Care Home Educational Programme 2019 Safeguarding Adults

1. Care Home Educational Programme 2019 Safeguarding Adults NHS Ashford Clinical Commissioning Group | NHS NHS South Kent Coast Clinical Commissioning Group | NHS Thanet Clinical Commissioning Group

2. Outline of the Day… • What is Safeguarding • The Legal Position • Types and Pattern's of Abuse (BREAK) • Prevention and our own practice • Making Safeguarding Personal (MSP) • Responding to concerns - Your Roles and Responsibilities for Safeguarding • Tasks to take away

3. What is Safeguarding? Section 14.7 of The Care Act 2014 • Safeguarding means protecting an adult’s right to live in safety, free from abuse and neglect. • People and organisations working together to prevent or stop the risk of abuse. • Promote the adult’s wellbeing and listen to their views.

4. The Care Act : replaces ‘No Secrets’

5. Aims of Adult SafeguardingSection 14.11 of The Care Act- • Stop abuse and neglect wherever possible. • Prevent harm and reduce risk. • Safeguarding to support choice and control. • Focus on improving life. • Raise awareness. • Provide information and support. • Address what has caused the abuse or neglect.

6. Care Act 2014 • Definition of Adult at Risk(previously referred to as VA) “Someone who has needs for care and support(whether or not they are being met) is experiencing, or at risk of, abuse or neglect and as a result of those needs is unable to protect themselvesagainst the abuse or neglect or the risk of it .” Section 42 enquiries

7. Statutory vs Non Statutory Enquiry STATUTORY - If the victim of abuse is an adult that fits the criteria outlined in section 42 of the Care Act then the Local Authority is required BY LAW to conduct enquires or ensure enquires are made. NON STATUTORY- Safeguarding enquires carried out on behalf of adults who DO NOT fit the criteria outlined in section 42 (they may be regarding a carer); Local Authorities are NOT required by Law to carry out these enquires and will do so at their own discretion. It is not your responsibility to decide if something meets statutory criteria…it is your responsibility to raise your concern.

8. ABUSEMulti Agency Safeguarding Adults Policy, Protocols and Practitioner Guidance for Kent and Medway September 2017 • Abuse or neglect may be deliberate or the result of negligence or ignorance. • In some settings the behaviour historically may not have been considered abuse (i.e. due to capacity/mental health etc.); this should not be the case. There is still an entitlement to be protected from abuse and prevented from abusing other adults at risk. • Abuse can happen anywhere. • Abuse and neglect can take many forms.

9. Types and Patten’s of AbuseMulti Agency Safeguarding Adults Policy, Protocols and Practitioner Guidance for Kent and Medway September 2017 • Physical Abuse - Hitting, slapping, scratching, rough handling, assault, restraining without justifiable reason, Inappropriate and unauthorised use of medication, using medication as a chemical form of restraint, Inappropriate sanctions including deprivation of food clothing, warmth and health care needs, female genital mutilation. • Sexual Abuse - Sexual activity which an adult client cannot or has not consented to or has been pressured into, sexual activity which takes place when the adult client is unaware of the consequences or risk involved, rape, attempted rape, sexual assault, sexual harassment, non contact abuse e.g. voyeurism, pornography. • Psychological Abuse - Emotional abuse, verbal abuse, humiliation and ridicule, threats of punishment, abandonment, intimidation or exclusion from services, isolation or withdrawal from services or supportive networks, deliberate denial of religious or cultural needs, forced marriage, failure to provide access to appropriate social skills and educational training, faith abuse.

10. Exploitation -Can be opportunistic or premeditated and include: unfairly manipulating someone for profit or personal gain, modern slavery, human trafficking, radicalisation. • Financial or Material Abuse - Having money misused or stolen, having property stolen, being defrauded, being put under pressure in relation to money or property, having money or property misused. • Neglect and acts of omission - Ignoring medical or physical care needs, failure to access care or equipment for functional independence, failure to give prescribed medication, failure to provide access to appropriate health, social care or educational services, Neglect of accommodation, failure to give privacy and dignity, professional neglect. • Self Neglect or self Injurious Behaviour -This should necessitate by social and health care professionals and be carried out with guidance contained in the MCA 2005, see Kent and Medway Self neglect policy.

11. Discrimination - demonstrated on any grounds, harassment and slurs which are degrading, hate crime. • Organisational Abuse -refers to abusive and poor care and or clinical practices that may develop when and adult is living/staying in a care home, receiving respite, attending a day care establishment or is receiving treatment or assessment in hospital especially where standards and practices fall below the essential standards for quality and care. • Multiple forms of Abuse -multiple patterns of abuse. • Inappropriate Restraint -staff must not deliberately restrain people in a way that impacts their airway, breathing or circulation such as face down restraint, must not include deliberate application of pain and must represent the least restrictive option, providers must have clear local policy’s.

