Safeguarding and dignity: the role of housing staff Elaine Cass

Changing practice Still working to No Secrets and current local procedures The Government statement on safeguarding 2013 and the 6 principles bridge the gap The forthcoming Care Act Moving away from process to personalising safeguarding – see Making Safeguarding Personal (LGA, ADASS, SCIE) Safeguarding practice that is not person centred can make things worse!

Six safeguarding principles Empowerment Protection Prevention Proportionate responses Partnership Accountability

Empowerment Raise awareness and educate people to protect themselves Empower people with information, advice and advocacy Avoid risk averse practice – losing independence, choice and control can have worse outcomes Reduce social isolation Practice relationship-based, person-centred working Recognise the central role of carers Ensure appropriate access to advocacy, or an Independent Mental Capacity Advocate (IMCA) Minimising risk with the options least restrictive of the person’s rights and freedoms Consider the use of mediation and family group conferences

Proportionate responses Person centred - what does the person want? Mental capacity issues Coercion or duress Is anyone else at risk? Who needs to be involved (police?) Support for victims Support for perpetrators Mediation /family group conferences Integrating personalisation and safeguarding

What is the purpose of the Safeguarding Adults process? Choice and control balanced with minimising risk Preventing and protecting people with care and support needs from abuse Supporting people who have been abused and minimising future risk Supporting people with care and support needs who pose a risk to others Improving service quality Learning from experience deciding whether a mental capacity assessment is needed to clarify issues of consent taking appropriate action for the person causing harm taking appropriate action with a service and/or its management if they have been culpable, ineffective or negligent identifying any lessons to be learnt for the future, including recommendations for any changes to the organisation and service delivery.

New SCIE work: Safeguarding in housing Summary of key messages Housing staff are well placed to identify people at risk of abuse Joint working between housing and adult social care is essential SCRs highlight the need for housing to play a more effective role False perceptions about needing consent for safeguarding referrals Negative attitudes towards housing staff from social care No national agreement on the threshold for housing referrals Complex networks; housing providers may have to work with numerous local authorities in their area and vice versa Some housing providers have IT systems inadequate for ‘customer profiling’

Housing: key areas for improvement Better joint working, information sharing and communication Better links with public protection forums (safeguarding boards, MARACs, MAPPAs, Health and Wellbeing Boards and Community Safety partnerships). Common understandings – shared language, training and policy development Clarity and understanding of the law relating to information sharing, confidentiality, data protection and human rights. Joint work to resolve issues where the individual may not be eligible for social care support, people who refuse support and those who self-neglect.

Housing: key areas for improvement cont… Training and awareness raising Training all front line housing staff and contractors Better understanding of the Mental Capacity Act Common understandings of language and definitions regarding vulnerability and safeguarding Recognition of the role of housing staff in safeguarding Inclusion of housing staff in strategy meetings and investigations / enquiries Keeping referrers informed Preventing abuse Empowering people with care and support needs, through education about abuse, to better enable them to protect themselves Support for perpetrators of anti-social behaviour to reduce behaviours Support for carers

Sharing information All staff should understand their responsibilities in relation to: sharing important information to keep people safe the duty of confidentiality the Data Protection Act 1998 the Human Rights Act 1998 the Mental Capacity Act 2005

Sharing information: The Data Protection Act Any personal information should be shared on the basis that it is: necessary for the purpose for which it is being shared shared only with those who have a need for it accurate and up to date shared securely and in a timely fashion not kept for longer than necessary for the original purpose

Sharing information: confidentiality Don’t give assurances about absolute confidentiality Try to gain consent to share information as necessary Consider the person’s mental capacity  to consent Make sure that others are not put at risk by information being kept confidential – is there a wider public interest, could your action prevent a crime? Don’t put management or organisational interests before safety Share information on a ‘need to know’ basis Record decision making about information that is shared

Human Rights Individuals have a right to respect for their private life under Article 8 of the European Convention on Human Rights. This is not an absolute right and, as long as it is necessary and in accordance with the law, it can be interfered with. This means that the any interference must be justified and for a particular purpose “for example, protection of a person’s health, prevention of crime, protection of the rights and freedoms of others.” (Mandelstam, 2011)

Understanding the Mental Capacity Act In most cases staff should be able to assess whether a person has the mental capacity to make a specific decision (in safeguarding practice this may be about their safety or about a risk). The two-stage functional test of capacity Stage 1. Is there an impairment of or disturbance in the functioning of a person’s mind or brain? If so, Stage 2. Is the impairment or disturbance sufficient that the person lacks the capacity to make a particular decision?

The five principles of the MCA which frame all decision-making A person must be assumed to have capacity unless it is established that they don’t A person must not be treated as unable to make a decision unless all practicable steps to help them do so have been taken without success People have the right to make decisions that others might regard as unwise or eccentric, this does not mean that they lack capacity If you do something to, or on behalf of, someone who lacks capacity to consent to it, you must act in the person’s best interests Any decision or act must not restrict the person’s rights freedoms more than is absolutely necessary.

Making decisions with capacity The MCA says that a person is unable to make their own decision if they cannot do one or more of the following four things: understand information given to them retain that information long enough to be able to make the decision weigh up the information available to make the decision communicate their decision – this could be by talking, using sign language or even simple muscle movements such as blinking an eye or squeezing a hand.

Respecting people’s wishes If a person refuses intervention and has the mental capacity to do so, their wishes should be respected unless: other people are at risk the alleged perpetrator has care and support needs and may also be at risk a serious crime has been committed staff are implicated coercion is involved

Case studies in the context of the 6 principles Empowerment Protection Prevention Proportionate responses Partnership Accountability

xxxxxxxxx @SCIE_socialcare Elaine.Cass@scie.org.uk www.scie.org.uk Social Care Institute for Excellence Elaine.Cass@scie.org.uk www.scie.org.uk Info@scie.org.uk xxxxxxxxx