SAFEGUARDING VULNERABLE ADULTS

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1 This document is uncontrolled once printed. Please refer to the Trusts Intranet site (Procedural Documents) for the most up to date version SAFEGUARDING VULNERABLE ADULTS NGH-PO-241 Ratified By: Procedural Document Group Date Ratified: June 2015 Version No: 3.3 Supersedes Document No: 3.2 Previous versions ratified by (group & date): October 2007V1, October 2009 V2 Date(s) Reviewed: June 2015 Next Review Date: June 2018 Responsibility for Review: The Safeguarding Adult Lead Contributors: Head of Safeguarding and Dementia, Acute Liaison Nurse Learning Disabilities NGH-PO-241 Page 1 of 14

2 CONTENTS Version Control Summary... 3 SUMMARY INTRODUCTION PURPOSE SCOPE COMPLIANCE STATEMENTS DEFINITIONS ROLES & RESPONSIBILITIES SUBSTANTIVE CONTENT Staff Responsibilities in Respect of Abuse (Appendix 2) Safeguarding Adult Notification Allegations of abuse by staff Preservation and Gathering of Evidence Physical Evidence Photographic Evidence Forensic Evidence Mental Capacity and Safeguarding Referrals Supporting Staff Information Sharing Information Sharing and confidentiality...error! Bookmark not defined Police involvement and safeguarding investigations Information Sharing and Police investigations Governance IMPLEMENTATION & TRAINING MONITORING & REVIEW REFERENCES & ASSOCIATED DOCUMENTATION Appendix 1 - What constitute abuse Appendix 2 - Information Leaflet all staff Appendix 3 - Information Leaflet - On call managers etc Appendix 4 - Reporting and Alerting Process NGH-PO-241 Page 2 of 14

3 Version Control Summary Version Date Author Status Comment V1 V2 October 2007 October 2009 V LH 1st draft LH Final Ratified by HMG LH Final Ratified by PDG V SC (Gov) Feedback for format etc. V LH Circulate for consultation V3.2 22/10/2014 LH Circulate for consultation NGH-PO-241 Page 3 of 14

4 SUMMARY All staff have a duty to safeguard and promote the welfare of vulnerable adults. They should: Attend training provided by the Trust (as detailed in section 9). Know how to obtain help and advice in relation to a vulnerable adult (appendix 4). Are aware of the internal and external policies regarding safeguarding. Maintain confidentiality of the adult. Report any suspected abuse by member of staff to a line manager (appendix 1) and 2 & 3). All incidents related to safeguarding must be reported using the Datix reporting system and where appropriate the Inter agency notifications forms. If you suspect any Safeguarding issues, please contact the Safeguarding Adult Lead the Trust Safeguarding Adults Lead on Ext 3769 and bleep NGH-PO-241 Page 4 of 14

5 1. INTRODUCTION Northampton General Hospital NHS Trust (the Trust) is committed to protecting the welfare of vulnerable adults and responding promptly when abuse is suspected. The Trust considers all incidents of abuse unacceptable and especially so when the victim is vulnerable. The Trust is committed to promoting a culture where abuse of any kind will not be tolerated and is dealt with promptly if it does occur. This policy is reflective of the Northamptonshire Safeguarding Adults Board Multi-Agency Policy and Procedure and should be read in conjunction with that document [link below]. 2. PURPOSE To ensure that vulnerable adults who access services at Northampton General Hospital are adequately safeguarded and protected. To ensure that Trust employees are fully aware of individual accountability for, and understand and implement local safeguarding procedures when abuse or neglect is suspected or identified. 3. SCOPE This policy applies to all Trust workers; both temporary and substantive and includes those engaged by the Trust in a non-remunerative capacity e.g., students and volunteers. All adult patients within the Trust could potentially be included in the definition of an adult at risk and therefore this policy applies to all Trust patients, regardless of the nature of the service accessed or type of attendance / admission. This policy should be read and utilised in conjunction with the procedures adopted by the Local Safeguarding Adult Boards: Safeguarding Adults Procedures COMPLIANCE STATEMENTS Equality & Diversity This policy has been designed to support the Trust s effort to promote Equality and Human Rights in the work place and has been assessed for any adverse impact using the Trust s Equality Impact assessment tool as required by the Trust s Equality and Human Rights Strategy. It is considered to be compliant with equality legislation and to uphold the implementation of Equality and Human Rights in practice. NGH-PO-241 Page 5 of 14

