Safeguarding Adults Policy. General Policy GP12

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1 Safeguarding Adults Policy General Policy GP12 Applies to: All staff in contact with patients Committee for Approval Quality and Governance Committee Date Ratified: July 2012 Review Date: October 2013 Name of Lead Manager Head of Safeguarding Version: 1 UNLESS THIS VERSION HAS BEEN TAKEN DIRECTLY FROM THE TRUST WEB SITE THERE IS NO ASSURANCE THIS IS THE CORRECT VERSION

2 Content Section Page 1 Aim of Policy 4 2 Target Group 4 3 Outcome 4 4 Relevant Legislation or Statutory Requirement 4 5 Local Definition 4 6 Basic Principles 4 Procedure to Follow if Staff Suspect Abuse 5 Confidentiality 6 7 Record Keeping 7 8 Specific Duties/Responsibilities 7 9 Training 8 10 References 9 11 Associated Documents 9 12 Useful Contact Details Equality Impact Assessment Consultation with Stakeholders Approval and Ratification Document Control Archiving Arrangements Process for Retrieving Archived Documents Monitoring Compliance of this Policy 11 Appendices Appendix 1 Referral Pathway Flowchart 12 Appendix 2 Post Referral 13 Appendix 3 Wirral Community NHS Trust Liaison Form 14 Appendix 4 Safeguarding Adults Contact Sheet 15 Appendix 5 Types of Abuse 16 Appendix 6 Monitoring Tool 18 2/18

3 Review and Amendment Log Version No Type of Change Date Description of change 1 Review of Policy New Organisation 3/18

4 1. Aim The purpose of this policy is to highlight the responsibilities and roles of all Wirral Community NHS Trust employees to help protect vulnerable adults at risk of abuse and mistreatment. It is designed to provide a framework to support all staff in contact with patients to recognise report and prevent the abuse of vulnerable adults. 2. Target Group This policy applies to all staff directly employed including bank staff, all students on placement 3. Outcome All staff will implement the policy. 4. Relevant legislation or statutory requirements This policy has been quality assured against all relevant Department of Health legislation and against all Equity and Diversity Standards in Wirral Community NHS Trust. This policy upholds the rights of individuals as regards to age, race, gender, disability, sexual orientation and religion. The principles are based on jointly agreed policies across the local health community, local authority and the police. The policy has been through the Impact Assessment Process. 5. Local definition Every adult has a right to respect, dignity, privacy and a life free from abuse. A vulnerable adult is defined in No Secrets (DH 2000) as: a person aged 18 years or over who is in receipt of or may be in need of community care services by reason of mental or other disability, age or illness and who is or may be unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation. 6. Basic Principles Abuse is unacceptable, and should not be condoned in any circumstance Staff need to consider their own personal safety and must not expose themselves to unnecessary risk. Line managers should be kept informed. Consideration should be given to clients psychological as well as physical health Advice and support should be offered, if appropriate and safe to do so. Victims should be given time and space to make choices and be supported, whatever decision they make. Consideration should be given to people who may have communication difficulties e.g. learning disabilities, cultural barriers, and speech, language or hearing problems. Any response must ensure that the safety of the victim and any children is the first priority 4/18

5 Do not blame the victim for the abuse. Responsibility for the abuse lies with the perpetrators Always believe a victim who discloses abuse Treat them with respect and dignity. Procedure to follow if staff suspects abuse If a member of staff suspects that a person is being abused, they have a duty of care to report it. Discussion should take place with the person allegedly being abused if it is safe to do so. Informed consent should be obtained, but if this is not possible and others are at risk, it may be necessary to override this requirement. It should be reported to:- Safeguarding Adults Lead for Wirral Community NHS Trust The staff member s Line Manager The abuser s Line Manager (following discussion with Safeguarding Adults Lead) Central Advice and Duty Team (CADT) Contact numbers can be found on page 10 of this policy 5/18

