1. Adult Protection & Vulnerable Adults

2. The extent of the problem: SCC AP referrals 2005-6 145 referrals went through AP process 145 referrals went through AP process >50% related to older adults –75+ with OPHM needs most at risk >50% related to older adults –75+ with OPHM needs most at risk 60% victims female, 60% perpetrators male 60% victims female, 60% perpetrators male >50% cases –abuse occurs at home >50% cases –abuse occurs at home 30% -abuse occurs in residential care –including hospital settings 30% -abuse occurs in residential care –including hospital settings > 30% abuser is paid carer, >30% abuser relative or partner > 30% abuser is paid carer, >30% abuser relative or partner 125% increase in referrals from previous year 125% increase in referrals from previous year

3. Who is vulnerable? 18+ yrs old 18+ yrs old In need of community care services In need of community care services Mental or other disability –age or illness Mental or other disability –age or illness Unable to take care of themselves Unable to take care of themselves Unable to protect themselves against harm or exploitation Unable to protect themselves against harm or exploitation Mental Capacity Mental Capacity

4. What affects vulnerability? Social exclusion Social exclusion Dependency on others – mobility, access to information and services, control of finances, ADLs Dependency on others – mobility, access to information and services, control of finances, ADLs Social acceptability of low standards of care Social acceptability of low standards of care Social acceptability of domestic abuse Social acceptability of domestic abuse Dynamics of power within institutional care settings –this includes hospitals Dynamics of power within institutional care settings –this includes hospitals

5. What is abuse? Violation of human and/or civil rights Violation of human and/or civil rights Causing harm by someone in a position of power, authority or trust –Harm may be: Causing harm by someone in a position of power, authority or trust –Harm may be:  Physical  Psychological  Emotional  Sexual  Financial  Neglect  Discriminatory  Institutional

6. Zero Tolerance A multi-agency approach (No Secrets, DoH 2000) A multi-agency approach (No Secrets, DoH 2000) All causes for concern should be reported – the ALERT system All causes for concern should be reported – the ALERT system Investigations should run in tandem with complaints, Personnel, Professional Regulatory bodies (NMC, GMC) Investigations should run in tandem with complaints, Personnel, Professional Regulatory bodies (NMC, GMC)

7. Institutional Abuse Rigid routines and regimes Rigid routines and regimes Lack of choice and consultation Lack of choice and consultation Poor quality environment Poor quality environment Staff focussed Staff focussed Low staff morale Low staff morale Lack of staff training Lack of staff training No evidence of effective policies and procedures No evidence of effective policies and procedures

8. Who can abuse? Anyone – Anyone –  Relatives  Informal Carers  Paid Carers  Professionals  Strangers  Neighbours  Other service users

9. Adult Protection in SUHT Adult Protection Alert Process piloted in A&E since July 05 and now Trustwide Adult Protection Alert Process piloted in A&E since July 05 and now Trustwide Alert Forms revised to include guidance notes and referral contact details Alert Forms revised to include guidance notes and referral contact details Is now reconfigured as Adult Protection Steering Group to monitor AP policy implementation. Is now reconfigured as Adult Protection Steering Group to monitor AP policy implementation.

10. Progress to date: Policy approved and launched July 06 Policy approved and launched July 06 ALERT forms implemented across Trust – download from Suhtranet ALERT forms implemented across Trust – download from Suhtranet Single point of access for ALERTS within hours – 2 access points for OOH Single point of access for ALERTS within hours – 2 access points for OOH Training the Trainers completed Training the Trainers completed Training programme devised for roll-out over next 12 months – MEC lead: Claire Rogers, Cancer Care, Nikki McKeag Training programme devised for roll-out over next 12 months – MEC lead: Claire Rogers, Cancer Care, Nikki McKeag

11. Key Principles First Priority –ENSURE SAFETY OF VULNERABLE ADULT First Priority –ENSURE SAFETY OF VULNERABLE ADULT Raise an ALERT –follow SUHT reporting protocol Raise an ALERT –follow SUHT reporting protocol Act on any cause for concern Act on any cause for concern Preserve evidence Preserve evidence Share your knowledge Share your knowledge Joint working Joint working Ensure you have had adequate training Ensure you have had adequate training Maintain accurate and up to date records Maintain accurate and up to date records