12. Domestic Abuse - a pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. Hate Crime –Incidents can be against a person or property and are motivated by the offenders hatred of people who are seen to be different. Modern Slavery -movement of a person from one place to another into conditions of exploitation, using deception, coercion, the abuse of power or abuse of someone's vulnerability. It is possible to be a victim of trafficking even if your consent has been given to being moved.

13. BREAK

14. Prevention and our own practice • https://www.youtube.com/watch?v=9mL9gmrR17E • https://www.youtube.com/watch?v=iohhQgGygOw

15. Making safeguarding personal We are all different aren’t we? Different ….. • Preferences • Histories • circumstances • life-styles So why would we think it is ok to have the same prescribed process whenever a concern is raised? Making safeguarding personal means it should; • Be person-led and outcome focused. • Engage the person in a conversation about how best to respond to their safeguarding situation. • Enhance their involvement, choice and control and improves quality of life, wellbeing and safety.

16. Making safeguarding personal 6 principles from the DOH supported by the Care Act • Empowerment- Presumption of person led decisions and informed consent. • Protection – Support and representation for those in greatest need. • Prevention – It is better to take action before harm occurs. • Proportionality – Proportionate and least intrusive response appropriate to the risk identified. • Partnership – Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse. • Accountability - Accountability and transparency in delivering safeguarding.

17. When to share? • Consent! • Capacity! • Best Interests! • Duty to Share!

18. Your Roles and Responsibilities for Safeguarding - Responding to concerns If a disclosure is being made directly to you: • Remain calm and try not to show any shock or disbelief. • Listen very carefully to what you are being told. • Demonstrate a sympathetic approach by acknowledging concern that this has happened to them. • Explain that they have done the right thing by sharing the information with you. • Explain that you are treating the information seriously. • Explain that the abuse is not their fault (if the information is being shared by the ‘victim’). • Be aware of contaminating evidence, always consult with the Police in the first instance, where a crime may have taken place.

19. Your Responsibilities It is your responsibility to: • Make sure that the person is safe from immediate further abuse. • Make sure that the person feels listened to. • Tell your line manager (unless the allegation is about them in which case tell their line manager). • After consultation with your line manager phone the Central Duty Team to discuss your concern (for a pre referral consultation… do not delay this consultation though if you are unable to contact your manager). • Record the outcome of the consultation with the Local authority with the rationale given and who this was given by! • Where agreed, complete a KSAF including what you have witnessed or what has been disclosed. • Make clear factual statements • Submit as agreed in your consultation • Ensure you follow your own internal reporting process that should be supported in your organisations safeguarding policy .

20. Reporting concerns Concerned about an adult? • Call 03000 41 61 61 Concerned about a child? • Call 03000 41 11 11 Outside of normal office hours • Call 03000 41 91 91. IT IS YOUR RESPONSIBILITY TO RAISE YOUR CONCERNS BY SHARING THE INFORMATION YOU HAVE. Numbers do sometimes change so if in doubt check the Kent County Council adult protection.

21. Forms and guidance for completion can be found at: https://www.kent.gov.uk/social-care-and-health/information-for-professionals/adult-safeguarding/adult-protection-forms-and-policies/adult-protection-forms

22. When completing the form think about ? • Consent! Best Interests! Duty to Share? • The persons wishes, thoughts and feelings. • What is the Impact on the person at risk? • What is the Impact on others? • Illegality of the perpetrators actions? • Risk of further abuse being perpetrated against this adult? • Risk of further abuse being perpetrated against other adults at risk. • Risk of the abuse being perpetrated against children.

23. Completing the paper work top tips! • Don’t save a blank version of the form for future use. • Complete the form electronically. • Don’t forget to save the form before sending. • Don’t think completing the form makes someone safer. • You complete it! • Make sure you include the actions you have taken to minimise the risk. • You were concerned enough to complete it , make sure you follow up!

24. Tasks to take away • Do know where to find your organisations safeguarding policy? Is it up to date? Are you clear on your process? • Does your organisation have a way of logging safeguarding concerns that have been raised and are you able to evidence the outcomes ? • Culture, Culture, Culture how does your organisation make safeguarding everyone’s responsibility ? Everyone can play a part in this, what can you contribute? • How can you support Empowerment and reduce the risk of abuse and neglect?

25. Useful Links • The link for KCC adult protection pages are where you can access and print information leaflets and the KASAF Alert form http://www.kent.gov.uk/social-care-and-health/information-for-professionals/adult-protection/adult-protection-forms-and-policies and other public information • The website http://www.domesticabuseservices.org.uk/ for your information on Domestic abuse support services across Kent and Medway