Adult Safeguarding – An Introduction

1. Adult Safeguarding – An Introduction Version 4: Reviewed 2019-02-27 welcome delivered by

2. Course aim the aim of this session is: • to provide basic awareness of adult safeguarding • to understand that safeguarding is everyone’s responsibility

3. Course objectives by the end of the session you should: • understand what safeguarding is and your role in safeguarding adults at risk • be able to recognise signs of abuse and neglect • know how to act upon a concern or disclosure • be aware of how values and attitudes may influence decision making • be aware of relevant legislation and local policy and procedures for supporting and protecting adults

4. Activity What Does Adult Safeguarding mean to you? You have 5 min in your groups to come up with your definition and what does this mean to you and your organisation.

5. What does this mean to you? • working to ensure safe practice and in a way that upholds people’s rights, and treats people with dignity and respect • being alert to the potential for abuse to occur and vigilant when abuse may be taking place • knowing who you need to report any concerns to We all have a duty to report concerns about abuse or neglect

6. What is safeguarding? Protecting an adult’s right to live in society, free from abuse and neglect. Working together to prevent and stop both the risks and experiences of abuse or neglect, while at the same time making sure that the adult’s wellbeing is promoted The Care Act 2014

7. What is adult safeguarding? • The term ‘vulnerable adults’ has changed with the Care Act 2014 to ‘adults at risk of harm’, usually shortened to ‘adults at risk’. • ‘Adults at risk’ are always ‘adults with a care and support need’, with the exception of individuals who are victims of domestic abuse or modern day slavery. • The Care Act 2014, makes it clear that abuse of adults links to circumstances rather than the characteristics of the people experiencing the harm. • Labelling groups of people as inherently ‘vulnerable’ is seen to be disempowering.

8. Yasmine’s story Yasmine’s Story

9. Why do we need to take Adult Safeguarding seriously? • Everyone has the right to live their life free from violence, fear and abuse • Not everyone can protect themselves • Adult safeguarding is integral and central to all of the work we do • We all have a duty of care • Safeguarding Adult Reviews continue to highlight the need for improvement

10. Who is an Adult at Risk? • The Safeguarding duties set out in the Care Act 2014 apply to an adult who: • has needs for care and support (whether or not the local authority is meeting any of those needs); • and • is experiencing, or is at risk of abuse or neglect; • and • as a result of their care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect.

11. Identifying Adults at Risk • In your groups list the kind of care and support needs which could place adults at increased risk

12. Who’s at increased risk? • People dependant on others for assistance, especially with finances and personal care • People who lack the capacity to consent • People who need support with communication • People who need support with mobility • People who are isolated • People receiving care in their own homes • People that may experience discrimination (e.g. hate crime)

13. Adult abuse in the U.K. Fiona Pilkington and Francesca Hardwick Steven Hoskins Mid Staffordshire Hospital Trust Winterbourne View Learning from tragic events and systemic failings, such as those at Winterbourne and Mid Staffordshire, have driven key changes through the Care Act (2014)

14. Adult abuse in the UK Gemma Hayter She just wanted to be accepted so badly that she would put up with anything and often she didn’t realise people were just taking the mick. She was murdered by so called friends who she was out with the night before. There was clear evidence that Gemma was an adult with care and support needs and that she had been a victim of “mate crime” on a regular basis over a period of time, by a number of people who were known to her.

15. Learning from local S.A.R.s One of the Suffolk Safeguarding Adults Board’s core statutory duties is to conduct reviews in accordance with Section 44 of the Care Act. SARs provide opportunities to learn lessons when abuse or neglect is suspected to be a factor in the death or serious harm of an adult with care and support needs. https://www.suffolkas.org/working-with-adults/safeguarding-adults-reviews/

16. Effective practice • The Care Act sets out that organisations should • provide clear guidance to their staff in relation to: • Identifying adults at risk • Recognising abusive or neglectful behaviour • Working within agreed operational guidelines to • maintain best practice.

17. Key principles of safeguarding The Care Act 2014 emphasises six key principles: Empowerment Prevention Protection Accountability Proportionality Partnership

18. Activity: The Principles In pairs discuss and be ready to feed-back to the group: For each principle think of an example of how you would apply that principle in practice, to make a difference to adults with care and support needs.