6 NHS Constitution The contents of this document incorporates the NHS Constitution and sets out the rights, to which, where applicable, patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with the responsibilities which, where applicable, public, patients and staff owe to one another. The foundation of this document is based on the Principles and Values of the NHS along with the Vision and Values of Northampton General Hospital NHS Trust. 5. DEFINITIONS Adult at Risk Community services Abuse Physical Abuse Sexual Abuse Psychological Abuse Financial Abuse Neglect / Omission Discrimination Significant Harm Domestic Abuse Any adult (persons aged 18 years or over) who is or may be in need of community services by reason of mental, or other disability, age or illness and who is unable to take care, or protect themselves against harm or exploitation All care services provided in any setting or context, including acute hospital care. Abuse is a violation of an individual s rights by another person. Abuse can be one single act or repeated acts. Examples: slapping, kicking, unapproved physical restraint. Non-consensual sexual activities, indecent exposures, harassment. Emotional abuse, mental abuse A form of mistreatment in which there is intent to cause mental or emotional pain or injury; PA includes verbal aggression, statements intended to humiliate or infantilize, insults, threats of abandonment or institutionalization; PA results in stress, social withdrawal, long-term or recalcitrant depression, anxiety Examples: threats, humiliation In appropriate management of a person s financial affairs. Deprivation of a person basic needs, personal care, inappropriate use of medication. Disregarding a person s values and beliefs, verbal abuse, harassment, deliberate exclusion. Impairment of or avoidable deterioration of a person physical/ mental health. abuse or violence commonly describing spouse or partner abuse, including physical and/or sexual violence (use of physical force) or threats of such violence or psychological and/or emotional abuse and/or coercive tactics. Example: NGH-PO-241 Page 6 of 14

7 NCC An incident of threatening behaviour, violence or abuse between adults who are or have been intimate partners or family members regardless of gender and sexuality. Northamptonshire County Council These definitions are taken from Protecting Vulnerable Adults from Abuse: Northamptonshire inter-agency safeguarding adult s procedures [online] Northampton. NCC 6. ROLES & RESPONSIBILITIES ROLE Chief Executive and the Trust Board Director of Nursing, Midwifery and Patient Services Head of Safeguarding and Dementia The Director of Workforce and Transformation Safeguarding Adult Lead All Trust Employees RESPONSIBILITY Are responsible for ensuring there is a policy in place. Is the portfolio holder for safeguarding and has Board level responsibilities for the requirements under Regulation 11 of the Care Standards Act 2001 and Care Act The Head of Safeguarding and Dementia is the Trust wide strategic lead for safeguarding. The Director of Workforce and Transformation is responsible for ensuring that: Recruitment and retention policies will comply with relevant legislation and guidance relating to staff working with children and include enhanced Disclosure and Barring Service checks Named Professional provide an internal lead point of contact for advice and support to NGH staff in relation to issues surrounding Safeguarding Vulnerable Adults Have a responsibility to: Support the Trust to achieve its Vision Act at all times in accordance with the Trust values Follow duties and expectations of staff as detailed in the NHS Constitution Staff Responsibilities See section 7.1 & Appendix 2 NGH-PO-241 Page 7 of 14

8 7. SUBSTANTIVE CONTENT 7.1. Staff Responsibilities in Respect of Abuse) All allegations of abuse must be regarded as serious, reported appropriately and investigated immediately. The Trust has adopted the Northamptonshire Safeguarding Vulnerable Adults Board - Inter-agency procedures. Staff have the right to form their own judgment and to challenge other opinions, including medical statements, where they believe this is in the adult s best interest. Where a staff member s concerns appear not to be taken seriously, it is appropriate to escalate to a more senior manager and/or the named nurse, and in exceptional circumstances to Trust Directors/ Executives Safeguarding Adult Notification Within Northamptonshire, all new notifications should be made to the Adult Care Team. Generally adults and their carers should be informed of a notification and the content of any report. However there may be some circumstances where these notifications are made without person s knowledge for example: if the adult may be put at increased risk; if there are immediate risks to the practitioner making the referral, or in circumstances where the abuse, is suspected and the perpetrator not verified. In these circumstances it should be made clear that knowledge of notification is limited. All adult protection concerns should be discussed where necessary with a manager. All allegations or disclosures of abuse must be treated seriously. The member of staff raising concerns should ensure there is documented evidence of all actions taken. Where possible a copy of the referral should be filed in the patients medical notes. It is important that any information recorded and/or reported is factual and not based on opinion or conjecture. If staff are not satisfied with the response to a notification or where staff have concerns about an adult being at risk of significant harm but feel their concerns are not being taken seriously, they should seek advice and support regarding their concerns from the Head of Safeguarding, Safeguarding Adult Lead, Matron or on call team escalate your concern to the NCC Safeguarding Team on Allegations of abuse by staff When an allegation of abuse/ concerns an NGH employee staffs should follow the procedures outlined in the Managing Concerns or Allegations of Abuse Made against Staff NGH-PO Preservation and Gathering of Evidence Physical Evidence Where there is allegation of physical abuse then staff should attempt to gather any physical evidence. Staff should ensure that their first priority is the welfare of the alleged victim. A body map should be used to evidence any physical evidence. NGH-PO-241 Page 8 of 14

