1.3 Explain the legislative framework for safeguarding vulnerable adults. 1.4 Evaluate how serious case reviews or inquiries have influenced quality assurance, regulation and inspection relating to the safeguarding of vulnerable adults. 1.5 Explain the protocols and referral procedures when harm or abuse is alleged or suspected. 2 Be able to lead service provision that protects vulnerable adults. 2.1 Promote service provision that supports vulnerable adults to assess risks and make informed choices.
2.2 Provide information to others on:
– Indicators of abuse
– Indicators of Sexual Abuse:
– Indicators of Financial Abuse:
– Indicators of Neglect:
– Indicators of Psychological or Emotional Abuse:
– Measures that can be taken to avoid abuse taking place
– Steps that need to be taken in the case of suspected or alleged abuse.
2.3 Identify the policies and procedures in own work setting that contribute towards safeguarding and the prevention of abuse.
2.4 Monitor the implementation of policies and procedures that aim to safeguard vulnerable adults and prevent abuse from occurring.
2.5 Provide feedback to others on practice that supports the protection of vulnerable adults.
3 Be able to manage inter-agency, joint or integrated working in order to protect vulnerable adults.
3.1 Follow agreed protocols for working in partnership with other organisations.
3.2 Review the effectiveness of systems and procedures for working in partnership with other organisations.
4 Be able to monitor and evaluate the systems, processes and practice that safeguards vulnerable adults.
4.1 Support the participation of vulnerable adults in a review of systems and procedures. 4.2 Evaluate the effectiveness of systems and procedures to protect vulnerable adults in own service setting.
4.3 Challenge ineffective practice in the promotion of the safeguarding of vulnerable adults. 4.4 Recommend proposals for improvements in systems and procedures in own service setting.
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1. Understand the legislation, regulations and policies that underpin the protection of vulnerable adults.
1.1 Analyse the differences between the concept of safeguarding and the concept of protection in relation to vulnerable adults.
There is a difference between Safeguarding vulnerable adults/children and adult/child protection. Safeguarding is everybody’s responsibility, and includes measures to prevent or minimise the potential for abuse occurring. Protection is considered a statutory responsibility in response to individual cases where risk of harm has been identified POVA or Protection of Vulnerable Adults was changed and implemented to SOVA or Safeguarding of Vulnerable Adults in 2007.
This meant that the SOVA register was to replace the POVA and other individuals who are deemed unsuitable to work with children and vulnerable adults. Safeguarding means to ‘safeguard’ an individual, to promote and prompt the safety of a vulnerable child or adult. Ensuring you have the appropriate measures in place to maximise the safeguarding of others. Safeguarding is everyone’s responsibility that comes into contact with a vulnerable person and it is their responsibility to raise an alert immediately should anything be ‘out of the ordinary’
Protection is a central part of safeguarding and promoting welfare. It is the process of protecting an individual identified as either suffering or at risk of suffering significant harm as a result of abuse or neglect; you protect a vulnerable person when it is clear they are at risk or currently a risk.
1.2 Evaluate the impact of policy developments on approaches to safeguarding vulnerable adults in own service setting.
It is vital that as an organisation we evaluate our policies and improve and develop them as new criteria and legislation comes into place and is to be followed. All staff will receive updates and changes as to when these become in place and receive yearly ‘safeguarding alerts training’ upon assessment service users are explained the complaints and compliments process and this is also available in print format in their provider file which stays in their home. My responsibility is to explain that as our duty of care as a care provider, safeguarding is a huge role in our responsibility and that any signs or evidence that things are out of the ordinary will be reported to the necessary professionals. Service users are to sign an authorisation form upon assessment to agree with this process and that they consent to information sharing on a need to know basis.
My responsibility is for all staff to have fully DBS checked and they are all trained to the same standard, this ensures that where reporting and whistle blowing is concerned everyone is familiar with the same policies. Each member of staff will receive our ‘safeguarding vulnerable adults policy’ this includes explaining safeguarding, who a vulnerable adult is, different types of abuse, who may abuse, factors and indicators of abuse, the 4 point approach to abuse, our procedure as an organisation and what to expect and an easy to read flow chart on the stages of reporting. Each member of staff will sign to say they understand the guide and that they have received a copy. Each policies and procedures are reviewed and updated yearly.
