A vulnerable adult is defined as a person who, for any reason, may be unable to take care of themselves or protect themselves or exploitation. Safeguarding vulnerable adults involves reducing or preventing the risk of significant harm from neglect or abuse, while also supporting people to maintain control of their own lives. This does not only refer to adults who lack capacity. Adults with full capacity can still be considered vulnerable if they are unable to take care of themselves or protect themselves from significant harm.
When safeguarding a vulnerable adult, you: Ensure they can live in safety, free from abuse and neglect. Empower them by encouraging them to make their own decisions and provide informed consent. Prevent the risk of abuse or neglect and stop it from occurring. Promote their well-being and take their views, wishes, feelings and beliefs into account.(Kate Martinelli, April 11 2018 high speed training)
In March 2000 the No Secrets’ Department of Health guidance was issued under section 7 of the Local Authority Services Act 1970.
It places a responsibility on social services to play a coordinating role in developing local policies and procedures for the protection of vulnerable adults from abuse. In addition, it states that other statutory agencies should work together in partnership to ensure that appropriate policies and procedures and practices are in place and implemented locally’. In October 2005 the Association of Directors of Adult Social Services published safeguarding adults, a national framework of standards for good practice. This framework identified eleven sets of good practice standards which if implementation will lead to the development of consistent, high quality adult protection work.
The Association of Directors of Adult Social Services recognised significant changes within the adult protection field and moved the agenda from the protection of vulnerable adults and adult protection work to the new term: Safeguarding Adults’, placing more of an emphasis on the early intervention and prevention of abuse. This phrase means all work which enables an adult who is or may eligible for community care services to retain independence, wellbeing and choice and to access their human right to live a life that is free from abuse and neglect. The change in the name from POVA to SOVA focused early intervention and prevention of abuse. Vulnerable adults became Adults in need of safeguarding to recognise a shift in service philosophy and practice since the launch of No Secrets in 2000. The term Vulnerable Adults can be disempowering and can also suggest that the cause of abuse is located with the victim rather that acts or omissions of others.
This is a summary of relevant legislation, however, legal advice needs to be sought for a more detailed interpretation of the main requirements of each piece of legislation. No secrets is the current Department of Health guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse in England. It will remain as statutory guidance until at least 2013. In May 2011 the government published a statement of government policy on adult safeguarding. The statement sets out the six principles of safeguarding which have taken account of the responses to the public consultation on No Secrets in 2008/0, the implementation of the Mental Capacity Act 2005 and the drive towards increasing personalisation of services.’ The government intends to legislate to make Safeguarding Adults Boards statutory.
Local authorities have the lead responsibility for developing local multi-agency safeguarding procedures and ensuring implementation with key partners including the police, health and housing. Adherence to local procedures should form part of the contractual arrangements with care home providers. Providers may also develop more detailed guidance for their staff (social care institute of excellence 2012)The independent safeguarding authorityThe independent safeguarding authority was created to implement the Safeguarding Vulnerable Groups Act 2006, to help prevent unsuitable people from working with children and vulnerable adults. It took over the functions previously under: the Protection of Vulnerable Adults (PoVA) list the Protection of Children Act (PoCA) list List 99 (a list of people considered unsuitable for work with children, held by the Department for Children, Schools and Families). The coalition government is reviewing the implementation of the scheme and will make recommendations in 2011 ‘The deprivation of liberty safeguards mean that a managing authority’ (i.e. the relevant hospital or care home) must seek authorisation from a supervisory body’ in order to be able lawfully to deprive someone of their liberty.’ (Ministry of Justice, 2008)
Care home managers and staff should have an understanding of the Deprivation of Liberty Safeguards. The DOLS apply to people who: are aged 18 or over are living in a care home or long term hospital do not have the capacity to make a decision about this aspect of their liberty and their care.Care homes staff should be aware of the types of circumstances in which they should make an application for deprivation of liberty to be authorised. Care homes are required to notify the Care Quality Commission of any applications and the outcome of the application. Commissioners should be alert to the possibility that they are commissioning services which may deprive an individual of their liberty. In some cases this may be in the person’s best interests; in others this could be a breach of their human rights. Particular attention should be given if a person: is restrained, either physically or by the use of medication requires a minimum of 1-1 support when out has their contact with family or friends restricted, even if this is to protect them from abuse.Safeguarding Vulnerable Groups 2006 The purpose of the Safeguarding Vulnerable Groups Act 2006 is to restrict contact between children and persons at risk and those who might do them harm.
