This session builds on Safeguarding Adults Level 1. It will equip you with a greater knowledge and understanding of:
Your role in relation to safeguarding adults
How to raise safeguarding concerns
Multi-agency adult safeguarding procedures
Note that the session refers to UK-wide and England-only legislation and guidance, but does not specifically cover legislation relevant to Northern Ireland, Scotland or Wales.
This session addresses the Level 2 learning outcomes for Safeguarding Adults defined in the UK Core Skills Training Framework (UK CSTF).
There has been significant media coverage of adult safeguarding issues, in particular relating to the abuse and neglect at Winterbourne View [1] and Mid-Staffordshire NHS Foundation Trust [2].
These events were significant drivers in placing safeguarding adults on a statutory footing and highlighted the importance of the role of health professionals in recognising, responding to and preventing abuse and neglect.
As a result, the Care Act (2014) [3] replaced previous laws and practice guidance.
The Care Act 2014
Safeguarding duties under the Care Act (2014) [3] and supporting statutory care and support guidance introduced the following:
Duty to arrange an independent advocate
A duty for the local authority to arrange independent advocacy if a person would otherwise be unable to participate in or understand the care and support system.
A framework for protecting adults
New statutory framework for protecting adults from neglect and abuse.
Enquiries into suspected abuse or neglect
Duty on local authorities to carry out enquiries into suspected abuse or neglect, past or present, experienced by adults still living and deceased.
Assessment of young people in transition from children’s to adult services
Duty to assess young people and their carers in advance of transition from children’s to adult services, where they are likely to need care and support as an adult.
Care and Support Statutory Guidance (updated 2016)
The 'No Secrets' (Para 14.1) document has been replaced by Chapter 14 of the Care and Support Statutory Guidance (updated 2016).
The Principles Underpinning The Safeguarding Duties In The Care Act
The Care Act (2014) [3] is a major change in practice - a move away from the process-led, tickbox culture to a person-centred approach which achieves the outcomes that people want. Practice must focus on the person, which accounts for the possibility that individuals can change their mind on what outcomes they want through the course of the intervention.
You have learnt about the six principles of Adult Safeguarding in Level 1
Empowerment - people being supported and encouraged to make their own decisions and give informed consent
Prevention - it's better to take action before harm occurs
Proportionality - the least intrusive response necessary to the risk presented
Protection - support and representation for those in greatest need
Partnership - working in partnership to achieve local solutions in communities where we live. Communities have a part to play in preventing, detecting and reporting abuse and neglect
Accountability - accountability and transparency in delivering safeguarding and fulfilling our duty of candour
What are the outcomes that the principles aim for?
The Care Act 2014 - Terminology
The Care Act 2014 consolidates previous legislation. The Care and Support Statutory Guidance (updated 2016) replaced ‘No Secrets’ and the previous safeguarding procedures and terminology used.
The terms on the left of the diagram below have now been replaced with the terms on the right.
Types of Abuse
In Level 1 you learnt about the different types of abuse. If you need a recap select each of the headings below.
Physical abuse
Physical abuse including:
Assault
Hitting
Slapping
Pushing
Misuse of medication
Restraint
Inappropriate physical sanctions
Domestic violence
Domestic violence including:
Psychological
Physical
Sexual
Financial
Emotional abuse
So called ‘honour’ based violence
Sexual abuse
Sexual abuse including:
Rape
Indecent exposure
Sexual harassment
Inappropriate looking or touching
Sexual teasing or innuendo
Sexual photography
Subjection to pornography or witnessing sexual acts
Sexual assault
Sexual acts to which the adult has not consented or was pressured into consenting
Modern slavery
Modern slavery encompasses:
Slavery
Human trafficking
Forced labour and domestic servitude.
