Safeguarding Adults Policy – New Road Surgery
Purpose of this Policy
The purpose of this policy for practice staff is to ensure that New Road Surgery has agreed procedures and protocols in place to safeguard vulnerable adults and to make explicit the roles and responsibilities of all practice employees. The practice is committed to working with other agencies to Safeguard Adults and will comply with the agreed Multi-Agency Framework for Safeguarding Adults in Worcestershire and the Worcestershire Adult Protection Policy and Procedures (2008) which can be accessed via the PCT intranet page or directly via; www.worcestershire.gov.uk/safeguardingadults
The purpose of this policy for service users is to ensure that they understand what abuse is and how to report concerns.
The Policy recognises that Safeguarding Adults is everyone’s responsibility
Introduction
The practice has a duty of care to protect its patients from abuse. It must respond promptly when abuse is suspected or reported. This Policy has been developed to outline the practice and procedures for all staff to follow. It aims to promote protection from abuse of people aged 18 years or older who are in receipt of our services and to ensure appropriate action is taken where abuse is suspected. People are vulnerable whenever their health or usual function is compromised and as a consequence they may be unable to protect themselves against harm or exploitation. A person’s vulnerability increases when they are in unfamiliar surroundings, situations or relationships and when they become reliant on others for care. Although illness and disability at any age can make people vulnerable, some people are more vulnerable to abuse than others e.g. those who are physically frail, those who have mental health problems and those with a learning disability.
This policy sets out procedures, staff roles and responsibilities and must be read in conjunction with the Multi-Agency Framework for Safeguarding Adults in Worcestershire and the Worcestershire Adult Protection Policy and Procedures (2010) available via the PCT intranet or at www.worcestershire.gov.uk/safeguardingadults
Scope of the Policy
This policy applies to all staff employed by New Road Surgery who work with vulnerable adults.
This policy does not cover safeguarding children so staff caring for anyone under the age of 18 years should refer to the Safeguarding Children’s Policy and Procedures available via emis practice documents.
Definitions
Vulnerable Adult - the term vulnerable adult refers to any person aged 18 and over who: “…is or maybe in need of community care services by reason of mental or other disability, age or illness; and who is or maybe unable to protect him or herself against significant harm or serious exploitation” (No Secrets, Department of Health 2000)
Abuse - the term Abuse is defined as: “Abuse is a violation of an individual’s human and civil rights by any other person or persons” (No Secrets, Department of Health 2000)
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 transaction to which he or 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.
Categories of abuse (and examples of types of abuse) are;
. Discriminatory Abuse - ridicule or threats because of race, gender, disability, age, sexual orientation
. Physical Abuse - being hit or restrained, misuse of medication
. Sexual Abuse - being harassed, teased or being forced to have sex without consent
. Psychological Abuse - bullying, threats, verbal abuse
. Financial Abuse - theft, fraud, exploitation, pressures to change a will, misappropriation of property and possessions
. Neglect and Acts of Omission - not getting adequate care, food, medication, heating
. Institutional Abuse - mistreatment by an organisation or individual where care is provided
Safeguarding Adults - the term „Safeguarding Adults means: All work which enables any adult “who is or may be eligible for community care services” to retain independence, wellbeing and choice and to access their human right to live a life that is free from abuse and neglect. (Association of Directors of Social Services 2005)
Mental capacity
Many adults who lack capacity are deemed as vulnerable. The Mental Capacity Act (2005) governs decision making on behalf of adults who lose mental capacity at some point in their lives. The act contains a number of provisions designed to protect vulnerable people and staff can refer to guidance on the MCA via the Worcestershire PCT website.
Roles and Responsibilities
Worcestershire County Council’s Adult and Community Services acts as the lead agency with responsibility for co-ordinating local activity for the safeguarding of vulnerable.
Dr J Cheetham is the appointed Clinical Safeguarding Lead within the practice.
Dr J Boden is the appointed Clinical Safeguarding Deputy Lead within the practice.
The Clinical Safeguarding Lead and Clinical Safeguarding Deputy Lead are responsible for all aspects of the implementation and review of the vulnerable adult’s safeguarding procedure in this practice.
Staff: it is the responsibility of all staff members to make themselves aware of the content of this policy. It is everyone’s duty to report any suspicions or witnessing of adult abuse. Abuse can happen anywhere and by anyone, including relatives, friends, neighbours, paid workers, volunteers, professional staff, other service users, contractors and strangers. An allegation of abuse must be treated seriously, regardless of the source of the information. It is important for staff to pass on information or concerns immediately to the duty doctor who will be responsible for deciding what further action to take. Where a criminal offence is suspected, the police must be informed immediately.
