1. Louise Tanner, Learning and Development Officer
Safeguarding Adults
 What is it?
 Why have it?
 What next?
Louise Tanner, Learning and Development Officer
Safeguarding Adults Team, Manchester City Council

2. A.S.C. S.A.R. M.S.P. S.C.R. M.C.A. B.I.A. D.H.R.
T.L.A. bingo… 
Adult Social Care
Deprivation of Liberty Safeguards
Independent Domestic Violence Advisor
Manchester Safeguarding Adults Board
A.S.C.
M.S.A.B.
D.O.L.S.
I.D.V.A.
Serious Case Review
Manchester Safeguarding Childrens Board
Making Safeguarding Personal
M.S.C.B.
S.A.R.
Safeguarding Adult Review
M.S.P.
S.C.R.
Best Interest Assessor
Domestic Homicide Review
Mental Capacity Act
Domestic Violence and Abuse
M.C.A.
D.V.&A.
B.I.A.
D.H.R.

3. …20th century care… “Old folk hit and bite don’t they?”
“Well at least she’s had a good life…”
“Bad care happens in care homes…”
“…but I wouldn’t want that for my mum or dad!”
“…we almost didn’t recognise Great Aunt Gladys in her new care home – she had odd slippers and a man’s cardigan on, and they’d lost her glasses, hearing aid and false teeth – all in 3 days!

5. Timeline for Adult Safeguarding
1979
Government Guidance ‘No Secrets’
2018
Mental Capacity Act
Care Act
14th May 2014
Introduction of MSP
Safeguarding became statutory
1st April 2015
2012 and ongoing
Today
7th April 2005
Consultation on the Review of ‘No Secrets’
20th March 2000
Consultation on Care and Support Bill
2000
2005
2006
2007
2008
2011
2012
2014
2015
MENCAP ‘Living in Fear’ Report
UK Study of Abuse and Neglect (1)
UK Study of Abuse and Neglect (2)
Murder of Steven Hoskin
West Yorkshire Inquiry Report into 70+ allegations of sexual abuse by consultant psychiatrists William Kerr and
Michael
Haslam
2011 Panorama TV Programme ‘Winterbourne View’ led to 11 workers prosecuted under MCA, and closure of the assessment centre in 2012
Cornwall SCR Mr SH published Dec 2007

6. NEW STATUTORY DUTIES
The Care Act sets out Local Authority responsibilities for adult safeguarding in primary legislation.
Responsibility to ensure Section 42 Enquiries are made where safeguarding criteria met.
Safeguarding Adult Boards become statutory.
Requirement to conduct Safeguarding Adult Reviews.
Information sharing and whistleblowing duties.

7. SAFEGUARDING ADULT REVIEWS
Previously known as Serious Case Reviews (commonly on behalf of children).
Purpose of a Safeguarding Adult Review (SAR) must be to learn lessons, improve practice and interagency work.
Boards have the power to require information from relevant agencies relevant to the SAR’s function.
Anyone can request a SAR.

8. What is Adult Safeguarding?
“‘Adult Safeguarding’ is a range of activity aimed at upholding an adult’s fundamental right to be safe, at the same time as respecting people’s rights to make choices.”
(Dept of Health, 2011)

10. Adult Abuse
Is a violation of an individual’s human and civil rights by another person/s
Can come in many forms
Can be a single or repeated act
May result in physical injury or illness
Includes ‘failure to act to protect’
Abuse: Human Rights issue – as a public agency MCC has duty to intervene. Abuse has an impact on individual’s health, well-being and independence. Ask group to remember that ‘failure to act to protect’ is abuse – either deliberate or negligent and as professionals we are responsible to ensure we report any suspicions or disclosures of abuse.

11. Types of Adult Abuse: Physical Abuse / Assaults
Sexual Abuse and Sexual Exploitation
Emotional or Psychological Abuse
Financial and/or Material Abuse (Theft, Fraud)
Neglect and/or Acts of Omission (includes Self Neglect)
Institutional/Organisational Abuse
Discriminatory Abuse / Hate Crimes
Abuse of Human and Civil Rights
Domestic Violence and Abuse, FM, FGM and ‘so called HBV’
Modern Day Slavery, Trafficking and Exploitation
Concerns about risk of radicalisation

12. A Definition of Consent
A voluntary or un-coerced decision:
By a competent or autonomous person
Given adequate information and deliberation
Who actively accepts the course of action
Necessary to determine whether the act, relationship or situation is abuse – has consent been given?
(It is the Enquiry Officer’s role to determine whether consent has been given)
Consent: Is crucial part of the investigation to determine whether the act, relationship or situation is abusive – and is necessary to determine whether the person could and did give informed consent to whatever took place – understanding risks, benefits, likely consequences, given time to make decision. Link to MCA training.

