Safeguarding Vulnerable Adults & Dementia

“Every adult has a right to respect, dignity, privacy, equity and a life free from abuse”

Joint committee on Human Rights

Our Mission statement

The Safeguarding Team aims to support all Trust staff in contact with patients to recognise, report and prevent the abuse of vulnerable adults, children and

staff, through raising awareness, providing appropriate training and investigating all allegations

of abuse.

The Team comprise of Senior Acute Care Health Professionals with experience in Midwifery,

Paediatrics, Surgery, A&E, Critical Care and Elderly Care. The team act both strategically and

operationally in preventing and investigating abuse in order to safeguard both patients and staff.

Safeguarding Structure

LEAD NURSE FOR SAFEGUARDING

Mandy McDonough

Director of Nursing & Midwifery / Executive Lead for Safeguarding

Jill Galvani

ADULT PROTECTION

TEAM

Carl GriffithsNamed Nurse for Adult Protection

Karolyn ShawNamed Nurse for Adult Protection

DOMESTIC ABUSE

Sheila OakleyDomestic Abuse

coordinator

CHILD PROTECTIONTEAM

Maggie ChessallNamed Midwife for Child

Protection

Sue FogartyNamed Nurse for Child

Protection

Sue HessSafeguarding Practitioner

Behaviour Management

Barry SmithBehaviour

Management Specialist Nurse

SAFEGUARDING CO-ORDINATOR

Matt O’Neill

A Government Response

House of Commons Health Select Committee April 2004

Abuse of adult /elderly people is a hidden, and often ignored, problem in society. The profile of child abuse has been dramatically raised in the past few years and the Government has acted to introduce controls and measures to identify and tackle that problem; but abuse of older people remains in the background.

It has been put to us that 500,000 older people in England are being abused at any one time, yet many people are unaware of the problem and few measures have been taken to address it.

Often care staff take no action because they lack training in identifying abuse or are ignorant of the reporting procedures.

Equality and Human Rights Commission23 November 2011

The Commission's inquiry into the home care system in England reveals disturbing evidence that the poor treatment of many older people is breaching their human rights and too many are struggling to voice their concerns about their care or be listened to about what kind of support they want.

The final report of the Commission’s inquiry says ‘hundreds of thousands of older people lack protection under the Human Rights Act’.

Mid Staffordshire NHS Foundation Trust Public Inquiry 6th February 2013

The report into the care provided by Mid Staffordshire NHS Foundation Trust concluded that for many patients the most basic elements of care were neglected.

Robert Francis QC said: "I heard so many stories of shocking care. These patients rightly expected to be well cared for and treated. Instead, many suffered horrific experiences that will haunt them and their loved ones for the rest of their lives."

PhysicalPsychologicalSexualNeglectDiscriminationFinancialInstitutionalDomestic Abuse Deliberate Self Harm

Categories of abuse

• Assumptions are easier to make.• Older adults tend to have a negative

stereotype, we tend to focus on inability rather than ability

• Older adults have money, possessions and property to exploit.

• Older adults can refuse a service• Agencies have less power to intervene.

• Identification of mistreatment is more

difficult due to less contact.

Does age make a difference?

Physical Abuse

• Hitting, slapping, scratching and kicking

• Pushing or rough handling

• Misuse of medication

• Deprivation of food, drink, warmth

• Inappropriate restraint

Neglect

Mental Capacity Act 2005 creates a new offence of ill treatment and neglect.

• Applies to all - Carers and Professionals

• Punishable by up to five years in prison

Mental Capacity Act 2005 Morris & Taylor The Law Society

When you pay too little attention, or no attention to the individual.

To fail to take proper care of someone

Or omit to doFenella Morris

Barrister (specialist in mental health) 2005

Neglect

FIVE members of staff at a Merseyside care home were accused of leaving elderly dementia patients covered in their own filth after “downing  tools” and are being charged with 11 counts of willful neglect of a person lacking capacity.

The prosecution stated when the night shift arrived at 9pm they found 11 elderly patients caked in their own waste, with many of them having not been put to bed, changed, or given incontinence pads. One of the residents was also found to have gone to the toilet in a kitchen bin.

It is the Crown’s case that each of the 11 residents named in the indictment were sorely neglected by each of the defendants, who were responsible for their care, to the extent that all had been left uncleaned and unchanged for such a significant period of time that each of the 11 was in a state of obvious significant discomfort and in immediate need of cleaning and changing.

13th June 2013

Institutional Abuse

Examples of institutional abuse are:

Observed lack of dignity and respect in the care setting.

Rigid routines, processes and tasks organised to meet the needs of the staff and not the person.

Disrespectful language and attitudes which lead or may lead to harm.

Named Nurse interviews alleged victim, ascertains capacity and ensures victim is safe

Gathers information and liaises with other agencies to see if the threshold for referral has been met.

Strategy Meeting is held and safety plan is approved

Lead Agency Appointed for investigationInvestigation proceeds

Case conference held and is either closed or identified for review

Process for alert

• Did the adult give consent to the activity that is deemed abusive?

• Was the adult coerced?• What harm was sustained?• What is the standard expected?• Has a crime been committed?• Do we have a duty under law?• Do we have a duty to care, either for the

individual or for others which overrides the persons consent (nature and severity of abuse will determine as well as the setting)

Process for alert

……a person who is CAPABLE of making his/her own decisions has the right to decline the authorities help and protection, even if this means that he / she is left in an environment which is harmful to him/her.The worker should make clear the available options but their rights to refuse intervention should be respected……..

Law Commission 2002

Refusing Help

Adult Protection team receives referral

Adult Protection team review and decide if

appropriate for referral

Protection plan agreed and

implemented

Liaises with Central Advice and Duty Team

Case opened with DASS,

Social Worker identified

Appropriate agency identified as lead

i.e. Police Investigation commences

Professionals / Strategy meeting

Review

Self Neglect

Self Neglect is an umbrella term that covers a wide range of behaviours

- Neglect of self- Neglect of environment- Risky lifestyle behaviour

Self neglect may arise from an inability or unwillingness to care for oneself or a combination of both.

Self Neglect

Emerging themes from a small body of research indicate:

Pride in self sufficiencySense of connectedness to a place and possessionsA drive to preserve a sense of identity and controlTraumatic life events that have had a life changing effect.

MCA 2005

Both the Named Nurses in Adult Protection and the Behaviour Management Specialist Nurse are qualified Best Interest Assessors for Deprivation of Liberty Safeguards (DoLS)

We regularly advise Trust and external agency staff on the appropriate use of the Act in relation to medical treatments, discharge destination and behaviour management.

Thank you