Service users who have concerns regarding abuse by any member of staff should report these via the practice complaints policy. Service users with concerns about abuse by any other person should report these to Worcestershire Adult Protection Team on 0845 607 2000.
Safeguarding Adults procedures to follow
Any member of staff identifying concerns that they may have about the abuse of patients must report these to the duty doctor immediately. The duty doctor will be responsible for deciding what further action to take. The duty doctor will ensure that any incident is reported as a significant event and discussed to ensure that any learning/further action is always considered - see Significant Event Reporting Procedure – New Road Surgery.
Contact Details/Further Advice
Contact details are available on the WHCT website and doctors can contact their defence unions for further advice.
For a copy of the Worcestershire PCT Adult Safeguarding policy and procedures please refer to the web address as below, or you may contact the Adult Protection team on 01527 556050. www.worcestershire.gov.uk/safeguardingadults
Safe employment practices
It is the responsibility of the organisation to ensure that we recruit and employ individuals who pose no risk to children and young people and will actively promote their safety and welfare; this includes temporary, locum and agency staff as well as permanent staff.
The practice has policies, procedures and good practice in place to ensure that the appropriate checks are made when recruiting new staff.
Training for Adult Safeguarding
Training will be delivered by on-line training - using NHS Core Skills Website.
Appendix 1
Worcestershire PCT
Mental Capacity Act (MCA) and Adult Safeguarding Steering Group (MCAAS)
The committee will:
REFERENCE DOCUMENTS and RESOURCES
www.worcestershire.gov.uk/safeguardingadults
You can seek advice from Adult Protection Team (ASC) on 01527 556050
REFER WITHOUT DELAY TO THE SOCIAL CARE ACCESS CENTRE on 01905 768053.
If out-of-hours and urgent, please ring Emergency Duty Team on 01905 768020
This Policy should be read in conjunction with the following:
Consent to treatment
Confidentiality
Chaperone Policy
Whistle Blowing Policy
Acknowledgements –information used in this document has been taken from the Worcestershire Acute Hospitals NHS Trust website.
Date Oct 2012
Review due Oct 2013
Safeguarding Children and Young People Policy – New Road Surgery Rubery
Document Purpose
To ensure staff are aware of practice and individual responsibilities regarding safeguarding children and young people.
To ensure that service users understand what abuse is and how to report concerns.
Introduction
All staff at New Road Surgery have regular contact with children. This includes children as serviceusers, children as relatives, close contacts or carers of adult patients. All children will be affordedthe same level of safeguarding regardless of their age, religion, disability, race, culture, gender etc. The practice will be guided primarily by Worcestershire Primary Care Trust safeguarding procedures, along with statutory guidelines. The practice aims to:
- Respond quickly and appropriately where abuse is suspected or allegations are made.
- Provide both parents and children with the chance to raise concerns over their own care or the care of others.
- Have a system for dealing with, escalating and reviewing concerns.
- Remain aware of child protection procedures and maintain links with other bodies, especially the primary care trust appointed contacts.
- The practice will ensure that all staff are trained to a level appropriate to their role, and that this is repeated regularly.
Definitions
This is not an exhaustive list but should help the reader with some of the common terms and words used in relation to Safeguarding Children and Young People.
A child is anyone who has not yet reached their 18th birthday (Children Act 1989 and 2004).
NB The fact that a child has reached 16 years of age is living independently or is in further education, is a member of the armed forces, is in hospital, prison or a young offender’s institution does not change his or her status or entitlement to services or protection under the Children Act 1989. Young people who are in this category as well as younger adolescents often fall through the net of services, not seen as an adult but no longer a child; they are often very vulnerable.
Safeguarding and promoting the welfare of children is defined as: protecting children from maltreatment, preventing impairment of children’s health and development, ensuring that children are growing up in circumstances consistent with the provision of safe and effective care and enabling children to have optimum life chances and enter adulthood successfully. (Working Together to Safeguard Children 2010)
Child Protection is part of safeguarding and promoting welfare. It describes the activity undertaken to protect specific children who are suffering, or at risk of suffering or significant harm.
NB Child protection is really important but individuals and the organisation should aim to proactively safeguard and promote the welfare of children so that the need for action to protect is reduced. This includes good risk assessment, care planning, inter agency working and sharing of relevant information. Practitioners therefore need to understand risk factors warning signs and how to share information effectively.