As on organisation there are certain national policies that we must abide by and some guidelines that have been recommended. For example – No secrets guidelines, influences us as an organisation that we have a duty to investigate and take immediate action whenever we believe a vulnerable adult is at risk or is at harm. That we have a duty to report it to the appropriate people and take their lead if necessary. It is also a national policy that each employee in the Health and Social Care setting must obtain a DBS check.
And they will only be allowed to ‘loan work’ once a satisfactory check has been obtained. 1.3 Explain the legislative framework for safeguarding vulnerable adults. There are many legislations and policies that relate to safeguarding and that care providers and other health professionals must follow. I must have legislations and policies in place to ensure the health and safety of those vulnerable people we are supporting. People working in care and in the health profession need to have clear, good knowledge of the safeguarding procedure and policies that are in place.
I am responsible for staff to feel confident about them and confident to follow them and put them into practice if need be. Some of the obvious ones would be legislations such as the – Health and Social Care Act, Mental Capacity Act, Mental Health Act, Social Services Act, Safeguarding Vulnerable Groups Act, Discrimination and Equality Act. The no secrets guidance is not legislation as such, No Secrets’ sets out a code of practice for the protection of vulnerable adults. It explains how commissioners and providers of health and social care services should work together to produce and implement local policies and procedures. This consultation paper is about learning. It is about how we learn to empower people, both the public and the professionals to identify risk and manage risk.
It is about how we empower people to say no to abusive situations and criminal behaviour. It is about locating safeguarding in the wider agenda of choice and control. It is about recognising safeguarding as everyone’s business. It is about identifying the tools we need for better safeguarding. The guidance is for everyone such as social workers, housing officers, police officers, lawyers, service users, support workers and members of their families. The Human Rights Act protects all of us, young and old, rich and poor. Hopefully you will never need to rely on it, but every year hundreds of people do. Despite this, the Act is frequently misunderstood and misrepresented.
The human rights that are contained within the law are based on the articles of the European Convention on Human Rights. The Act ‘gives further effect’ to rights and freedoms guaranteed under the European Convention. The Mental Capacity Act 2005 (MCA) creates a framework to provide protection for people who cannot make decisions for themselves. It contains provision for assessing whether people have the mental capacity to make decisions, procedures for making decisions on behalf of people who lack mental capacity and safeguards. The underlying philosophy of the MCA is that any decision made, or action taken, on behalf of someone who lacks the capacity to make the decision or act for themselves must be made in their best interests.
1.4 Evaluate how serious case reviews or inquiries have influenced quality assurance, regulation and inspection relating to the safeguarding of vulnerable adults. Unfortunately sometimes local authorities, care providers and other health professionals only tend to put severe measures into place when something previously has gone very wrong e.g. a big safeguarding issue. In 2011 it became apparent that there was a scandal of abuse going on at a care home in Bristol. Under cover panorama had been it to secretly film and it was shown on British television. South Gloucestershire Council, CQC and the management of the privately owned home had ignored and not seriously acted upon, complaints and reports / concerns previously to this. The home was shortly after shut down and many members of staff were suspended.
The members of staff were all punished, some receiving prison sentences after being found guilty of physical, emotional and verbal abuse. Since this has happened, South Gloucestershire Council have made big changes, especially around its safeguarding policy and procedures and have a large team which deal with any safeguarding issues or concerns. They are acted upon almost immediately. There was also a case in Cornwall back in 2004. Budock hospital, which was part of the NHS. It was brought to light that members of staff working at the hospital had been suspended and was pending investigation due to allegations of abuse. It became apparent that severe institutional abuse had taken place. Residence that had been staying at the hospital got removed from the premises into a ‘safe place’ and investigations took place.
When an undercover investigator went in, it was found that service users were being tied to wheelchairs, being forced medication due to ‘bad behaviour and some were locked in their rooms for 16 hours a day. Some service users did not have assessments or plans that would be person cantered to them. However from this case, a lot of policies, procedures and expectations got put into place. The word ‘safeguarding’ came into place and guidelines were expected to be followed. Service user’s plans were to be person cantered and individual to them.
Staff undertook specific training for those service users they were working with. Any domiciliary or health care agency / bodies that would be carrying out personal care tasks would HAVE to register with the regulating body. (which is now CQC) this would make potential abuse harder for a perpetuator as there were more stricter policies and guidelines in place, as along with all the new strategies in place, residential and domiciliary care were also reviewed and were expected to follow suit.
