Safeguarding Vulnerable Adults POLICY

Safeguarding Vulnerable Adults POLICY

NEC019

This policy is a North Essex Cluster policy.

NHS North Essex is a cluster of three primary care trusts working as a single organisation on behalf of Mid Essex PCT, North East Essex PCT and West Essex PCT

This document has been written as a North Essex cluster policy and replaces:

North East Essex PCT - Safeguarding Adults Policy
Mid Essex PCT – Safeguarding Vulnerable Adults Policy
West Essex PCT – Safeguarding Vulnerable Adults Policy

This document should be read in conjunction with the following documents:

Southend Essex and Thurrock Safeguarding Vulnerable Adults Guidelines (2010)
Southend Essex and Thurrock Information Sharing Protocol

And also in conjunction with the following NHS West Essex documents until they are replaced by a North Essex cluster policy:

Data Protection Act Policy
Information Governance Policy
Integrated Governance Strategy
Incident reporting policy
Consent to Treatment Policy
Recruitment and Retention Policy
Records Management Policy
Domestic Abuse Policy
Whistleblowing Policy
Safeguarding Children and Families Guidelines & Policy
Building Partnerships and Staying Safe – Prevent Strategy (November 2011)
Professional Codes of Conduct

Aims

The NHS North Essex cluster is committed to:

Ensuring that the welfare of adults is paramount at all times
Maximising people’s choice, control and inclusion and protecting their human rights
Working in partnership with others in order to safeguarding vulnerable adults
Ensuring safe and effective working practices are in place.
Supporting staff within the organisation.

Introduction

NHS North Essex operates as a cluster of three Primary Care Trusts – North East Essex, Mid Essex and West Essex. This policy sets out the roles and responsibilities of all staff within the NHS North Essex cluster in working together with other professionals and agencies in promoting adults welfare and safeguarding them from abuse and neglect.

This policy is intended to support staff working within the NHS North Essex cluster. It does not replace, but is supplementary to the Southend, Essex, Thurrock (SET) Safeguarding Adults Guidelines (2010) available at

Scope

This policy applies to all staff (permanent, seconded or temporary and volunteers of the NHS North Essex cluster as well as all people who work on behalf of the NHS North Essex (including independent contractors).

Definitions

A vulnerable adult is defined as:

any person aged 18 or over
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 maybe unable to take care of him or herself or unable to protect him or herself against significant harm or serious exploitation

No Secrets (2000) – Department of Health

Therefore all adults who meet the above criteria may be defined as “vulnerable”. Throughout this policy, the term “Vulnerable Adult” is used to refer to a service user who falls within the above definition.

Definition of abuse

Definitions of the types of abuse and adult safeguarding principles are identified within the Southend, Essex, Thurrock Safeguarding Adults Guidelines (2010) and include:

Physical abuse - including hitting, slapping, pushing, kicking, misuse of medication, restraint, orinappropriate sanctions;

Sexual abuse -including rape and sexual assault or sexual acts to which the adult has notconsented, could not consent to, or was pressured into consenting;

Psychological abuse - including emotional abuse, threats of harm or abandonment, deprivation ofcontact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, isolationor withdrawal from services or supportive networks

Financial or material abuse - including theft, fraud, exploitation, pressure in connection with Wills, property or inheritance or financial transactions, possessions or benefits

Neglect and acts of omission - including ignoring medical or physical care needs, failure toprovide access to appropriate health, social care or educational services, the withholding of essentials such as medication, adequate nutrition and heating

Discriminatory Abuse - including racist, sexist, that based on a person’s disability, and other formsof harassment, slurs or similar treatment

Institutional Abuse - can include any of the above and poor or unsatisfactory professionalpractice, or pervasive ill treatment or gross misconduct. It is abuse or mistreatment by a regime aswell as by individuals, within any setting where care is provided.

It is important that Trust staff are familiar with generally agreed definitions of types of abuse so thatappropriate decisions are made about whether information received may constitute abuse.

Duty to Safeguard Vulnerable Adults

Everyone has the right to live their lives free from violence and abuse. This right is

underpinned by the duty on public agencies under the Human Rights Act (1998) to interveneproportionately to protect the rights of citizens. These rights include

Article 2: ‘the Right to life’;

Article 3: ‘the Right to Freedom from torture’ (including humiliating and degrading treatment);

Article 8: ‘the Right to family life’ (one that sustains the individual).

Responsibilities of the NHS North Essex Cluster

The NHS North Essex cluster has signed up and accepts the principles laid down within the Essex Safeguarding Adults Board Guidelines. These include:

To take action to identify and prevent abuse from happening.
Respond appropriately when abuse has or is suspected to have occurred.
Ensure that the agreed safeguarding adults procedures are followed at all times, these are available at
Provide support, advice and resources to staff in responding to safeguarding adult issues.
Inform staff of any local or national issues relating to safeguarding adults.
Ensure staff are aware of their responsibilities to attend training and to support staff in accessing these events.
Ensure staff have access to appropriate training.
Ensure that the organisation has a dedicated staff member with an expertise in safeguarding adults.
Ensure staff have access to appropriate consultation and supervision regarding safeguarding adults.
Understand how diversity, beliefs and values of people who use services may influence the identification, prevention and response to safeguarding concerns.
Ensure that information is available for people that use services, family members setting out what to do if they have a concern (e.g. ASK SAL helpline).
Ensure that all employees who come in contact with vulnerable adults have a CRB check in line with the requirements of the Independent Safeguarding Authority Vetting and Barring Scheme.