19. Mental Capacity Act (2005) • Every adult has the right to make his or her own decisions and must be assumed to have capacity to do so unless it is proved otherwise. • Individuals should be supported to make their own decisions where possible • Anything done for or on behalf of people without capacity must be in their best interests. • Anything done for or on behalf of people without capacity should be the least restrictive of their basic rights and freedoms • You must not assume incapacity simply because someone makes an unwise decision

20. Making Safeguarding Personal • Making Safeguarding Personal is at the heart of safeguarding and means that we should: • Reflect the adults’ wishes, wherever possible • Make decisions which should be proportionate to the level of concern and in the adults’ best interests, if they are not able to make the decision • Involve the person at all stages and make sure they are empowered to make the decisions about what happens next.

21. Making Safeguarding Personal • We should work with the adult to establish what being safe means to them and how that can be best achieved. • Professionals and other staff/ volunteers should not be advocating ‘safety’ measures that do not take account of individual well-being.

22. Activity Activity: Making Safeguarding Personal • In small groups discuss ways in which you, as individuals and professionals can take some responsibility for preventing adults at risk of being abused. • Try and think of something new, not something you are already doing.

23. Activity Attitudes and Values What do you think? How do our personal beliefs and values influence our decision making?

24. Types of abuse The Care Act 2014 sets guidance as to the sort of behaviours that could give rise to a safeguarding concern, and identifies the following categories, within which exploitation is a common theme: Physical Domestic Violence Sexual Neglect/acts of omission Financial/material Psychological Self-Neglect Discriminatory Modern Slavery Organisational

25. Distinct examples Sexual exploitation Domestic abuse Scams Trafficking Forced marriage Hate Crime Honour based abuse Radicalisation Mate Crime Modern Day Slavery Female genital mutilation

26. Activity: Indicators of Abuse • In pairs, give 10 examples of indicators of abuse and think what type of abuse they could raise concerns about! • Remember, it is often a series or patterns of indicators that lead to a concern; • There could be other explanations for most indicators, but all would need addressing; • Don’t wait until you are sure someone is being abused.

27. The Prevent Duty The Counter Terrorism and Security Act 2015 places a duty on specified authorities including local authorities, schools, HE and FE colleges, health, probation and the police to have “due regard to the need to prevent people from being drawn into terrorism”. Radicalisation – the process by which a person comes to support terrorism and extremist ideologies Extremism – the vocal or active opposition to fundamental British values What do I need to do? Be aware of the vulnerabilities and changes in behaviour that may give you a cause for concern in the individual you are working with. https://www.suffolkas.org/safeguarding-topics/prevent-and-vulnerable-to-radicalisation/

28. Give an example of the types of abuse that could happen within your workplace setting

29. Where else can abuse take place?

30. Contexts within which abuse occurs Abuse can happen to anyone and anywhere It can happen in: • the adult’s own home • residential and nursing homes or day centres • hospitals • police stations or other custodial settings • colleges or other education settings • places of work or worship • public places Anyone could be a source of risk – the majority of adults know the person who has abused them.

31. List why adults don’t always tell

32. Why adults don’t always tell • May not recognise they are being abused • May have communication and/or language difficulties. • May be dependent on or attached to the perpetrator (Care Act 2014: ‘source of risk’ instead of perpetrator). • May be scared of the consequences. • May feel guilty, embarrassed or ashamed • May not be able to see a way out of their situation

33. Dealing with a disclosure- Do’s Be transparent about what you will do with the information Listen carefully Offer reassurance Ask open questions (what, who, where, when, how) Record (verbatim) Refer/seek advice Consider the person’s immediate safety

34. LENS – Making Safeguarding Personal LENS - MAKING SAFEGUARDING PERSONAL (FIRST RESPONSE) Listen – Don’t be judgmental. Don’t hurry. Listen actively. Environment – Help the person feel safe. Find somewhere calm to talk. Make sure the conversation is private. Next Steps – Establish what the person wants. Be transparent about what you will do. Share information only with the right people. Preserve evidence if necessary. Safer – Check if immediate help is needed. Ensure confidence in what happens next. Help the person to be safe and feel safe.

