Safeguarding Vulnerable Adults E-Learning Module

Safeguarding Vulnerable Adults (Mandatory - All Staff)

E-Learning pre -course reading

Introduction 

This is a printed copy of the Training Tracker e-learning module on Safeguarding

Vulnerable Adults. This course is aimed at all Trust staff.

Module Aims 

The main aims of this module are to ensure you understand the principles of safeguarding,

the indicators of abuse and the roles, responsibilities and actions that you must take in

safeguarding vulnerable adults.

It is everyone's responsibility to be aware and informed about safeguarding. The 5 R's are

key to learning for this module.

 Respond appropriately and accurately.

 Recognise safeguarding needs and signs and symptoms of abuse with vulnerable

adults.

 Responsibilities Understand your responsibilities

 Record important and relevant material accurately and in a timely fashion.

 Reporting to the appropriate manager.

So how do you respond, recognise, and understand your responsibilities, record and

report?

What is meant by Safeguarding? 

 Protecting vulnerable adults from further harm if it has already occurred.

 Investigating where abuse or crime has taken place (often in conjunction with

the Police).

...and commissioning safe services, for example:

 Ensuring that care packages and care placements are meeting a client's

needs and keeping the client safe.

 Meeting the requirements of the Care Quality Commission (CQC). All NHS and

private care providers are subject to inspection and regulation by the CQC.

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Helping people to take 'safe' risks, through robust risk assessment, and

planning care to meet their needs without taking away choice and freedom.

National Statistical Information 

Here are some facts and figures about the incidence of abuse nationally…

 500,000 people are believed to be abused at any one time in the UK.

 Approximately 20 people in 100,000 report abuse each year.

 27% of people who have a Learning Disability report that they have been

abused.
 46% of people who abuse are related to the person they are abusing.

 A quarter of those who abuse are the sons or daughters of the victim.

 Two thirds of abuse is committed at home by someone in a position of trust.

 In 37% of situations more than one type of abuse is occurring

simultaneously.

How Do We Keep People Safe? 

 Criminal record checks and an independent safeguarding authority scrutiny

prior to employment of staff.

 Care Quality Commission inspection and regulation.

 Training for all staff who are responsible for the safeguarding of vulnerable

adults.
 Effective care planning taking account of client needs, choice and freedom,

always working within the client's best interests.

 Reporting incidents that are of concern, complaint or comment in relation to

safeguarding vulnerable adults.

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 Handling all patients safely in accordance with manual handling guidance and

risk assessment, ensuring appropriate training is given, and using equipment

assessed for the client and the purpose.

 The advocacy service provides trained lay people to advocate on behalf of

service users who have difficulty advocating for themselves and have no

appropriate representative.
 Monitoring every contact with service users to ensure that they are treated

with dignity and respect at all times (Link privacy and dignity policy)

Local Statistical
Information

Here are some figures about abuse

incidence locally…

 There are approximately 164 alerts to the Island Social Services each month.

 Most reports are about abuse against people who are aged 75+.

 Most are reports of physical abuse or neglect.

 The largest groups who are reported as being subjected to abuse are older people

and people who have a learning disability.

Inquiries and Other Drivers 

The list of inquiries that follow all relate to the abuse of vulnerable adults both in
hospital and in the community. Many of the enquires have found failings in
systems and procedures. Some of the incidents could have been avoided if
appropriate actions were taken by healthcare professionals. It's important we
learn from these events to ensure that there is no repeat of the tragic and
sometimes fatal incidents.

Bichard Inquiry 2004

Cornwall Inquiry 2006

Stephen Hoskins Inquiry 2007

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Sutton and Merton 2007

No Secrets 2000 (currently under review)

Death by Indifference (Mencap) 2007

Isle of Wight Multi-Agency Safeguarding Adults Policy 2007 (Link)

6 Lives (2009)

The Pilkington Case (2008)

These inquiries and government papers will inform you of the recommendations in relation

to children and adults which aim to protect them when vulnerable.

