Signs and Symptoms Possible Observed Practices 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 Poor physical appearance, isolation, poor living conditions, few or no personal effects, restricted freedom of movement, unusual travel habits, reluctance to seek help Navigation Toolbar

Possible Observed Practices 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. Possible Observed Signs and Symptoms Possible Observed Practices 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. 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 Navigation Toolbar

Question One of your patients/service users tells you they are fed up with their grandchildren hitting them and demanding money. What type of abuse is this? Financial Physical & Financial Emotional Physical Navigation Toolbar

Question One of your patients/service users tells you they were hit by another patient on more than one occasion. What type of abuse is this? Physical Financial Emotional Physical & Financial Navigation Toolbar

What to do if you suspect abuse or someone discloses that abuse has happened If there is a disclosure or you witness abuse, ensure you record factual information, what the service user said, what questions you ask and what they replied. Consider the mental capacity of the person with regard to the disclosure and actions they want you to take. If you are not sure what you have seen, then talk to your manager, someone senior or safeguarding team immediately. Team work is essential in supporting each other to recognise and report situations that could be abusive. Navigation Toolbar

Protection of Evidence Record all actions accurately If there are items you think may be used as evidence do not handle them unless you have to Any written evidence can be copied to preserve this Ask for assistance as soon as possible if you think a criminal investigation may be required. The police will advise on preservation of evidence in each circumstance. Navigation Toolbar

What to do if someone discloses abuse or is at risk of abuse The service users immediate safety needs must be met. This may include use of emergency service or out of hours teams. Ensure any immediate protection needs are addressed. Inform your manager immediately. Complete the Safeguarding Alert Form. Ensure that the Safeguarding Concern Form has been sent to the appropriate people. Contact the Safeguarding Team if you need further help and advice Remember Complete a DATIX Form and attach the safeguarding alert form You must make sure you know who needs to be informed about the potential abuse. See the SEPT Safeguarding Intranet page for details. Navigation Toolbar

No adult can be offered a confidential service Confidentiality and Consent No adult can be offered a confidential service I I I Whilst every effort should be made to ensure confidentiality is preserved, the disclosure of information which may assist in the prevention or detection of abuse is permissible This applies both to information about third parties e.g. adults who may pose a risk of harm to children or about those who may be the subject of abuse Staff should consult the Trust Safeguarding Policies or the Trust policy on Confidentiality CPG9 If you are uncertain about when to share confidential information, always seek advice from the Safeguarding Team or your line manager Navigation Toolbar

Safeguarding and Mental Capacity Mental Capacity is the ability to: Understand the information relevant to a specific decision Retain that information Use or weigh up that information Communicate the decision (by talking, sign language or any other method) Unless a person can achieve all four elements they lack capacity to make that particular decision. I Important to note A capacity assessment must be undertaken where there are concerns that a person has not got capacity to make a specific decision Best interests – anything done for or on behalf of people without capacity must be in their best interests Least restrictive intervention – anything done for or on behalf of people without capacity should be in the least restrictive Think about how the mental capacity of the victim will impact on the safeguarding process Navigation Toolbar

Deprivation of Liberty The Government has added further provisions to the Mental Capacity Act 2005 called the Deprivation of Liberty (DOL) safeguards The DOL process is a legal requirement where the deprivation of a person’s liberty to prevent them leaving a specific location, including a hospital ward or regulated care home is required in order to provide care or treatment needed This only applies to those who lack capacity to consent to treatment or services being offered and who are not detained under the Mental Health Act. Navigation Toolbar

This completes the Adult’s section for level 2. Please proceed to the Domestic Abuse part of the course. Navigation Toolbar