1. National Award in the Safeguarding of Vulnerable Adults
AOFAQ Level 2
National Award in the Safeguarding of Vulnerable Adults

2. Student Introductions Course register Health & Safety
HOUSEKEEPING
Trainer Introduction
Student Introductions
Course register
Health & Safety
Assessment process and format
Student manuals
Toilets
Tea/coffee
Time keeping
Meals
Mutual respect
Smoking
Mobile phones
Breaks
Special Requests

3. AIM
The aim of the course is to provide you with the underpinning knowledge to support you and your organisation in your responsibilities to protect vulnerable adults in the health and social care setting.

4. By the end of the session, you will be able to:
LEARNING OUTCOMES
By the end of the session, you will be able to:
Describe the term “safeguarding”
State who is vulnerable from abuse
State reasons where abuse could happen
Define the term “dignity”
State the role of the Disclosure and Barring Service

5. FOR YOUR INFORMATION
All images contained in this presentation have been undertaken by trained actors and actresses.
Due to the sensitivity of this subject, if you feel upset at any point, please feel free to leave the room

7. Introduction to abuse in health and social care
Session 1
Introduction to abuse in health and social care

8. AIM
The aim of the course is to provide you with the underpinning knowledge to support you and your organisation in your responsibilities to protect vulnerable adults in the health and social care setting.

9. By the end of the session, you will be able to:
LEARNING OUTCOMES
By the end of the session, you will be able to:
Describe the term “safeguarding”
State who is vulnerable from abuse
State reasons where abuse could happen
Define the term “dignity”
State the role of the Disclosure and Barring Service

10. Abuse may be a single or repeated event Abuse destroys lives
1.1 INTRODUCTION TO ABUSE
Abuse is real
Between April 2010 and March 2011, there were 96,000 reported cases of alleged abuse in England (source: BBC)
Abuse may be a single or repeated event
Abuse destroys lives
Abuse is illegal

11. 1.1 INTRODUCTION TO ABUSE

12. 1.1 WHAT IS A ‘VULNERABLE ADULT’?
‘No Secrets’ (DOH, 2000) describes them as any person aged 18 years & over who: “..is or may be in need of community care services by reason of mental or other disability, age or illness; and who is unable to take care of himself or herself, or unable to protect him or herself against significant harm or exploitation”.

13. There is no definitive term for safeguarding
1.1 WHAT IS SAFEGUARDING?
There is no definitive term for safeguarding
It is generally considered as an overarching term which comprises of prevention, response to concerns and allegations and disclosures of abuse
Some organisations refer to safeguarding as “adult protection”

14. People are more vulnerable if:
1.1 WHO ARE VULNERABLE?
People are more vulnerable if:
They are isolated from friends and family
Do not have much contact with neighbours
They have memory problems
They have difficulty in communicating with others
They do not get on with their carer
They are addicted to alcohol and/or drugs
They have a disability
They are frail
They have a mental health condition

15. In a residential or nursing home In a hospital In the workplace
1.1 WHERE CAN ABUSE HAPPEN?
In a person’s own home
In a residential or nursing home
In a hospital
In the workplace
At a day centre or educational establishment
In supported housing
In the street
It can happen in any place and at any time

16. A paid carer in a residential home or from a home care service
1.1 WHO MAY BE THE ABUSER?
The person responsible for the abuse is often well known to the person being abused, and could be:
A paid carer in a residential home or from a home care service
A social care worker, health worker, nurse, doctor or therapist
A relative, friend, or neighbour
Another resident or person in a shared care setting
Someone providing a support service
A person employed directly by someone in their own home as a carer or a personal assistant
Deceptive people who try to ‘befriend’ or impersonate a utility provider or respectable business

17. 1.1 DIGNITY IN SAFEGUARDING
If someone's dignity is not respected and poor care is given (weather purposely or not intentionally), it could result in a person being abused or neglected
Dignity in care is essential and this must be preserved at all times
You must ensure that:

18. 1.1 DIGNITY IN SAFEGUARDING
There is a zero tolerance approach towards abuse
Do not stereotype or label any person
Respect a persons privacy
Treat people as an individual
Treat people with respect
Involve people in decisions which effect them
Take the time to communicate
Don't use any jargon

19. 1.2 DEFINITION OF ABUSE
Abuse is defined as:
“Abuse is a violation of an individual’s human and civil rights by any other person or persons.” (No Secrets 2000)

20. 1.2 DEFINITION OF SIGNIFICANT HARM/HARM
There is no definition of “harm” in law which relates to adults. No Secrets (2000) states that it is:
“Harm should be taken to include not only ill treatment (including sexual, and other forms of ill treatment that are not physical), but also the impairment of, or an avoidable deterioration in, physical or mental health; and the impairment of physical, intellectual, emotional, social or behavioural development”

