Abuse is doing something to child, young person or vulnerable adult that should not be done, anything that injurer distress or interrupt their development. Failing to do something for a child, young person or vulnerable adult that should be done for the sake of their wellbeing and safety (Lindon 2008). As a vulnerable adult’s are more susceptible to abuse, such as physical injury and attack and more liable to succumb to persuasion. Levels of vulnerability can be made worse by age, mobility and mental capacity. Andrew is a twenty-two-year-old vulnerable adult, he is autistic and has suspected learning difficulties. ‘No Secrets’ guidance defines a vulnerable adult as a person: who is or may be in need of community care services, who is or may be unable to take care of himself or unable to protect himself again significant harm or exploitation. Due to Andrews vulnerable status he will be protected under the Safeguarding Vulnerable Adult Act 2006 and The Care Act 2014.” Which introduces new safeguarding duties for local authorities including; leading a multi-agency local adult safeguarding system, making or causing enquiries to be made where there is a safeguarding concern, hosting safeguarding adults board, carrying out safeguarding adult’s reviews and arranging for the provision of independent advocates.” (Scie.org.uk, 2016)
Andrew has grown up in the care of children’s services and residential care, he is now living in a short stay hostel and not receiving any support or care that he requires. Andrew has already had issues living on his own, which have already been recognized as he has left two tenancies as he struggled living on his own. He should have a named social worker, who should have visit regular to make sure Andrew is copying living alone. As Andrew has showed signs of not coping he should have been moved into residential care for his own safety. Andrew has also been struggling with his personal hygiene, this is self-neglect but as Andrew has always lived in care and supportive living he probably doesn’t know when to get washed, when to change his clothes. Self-neglect is defined as the failure, usually of an adult, to care for and protect themselves, for example by living in unsanitary, hazardous conditions; failing to eat and drink properly or maintain personal hygiene.
Andrew is known to the health services and the police, he has been assaulted a number of times. Andrew has also said he has been receiving threatening messages and that he is too scared to leave the house as he believes he will be seriously assaulted. All of these events should have been flagged by the police and health services due to safeguarding training they should have received. There is a possibility of bulling, both police and health services should have communicated with his social worker as he has been in hospital on a number of occasions. Social care plays an important role in helping people with care and support needs to live full lives, from abuse and neglect. This includes preventing abuse, minimizing risk without taking control away from individuals and responding proportionately if abuse or neglect has occurred. Local authorities, care provides, health services, housing providers and criminal justice agencies are all important safeguarding partners. Partnership working in safeguarding as the coming together of agencies that have shared interest in supporting people who have care needs. They key principles of partnership working according to (Morris and Michie, 2010), shared values, agreed goals or outcomes for the individuals they support and regular communication.
There are a number of practitioners and agencies that involved in safeguarding Andrew, Social worker/services, nurses, doctors, police, support worker. There’s obvious failings in Andrew safeguarding, his social worker should coordinate the response to the suspected abuse of Andrew. The role of an adult social worker is to work out what type of care is needed, and revisit people who use care services to reassess their needs over a set period of time. They usually work as part of a team, responsible for a number of cases which all might need different approaches. They also need to work closely with organization such as police and health services, (Skillsforcare.org.uk, 2016). The negatives of the role of a social worker is, possibly a heavy case load which can let people ‘slip through the net’, could work part time and doesn’t hand over cases to a high standard and possible lack of funding for care services. Support workers are the ‘front line’ staff who work with people who have safeguarding needs, the cost of a support worker could be a problem if there is a low budget. As consequence of cutting care services Andrew has now suffered suspected abuse. Nurses should have the skills to confidently recognise and effectively manager situations where suspected abuse or neglect, including poor practice. The nurses could be understaffed, not received significant safeguarding training, lack of communication when handing over patient and neglect and abuse are not also recognized by health care staff. Bringing all the professions together to discuss safeguarding and care issues can be difficult, as all these professionals have to be together at the same time to discuss cases and arguing over budgets.
Safeguarding Adults Boards bring together local agencies that work with vulnerable adults and monitor their use of safeguarding policies and procedures. Agencies include public sector organization’s such as health care providers, learning disability teams, residential, sheltered and supported housing. (Morris and Michie, 2010.) There are many benefits of partnership working in safeguarding, as a number of health care agencies working together as opposed to on their own, in isolation, can deliver more services to more people in more places. As more agencies applying for funding means more money for services for individuals. It allows services to be delivered in joined-up way, this has benefits in terms of providing an holistic service that meets all an individual’s needs. All these health care agencies can share experiences, knowledge and skills, this enables people to learning from each other and results in new and better ideas on how to tackle issues within safeguarding. (Morris and Michie, 2010)
‘The Care Act 2014 sets out clear legal framework for local authorities and other parts of the system should protect adults who are at risk of abuse or neglect’ (Scie.org.uk, 2016). According to the Social Care Institute for Excellence 2016, Local Authorities duties to safeguarding are to lead a Multi-Agency Local Adult Safeguarding system that prevent abuse and neglect and when it happens to stop it quickly. They also make enquiries or request other to do so when they think an adult with care and support needs may be at risk of abuse or neglect and they need to find out what action is needed. They must establish Safeguarding Adult Boards, which include local authority, NHS and police, which will develop, share and implement a joint safeguarding strategy. Arranging for an independent advocate to represent and support a person who is the subject of a safeguarding enquiry if required.