Traffickers and slave masters using whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment
Discriminatory abuse
Discriminatory abuse including forms of:
Harassment
Slurs or similar treatment because of:
Race
Gender and gender identity
Age
Disability
Sexual orientation
Religion
Organisational abuse
Organisational abuse
Including neglect and poor care practice within an institution or specific care setting such as a hospital or care home, for example, or in relation to care provided in one’s own home. This may range from one off incidents to on-going ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation.
Self-neglect
This covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding. It should be noted that self-neglect may not prompt a section 42 enquiry. An assessment should be made on a case by case basis. A decision on whether a response is required under safeguarding will depend on the adult’s ability to protect themselves by controlling their own behaviour. There may come a point when they are no longer able to do this, without external support.
Neglect and acts of omission
Neglect and acts of omission including:
Ignoring medical emotional or physical care needs
Failure to provide access to appropriate health, care and support or educational services
The withholding of the necessities of life, such as medication, adequate nutrition and heating
Financial or material abuse
Financial or material abuse including:
Theft
Fraud
Internet scamming
Coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions
The misuse or misappropriation of property, possessions or benefits
Psychological abuse
Psychological abuse including:
Emotional abuse
Threats of harm or abandonment
Deprivation of contact
Humiliation
Blaming
Controlling
Intimidation
Coercion
Harassment
Verbal abuse
Cyber bullying
Isolation
Unreasonable and unjustified withdrawal of services or supportive networks
Have a look at each scenario and decide what type of abuse it is.
Marjorie says that her carer is always showing her indecent pictures. He says he’s just having a laugh but she doesn’t want to see them.
Dominic lives in a care home. He is in pain as he has severe arthritis. He is told that he is not allowed any more pain relief as the person who dispenses medicine has gone home.
Sexual Abuse
Sexual abuse can include rape, sexual assault, being forced to look at sexual images or any sexual acts to which the adult has not consented or was pressured into consenting.
Organisational abuse
Organisational abuse can include neglect and poor care practice within an institution or specific care setting such as a hospital or care home. Poor professional practice can be the result of the structure, policies, processes and practices within an organisation.
Multi-Agency Working and Parallel Processes
Have a look at the different agencies and their processes.
Local Statutory Safeguarding Adult Board
A multi-agency statutory board which has responsibility for providing strategic leadership and oversight in preventing, detecting and protecting adults who are at risk from abusive behaviour and practice in all its forms in each local authority area. This includes the implementation and quality assurance of local guidance and procedures for safeguarding adults. Each board should have its own website or web page on the local authority website. Your safeguarding lead will know who your organisations Board member or link is.
Multi-Agency Public Protection Arrangements (MAPPA)
The police have a shared responsibility for the management of sexual offenders and violent offenders when they are released from prison into the community. This is managed in partnership with probation staff and prison staff as well as other agencies such as social services, housing and health. This is known as the Multi-Agency Public Protection Agreements (MAPPA). The statutory MAPPA guidance can be accessed online via the GOV.UK website - see Resources for a link to the website.
Multi-Agency Risk Assessment Conference (MARAC)
Multi-Agency Risk Assessment Conference (MARAC) is a risk-management meeting where professionals share information on high-risk cases of domestic violence and abuse and put in place a risk management plan.
See your safeguarding and/or domestic abuse policy and speak to your safeguarding lead for more information.
Channel Panel
The Channel Panel in each local authority area is part of the Counter Terrorism Prevent strategy. The process is a multi-agency approach to identify and provide support to individuals who are at risk of being drawn into terrorism.
Community Safety Partnerships
Community Safety Partnerships are made up of representatives from the police, Local Authorities, fire and rescue authorities, health, and probation services (the 'responsible authorities'). The responsible authorities work together to protect their local communities from crime and to help people feel safer.
Local Safeguarding Children Partnership (LSCP)
)The Local Safeguarding Children Partnership (LSCP) is the key statutory mechanism for agreeing how the relevant agencies in each local area will co-operate to safeguard and promote the welfare of children in that locality, and for ensuring the effectiveness of what they do.