Keeping people safe from harm


Purpose and Aims
Derbyshire House takes a person-centred approach to the safeguarding of people who use our services and is mindful at all times that we are working to safeguard adults who have the right to be involved in and informed of all safeguarding decisions which affect them.

We work preventatively, following robust procedures for responding effectively to all incidents of abuse or harm. Our response will be unique to the individual, and will uphold their rights, dignity and wellbeing.

We will protect the people who live with us from abuse whether it is deliberate, through negligence or ignorance of the staff.

The purpose of this policy is to help ensure we:

  • take a thorough, fit for purpose and transparent person-centred approach to all adult safeguarding issues and are able to recognise signs of abuse, respond effectively, respect the rights and wishes of the adult at risk and report our concerns appropriately;
  • meet our safeguarding adults’ standards whilst working within the framework of the six safeguarding adult principles; which are aligned with the Making Safeguarding Personal and Nottingham MASH procedures and the principles of the Care Act 2014 and the Mental Capacity Act 2005.
  • Ensure people are supported to make their own informed safeguarding decisions where they can act or prompt action in ways which are legal, necessary and proportionate when they are not able to protect themselves and act in the ‘best interests’ of people who lack the capacity to make the decision that needs to be made at that time.

Definitions

Vulnerable adults
A vulnerable adult is any person aged 18 years or over:

    • Who is or may be in need of community care services by reason of mental or other disability, age or illness
    • Who is or may be unable to take care of him/herself from significant harm or exploitation

Abuse
Abuse is usually carried out by people who are in a position of power, trust or authority and can be perpetrated by a wide range of people including relatives, family members, neighbours, friends, professional staff, care workers, volunteers or other people living in our home.

“No secrets” definition of abuse:

“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 transition to which he/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”.

Types of Abuse

Physical Abuse
Physical abuse includes hitting, slapping, pushing, kicking, and misuse of medication, restraint or inappropriate sanctions. Building on this definition of physical abuse within “no secrets”, it can be helpful to consider the following different categories of physical abuse:

    • Bodily assaults – resulting in injuries such as bruises, fractures, dislocations, wounds pressure sores or marks of physical restraint
    • Bodily impairment – manifested in malnutrition, dehydration, poor hygiene, sleep deprivation, failure to thrive, unexplained fatigue, or improper ventilation
    • Medical/healthcare maltreatment – inappropriate medication, over/under medication, inappropriate administration of medication (method). Provision of health care may be unavailable to an excessive degree, or irregular, improper, inadequate or duplicated in some way

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. Sexual abuse might also include exposure to pornographic materials being made to witness sexual acts and encompasses sexual harassment and non-contact abuse.

Psychological/Emotional Abuse
This might include the following:

    • Playing on someone’s emotions to make them afraid, uneasy or unnecessarily dependent.
    • Bullying
    • Shouting
    • Threats of harm or abandonment
    • Intimidation
    • Persistent ignoring
    • Isolation or withdrawal from social contact or supportive networks
    • Emotional blackmail
    • Undermining
    • Ridiculing
    • Racial abuse
    • Deprivation of contact
    • Blaming
    • Controlling

Neglect, acts of Omission and Poor Professional Practice
Including ignoring medical or physical care needs, failure to provide access to appropriate health, social care, the withholding of the necessities of life, such as medication, adequate nutrition and heating.

Financial or Material Abuse
Includes theft, fraud exploitation, pressure in connection with wills, property or inheritance or financial transactions, or misuse or misappropriation of property

Discriminatory Abuse
Including racist, sexist, that is based on a person’s disability, and other forms of harassment, slurs or similar treatment. Multiple forms of abuse may occur in an ongoing relationship or an abusive service setting to one person, or to more than one person at a time, making it important to look beyond single incidents or breaches in standards, to underlying dynamics and patterns of harm. Any or all of these types of abuse may be perpetrated as the result or deliberate intent and targeting of vulnerable people, negligence or ignorance.

