Safeguarding adults National surveys have indicated that only 5% of all adult abuse and mistreatment gets reported to local authorities.

Vulnerable adult The definition of ‘vulnerable adult’ is someone who: –‘has attained the age of 18; is in residential care or is in sheltered accommodation or receives domiciliary care or receives any form of health care and has any form of disability’ –(Safeguarding Vulnerable Groups Act 2006) And –'someone who is or may be in need of community care services by reason of mental or other disability, age or illness; and who is or may be unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation'. –(No Secrets 2000)

What is safeguarding? Simply put: Protecting adults from harm

What is abuse? Mistreatment by any other person that violates a person's human and civil rights. Abuse can vary from treating someone with disrespect in a way that affects the person's quality of life, to causing actual physical suffering. Abuse can happen anywhere - in a residential or nursing home, a hospital, in the workplace, at a day centre or educational establishment, in supported housing or in the street.

Types of abuse There are different forms of abuse, including: Physical abuse, Sexual abuse, Psychological or emotional abuse, Financial or material abuse, Neglect, Discriminatory abuse and Institutional abuse Abuse can be deliberate, the result of ignorance, or lack of training, knowledge or understanding. Often if a person is being abused in one way they are also being abused in other ways.

Identifying abuse Abuse occurs when someone’s human and civil rights are violated by someone else. This can be: –A single or series of actions of abuse –Deliberately or unknowingly causing harm –Failure to protect people from abuse.

Who can abuse Anyone can abuse, often it can be the person you least expect, such as: –Spouse/partner –Carers and Care Workers –Family member/relative –Friend –Neighbour –Volunteer helper –Someone not known to the person.

Basic signs to look out for; Things to look out for: –Possible changes in the persons behaviour or mood/personality –Unexplained injury or a series of injuries –Signs of fear or distress –Signs of neglect –Theft, fraud or unexplained financial worries.

Abuse and reporting abuse If the abuse is also a crime such as assault, racial harassment, rape or theft it should also be reported to the police. If people are worried about contacting the police they can contact LCC Safeguarding team and talk things over. If immediate action is needed dial 999.

Who to report abuse to? Adult Social Care Services: –Telephone Lancashire Police: –Telephone Health or social care staff: –(For example; social worker, nurse, doctor, occupational therapist) –Tell someone you trust. Ask them to report the matter for you. –If you are in immediate danger or you think a criminal act is being committed contact the Police by calling 999.

Supporting people to deal with suspected abuse Is the person able to co-operate with an impending investigation? –Are they mentally capable of understanding what is happening? “It may be that their capacity to make decisions for themselves is impaired by their disability, and further impaired by the trauma of the abuse: every effort should be made to determine capacity, and to ensure the victim's voice is not lost.” (LCC Safeguarding Adults policy)

What to consider? Can the person consent to the proposed action(s) to keep them safe? What are the person's wishes? What is in the person's immediate best interests? Does the proposed action have any legal implications? Has the person an advocate to speak on their behalf? Has a named, familiar worker been identified to support the service user? Response to alleged or proven perpetrator who is also a vulnerable adult

Checklist – Victim and Perpetrator (alleged or proven) intervention  Immediate safety concerns / risk assessment  Interim keeping safe action plan  Capacity to consent to plan if necessary  Wishes and opinions  Best Interests  Advocacy and representation  Legal issues (e.g. Deprivation of liberty)

Examples of abuse The home Mrs T is in alleged that her sister, who dealt with her finances, was not paying her contribution for her care and Mrs T had not been receiving her personal allowance. The investigation substantiated this allegation and the social worker arranged for the sister's appointeeship to cease and the authority became appointee. Mrs T was very happy with the outcome, her finances now being dealt with satisfactorily.

Example of abuse Mr T, severely disabled, lives with his wife, his main carer. It was alleged by workers from his care agency that his wife slapped him, was rough with him and verbally abused him. It was found that Mrs T cared greatly for her husband but was becoming very stressed by her caring role and was in poor health herself. In consequence the long term team offered support. The couple are now supported by a social worker, continue to receive respite care, day care and assistance at home and the situation continues to be monitored.

Reference / Background reading · 'No Secrets' 2000 · Safeguarding Adults - Consultation of the Review of the 'No Secrets' Guidance 2009 · Human Rights Act 1998 · CQC (CSCI) Safeguarding Adults Protocol and Guidance 2007 · CQC Safeguarding Statement 2009 · Mental Capacity Act Code of Practice 2005 · Deprivation of Liberty Safeguards Code of Practice 2009 · Safeguarding Vulnerable Groups 2006 · Bichard Inquiry Report 2009

LCC Safeguarding board Lancashire Adult and Community Services Directorate Police PCTs NHS Trusts Voluntary Sector Independent Social Care Providers inc. Supporting People Probation Service Safeguarding Children representative

Lancashire County Council We have a multi-agency framework for safeguarding adults at risk from abuse. The aim is to raise awareness of the guidance, protocols, policies and procedures in the protection of adults at risk from abuse; to help people recognise what constitutes abuse; and to explain what to do if someone suspects abuse. We ensure that social workers and care staff undertake ongoing adult protection awareness and investigation training. All suspected incidents of abuse will be investigated fully and appropriately in accordance with the safeguarding adult procedures.

Lancashire County Council Multi-agency policy & procedure aims Everyone has the right to live their life free from violence, fear and abuse. All adults have the right to be protected from harm and exploitation. All adults have the right to self- determination, which involves a degree of risk.

Recording suspected abuse All information should be factual and include times, dates, names of people contacted. All contact with the abused person, alleged perpetrator and any witnesses must be recorded using the exact words the person used. If there are any physical injuries, these can be recorded using the body maps and the form to describe the shape, size, colour of bruises.

Recording contd When contacting and consulting with other agencies, any questions and answers should be recorded. All decisions and who has made these should be clearly recorded, particularly when there is a decision not to contact the police or not to make a referral to proceed to a safeguarding investigation.

Recording contd All records must be stored in accordance with the agency’s own policies with regard to the Data Protection Act (1998). It may be inappropriate to document certain information in the place normally used for client records, if the suspected perpetrator or associates may have access to that record, e.g. The single record held at a vulnerable adult’s home, or an incident log book in a provider service. If in doubt, seek advice from:- –A Manager from within the organisation. –Commissioners of services. –Care Quality Commission (if a regulated service).

Preserving evidence In the case of abuse- anything could be evidence; –Remember: Don’t move or touch anything at the scene of event Where possible, leave things as and where they are. If anything has to be handled, keep this to a minimum. Do not clean up. Do not touch what you do not have to. Do not wash anything or in any way remove fibres, blood etc Preserve the clothing and footwear of the victim. Handle these as little as possible to avoid cross contamination. Preserve anything used to comfort or warm a victim – e.g. a blanket. Note in writing the state of the clothing of both alleged victim and alleged perpetrator. Note injuries in writing. Make full written notes on the conditions and attitudes of the people involved in the incident. Note and preserve any obvious evidence such as footprints or fingerprints.