Children in Need are those whose vulnerability is such that they are unlikely to reach or maintain a satisfactory level of health or development without the provision of services and those who are disabled. (Children Act 1989)
Harm means ill treatment or the impairment of health or development.
Development means physical intellectual emotional social or behavioural development.
Significant Harm – there is no absolute definition of the criteria for significant harm.
Most often it is a compilation of significant events both acute and long standing which interrupt, change or damage the child’s physical and psychological development.
Abuse and Neglect are forms of maltreatment. This includes inflicting harm and failing to prevent harm. This could take place within the family, an institutional or community setting, by an adult or adults, child or children known to the child or less frequently a stranger.
Physical Abuse is causing physical harm to a child which also includes fabricating or inducing illness in a child.
Emotional Abuse is the persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on emotional development. Some level of emotional abuse is involved in all types of maltreatment though it may occur alone.
Sexual Abuse involves forcing or enticing a child or young person to take part in sexual activity including prostitution whether or not the child is aware of what is happening.
Neglect is the persistent failure to meet a child’s basic physical and or psychological needs likely to result in the serious impairment of the child’s health or development. This can include failure to provide food, clothing and shelter, protection from harm, adequate supervision and access to appropriate medical care or treatment.
All of these definitions can be found in Working Together to Safeguard Children (2010)
Responsibilities
SAFEGUARDING IS EVERYONE’S RESPONSIBILITY
Dr J Cheetham is the appointed Clinical Safeguarding Lead within the practice.
Dr J Boden is the appointed Clinical Safeguarding Deputy Lead within the practice.
The Clinical Safeguarding Lead and Clinical Safeguarding Deputy Lead are responsible for all aspects of the implementation and review of the children’s safeguarding procedure in this practice.
Clinicians are responsible for acting to protect all children who they come into contact with and adhere to local & national guidelines and observe the code of conduct and recommendations of their professional bodies.
Non-clinical staff are responsible for acting to protect all children who they come into contact with and must report any incident of suspected abuse, or neglect to the duty doctor as required by the practice Child Protection Policy.
Service users who have concerns regarding abuse by any member of staff should report these via the practice complaints policy. Service users with concerns about abuse by any other person should report these to Worcestershire Child Protection on 0845 607 2000.
All staff of New Road Surgery must make themselves familiar with this policy and be aware of what to do if they are worried about a child or young person.
Any incident must be reported as significant events and discussed to ensure that any learning/further action is always considered - see Significant Event Reporting Procedure – New Road Surgery.
Worcestershire Health Care Trust has a named doctor and nurse who should be contacted in the event of a safeguarding issue being identified their details are contained in the WHCT Safeguarding Children & Young People Policy this can be obtained from the WHCT internet:
http://nww.hacw.nhs.uk/trust-a---z/safeguarding/safeguarding-children-and-young-people/what-to-do-if-you-are-worried.aspx
Individual Responsibility
All health professionals who work with children, young people and families should be able to: understand risk factors and recognise children and young people in need of support and/or safeguarding. Recognise the needs of parents who may need extra help in bringing up their children, and know where to refer for help and use the Common Assessment Framework to access support as appropriate for them. Recognise the risks of abuse or neglect to an unborn child. Communicate effectively with children and young people and stay focused on the child’s safety and welfare. Liaise closely with other agencies, including other health professionals, and share information as appropriate. Assess the needs of children and the capacity of parents/carers to meet their children’s needs, including the needs of children who display sexually harmful behaviours. Plan and respond to the needs of children and their families, particularly those who are vulnerable. Contribute to child protection conferences, family group conferences and strategy discussions. Contribute to planning and commissioning support for children who are suffering, or likely to suffer, significant harm, for example, children living in households with domestic violence or parental substance misuse. Help ensure that children who have been abused or neglected and parents under stress have access to services to support them. Be alert to the strong links between adult domestic violence and substance misuse and child abuse and recognise when a child is in need of help, services or at potential risk of suffering significant harm. Where appropriate, play an active part, through the child protection plan, in keeping the child safe. As part of generally safeguarding children and young people, provide ongoing promotional and preventative support, through proactive work with children, families and expectant parents and contribute to child death and Serious Case Reviews and implementation of the lessons learned (Working Together to Safeguard Children 2010).
Safe employment practices
It is the responsibility of the organisation to ensure that we recruit and employ individuals who pose no risk to children and young people and will actively promote their safety and welfare; this includes temporary, locum and agency staff as well as permanent staff.
The practice has policies, procedures and good practice in place to ensure that the appropriate checks are made when recruiting new staff.