Signs of Possible Abuse

Physical

    • Unexplained bruises or cuts, especially where they reflect the shape of an object used, of hand or finger marks
    • Loss of hair in clumps or abrasions on the scalp of hair pulling
    • Unexplained fractures
    • Unexplained burns or scalding
    • Delays in reporting injuries
    • Vague, implausible or inappropriate explanations
    • Multiple injuries or a history of past injuries especially falls

Neglect

    • Debilitation or weakness through malnutrition or dehydration
    • Unexplained weight loss
    • Poor hygiene – unkempt, dirty clothes or surroundings
    • Inappropriate dress
    • Pressure sores
    • Poor skin condition and poor resistance to infection and diseases

Psychological/Emotional

    • Fearfulness
    • Mood changes including depression, irritability and unhappiness
    • Low self-esteem
    • Changes in sleep and eating patterns
    • Withdrawn self-isolating behaviour

Financial

    • Unexplained loss of money or unable to pay bills
    • Sudden withdrawal of money
    • Sudden disappearance of favourite valuables
    • Loss of financial documents such as pension books, bank books etc.

Sexual

    • Unexplained difficulty walking
    • Bleeding or bruised genitals
    • Reluctance to be alone with a particular person
    • Sudden behaviour change

Discriminatory

    • Lack of respect shown to an individual
    • Signs of a sub-standard service offered to an individual
    • Repeated exclusion from rights afforded to people such as health

We take all signs of abuse seriously and will take the appropriate course of action if abuse is suspected. We will also take into consideration and act when people who have communication difficulties and use their body language and facial expressions as an indicator of possible signs of abuse.

 

 

 

  1. EMPOWERMENT: we will seek informed consent and people will be supported and encouraged to make their own decisions
  2. PREVENTION: it is better to take action before harm occurs. We will provide clear and simple information about abuse, how to recognise the signs and what people can do to seek help
  3. PARTNERSHIP: local solutions – communities have a part to play in preventing, detecting and reporting abuse and neglect. We will treat any personal and sensitive information in confidence, only sharing what is helpful and necessary. We will work with professionals to get the best result.
  4. PROTECTION: support and protection for those in greatest need. We will help and support people to report abuse and neglect so that they are able to take part in the safeguarding processes to the extent in which they want to.
  5. PROPORTIONALITY: the least intrusive response appropriate to the risk presented. We will work in the best interest of the individual and only get involved as much as we are needed
  6. ACCOUNTABILITY: accountability and transparency in delivering safeguarding. we will ensure staff understand their roles and responsibilities and that the individuals understand the roles of everyone involved in their lives.

We are open to and learning from our safeguarding adults’ procedures (both good practice and areas for improvement) and relationships and interactions with the people we support who are at risk.

We will set standards work within a framework that identifies and promotes best practice, and minimises uncertainty in staff  regarding their own behaviour and conduct it will include how to respond when they have concerns about adults and any duties and responsibilities it places upon them.

Responsibilities

Working with adults to help them keep themselves safe is the responsibility of all of our staff. and anyone who hears from (or in relation to) an adult at risk about a safeguarding issue has a responsibility to take what they hear seriously by responding to the person at risk with dignity, respect and confidence, and following the reporting process.

Reporting processes
If a safeguarding concern is identified by a member of staff or reported to a them no matter how small, they should always do something:

  • If able to speak with the individual and/or the person that has highlighted the risk and record all information given. They should not ask any leading questions and should listen carefully and provide reassurance.
  • The member of staff should not investigate any suspicions and report them.
  • Depending on the severity of the concern, ensure all immediate risks are eliminated from the individual
  • Immediate action to be taken – if there is a risk of immediate harm, the member of staff should take themselves and where possible, the individual(s) out of danger and if necessary, contact the emergency services (eg. Police, ambulance) the member of staff should never put themselves in danger.
  • Report the concern to the safeguarding lead, Sharon Smith, or one of the Safeguarding referrers, Zoe Evley, Lisa Constantine or Sarah Espin.
  • The concern will then escalate to the safeguarding lead or role of the referrer decision making process starting with the deciding if you need to raise a safeguarding concern to the local authority/multi-agency safeguarding hub (MASH), flowchart.
  • The individual families/advocates will also be contacted and kept informed.