9 Photographic Evidence If photographic evidence is required, it will be gathered in line with Photography and Video Recording of Patients NGH-PO Forensic Evidence If staff have concerns about the potential sexual / physical or allegations of a criminal act being committed, physical evidence will need to be collected. In serious cases an examination of the alleged victim will be carried out by a trained forensic examiner Mental Capacity and Safeguarding Referrals When Staff is considering undertaking a referral through the safeguarding process they must adhere to the principles of the Mental Capacity 2005 at all times. Vulnerable adults should be assumed to have capacity and should be encouraged and enabled to make their own decisions when required. This should include consent for a safeguarding referral to be completed Staff must consider two key factors: 1. Did the vulnerable adult give meaningful consent to the act relationship or situation which constitutes the alleged or suspected abuse? 2. Does the person now give meaningful consent to any preventable action, investigation or report? Mental Capacity Act including Deprivation of Liberty NGH-PO Supporting Staff The Trust recognises that involvement in any aspect of adult abuse can be stressful for staff. It is therefore committed to offering help and support for any staff that have concerns. Staff are advised at training that the Trust provides a counselling service via the occupational health department. This service can be accessed by self-referral or by referral by a line manager Information Sharing Information sharing and recording of information will comply at all times with the Trust policies and professional codes of conduct relating to confidentiality, Data Protection Act (1998), Health Records Policy (2006), Human Rights Act (1998) and Information Sharing: Practitioners Guide (2006). See NCC document for further details: ng%20adults%20board%20information%20sharing%20protocol%20v5.0%20(pdf%20for mat%20870kb).pdf Staff should be made aware of the Northamptonshire Safeguarding Adults Board information sharing agreement. The Trust has agreed the process for information sharing and is signatory to the current policy. Any request for information regarding a vulnerable adult should follow the process as identified within the policy. Staff should contact NGH-PO-241 Page 9 of 14

10 Safeguarding Vulnerable Adults & Mental Capacity Lead for advice and support where necessary. Where possible Trust staff should be working on the one set record only philosophy. All information exchanged or shared with other agencies will be documented in the clinical records. All information relating to safeguarding will stored within the Governance department. Written records must be kept, documenting any concerns, allegations or disclosures of abuse, noting dates and incidents. Any discussions with adults/carers, managers or other agencies/professionals must be documented. Staff should listen carefully to any person who discloses abuse and record any information obtained from an interview with said person immediately in the health record. Staff must not promise confidentiality in respect of such information. Practitioners will know how to contact their Safeguarding Adults Professionals within the Trust for advice and support on safeguarding adult s issues. This will be achieved through a robust programme of training, provided by the Trust Police Involvement and Safeguarding Investigations There are times when the primary investigations are held by the police. In these circumstances the officer in care of the case or senate investigating officer will contact the Trust Safeguarding Adult Lead or Head of Safeguarding to ensure internal process do not conflict with normal enquires Information Sharing and Police investigations In the event of death or serious assault Northamptonshire police may request the person s health records to assist them in their inquiries. The process to be followed: 1) Prior to collection the police will telephone or the Safeguarding Adult Lead/Risk department to make the request, identify the records required and give a date and time for collection (within 2 working days). 2) Following this request the records should be photocopied. The police officer will provide a letter on headed notepaper on behalf of the Senior Officer within the Police Force, stating the reason for the request. This letter will bear the signature of the police officer working on the case and will be given to the member of staff who has responsibility for the notes. This will remain in the professional s keeping with the original notes. 3) The copy of the records will be handed to the police and the original retained by the health professional. Should the police have previously specified that they require the originals, you will retain the photocopy and hand them the original records. 4) The date and time the records are handed to the police should be entered on both the copy and the original under the last entry and signed. NGH-PO-241 Page 10 of 14

