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1.3 Safeguarding Adults

1. Introduction

Safeguarding adults is an issue that is attracting significant government and local focus. It is important that strong multi-agency policies and procedures are established to enable adults who are experiencing or at risk of abuse or neglect to be properly protected. This policy is intended to contribute to raising levels of awareness and to encourage safeguarding reports by professionals where appropriate.

2. Adult who is experiencing or at risk of abuse or neglect

In safeguarding situations the adult must be involved from the outset (unless doing so would put them at greater risk of harm). They must be seen by a worker from the investigating / assessing team to discuss the allegation or disclosure. The discussion must include how they view the risk, and their opinions and desired outcomes from the enquiry must be sought. They must be included throughout the process and at the conclusion a check must be made to establish whether their desired outcomes from the enquiry have been met.

 3. Family and Friends

Family, friends and other relevant people who are not implicated in the allegation of abuse often have an important part to play in the safeguarding adults process, and can provide valuable support to the individual. In some cases they can also assist in managing the risk.

If the adult has mental capacity and gives their consent, and there are no evidential constraints, family and friends should be consulted. If the adult does not have mental capacity, family and friends must be consulted in accordance with the principles of the Mental Capacity Act 2005 (see also Mental Capacity and Deprivation of Liberty Safeguards).

A record should be made of the decision to consult or not to consult family and friends with reasons being given and recorded.

 4. Witness Support and Special Measures

If there is a police investigation, the police will ensure that interviews with the adult who is a vulnerable or intimidated witness are conducted in accordance with Achieving Best Evidence in Criminal Proceedings (Crown Prosecution Service).

‘Special measures’ can be used to assist eligible witnesses. The measures can include the use of screens in court proceedings, the removal of wigs and gowns, the sharing of visually recorded evidence in chief (the evidence given by a witness for the party who called him or her), cross examination and re-examination and the use of intermediaries and aids to communication.

Intermediaries play an important role in improving access to justice for some of the most vulnerable people in society, giving them a voice within the criminal justice process. They help children and adults who have communication difficulties to understand the questions that are put to them and to have their answers understood, enabling them to deliver their best evidence for the police and the courts.

The Witness Service is free and independent of the police or courts and provides practical and emotional support to victims and witnesses (either for the defence or the prosecution).

The support is available before, during and after a court case to enable the witness, their family and friends to have information about the court proceedings, and can include arrangements to visit the court in advance of the trial.

5. Victim support

Victim Support is a national charity which provides support for victims and witnesses of crime in England and Wales. It provides free and confidential help to family, friends and anyone else affected by crime. This includes information, emotional support and practical assistance. Help can be accessed either directly from local branches or through the Victim Support helpline.

6. All Staff, Volunteers and Organisations

The first priority of all staff and volunteers must always be to ensure the safety and protection of the adult.

All staff and volunteers from any service or setting should be aware of this multi-agency policy and procedures and have a responsibility to be aware of issues of abuse, neglect or exploitation. This includes personal assistants paid for from direct payments or personal budgets.

All staff and volunteers have a duty to act in a timely manner on any concern or suspicion that an adult who is at risk is being, or is at risk of being, abused, neglected or exploited and to ensure that the situation is assessed and investigated.

All organisations that provide services to adults have a responsibility to make sure that their staff are fit to work with such adults. In particular, human resources (HR) departments (or the equivalent) should make sure that:

  • safeguarding adults is taken into account in all appropriate HR strategies, systems, policies and procedures;
  • national safe recruitment and employment practices are adhered to, including the guidelines issued by the Disclosure and Barring Service (DBS);
  • staff and volunteers in contact with adults have regular supervision and support, and appropriate training to help them identify and respond to possible abuse and neglect.

7. Alerting Managers

The alerting manager could be any manager, including a designated manager or lead, matron or care home manager.  The role and responsibility of the alerting manager is:

  • to ensure the alleged victim is made safe and to preserve any evidence relating to the abuse;
  • to ensure that any member of staff or volunteer who may have caused harm is not in contact with the alleged victim, other service users or others who may be at risk, or where relevant contact is appropriately monitored in order to manage risk (for example, whistle blowing);
  • to ensure that safeguarding referrals are raised as appropriate;
  • to ensure that appropriate information is provided in accordance with local policy guidance and time frames.

