There has been growing awareness of the vulnerability of some adults to abuse or neglect. Home Church, its Trustees, Staff and Volunteers (hereafter referred to as HC) are likely to have regular contact with vulnerable adults or their carer’s and in the course of their duties may become aware of situations where a vulnerable adult is at risk of abuse, or is being abused. It is important that HC are alert to signs of abuse and take appropriate action to safeguard vulnerable adults.
This policy is intended to help raise awareness of the ways in which vulnerable adults may be being abused and advice on what HC should do if abuse is suspected. The key principles are set out in the box below.
2. DEFINITION OF VULNERABLE ADULT A vulnerable adult is someone who is aged 18 years or over who ‘Is or may be in need of community care services by reasons of their mental health or other disability, age or illness’ and ‘Is or may be unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation’ (Who Decides – Lord Chancellors Dept 1997)
A vulnerable adult may be a person who • Is elderly or frail • Has a learning disability • Suffers from mental illness (e.g. dementia, personality disorder) • Has a physical disability • Is a substance misuser • Is homeless • Is in an abusive relationship (It should be noted that disability or age alone does not signify that an adult is vulnerable)
Key Principles
HC should: • Be alert to and act on indications when a vulnerable adult may be being abused or at risk of abuse. • Know how to access details of local policies for the protection of vulnerable adults • Act in accordance with local policies to protect vulnerable adults
HC-(P)20 Safeguarding Policy (Vulnerable Adults)-Issue 1 (February 2019)
3. ABUSE OF ADULTS Abuse can consist of a single or repeated act of harm or exploitation. It may be perpetrated as a result of deliberate intent, negligence or ignorance. Abuse can be physical, verbal, psychological, emotional, or a result of neglect or an omission to act. Abuse can also occur when a vulnerable adult is persuaded to enter into a financial arrangement or sexual relationship to which they have not, or could not, consent to or understand e.g. as a result of mental or physical incapacity.
Vulnerable adults may be abused by a wide range of people including family members, friends, professional staff, care workers, volunteers or other service users.
Abuse can occur in a variety of circumstances. It may take place within the vulnerable adult’s own home, nursing, residential or day care facilities, hospitals or other institutional settings. Incidents of abuse can be either to one person or more than one person at a time. Some instances of abuse will constitute a criminal offence for example, assault, rape, theft or fraud.
Patterns of abuse vary and can include: • Serial abusing, where the perpetrator seeks out and ‘grooms’ vulnerable adults (sexual abuse and some forms of financial abuse usually fall into this pattern). • Situational abuse, as a result of pressures building up and/or because of difficult or challenging behaviour. • Long term abuse in the context of an ongoing family relationship, for example domestic violence. • Neglect of a person’s needs because others are unable to take responsibility for their care e.g. the carer has financial, alcohol or mental health problems. • Institutional abuse arising from poor standards of care, inadequate staffing, and lack of response to individual patient’s complex needs, insufficient knowledge base and expertise. • Unacceptable treatment programmes including over medication, unnecessary use of restraint, withholding food, drink or medication. • Inability or failure to access key health and social care services. • Misappropriation of benefits and/or use of vulnerable adult’s money by other members of the household. • Fraud or intimidation in connection with wills, property or other assets.
4. FRAMEWORK FOR THE PROTECTION OF ADULTS Autonomy, capacity and the ability to consent are key components in working with vulnerable adults. All vulnerable adults have a right to live and receive services in an environment which is free from prejudice and safe from exploitation or abuse. A vulnerable adult’s wishes should be taken into account at all times.
At present, there is no specific legislation which directly protects vulnerable adults, instead the applicable duties and powers to assess and intervene are contained with a range of legislation. The primary aim should be to prevent abuse where possible, but if preventative measures fail, robust procedures should be in place to deal with incidents of abuse effectively and sensitively. Social Service authorities (and where a criminal offence may have been committed, the police) have a responsibility to make inquiries into concerns about the welfare of a vulnerable adult. At a local level agencies involved in the care and protection of vulnerable adults (e.g. commissioners, providers and regulators of health and social care services; the police; local housing and education departments; voluntary and private sector organisations) are beginning to work in partnership to ensure robust procedures are in place.
HC-(P)20 Safeguarding Policy (Vulnerable Adults)-Issue 1 (February 2019)
Work has also been undertaken to develop lists of people who are considered unsuitable to work with vulnerable adults. In England and Wales, the Protection of Vulnerable Adults Scheme for care homes and domiciliary care agencies introduced a list of care workers who have harmed a vulnerable adult or put them at risk of harm. Full details of this scheme can be obtained at www.doh.gov.uk. In Scotland, the Scottish Executive has consulted on proposals to compile and maintain a list of people who are considered unsuitable to work with vulnerable adults (www.scotland.gov.uk).
HC are advised and know, if required, how to access details about local policies and procedures (e.g. via local primary care organisation, trust or social service) and ensure they act in accordance with them.