Training and Development
The practice arranges for Worcestershire’s Named Nurse for Safeguarding Children to give regular training sessions at the practice. ALL staff are required to make every possible effort to attend these events. The training reinforces the message to non-clinical staff to always report any areas of concern to the duty doctor who will take responsibility for further action in each case.
Contact Details/Further Advice
Contact details are available on the WHCT website and doctors can contact their defence unions for further advice.
Designated Nurse: Catherine Whitehouse Tel: 01905 733608 Mobile: 07501480107 www.worcestershiresafeguarding.org.uk
PREVENTING HARM TO CHILDREN WHERE PARENTS HAVE SERIOUS MENTAL ILLNESS
Very serious risks may arise if an adult’s illness incorporates delusional beliefs about a child or children in general; or there is the potential for an adult to harm a child as a result of a suicide plan. Emotional harm results from the involvement of a child in an adult’s suicide plan even if the child’s life is not threatened directly.
Information Sharing
Professionals often face moral and practice dilemmas in relation to information sharing especially if that information involves adults they are caring for. The law is very clear when information sharing is required in relation to Safeguarding Children and Young People. The child’s safety and welfare is paramount and information must be shared with relevant agencies/professionals if it is in the interest of the child or in the public interest.
Good practice demands that effective information sharing starts when the practitioner establishes a relationship with the service user ensuring that the service user understands when information they impart, or the practitioner observes, must be shared.
The practitioner will be required morally, legally and professionally to share information when the practitioner is concerned for the safety or well being of a child or young person.
The practitioner should wherever practical and possible share information in the full knowledge of the service user, acknowledging that occasionally it may be inappropriate to do this because of risk management or legal issues.
Practitioners who are worried about betraying a confidence should always consider why the individual has disclosed the information in the first place. It is often a cry for help.
The practitioner should use the six Caldicott principles for effective information sharing:
. Justify the purpose for using confidential information
. Use when absolutely necessary
. Use the minimum that is required
. Access should be on a need to know basis
. Everyone must understand their responsibilities
. Understand and comply with the law
There are policies and procedures to support and guide practitioners through ways in which to share information effectively and appropriately. Individuals should ensure that they are familiar with these and know where to access them in an emergency. Key documents include:
. What to Do If You Are Worried About a Child (DOH 2003)
. Information Sharing Practitioners Guide (2008)
. Standard for Sharing Personal Data (January 2007)
. The Caldicott Guardian Manual 2006
. The Data Protection Act 1998
. The Human Rights Act 1998
. The Freedom of Information Act 2000
. Health and Social Care Act 2001
. NHS Confidentiality Code of Practice
Full and Pocket Guidance relating to Information Sharing issued in October 2008 is available on Every Child Matters website https://www.education.gov.uk/publications/eOrderingDownload/00808-2008BKT-EN-March09.pdf
All decisions related to the sharing (or not) of information should be recorded in the patient records. A decision not to share information may be challenged. It is unlikely that a similar challenge will be received for the appropriate sharing of information provided that the guidance has been followed.
Making and Documenting a Referral to Children’s Services
If you are concerned about a child or young person those concerns must be reported to the Children’s Access Centre by telephone. All referrals must be followed up in writing within 48 hours using the guidance and documentation found on the link on the Trust’s Safeguarding children Intranet site.
Media Requests
Where serious situations arise which may result in significant media interest (such as the death of a child) no comment should be made and the practice manager or duty doctor will liaise with Worcestershire Primary Care Trust to agree an appropriate statement.
Documentation
All records made by health and social care professionals need to be defensible documents, meaning that they must be accurate, factual and complete. They must be dated and signed by the person completing them. All contemporaneous records (written at the time of an incident) such as risk assessments etc. should be kept even when written up in a formal way at a later date.
DEALING WITH ALLEGATIONS AGAINST STAFF RELATING TO CHILD
Allegations may be related to staff as professional carer’s of children and or their families or in the context of their personal lives. WHCT has to consider a member of staff’s suitability to work with either adults or children during any investigation into child protection allegations, professional or personal. In all cases immediate advice should be sought from the PCT Safeguarding Lead.
REFERENCE DOCUMENTS and RESOURCES
This Policy should be read in conjunction with the following:
Child Protection Policy
Consent to treatment
Confidentiality
Chaperone Policy
Whistle Blowing Policy
Acknowledgements –information used in this document has been taken from the Worcestershire Acute Hospitals NHS Trust website.
Date Oct 2012
Review due Oct 2013