35. Suffolk SAB: Vision, Mission, Values and Pledges

36. Suffolk SAB: Adult Safeguarding Framework

37. Suffolk SAB: Adult Safeguarding Framework An adult who meets the above criteria is referred to as an “adult at risk”. However practitioners need to be mindful that safeguarding duties apply to family carers experiencing intentional or unintentional harm from the adult they are supporting or from professionals and organisations they are in contact with. As well as victims of domestic abuse or modern slavery who are not in receipt of care and support. * - In some situations the Local Authority can undertake enquiries for those that only have support needs

38. Suffolk SAB: Adult Safeguarding Framework

39. Suffolk SAB: Adult Safeguarding Framework

40. Suffolk’s Adult Safeguarding Journey

41. Dealing with a disclosure- Don’ts Do not show shock or disbelief Do not ask leading questions Do not promise confidentiality, even if the adult asks you for this Do not confront the source of risk

42. Safeguarding Adults Boards (SAB) The Suffolk Safeguarding Adults Board (SAB) is a multi-agency partnership that promotes the development of adult safeguarding work throughout Suffolk. The Board consists of senior officers nominated by each of the main agencies who will be responsible for developing and maintaining strong and effective inter agency protocols to safeguard vulnerable adults from abuse. Website: www.suffolkas.org

43. If you have a concern about an adult Talk to your Designated Safeguarding Lead If you have a concern about an adult and wish to make a safeguarding referral you will need to use the Suffolk County Council Adult Care Portal. The first time you complete a form you will be asked to create a new portal account. It’s quick and easy to register for an account, and means the information you send to us is secure. You can access the portal via the SAB website: https://suffolkas.org/concerned/ If you would like to discuss whether or not a referral is required, you can call the Professional Consultation Line on 03456 061 499 to speak with a MASH social worker. For Self-Neglect & Hoarding concerns, please complete the Self-Neglect and Hoarding Referral Form available from: http://www.suffolkas.org If you have an urgent safeguarding concern or are unable to access the Portal you should contact: Customer First: 0808 800 4005. Suffolk Police: 01473 613500 or in an emergency call 999.

44. Modern Day Slavery Act 2005 - National Referral Mechanism (NRM) & Duty to Notify • http://www.suffolkscb.org.uk/assets/Safeguarding-Topics/Modern-Day-Slavery/Modern-Slavery-Poster-v3.pdf • The NRM Form should be sent to the NCA Modern Slavery and Human Trafficking Unit via email to nrm@nca.x.gsi.gov.uk • Completed MS1 forms should be sent to dutytonotify@homeoffice.gsi.gov.uk

45. Multi Agency Safeguarding Hub Domestic abuse Social Care Early Help Service Police Education Health Early Years Youth Offending Housing Probation

46. What happens next? The MASH work together to decide on appropriate action, following receiving the referral (Concern). The MASH does an initial rating of risk and decides how quickly partners will share information in order to make a decision on next steps. As part of information gathering, the MASH practitioners, where appropriate, will seek to discuss with the adult at risk. https://www.suffolkas.org/working-with-adults/the-multi-agency-safeguarding-hub-mash/

47. What happens next? • Following the information sharing process within the MASH, a strategy discussion will be held to determine the level of risk and the action that needs to be taken. • Low level Concerns will be investigated by local Social Care teams or the relevant organisation. • Medium and high level Concerns may be investigated by the Adult Protection Team in conjunction with other organisations, such as Police, CCG, Trading Standards, CQC, etc. • All agencies have a duty to co-operate with the Local Authority in respect of safeguarding enquiries

48. Professional Safety Induction and training Safe recruitment Whistleblowing Supervision

49. Further information Suffolk Adult Safeguarding Board www.suffolkas.org Suffolk County Council – adult safeguarding https://www.suffolk.gov.uk/adult -social-care-and-health/keeping-you-safe/safeguarding/ Suffolk Mental Capacity Act and DOLS website: https://www.suffolk.gov.uk/mca The Care Act 2014 – Care and Support statutory guidance (safeguarding) https://www.gov.uk/guidance/care-and-support-statutory-guidance/safeguarding SCIE adult safeguarding questions: http://www.scie.org.uk/care-act-2014/safeguarding-adults/adult-safeguarding-practice-questions/