1. Safeguarding Adults Level 2
For all clinical staff.
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2. Safeguarding Adults Law is covered by the Care Act 2014
What is Safeguarding Adults?
Safeguarding Adults Law is covered by the Care Act 2014
It applies to those people over 18 years of age :
Who have needs for care and support (whether or not the local authority is meeting any of those needs) and;
is experiencing, or at risk of, abuse or neglect; and
as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect.’’.
Also a carer may experience intentional or unintentional harm from the adult they are trying to support or from professionals and organisations they are in contact with
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3. Consider each principle in all aspects of safeguarding adults
Safeguarding Adults Principles
There are six key principles defined by the Care Act 2014
Empowerment: Presumption of person led decisions and consent
Protection: Support and representation for those in greatest need
Prevention: Prevention of neglect, harm and abuse is a primary objective
Proportionality: Least intrusive response appropriate to the risks presented
Partnership: Local solutions through services working with communities
Accountability: Accountability and transparency in delivering safeguarding
Consider each principle in all aspects of safeguarding adults
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4. Who Abuses Adults Anyone
Who has POWER over others, this can be by being a Social or Health Care Professional, a paid carer or unpaid carer, a family member of friend
THINK
WHAT have you seen in practice that has made you think abuse may have taken place??
Often it can be a feeling that things are not right, that service users are not getting treatment provided in a way we would accept, or that they are being exploited by others.
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5. There are 10 different categories of abuse
Think about the Ten types of abuse that can take place;
Physical Abuse
These are often ones you would recognise easily as abuse
Hitting, Punching, Slapping, Kicking, Drowning, Shaking, Biting
Restraint, Medication, Lap Belts, Locked Doors
These are not so obvious but can be associated with abuse if not used properly
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6. Possible Observed Practices
Sexual Abuse
Direct or indirect involvement in sexual activity without consent or ability to give consent, this includes rape, indecent assault, indecent exposure or exposure to explicit sexual behaviour, material or images.
Possible Observed
Signs and Symptoms
Possible Observed Practices
Sexually transmitted diseases or pregnancy
New tendency of withdrawn behaviour
Tears or bruises in genital/ anal areas
Soreness when sitting
Sexualised behaviour
Deliberate Self Harm
Incontinence and bedwetting
Excessive washing
Sexual acts the person hasn’t consented to, was pressurised into consenting to
Touching inappropriately
Penetration
Indecent exposure
Taking photographs
Using in appropriate language
Think: Preserving evidence can include supporting the victim not to wash/shower before evidence is collected
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7. Possible Observed Practices
Neglect or Acts of Omission
Failure to provide access to Health, Social or Educational Services, withholding daily necessities or basic care i.e. nutrition, clothing, shelter and warmth.
Possible Observed
Signs and Symptoms
Possible Observed Practices
Untreated physical illnesses
Inconsistent or reluctant contact with health or social care agencies
Lack of safety equipment being used following recommendation
Clear failure to ensure the taking of medication appropriately
Dehydration/weight loss/ malnutrition
Withholding of ‘necessaries’ e.g. nutrition, medication, healthcare, education, social stimulation
Withholding assistance to use toilet, keep clean, warm and comfortable
Avoidable Pressure Ulcers
Repeated Falls
Failure to ensure privacy and dignity in living conditions
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8. Possible Observed Practices
Psychological Abuse
Acts or behaviour affecting the emotional health causing distress or anguish to individuals including threats of harm or abandonment, isolation, humiliation, blaming, controlling or hostile behaviour.
Possible Observed
Signs and Symptoms
Possible Observed Practices
Deprivation of privacy, dignity or choice
Difficulty gaining access to the adult on their own
Low self-esteem, lack of confidence and anxiety
Sharp changes in behaviour in the presence of certain persons
Self abusive behaviour – self mutilation, head banging
Loss of weight
Disturbed sleep
Shouting ,swearing, name calling
Bullying
Insulting, humiliating, ridiculing
Intimidating
Controlling behaviour
Control of access (family, friends, phone, post, pull cord, visitors)
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9. Possible Observed Practices
Financial or Material Abuse
Includes theft, fraud, exploitation, pressure in connection with
wills or estates, misuse or appropriation of property and
possessions or benefits.
Possible Observed
Signs and Symptoms
Possible Observed Practices
Unexplained or sudden inability to pay bills
Unexplained or sudden withdrawal of money
Personal possessions of value go missing from home without explanation
Someone has taken responsibility for paying bills, rent, buying foot etc. but is clearly not doing so
Exploitation of dependence for personal gain
Prevention of necessary care options
Misuse of funds, including lack of ‘best interest’ decisions
Pressure or misappropriation of property, wills, bank accounts, benefits or assets
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10. Possible Observed Practices
Discriminatory Abuse
This abuse is motivated by discriminatory and oppressive attitudes towards a person due to their race, gender, cultural background, religion, physical and/or sensory impairment, sexual orientation and age. Discriminatory abuse manifests itself as any of the other categories of abuse.
Possible Observed
Signs and Symptoms
Possible Observed Practices
Omitting services or activities based on preconceived ideas about someone’s age or condition
Cultural or religious needs are not being met
Direct or indirect discrimination based on race, gender, culture, disability, sexuality, religion, belief or values
Harassment
Incitement of others to commit abusive acts or make abusive comments
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11. Organisational Abuse
Abuse by an organisation imposing rigid and insensitive routines; unskilled, intrusive or invasive interventions; or an environment allowing inadequate privacy or physical comfort.
Possible Observed
Signs and Symptoms
Possible Observed Practices
Poor care planning
Inflexible routines
Little opportunity for outside activities
Lack of privacy
Poor staff morale, high turnover, high sickness rate
Few visitors and/or staff insistent on notification before visits
Inadequate staffing or insufficient knowledge base within the service.