11 5) When the police have completed their investigation the photo-copied records will: a) Be destroyed if there is no further action b) Be retained in a secure place with other documentation relating to the enquiry if a prosecution is to take place. Following the prosecution the records will be kept for the same period as the associated police records. 6) The originals will be returned Governance External Notifications In the event that an external notification is received by the Trust, the safeguarding team will manage the investigatory response in line with safeguarding standard operation procedures. 8. IMPLEMENTATION & TRAINING This policy and the Northamptonshire wide procedure will be made available to staff via the Trust intranet. The content of the policy will be communicated through induction training and mandatory training sessions for all staff Ward Managers, Matron, Clinical Lead and General Managers of each division are responsible for ensuring that staff are made aware of new and revised policies and provided access to copies of those policies. Review of training as part of annual performance review Managers undertaking annual individual performance reviews of clinical staff should include reference to vulnerable adult awareness and training as appropriate for their level and role. Arrangements for training The Safeguarding Adult Lead will undertake a training needs analysis to determine which groups of staff should attend training. Training will be accessed in conjunction with the Clinical commissioning group (CCG) and the local Mental Health Trust to promote joint learning between specialists in the healthcare community. Training linked to this policy is mandatory for some staff groups. Therefore as part of the Mandatory Training Policy (NGH-PO-306), the organisation has undertaken a training needs analysis to identify which staff groups need training for this policy. The updated TNA is located on the Trust intranet- please click here to access the Training Needs Analysis (TNA). Each subject found on the TNA also has a more detailed course outline which can also be found on the intranet, click here: Mandatory Training-Course Outlines. NGH-PO-241 Page 11 of 14

12 9. MONITORING & REVIEW Minimum policy requirement to be monitored Process for monitoring Responsible individual/ group/ committee Frequency of monitoring Responsible individual/ group/ committee for review of results Responsible individual/ group/ committee for development of action plan Responsible individual/ group/ committee for monitoring of action plan Annual Quarterly/ Reporting to Safeguarding Committee Safeguarding Committee Quarterly Quality Governance Committee Safeguarding Committee Safeguarding Committee 10. REFERENCES & ASSOCIATED DOCUMENTATION Association of Directors of Social Services (2005) Safeguarding Adults: a National Framework of Standards for good practice and outcomes in adult protection work. [online] London. ADSS Available from: [Accessed ] Care Act 2014 (c.23) London, The Stationery Office Care Standards Act 2000 (c. 14) London. HMSO Convention for the Protection of Human Rights and Fundamental Freedoms (1950). [online] Rome. Council of Europe. Available from: [Accessed ] Data Protection Act 1998 (c. 29) London. HMSO Department for Constitutional Affairs (2007) Mental Capacity Act 2005: Code of Practice [online]. London. TSO. Available from: Department of Health (1998). Implementing Section 21 of the Disability Discrimination Act 1995 across the NHS (HSC 1999/156). London. DH Department of Health (2014) Care and support statutory guidance: issued under the Care Act [online] London, DH. Available from: /43380_ _Care_Act_Book.pdf [Accessed ] Department of Health (2004) Speech by Stephen Ladyman MP, Parliamentary Undersecretary of State for Community, 22nd March 2004: Speech to Action on Elder Abuse conference [online]. London. DH. Available NGH-PO-241 Page 12 of 14

13 from: News/Speeches/Speecheslist/DH_ [Accessed ] Directors of Adult Social Services (2011) Safeguarding adults [online] London, ADASS Available from: vicenote0411b.pdf [Accessed ] Domestic Violence, Crime and Victims Act 2004 (c. 28) London. HMSO Health Act 1999 (c. 8) London. HMSO HM Government (2008) Information Sharing: guide for practitioners and managers. [online] Nottingham. Department for Children, Schools and Families and Communities and Local Government. Available from: /information_sharing_guidance_for_practitioners_and_managers.pdf [Accessed ] Home Office (1998). Speaking Up for Justice: report of the Interdepartmental Working Group on the treatment of vulnerable or intimidated witnesses in the criminal justice system. London. Home Office Human Rights Act (c. 42) London. HMSO Local Authority Social Services Act 1970 (c. 42). London. HMSO Local Government Association & Directors of Adult Social Services (2013) Safeguarding adults: advice and guidance to Directors of Adult Social Services [online] London, LGA Available from: s/key_documents/lga%20adass_safeguardingadviceandguidancetodass_mar13.pdf [Accessed ] Mental Capacity Act 2005 (c.9) London. HMSO Modernising social services: Promoting independence, improving protection, raising standards. (Cm 4169, 1998) London. The Stationery Office Northamptonshire County Council (2014) Safeguarding adults. [online] Northampton, NCC. Available from: [Accessed ] Northamptonshire County Council and Northamptonshire Safeguarding Adults (2010) Protecting Vulnerable Adults from Abuse: Northamptonshire inter-agency safeguarding adults procedures [online] Northampton. NCC. Available from: [Accessed ] Northamptonshire Healthcare NHS Foundation Trust (2015) Policy for safeguarding vulnerable adults. Kettering, NHFT NGH-PO-241 Page 13 of 14

