Safeguarding Adults local procedures - Patricia Orme Head of Adult Safeguarding Health and Community Services

Safeguarding Adults at Risk Safeguarding Adults at Risk is the multi - agency policy, procedure and practice guidance for safeguarding adults from abuse in Hertfordshire and must be followed by all organisations working with adults at risk in Hertfordshire. Hertfordshire Safeguarding Adults Board issued the revised policy in July 2014 http://www.hertsdirect.org/services/healthsoc/supportforadults/worriedabout/vulnadult/ (The Care Act, due to come into effect from 1 April 2015, is now scheduled for Royal Assent on 7 May 2014) The principles set out in government policy on Adult Safeguarding (Statement of Government Policy on Adult Safeguarding: department of Health: May 2013) Empowerment -Presumption of person led decisions and informed consent. (Individuals have the right to make choices about their care and treatment and are enabled to control decisions about their care to the extent they are able. – this includes making decisions about their safety, even where those decisions may seem to others to be unwise ) Prevention -It is better to take action before harm occurs. Proportionality – Proportionate and least intrusive response appropriate to the risk presented. Any actions that do not have the person’s full and informed consent must have a clear justification, be permissible in law and the least restrictive of the person’s rights to meet the justifiable outcome Protection -Support and representation for those in greatest need. Partnership -Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse. Accountability -Accountability and transparency in delivering safeguarding.

What has changed? Format The Policy is in three parts Policy Procedure Practice Guidance The policy has been developed in line with the proposed legislative changes set in the Care Bill Policy framework – sets out the strategic aims, roles and responsibilities of HSAB partnership and the responsibilities of all organisations who work with adults at risk of harm in Hertfordshire Although local authorities have been responsible for safeguarding for many years, there has never been a legal framework for this which has lead to a lack of clarity on who is responsible for what in practice. The Act aims to put this right by creating a legal framework so key organisations and individuals with responsibilities for adult safeguarding can agree on how they must work together and what roles they must play to keep adults at risk safe. 2. Procedure – has not changed. Procedures which must be followed are to Report and investigate suspected or actual abuse of an adult at risk of harm, including the specific roles and expectations of all partner organisations who work with adults at risk of harm Manage serious concerns about provider services and carry out safeguarding adults reviews Complete ongoing monitoring following the closure of the safeguarding process 3. Practice guidance – to support good practice and decision making in adult safeguarding – covers a number of topics giving guidance in appendices

What has changed? Terminology Adult at risk (of harm) Person who (may have) caused harm Safeguarding enquiry Updates terminology Adult at risk replaces vulnerable adult – as previously stated in presentation this person has needs for care and support (whether or not the authority is meeting any of those needs), And is experiencing, or is at risk of, abuse or neglect, as a result of those needs is unable to protect himself or herself against the abuse or neglect or the risk of it Person who has or may have caused harm replaces perpetrator or abuser Local Authority conduct safeguarding enquiries, the police investigate! enquiry, as there is risk of practitioners being caught up in ‘pinning someone’ for the act and losing the outcome as wished for by the service user, Strategy discussion or meeting – can be either but must be within timescales (5 days) and recorded accurately Case conference now replaces reconvened strategy meeting

What has changed? Policy The Care Act states that an enquiry will be carried out under the Safeguarding Adults from Abuse procedures when an adult: has needs for care and support (whether or not the local authority is meeting any of those needs), And is experiencing, or is at risk of, abuse or neglect, as a result of those needs is unable to protect himself or herself against the abuse or neglect or the risk of it

What has changed? Procedure Seven Stages to a safeguarding enquiry 1. Having a concern 2. Raising an alert (initiating an enquiry) 3. Making a referral There are seven key stages in the safeguarding adults process, to be discussed – new titles. Raises expectation on other agencies re having concern/making referral During each of these stages, key considerations are: supporting and enabling the adult at risk to achieve outcomes that they see as the best for them, where possible assessing and addressing risk taking action to protect and support the adult at risk whether a mental capacity assessment is needed in regard to specific decisions whether the adult at risk should be represented by an advocate and/or an Independent Mental Capacity Advocate (IMCA) taking appropriate action for the person causing harm taking appropriate action with a service and/or its management if they have been culpable, ineffective or negligent identifying any lessons to be learnt for the future, including recommendations for any changes to the organisation and service delivery whether there concerns about a provider which need investigation under the serious concerns procedures Stage 1 Having a concern A disclosure is received or a suspicion of possible abuse or neglect aroused – discuss with manager if in service or contact Health and Community Services, Hertfordshire Partnership University NHS Foundation Trust or the Police if a member of the public Stage 2 Raising an Alert If in service, manager decides whether to raise a safeguarding alert with Health and Community Services, Hertfordshire Partnership University NHS Foundation Trust or the Police; if member of the public has contacted the above record as an Alert. Stage 3 Making a referral/initiating an enquiry (this is where we become involved as investigating teams – please note ACSIS proccess has not changed – mgr still needs to decide whether to investigate within one working day and discussion with 5 days) Manager decides whether Safeguarding Adults from Abuse procedures apply; if they do, converts alert to a referral, initiates the procedures and puts in place a safeguarding protection plan. If the safeguarding procedures do not apply manager ensures an appropriate response is made to the alert

What has changed? Procedure 4. Holding a strategy discussion or meeting 5. Undertaking an investigation 6. Holding a case conference and reviewing the protection plan 7. Closing the safeguarding adults process Stage 4 Holding a strategy discussion or meeting Manager gathers relevant information from partner agencies to decide if a formal investigation under these procedures is appropriate and to coordinate its implementation; if it is agreed this is not appropriate, manager ensures an appropriate response is made to the referral Stage 5 Undertaking an Investigation The relevant agencies carry out their internal investigations to clarify the situation and the risk posed to the individual/s and to identify any further actions that may be required to safeguard the individual/s. It remains the LA responsibility to ensure enquiries made. This may lead to us investigating or other agencies may take on part of the process Stage 6 Holding a Case Conference (reconvened Strategy Meeting) and reviewing the Safeguarding Protection Plan The findings of the investigations to date are shared and collated to agree any further actions in the light of reviewing the safeguarding protection plan. This may require further meetings until the investigations are completed. Stage 7 Closing the Safeguarding Adults Process Once the investigations are completed and any remedial actions completed, the Safeguarding Protection Plan should be closed and replaced by a Community Care Plan or its equivalent for on-going monitoring and the safeguarding procedures closed.

Reporting Abuse

What is the same? Definitions of abuse Physical Sexual Psychological/emotional Financial Neglect Institutional Discriminatory

Contacts Health and Community Services 0300 123 4042 Hertfordshire Partnership NHS Foundation Trust (HPFT) 0300 777 0707

Thank You. Summary