Unfortunately sometimes it will take something drastic to happen for them to review their policies, procedures and guidelines to put stricter guidelines and rules into place. CQC inspections have become more intense and thorough, making it more difficult for care providers that are slack on their guidelines to ‘fall through the net’
1.5 Explain the protocols and referral procedures when harm or abuse is alleged or suspected.
A safeguarding alert can be made by anyone, whether it maybe a service user, a support worker, a family member, a colleague, a friend, a neighbour or a member of the public when any harm, abuse or something concerning which is out of the ordinary is suspected it is important to act upon immediately. If the person is in immediate danger, a crime has been committed or they are at harm then the police will need to be informed ASAP and try to ensure the person is safe, however ensuring you are safeguarding yourself also, EG if the perpetrator is still there, they could turn towards you as you are ‘helping’ the victim. The member of staff would then need to contact there line manager so they are able to contact the Local Safeguarding Authority.
If the concern is not a police matter, it is still vital to act upon ASAP, by informing your line manager for them to again, inform Local Safeguarding Authority so they are able to screen the concern and decide what to do. The Police / Safeguarding authority will gather evidence. This will probably involve asking for record keeping about the victim and a statement from the reporter / whistle blower on what they have witnessed or been told. In most circumstances the Safeguarding Authority might ask us to complete an alerts form, which asks us information about the victim, what we have been told or witnessed and any physical marks or appearance changes we have noticed. A copy of the averter form will also need to be sent to CQC as a regulating body for the services being provided.
There will be a strategy meeting, where professionals such as social workers, safeguarding team managers, OT’s, GP’s, Care managers and the police if relevant can attend. This is a meeting to discuss the way forward. It will discuss what is going to happen, any input anyone has and what will happen next. In some cases there will be a strategy discussion, which is less formal, and can be held over the telephone. A risk assessment to reduce the risk of it happening again and what has been put into place to reduce the risk will be put into place.
A safeguarding meeting will take place to discuss the outcome and what will be happening. A plan will be put into place along with the risk assessment; this should be person cantered to the individual and each person involved in that persons care should adhere to it and follow it. There should be close monitoring and reviews after this has all taken place. The victim’s behaviour needs to be monitored; they may need support or counselling. There should be regular reviews and spot checks to ensure the victim is feeling safe and happy with things that have been put into place.
If it was found that the concern was not a safeguarding matter. The care plan should still be reviewed as appropriate. If there has been a change in the service user’s needs or a change in family life / home life. The care plan must be updated accordingly so that it is clear to other people that it is not a concern and that it is now part of ‘the ordinary’
Be able to lead service provision that protects vulnerable adults.
2.1 Promote service provision that supports vulnerable adults to assess risks and make informed choices. The identification of risk should usually be undertaken with the person who has been, or appears to have been, harmed, unless doing so is likely to increase the risk of harm or puts other people at risk.
A person’s right to make choices about their own safety has to be balanced with the rights of others to be safe. An adult’s wishes should not override a worker’s individual and organisational responsibilities to report a concern of possible abuse. Workers and organisations should ensure they provide clear information for their service users, their representatives and the public regarding their responsibilities to alert concerns relating to possible abuse. It is good practice to inform the adult at risk that an alert needs to be raised unless doing so would increase the risk of harm to them or others. It should always be made clear to the person that raising an alert does not mean that an investigation under the safeguarding procedures would be carried out against their wishes, unless others were at risk from the same person, service or setting. I also ensure that I:
• speak to them in a private and safe place and informing them of any concerns;
• get their views on what has happened and what they want done about it;
• give them information about the safeguarding adults process and how that could help to make them safer;
• support them to ask questions about issues of confidentiality;
• identify communication needs, and relevant decision making capacity issues;
• explain how they will be kept informed and supported.
For those individuals who are less able to be involved in the formulation of risk management plans and make choices in such an advanced way, we strive to develop other ways for them to be involved. We include family members, independent advocates, care management and any other people integral to that person’s life and make decisions together. Where there is conflict around decision making for or from the individuals we support we use the mental capacity act to determine an individual’s ability to make a decision and if they lack the capacity, make a best interest decision.
Courtney from Study Moose
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