5. WHAT TO DO IF ABUSE IS SUSPECTED Concerns must be reported as soon as possible to Anita Wise (hereafter “Safeguarding Lead” tel no: 01803 291 156 (work), 07595 921 318 (mobile) who is nominated by the trustees to act on their behalf in dealing with the allegation or suspicion of neglect or abuse, including referring the matter on to the statutory authorities.
In the absence of the Safeguarding Lead, or if the suspicions in any way involve the Safeguarding Lead then the report should be made to Chrissie Slaney (hereafter the Deputy Safeguarding Lead) tel no: 01803 328 820 (home), 07804 797 655 (mobile). If the suspicions implicate both the Safeguarding Leads, then the report should be made to the relevant statutory authority.
HC may become concerned that a vulnerable adult is being abused, or is at risk of abuse, as a result of one or more of the following: • Direct disclosure by the vulnerable adult • A complaint or expression of concern by another person, or • Observing the behaviour of the vulnerable adult.
It is important that Home Church’s trustees, staff and volunteers do not discuss concerns about abuse with the alleged perpetrator. Care must also be taken not to disturb or destroy articles that may be used in evidence during a criminal investigation or ultimate prosecution.
If abuse is suspected or reported, HC should act in line with local policies and procedures to: 1. Discuss with Safeguarding Lead suspected abuse and action required to be taken 2. Obtain permission
from the vulnerable adult before disclosing confidential information about them (see below for further guidance on confidentiality and consent) 3. Take reasonable steps to ensure the adult is in no immediate danger. 4. Seek appropriate medical treatment for the adult if required. 5. Contact the police if it is believed that a crime may have been committed. 6. Consider the need to inform the vulnerable adult’s GP or treating doctor. 7. If, after discussion, abuse or neglect is still considered to be a possibility a referral should be made to the Social Services Department. 8. Where a child is also at risk child protection procedures should be followed. 9. Records should be kept of all concerns and discussions about the adult, the decisions made and reasons for these decisions and dated and signed appropriately. As abuse can often be a culmination of events, it is important to maintain appropriate records of concerns whether or not further action is taken at the time.
HC-(P)20 Safeguarding Policy (Vulnerable Adults)-Issue 1 (February 2019)
6. CONSENT A key issue in the protection of vulnerable adults is one of consent. HC must help individuals to make informed decisions about whether they wish to use particular services or treatment options, and ensure that when a patient is not legally competent, any treatment or care provided is in accordance with the appropriate legal requirements. Vulnerable adults have a fundamental human right to decide how and with whom they live. A person who is able to make decisions for themselves is entitled to refuse protection. However, if the person lacks mental capacity to make this decision or there is an overriding public interest (e.g. other vulnerable adults are at risk) the need for referral should be considered. Wherever possible, the vulnerable adult should be informed that a referral will be made and the reasons for this.
The law relating to consent is complex. HC are unlikely to be in a position to accurately assess a person’s mental capacity. Therefore where there is a concern about a vulnerable adult’s mental capacity to consent to protection, it is advisable to discuss concerns with other appropriate professionals and person involved in the adults care. If this is not possible HC should use their judgement, based on the information they have, to act in the vulnerable adult’s best interests.
7. CONFIDENTIALITY HC have a duty to respect and protect the confidentiality of any information they have relating to a vulnerable adult. Such information should not normally be disclosed without the vulnerable adult’s consent. However, there is an underlying requirement to act in the interests of a vulnerable adult and other members of the public. Consideration may need to be given to disclosure without the vulnerable adult’s consent in situations where: • A vulnerable adults health renders them incapable of consent (e.g. mental incapacity) • Disclosure is necessary to prevent serious injury or damage to the health of the vulnerable adult, third party or to public health (e.g. other vulnerable adults are also at risk). • Disclosure is required by law or under an order of the Court.
Information should only be disclosed to relevant persons or agencies on a ‘need to know’ basis.
HC should not give a vulnerable adult assurance of absolute confidentiality of information disclosed to them, especially in situations where other vulnerable people may be at risk. Wherever possible, the vulnerable adult should be informed of any decision to share information that is contrary to their wishes. They should be aware of what information is being shared and with whom.
8. APPOINTMENT, SUPPORT, SUPERVISION & TRAINING The Trustees will ensure all workers will be appointed, trained, supported and supervised in accordance with the principles set out in government guidelines “No Secrets” and “In Safe Hands”.
9. FURTHER INFORMATION AND ADVICE HC will get advice about any local procedures for the protection of vulnerable adults by contacting their primary care organisation, NHS Trust, Health Board or Social Services Authority. Further information can also be obtained from the following sources:- 1. No secrets: Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse. Department of Heath/Home Office. London: Department of Health; 2000. Available at www.doh.gov.uk/scg/nosecrets.htm 2. Protection of vulnerable adult’s scheme in England and Wales for care homes and domiciliary agencies. Department of Health. London: Department of Health; 2004. Available at www.doh.gov.uk