21. 1.2 DEFINITION OF SIGNIFICANT HARM/HARM
Section 120 of the Adoption and Children Act provides a definition for ‘harm’ as:
“including for example, impairment suffered from seeing or hearing the ill-treatment of another”

22. 1.3 SITUATIONS WHEN VULNERABLE ADULTS MAY BE ABUSED AT HOME
Carers have had to change their lifestyle to suit the needs of the client unwillingly
The client has communication issues
The client has mental health issues
No support is available from family or other carers
Carers have alcohol and/or drug problems
Carers have no privacy
The client is often difficult or inconsiderate to the support provided by the carer

23. 1.3 SITUATIONS WHEN ABUSE COULD HAPPEN IN A CARE SETTING
Staff are poorly trained or untrained
Staff work in isolations situations
There is inadequate numbers of staff to cope with demands and pressures from service users
There is little or no management/supervision

24. The checks available include
1.4 THE ROLE OF THE DISCLOSURE AND BARRING SERVICE
On 1 December 2012 the Criminal Records Bureau (CRB) and Independent Safeguarding Authority (ISA) merged to become the Disclosure and Barring Service (DBS).
The role is to help employers with recruitment by preventing unsuitable people from working with vulnerable children and adults.
Criminal records and barring records are checked and passed on to the employer.
The checks available include

25. There are three types of DBS checks: Standard disclosure
1.4 THE ROLE OF THE DISCLOSURE AND BARRING SERVICE
There are three types of DBS checks:
Standard disclosure
Enhanced disclosure
Enhanced with list checks

26. The check is made against the police national computer.
1.4 THE ROLE OF THE DISCLOSURE AND BARRING SERVICE
Standard disclosure:
It is primarily for people who will work with vulnerable adults and children on a regular basis.
It can be used for other professions who high levels of responsibility e.g. accountants, magistrates etc.
The check is made against the police national computer.
It will reveal details of any conviction, caution, reprimand and/or final warnings issued.

27. The police will decide what additional information will be disclosed.
1.4 THE ROLE OF THE DISCLOSURE AND BARRING SERVICE
Enhanced disclosure:
In general, this check is for those who are regularly involved in caring for, supervising, training or being in the sole charge of vulnerable adults
Examples include carers, teachers, youth workers, dentists, nurses etc.
It checks as required for the standard check as well as with the police for any investigations which have taken place that have not led to a criminal record.
The police will decide what additional information will be disclosed.

28. Enhanced with list checks:
1.4 THE ROLE OF THE DISCLOSURE AND BARRING SERVICE
Enhanced with list checks:
This includes the same as the enhanced check plus checks of the barred lists

29. SUMMARY: STOPPING ABUSE
To stop abuse, the following is needed:
Believe that abuse does happen
Recognise the signs of abuse
Understand that anyone can abuse
Know the policies and procedures in your workplace for handling abuse
Follow the individuals care plan (if applicable)
Report any concerns or suspicions

30. AIM
The aim of the course is to provide you with the underpinning knowledge to support you and your organisation in your responsibilities to protect vulnerable adults in the health and social care setting.

31. Abuse may be a single or repeated event Abuse destroys lives
1.1 INTRODUCTION TO ABUSE
Abuse is real
Between April 2010 and March 2011, there were 96,000 reported cases of alleged abuse in England (source: BBC)
Abuse may be a single or repeated event
Abuse destroys lives
Abuse is illegal

33. The different types of abuse
Session 2
The different types of abuse

34. AIM
The aim of the session is to provide you with the underpinning knowledge to recognise the different types of abuse in health and social care.

35. By the end of the session, you will be able to:
LEARNING OUTCOMES
By the end of the session, you will be able to:
State the different types of abuse
List the possible indicators of each type of abuse

36. Physical Sexual Emotional Financial Neglect Institutional
2.1 TYPES OF ABUSE
Physical
Sexual
Emotional
Financial
Neglect
Institutional
Discriminatory

37. 2.1 DEFINITION OF PHYSICAL ABUSE
‘No Secrets’ (2000) define it as:
“including hitting, slapping, pushing, kicking, misuse of medication, restraint, or inappropriate sanctions.”

38. 2.1 EXAMPLES OF PHYSICAL ABUSE INCLUDE
Pushing
Shaking
Pinching
Slapping
Kicking
Force feeding
Punching
Inappropriate manual handling
Restraint
Denial of medication (prescribed)
Forced confinement
Unjustifiable physical discomfort

39. 2.1 POSSIBLE INDICATORS OF PHYSICAL ABUSE
Injuries that are consistent with physical abuse
A person discloses they are being abused
There are unexplained injuries
Skin infections
Change of behaviour
Self-harm
Unexplained weight changes
Behaviour that indicates that the person is afraid of the perpetrator
Injuries at different stages of the healing process

40. 2.1 DEFINITION OF SEXUAL ABUSE
‘No Secrets’ (2000) define it as:
“including rape and sexual assault or sexual acts to which the vulnerable adult has not consented, or could not consent or was pressured into consenting.”