14 Public Interest Disclosure Act 1998 (c. 23). London, HMSO Sexual Offences Act 2003 (c. 42). London. HMSO Youth Justice and Criminal Evidence Act 1999 (c. 23) London. HMSO This policy should be read in conjunction with the following polices: Northampton General Hospital (2015) Trust and Local Induction NGH-PO-386 Northampton, NGHT Northampton General Hospital (2014) Health Records Management. NGH-PO-058 Northampton, NGHT Northampton General Hospital (2014) Information Governance Policy NGH-PO-233 Northampton, NGHT Northampton General Hospital (2014) Managing concerns for allegations of abuse made against staff. NGH-PO-484. Northampton, NGHT Northampton General Hospital (2014) Mandatory Training NGH-PO-306 Northampton, NGHT Northampton General Hospital (2014) Mental Capacity Act 2005 (including Deprivation of Liberty safeguards 2008). NGH-PO-303. Northampton, NGHT Northampton General Hospital (2014) Trust Risk Management Strategy NGH-SY-426 Northampton, NGHT Northampton General Hospital (2013) Photography and video recording of patients.. NGH- PO-068. Northampton, NGHT Northampton General Hospital (2013) Raising concerns at work (Whistleblowing) NGH-PO- 002 Northampton, NGHT Northampton General Hospital (2010) Management of Incidents (including serious incidents) NGH-PO-393 Northampton, NGHT NGH-PO-241 Page 14 of 14

15 Appendix1 What constitutes abuse- A brief guide for staff What constitutes abuse? The term abuse can be subject to wide interpretation. The No Secrets guidance defines abuse as a violation of an individuals human and civil rights by another person or person. The abuse can vary from treating someone with disrespect in a way, which significantly affects the person s quality of life, to causing actual physical suffering. The Department of Health recognises that abuse may not just be physical, sexual or an obvious act of cruelty. There are many types of abuse including mental, emotional, financial and discriminatory abuse. There is no hierarchy among these types of abuse. Depending on the circumstances, pernicious racist abuse can have as profound an effect as, for example, physical abuse on a vulnerable adult. Bullying or daily humiliations, perhaps presented as jokes by the perpetrators, can be as harmful as single acts of cruelty. Similarly unintended abuse or neglect can have the same impact as deliberate (Stephen Ladyman, 2004). Abuse can be: Physical abuse, including hitting, slapping, pushing, kicking, misuse of medication, restraint or inappropriate sanctions. Sexual abuse, including rape and sexual assault or sexual acts to which the vulnerable adult has not consented, or could not consent or was pressured into consenting. Psychological abuse, including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, isolation or withdrawal from services or supportive networks. Financial or material abuse, including theft, fraud, exploitation, pressure in connection with wills, property or inheritance of 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, withholding of the necessities of life, such as medication, adequate nutrition and heating. Discriminatory abuse, including racist, sexist, that is based on a person s disability, and other forms of harassment, slurs or similar treatment. Neglect and poor professional practice also need to be taken into account. This may take the form of isolated incidents of poor or unsatisfactory professional practice as in institutional abuse. Vulnerable adults may be abused by a wide range of people including relatives, professional staff, paid care workers, volunteers, other service users, neighbours, NGH-PO-241 Page 1 of 2 Version 3.2 October 2011

16 friends and associates, people who deliberately exploit vulnerable people and strangers. There is particular concern when abuse is perpetrated by someone in a position of power or authority who uses his or her position to the detriment of the health, safety and well being of a vulnerable person. Abuse can take place in any context. It may occur when a vulnerable adult lives alone or with a relative. It may also occur within nursing, residential of day care settings and in hospitals. The seriousness or extent of the abuse is often not clear. It is important therefore when considering the appropriateness of intervention, to approach reports of incidents or allegations with an open mind. In making any assessment of seriousness the following factors need to be considered: The vulnerability of the individual The nature and extent of the abuse The length of time it has been occurring The impact on the individual The risk of repeated or increasingly serious acts involving this or other vulnerable adults NGH-PO-241 Page 2 of 2 Version 3.2 October 2011

17 Safeguarding Concerns raised by You I have a concern about the safety or wellbeing of people in my care or in the environment in which I work Step 1: Raise your concern internally with your line manager e.g. Ward Sister or Nurse in Charge and document this in the patient s notes Raise the concern as a Datix If unable to do this for whatever reason If there is an immediate risk of harm, report your concerns without delay to the appropriate person or authority Step 2: Raise your concern internally with a designated person eg the SOVA Lead ext 3769, Bleep 8520 or if out of hours the Site Manager and document this SAFEGUARDING THE VULNERABLE ADULT Concern not addressed adequately and/or immediate risk to others Step 3: Escalate your concern internally to a higher level eg your Modern Matron or Lead Nurse Concern not addressed adequately and/or immediate risk to others seek independent, confidential advise Information Leaflet For All Staff Step 4: Escalate your concern to the NCC Safeguarding Team on

