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Safeguarding Vulnerable Children & Adults

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Shaun Durkin

on 3 October 2016

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Transcript of Safeguarding Vulnerable Children & Adults

Tony Doyle / Christina Hennessey / Kevin Coffey / Laura Behan / Gary Brennan / Cliona Quigley / Lorraine Gibbons / Clare Kean
Building Blocks for Safeguarding
Safeguarding Vulnerable Persons at Risk of Abuse
Definitions of Abuse
Special Considerations
Responding to Concerns or Allegations
A word of caution:
Feelings - past and present
Personal experiences
Respect other views and opinions
Ensure confidentiality at all times
Conclusion:
Are you all clear on all aspects of the course?
Because sensitive material has been covered on this course, make sure you are comfortable to leave these issues in training.
Barriers for Vulnerable Persons Disclosing Abuse
Fear on the part of the service user of having to leave their home or service as a result of disclosing abuse;
A lack of awareness that what they are experiencing is abuse;
A lack of clarity as to whom they should talk to;
Lack of capacity to understand and report the incident;
Fear of an alleged abuser;
Ambivalence regarding a person who may be abusive;
Limited verbal and other communication skills;
Fear of upsetting relationships;
Shame and/or embarrassment.
Capacity
All persons should be supported to act according to their own wishes.
A key challenge arises in relation to working with vulnerable persons regarding capacity and consent. It is necessary to consider if a vulnerable person gave meaningful consent to an act, relationship or situation which is being considered as possibly representing abuse.
While no assumptions must be made regarding lack of capacity, it is clear that abuse occurs when the vulnerable person does not or is unable to consent to an activity or other barriers to consent exist, for example, where the person may be experiencing intimidation or coercion. For a valid consent to be given, consent must be full, free and informed.
Complaints
It is important that a vulnerable person is supported in making his/her own decisions about how he/she wishes to deal with concerns or complaints. The vulnerable person should be assured that his/her wishes concerning a complaint will
only
be overridden if it is considered essential for his/her own safety or the safety of others or arising from legal responsibilities.
Complaints procedures provide an opportunity to put things right for service users and their families. They are also a useful additional means of monitoring the quality of service provision
Particular attention should be paid to complaints which are suggestive of abusive or neglectful practices or which indicate a degree of vulnerability.
Principles critical to the safeguarding of vulnerable adults
Human Rights
Person Centredness
Advocacy
Confidentiality
Empowerment
Collaboration
"People are facilitated and encouraged to integrate into their communities. The centre is proactive in identifying initiatives for participation in the wider community, developing friendships and involvement in local social, educational and professional networks"
"Each resident has a lifestyle in the residential care setting that is consistent with his/her previous routines, expectations and preferences, and satisfies his/her social, cultural, language, religious and recreational interests and needs"
Standard 1.4.2
Standard 18: Routines and Expectations
"Each person has access to an advocate to facilitate communication and information sharing" and
"Each person is facilitated to access citizens information, advocacy services or an advocate of their choice when making decisions, in accordance with their wishes"
"Each resident has access to information, in an accessible format, appropriate to his/her individual needs, to assist in decision making"
All information regarding concerns or allegations of abuse of a vulnerable person should be shared, on 'a need to know' basis in the interests of the vulnerable person, with the relevant statutory authorities and relevant professionals
The Criminal Justice (Withholding of Information on Offences against Children and Vulnerable Persons) Act 2012 came into force on 1st August, 2012. It is an offence to withhold information on certain offences against children and vulnerable persons from An Garda Siochana.
This principle recognises the right of all persons to lead as independent a life as possible. Every possible support should be provided in order to realise that right. Self directedness recognises the right of the individual to self-determination insofar as is possible, even if this entails some degree of risk. Abiding by this principle means ensuring that vrisks are recognised, understood and minimised as far as possible, while supporting the person to pursue their goals and preferences.
A number of key features have been identified to promote good interagency collaboration:
Leadership commitment to collaboration
Team working on a multidisciplinary level
A history of joint working/joint protocols
Development of information sharing processes
Perceptions of good will and positive relationships
Mutual understanding and shared acknowledgment of the importance of adult protection
The topic of this training can be emotive. A free confidential counselling service is available to adults who have experienced childhood physical, emotional or sexual abuse in an institutional, educational or family setting.
1800 477 477

