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

2. 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

3. 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.

4. The Care Act 2014 replaces many previous laws
… … … … …
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

5. 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

6. 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

7. 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.

8. 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?

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

10. 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

11. 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.

12. 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

13. 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.

14. 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

15. 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

16. 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

17. 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.

18. 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.

19. 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.