Responsibilities of all staff

Follow the safeguarding policies and procedures at all times, particularly if concerns arise about the safety or welfare of a vulnerable adult.
Participate in safeguarding adults training and maintain current working knowledge.
Be familiar with the SET Safeguarding Adults Guidelines.
Discuss any concerns about the welfare of a vulnerable adult with their line manager and complete a SETSAF1 to formally report concerns.
Contribute to actions required including information sharing and attending meetings.
Work collaboratively with other agencies to safeguarding and protect the welfare of people who use services.
Remain alert at all times to the possibility of abuse.
Recognise the impact that diversity, beliefs and values of people who use services can have.

In addition,Managers have the following responsibilities:

To ensure that all their own staff members have adequate and appropriatetraining for their roles and responsibilities within Adult Safeguarding in line with the ESAB Training Strategy.
To provide support and advice (within their own competency) to all staff when dealing with Adult Safeguarding issues and to provide support, advice and resources to enable the Safeguarding Vulnerable Adults Lead to fulfil their role.
To provide a safe environment in which to work and receive services,

without fear of reprisal in accordance with the Whistleblowing Policy.

To encourage an atmosphere of openness so that staff can approach them with any concerns regarding Vulnerable Adults.

To ensure that safeguarding Vulnerable Adults becomes fully integrated into NHS systems.

Common Law

There is a common law Duty of Confidencewhere a person has a right to expect information given in confidence to be kept confidential by the person receiving the information, i.e. doctor and patient, solicitor and client.

The Duty of Confidenceis not absolute and disclosures can be justified if, when looked at, the information is not of a confidential nature and can be accessed elsewhere and if it is in the public interest to disclose the information (if a court orders the disclosure). When deciding on disclosing information without consent of the person the disclosure would have to be proportionate to the need to protect the vulnerable adult. If there is doubt whether to disclose such information the person wishing to share the information should obtain advice from their legal advisor.

Training

All staff should receive a basic Safeguarding Vulnerable Adults awareness training at a level according to their role and as stated within the Essex Safeguarding Adults Board Training Strategy. This should be refreshed as a minimum every two years.

Professional Leads

The named professional is responsible for Safeguarding Vulnerable Adults. They will provide a contact point for other agencies and is responsible for linking in with the wider network to share information.

Within the NHS North Essex cluster the professional leads for adult safeguarding matters are the Safeguarding Vulnerable Adults team:

Assistant Director for Safeguarding Vulnerable Adults

Safeguarding Vulnerable Adults Lead

Safeguarding Vulnerable Adults Nurse

Administrative Assistant for safeguarding Vulnerable Adults Team

How to Report Abuse

It is expected that all staff follow the SET Safeguarding Adults Guidelines (for full set of procedures see

If staff suspect a vulnerable person is being abused or is at risk of abuse, they are expected to report concerns to a line manager (unless they suspect that the line manager is implicated – in such circumstances the Whistleblowing Policy should be followed.
If at any time staff feel the person needs urgent medical assistance, they have a duty to call for an ambulance or arrange for a doctor to see the person at the earliest opportunity.
If at the time staff have reason to believe the vulnerable person is in immediate and serious risk of harm or that a crime has been committed the police must be called.
A SET SAF 1 form (SEE APPENDIX ONE) must be completed where there are allegations of abuse and sent to the relevant Social Care area. Guidance notes are available on

All service users need to be safe. Throughout the process the service user’s needs remain paramount. This process is about protecting the adult and prevention of abuse.

Allegation of abuse by a staff member

Employees should be aware that abuse is a serious matter that can lead to a criminal conviction. Where applicable the organisations disciplinary policy should be implemented.

Capacity and Consent

One of the overriding principles in Safeguarding Vulnerable Adults is capacity and consent. Whenever possible every effort must be made to obtain the consent of an adult to report abuse taking into consideration the definitions of the Mental Capacity Act (2005). However when there is a duty of care and the adult does not have the capacity to protect him / herself the matter must be discussed with the Safeguarding Vulnerable Adults Lead to determine how best to proceed.

Any patient affected by abuse, who has capacity, should be consulted as to whether or not they wish action to be taken in relation to their own situation. However, their response will be viewed in the context of the need for any intervention in order to protect other service users and / or staff from harm or risk of harm. If the individual does not wish to report the abuse a discussion must take place the Safeguarding Vulnerable Adults Lead as to the appropriate course of action to safeguard other service users and staff or in the public interest.

