Safeguarding of Adults at Risk Care Act Briefings

Safeguarding of Adults at Risk Care Act Briefings Welcome 6th March 2015 Neil Lee

Safeguarding of Adults at Risk Care Act Briefings • House Keeping • Group Agreement

Aims • Overview of references to Safeguarding in the Care Act • Discussion of sections relevant to Safeguarding • Explore implications for your service

Objectives • Explain what changes have impacted on Safeguarding Adults • Describe the changes in terminology • Identify policy and procedure with your service

Ice Breaker • On the back page of your power point handout please write down what Safeguarding Adults is to you

What is the Care Act? • New Legislation - Consolidating over 40 separate pieces of legislation • Two Phase Implementation – April 2015 and April 2016 • Providing support based on a person’s overall wellbeing and promotion of independence • Putting people’s needs, goals and aspirations at the centre of care and support • Supporting people to make their own decisions and realise their potential • Information and Advice provision

Why Have A Care Act? • Concerns about: • “Patchwork” of community care legislation • Duties v powers • Concerns for: • Carers • Safeguarding Adults

General Responsibilities Promoting Wellbeing: Wellbeing is a broad concept and it is described as relating to the following areas in particular: • Personal Dignity (including treatment of the individual with respect) • Physical and mental health and emotional wellbeing • Protection from abuse and neglect • Control by the individual over day-today life (including over care and support provided and the way it is provided) • Participation in work, education, training or recreation • Social and economic wellbeing • Domestic, family and personal relationships • Suitability of living accommodation • The individual’s contribution to society

Aims of Safeguarding Adults • Care Act Guidance: • To prevent harm and reduce the risk of abuse or neglect to adults with care and support needs • To safeguard individuals in a way that supports them in making choices and having control in how they choose to live their lives • To promote an outcomes approach in safeguarding that works for people resulting in the best experience possible • To raise public awareness so that professionals, other staff and communities as a whole play their part in preventing, identifying and responding to abuse and neglect • Adult safeguarding means protecting a persons right to live in safety, free from abuse and neglect

Six Values & Principles • DH & Care Act • Empowerment • Prevention • Protection • Partnerships • Proportionality • Accountability • In groups discuss and feedback how we achieve these in practice

What Safeguarding Isn’t • Safeguarding is not a substitute for: • Providers’ responsibility to provide safe and high quality care and support • Commissioners regularly assuring themselves of the safety and effectiveness of commissioned services • The Care Quality Commission (CQC) ensuring that regulated providers comply with the fundamental standards of care by taking enforcement action • The core duties of the Police to prevent and detect crime and protect life and property

Safeguarding Process Adult At Risk: • Care Act – Section 42 • Where a local authority has reasonable cause to suspect that an adult in its area (whether or not ordinarily resident there) • Has needs for care and support (whether or not the authority is meeting any of those) • Is experiencing, or is at risk of abuse or neglect and • As a result of those needs is unable to protect himself or herself against the abuse or neglect or the risk of it http://www.legislation.gov.uk/ukpga/2014/23/section/42/enacted

Safeguarding Process (cont) Enquiry by local authority: • Care Act – Section 42 • Where a local authority…. • The local authority must make (or cause to be made) whatever enquires it thinks necessary to enable it to decide whether any action should be taken in the adults case (whether under this part or otherwise) and, if so, what and by whom • An enquiry could range from: • A conversation with 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 • Everything must be recorded i.e. the concern, the adult’s views and wishes, any immediate action has taken and the reasons for those actions.

Safeguarding Process (cont) Enquiries: • What is suitable, relevant and proportionate enquiry? • Wishes and choices of the person concerned • Influenced by nature of the incident • Shaped by the intent • Is it always multi agency?

Purpose of Enquiry • 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 • What happens as a result of an enquiry should reflect the adult‘s wishes wherever possible, as stated by them or by their representative or advocate • The adult should always be involved from the beginning of the enquiry unless there are exceptional circumstances that would increase the risk of abuse. If the adult has substantial difficulty in being involved, and where there is no one appropriate to support them, then the local authority must arrange for an independent advocate to represent them for the purpose of facilitating their involvement

Objectives of Enquiry • Establish facts • Ascertain the adult’s views and wishes • Assess the needs of the adult for protection, support and redress and how they might be met • Protect from the abuse and neglect, in accordance with the wishes of the adult • Make decisions as to what follow-up action should be taken with regard to the person or organisation responsible for the abuse or neglect • Enable the adult to achieve resolution and recovery

What an Enquiry Should Take Into Account It is important, when considering the management of any intervention or enquiry, to approach reports of incidents or allegations with an open mind. In considering how to respond the following factors need to be considered: • The adult’s needs for care and support • The adult’s risk of abuse or neglect • The adult’s ability to protect themselves or the ability of their networks to increase the • Support they offer

What an Enquiry Should Take Into Account (cont) • The impact on the adult, their wishes • The possible impact on important relationships • Potential of action and increasing risk to the adult • The risk of repeated or increasingly serious acts involving children, or another adult at risk of abuse or neglect • The responsibility of the person or organisation that has caused the abuse or neglect • Research evidence to support any intervention