When Abuse is suspected, first identify what type of abuse is suspected, which are in Andrews care neglect by others, institutional abuse, self-neglect and bullying. When dealing with suspected abuse the approaches to communication are vital. Giving verbal communication the tone of voice, choice of words and pace of speech are important when dealing with the victim and when reporting the abuse. When dealing with the victim the non-verbal communication is very important, to keep eye contact with the victim, have positive body language. The short stay hostel staff may suspect self-neglect as of Andrew appearance.
This person has a responsibility to speak out, regardless of any concerns about the consequences of doing so. The short stay hostel will have a safeguarding procedure which will advise on dealing with suspicions of abuse. Firstly, discuss concerns about Andrew with your supervisor or line manager, they will decide an appropriate course of action, for example, whether to contact health or social services, police, family or “referring to OPG to the appropriate adult social services by making a safeguarding adults at risk referral ( SAAR)” (Gov.uk, 2015). The Office of the Public Guardian (OPG) was established in October 2007 by the Mental Capacity Act 2005 (MCA), the Mental Capacity Act 2005 set out the role of Public Guardian. This policy supports the Public Guardian’s role in safeguarding. It shows how OPG will work with other agencies to recognise and manage suspicions, allegations and findings of abuse of adults and children at risk, who are within the Public Guardian’s remit (Gov.uk, 2015). The next step is to record concerns on the appropriate report form. Records should be, easy to understand, concise and relevant and clear. If there is any evidence, make every effort to preserve any evidence of abuse. “Safeguarding is about keeping vulnerable adult’s safety from harm. It involves identifying adults who may be vulnerable, assessing their needs and working with them and with other agencies in order to protect them from avoidable harms.” (Northway and Jenkins, 2013).
Abuse occurs as the results of deliberate intent or negligence and usually stems from the fact that perpetrators have little or no regards for their victims. They don’t value them as people. To get the best practice in health and social setting requires workers to use person-centered values in their work. According to (Morris and Michie, 2010) By doing, they demonstrate respect for, personal values, beliefs, preferences and life experiences. A lack of respected for the values someone holds for their family, treasured possessions, religious and political beliefs can be emotion abuse. Having respect for individual’s choice, denying a choice of food can be physical abuse, and prevents someone from getting up and going to bed when they choose to can be a form of institutional abuse. Having respect for individual’s rights, failing to protect from danger, denying medication amounts to physical abuse. Respecting active participation and independence, we all need to be involved in everyday life and to develop and maintain independence. Failure to encourage an individual to take part in activities. By treating people choices, rights and active participation with respect as well as Knowledge and understanding all relevant laws, policies and procedures, being honest and open in practice, good communication, good tram work, accountability, correctly and safely applying skills and knowledge acquired through training and service users trust. ‘The likelihood of abuse is reduced by working with person-centered values, promoting choice and rights and encouraging active participation. Anything else is bad practice and synonymous with abuse’. (Morris and Michie, 2010).
Safeguarding adult’s boards brings together and oversee the agencies that work with vulnerable adults, to ensure effective inter-agency working. All involved in safeguarding have a responsibility and commitment to cooperate working and sharing information. This will empower and promote the well-being of vulnerable adults, support their rights to be independent and make choices and to recognised when they are unable to make decisions without support and guidance. The main point of following these procedures is to ensure safety of vulnerable adults.” There is some concern nationally that the development of adult safeguarding working arrangements has resulted in too much focus on a specific process (of referral, strategy meeting, investigation, protection planning, case conference and review) and not enough on agreeing which actions will achieve the most positive outcomes for people. In some cases, other powers and actions could be used more quickly and beneficially rather than solely pursuing current formal safeguarding procedures. “(Pasauk.org.uk, 2016)
There are working strategies and procedures to reduce the risk of abuse of adults, having the correct procedure in place when recruiting staff is vital. Having the access to information in regards to an individuals barred from working with people who uses services, this is a vital way of vetting prospective employees. Having set quality that are needed for a health care job need to make sure there met such as honestly, preferable experience and a good reference.” Protection of Vulnerable Adults Scheme (POVA), Vetting and Barring Scheme, Independent Safeguarding Authority (ISA) and the role of the DBS Disclosure and Barring Service “(Fisher, 2006) The key requirements on safeguarding are to have a knowledge of, access to current and up to date relevant legislation, policies and procedures by service provider. A strength of policies is that there is something a health care provide can follow and it’s easy to access. Weaknesses of polices is that staff may not be able to read or understand them, staff may not know where they are so they need to be easy to access and broking down into understandable terms. Safeguarding training is vital for health care professionals as it keep staff up to date with their training and improves care for service users. Weakness of training is the budget for training could be limited, staff could not be able to complete training and finding a competence trainer. Monitoring health care professions is key for safeguarding, strengths are, training and competence, as well as regular performance reviews. The weaknesses of this can staff can have the ‘big brother feeling’ and inefficient monitoring and poor practice slips through. Recruitments practices such as screen of applicants, training, monitoring and supervision. Working practices such as accountability career to service user’s privacy, trust, dignity, confidentiality and whilst blowing.
Complaints procedures need to be accessible, this is very important given the vulnerability of people using the health and social care services. For a complains procedure to be accessible it needs to be publicised and easy to get hold of, to advertise that people have the right to complain and to encourage them to do so. This includes everyone who suspect, has witnessed or is a victim of abuse. It needs to be clear and understandable as some services use have learning difficulties. Complaints procedures must be published in a variety of formats to reflect age, understanding, ability and communication needs of different people involved. It vital to reassure complainants that they receive support that meets their needs whilst their complaints being investigated. Andrew has many things to complain about, due to his vulnerability, learning difficulties and being autistic he might not be aware of abuse he has suffered.
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