1. Safeguarding & Protecting Vulnerable Adults

2. Jenab (Zen) Yousuf Associate Head of Safeguarding/Named Professional Vulnerable Adults

3. Learning outcomes Increase awareness of - Safeguarding Prevention Response Protection - Definition of Vulnerability - Types of abuse - Support

7. “ “I want people to be as outraged by the abuse of an older person as they are by the abuse of a child. Sadly, we are nowhere near that as a society but that culture has to change.” Ivan Lewis MP

8. Definition of abuse ‘Abuse is a violation of an individual’s human and civil rights by any other person or persons.’ Abuse may consist of a single act or repeated acts. Abuse can occur in any relationship and may result in significant harm to, or exploitation of, the person subjected to it.’ No Secrets (DOH 2000)

9. Safeguarding Principles ‘The right of all people to live their lives free from violence and abuse’. Human Rights Act 1988 Article 2: The right to life Article 3: Freedom from torture Article 8: Right to family life (one that sustains an individual)

10. Who is a vulnerable adult? A person who is aged 18 or over and who may need community care services due to mental or other disabilities, age or illness, and who is or maybe unable to take care of themselves or unable to protect themselves against significant harm or exploitation.

11. Determining Vulnerability Lack of social networks Dependency on others Lack of access to remedies for abuse Acceptability of low standards for care Acceptability of domestic abuse Dynamics of power within institutional settings

12. Types of abuse Discriminatory abuse Emotional or psychological abuse Financial abuse Institutional abuse Neglect Physical abuse Sexual abuse

13. Psychological abuse All abuse is likely to have a psychological effect on the victim. Examples are: Criticising or making fun Threatening to harm or abandon Depriving contact with others Intimidating, humiliating or blaming Controlling or coercing them Harassment or verbal abuse Isolation

14. Discriminatory abuse An act (or omission), or remarks showing prejudice towards a person’s age, gender, disability, race, colour, sexual or religious orientation. For example: A person with a disability living in a residential home is not helped to go to the toilet or being is being taken late to meals.

15. Financial abuse Illegal or improper use of someone’s property, finances or other assets either without their informed consent or where consent is obtained by fraud. Examples… Misuse or theft of possessions or benefits Being persuaded to part with money Pressure in connection with wills Selling property of person in care

16. Institutional abuse This takes place in settings where a number of vulnerable people are placed. It is systematic mistreatment at the place where care is provided. More than one person perpetrates the abuse and it can include whole staff team. Can range from neglect to outright assault. Includes misuse of medication.

17. Mid Staffordshire NHS Foundation Trust 2008 Nurse raised concerns in 2007 Catalogue of failures: Dehydrated patients forced to drink out of flower vases Patients left in soiled bedclothes 400 deaths that can’t be explained Receptionists carry out initial checks on patients Junior doctors bullied into discharging patients

18. Neglect Neglect is not paying attention to the needs of vulnerable people or leaving them uncared for. Could include ignoring medical or physical care needs, failing to provide access to health or social care. Withholding essential necessities of life such as medication, adequate nutrition and heating.

19. Man starves to death in Hospital Martin Ryan went 26 days without food in an NHS Hospital Martin had suffered a stroke which left him unable to swallow. A breakdown in communication meant that he was not given alternative treatment. Doctors had thought nurses were feeding him via NG tube. He was then too weak to insert a PEG. He died five days later.

20. Sexual abuse Sexual abuse includes rape, sexual assault, inappropriate touching or sexual acts to which the person has not consented, could not understand or was forced into. Sexual abuse can be experienced by all ages, from young to the elderly, regardless of disability, race, culture or gender. Can include non-contact abuse such as or exposure to pornography.

21. Physical abuse Mostly pre-meditated assault Inflicting physical harm or pain by mistreatment (hitting, shaking, slapping, punching, suffocating, stabbing, burning or scalding). Prolonged deprivation of food or water Inappropriate restraint or abuse of medication.

22. The dignity and abuse continuum Dignified care Abuse

23. The Dignity Agenda Department of Health campaign to promote dignity in the health and social care sectors. Respect Privacy Self-esteem Autonomy

24. Mental Capacity Act 2005 Protects the rights of adults who are unable to make decisions for themselves. Gives guidance and protection from liability to professionals and informal carers. Provides adults with ways to plan for the future when they may loose capacity. Provides clarification of the decision making process.

25. Everyone is an alerter! Recognise that abuse is happening Ensure the immediate safety of the adult Seek medical help if needed Preserve evidence Call the Police if a crime has just occurred Contact your manager Refer to LCC as a Safeguarding Alert Write up what was witnessed and actions taken Complete IR1 as a Safeguarding issue.

26. Where to make a referral? LCC 0845 053 0028 Or www.lancashire.gov.uk/safeguardingadults

27. A PERSON(S) MAKES A DISCLOSURE OR YOU DISCOVER OR SUSPECT ABUSE DANGER? CRIME? EVIDENCE? DIAL 999 IMMEDIATELY INFORM LINE MANAGER CONSULT WITH LINE MANAGER [OR SEEK ANOTHER IF UNAVAILABLE OR IMPLICATED] ALL INCIDENTS OR CONCERNS TO BE REPORTED AND RECORDED ON IR1 SAFEGUARDING ALERT TO BE RAISED WITH LCC YES NO

28. Alert to LCC on 0845 053 0028 Or www.lancashire.gov.uk/safeguardingadults Safeguarding Procedures Alerter notified of decision Decision by LCC Manager Sent to local team YES NO Lancashire Safeguarding Adults Procedure

29. NEVER DO NOTHING Finally Safeguarding and Protecting Vulnerable Adults is EVERYONE’S responsibility SO If you have concerns regarding a vulnerable adults welfare