6 IF YOU SUSPECT ABUSE, REPORT IT Staff must to be aware that it is NOT their responsibility to investigate cases of abuse or mistreatment of vulnerable adults. Wirral Community NHS Trust staff do not organise strategy meetings or Adult Case Conferences were DASS are Lead professionals but staff should be aware they will be expected to share information and work closely with the Department of Adult social Services (DASS) to meet the best interests of the patient. If there is no input to DASS, Wirral Community NHS Trust staff will be expected to arrange Professionals meetings to allow staff members working with clients to voice opinions on patient care and outcome. Reporting abuse will enable Wirral Community NHS Trust to implement safeguards and improvements to services to help protect people from abuse. Confidentiality The Information Sharing: Pocket Guide (HM Government 2008) advises health care staff on issues of confidentiality. The NHS does have a duty to protect privacy and not disclose inappropriately. Health information is shared with other health professionals and outside agencies on a need to know basis to provide safe and effective health care. However, there are occasions when information needs to be shared to protect the best interests of the patient and those most vulnerable in society. It is important to recognise that the person being abused may not wish to take action. If this is the case it is still important to report it so that the incident can be recorded. Reporting abuse will provide information that can be used as part of a future investigation. Without this information, abuse may continue and previous evidence will not exist. There is legislation which supports this, for example The Crime and Disorder Act 1998, which aims to protect public interest:- Information will be shared on a need to know basis when it is in the best interest of the service user Informed consent should be obtained, but if this is not possible and others are at risk, it may be necessary to override this requirement Decisions about who needs to know and what needs to be known, should be taken case by case in discussion with line managers If there is a disclosure which the alerter feels may be in the public interest to release information to other agencies a conversation must take place with the Caldicott Guardian for Wirral Community NHS Trust. 6/18

7 Domestic Abuse In cases of domestic abuse where the definition of a Vulnerable Adult (as defined in this policy) is not clear, then further discussion with Wirral Community NHS Trust Safeguarding Lead is imperative. Contact numbers can be found on page 10 of this policy. 7. Record Keeping Health records play an important role in responding to domestic abuse, not just in a health setting. All record keeping needs to follow Wirral Community NHS Trust s Policy and Procedures guidance (Policy for Managing the Quality of Health Records GP6). All departments should have clear and robust arrangements for the recording and storage of information according to Wirral Community NHS Trust Policies and procedures. The British Medical Association for medical practitioners and Crown Prosecution Service have stressed the need for evidence that is beyond reasonable doubt e.g. reliable, available and cogent, particularly in the event of the perpetrator of violence being charged with assault. This is important as records you keep can be used in:- Criminal proceedings Obtaining an injunction or court order Housing provision Civil procedures in family courts to assess the risks associated with parent/child contact. 8. Specific Duties/Responsibilities Professionals within the organisation who are available for support post disclosure are: Trust Board The Trust Board have overall responsibility for ensuring that the Trust delivers high quality services that are efficient and effective. The Trust Board is made up of the Chairman, Chief Executive, Executive Directors, Medical Director and Non-Executive Directors. The Board of Directors oversee the running of the Trust, make the decisions that shape future direction, monitor performance and ensure accountability 7/18

8 Chief Executive has ultimate accountability for ensuring the provision of high quality, safe and effective services within Wirral Community NHS Trust. Director of Quality & Governance and the Executive Lead for Safeguarding are responsible for ensuring this policy is disseminated. Safeguarding Service will ensure all policies are up to date and will provide support to members of the organisation. Service Leads/Heads of Service are responsible for ensuring all relevant staff are compliant with this policy and to fulfil the standards expected by the Trust Employees must comply with the standards in this policy and support clinical audits being undertaken on behalf of the Trust and attend Essential Learning Training as per Trust Training Matrix 9. Training It is the responsibility of all Service Leads/Heads of Service to ensure staff are competent to comply with this Policy and its contents. Learning needs to be appropriate to skills and knowledge as outlined in the KSF. Managers need to evidence how staff have gained the knowledge and skills to follow the principles of this policy e.g. team meeting minutes, staff forums, training sessions. Specific training that supports this policy and is available to staff are: Clinical Safeguarding Adults/MCA/DoLs Training Non-Clinical Safeguarding Adults/MCA/DoLs Training Clinical Safeguarding Children Training (Level 2&3) Non-Clinical Safeguarding Training Clinical Looked After Children Training Non-Clinical Looked After Children Training Clinical Domestic Abuse Training Non- Clinical Domestic Abuse Training Mental Capacity Assessment Champions Training Equity and diversity training Conflict Resolution training 8/18

9 10. References DH (2005) Working together to protect adults from abuse No Secrets Policy and Procedure Guide Safeguarding Adults (Wirral Borough Council) Available via website link follow link for safeguarding adults Safeguarding Adults A National Framework of Standards for good practice and outcomes in adult protection work (Leaders in Social Care 2005) DH (2000) No Secrets Guidance on developing and implementing multi-agency policies and procedures to product vulnerable adults from abuse DH (2001) National Service framework in older people Protecting Adults at Risk: London Multi-Agency Policy and Procedures to Safeguard Adults from Abuse. Link: DH (2011) Safeguarding Adults: The Role of the Health Service, March 14. DH (2011) Safeguarding Adults: the role of the health service practitioner, March 14. DH (2008) Information Sharing: Guide for Practitioners and Managers, October. 11. Associated Documents This policy should be read in conjunction with:- Patient Information and Consent Policy (GP2) Policy for Managing the Quality of Health Records (GP6) Incident Reporting Policy (GP8) Local Safeguarding Children s Board Policy and Procedures Domestic Abuse Policy (GP29) Lone Working Policy (HS6) Local Security Management Policy and Procedure (HS18) MD03 Procedure for supervision and preceptorship 9/18