Staff who fail to follow this procedure and knowingly withhold information or evidence on any of the abuse occurrences or area may be subject to disciplinary action, or to criminal proceedings in the event of a criminal investigation

If concerned about any form of malpractice, staff should raise the matter with the safeguarding lead verbally or in writing. If they are not satisfied with the outcome or they feel the matter is too serious to discuss, they should follow the referral process and the complaint procedure.

If a member of staff has been abused by a person living with us, the necessary Adult Access team will be contacted to carry out an assessment and see if the home is still capable of providing sufficient needs to the individual.

Action for Manager/Safeguarding Lead/referrers: On hearing a report of suspected abuse, they should listen carefully and reassure the reporter that they have done the right thing by raising the alert. Advise on any immediate action needed to be taken.

Within 24 hours, they will follow, wherever practicably possible, the flow chart for Deciding if You Need To raise a Safeguarding Concern to the Local Authority/Multi-Agency Safeguarding Hub (MASH), and should consider risk issues, the individual wishes and action taken, accurately recording this assessment to decide if the matter will be dealt with internally, if any other professional needs to be involved or referral. If the vulnerable adult expressed a wish for their concerns not to be pursued, this should be respected wherever possible. However, decisions about whether to act in accordance with the person’s wishes will take into account the level of possible risk both to the individual, others and the capacity of the person to understand the decision to be made, its consequences and whether an advocate might be necessary. It may be necessary to override their wish not to proceed, but such a decision and the reasons for it will be accurately recorded. Report the incident to the police if a criminal offence appears to have been committed and inform CQC of the incident. Refer to Adult Services Team (staff to make direct contact with adult services/police/CQC if Manager is implicated). Consider internal disciplinary action including the need for suspensions if it is suspected that a member of staff has committed the abuse. Consider if a referral to the Independent Safeguarding Authority  (ISA) is necessary, record reasons for any variation on timescales, and ensure that the Trustees are aware of serious cases.

Consent and Information Sharing:
We will always endeavour to gain informed consent for any action or information sharing from the individual. However, there are cases where the adult concerned will refuse their consent for their information to be shared. Whilst the adult has the right to make their own decisions and express a wish for concerns not to be pursued. Their wishes should be respected wherever possible, but there are times when their wishes can be overridden. Consideration will need to be given to other factors such as the seriousness and pervasiveness of the abuse; the ability of the individual to make decisions; the effect of the abuse on the individual in question, and on others; whether a criminal offence has occurred; and whether there is a need for others to know (e.g. to protect others who may not be involved in the immediate situation).

The Care Act 2014, requires us to share information where there are concerns about abuse or neglect and we may need to do this without the consent of the individual if we feel an individual is at risk of abuse or neglect. We will always explain to the adult what we are doing, who we are making the referral to and why. None consent does not mean abandonment.

Decision Making
We will use “scaffolding decision making” this is a process of gathering information and consent and speaking to the individual, possible referral or involvement to other professionals or identifying any immediate changes to eliminate further risk. This records how and why any decision is made along with the relevant others that were involved including the wishes of the individual.

The decision-making process will be inclusive and recorded and we will follow the guidance set out in making safeguarding personal in conjunction with the local authority safeguarding guidance for the individual involved

Wherever practicably possible we will follow the wishes of the person at the centre of the abuse or neglect and ask what they want.

Where a person lacks capacity, we will still endeavour to involve them by making any decisions they are able to make. We will use the two-stage test to determine the capacity and make conversations as simple and as legible as possible to help them understand that decision. Where there is an identified need for an IMCA we will make the relevant referral for this.

Where a referral is not made, we will document a full understanding of how we came to the decision.

Where it is felt that a referral is required, we will follow the guidance for the local authority that the individual is under and their referral processes.

An individual can change their mind at any stage during the safeguarding and we will review and record their decisions and the impact it is having on them regularly.

In cases of alleged or suspected abuse, any action will take into account and respond to individuals’ race, culture, religion, gender, sexual orientation, disability and communication needs. This may mean further advice will have to be sought to ensure sensitive and effective intervention to ensure key considerations are not overlooked.

Where a crime has taken place there is an overriding public duty for the public to investigate.

Individuals against whom an allegation has been made have the right to fair and unbiased treatment, and to be kept fully informed.