13. Who is affected by the MCA?
700,000 people with Dementia
One in six adults (aged 16 – 64)
who have a severe mental illness
145,000 adults with severe and profound learning disabilities
310,000 adults with Autistic Spectrum Disorder
135,000 people requiring 24 hour care after surviving a severe head injury
300,000 people disabled following a stroke
Upto 6 million informal carers and adult health and social care professionals

14. The Five MCA Principles:
A presumption of capacity
The right for individuals to be supported to make their own decisions.
The right to make unwise or eccentric decisions.
The right to a decision which is in their best interests.
The right to the least restrictive alternative.
unless have doubts…
If the capacity assessment finds that person lacks capacity…
MCA: The five statutory principles
The five principles are outlined in the Section 1 of the Act. These are designed to protect people who lack capacity to make particular decisions, but also to maximise their ability to make decisions, or to participate in decision-making, as far as they are able to do so.
1. A person must be assumed to have capacity unless it is established that he/she lacks capacity.
2. A person is not to be treated as unable to make a decision unless all practicable steps to help him/her to do so have been taken without success.
3. A person is not to be treated as unable to make a decision merely because he/she makes an unwise decision.
4. An act done, or decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made, in his/ her best interests.
5. Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person’s rights and freedom of action.[4]

15. Legal Assessment of Capacity (2 stage capacity test):
“Is there an impairment of, or disturbance in, the functioning of the person’s mind or brain?”
If so…
“Is the impairment or disturbance sufficient that the person lacks the capacity to make that particular decision?”
(“is it so bad, right now”?)

16. “Is it so bad, right now?” – can the person…
Understand the decision which needs to be made?
Retain all the relevant information long enough to make the decision?
Use and weigh all relevant information as part of the decision-making process (pro’s and con’s)?
Communicate their decision by any means?

17. AFTER THE DEATH OF A CLAIMANT IN 2000, THE DWP INTRODUCED THE ‘MINIMUM REQUIREMENTS’.
These requirements were designed to ensure that the DWP is ‘not found to be neglectful in (its) duty of care’ towards claimants with a ‘known background of mental illness’.
THE MINIMUM REQUIREMENTS ARE:
where a claimant has been attending a psychiatric unit, a liaison officer should be appointed to maintain good relations between the Jobcentre Plus and the patient affairs officer;
where it is known that a claimant has a social worker designated to her/him, the DWP should liaise closely with the social services department;
where there is a known history of mental illness, all cases should be referred to a manager before a decision is made to withdraw benefit.
THE SAFEGUARDING INTENTIONS BEHIND THE MINIMUM REQUIREMENTS HAVE SINCE BEEN USED AS THE BASIS OF DWP SAFEGUARDING GUIDANCE.

18. DWP and Safeguarding
“Safeguarding procedures exist within DWP guidance to protect vulnerable claimants if their claim is about to be stopped”.
“Greenwich Welfare Rights Service has found that querying with the DWP when the guidance has not been applied has regularly resulted in benefit being reinstated quickly”.

19. ESA Work Programme Provider Guidance (1/3/16)
The Work Programme definition of a vulnerable ESA participant is:
“vulnerable ESA participants are those who have mental health conditions or learning disabilities or conditions affecting communication/cognition”
(para 6, page 3)

20. DWP Version 3 updated 1 March 2016

21. ESA Work Programme Provider Guidance (1/3/16)
DWP Safeguarding procedures:
“before raising a compliance doubt for vulnerable ESA participants you must engage face-to-face (and be able to show evidence),
…to ensure that they have understood the mandatory requirement of the activity and possible consequences of not carrying out the activity”.
DWP refers to this procedure as ‘safeguarding’

22. “If you have had a face to face discussion with the participant (either at the point of mandation where you explained and issued the mandatory notification, or after they have failed to complete the mandatory requirement)
AND
“you are content that they did understand the requirements and possible consequences of not carrying out the mandated activity, the appropriate safeguarding steps have been undertaken”.
(WPP Guidance, Page 4, Chapter 4b v3 1/3/16)

23. Safeguarding is everyone’s business We all have a duty of care
…21st century care…
Safeguarding is everyone’s business
We all have a duty of care

24. Thanks for listening Any questions?
 What is it?
 Why have it?
 What next…?
Manchester Contact Service:
“I want to report an adult safeguarding concern”
Thanks for listening Any questions?

25. “It is important to remember…that in some cases, an accumulation of events, as opposed to a single act, may increase the severity of the concern and the impact upon the individual or individuals at risk.”

27. My decision is: should I wear my hearing aid? Reasons to say “yes”
Reasons to say “no”
I don’t mind how it looks
It hurts my ear
I can hear better
I don’t like it
I can listen to Jodie better
Total :
Total :
My decision is : that I will wear my hearing aid