BOROUGH OF POOLE
COMMUNITY SUPPORT & EDUCATION SCRUTINY COMMITTEE
REPORT OF HEAD OF ADULT SOCIAL SERVICES
ADULT PROTECTION
1. PURPOSE OF THE REPORT
1.1 This report presents the 2006/2007 Bournemouth, Dorset and Poole Adult Protection Committee Annual Report (Appendix 1) In particular it summarises the development of Adult Protection in Poole and sets out the priorities for 2007/2008.
2. RECOMMENDATIONS
2.1 To inform members of the Adult Protection developments in Poole in 2006/2007 and the priorities for 2007/2008.
2.2 Community Support and Education Scrutiny Committee continue to receive subsequent annual reports on Adult Protection setting out performance against an agreed action plan.
3. WHAT IS ADULT PROTECTION?
3.1 Adult Protection is a framework that enables organisations to protect adults who are considered to be vulnerable from a variety of abusive situations.
3.2 A vulnerable adult is a person who is, or maybe in need of Community Care Services by reason of mental or other disability, age or illness. They may be unable to protect themselves against significant harm or exploitation.
3.3 Abuse is a violation of an individual's human rights by a person or persons. It can consist of a single or repeated act(s) of a physical, verbal or psychological nature. There are seven main categories: physical; sexual; financial or psychological abuse; neglect; institutional abuse; and discrimination.
3.4 Adult Protection is a multi-agency approach involving Social Services, Primary Care Trusts, Hospital Trusts, Dorset Police, Crown Prosecution Service as well as residential nursing homes, housing and the voluntary sector.
4 BACKGROUND OF THE REPORT
4.1 The Department of Health produced the "No Secrets" guidance in November 2000. It states that Partners should work together to create a multi-agency framework to prevent abuse where possible. If, however, a preventative strategy fails, they must ensure that robust procedures are in place for dealing with incidents of abuse. Adult Social Services have the responsibility to investigate and take action, when a person is alleging to be suffering abuse.
4.2 The "No Secrets" policy is designed to ensure that all Councils with Adult Social Services responsibility have in place policy and procedures, so there is a framework for action within which all responsible Agencies work together to protect vulnerable adults at risk of abuse.
4.4 In responding locally to "No Secrets" extensive work is taking place with a wide range of partners, including the police, social and health care agencies to produce a local Adult Protection Policy. This is about to be distributed to approximately 600 Health and Social Care Agencies in Dorset, Bournemouth and Poole, together with an invitation to organisations to sign an agreement to work within the guidelines of the policy.
4.5 The major features of the policy for the partner organisations are:
- the awareness of staff and volunteers about the potential for abuse to
occur and heightened sensitivity to this;
and:
- the appropriate action they should take in circumstances where they
suspect or are aware that abuse is taking place.
4.6 In general this will lead them to report concerns to Police and or/Social services for further enquiries and possible investigation.
4.7 In keeping with national good practice guidelines, a multi-agency Adult Protection Committee has been established in partnership with Bournemouth Borough Council and Dorset County Council. The annual report of this committee is attached in Appendix 1.
5. ANALYSIS OF POOLE ADULT PROTECTION REFERRALS 2006/2007
5.1 Risk factors that increase the possibility of abuse include the social isolation of the vulnerable adult, and the history of poor relationships between the abuser and the victim. The abuser may have a problem with mental ill health, drug or alcohol abuse. In care settings, abuse may be a symptom of poorly run establishments. It appears that it is most likelyto occur when staff are inadequately trained, poorly supervised, have little support from management or work in isolation.
5.2 Details of adult abuse referrals in relation to Poole residents are outlined in Appendix 2. In Figure 1 there were 205 reported incidents of abuse in the Borough of Poole during 2006/2007 compared with 123 in 2005/2006. It is difficult to state whether this increase is due to a higher incidence or an increased likelihood of reporting due to greater knowledge on behalf of the Public and those working with vulnerable adults. It is now a statutory requirement for all staff within Poole Adult Social Services to attend adult protection awareness training every three years, and the independent voluntary sector are also encouraged to use this training.
5.3 In Figure 2, it is clear that older people are the client group most vulnerable to abuse. For example, in 2005 there were 28,600 people in Poole aged over 65 years which comprised 21% of the total population, compared with national average of 16%. The projection for 2008 is that there will be 29,500 aged 65+ in Poole. Older people are also a client group who are much more isolated and more often in need of Community Care Services.