10 12. Useful Contact details Agency Department of Adult Social Services (DASS) Central Advice and Duty Team (CADT) 9am-5pm Monday Friday Department of Adult Social Services (DASS) Emergency Duty Team (EDT) 5pm-9am (Mon-Fri and all weekends) Wirral Community NHS Trust Lead for Safeguarding Adults/Domestic Abuse Lead for MCA/DoLs Department of Adult Social Services (DASS) Safeguarding Adults Co-ordinator Police - Family Crime Investigation Unit (FCIU) Birkenhead Police Station Telephone Tel: Fax: Tel: Fax: Tel: Tel: Tel: Tel: Police (Emergency Situations) 999 Care Quality Commission (CQC) Wirral University Teaching Hospital NHS Trust Named Nurse for Safeguarding Adults Cheshire & Wirral Partnership NHS Foundation Trust Safeguarding Adults Practitioner Tel: Ext: 8082/2441 Tel: Equality Impact Assessment In line with the Trust s Equality Scheme, each procedural document should be screened using the Policy Equality Impact Assessment Screening Tool by the manager responsible for its development, to consider whether there is an equality dimension or whether it is applicable to the Trust s duty to promote equality. The equality screening process and any wider impact assessment should be forwarded with the policy when approved to the Compliance Officer. As part of its development, this policy and its impact on equality have been reviewed by the Head of Safeguarding, as described above. The purpose of the assessment is to minimise and if possible remove any disproportionate impact on employees on the grounds of race, sex, disability, age, sexual orientation or religious belief. No detriment was identified. 10/18

11 14. Consultation with stakeholders The Safeguarding Adults policy will be discussed at the Safeguarding Group and the multi-agency Safeguarding Adults Partnership Board. 15. Approval and Ratification The Policy will be reviewed and approved at the Safeguarding Group and will then be submitted to the Quality and Governance Committee for final approval and ratification. 16. Document Control It is the responsibility of the policy author to submit the approved Policy to the Compliance Officer who will archive any old versions of policies and will liaise with the Communications Team to ensure that the new Policy is added to the website and referenced in the Staff Bulletin. 17. Archiving Arrangements Policies need to be kept for a minimum of 10 years (DH 2006-Records Management: NHS Code of Practice) for litigious purposes. It is important that the version of the policy is clearly recorded on the front cover of the policy. 18. Process for retrieving archived documents When a new version of an existing policy has been distributed for dissemination the team leader or individual responsible for the policy file within each team will need to replace the old policy version for the new one, or inform the team members of the newer version having been replaced on the Trust s intranet. 19. Monitoring compliance of this policy See Appendix 6 for Monitoring Tool for this Policy. 11/18

12 Appendix 1 Staff member has concerns regarding a Vulnerable Adult Abuse Suspected Is adult at risk of immediate danger or need medical treatment YES NO Consult with Safeguarding Adults Lead for Wirral Community NHS Trust Safeguarding Adults Issue confirmed NO Contact with DASS if adult at risk is open to services and consider review of current package of care Document outcome of the discussions and actions in the patient s records. YES Contact appropriate Emergency service (Police, Ambulance Fire Service) Is there evidence a crime has been committed? Contact CADT and CQC and ensure line manager is aware YES Contact Police Alerter to complete a Safeguarding Adults Liaison Form. The form can be faxed or ed to the Safeguarding Adults Lead. Safeguarding Team to complete contact sheet and pass to SGA Lead To be completed within 24 hours of disclosure Contact Numbers: Merseyside Police (Non-emergency) 999 (Emergency) Central Advice Duty Team: Emergency Duty Team: Safeguarding Adults Lead: Fax: CQC: /18

13 Appendix 2 Post Referral Safeguarding Adults Lead will review the liaison form Safeguarding Lead (if necessary will liaise with partner agencies to share information Following completion Safeguarding Adults liaison form, front line staff must inform the Lead for Safeguarding Adults/Domestic Abuse of any actions taken within 2 working days to update all key agencies involved Lead for Safeguarding Adults informs front line staff of any updates and actions following any consultation with partner agencies or attending any strategy meetings 13/18