41. 2.1 EXAMPLES OF SEXUAL ABUSE
Rape
Sexual assault
Sexual acts which a vulnerable adult has not consented
Being forced or coerced into being photographed or videoed to allow others to look at their body and/or sexual acts

42. 2.1 SEXUAL ABUSE
A sexual relationship between a care worker and a person with a mental disorder (learning disability or mental illness) is abuse and is an offence under the Sexual Offences Act 2003.

43. 2.1 POSSIBLE INDICATORS OF SEXUAL ABUSE
A disclosure is made
Urinary tract infections, sexually transmitted diseases or vaginal infections that are not otherwise explained
Significant change in sexual behaviour or outlook
Clothing is torn, stained or bloody
Pregnancy
Soreness when sitting

44. 2.1 DEFINITION OF EMOTIONAL ABUSE
‘No Secrets’ (2000) define it as:
“including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, isolation or withdrawal from services or supportive networks”

45. 2.1 EXAMPLES OF EMOTIONAL ABUSE
Threats of harm or abandonment
Humiliation
Intimidation
Harassment
Verbal abuse
Isolation
Ignoring
Hostility
Withdrawal from supportive networks

46. A person can suffer multiple types of abuse
2.1 EMOTIONAL ABUSE
Be aware that emotional abuse will almost inevitably be involved in every other category of abuse.
A person can suffer multiple types of abuse

47. 2.1 POSSIBLE INDICATORS OF EMOTIONAL ABUSE
Frightened/anxious
Withdrawn in the presence of a particular person
Low self esteem
Changes in behaviour e.g. Continence or sleep problems
Humiliation
Instilling fear
Verbal abuse
Denial of access to family and friends

48. 2.1 DEFINITION OF FINANCIAL ABUSE
‘No Secrets’ (2000) define it as:
“including theft, fraud, exploitation, pressure in connection with wills, property or inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.”

49. 2.1 EXAMPLES OF FINANCIAL ABUSE
Theft
Fraud
Wills
Inheritance
Exploitation
Misuse or misappropriation of property
Withholding money
Improper use of a persons money

50. 2.1 POSSIBLE INDICATORS OF FINANCIAL ABUSE
Lack of money
Removal of personal possessions
Inadequate explanations for withdrawal of money
Inability to pay bills
Power of Attorney obtained when a service user lacks the capacity to make an informed decision
Insufficient food
Sudden loss of assets

51. ‘No Secrets’ (2000) define it as:
2.1 DEFINITION OF NEGLECT
‘No Secrets’ (2000) define it as:
“Including ignoring medical or physical care needs, failure to provide access to appropriate health, social care or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating.”
Neglect is the deliberate withholding or unintentional failure to provide the support and help that is expected to support a vulnerable adult
Neglect also includes the failure to take action in any situation that is dangerous

52. Ignoring a service users medical or physical needs
2.1 EXAMPLES OF NEGLECT
Ignoring a service users medical or physical needs
Withholding necessities of life e.g. Medication, nutrition, hydration, heating etc
Failure to provide access to social care
Failure to provide access to educational services

53. 2.1 POSSIBLE INDICATORS OF NEGLECT
Inadequate heating and lighting
Malnourished
Cannot access appropriate medical care (including medication)
Not afforded appropriate privacy or dignity
Visitors are refused access to the service user
Service user is exposed to an unacceptable risk
Inadequate or inappropriate clothing
Lack of personal care e.g. Rashes and sores

54. 2.1 DEFINITION OF INSTITUTIONAL ABUSE
‘No Secrets’ (2000) define it as:
“This may be in the form of isolated incidents of poor or unsatisfactory professional practice, at one end of the spectrum, through to pervasive ill treatment or gross misconduct at the other. Repeated instances of poor care may be an indication of more serious problems”
Institutional abuse is often linked with other categories of abuse e.g. neglect

55. 2.1 EXAMPLES OF INSTITUTIONAL ABUSE
Lack of flexibility, choice and options
Lack of dignity
Staff not available
Entering rooms without knocking
Staff having an overly controlling relationship with service users
Inappropriate restraint
Lack of privacy e.g. Intercepting mail
Skin sores and skin tears
Public discussion on personal matters

56. 2.1 DEFINITION OF DISCRIMINATORY ABUSE
Discriminatory abuse is unwanted conduct which is based on a persons social identity e.g. Race, disability, age, culture, religion, sexual orientation, nationality or any other personal characteristic of the individual
The conduct affects the dignity of the service user
It could be a one off incident or persistent conduct
The actions or comments are perceived as demeaning and unacceptable by the recipient

57. 2.1 EXAMPLES OF DISCRIMINATORY ABUSE
Name calling
Bullying
Harassment
Denial of access to religious or cultural services
Discriminatory abuse can lead to any other type of abuse

58. AIM
The aim of the session is to provide you with the underpinning knowledge to recognise the different types of abuse in health and social care.