18 Who might be a vulnerable adult? Anyone who is 18 years or over and because of age, illness, disability or a mental health problem cannot protect themselves from abuse. What is adult abuse? Adult abuse can consist of a single or repeated act of harm or exploitation. It may be perpetrated as a result of deliberate intent, neglect or ignorance and is a violation of an individual s human and civil rights by any other person or persons. Physical Abuse Physical ill treatment of an adult, which is wilfully inflicted by a person who has responsibility, charge, care or custody of the vulnerable adult, or who stands in a position of trust to a vulnerable adult. The abuse may or may not cause a physical injury; it includes such things as burning, slapping, pushing, kicking, hair pulling, rough handling, misuse of medicines, restraint and exposure to unnecessary risk or danger. Sexual Abuse This includes rape and sexual assault; sexual acts which the vulnerable adult didn t want to do but was made to carry out; sexual acts the vulnerable person didn t understand or agree to. It also includes inappropriate touching of any part of the body, offensive use of explicit sexual language and denial of respect for a person s privacy. Please note that there may be a lack of awareness by the person that this type of abuse is wrong. Financial Abuse This includes the theft or misuse of a person s property, money, benefits, pension, bank account, or other belongings without their permission. Neglect This includes ignoring medical or physical care needs, or withholding the necessities of life such as food, heating and medicines which causes the person to suffer. Psychological/Emotional Abuse This is wilful infliction of mental suffering on a vulnerable adult by any other person or persons. Psychological abuse may indicate that other forms of abuse are also taking place. Psychological and emotional abuse includes: threats, intimidation, humiliation, denial of personal respect and dignity, verbal abuse, bullying, instilling fear and isolation Discriminatory Abuse This includes any abuse or harassment that is aimed around a vulnerable adult s mental or physical ability, race, gender, culture, religion, age or sex. Institutional Abuse Indicated by repeated instances of unsatisfactory professional practice, pervasive ill treatment or gross misconduct indicating an abusive climate. Who may abuse? Vulnerable adults may be abused by a wide range of people including: A partner, child, relatives and other family members A paid or volunteer carer Health, social care or other professional staff Other service users Neighbours and friends Strangers Anyone Where does abuse happen? Abuse can happen anywhere including: In someone s own home At a carer s home At day care In care homes, residential or nursing homes In hospital At work or in education settings In Public places Anywhere What should you do if you are worried or suspect a vulnerable adult is being abused? If you have a concern about the safety or well-being of people in your care or if there is an immediate risk of harm, report your concerns without delay to your line manager Staff of Northampton General Hospital Refer to the Multi-Agency Policies and Procedures for the Protection of Vulnerable Adults from Abuse. These can be found in the policies and procedures section in the intranet. For further support or advise please contact: Lorraine Hunt - Safeguarding Vulnerable Adults Lead Tel: , Bleep 8520 Or Out of Hours the Site Manager or Bed Manager If a patient with learning disabilities is admitted to your ward or for further advice please contact: Debbie Wigley, the Learning Disability Acute Liaison Nurse on: /

19 What to do if Safeguarding Concerns are raised to You Consider whether safeguarding concerns are founded Ensure the patient is safe and out of immediate danger Document in the patient s records and verbally handover to nursing team If the safeguarding concern is founded inform: The SOVA Lead if in hours Senior Nurse/ escalate to on-call manager if out of hours Medical Team Next of Kin/ family as appropriate Capacity Ensure that patient has consented for procedure to be implemented. If it is found that the adult does not have Capacity to make a decision, the Trust Acts in the patient s best interest at all times SAFEGUARDING THE VULNERABLE ADULT Ensure a datix is completed In Hours - Inform the Trust SOVA Lead Telephone ext 3769 Bleep 8520 Out of Hours - Fax notification form (SO1) within 24 hours to the NCC Safeguarding Team: Tel no and send a copy of the Notification to the Trust SOVA Lead: Insert a copy of the Notification Form (SA1) into the patient s medical notes Information Leaflet For On-Call Staff and Line Managers If you are concerned about abuse by a member of staff, consult the Managing Allegations of Abuse made against a Member of Staff Policy (for consultation at the time of going to press June 2011)

