1. Unit 104 – Awareness of protection and safeguarding in health and social care
Julie Stokes Jones

2. Reasons for this Unit?? http://www.youtube.com/watch?v=7dmjEYK_72k

3. What is a vulnerable adult
What makes us vulnerable?
Record your groups ideas about common factors on flip chart paper for feedback

4. Vulnerability factors could include:
Limited or no verbal communication
Lacking understanding
Unaware of their rights
Low self esteem/self worth
Unable to protect themselves
“Institutionalised”
Institutional poor practice
Violence, drug/alcohol misuse in relationships
Disability
Isolated family or individual
Previous abuse has occurred
If participants are working with CYP then it should be noted all children are vulnerable due to their age and dependence but there are other factors to consider. A person’s vulnerability will depend on his/her circumstances. Vulnerable adult is defined in Wales Interim Policy & Procedures for the Protection of Vulnerable Adults from Abuse 2011 and In Safe Hands 2000 as  
A vulnerable adult is a person over 18 years of age 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 himself or herself, or unable to protect himself or herself against significant harm or serious exploitation. This definition may include a person who:
has learning disabilities; has mental health problems, including dementia; is an older person with support/care needs; is physically frail or has a chronic illness; has a physical or sensory disability; misuses drugs or alcohol; has social or emotional problems; has an autistic spectrum disorder

5. “Safeguarding of Adults at Risk”
Anyone over 18
To be protected from
Danger
Harm
Abuse

6. Activity 3 What is acceptable?
using your cards decide if you
think this is abuse
true or false
Participants each given a true and false card. Statements are read by the facilitator appropriate for the learner group and individually people raise either true or false to the question is this acceptable or is this abuse

7. What do you think?
A nurse feels that force feeding a patient is acceptable if that patient is malnourished, even if that means forcing the food down the patient’s throat.
A daughter locks her father, who is prone to wandering, in his room, whilst she is out. She does this to prevent him leaving the house and possibly injuring himself or getting lost.

8. Is it Acceptable When….
A confused older person is drugged to keep them quiet?
A mentally ill wife stops preparing food for her dependant husband when she stops eating?
A relative takes some of the pension for all the help that they give?

9. Abuse of adults is defined as:
a violation of an individual’s human and civil rights by another person or persons which results in significant harm. (In Safe Hands, National Assembly for Wales July 2000)
For adults - Taken from Wales Interim Policy & Procedures for the Protection of Vulnerable Adults from Abuse A new definition is expected in 2014 and this slide will need updating.

10. Significant harm - adults
ill-treatment (including sexual abuse and forms of ill-treatment that are not physical)
impairment of, or an avoidable deterioration in, physical or mental health
impairment of physical, emotional, social or behavioural development
For adults - Significant harm may result from a series of incidents that, in isolation, may not seem significant but when repeated become serious. The impact of abuse on individuals is personal to them

11. “Safeguarding of Children at Risk”
Anyone under 18
To be protected from
Danger
Harm
Abuse

12. Definition of Child Abuse and Neglect
A child is abused or neglected when somebody inflicts harm, or fails to act to prevent harm. Children may be abused in a family or in an institutional or community setting, by those known to them or, more rarely, by a stranger. (All Wales Child Protection Procedures 2008)
A new definition is expected in 2014 and this slide will need updating. For CYP this definition comes from the AWCCP 2008.

13. Significant harm – children and young people
ill treatment or the impairment of health and development
the effects of sexual, physical, emotional abuse or neglect, or a combination of different types
The Children Act 1989 introduced the concept of significant harm as the threshold that justifies compulsory intervention in family life in order to protect children. Local authorities have a statutory duty under the Children Act 1989 section 47 (1) (b) to make enquiries, or cause enquiries to be made, where they have reasonable cause to suspect that a child who lives, or is found in their area is suffering, or likely to suffer, significant harm.

14. Abuse: a single or repeated act, or multiple acts
a lack of appropriate action
a result of deliberate intent, negligence or ignorance
an act of omission or neglect
a child or vulnerable adult being persuaded or forced to enter into a financial or sexual arrangement to which they have not, or could not, consent
can occur in any relationship and fundamentally is an abuse of trust, including failure to meet a duty of care
This has been adapted to cover both adults and CYP. It may be of interest to the group that these factors apply across age groups.

