Velindre NHS Trust Policy for the Protection of

Vulnerable Adults

Trust Policy Policy Lead: Diane Smith

Velindre NHS Trust

Ref: Black 47a

Trust Policy

Policy for the

Protection of Vulnerable Adults

Policy Lead:

Diane Smith, Executive Director of Nursing and Quality

(This policy must be read in conjunction with a “Model Procedure” for Reporting Suspected Abuse of Adults - Attached)

Contents

Page No
Introduction / 3
Which Adults are Vulnerable / 4-6
Core Values/Principles
/ 7-8
Monitoring Referrals
/ 9
References
/ 10

Introduction

The South Wales Adult Protection Forum (SWAP) was set up in 2000 following the publication of ‘In Safe Hands’ (Welsh Assembly Government) which called for the development and implementation of multi-agency policies and procedures to protect and support vulnerable adults from abuse and inappropriate care.

South Wales Inter-Agency Policy and Procedures were developed to enable a multi-agency response to the abuse of vulnerable adults. These were revised in 2004. This is coordinated locally by each Local Authority Social Services Department in collaboration with health, police and those agencies tasked with the care and protection of vulnerable adults. (Area Adult Protection Committee)

The South Wales Adult Protection Forum encompasses the seven Local Authorities of Bridgend, Cardiff, Merthyr Tydfil, Neath Port Talbot, Rhondda Cynon Taff, Swansea, the Vale of Glamorgan, the South Wales Police Authority together with seven LHB’s coterminous with the LA’s and the six NHS Trusts of Bro Morgannwg, Cardiff and Vale, North Glamorgan, Pontypridd and Rhondda, Swansea and Velindre.

(However each of the Police Authorities across Wales have developed their own policies and procedures. These can all be accessed via the ‘All Wales unit’ website @ www.allwalesunit.gov.uk)

Partner Agencies are both accountable and responsible for the implementation of their own policies/procedures and will have a responsibility to respond to suspicions, allegations or incidents of abuse as described in these procedures and instigation of any disciplinary proceedings that may arise from a breach of these procedures

The Trust Policy and Procedure has been developed to give staff information and guidance when dealing with Vulnerable Adults.

Definition

1. Which adults are vulnerable?

The broad definition of a vulnerable adult is:

‘A person who is 18 years of age or over, and who is or may be in need of community care services by reason of mental or other disability, age or illness and who is or may be unable to take care of him/herself, or unable to protect him/herself against significant harm or serious exploitation’.

(Law Commission - Who decides?: Making decisions on behalf of mentally incapacitated adults 1997).

1.1 Vulnerable adults include:

People with learning disabilities, mental health problems, older people and disabled people may fall within this definition, particularly when their situation is complicated by additional factors such as:

§  Physical frailty

§  Chronic illness

§  Sensory impairment

§  Challenging behaviour

§  Social problems

§  Emotional problems

§  Poverty

§  Homelessness

§  Substance abuse

1.2 In addition to information about this client group, Trust personnel should make note where clients are from either a ethnic or minority community and/or where they are Welsh speakers or where neither English nor Welsh is their first language.

1.3 What actions or omissions constitute abuse?

1.4 The term ‘abuse’ can be subject to a wide interpretation. The following definition of abuse provides the basis from which to develop practice:

Abuse is a violation of an individual’s human and/or civil rights by any other person or persons.

1.5 What are the categories and indicators of abuse?

Based on the categories of abuse provided by the In Safe Hands guidance, the following categories and possible indicators of abuse have been identified:

▪Physical Abuse:

Physical abuse – includes hitting, slapping, pushing, kicking, misuse of medication, undue restraint or inappropriate sanctions.

▪Sexual Abuse:

Sexual abuse – includes rape and sexual assault or sexual acts to which the vulnerable adult has not or could not consent and/or was pressured into consenting.

▪ Psychological Abuse:

Psychological abuse – includes threats of harm or abandonment, humiliation, verbal or racial abuse, isolation or withdrawal from services or supportive networks.

▪Financial Abuse:

Financial or material abuse – includes theft, fraud, pressure around wills, property or inheritance, misuse or misappropriation of benefits.

▪Neglect and/or Acts of Omission:

Neglect and acts of omission – includes failure to provide access to medical care or services, negligence in the face of risk-taking, failure to give prescribed medication, poor nutrition or lack of heating.

▪Racially motivated abuse:

Whilst not classified as an individual category of abuse, racially motivated abuse can take any of these forms and this needs to be noted additionally in situations when the victim perceives abuse to have been racist in its intent.

1.6 Criminal Offences:

Some instances of abuse will constitute a criminal offence. In this respect, vulnerable adults are entitled to the protection of the law in the same way as any other member of the public. In addition, statutory offences have been created which specifically protect those who may be incapacitated in various ways. See section 2 for further details.

