Safeguarding means protecting an adults right to live in safety, free from abuse and neglect. it is about people, society and organisations working together to prevent abuse or neglect from happening while ensuring the adults’ wellbeing are supported, including listening to their views wishes feelings and beliefs in deciding on any action. also safeguarding was defined as the care act 2014 as protecting an adult right to live in safety, free from abuse and neglect. agencies and organization working with children and vulnerable adults take all practical measures to ensure that the risks of harm to the individual welfare are minimised and where there are concerns about the welfare of children and vulnerable adult all agencies and organizations take all suitable actions to address these concerns by working together. safeguarding practice is most commonly applied to children and young people under the age of 18 and is further differentiated in some texts were children refers to those under the age of 18 who are still in full-time education and young people as those under the age of 18 who have left full-time education. furthermore, a vulnerable adult is defined as an individual aged 18 or over who depends on others for assistance with respect to the basic functions or who has a severe impairment in the ability to communicate and therefore a reduced ability to protect themselves from assault, abuse or neglect. the term safeguarding practice is most commonly applied to children under the age of 18 and vulnerable adult. safeguarding of children and vulnerable adult is everyone’s responsibility. they are different measures in place to prevent and reduce the potential for abuse occurring. according to no secret document, safeguarding adults is about the safety and well-being of all patients, but providing additional measures for those least able to protect themselves from harm or abuse. protection is considered a legal responsibility in response to individual cases where the risk of harm has been identified. pova refers to guidance and action in relation to protecting vulnerable adults. this was later replaced by sova with an emphasis on prevention and empowering individuals to maintain their own safety. sova reduced the likelihood of abuse to happen by promoting empowerment prevention, managing risk and by working according to the individual personal cantered plan. empowerment means allowing people to make their own choices and decisions and be in charge of their own safety. Moreover, managing risk means the way of working and support individuals to exercise choices, rights and identifying the balance between managing risk and enabling independence, choice and control. safeguarding is an important part of combined working when professionals work together in a joint way and put the individual at the centre of all activities to help recognise their full needs earlier and improve their life outcomes. it is vital to understand safeguarding as part of a continuum where prevention and early intervention can help children, vulnerable adults and families get back on track and avoid problems turning into a crisis. Protection is a central part of safeguarding and promoting the welfare and it is the process of protecting an individual identified as either suffering or at risk of suffering significant harm as a result of abuse or neglect.
2. Evaluate the impact of policy developments on approaches to safeguarding vulnerable adults in own service setting
Regard is committed to ensuring all of its service users live their lives free from harm or fear of aggression or violence. Regard will work in partnership with all legal and caring agencies to uphold this right and to ensure our service users are protected from abuse, neglect or exploitation at all times.
Our organization acknowledges the importance of national guidance and seeks to comply in all respects with current safeguarding legislation and regulations.
The Care Act 2014 introduces six key safeguarding principles, which Regard adopts in its work with adults with care and support needs
empowerment people should be supported and encouraged to make their own decisions and give informed consent
prevention – it is better to take action before harm occurs rather than waiting until it does occur
proportionality – the response should be the least intrusive and the most appropriate to the risk presented
protection – there should be support and representation for those in greatest need
partnership – services should work with their communities to produce local solutions
communities have a part to play in preventing, detecting and reporting neglect and abuse
accountability – safeguarding practice should be accountable and transparent.
The aim of this policy is to ensure all service users are protected from harm, or the risk of harm and their human rights are respected and upheld. Further aims of this policy are to ensure staff receive the appropriate level of training in order that they recognise poor practice and respond accordingly.
Regard will take action to identify and prevent abuse from happening; respond appropriately when it is suspected that abuse has occurred or is at risk of occurring and ensure that Government and local guidance about safeguarding people from abuse and neglect is accessible to all staff and put into practice. Furthermore, regard staff must understand how diversity, beliefs and values of service users may influence the identification, prevention and response to safeguarding concerns. Regard will protect others from the negative effect of any behaviour by a service user; work collaboratively with other services, teams, individuals and agencies.
