Safeguarding Adults

1. What is it?  Why have it?  What next? Safeguarding Adults Louise Tanner, Learning and Development Officer Safeguarding Adults Team, Manchester City Council 0161 234 3793 Safeguardingadultstraining@manchester.gov.uk

2. T.L.A. bingo…  M.C.A. 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. Manchester Safeguarding Childrens Board Serious Case Review 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 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 2018 Government Guidance ‘No Secrets’ Care Act Mental Capacity Act 14th May 2014 Introduction of MSP Safeguarding became statutory 1st April 2015 Today 2012 and ongoing 7th April 2005 Consultation on the Review of ‘No Secrets’ Consultation on Care and Support Bill 20th March 2000 2011 2000 2005 2006 2007 2008 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’

11. 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 Types of Adult Abuse:

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)

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…

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

24.  What is it?  Why have it?  What next…? Thanks for listeningAny questions? Manchester Contact Service: 0161 255 8250 mcsreply@manchester.gov.uk “I want to report an adult safeguarding concern”

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.”