Responding In a Regulated Care Setting • It is important that all partners are clear where responsibility lies where abuse or neglect is carried out by employees or in a regulated setting, such as a care home, hospital, or college • The first responsibility to act must be with the employing organisation as provider of the service. However, social workers or counsellors may need to be involved in order to support the adult to recover • When an employer is aware of abuse or neglect in their organisation, then they are under a duty to correct this and protect the adult from harm as soon as possible and inform the local authority, CQC and CCG where the latter is the commissioner

Definition & Types of Abuse • No longer a definition • There is a list defined in the Act but is not intended to be an exhaustive list but an illustrative guide as to the sort of behaviour which could give rise to a safeguarding concern • What are the types of Abuse? Discuss and feedback

Other Sections • Section 43 • Safeguarding Adults Boards • Section 44 • Safeguarding Adults Review • Section 45 • Supply of information

Section 43 Safeguarding Adults Boards: • The objective of an SAB is to help and protect adults in its area in cases of the kind described in Section 42 (1) • An SAB may do anything which appears to it to be necessary or desirable for the purpose of achieving its objectives • The SAB must: • Publish a strategic plan for each financial year that sets how it will meet its main objective and what the members will do to achieve this • Publish an annual report • Conduct any Safeguarding Adults Reviews in accordance with Section 44 of the Act http://www.legislation.gov.uk/ukpga/2014/23/section/43/enacted

Section 44 Safeguarding Adults Review: • Must be arranged where reasonable cause for concern about how the SAB, members of it or other persons with relevant functions worked together to safeguard the adult • And either: • The adult has died, and the SAB knows or suspects that the death resulted from abuse or neglect (whether or not it knew about or suspected the abuse or neglect before the adult died) • The adult is still alive, and the SAB knows or suspects that the adult has experienced serious abuse or neglect http://www.legislation.gov.uk/ukpga/2014/23/section/44/enacted

Case Study SAR • Read through the summarised case and in your groups discuss and consider: • What are the key issues? • How was this person failed and by who? • What is the learning?

Section 45 Supply Of Information: • Is an SAB requests information the request must be complied with • Information may be used by the SAB, or other person to whom it is supplied under subsection (1), only for the purpose of enabling or assisting the SAB to exercise its functions • Data Protection Act • Caldicott Principles • Patient Confidentiality • Information Governance • Information sharing agreements http://www.legislation.gov.uk/ukpga/2014/23/section/45/enacted

Designated Adult Safeguarding Manager • Each member of the SAB should have a Designated Adult Safeguarding Manager (DASM); • DASMs should keep in regular contact with their counterparts in partner organisations • They should also have a role in highlighting the extent to which their own organisation prevents abuse and neglect taking place • The DASM should provide advice and guidance within their organisation, liaising with other agencies as necessary • The DASM should monitor the progress of cases to ensure that they are dealt with as quickly as possible, consistent with a thorough and fair process • Referral of individual employees to the DBS and, or, Regulatory Bodies (e.g. CQC, HCPC, GMC, NMC) are made promptly and appropriately

Carers & Safeguarding • Assessment of both the carer and the adult they care for must include consideration of both their wellbeing • A needs or carer’s assessment is an important opportunity to explore the individuals’ circumstances and consider whether it would be possible to provide information, or support that prevents abuse or neglect from occurring, for example • By providing training to the carer about the condition that the adult they care for has or to support them to care more safely; • Where that is necessary the local authority should make arrangements for providing it

Carers & Safeguarding (cont) If a carer speaks up about abuse or neglect, it is essential that they are listened to and that where appropriate a safeguarding enquiry is undertaken and other agencies are involved as appropriate Other key considerations in relation to carers should include: • Involving carers in safeguarding enquiries relating to the adult they care for, as appropriate • Whether or not joint assessment is appropriate in each individual circumstance • The risk factors that may increase the likelihood of abuse or neglect occurring • Whether a change in circumstance changes the risk of abuse or neglect occurring

Advocacy • The advocacy duty will apply from the point of first contact with the local authority and at any subsequent stage of the assessment, planning, care review, safeguarding enquiry or safeguarding adult review • If it appears to the authority that a person has care and support needs, then a judgement must be made as to whether that person has substantial difficulty in being involved • If they do, is there an appropriate individual to support them? • An independent advocate must be appointed to support and represent the person for the purpose of assisting their involvement if these two conditions are met

Resources • The Care Act http://www.legislation.gov.uk/ukpga/2014/23/enacted • Care & Support Statutory Guidance https://www.gov.uk/government/publications/care-act-2014-statutory-guidance-for-implementation • SCIE Care Act Resources http://www.scie.org.uk/care-act-2014/ • Skills For Care Briefing http://www.skillsforcare.org.uk/Document-library/Standards/Care-Act/learning-and-development/care-act-implications-for-safeguarding-adults-briefing.pdf

Safeguarding of Adults at Risk Care Act Briefings • Video to recap • Any questions • Evaluations & Certificates

“The great end of learning is not knowledge, but action”Peter Honey Neil Lee 01132174571 07753283048 www.neilleetraining.co.uk neilleetraining@gmail.com Thank you

Safeguarding of Adults at Risk Care Act Briefings