While the 2006 Act itself is very complex, its key principles are straightforward and they are as follows: unsuitable persons should be barred from working with children or persons at risk; employers should have a straightforward means of checking that a person is not barred from working with children or persons at risk; suitability checks should not be one-offs: they should be an element of ongoing assessment of suitability to catch those who commit wrongs following a suitability check.Mental Capacity Act 2005 There will be circumstances where an individual adult appears not to be able to make a decision about whether to consent to information being shared with others. The Mental Capacity Act and the associated code of practice contain guidance about the consideration of a person’s capacity, or lack of capacity, to give consent to sharing information. The starting assumption must be that the person has capacity unless it is established that they do not, and only then after all practical steps to help the person make the relevant decision have been taken but have been unsuccessful. An unwise decision taken by the relevant person does not mean they lack capacity. Where a decision is made on behalf of the person who lacks capacity to share personal information, it must still comply with the requirements of the Data Protection Act and be in their best interests.
Sharing health information can be a contentious area. There is guidance from professional health bodies, which NHS staff refer to, as well as local health trust policies. Local practice agreements need to be in place to ensure consistency across health and social care agencies and it is advisable to find out what these arrangements are when seeking the co-operation of health care staff. In general terms there are two pieces of relevant legislation, outlined briefly below.Protection of Freedoms Act 2012 The Protection of Freedoms Bill gained royal assent on 1 May 2012 and includes a reform of the vetting and barring and criminal records regime and a change in the law to allow people who were prosecuted for consensual sex with a person aged 16 or over, at a time when this was illegal, to apply to have their convictions removed from the Police National Computer and other police records if they meet the conditions laid down in the Protection of Freedoms Act 2012. As a result, if the individual has successfully applied to have them removed, these historical convictions will no longer be released as part of a DBS check. The Disclosure and Barring Service was introduced in December 2012 and brought together the Independent Safeguarding Authority and the Criminal Records Bureau and more information can be found at 2019
The purpose of serious case reviews or inquiries is not to reinvestigate or to apportion blame, but rather: To establish whether there are lessons to be learnt from the circumstances of the case about the way in which local professionals and agencies work together to safeguard vulnerable adults and to learn from past experience To review the effectiveness of procedures (both multi-agency and those of individual organisations) and to improve future practice by acting on the learning To inform and improve local inter-agency practice and improve multi-agency working To improve practice by acting on learning (developing best practice) To prepare or commission an overview report which brings together and analyses the findings of the various reports from agencies in order to make recommendations for future action and to review safeguarding adults procedures.Adult abuse pervades the lives of many people around the world today. The current definition of adult abuse used in health and social care today states abuse ” May consist of a single or repeated act. It may be physical, verbal or psychological; it may be an act of neglect or failure to act; or it may occur when a vulnerable person is persuaded to enter into a financial or sexual transaction to which he/she has not consented, or cannot give consent’ (Department of Health 2000).Adult abuse has received increasing recognition over the past 40 years at a national and international level.
Initial focus has been on the abuse of older people, however, there is now an awareness of the vulnerability of other groups of adults to abuse, including those with learning disabilities and mental health problems.There have been several high profile cases of abuse in recent years, resulting in serious case reviews. Below are two examples where serious case reviews or inquiries have influenced quality assurance, regulation and inspection relating to the safeguarding of vulnerable adults. Sexual abuse of eight primary school aged children by an approved local authority foster carer. The foster carer was a man in his 50s who, along with his wife, had fostered more than 30 children, placed by the local authority since their approval in 2001. First allegation of sexual abuse was made in May 2012 with further allegations in 2014 and 2015.