5.4 The second most common client group who are vulnerable to abuse are people with learning disabilities. Typically, within this client group, the perpetrator tends to also be a vulnerable service user with a learning disability, often living together in the same residence.
5.5 Analysis of the data in Figure 4 shows that the most common form of abuse recorded is physical abuse, followed by neglect as the second most common. Financial abuse is highlighted as the third most common type of abuse suffered by vulnerable adults. Further investigation is needed in relation to how clients manage their finances on a day to day basis. With the introduction of the Mental Capacity Act, the Borough of Poole may be able to reduce this occurrence in the long-term and actually safeguard to prevent this abuse from occurring so often.
5.6 The majority of abuse occurs in the person's own home or in the homes of close relatives; the second main setting being residential/nursing home. Working with care providers, the Commission for Social Care Inspection (CSCI), relatives and friends we are able to investigate these incidences and by influencing the contracts and commissioning sections of Adult Social Services and the Primary Care Trust work to improve the standards of Care. Adult Social Services contract monitoring check that care providers have adult protection guidance policy in place, and staff are adequately trained in adult protection awareness.
5.7 Where clients are the perpetrators it is important to look in more detail at the incidences themselves in order to identify trends and contributing factors. For example it may be that two clients should not be living in the same supported accommodation because they are vulnerable to each other. It may be that staff are not managing the perpetrators behaviour effectively and therefore abuse is the outcome of this.
5.8 Reducing the abuse that occurs behind closed doors, away from view, is our greatest challenge. We know from the lessons of child protection and domestic violence that inter-generational abuse within families poses very real dilemmas for potential alerters.
6. PROTECTION DEVELOPMENTS IN POOLE 2006/2007
6.1 In September 2006, Debbie Bailey was appointed to the post of Principal Officer with a lead in Adult Protection.
6.2 Alerters Training became mandatory for all Adult Social Services employees. Poole have also continued to encourage care providers to attend the Alerters Training.
6.3 There were three Investigators Workshops in the year. Investigators Training has increased to 7 days including a consolidation day after 3 months of the initial training, where investigators can reflect on their first cases. By the end of the financial year, 30 staff have been trained as investigators.
6.4 All Managers who directly supervise investigators undertook a two-day Manager Training Course.
6.5 Mental Capacity Act training for investigators was undertaken during the year to enable police and adult social services staff to become more familiar with the implications of the Act and work together on real case examples.
6.6 The Principal Officer has ensured that there are well established links with the Contract Monitoring section particularly in relation to joint working on investigations into services which are contracted to Adult Social Services.
6.7 The introduction of the Mental Capacity Act in April 2007 means that the Borough of Poole are now formally assessing client's capacity and are now to commission Independent Mental Capacity Advocates (IMCA's) for Adult Protection uses where appropriate, particularly if the perpetrator is a family member or potential conflicts in any decision making.
7. 2007/2008 ACTION PLAN
Mia Lloyd appointed to the new post of Senior Practitioner, Adult Protection. The Principal Officer and Senior Practitioner are made aware of every Adult Protection alert and investigation in the Borough of Poole, including its progress and quality of the investigation. The Senior Practitioner attends various Adult Protection Case conferences, to ensure there is an overview of the cases which are currently active. / April 2007Introduction of 2 day Manager Training Course for Managers who directly supervise investigators. Includes training on chairing Adult Protection strategy and case conference meetings. / April 2007
Introduction of 3 year refresher course for Alerters training. / May 2007
Introduction of Borough of Poole Adult Protection Newsletter for all workers and managers providing them with up to date information on new developments and research. Produced on the first Friday of every month. / June 2007
Serious case review protocol agreed in order to look at lessons learned and how practice can be improved for the future. / August 2007
Large scale investigation protocol to be agreed with Primary Care Trusts and the Commission for Social Care Inspection in order to provide clarity to agencies on their roles and responsibilities. / November 2007
New Adult Protection leaflet developed for service users, to enable vulnerable adults to have access to information on Adult Protection which they can understand (includes an easy read version). / December 2007
Introduction of more detailed database on Adult Protection. / January 2008
Quality Assurance Audit of adult protection investigations and outcomes to be completed / February 2008
Appointment of Adult Protection Minute Taker / March 2008
JOHN DERMODY
29 September 2007
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