1. Safeguarding Adults Briefing 31 st March 2014 Kate Spreadbury Service Manager

2. What is safeguarding adults? Anyone who works or lives with an adult who cannot protect themselves does this everyday – preventing harm If significant harm occurs to an adult who cannot protect themselves then reactive measures can be used: Safeguarding Adults procedures

3. Brief Background Safeguarding adults policies and protocols date from No Secrets 2000, the national policy guidance which created multi agency frameworks for the protection of vulnerable adults from abuse All safeguarding is multi agency, but the local authority is the lead for operational and strategic safeguarding Safeguarding adults is currently not supported by legislation, but this is changing, Care Act 2014

4. Who do Safeguarding Adults procedures apply to A vulnerable adult or adult at risk is over 18 years old and 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

5. What is abuse? “Abuse is a violation of an individual’s human and civil rights by any other person or persons” No Secrets 2000

6. Types of abuse Includes harm which is : Physical Sexual Emotional Financial Or results from Discriminatory Abuse ( inc. hate crime) Institutional Abuse Neglect

7. Domestic abuse If any of the above are perpetrated by someone who is or has been an intimate partner or family member of the vulnerable person the abuse can also be seen as Domestic Abuse. Family members are defined as – mother, father, son, daughter, brother, sister and grandparents, whether directly related, in-laws or step-family. Domestic abuse can happen to anyone, in any relationship. Domestic abuse can happen at any point of a relationship; in a new relationship or after many years, whilst the couple are still in a relationship, during separation, or even after separation. Separation is sometimes the most dangerous time in a relationship. A person who is an adult at risk or vulnerable adult as defined in No Secrets in Bristol and who is subject to Domestic abuse comes under the safeguarding adults procedures

8. Significant harm If an alert meets the criteria, “is this person an adult at risk” and “is abuse/neglect by a third party alleged” a referral is accepted. In order to assess whether a referral crosses the threshold for use of the safeguarding adults procedures, the decision needs to be made as to whether “significant harm” is likely to have occurred or not. This decision should be made by a manager or senior practitioner in the social work team. Not all breaches of human rights need a safeguarding adults response, only those that cross the threshold of “significant harm “ ‘harm’ should be taken to include not only ill treatment (including sexual abuse and forms of ill treatment which are not physical), but also the impairment of, or an avoidable deterioration in, physical or mental health; and the impairment of physical, intellectual, emotional, social or behavioural development’.” ”. Law Commission (Who Decides? 1997)

9. Assessing significant harm – some principles Whether abuse is intentional or not is irrelevant, what is important is the harm done and whether the harm might be repeated.

10. Government Principles April 2011 Empowerment - Presumption of person led decisions and consent Protection -Support and representation for those in greatest need Prevention- Prevention of harm and abuse is a primary objective Proportionality – Proportionality and least intrusive response appropriate to the risk presented Partnerships - Local solutions through services working with communities Accountability - Accountability and transparency in delivering safeguarding

11. Operational principles Once safeguarding procedures have been initiated an adult at risk should be assured: That their views, needs and well being are held to be central in any investigation, protection planning, or other process. That their human and civil rights, including the right to self determination, will be upheld throughout the process. That they will be supported to access the same services and have the same rights as all other citizens, or those rights and services will be accessed on their behalf if they are unable to do this with support.

12. Stages in safeguarding adults procedures Safeguarding Adults procedures are multi agency in nature, governed by safeguarding adults information sharing protocols, and have the following stages: Alert Referral Decision (or threshold decision) Safeguarding Assessment Strategy (meeting or discussion) Safeguarding Assessment (or “Investigation”) Safeguarding Plan (or “Protection plan”) Safeguarding Plan Review All actions within the procedure should be recorded and monitored.

13. Case study Mrs Douglas has been admitted to hospital after a fall at home. She has dementia and is even more confused by being in hospital. You visit and are concerned that she is not eating or drinking. Ward staff seem very busy. Other patients on the ward are calling for help but no one is answering. The patient in the next bed is naked and needs some help to clean up. You have complained to the ward manager but nothing seems to change

14. Case study You are working with John, a young man who lives alone in a flat with support. He is diagnosed with “mild learning difficulties”. Normally John is chatty but over the last few days has been subdued. He says that friends are coming to his flat and keeping him up late. You notice cigarette burns on his arm, he says he did these himself but he does not smoke. His hygiene has gone down, he doesn’t have any money for lunch and says he is currently “broke”.

15. Whats happening in Bristol? Safeguarding Adults Board Partnerships Targeting help to the most at risk Policy and more information out on line: www.bristol.gov.uk Safeguarding Adults

16. What are your responsibilities? If you are concerned that someone who cannot protect themselves is being harmed call : Bristol Care Direct 0117 922 2700 adult.care@bristol.gov.uk