The children were removed from the home and the foster carers were deregistered in December 2015. The male foster carer was charged with voyeurism, sexual assaults and rape; victims were aged between 1-year-9-months and 11-years at the time of the offences; with one exception all victims were girls. Ethnicity or nationality is not stated. Findings: lack of rigour and thoroughness in assessment and approval process in recruitment and approval of prospective foster carers; arrangements for placement of children was above the approved level and outside the approved age range; shortcomings in procedures and practice make looked after children more vulnerable to abuse and less likely to report it. Recommendations: to apply standards of good practice to all aspects of recruitment of foster carers; foster care placements must be made as far as possible with carers who have been assessed as able to meet their needs; that systems for granting exemptions to the approved number of children placed in a foster home operate in line with fostering regulations; provide assurance that arrangements for supervision and oversight of the work of foster carers are effective (NSPCC Learning 2019)
The Care Standards Act 2000 has had an enormous impact on everyone working in the social care sector. It created a new regulatory framework for all regulated social care and independent health care services. The Act has two fundamental aims to: Protect vulnerable people from abuse and neglect Promote the highest standards of quality in the care that people receiveThe aim is to ensure that children in care are protected from abuse and neglect, older people and people with a disability who reply on care services, get appropriate standards of care and the protection they deserve, private hospitals and clinics provide modern standards of healthcare and parents who use child minders or day care can be assured that their children are in safe hands. The General Social Care Council was set up under the Care Standards Act 2000, along with the National Care Standards Commission and the Social Services Inspectorate (SSI).
NCSC and SSI merged in April 2004 to become the Commission for Social Care Inspection (CSCI) which is now the CQC.The Public Interest Disclosure Act 1998 or Whistleblowing’ is officially defined as making a disclosure that is in the public interest. It will usually occur when an employee discloses to a public body, usually the police or a regulatory commission that their employer is partaking in unlawful practices. A series of disasters, crimes and scandals in the late 1980’s and early 1990s resulted in a number of public inquiries. These inquiries found that often people within the organisations knew of the potential dangers or malpractice and for a variety of reasons either were unwilling to raise the alarm or if they did raise it, did so with the wrong person or in the wrong way.
All persons have the right to live their lives free from violence and abuse. This right is underpinned by the duty on public agencies under the Human Rights Act (1998) to intervene proportionately to protect the rights of citizens. These rights include the right to life Freedom from torture (including humiliating and degrading treatment) Right to family life’ (one that sustains the individual).When an allegation of abuse is made, the receiving agency must always notify the appropriate regulatory body, within any stipulated time limits and also any other authority who may be using the service provider.
Responding to abuse and neglect The primary responsibility of the Safeguarding Adults’ partnership is to enable all adults who is or may be eligible for community care services to access appropriate services if they need support to live a life that is free from abuse and neglect. The framework for enabling adults to access such support is referred to as the Safeguarding Adults’ Procedures. They should ensure that those adults who is or may be eligible for community care services and who may be experiencing abuse or neglect, receive an assessment of the risk they are facing. Where they face a critical or substantial risk to their independence and well-being, community care services should be considered as part of a safeguarding plan. Where the assessment does not lead to community care services being provided or purchased other appropriate services should be signposted.
The procedures should be based on the presumption of mental capacity and on the consequent right of such adults to make their own choices in relation to safety from abuse and neglect ” except where the rights of others would be compromised for people who are eligible for community care services and who have mental capacity, Safeguarding Adults’ procedures should enable them to access to mainstream services that will support them to live safer lives ” as well as providing specific services to meet additional needs. For example, some adults have impairments which mean that they need assistance to overcome current barriers to existing services, in order to choose how to achieve a safer life. GOOD PRACTICE ALERT ” Immediate action to safeguard anyone at immediate risk REFERRAL ” Within the same working day DECISION ” By the end of the working day following the one on which the safeguarding referral was made SAFEGUARDING ASSESSMENT STRATGEY ” Within five working days SAFEGUARDING ASSESSMENT ” Within four weeks of the safeguarding referral SAFEGUARDING PLAN ” Within four weeks of the safeguarding assessment being completed REVIEW ” Within six months for first review and thereafter yearly