Adult Safeguarding Back to Basics JUDY EKE ADULT

Adult Safeguarding – Back to Basics JUDY EKE ADULT SAFEGUARDING MANAGER SOUTH GLOUCESTERSHIRE COUNCIL

The Care Act 2014

What do we mean by safeguarding? Safeguarding means protecting an adult’s right to live in safety, free from abuse and neglect. It is about people and organisations working together to prevent and stop both the risks and experience of abuse or neglect, while at the same time making sure that the adult’s wellbeing is promoted including, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action. This must recognise that adults sometimes have complex interpersonal relationships and may be ambivalent, unclear or unrealistic about their personal circumstances. The Care Act Statutory Guidance 2020

Types of Abuse Physical Abuse Domestic Abuse Sexual Abuse Psychological Abuse Financial Abuse Modern Slavery Discriminatory Abuse Organisational Abuse Neglect and acts of omission Self-neglect

Who does safeguarding apply to? Any adult who: has needs for care and support (whether or not the local authority is meeting any of those needs) is experiencing, or at risk of, abuse or neglect as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect The Care Act Statutory Guidance 2020

The objectives of an enquiry establish facts ascertain the adult’s views and wishes assess the needs of the adult for protection, support and redress and how they might be met protect from the abuse and neglect, in accordance with the wishes of the adult; make decisions as to what follow-up action should be taken with regard to the person or organisation responsible for the abuse or neglect enable the adult to achieve resolution and recovery The Care Act Statutory Guidance 2020

Keeping accurate records, using advice Emily Gunnell Senior Practitioner Safeguarding Adults Team Bristol City Council

Making Safeguarding Personal • MSP should be considered at: v. Board Level – Information for the public, hearing the voice of the person, monitoring outcomes the person wanted from safeguarding, feedback from people supported v. For all individual concerns

Raising a concern

Enquiries and Outcomes

MSP and Duty of Candour • For registered providers – clear link between MSP and Duty of Candour • The DUTY OF CANDOUR is a statutory (legal) duty to be open and honest with patients (or 'service users'), or their families, when something goes wrong that appears to have caused or could lead to significant harm in the future.

Do. LS (LPS) and Covid update, plus Q & A Dameon Caddy MCA/Do. LS Manager NSC & BNSSG CCG

LPS Implementation • Statment from Helen Whatey • Minister of State (Minister for Care) • 16 July 2020 • “It is now clear that successful implementation is not possible by this October. We now aim for full implementation of LPS by April 2022. Some provisions, covering new roles and training, will come into force ahead of that date” https: //www. parliament. uk/business/publications/written-questions-answersstatements/written-statement/Commons/2020 -07 -16/HCWS 377/ • Code of Practice and consultation on this due 2021. Feedback or questions before this date via lps. cop@dhsc. gov. uk. • Do. LS remains in situ and the law until April 2022

Do. LS & Covid-19 – Review • DHSC - The Mental Capacity Act (2005) (MCA) and deprivation of liberty safeguards (Do. LS) during the coronavirus (COVID-19) pandemic published several weeks into pandemic. https: //www. gov. uk/government/publications/coronavirus-covid-19 -looking-after-people-who-lack -mental-capacity/the-mental-capacity-act-2005 -mca-and-deprivation-of-liberty-safeguards-dolsduring-the-coronavirus-covid-19 -pandemic • Duties under MCA/Do. LS remain in place - Not rescinded • “In most cases, changes to a person’s care or treatment in these scenarios will not constitute a new deprivation of liberty, and a Do. LS authorisation will not be required. ” • However also states that if the proposed arrangements are “more restrictive” then a review may be required. • “All decision-makers are responsible for implementing the emerging government public health advice. ”

Do. LS & Covid-19 – Review • “Any resident presenting with symptoms of COVID-19 should be promptly isolated (if not already) and tested. . . This should be in a single room with a separate bathroom, where possible. ” https: //www. gov. uk/government/publications/coronavirus-covid-19 -admission-and-care-ofpeople-in-care-homes/coronavirus-covid-19 -admission-and-care-of-people-in-care-homes • The document also discusses cohorting residents and limiting their free access around the home to prevent the spread of the virus • ? Significant increase in restrictions across care home population. • MCA can only consider ‘risk to self’ not ‘risk to others’. If someone has already contracted Covid-19 how does self isolation protect them ? • ‘Risk to others’ can be authorised by new public health powers (2020 Coronavirus Act ) but little in the way of resource to implement these.

Do. LS & Covid-19 – Assessment • DHSC guidance first published 9 April 2020 • Recommended that assessors should not go into homes and that assessment should happen via remote means. (e. g video calls) • Update to above guidance published 7 Sept 2020 • “To carry out Do. LS assessments and reviews, remote techniques can be considered, such as telephone or video calls where appropriate to do so, and the person’s communication needs should be taken into consideration” • “Face-to-face visits by professionals are an important part of the Do. LS legal framework. These visits should currently occur if needed, for example to meet the person’s specific communication needs, urgency or if there are concerns about the person’s human rights. ” https: //www. gov. uk/government/publications/coronavirus-covid-19 -looking-after-people-who-lack -mental-capacity/the-mental-capacity-act-2005 -mca-and-deprivation-of-liberty-safeguards-dolsduring-the-coronavirus-covid-19 -pandemic.

MCA & Covid-19 – Right to family life and privacy • Do. LS cannot authorise restrictions on contact and family life (Article 8 Human Rights Act) • Visiting Care Homes during Coronavirus https: //www. gov. uk/government/publications/visiting-care-homes-during-coronavirus/update-onpolicies-for-visiting-arrangements-in-care-homes • “limiting the numbers of visitors to a single constant visitor per resident” • “In the event of an outbreak in a care home and/or evidence of community hotspots or outbreaks, care homes may rapidly impose visiting restrictions to protect vulnerable residents. ” • “visitors should be encouraged to keep personal interaction with the resident to a minimum, for example avoid skin-to-skin contact (handshake, hug) and follow the latest social-distancing advice for as much of the visit as possible” • How compliant is national guidance with human rights law https: //www. theguardian. com/society/2020/sep/09/care-home-visits-guidance-england-unlawfulcharity-claims

The Path Forward • Follow national guidance regarding public health measures alongside own risk assessment. • Continue to use the general provisions of the MCA to consider individual circumstances. • Ensure that relevant local authority and / or Do. LS office are aware where there is any objection to proposed arrangements / restrictions. • Keep abreast of guidance (changes/updates regularly at www. gov. uk) • Second Wave ? ? ? • Questions ? ? ?