To ensure that staff are equipped with appropriate skills, knowledge and values to deliver an effective service to adults;
To ensure that staff are aware of relevant legislation, national guidelines and local adult protection procedures and protocols;
To translate learning into a better service for adults in collaboration with other service providers;
To strengthen relationships through inter-agency training.
Prevention
People being informed of their rights
A well trained workforce
A sound framework for confidentiality
Needs and risk assessments
A range of options for supports
Services that prioritise both safeguarding and independence
Multi-disciplinary team work and information sharing
The Commission for Social Care Inspection (now the CQC) identified some of the following building blocks for prevention and early intervention
Risk Management
Each organisation must have an effective procedure for assessing and managing risks with regard to safeguarding
Common personal risk factors include:
diminished social skills / judgement
diminished capacity
physical dependence
need for help with personal hygiene and intimate body care
lack of knowledge about how to defend against abuse
Common organisational risk factors include:
low staffing levels
high staff turnover
lack of policy awareness
isolated services
a neglected physical environment
weak / inappropriate management
staff competencies not matched to service requirements
staff not supported by training / ongoing professional development
... are we at risk?
Definitions of Abuse
Abuse may be defined as
"any act, or failure to act, which results in a breach of a vulnerable person's human right, civil liberties, physical and mental integrity, dignity or general well being, whether intended or through negligence, including sexual relationships or financial transactions to which the person does not or cannot validly consent, or which are deliberately exploitative. Abuse may take a variety of forms,"
This definition excludes self-neglect which is an inability or unwillingness to provide for oneself. However, it is acknowledged that people may come into contact with individuals living in conditions of extreme self-neglect. To address this issue the HSE has developed a specific policy to manage such situations.
Neglect and acts of omission
... includes 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
Psychological abuse
... includes emotional abuse, threats or harm of abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, isolation or withdrawal from services or supportive networks.
Sexual abuse
... includes rape and sexual assault, or sexual acts to which the vulnerable person has not consented, or could not consent, or into which he or she was compelled to consent.
Physical Abuse
Financial or material abuse
Discriminatory
Roles and Responsibilities:
Senior Management
Designated Officer (DO) - Regional Managers, Rehabilitation Psychologists
Designated Liaison Officers (DLO) - National Support
All staff
Questioning and reflecting on existing practices
Is it appropriate to use a hoist to assist an older person in getting out of bed or out of a chair?
(What if you have not been trained in how to use it?)
What might you say to a person who is frightened or being lifted in a hoist?
What can you do to meet the preferences of an older person in relation to their washing or bathing routine?
What would you say constitutes encouragement to take medication and what constitutes coercion?
... includes hitting, slapping, kicking, misuse of medication, restraint or inappropriate sanctions
Video Clip:
HSE 'Recognising and Responding to Elder Abuse in Residential Care Settings'
(Physical Abuse
(4 minutes)
Video Clip: John (10 minutes)
... includes theft, fraud, exploitation, pressure in connection with wills, property, inheritance, or financial transactions, or the misuse or misappropriation or property, possessions or benefits.
Video Clip: HSE 'Recognising and Responding to Elder Abuse in Residential Care Settings' (Abuse by Discrimination) (4 minutes)
This is any abusive act committed against a person or their property because of their Gender, Civil Status, Family Status, Age, Race, Religion, Disability, Sexual Orientation and membership of the Travelling Community. It includes bullying, assaults, harassment, threats or being called names.

It can result from situations that exploit a person's vulnerability by treating the person in a way that excludes them from opportunities they should have as equal citizens, for example, education, health, justice and access to services and protection.
All services must have the capacity/capability to implement policy/procedure and safeguard vulnerable persons.
The specific provisions agreed with each agency will be identified in the relevent Service Level / Contractual Agreements.
This procedure applies to all HSE services personnel and to service provider in receipt of HSE funding.
Responding to Concerns or Allegations of Abuse
The following are key responsibilities and actions for
any staff member or volunteer
who has a concern in relation to the abuse or neglect of a vulnerable adult.
These responsibilities must be addressed on the
same day
as the alert is raised.
Immediate Protection
Take any immediate actions to safeguard anyone at risk of harm including seeking, for example, medical assistance or the assistance of An Garda Siochana, as appropriate.
Listen, Reassure and Support
If the Vulnerable Adult has made a direct disclosure of abuse or is upset and distressed about an abusive incident, listen to what he/she says and ensure he/she is given the support needed.
Do not:
Appear shocked or display negative emotions
Press the individual for details
Make judgements
Promise to keep secrets
Give sweeping reassurances
Detection and Prevention of Crime
Where there is a concern that a serious criminal offence may have taken place, or a crime may be about to be committed, contact An Garda Siochana immediately.
Record and Preserve Evidence
As soon as possible on the same day, make a detailed written record of what you have seen, been told or have concerns about and who reported it to. Try to make sure anyone else who saw or head anything relating to the concern of abuse also makes a written report.
Report and Inform
Report to the Designated Officer / Line Manager as soon as possible. This must be reported on the same day as the concern is raised.
The Designated Officer or Line Manager must report the concern to the Safeguarding and Protection Team (Vulnerable Persons) within
3 working days
after he/she has been informed of the concern.
If the concern relates to a designated centre, the Line Manager must notify HIQA in writing within 3 working days on the appropriate form. The Line Manager must also notify Tulsa immediately if there are concerns in relation to children.
Is Self-Neglect a Safeguarding Issue?
Self-neglect can be a complex and challenging issue for practitioners to address, because of the need to find the right balance between respecting a person's autonomy and fulfilling their duty to protect the adult's health and wellbeing. Both perspectives can be supported by human rights arguments.
The Health Service Executive is committed to the protection of vulnerable persons who seriously neglect themselves and is concerned with vulnerable persons where concern has arisen due to the vulnerable person seriously neglecting his/her own care and welfare and putting him/herself and/or others at serious risk.
The focus is on the person's choices, goals, dreams, ambitions and potential with the service seen as supporting and enabling the realisation of the person's goals rather than a person fitting into what the services or system can offer.
A registered provider shall, in so far as is reasonably practical, ensure that a resident ... has access to independent advocacy services"
Full transcript