59. By the end of the session, you will be able to:
LEARNING OUTCOMES
By the end of the session, you will be able to:
State the different types of abuse
List the possible indicators of each type of abuse

61. Alerting and reporting suspected abuse
Session 3
Alerting and reporting suspected abuse

62. AIM
The aim of the session is to provide you with underpinning knowledge to respond to suspected abuse appropriately.

63. By the end of the session, you will be able to:
LEARNING OUTCOMES
By the end of the session, you will be able to:
State the reasons that abuse come to light
List the responsibilities of employees in dealing with suspected abuse
Define the term ‘whistle blowing’
State the key features for making a referral

64. 3.1 REASONS THAT ABUSE COME TO LIGHT
A service user makes a disclosure to a member of staff stating that they are being abused
You may have clear evidence that abuse or neglect is taking place
You may have concerns or suspicions, but there is no direct evidence
A person or agency suspects abuse is taken place or has evidence that it is taking place

65. 3.1 EMPLOYEE RESPONSIBILITIES
Anyone can abuse, regardless of their role
It is the moral responsibility of every member of staff to report abuse
You must follow your workplace policies and procedures
The law will protect you for making a referral- this is a term called ‘whistle blowing’

66. You cannot be victimised for ‘whistle blowing’
An Act of Parliament called the Public Interest Disclosure Act (1998) protects you
This Act encourages people to ‘blow the whistle’ about malpractice in the workplace and is designed to ensure that organisations respond by acting on the message rather than punishing the messenger
It is important that you familiarise yourself with your workplace ‘whistle blowing policy’

67. It applies even if the information is confidential
3.2 WHISTLE BLOWING
This Act applies to employees reporting crime, civil offences, miscarriage of justice, danger to health and safety or the environment and the covering up of any of these
It applies even if the information is confidential
The Act means that your employer cannot take any action against you because you have reported genuine concerns

68. Inform your line manager
3.3 MAKING A REFERRAL
Inform your line manager
If the vulnerable adult is in immediate physical danger or medical care is needed, then this will need to be dealt with as priority
If there is evidence of any criminal activity taking place, then the police will need to be informed
Once the abuse has been reported to your manager, the responsibility for action will not lie with you, but with your manager

69. 3.3 RESPONDING TO A DISCLOSURE - THE DO’S
Stay calm
Listen carefully
Be sympathetic
If you need to ask for more information, confine your questions to TED:
Tell me
Explain
Describe

70. 3.3 RESPONDING TO A DISCLOSURE - THE DO’S
Tell the person
They did the right thing to tell you
You are treating this information seriously
It was not their fault
You must inform your manager
The manager will contact social services (with their consent)
If their is criminal activity then it will be reported to the police
If appropriate, the service/agency will take steps to support and protect them
Write down as soon as possible the information you have gathered
Use a body chart to record locations of any injuries (if appropriate)
Ensure the information is noted in the case file

71. 3.3 RESPONDING TO A DISCLOSURE - THE DONT’S
Keep concerns, allegations or disclosures to yourself
Stop someone who is recalling the events
Ask leading questions e.g. Did they hit you?
Promise to keep secrets
Make promises that you cant keep
Contact the alleged abuser
Be judgemental e.g. It was your fault
Jump to conclusions or make any assumptions
Gossip with other members of staff

72. 3.3 RESPONDING TO A DISCLOSURE
Do not undertake an investigation yourself
Protect and preserve any evidence
If the alleged perpetrator contacts you, you must not provide them with any information about the incident
Do not discuss the case with the relatives or carers of the abused person or any other worker at the time of investigation

73. 3.3 FINAL NOTE:
“If abuse is not acknowledged people cannot be protected, or given support to recover, and, in those cases where other adults may be at risk, they too are left exposed to further abuses, hence a failure to acknowledge abuse may lead to failures in prevention as well as in response” (Hilary Brown, 1998)

74. AIM
The aim of the session is to provide you with underpinning knowledge to respond to suspected abuse appropriately.

75. By the end of the session, you will be able to:
LEARNING OUTCOMES
By the end of the session, you will be able to:
State the reasons that abuse come to light
List the responsibilities of employees in dealing with suspected abuse
Define the term ‘whistle blowing’
State the key features for making a referral