Choices and Risk

On occasions, vulnerable adults are left in situations, which leave them seriously at risk of abuse. Sometimes attempts to justify this are made on the grounds of a person’s right to make choices about their lifestyle, which may involve risk.

Decisions about risk atthis level should never be taken by individual staff but through a properly constituted professionalsmeeting and by involving risk assessments.

Supporting Vulnerable Adults who fail to attend Appointments

It is recognised that vulnerable adults often experience difficulties accessing health services. It is imperative services are readily available and easily accessible to ensure inequality in health provision does not occur.

Failure to attend appointments may be an indication that the carers of the vulnerable adult are failing to engage with health professionals and can be an indication they are not meeting the health and welfare needs of the vulnerable adult.

Early signs of potential or actual disengagement with health services need to be recognised and assessed as this may be a precursor or indication that the vulnerable adult may be experiencing abuse.

Therefore it is vital that all providers of health services have robust systems in place to monitor failure to attend appointments and processes to inform the referrer of the non attendance.

Proactive measures that health service providers may wish to put in place to support vulnerable adults to attend include:

to ensure that they have up to date contact details for the vulnerable adult, Next of Kin and other significant contacts
to check regularly that contact information is correct
to ascertain the best way of contacting/communicating with the vulnerable adult. E.g. if the vulnerable adult is unable to read, contacting by telephone may be the most appropriate method
to ascertain the level of understanding of the vulnerable adult as a learning disability or literacy, language or communication difficulty needs to be recognised and addressed. Attempts should be made to aid communication in a way that is appropriate to their needs.
to place a “flag” or “alert” on the vulnerable adult’s records to inform all persons accessing the records of any specific needs of the vulnerable adult
to identify ways to support the vulnerable adult to remember their appointment
to ensure that the vulnerable adult knows how to make contact with the service

If a vulnerable adult has failed or continues to fail to attend a scheduled appointment the responsible professional should consider if the appointment is essential and if the vulnerable adult’s health needs are being neglected.

All attempts should be made to contact the vulnerable adult and carer to ascertain why the appointment was not attended and a rescheduled appointment should be offered. Reasons for non attendance and actions taken should be documented in the patient records.

Consideration should be given to contacting other professionals directly involved with the vulnerable adult as they may be able to assist in identifying issues with non –attendance or confirm any concerns.

Where difficulty is experienced in gaining access to the vulnerable adult and there is cause for concern, further action should be taken – a SETSAF1 should be completed or 999 in emergencies. Staff should follow the Southend, Essex and Thurrock Safeguarding Adults Guidelines (2010).

Advice should be sought from the Safeguarding Vulnerable Adults Lead if there is any doubt around what action to take.

Monitoring compliance with this policy

Compliance with this policy will be monitored by the Safeguarding Adults Team by undertaking relevant audits such as the Essex Safeguarding Adults Board annual audit with any recommendations shared and implemented across the North Essex cluster and monitored through an appropriate action plan.

In addition the Safeguarding Adults Team will submit quarterly reports to the Clinical Quality Review groups in each locality.

SET SAF 1 – SAFEGUARDING ADULT CONCERN FORM

Service User reference/NHS No:
(Swift/PRN/NHS) (if known)
Date Form Completed:

1.Tell us if the concern is for a person or an Organisation:
(please complete as much of this as is known – if not known put N/K)

Name of person who you are concerned about:
Organisation:
Gender:
Home Address:
Telephone Number:
Age: DOB:
Ethnic Origin and or Nationality:
Does the person have any Communication Needs:
Are they aware of this referral: Yes No
Have they agreed to this referral: Yes No
If not, why not:

Is the vulnerable adult in receipt of any social or health care services:
Yes No Not Known
Please give brief details:

2a. – Current Situation and Details of the Incident/Concern(s) being raised

Does the person continue to be at risk of harm? Yes No
Are there other people who may be at risk of harm? Yes No
If the answer to either of the above is yes, please describe the risk that remains and the names of any others potentially at risk:
(please only refer to identified risk that relates directly to the concern)
2b. Details of the concern(s) being raised
Time of incident/ Date:
Concern:
Location of Incident:
Brief factual details of the incident:
This should include a clear factual outline of the concern being raised with details of times, dates, people and places where appropriate.
(please continue on separate sheet if required).
If injuries are present Please give a brief/accurate description:
Has a body chart been completed? Yes No
(If completed please attach to SET SAF 1 or forward as soon as possible.)
Details of any medical attention sought:
Doctor Informed? Yes No
Name of Doctor informed:
Date and time of information given:
Actions taken to date to safeguard the individual:
Are any other professionals aware in this alert?
(in particular please specify if the police are involved)?
If police have been contacted Is there a crime incident number?

3. Relative/Name of Main Carer

Name:
Relationship to Person:
Is Relative/Carer aware of this referral? Yes No
Contact Address: Telephone No:
Mobile No:
Email:
County: Postcode: