Worcestershire Primary Care Trust Safeguarding Adults Policy Version: Final Ratified by: Quality and Safety Committee Date ratified: March 2009 Name of originator/author: Vicky Preece Name of responsible committee/individual: Vicky Preece Date issued: April 2009 Review date: March 2012 Target audience: Staff working with vulnerable adults 1
CONTRIBUTION LIST Key individuals involved in developing the document Name Vicky Preece Designation Associate Director of Nursing Circulated to the following individuals for consultation Name Nicky Barry Sandra Hulme Lesley Way Lin Ingles Chris Freke Sandra Rote Lisa Levy Sue Warner Marie McCurry Jane Pugh Maria Wilday Lyn Takavarasha Designation Adult Protection Co-Ordinator Associate Director of Provider Services Patient Safety Manager Matron Malvern Hospital Professional Practice Facilitator District Nursing Director of Clinical Development and Executive Nurse Associate Director of Provider Services Associate Director of Provider Services Associate Director of Provider Services Deputy Director of Provider Services Matron, POWCH Acting Head of Non-Acute Commissioning 2
CONTENTS Paragraph Page 1 Purpose 4 2 Introduction 4 3 Scope of the policy 3.2 Compliance with other statutory requirements and other guidance 3.3 Exclusions 4 4 4 Definitions 4.1 Vulnerable adult 4.2 Abuse 4.3 Safeguarding adults 4.4 Mental capacity 6 Roles and responsibilities 6 6 Safeguarding adult procedures to follow 6 7 Training for safeguarding adults 6 8 Plan for implementation 7 9 Monitoring the policy 7 10 Appendix 1 - Worcestershire PCT Mental Capacity Act (MCA) and Adult Safeguarding Steering Group (MCAAS) Terms of Reference 8 11 Appendix 2 Safeguarding Adults Referral Checklist and Guidance for PCT staff 10 3
1. Purpose of this Policy The purpose of this policy is to ensure that the PCT has agreed procedures and protocols in place to safeguard vulnerable adults and to make explicit the roles and responsibilities of all PCT employees. The PCT is committed to working with other agencies to Safeguard Adults and will comply with the agreed Multi-Agency Framework for Safeguarding Adults in Worcestershire and the Worcestershire Adult Protection Policy and Procedures (2008) which can be accessed via the PCT intranet page or directly via; www.worcestershire.gov.uk/safeguardingadults The Policy recognises that Safeguarding Adults is everyone s responsibility 2. Introduction The PCT has a duty of care to protect its patients from abuse. It must respond promptly when abuse is suspected or reported. This Policy has been developed to outline the practice and procedures for all PCT staff to follow from which to contribute to the prevention of abuse to vulnerable adults. It aims to promote protection from abuse of people aged 18 years or older who are in receipt of our services and to ensure appropriate action is taken where abuse is suspected. People are vulnerable whenever their health or usual function is compromised and as a consequence they may be unable to protect themselves against harm or exploitation. A person s vulnerability increases when they are in unfamiliar surroundings, situations or relationships and when they become reliant on others for care. Although illness and disability at any age can make people vulnerable, some people are more vulnerable to abuse than others e.g. those who are physically frail, those who have mental health problems and those with a learning disability. In March 2000 the Department of Health issued a guidance document No Secrets which required the development and implementation of multi-agency policies and procedures to protect vulnerable adults from abuse. The Trust has worked in partnership with the Worcestershire Safeguarding Adults Board to implement the agreed Multi-Agency Framework for Safeguarding Adults in Worcestershire and the Worcestershire Adult Protection Policy and Procedures (2010). This policy sets out the PCT s internal procedures, staff roles and responsibilities and must be read in conjunction with the Multi-Agency Framework for Safeguarding Adults in Worcestershire and the Worcestershire Adult Protection Policy and Procedures (2010) available via the PCT intranet or at www.worcestershire.gov.uk/safeguardingadults Local arrangements for safeguarding adults within the PCT will be managed through the PCT s Mental Capacity Act and Adult Safeguarding Steering Group (MCAAS). The terms of reference and membership of this group are attached as Appendix 1. 3. Scope of the Policy This policy applies to all staff employed by Worcestershire PCT who work with vulnerable adults. 3.2 Compliance with statutory requirements and other guidance 4
This policy complies with and should be read in conjunction with the Multi-Agency Framework for Safeguarding Adults in Worcestershire and the Worcestershire Adult Protection Policy and Procedures (2010) and the Mental Capacity Act (200) Guidance available via the PCT intranet or at www.worcestershire.gov.uk/mentalcapacityact. 3.3 Exclusions This policy does not cover safeguarding children so staff caring for anyone under the age of 18 years should refer to the Safeguarding Children s Policy and Procedures (2006) available via the PCT Intranet. 4. Definitions 4.1 Vulnerable Adult The term Vulnerable Adult refers to any person aged 18 and over who: is or maybe in need of community care services by reason of mental or other disability, age or illness; and who is or maybe unable to protect him or herself against significant harm or serious exploitation (No Secrets, Department of Health 2000) 4.2 Abuse The term Abuse is defined as: Abuse is a violation of an individual s human and civil rights by any other person or persons (No Secrets, Department of Health 2000) Abuse may consist of a single act or repeated acts. It may be physical, verbal or psychological, it may be an act of neglect or an omission to act, or it may occur when a vulnerable person is persuaded to enter into a financial or sexual transaction to which he or she has not consented, or cannot consent. Abuse can occur in any relationship and may result in significant harm to or exploitation of, the person subjected to it. Categories of abuse are; Discriminatory Abuse Physical Abuse Sexual Abuse Psychological Abuse Financial Abuse Neglect and Acts of Omission Institutional Abuse 4.3 Safeguarding Adults The term Safeguarding Adults means: All work which enables any adult who is or may be eligible for community care services to retain independence, wellbeing and choice and to access their human right to live a life that is free from abuse and neglect. (Association of Directors of Social Services (200) )
4.4. Mental capacity Many adults who lack capacity are deemed as vulnerable. The Mental Capacity Act (200) governs decision making on behalf of adults who lose mental capacity at some point in their lives. The act contains a number of provisions designed to protect vulnerable people and staff should refer to guidance on the MCA via the PCT website (See 3.2).. Roles and Responsibilities Worcestershire County Council s Adult and Community Services acts as the lead agency with responsibility for co-ordinating local activity for the safeguarding of vulnerable adults but all agencies should have a designated Lead Officer. The PCTs designated Lead Officer for Safeguarding Adults is the Lead Nurse Provider Services/Associate Director of Nursing and the Executive Director accountable for adult safeguarding is the Director of Clinical Development and Executive Nurse. Managers: should support all members of staff who are involved in any issues or incidents pertaining to a vulnerable adult. Staff: every member of staff who may come into contact with, or is responsible for caring for a vulnerable adult as part of their duties must attend Safeguarding Adults Awareness training (see the Mandatory/Statutory/Essential Training Checklist). It is everyone s duty to report any suspicions or witnessing of adult abuse. An allegation of abuse must be treated seriously, regardless of the source of the information. It is important for staff to pass on information or concerns immediately to the nurse or manager charge. Where a criminal offence is suspected, the police must be informed immediately. 6. Safeguarding Adults procedures to follow Any member of staff identifying concerns that they may have about the abuse of patients must report these to their line manager in line with the process outlined in the Worcestershire PCT Safeguarding Adults Referral Checklist (Appendix 2). Line managers should ensure that the Lead Nurse Provider Services Associate Director of Nursing is informed as soon as possible, who in turn will inform the relevant senior manager. 7. Training for Adult Safeguarding Worcestershire PCT employs many frontline staff who may have some or regular contact with vulnerable adults in the course of their work. Relevant staff falling into this category will be required to undertake Adult Safeguarding Awareness training. Details of this can be found in the Statutory/Mandatory/Essential Training Checklist via the PCT intranet Training will be delivered either at training sessions delivered by the Adult Protection Team or via a training DVD which is held by the Professional Development Team. 6
Training records will be held centrally via the Professional Development Team and then data stored on OLM. PCT managers required to carry out investigations related to allegations of abuse must have attended Investigatory Skills training. 8. Plan for Implementation This policy will be supported by a series of awareness raising workshops and notices to staff. Designated areas across the PCT will be provided with pocket sized policy and procedure booklets which have been published by Worcestershire County Council. All clinical areas will be provided with laminated copies of the Worcestershire PCT Safeguarding Adults Referral Checklist. Staff will have easy access to the policy via the Intranet. The Trust Lead Officer for Safeguarding Vulnerable Adults is the Lead Nurse Provider Services/Associate Director of Nursing who will set up and chair a PCT Mental Capacity Act and Adult Safeguarding Steering Group to co-ordinate and monitor implementation of this policy within the organisation. The Trust Lead Officer should be advised of any incidents, allegations or disclosures of abuse and any actions taken. Managers will be required to implement this policy within their areas of responsibility and can be contacted by staff for advice. 9. Monitoring of the Policy The Trust Board will receive an annual progress report from the Lead Officer for Adult Safeguarding. The Lead Officer for Adult Safeguarding will liaise closely with the Executive Director of Adult Safeguarding, ensuring regular updates take place. The Lead Officer will be the PCT representative on the Worcestershire Adult Safeguarding Board and ensure that this policy remains in line with county policies and procedures for safeguarding. The PCT Mental Capacity Act and Adult Safeguarding Steering Group within their terms of reference will monitor the number of adult protection incidents reported on a three monthly basis as part of its core business. The PCT Mental Capacity Act and Adult Safeguarding Steering Group will also obtain feedback from the Adult Protection Team of the outcome of reported cases. Cases will be discussed and lessons shared by disseminating findings from the investigations through the directorates governance structures. The board will also monitor the number of staff training in Safeguarding adults. The Clinical Risk Manager is a member of the Mental Capacity Act and Adult Safeguarding Steering Group and will provide reports on all Serious Untoward Incidents (SUI) related to Adult Safeguarding. 7