In relation to all safeguarding matters, and in line with local multi-agency Safeguarding Adults Board procedures. Regard staff understand the local Safeguarding Adults Board procedures, and the actions needed to take in response to suspicions and allegations of abuse, no matter who raises the concern or who the alleged abuser may be. These include timescales for action and the local arrangements for investigation. Also Regard, staff understand their individual role and associated responsibilities in supporting the actions Regard take in responding to any allegation or concern about abuse.
This policy applies to all Regard staff, including agency workers, contractors and volunteers, across all areas of service delivery – staff working within service users homes, office-based staff and remote workers. Information on Safeguarding is available to service users and their families and friends including how to raise a concern.
3. Explain the legislative framework for safeguarding vulnerable adults
The Care Act 2014 came into effect on 1st April 2015, with a further stage of implementation in 2020. The purpose of the Act is to reform the law relating to care and support for adults and the law relating to support for carers; to make provision about safeguarding adults from abuse or neglect; to make provision about care standards; to make provision about integrating care and support with health services … and for connected purposes.” (Care Act 2014)
It unites a number of different Acts into one single legislative framework of care and support for adults and their carers. Individual clauses are either:
• new legislation which will impact on local authorities;
• new legislation but not new policy, therefore a large number of local authorities may already be carrying out such activities; or
• consolidate or refresh existing legislation.
The Department of Health and Social Care has issued statutory guidance – Care and Support Statutory Guidance – for local authorities and partner agencies. Chapter 14 of the guidance replaces the previous statutory guidance No Secrets: Guidance on Developing and Implementing Multi-Agency Policies and Procedures to Protect Vulnerable Adults from Abuse (Department of Health,2000).
Safeguarding Vulnerable Groups Act 2006 – Following the murders, Soham and the Bichard Inquiry (2004) suggested the development of a central service to bar unsuitable people from working with children or vulnerable adults. As a result of this Safeguarding Vulnerable Groups, Act was agreed and the Independent Safeguarding Authority was established. Under this Act, employers must not employ people who are barred from working with vulnerable adults and must refer people to the vetting and barring scheme if they have been fired for harming a vulnerable adult.
Equality Act 2010 explain about equality and diversity regard people who worked in care must understand their individual responsibilities in preventing discrimination in relation to the protected characteristics set out in the: age; disability; gender reassignment; marriage and civil partnership; pregnancy and maternity; race; religion or belief; sex; and sexual orientation. Also, service users must be supported when they make allegations of discrimination or actually experience discrimination. They must not be victimised for making a complaint about discrimination. Equality legislation is an important tool Where an allegation of discrimination is substantiated or when responding to this type of abuse. Local authorities and service providers need to take corrective action and make changes to prevent it from happening again. This may involve seeking specialist advice or support.
Deprivation of Liberty Safeguards (DoLS) means protecting the human rights of people who lack capacity to consent to care or treatment in a hospital or registered care home, when – in their best interests – they receive care that amounts to a deprivation of liberty (as defined by Article 5, Right to Liberty, Human Rights Act1998).
DoLS is an amendment to the Mental Capacity Act 2005 (MCA), as introduced by the Mental Health Act 2007.
The Supreme Court held that a deprivation of liberty can also occur in domestic / home type settings where the State is responsible for imposing such arrangements. This may include placement in a supported living arrangement in the community. These must be authorised by the Court of Protection.
There is a difference between deprivation of liberty (which is unlawful, unless authorised) and restrictions on an individual’s f Restrictions of movement (if in accordance with the principles and guidelines of the MCA) can be lawfully carried out in someone’s best interest to prevent harm. This includes the use of physical restraint where that is proportionate to the risk of harm to the person and in line with best practice.