20 Who might be a vulnerable adult? Anyone who is 18 years or over and because of age, illness, disability or a mental health problem cannot protect themselves from abuse. What is adult abuse? Adult abuse can consist of a single or repeated act of harm or exploitation. It may be perpetrated as a result of deliberate intent, neglect or ignorance and is a violation of an individual s human and civil rights by any other person or persons. Physical Abuse Physical ill treatment of an adult, which is wilfully inflicted by a person who has responsibility, charge, care or custody of the vulnerable adult, or who stands in a position of trust to a vulnerable adult. The abuse may or may not cause a physical injury; it includes such things as burning, slapping, pushing, kicking, hair pulling, rough handling, misuse of medicines, restraint and exposure to unnecessary risk or danger. Sexual Abuse This includes rape and sexual assault; sexual acts which the vulnerable adult didn t want to do but was made to carry out; sexual acts the vulnerable person didn t understand or agree to. It also includes inappropriate touching of any part of the body, offensive use of explicit sexual language and denial of respect for a person s privacy. Financial Abuse This includes the theft or misuse of a person s property, money, benefits, pension, bank account, or other belongings without their permission. Neglect This includes ignoring medical or physical care needs, or withholding the necessities of life such as food, heating and medicines which causes the person to suffer. Psychological/Emotional Abuse This is wilful infliction of mental suffering on a vulnerable adult by any other person or persons. Psychological abuse may indicate that other forms of abuse are also taking place. Psychological and emotional abuse includes: threats, intimidation, humiliation, denial of personal respect and dignity, verbal abuse, bullying, instilling fear and isolation Discriminatory Abuse This includes any abuse or harassment that is aimed around a vulnerable adult s mental or physical ability, race, gender, culture, religion, age or sex. Institutional Abuse Indicated by repeated instances of unsatisfactory professional practice, pervasive ill treatment or gross misconduct indicating an abusive climate. Who may abuse? Vulnerable adults may be abused by a wide range of people including: A partner, child, relatives and other family members A paid or volunteer carer Health, social care or other professional staff Other service users Neighbours and friends Strangers Anyone Where does abuse happen? Abuse can happen anywhere including: In someone s own home At a carer s home At day care In care homes, residential or nursing homes In hospital At work or in education settings In Public places Anywhere What should you do if you are worried or suspect a vulnerable adult is being abused? Follow the flow chart over the page and for further information refer to the Multi-Agency Policies and Procedures for the Protection of Vulnerable Adults from Abuse, which can be found on the Policies and Procedures section of the intranet. For further support or advice please contact: Lorraine Hunt - Safeguarding Vulnerable Adults Lead Tel: , Bleep 8520 Or Out of Hours the Sister on Call or Bed Manager If a patient with learning disabilities is admitted or for further advice please contact: Debbie Wigley, the Learning Disability Acute Liaison Nurse on: / To make a safeguarding referral or for further support or advice please contact: The NCC Safeguarding Team can be contacted for support or advice or OR to make a referral or discuss concerns out of hours call

21 Appendix 4 Reporting and Alerting Process Adult: SOVA Notification (link to Northamptonshire County Council website for Adult Safeguarding Referral Form SA1) NGH-PO-241 Page 1 of 1 Version 3.1 October 2011

22 FORM 1 & 2 - To be completed by document lead FORM 1a- RATIFICATION FORM - FOR COMPLETION BY DOCUMENT LEAD Note: Delegated ratification groups may use alternative ratification documents approved by the procedural document groups. DOCUMENT DETAILS Document Name: Safeguarding Adults Is the document new? No If yes a new number will be allocated by Governance N/A If No - quote old Document Reference Number NGH-PO-241 This Version Number: Version: 3.2 Date originally ratified: Date reviewed: February 2015 Date of next review: a 3 year date will be given unless you February 2018 (3 Years) specify different If a Policy has the document been Yes Equality & Diversity Impact Assessed? (please attach the electronic copy) DETAILS OF NOMINATED LEAD Full Name: Lorraine Hunt Job Title: Safeguarding Vulnerable Adults Lead Directorate: Safeguarding Address: Lorraine.hunt@ngh-nhs.uk Ext No: DOCUMENT IDENTIFICATION Keywords: please give up to 10 Adults, safeguarding, abuse, mental capacity, to assist a search on intranet allegations, GROUPS WHO THIS DOCUMENT WILL AFFECT? ( please highlight the Directorates below who will need to take note of this updated / new Document ) Anaesthetics & Critical Care General Medicine & Emergency Care Medical Physics Child Health Gynaecology Nursing & Patient Services Corporate Affairs Haematology & Oncology Obstetrics Diagnostics Head & Neck Ophthalmology Estates & Facilities Human Resources Planning & Development Finance Infection Control Trauma & Orthopaedics General Surgery Information Governance Trust Wide TO BE DISSEMINATED TO: NB if Trust wide document it should be electronically disseminated to Head Nurses/ Dm s and CD s.list below all additional ways you as document lead intend to implement this policy such as; as presentations at groups, forums, meetings, workshops, The Point, Insight, newsletters, training etc below: Where When Who Updated August 2014 Page 1 of 2