14 Appendix 3 SAFEGUARDING ADULTS LIAISON FORM One copy of this form to be kept in the patient s records One copy fax to Wirral Community Trust Lead for Adult Safeguarding - Fax One copy to Service Manager One copy to the General Practitioner Details of alleged victim Name Date of Birth: Address. G.P: Patient consent: Yes/No Nature of incident Physical Sexual Psychological Financial Neglect Immediate action taken: Referral to Social Services: Yes/No SWIFT NUMBER:.. Name of person spoken to:. Brief details of incident or concern: Action Plan following consultation: Name of referrer Signature.. Designation.Service Telephone number.. Fax number Date and time form completed: 14/18

15 Appendix 4 Safeguarding Adults Contact Sheet (For Safeguarding Service Staff Use only) Date of contact Name of Client:. Address: Name of Alerter:.. Designation: Time: Date of Birth:.. GP:.. Base: Tel:... Brief details of incident or concerns: Action Taken: Refer to D.A.S.S for Safeguarding - Swift Number:. Name of Person spoken to: Refer to D.A.S.S for Package of Care - Advice given, no further action - Incident form received no further action - Contracts PCT, action required - DASS Contracts Information only - Incident form received Safeguarding required - CQC contacted - Additional Information: Signature: Print Name: Designation: Tel Contact Number: Date& Time of completing form: 15/18

16 Appendix 5 Types of Abuse Abuse refers to various forms of force, threats and fraud against someone. Abuse is any behaviour towards a person that deliberately or unknowingly causes them harm, endangers their life or violates their life. Abuse could occur a single or repeated act. It can happen in any relationship and may result in significant harm to, or exploitation of, the individual. Physical abuse physical ill treatment of an adult, which may or may not cause physical injury, including hitting, slapping, pushing, pinching, kicking misuse of medication, restraint, force feeding or appropriate sanctions. Sexual Abuse any form of sexual activity the adults does not want and to which they have not consented to nor have the capacity to consent to. This includes rape and sexual assault or sexual acts to which the vulnerable adult has not consented, or could not consent, or was pressurised into consenting. Psychological Abuse the use of intimidation, indifference, hostility, rejection, humiliation, shouting, swearing or the use of discriminatory and /or oppressive language. This includes threats of harm or abandonment, deprivation of contact, isolation or withdrawal from services or supportive networks. This can result in the adult s choices, opinions and wishes being negated. Financial or economic abuse including theft, fraud, and exploitation pressure in connection with wills property or inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits. Neglect and acts of omission including ignoring medical or physical care needs, failure to provide access to appropriate health, social care or educational services, the withholding of the necessities of life such as medication, adequate nutrition and heating. Neglect also includes failure to intervene in situations that are dangerous to the person concerned or to others, particularly when the person lacks the mental capacity to assess risk. Racial/discriminatory abuse directed at someone because of their race, skin colour, nationality (including citizenship), ethnic or national origin, religious beliefs, language or cultural differences. An individual, group or organisation may perpetrate abuse. Who could be an abuser? Anyone could be an abuser. They may be: Relative, friend, neighbour, partner, paid or unpaid carer or family member Service user or patient Professional or volunteer worker Stranger who takes advantage of a persons vulnerability 16/18

17 Where can Abuse happen? Abuse can happen anywhere. It may happen:- When a person lives alone or with a relative In nursing, residential or day care settings In hospital While in police custody or prison In a persons own home by people providing care services In a public place Why does abuse happen? No single explanation why abuse happens. Reason could include:- Care staff not adequately trained Carer s are not getting right kind of training or supervision People deliberately wish to harm vulnerable adults Misuse of power, control and/or authority 17/18

18 Appendix 6 MONITORING TOOL Minimum requirement to be monitored Process for monitoring Responsibility for completion Frequency of Monitoring Responsibility for Development of Action Plans Responsibility for Review of Results / Outcomes Number of Safeguarding Adult enquiries by Wirral Community NHS Trust staff Number of Safeguarding Adult referrals made to Department of Adult Social Services (DASS) by Wirral Community NHS Trust How the organisation trains staff on the safeguarding process in line with the training needs analysis Audit Audit Reports on attendance Head of Safeguarding Head of Safeguarding Learning and Development Lead At least four times in a calendar year At least four times in a calendar year A minimum of twice in the financial year Divisional Managers Divisional Managers Divisional Managers Quality & Governance Committee Quality & Governance Committee Learning and Development Group 18/18

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