1. Safeguarding Adults for Provider Managers and Care Home Staff
Vincent Docherty
January 2018

2. Aims of the Course
To provide care home managers and staff with a sound understanding of the need to protect adults from abuse. To encourage managers and staff to take proactive steps in recognizing signs and symptoms of abuse and to report it accordingly.
To help managers and staff encourage safeguarding as a core skill within their teams, to promote safeguarding in their service.
To update managers and staff with the most recent policy and procedures to enable them to address the increasing demands of safeguarding.

3. Care Act – Sect 42
Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse. Now statute this guidance empowered local authorities to act.
The Local Authority were deemed to be the lead agency but all agencies must work together such as police, health, private and voluntary must work together to protect vulnerable adults from abuse

4. Principles of Safeguarding
Empowerment – Presumption of person led decisions and informed consent.
Protection – Support and representation for those in greatest need.
Prevention – It is better to take action before the harm occurs
Proportionality – proportionate and least intrusive response appropriate to the risk presented.
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.

5. Role of CQC Safe Caring Well Led Five Enquiry Lines Effective
Responsive

6. Safety + Safeguarding Medication Infection Control Safeguarding
Physical Environment

7. Social Care Institute for Excellence.
Social Care Institute for Excellence (SCIE) - Home page
- Cached - Similar
UK resource of good practice and knowledge aimed at improvement of social care services with focus on central role of people who use services.

8. SCIE: Social Care Institute of Excellence
Useful Guides and Reports
Report 39 – Protecting adults at risk: London multi agency policy and procedures to safeguard adults from abuse.
Guide At a glance guide of the procedures
Guide Safeguarding and quality in commissioning care homes.
Guide 46 – Commissioning care homes, common safeguarding challenges.

9. Preventive Practice
Research - Abuse in Care – Caroline White, University of Hull
7 key areas that could indicate or promote abusive practice
Leadership with Care Homes
Actions, practices of staff, staff knowledge, skills and actions
Behaviour of Service Users
Isolation of service users ( out of borough)
Defensiveness and lack of openness
Service Design, Placement Planning and Commissioning
Fundamental care and quality of the environment

10. Underlying Causes Recruitment difficulties Staffing levels
Non adherence to policy and procedure – whistle blowing specifically mentioned
Poor training
Choice of Service
Record Keeping – End of life and DOLS
Dehumanisation

11. Common Safeguarding Issues
Maladministration of medication
Pressure sores
Falls
Rough treatment, being rushed, shouted at or ignored
Poor nutritional care
Lack of social inclusion
Institutionalised care
Physical abuse between residents
Financial abuse

12. Common Record Keeping Issues
Poor pre admission records/assessments
Care plans
Risk assessments
Safeguarding referrals and investigations – link to Pan London
MAR Sheets
End of Life DNAR
Referrals to outside agencies
Staff handover records
Staff supervision
Complaints

13. Staffing Levels The low status and pay of care work
Poor training and support for staff feeling stressed, rushed and overworked
Leads to low morale, burnout and potentially poor standards of care
High levels of sickness increasing pressure on the remaining staff in the workplace
High staff turnover resulting in wasted training resources and high recruitment costs

14. Record Keeping Resident's care plans are person-centered and accurate.
Care plans include risk assessment and risk enablement.
There is evidence that staff adhere to care plans and they are regularly updated.
All records are recorded clearly in a manner that can be easily understood by others. The home manager regularly monitors the standard of record-keeping.

15. Record Keeping cont.
All records are accessible to those that need them while appropriate levels of confidentiality are maintained.
Where the home manages any aspect of a resident's finances, either through resident choice or lack of capacity, the records are subject to robust and regular checks.

16. Record Keeping
There is evidence that the home uses complaints to improve quality and practice.
There are records of regular staff supervision and team meetings and evidence that actions are followed up
All record-keeping practice is regularly reviewed, with input from frontline staff, as fit for purpose.

17. Dehumanisation Discriminated against or treated differently to others
Isolated, dismissed or ignored
Disrespected, mocked or belittled
Deprived of dignity and privacy
Deprived of choice and control
Stripped of one's identity
Deprived of basic needs (e.g. food)
Abused physically, sexually or in any other way.

18. Identifying problem areas
Can you identify any safeguarding areas that may need addressing in your organisation.
Are there any common themes

19. Ten Challenges 10 10. Individuality 9. Independence choice and control
3. Alleviate loneliness and isolation
6. Expression
5. Right to Privacy
1.Respect
2. Zero tolerance
7. Confidence and Self Esteem
8. Engagement
4. Ability to Complain

20. Questions ?