Neither the MCA nor DoLS can be used to justify the use of restraint for the protection of members of staff or other service users.
Deprivation of Liberty Safeguards (DoLS) only applies to adults in a care home or supported living arrangement including where The local authority where the person is ordinarily resident is the supervisory body for care homes. This will usually be the local authority area in which the care home is situated, unless the person is funded by a different local authority. there are plans to move a person to a care home where they may be deprived of their liberty. Final decisions about whether a person is being deprived of their liberty are made by the Courts.
The Mental Capacity Act 2005 (MCA 2005) provides a framework to protect and restore power to those who may lack, or have reduced, capacity to make certain decisions at particular times. It places the adult at the centre of the decision-making process.
‘Whenever the term ‘a person who lacks capacity’ is used, it means a person who lacks the capacity to make a particular decision or take a particular action for themselves at the time the decision or action needs to be taken.
This reflects the fact that people may lack the capacity to make some decisions for themselves, but will have the capacity to make other decisions. For example, they may have the capacity to make small decisions about everyday issues such as what to wear It also reflects the fact that a person who lacks the capacity to make a decision for themselves at a certain time may be able to make that decision at a later date. This may be because they have an illness or condition that means their capacity changes. Alternatively, it may be because at the time the decision needs to be made, they are unconscious or barely conscious whether due to an accident or being under anaesthetic or their ability to make a decision may be affected by the influence of alcohol or drugs.
Finally, it reflects the fact that while some people may always lack capacity to make some types of decisions – for example, due to a condition or severe learning disability that has affected them from birth – others may learn new skills that enable them to gain capacity and make decisions for themselves’ (MCA 2005 Code of Practice, 2007: p3).
or what to eat, but lack the capacity to make more complex decisions about financial matters.
Human Rights Act 1998 – Article 3 prohibits torture and inhuman or degrading treatment. Article 5 acknowledges that everyone has the right to liberty and that it should only be restricted if there is specific legal justification, Article 14 outlaws discrimination of all types.
The GDPR is a European regulation which intends to strengthen and unify data protection for all individuals (the data subjects) within the European Union (EU). It also includes the export of personal data outside the EU. It aims to give back control of their personal data to citizens and simplify the regulatory environment for international business. It came into force on 25th May 2018.
The regulatory detail will not change once Britain leaves the European Union (EU) in 2019; it is incorporated in the DPA.
The main reasons for introducing the GDPR include:
• outdated legislation which is out of step with technological advances;
• an inconsistent approach in different EU countries to data protection;
• limited control for individuals, as data subjects;
• limited rights for data subjects;
• a lack of security and privacy in product development (for example, website design).
In order to tackle these concerns, therefore, the GDPR:
• stipulates that each EU member must abide by the regulation and by any business that trades within the EU or with EU data;
• aims to create a consistent environment throughout Europe and beyond to enable the secure flow of data;
• gives individuals greater control of their data by improving consent processes;
• introduces the ‘right to be forgotten’ which enables the data subject to have their data ‘forgotten’ once it is no longer being used for the purpose which it was collected. The ‘right to data portability’ allows individuals to acquire and reuse their personal data across different services.
Safeguarding Adults a National Framework of Standards 2005 – The association of Directors of Social Services, with a number of partners published a set of standards for social services departments to use. The aim of the agenda is to try to support the work already under way and also to try to reduce the difference in practice and procedures across the country. The standards are not compulsory but have been adopted by councils and their partners.
4. Evaluate how serious case reviews or inquiries have influenced quality assurance, regulation and inspection relating to the safeguarding of vulnerable adults
The purpose of any case review is to protect vulnerable adults, by drawing upon lessons to be learned from individual cases, making recommendations aimed at preventing similar tragedy by strengthening and improving multi-agency procedures and arrangements.