23 FORM 1 & 2 - To be completed by document lead FORM 2 - RATIFICATION FORM to be completed by the document lead Please Note: Document will not be uploaded onto the intranet without completion of this form CONSULTATION PROCESS NB: You MUST request and record a response from those you consult, even if their response requires no changes. Consider Relevant staff groups that the document affects/ will be used by, Directorate Managers, Head of Department,CDs, Head Nurses, NGH library regarding References made, Staff Side (Unions), HR Others please specify Name, Committee or Group Consulted Date Policy Sent for Consultation Amendments requested? Amendments Made - Comments wards, matrons, senior nurse and consultants No feedback received Existing document only - FOR COMPLETION BY DOCUMENT LEAD Have there been any significant changes to this document? YES / NO if no you do not need to complete a consultation process Sections Amended: YES / NO Specific area amended within this section Re-formatted into current Trust format YES / NO Summary/ Introduction/Purpose YES / NO Scope YES / NO Definitions YES / NO Roles and responsibilities YES / NO Substantive content YES / NO Monitoring YES / NO Refs & Assoc Docs YES / NO Appendices YES / NO Updated August 2014 Page 2 of 2

24 Policy for Safeguarding Vulnerable Adults PAPER EQIA #NGH/PO/241 Area of Work Everyone Person Responsible Jessica Busuttil Created Last Review 25th August, th June, 2015 Status Next Review Complete 28th June, 2018 Screening Data Name, job title, department and telephone number of the person completing this Equality Impact Assessment What is the title and number of this policy/procedure/guideline? What are the main aims, objectives or purpose of this policy/procedure/guideline? Who is intended to benefit from this policy/procedure/guideline? Is this a Trustwide, Directorate only or Department only policy/procedure/guideline? Who is responsible for the implementation of the policy/procedure/guideline? What data are available to facilitate the screening of this policy? Is there any evidence of higher or lower participation, uptake or exclusion, by the following characteristics? In the context of the preceding sections are there any relevant groups which you believe should be consulted? Please specify and give reasons: What data are required in the future to ensure effective monitoring?

25 Considering all information above please indicate areas where a differential impact occurs or has the potential to occur. Any other comments on the policy Potential for differential impact? Recommend this EA for Full Analysis? No Comments PAPER EQIA Rate this EA Low Organisation Sign-off Data If the policy is implemented what is the potential risk of it having an adverse effect on equality? If the policy is implemented what is the potential of it having a positive effect on equality and relations? If the potential for risk or positive effect occurred what would be the potential number of people it effected? Based on the answers to questions 1-3 will this policy promote equality and diversity? Do you have any additional comments or observations about the policy? How will the results of the Equality Impact Assessment will be published? Have you completed any Action Boxes with recommended actions or changes for completion? If 'Yes' please print off an action plan report along with a copy of the Equality Impact Assessment report to the policy/procedure/guidelines owner, and record below who it has been sent to

26 If 'No' please print off a copy of the Equality Impact Assessment report to the policy/procedure/guidelines owner, and record below who it has been sent to Please give details of the monitoring arrangements Monitoring arrangements Next Review Date Outstanding Actions No outstanding actions

27 FORM 3- RATIFICATION FORM (FOR PROCEDURAL DOCUMENTS GROUP USE ONLY) Read in conjunction with FORM 2 Document Name: Overall Comments from PDG Consultation Do you feel that a reasonable attempt has been made to ensure relevant expertise has been used? Title -Is the title clear and unambiguous? Is it clear whether the document is a strategy, policy, protocol, guideline or standard? Summary Is it brief and to the point? Introduction Is it brief and to the point? Purpose Is the purpose for the development of the document clearly stated? Scope -Is the target audience clear and unambiguous? Compliance statements Is it the latest version? Definitions is it clear what definitions have been used in the Roles & Responsibilities Do the individuals listed understand about their role in managing and implementing the policy? Substantive Content is the Information presented clear/concise and sufficient? Implementation & Training is it clear how this will procedural document will be implemented and what training is required? Monitoring & Review (policy only) -Are you satisfied that the information given will in fact monitor compliance with the policy? References & Associated Documentation / Appendicesare these up to date and in Harvard Format? Does the information provide provide a clear evidence base? Are the keywords relevant Safeguarding Vulnerable Adults Policy Document No: NGH-PO-241 V3.3 YES / NO / NA Recommendations Recommendations completed YES / NO / NA YES / NO / NA YES / NO / NA YES / NO / NA YES / NO / NA YES / NO / NA YES / NO / NA YES / NO / NA YES / NO / NA YES / NO / NA Add a definition for Psychological abuse Domestic Abuse Do CCG have a role within this document? Updated in V3.3 YES / NO / NA 7.1 remove Best Remove brackets in Add NCC information sharing doc link Add LH full title Amend a few typos Updated in V3.3 YES / NO / NA Put CCG in Full Updated in V3.3 YES / NO / NA YES / NO / NA YES / NO / NA no Name of Ratification Group: Procedural Document Group Chair approval required after minor amendments Date of Meeting: 16/04/2015 Chair (SH) approved on 9/6/2015 Updated August 2014 Page 1 of 1

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