The routine/practice or management that is not responsive to or respectful to the individuals served
Often described as “thoughtless” practice or “we always do it this way” or “this is how we do it here”
Home care workers not providing care that has been assessed for
Bad practice that is not addressed by the institution
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12. Possible Observed Practices
Domestic Abuse
Incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse by someone who is or has been an intimate partner or family member regardless of gender or sexuality
Possible Observed
Signs and Symptoms
Possible Observed Practices
including psychological, physical, sexual, financial, emotional abuse;
so called ‘honour’ based violence
Female Genital Mutilation;
Forced marriage
people being prevented from seeing family/friends,
prevented from attending college/work/appointments,
being followed or continuingly being asked where they are,
accusations regarding other relationships unjustly,
feeling scared of others,
being threatened personally or threats against other family/friends,
prevented from leaving the home, withholding finances,
being forced to do something unwanted for their partner
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13. Possible Observed Practices
Modern Slavery
Encompasses slavery, human trafficking, forced labour and domestic servitude. Trafficking does not need to be through international borders, it is any movement of a person for exploitive gain
Possible Observed
Signs and Symptoms
Possible Observed Practices
Traffickers and slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment
Poor physical appearance,
isolation, poor living conditions,
few or no personal effects,
restricted freedom of movement,
unusual travel habits,
reluctance to seek help
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14. Possible Observed Practices
Self Neglect
This covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding. Self-neglect may or may not be a safeguarding issue, however agencies must assess concerns raised under their statutory duties; having consideration for an individual’s right to choose their lifestyle, balanced with their mental health or capacity to understand the consequences of their actions.
Possible Observed
Signs and Symptoms
Possible Observed Practices
Dehydration
Malnutrition
untreated or improperly attended medical conditions, and poor personal hygiene
hazardous or unsafe living conditions/arrangements (e.g., improper wiring, no indoor plumbing, no heat, no running water)
unsanitary or unclean living quarters (e.g., animal/insect infestation, no functioning toilet, faecal/urine smell)
lack of the necessary medical aids (e.g., glasses, hearing aids, dentures, walking aids);
grossly inadequate housing or homelessness.
Self-neglect generally manifests itself as a refusal or failure to provide himself/herself with
adequate food,
water,
clothing,
shelter,
personal hygiene,
medication (when indicated),
safety precautions
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15. Question
Continue
One of your patients/service users tells you they are fed up with their grandchildren hitting them and demanding money. What type of abuse is this?
Financial
Physical
Emotional
Physical & Financial
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16. Question
Continue
One of your patients/service users tells you they were hit by another patient on more than one occasion. What type of abuse is this?
Physical
Physical & Financial
Emotional
Financial
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17. What to do if you suspect abuse or someone discloses that abuse has happened
If there is a disclosure or you witness abuse, ensure you record factual information, what the service user said, what questions you ask and what they replied.
Consider the mental capacity of the person with regard to the disclosure and actions they want you to take.
If you are not sure what you have seen, then talk to your manager, someone senior or safeguarding team immediately. Team work is essential in supporting each other to recognise and report situations that could be abusive.
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18. Protection of Evidence
Record all actions accurately
If there are items you think may be used as evidence do not handle them unless you have to
Any written evidence can be copied to preserve this
Ask for assistance as soon as possible if you think a criminal investigation may be required. The police will advise on preservation of evidence in each circumstance.
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19. What to do if someone discloses abuse or is at risk of abuse
The service users immediate safety needs must be met. This may include use of emergency service or out of hours teams.
Ensure any immediate protection needs are addressed.
Inform your manager immediately. Complete the Safeguarding Alert Form.
Ensure that the Safeguarding Concern Form has been sent to the appropriate people.
Contact the Safeguarding Team if you need further help and advice
Remember
Complete a DATIX Form and attach the safeguarding alert form
You must make sure you know who needs to be informed about the potential abuse.
See the SEPT Safeguarding Intranet page for details.
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20. No adult can be offered a confidential service
Confidentiality and Consent
No adult can be offered a confidential service
Whilst every effort should be made to ensure confidentiality is preserved, the disclosure of information which may assist in the prevention or detection of abuse is permissible
This applies both to information about third parties e.g. adults who may pose a risk of harm to children or about those who may be the subject of abuse
Staff should consult the Trust Safeguarding Policies or the Trust policy on Confidentiality CPG9
If you are uncertain about when to share confidential information, always seek advice from the Safeguarding Team or your line manager
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21. Safeguarding and Mental Capacity
Mental Capacity is the ability to:
Understand the information relevant to a specific decision
Retain that information
Use or weigh up that information
Communicate the decision (by talking, sign language or any other method)
Unless a person can achieve all four elements they lack capacity to make that particular decision.
Important to note
A capacity assessment must be undertaken where there are concerns that a person has not got capacity to make a specific decision
Best interests – anything done for or on behalf of people without capacity must be in their best interests
Least restrictive intervention – anything done for or on behalf of people without capacity should be in the least restrictive
Think about how the mental capacity of the victim will impact on the safeguarding process
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22. Deprivation of Liberty
The Government has added further provisions to the Mental Capacity Act 2005 called the Deprivation of Liberty (DOL) safeguards
The DOL process is a legal requirement where the deprivation of a person’s liberty to prevent them leaving a specific location, including a hospital ward or regulated care home is required in order to provide care or treatment needed
This only applies to those who lack capacity to consent to treatment or services being offered and who are not detained under the Mental Health Act.
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23. This completes the Adult’s section for level 2.
Please proceed to the Domestic Abuse part of the course.
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