Serious Case Reviews (SCRs) in respect of vulnerable adults, inquiries are led by English adult protection or safeguarding boards at the local level when harm or death has occurred,
There is increasing concern about the risks faced by vulnerable adults to abuse, exploration and neglect and growing interest in achieving greater patient or user safety in care settings, including the home (Lang et al., 2008).
In order to promote better safety, professionals have sought to learn to look back from mistakes from serious incidents or even near misses.
In between the publication of the statutory guidance No Secrets (Department of Health and Home Office, 2000; the purpose of a SCR is ‘not to reinvestigate nor to apportion blame’, but rather: to establish whether there are lessons to be learnt from the circumstances of the case about the way in which local professionals and agencies work together to safeguard vulnerable adults to review the effectiveness of procedures (both multi-agency and those of individual organisations)
To inform and improve local inter-agency practice
To improve practice by acting on learning (developing best practice)
To prepare or commission an overview report which brings together and analyses the findings of the various reports from agencies in order to make recommendations for future action (ADASS, 2006).
This is the report of serious case review for Winterbourne View. The case came to the attention of the public after the broadcast of a BBC Panorama programme in May 2011. The documentary contained shocking undercover footage of abuse and humiliation carried out by a team of support workers who were supposed to be safeguarding service users. Staff were shown repeatedly abusing service users, including:
- humiliating patients
- restraining patients under chairs
- giving cold punishment showers
- leaving patients outside in cold weather
- pouring mouthwash into patients’ eyes
- pulling patients’ hair
- forcing medication into patients’ mouths.
Victims were shown screaming and shaking. One was seen trying to jump out of a second-floor window and being mocked by staff.
The abuser at Winterbourne View Hospital was prosecuted, eleven sentenced and six received custodial sentence. These offences were treated as a disability hate crime due to the lack of knowledge and prejudice
Systemic failings
The serious case review concluded systemic failings permitted untrained and supervised staff to abuse those in their care. Moreover, the finding reviews a history of former incidence at Winterbourne view hospital and missed warnings.
Winterbourne hospital was owned and operated by Castlebeck Care Ltd. Opened in December 2006 as a private hospital with two wards to accommodate 24 patients. It was listed as a hospital with the purpose of providing treatment, rehabilitation and assessment for people with learning difficulties. The admission of this hospital was supposed to be short term but stay to the hospital was around 19 months.
The serious case review report highlighted that the most alarming issue was the high number of documented physical intervention at his hospital. The documented physical interventions between 2010 and the quarter of 2011 were 558.
The Serious case review explained that chances were missed to identify the abuse and poor care by multiple agencies and by Castlebeck, examples.
- No process in a place to linking when patience from winterbourne attending NHS so that big picture appeared. 78 occasions winterbourne patient attended NHS
- Police involved in 29 incidents regarding Winterbourne Hospital patients and 40 safeguarding alerts to council
- If not for Panorama the abuse could have gone longer as Whistleblowing alerts to the CQC were ignored
The Serious Case Review identified many areas of poor care and management practice, including the following.
Most patients had constipation and dental problem
- No prescribing policy regarding anti-psychotic drug
- Restriction to the family and visitor to visit individual bedroom
- Complain were not dealt with properly
- No register manager for the service
- No adequate training
- Hospital had more support worker than nurses
- high staff sickness and staff turnover.
The final case review stated that have it should be identified as pointing to something seriously wrong at the hospital due to Most patients had constipation and dental problem, No prescribing policy regarding anti-psychotic drug, Restriction to the family and visitor to visit individual bedroom, Complain were not dealt with properly, No register manager for the service, No adequate training and hospital had more support worker than nurses.
They indication that the safeguarding team failed to put together. For example, individuals who are accountable for commissioning care were not told every time about safeguarding alerts.
Whistleblowing measures within the CQC have since been strengthened.
The final report action designed to address the issues and change the way services are delivered so that another incidence like Winterbourne View can never happen.
The report identifies the best practise guidance which has been available for years and there are no reasons for officials failing to commission services that will enable people to live free from abuse.