15. Categories of abuse There are 5 main categories: Physical Sexual
Emotional
Neglect
Financial
There are many ways in which a vulnerable individual may be abused. It is not unusual for an abused individual to suffer more than one kind of abuse. Accordingly, the impact of abuse and its seriousness for the individual must be evaluated in every case. These categories come from ‘In safe hands’ 2000 but are appropriate for CYP. Though financial is not always included it may well be a factor.

16. Signs and Symptoms of Abuse
Discuss in a group the signs and symptoms of the 5 main categories of Abuse
In a table list the signs and symptoms of the categories of Abuse, this table will be included in your assignment. Separate the signs and symptoms to adult and children

17. Real Case Studies (children)
Baby P
what could have been done differently?
Victoria Climbie

18. Activity 7 - Case reviews
Look at the summary of a case study you have been given.
What do you think would have made a difference to prevent or stop the harm or abuse?
Real case studies given to groups (appropriate to the learner group) to include key enquiries such as Winterbourne View Hospital, Vanessa George, Harold Shipman, Mid Staffordshire Hospital, Rochdale, Fiona Pilkington, Bichard enquiry, Steven Hoskins, and Victoria Climbie. These should challenge assumptions about who may be an abuser, where abuse might take place and who may be abused. Participants to read a selection of case summaries and asked what they think were key factors that would have made a difference to prevent and to stop the harm and abuse. Record on sheets given out and linked to each case study. Group asked to outline the case study/or studies they had and their thoughts shared. Contributions from the rest of the group are sought

19. Key agencies for adults include:
Social Services (Local Authority) duty to assess & ensure that needs are met, investigate and to co-ordinate adult and child protection systems.
Police - duty to investigate allegations of criminal activity
CSSIW - notified of referrals in a regulated setting and monitor the service
Adult Safeguarding Boards – a duty to investigate and report on cases and ensure partnership working
Medical Professionals – duty to report and work as partners with other agenices
You have a responsibility to report dangerous, abusive, discriminatory or exploitive behaviour & practice (Care Council for Wales Code of Practice for Social Care Workers)
Roles of different agencies in safeguarding. Remind group they have a responsibility to alert and inform ‘whistle-blowing’ even if it is colleague or manager. Care Council for Wales Social Care workers code of practice: 3.2 Using established processes & procedures to challenge & report dangerous, abusive, discriminatory or exploitive behaviour & practice 3.3 Following practice & procedures designed to keep you & other people safe from violent & abusive behaviour at work

20. Key agencies for Children include:
Children Social Care Services (Local Authority) duty to assess & ensure that needs are met, investigate and to co-ordinate adult and child protection systems.
Police - duty to investigate allegations of criminal activity
CSSIW - notified of referrals in a regulated setting and monitor the service
Children's Safeguarding Boards – a duty to investigate and report on cases and ensure partnership working
Medical Professionals – duty to report and work as partners with other agencies
NCPCC – they are a charity organisation which offer Childline for children
You have a responsibility to report dangerous, abusive, discriminatory or exploitive behaviour & practice (Care Council for Wales Code of Practice for Social Care Workers)

21. Essential Steps Believe that abuse can happen & never ignore a hunch
If the person or child is in danger call 999 for police or medical help
Report your concerns with your manager or other appropriate person
Do not cover up for others
Ensure that you know the Policy & Procedures
Know the limits of your responsibility
Report and record your suspicions as soon as possible
Record the facts, what is said and what you have seen
Do not tackle an alleged perpetrator yourself
Inform the victim of your steps and what the process will be
Taken from Wrexham Social Services

22. Do’s and Don’ts
Go through hand-out of what you shouldn’t do and what you should do

23. Support for Adult who has been abused
Where can they get support?
CSSIW
Social Services
Adult Safeguarding Board
Counselling GP
Websites

24. Support for the adult social care worker
Where can they get support?
Manager or Senior Staff
Counselling GP
Websites

25. Support for child who has been abused
Where can they get support?
CSSIW or Estyn
Children Social Care Services
Children Safeguarding Board
Counselling GP
Websites

26. Support for the children social care worker
Where can they get support?
Manager or Senior Staff
Counselling GP
Websites
Estyn
Children Safeguarding Board

27. Revision
Read examples and fill in what would you do?

28. Assignment
Design a Guide for Staff