1.7 Multiple forms of abuse:

These are often seen in ongoing relationships or an abusive service setting, making it important to look beyond single incidents or breaches in standards to underlying dynamics and patterns of harm. Any or all these types of abuse may be perpetrated as a result of deliberate intent and targeting of vulnerable people, negligence or ignorance. Where it is difficult to determine the point at which more insidious and pervasive forms of oppression should be named as abusive, action should be taken to challenge services that discriminate against, and/or ignore the needs of minority groups.

Who may be the abuser?

Vulnerable adults may be abused by a wide range of people including relatives and family members, professional staff, paid care workers, volunteers, other service users, neighbours, friends, associates and people who deliberately exploit vulnerable people.

The Trust along with the social care agencies have a responsibility towards vulnerable victims and this will usually involve making an assessment of their needs and taking steps to protect them from further harm. The Trust’s role, powers and duties to the alleged abuser will vary and the action they will need to take will depend on whether the alleged abuser is:

§  A member of staff

§  A member of a recognised professional group

§  A volunteer

§  Another service user

§  A spouse, relative or member of the person’s social network

§  Someone who is also a carer in their own right

§  A neighbour, member of the public or stranger

1.8 Stranger abuse:

This will warrant a different kind of response than the response to abuse within an ongoing relationship or care setting. Nevertheless in some instances, it may be appropriate to use locally agreed inter-agency adult protection procedures to ensure that the vulnerable adult receives the services and support they need. Such procedures may also be used when there is the potential for harm to other vulnerable people.

In what circumstances may abuse occur?

Abuse may occur when a vulnerable adult lives alone or with a relative or friend (s) It may also occur within a nursing, residential or day care setting, in hospitals, custodial situations or in people’s homes. It can also occur in places previously assumed safe or in public.

Core Values:

The following core values will always be recognised and adhered to by Trust employees in respect of every vulnerable adult.

§  Privacy – the right of individuals to be left alone or undisturbed and free from intrusion or public attention into their own affairs.

§  Dignity – the recognition of the intrinsic value of people regardless of circumstances by respecting their uniqueness and their personal needs; treating people with respect.

§  Independence and self-determination – the opportunity to act and think without reference to another person, including a willingness to incur a degree of personal risk.

§  Choice – the opportunity to select independently from a range of options.

§  Rights – the maintenance of all entitlements associated with citizenship.

§  Fulfilment – the realisation of personal aspirations and abilities in all aspects of daily life.

Core Principles

The following core principles will always apply in responding to suspicions, allegations or incidents of abuse involving vulnerable adults acknowledging:

§  that the person’s right to self-determination and involvement in decision making is promoted to the fullest capacity.

§  that the person is enabled to protect him or her self from harm.

§  the involvement of others significant to the person’s life are identified and supported.

§  that awareness and understanding of other agencies, organisations and the public is raised and promoted together with a commitment to respond.

§  that response is appropriate and only as intensive as the situation demands.

§  that the person is enabled, where possible, to live in the environment of their choice and this includes supporting families to remain together. Where this is not possible, maximum choices are given to where the person wants to live.

§  Vulnerable adult and the alleged abuser has the right to the protection of the law.

§  Vulnerable adult will have the opportunity and right to comment or complain about the service they receive.

Vulnerable adults will have the opportunity and right to independent advice and advocacy when they request it. This will also apply to those vulnerable adults who are incapable of making such a request but are deemed in need of such independent advice and advocacy.

Note

Detailed information on local policies and procedures across Wales can be found in www.allwalesunit.gov.uk

Monitoring of Referrals

The Executive Director of Nursing is the Board Lead for the Protection of Vulnerable Adults. A group has been set up with representation from NPHS, VCC and Screening Services to monitor referrals and training which is fed into the local AAPC’S as well as the SWAP Forum.

Learning Lessons from Referrals

It is important that the Trust uses the information from the referral process and outcome to ensure possible future referrals are handled in an appropriate and effective way.

Staff who have referred service users as possible victims of abuse will be involved in this process.

References

1. / National Assembly for Wales (2000). In Safe Hands – Protection of Vulnerable Adults National Assembly for Wales.
2. / South Wales Adult Protection Forum (2001). Protection of Vulnerable Adults – Inter-Agency Policy and Procedures for responding to Alleged Abuse and Inappropriate Care of Vulnerable Adults in South Wales.
3. / South Wales Adult Protection Forum (2004). Protection of Vulnerable Adults – Inter-Agency Policy and Procedures for responding to Alleged Abuse and Inappropriate Care of Vulnerable Adults in South Wales.

1

Ref: Black 47a Issue no 3

Approved by: Executive Board Approved Date: July 2006

Next Review Date: July 2009 Page 1 of 10