Appendix 1 Worcestershire PCT Mental Capacity Act (MCA) and Adult Safeguarding Steering Group (MCAAS) Membership Terms of Reference Chair Lead Nurse Provider Services/Associate Director of Nursing PCT lead for MCA and Adult Safeguarding PA to Lead Nurse Provider Services /Associate Director of Nursing secretary for the committee Matron representative Associate Director of Provider Services Clinical Risk manager Professional Practice Facilitator Team representative Representative from Continuing Healthcare Team Representative from Clinical Governance Representative from county council Adult Protection Team Mental Capacity Act Project Manager for the County PCT commissioner representative for MCA and the Deprivation of Liberty Safeguards (DOLS) The committee will: Ensure best practice is adhered to and applied consistently in order to add value and improve the patients experience in relation to Safeguarding Adults issues. Ensure best practice is adhered to and applied consistently in order to add value and improve the patients experience in relation to the Mental Capacity Act 200 and implementation of the Deprivation of Liberty Safeguards effective from April 2009. Contribute to the development, implementation and monitoring of countywide guidelines, policies and procedures in relation to Safeguarding Adults Contribute to the development, implementation and monitoring of countywide guidelines, policies and procedures in relation to Mental Capacity Act and DOLS Ensure that all appropriate staff from the PCT attend the Mental Capacity Act/DOLS, and Safeguarding Adults training and education programmes in support of PCT and countywide policies Contribute to the countywide implementation of Mental Capacity Act legislation and ensure that internal processes within the PCT support the monitoring processes arising from the MCA. Implement a robust reporting and monitoring process for incidents of abuse which is in line with the Trusts incident reporting policy, the governance structure and countywide policies and procedures. 8
Utilise the steering groups representation to discuss and share learning from cases that have been investigated and incidents which have been reported. Ensure systems are in place to share this learning with clinical teams across the Trust Implement a network of clinical leads for MCA and Adult Safeguarding across the PCT clinical areas, utilise them to raise awareness of MCA and safeguarding adults issues. Provide 4 monthly reports on Adult Safeguarding progress to the Quality & Safety Committee. Provide reports on MCA and Adult Safeguarding progress to the PCT Board, Provider Board and management teams as required. Ensure that all Trust staff are aware of and comply with the MCA and Adult Safeguarding policies and procedures and understand their responsibilities in relation to these. To offer advice and information to clinical teams on MCA and safeguarding adult issues To receive and monitor reports of training attendance at MCA and DOLS training programmes Meetings Three monthly Quoracy At least the chair or deputy, an Associate Director of Provider Services and a Matron Communication Quarterly report to go to the Provider Quality & Safety Committee, Notes of meetings to be circulated to group members, Provider Management Team and Chair of Worcestershire Adult Safeguarding Board. Secretary of group to take responsibility for circulation Published: September 2010 Review: September 2011 9
Appendix 2 SAFEGUARDING ADULTS GUIDANCE FOR PCT STAFF Who is a vulnerable adult? Someone over 18 years who might be unable to protect himself or herself from significant harm or serious exploitation because of a physical or mental disability, age or illness. What is abuse? It is the violation of an individual s human or civil rights by another person or people. It can take many different forms and examples such as: - Physical abuse - being hit or restrained, misuse of medication Sexual abuse - being harassed, teased or being forced to have sex without consent Neglect - not getting adequate care, food, medication, heating Psychological abuse - bullying, threats, verbal abuse Discriminatory abuse - ridicule or threats because of race, gender, disability, age, sexual orientation. Financial abuse - theft, fraud, exploitation, pressures to change a will, misappropriation of property and possessions. Institutional abuse - mistreatment by an organisation or individual where care is provided. Duty to report. Abuse can happen anywhere and by anyone, including relatives, friends, neighbours, paid workers, volunteers, professional staff, other service users, contractors and strangers. Whatever your position in the organisation you have a duty to report any allegation or suspicion of abuse of a vulnerable adult, wherever you may observe it or be made aware of it. You must follow the procedures described on the following flowchart which outlines how to report abuse in-line with the PCT s and the Adult Protection Process in Worcestershire. For a copy of the full Adult Safeguarding policy and procedures please refer to the web address as below, or you may contact the Adult Protection team on 0127 600. www.worcestershire.gov.uk/safeguardingadults 10
Safeguarding Adults Referral Checklist for PCT Staff SUSPECTED ABUSE OF A VULNERABLE PERSON You can seek advice from Adult Protection Team (ASC) on 0127 600 Inform PCT Line Manager that a referral needs to be made and complete Incident Reporting Form REFER WITHOUT DELAY TO THE SOCIAL CARE ACCESS CENTRE on 0190 76803. If out-of-hours and urgent, please ring Emergency Duty Team on 0190 768020 Inform Vicky Preece, PCT Adult Safeguarding Lead that a referral has been made as soon as possible on 0190 760072 Vicky Preece will ensure that relevant senior manager is aware of the referral. Manager/Senior Practitioner (ASC) will carry out Strategy Discussion and Checklist and appoint investigator Formal Strategy Meeting held chaired by ASC PCT may carry out own investigation Investigation carried out by ASC Police investigation may be necessary Case Conference Review and Case Closure PCT Primary Care Trust ASC Adult Social Care 11