Safeguarding and the Care Act 2014

Safeguarding and the Care Act 2014 Jay Aylett Safeguarding Adults Service Manager

Highlights for Adult Safeguarding under the Care Act 2014 • Statutory Safeguarding Adults Board – members dutiesto co-operate • Local Authorities dutyto make enquiries – free standing enquiries distinct from assessment and care planning functions • Requirement for Independent Advocacy to support the principles of Making Safeguarding Personal • Duty of Candour and crimes of false or misleading information

Key Safeguarding Sections of Care Act • Section 42- Enquiry by local authority • Section 43- The function of the Safeguarding Adults Board (SAB) • Section 44- The management of Safeguarding Adult Review (Serious Case Reviews) • Section 45- Supply of Information • Chapter 14 – Care and Support Statutory Guidance Issued under the Care Act 2014 Updated March 2016.

Adult safeguarding – what it is and why it matters Safeguarding means- • protecting an adult’s right to live in safety, free from abuse and neglect. (PROTECTION) • people and organisations working together to prevent and stop both the risks and experience of abuse or neglect, (PREVENTION AND PARTNERSHIP) • while at the same time making sure that the adult’s wellbeing is promoted including, (PROPORTIONALITY) • where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action. (PERSONALISATION) This must recognise that adults sometimes have complex interpersonal relationships and may be ambivalent, unclear or unrealistic about their personal circumstances.

14.11. The aims of adult safeguarding are to: • stop abuse or neglect wherever possible; • prevent harm and reduce the risk of abuse or neglect to adults with care and support needs; • safeguard adults in a way that supports them in making choices and having control about how they want to live; • promote an approach that concentrates on improving life for the adults concerned; • raise public awareness so that communities as a whole, alongside professionals, play their part in preventing, identifying and responding to abuse and neglect; • provide information and support in accessible ways to help people understand the different types of abuse, how to stay safe and what to do to raise a concern about the safety or well-being of an adult; and • address what has caused the abuse or neglect.

Safeguarding and self -neglect • Statutory guidance states makes clear that self neglect is a safeguarding issue if the adult concerned has care and support needs, but…… • Intervention most likely to be achieved under other parts of the act dealing with information and advice, assessment and care planning • It is vital to establish the adults mental capacity to make decisions about their well being • Exercise proportionality in striking a balance between respect for individual autonomy and duty to promote health and well being. (Human rights principles can be argued both ways….so evidence your decision making)

Safeguarding and self -neglect It may be reasonable not to intervene where: • no-one else is at risk • their adults 'vital interests' are not compromised – that is, there is no immediate risk of death or major harm • all decisions are fully explained and recorded • other agencies have been informed and involved as necessary. Research (SCIE 2011*)indicates that intervening successfully depends on practitioners taking time to gain the person's trust and build a relationship, and going at the person’s own pace. *SCIE Report 46: Self-neglect and adult safeguarding: findings from research

The missing links • We do not have any additional ‘investigative powers – power of entry or interview in private, removal of person causing concern • We do not have additional legal powers of intervention – we must use what is already in existence • We do not have to reach conclusions about abuse substantiated – focus on outcomes for the adult (MSP) • House of Lords committee has already criticised the sector for a lack of legal literacy in relation to the application of the Mental Capacity Act 2005

Care Act 2014 Section 42 Enquiry by local authority • (1)This section applies where a local authority has reasonable cause to suspect that an adult in its area (whether or not ordinarily resident there)— • (a) has needs for care and support (whether or not the authority is meeting any of those needs), • (b) isexperiencing, or is at risk of, abuse or neglect, and • (c) as a result of those needs is unable to protect himself or herself against the abuse or neglect or the risk of it.

When should an enquiry take place? • 14.77. Local authorities must make enquiries, or cause another agency to do so, whenever abuse or neglect are suspected in relation to an adult and the local authority thinks it necessary to enable it to decide what (if any) action is needed to help and protect the adult. • The scope of that enquiry, who leads it and its nature, and how long it takes, will depend on the particular circumstances. It will usually start with asking the adult their view and wishes which will often determine what next steps to take.

Local Authorities role in carrying out enquiries • 14.65. The purpose of the enquiry is to decide whether or not the local authority or another organisation, or person, should do something to help and protect the adult. If the local authority decides that another organisation should make the enquiry, for example a care provider, then the local authority should be clear about timescales, the need to know the outcomes of the enquiry and what action will follow if this is not done.

Local Authorities role in carrying out enquiries • 14.64. An enquiry is the action taken or instigated by the local authority in response to a concern that abuse or neglect may be taking place. An enquiry could range from a conversationwith the adult, or if they lack capacity, or have substantial difficulty in understanding the enquiry their representative or advocate, prior to initiating a formal enquiry under section 42, right through to a much more formal multi-agency plan or course of action. Whatever the course of subsequent action, the professional concerned should record the concern, the adult’s views and wishes, any immediate action has taken and the reasons for those actions.

Flowchart for Adult Protection Information or concern received by KASS Immediate discussion with line manager. Is urgent action required? Inter agency planning meeting to plan enquiries Enquiry Officer allocated. Police enquiries take priority KASS monitor and oversee - but most appropriate agency involved in leading enquiries Case conference to discuss outcomes of enquiries and plan responses Ongoing monitoring of plans for intervention

Safeguarding Adults Boards – what are they for • Although they are a statutory requirement they are given few mandatory functions so it will depend on local interpretation • Statutory and mandatory is the decision to undertake Safeguarding Adults Reviews (SAR’s) • Mandatory member are the Local Authority, NHS and Police but other can be invited • Board must publish and strategic plan and report annually on it’s implementation (including findings of any SAR’s) • Members can contribute financially but are not obligated to • Members have a duty to provide relevant information – no enforcement mechanism

Multi-agency working • 14.51. Local authorities must cooperate with each of their relevant partners, as described in section 6(7) of the Care Act, and those partners must also cooperate with the local authority, in the exercise of their functions relevant to care and support including those to protect adults(see also chapter 15 which sets out general responsibilities in relation to co-operation). • 14.52. Relevant partners of a local authority include any other local authority with whom they agree it would be appropriate to co-operate (e.g. neighbouring authorities with whom they provide joint shared services) and the following agencies or bodies who operate within the local authority’s area including: • NHS England; • Clinical Commissioning Groups (CCGs); • NHS trusts and NHS Foundation Trusts; • Department for Work and Pensions; • the Police; • Prisons; and • Probation services

A few learning points from SAR’s in Kent & Medway • The vulnerable adult is the primary client who should be at the heart of the protection process • To be wary of diagnostic overshadowing • We should never accept a situation as unchangeable simply because it is chronic • Caution about changing an older adult’s living environment should not preclude moving that person from an abusive or neglectful situation

Finally…… • Thank you for listening • Any questions or comments

Safeguarding and the Care Act 2014