The primary responsibility for coordinating information in response to a safeguarding adult concerns lies with the lead agency i.e. the local authority. However the local authority can delegate parts of the enquiry to other organisations whilst retaining overall responsibility for leading this (see also Thresholds).

All managers should ensure that they:

  • make staff aware of their duty to report any allegations or suspicions of abuse to their line manager, or if the line manager is implicated, to another responsible person or to the local authority, and the procedure for doing so;
  • meet their legal responsibilities and the Care Quality Commission Fundamental Standards, DBS and ensure compliance with registration, outcomes and guidance on compliance, quality, safeguarding and safety standards;
  • operate safe recruitment practices and routinely take up and check references;
  • adhere to and operate within their own organisation’s ‘whistleblowing’ policy and support staff who raise concerns;
  • ensure all staff receive training in safeguarding adults consistent with their job roles and responsibilities.

Managers have a responsibility for making checks on and referring staff and volunteers who have been found to have harmed an adult or put an adult at risk of harm.

Managers in health settings should report concerns as a ‘serious incident requiring investigation’ (SIRI), in line with clinical governance procedures, and a decision must be made whether the circumstances meet the criteria for referral to the safeguarding adults process in line with these multi-agency safeguarding policy and procedures.

Alerts relating to abuse / neglect in respect of other NHS staff / settings should be raised with the lead agency in the normal way (see Section 1, Introduction, Stage 1: Alert)

Managing officers should also be aware of their responsibility to consider a case for referring up to the appropriate Safeguarding Adults Board Safeguarding Adult Review Group if an adult has:

  • died (including suicide) and abuse or neglect is known or suspected to be a factor;
  • sustained a serious or life threatening injury or permanent impairment and abuse or neglect is known or suspected to be a factor;
  • there is in addition cause for concern about the way in which organisations and professionals involved in the case have worked together to safeguard and promote the welfare of the adult.

See:

8. Complaints

8.1 Complaints Officers

Local authorities have statutory complaints procedures. If a complaint received by a complaints officer could indicate that an adult is at risk, the officer will bring this to the attention of the relevant safeguarding adults lead or other manager.

If a complaint is made to the local authority that leads to a safeguarding adults enquiry, the local authority can decide not to commence the complaints enquiry if this would compromise the safeguarding adults enquiry.  The complainant would be informed of this course of action and the reason for it.

8.2 Safeguarding adults practice / process complaints

Complaints received from any source about safeguarding adults practice or arising from the safeguarding adults process should be handled by the relevant complaints procedures of the organisation about which the complaint has been made.

9. Supporting processes

9.1 Risk assessment and management

The assessment of the risk of abuse, neglect and exploitation of people using services should be integral in all assessment and planning processes, including assessments for self-directed support and the setting up of PB arrangements. Assessment of risk is dynamic and ongoing, especially during the safeguarding adults process, and should be reviewed throughout so that adjustments can be made in response to changes in the levels and nature of risk. The primary aim of a safeguarding adults risk assessment is to establish:

  • current risks that people face;
  • potential risks that they and other adults may face;

9.2 Whistleblowing

The Public Interest Disclosure Act 1998 provides a framework for whistleblowing across the private, public and voluntary sectors. Each member organisation of the SAB will have its own whistleblowing policy. These policies should provide people in the workplace with protection from victimisation when genuine concerns have been raised about malpractice. The aim is to reassure workers that it is safe for them to raise concerns, and partner organisations should establish proper procedures for dealing with such concerns.

9.3 Residents in an acute hospital setting

When hospitals provide clinical care to residents from a wide surrounding area, there may be negotiation about which local authority should take responsibility for investigating referrals that come to light in the hospital but which actually occurred in the placing authority’s area. In cases of dispute, the default position must apply.

9.4 Section 117

Special rules apply to adults who are also subject to Section 117 (After Care) of the MHA 1983. Case law has established that the duty falls in the first place on the authority for the area in which the patient was resident before being detained in hospital, even if the patient does not return to that area on discharge. If (but only if) no such residence can be established, the duty will fall on the authority for the area where the patient is to reside on discharge from hospital.

9.5 Risk resulting from disputes over responsibility

See also Resolving Professional Differences

Increased risk may result from intractable disputes over responsibility. All responses must still take place within the timescales of these procedures, using the default position if necessary. In such cases staff must alert their SAB so that discussions can take place.

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