Adult Safeguarding For GP’s 2015. Syed & Quinn Ltd 2015

Legislation and Guidance Examples are: Public Interest Disclosure Act 1998 Human Rights Act 1998 Mental Capacity Act 2005 and Deprivation of Liberty Safeguards 2007 Safeguarding Vulnerable Groups Act 2006 Safeguarding Vulnerable groups Act amended 2012 Health and Social Care Act 2006 (CQC) Health and Social Care Act 2013 (DBS) The Care Act 2014

Recent changes to be aware of. COP3 form change by Court of protection meaning social workers capacity assessments will now be seen a s valid for applications to the court. Supreme Court Ruling on 19th March 2014 re DoLS meaning anyone who lacks capacity and is being deprived of their liberty will need a DoLS or court of protection order in place providing they meet the ‘acid test’ ‘Is the person effectively under constant control or supervision? If they did try to leave would they be prevented from doing so?’ If the answer to both these questions is yes then DoLS or equivalent is required, even in a ‘domestic ‘setting ie supported living , adult placements etc. The Care Bill became The Care Act on Monday 19th May 2014 and the first part is implemented on April 1st.

The Care Act 2014 replaces many previous laws 1948 1960… 1970… 1980... 1990… 2000… 2010… National Assistance Act 1948 NHS and Community Care Act 1990 Carers (Recognition and Services) Act 1995 Chronically Sick and Disabled Person Act 1970 Community Care (Direct Payments) Act 1996

The framework of the Act and its statutory guidance Underpinning principle Wellbeing General responsibilities and key duties Prevention Integration, partnerships and transitions Information, advice and advocacy Diversity of provision and market oversight Safeguarding Key processes Assessment and eligibility Charging and financial assessment Care and support planning Personal budgets and direct payments Review

Key Points for Safeguarding Local Authority Lead Duty to enquire Safeguarding Adult Boards Safeguarding Adult Reviews Supply of Information Independent Advocacy Support Safeguarding enquiries and reviews Self Neglect NB From April 2015 each local authority must: Make enquires ,or ensure others do, if it believes is subject to or at risk of abuse or neglect Set up a Safeguarding Adults Board Arrange for an independent advocate where appropriate Cooperate with each of its relevant partners to protect

Local Authority Lead Enquiries. Enquiry- what is it? Criteria for intervention Make or cause to be made-delegation Responses Financial clause- why specified? Updates the scope of Adult Safeguarding to include, where a LA has reasonable cause to suspect that an adult in its area (whether or not they are ordinarily resident there) has: Needs for care and support (whether or not the LA is meeting any of those needs Is experiencing , or at risk of, abuse or neglect As a result of those needs is unable to protect themselves against the abuse or neglect or risk of it.

The Law Using the briefing provided and your existing knowledge, in small groups discuss:- 1. What is the aspect of the Care Act 2014 that is most relevant in Safeguarding Adults? Is the Human Rights Act relevant in Safeguarding Adults? Which article is most commonly referred to in this context? Why? 2. Why is it important for practitioners at all levels to have a good working knowledge of the law that underpins their practice? How you can ensure the people in your practice have up to date and detailed knowledge of the relevant legislation and guidance?

Key Roles and Responsibilities Adult Social Care General practitioners Safeguarding Manager NHS Commissioners CQC Police Safeguarding Co-ordinator Safeguarding leads

Challenges. What are the safeguarding challenges presented by;- Personalisation, self directed support, brokerage Self funded and organised care. (no ss assessment) Reduction in resources/ changes to FACS criteria Changes to the definitions of a regulated activity (DBS) Media involvement

What is the interface between safeguarding and other related agenda’s? Where vulnerable people are involved or targeted these can all become ‘safeguarding adults cases’. Forced Marriage Modern day slavery/ Human trafficking Honour Based Violence Domestic Violence Community Safety Cyber Crime Hate Crime It is essential that you acknowledge when you need additional support and expertise in these areas.

Involving vulnerable adults in the safeguarding process. Gaining consent when appropriate. Autonomous decision making Supported Decision making Giving clear information to the vulnerable adult throughout the process Finding out the vulnerable adults preferred outcome, it may not be possible but essential to ask. Ensuring the Safeguarding plan for their ongoing safety is fully explained to them

Information Sharing In summary partner agencies should be expected to share information as long as it is made clear The purpose of approaching other individuals or organisations The reasons for the disclosure of information Details of the individuals or organisations being contacted What information will be sought and shared Why the information is important What it is hoped it will achieve.

Gaining consent Where possible consent should be gained from the vulnerable individual. However in some circumstances this is not possible For example: Where to do so would increase the risk to the individual When it would damage the evidence trail Where the individual lacks the capacity to consent

The Relevance of MCA The Application of the five principles in Safeguarding Investigations The use of ‘Best Interest’ in decisions to act. The requirement to acknowledge the right to make unwise decisions. The importance of the presumption of capacity when considering intervention. The application of least restrictive option in Safeguarding Plans The supporting of individuals to make decisions or contribute to decisions made during and after the safeguarding process

Additional relevant aspects The Court of Protection, Court Appointed Guardians and I.M.C.A;s The LPA in Health and Well Being in addition to Money and Property. The guidance around restraint The criminal offence of ill treatment or neglect of vulnerable people The Deprivation of Liberty Safeguards 2007

Why is learning from practice essential to all of our practice? Mistakes have always been, and will always be made. Many of these will ,however hard we try to prevent it, have impact in the experiences and lives of customers/ service users/ patients / carers and sometimes the lives of colleagues and members of the public. While we strive to minimise these mistakes, when they do occur we have an absolute duty to ensure we analyse what happened and build all of the learning from that into our ongoing practice, to ensure the same errors are not repeated and necessary changes to process and practice occur.

Serious Case Reviews now Safeguarding Adults Reviews However if you look at the outcomes of Serious Case Reviews nationally they regularly highlight the following; poor joint working poor information sharing lack of proportionality in responses to alerts lack of consistency in process and in expectations of individual practitioners and providers failure of professionals to take responsibility failure of professionals to tackle poor practice If these points are regularly letting down customers we have an absolute responsibility to get these right.

Learning from practice and Accountability.. In two large groups discuss: Group 1. How can we ensure learning from practice becomes embedded into future practice? Group 2 Look at the particular issues on the last slide. Choose 2 examples. How can we improve practice in these areas? Then each group present the main points of their discussion to the other group.