Legislation 

Mental Health Act 1983/New Act 2007

Human Rights Act 1998

Public Interest and Disclosure Act 1998

Youth Justice and Criminal Justice Act 1999

Care Standards Act 2000

Sexual Offences Act 2003

Domestic Violence, Crime and Victims Act 2004

Mental Capacity Act/Deprivation of Liberty 2005

Disability Discrimination Act 2005

Safeguarding Vulnerable Groups Bill

This legislation enshrines in law the legal safeguards for vulnerable adults, young people

and those with mental health problems and disability. All Health and Social care

professionals and carers must abide by this legislation.

Mental Capacity and Safeguarding 

What is the Mental Capacity Act?

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The MCA provides a statutory framework to empower and protect people who may lack

capacity to make some decisions for themselves. It makes it clear who can take decisions

in which situations and how they should go about this. It enables people to plan ahead for

a time when they may lack capacity. It will cover decisions about someone’s property and

affairs, healthcare treatment and where the person lives, as well as everyday decisions

about personal care.

The principles of the act are:

 Assume a person has capacity unless proved otherwise.

 Do not treat people as incapable of making a decision unless you have tried

all you can to help them.

 Do not treat someone as incapable of making a decision because their

decision may seem unwise.

 Do things or take decisions for people without capacity in their best interests.

 Before doing something to someone or making a decision on their behalf,

consider whether you could achieve the outcome in a less restrictive way.

The MCA is designed to protect the rights of individuals and to empower vulnerable adults.

In the past, some people with dementia, learning disabilities and severe mental illness

have often not been listened to, and their rights to make decisions may not have been

recognised. The MCA covers decisions that range from day-to-day decisions such as what

to eat and wear, through to serious decisions about where to live, having an operation or

what to do about a person’s finances and property.

Who is a Vulnerable Adult? 

A vulnerable adult is a person who is aged 18 years or over who:

 ''Is or may be in need of community care services by reasons of mental or

other disability, age or illness; and who is or may be unable to take care of

him or herself, or unable to protect him or herself against significant harm or

exploitation”

(No Secrets 2000)

and

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 ''Whose independence and well being would be at risk if they did not receive

appropriate health and social care support''

(Safeguarding Adults 2005)

Who May Be Responsible For Abuse? 

This could be anybody in a position of authority or control or has power or influence over a

person who is potentially vulnerable.

It is important to remember that abuse may be unintentional as well as intentional and

may be caused by omission as well as action.

 Carer, paid or unpaid

 Family member

 Manager or group of managers of a care organisation

 Member of the public or tradesperson

 Volunteer

 Person acting with criminal intent

Who May Be Responsible For Abuse? 

This could be anybody in a position of authority or control or has power or

influence over a person who is potentially vulnerable.

It is important to remember that abuse may be unintentional as well as intentional and

may be caused by omission as well as action.

 Carer, paid or unpaid

 Family member

 Manager or group of managers of a care organisation

 Member of the public or tradesperson

 Volunteer

 Person acting with criminal intent

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How do we identify abuse? 

Abuse can come to light in many different ways:

 As a result of someone witnessing abuse

 As a result of disclosure from a vulnerable adult

 As a result of a complaint or concerns raised by family/friends/carers or

professionals i.e. District Nurses or GP

 From incident/accident reports

 As a result of “whistle blowing” or confidential reporting

Categories of Abuse 

Physical Abuse:

 Injuries inconsistent with the client's history

 Weight Loss

 Dehydration

 Over or under medication

 Use of restraint

 Inappropriate handling

Sexual Abuse:

 Disclosure or hints of sexual abuse

 Where sexual activities cause distress and/or where the person is deemed

incapable of informed consent

 Use of pornographic material where adults are not able to choose whether to

view or not

Verbal abuse:
 Shouting

 Threatening language

 Derogatory comments

 Attitude

Psychological/emotional abuse:

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 Threats

 Intimidation

 Coercion

 Harassment

 Exclusion

Categories of Abuse (continued) 

Financial Abuse:

 Person with known financial means not appearing to afford services or basic

purchases such as food, clothing, rent etc.

 Sudden loss of savings

 Missing valuable property, jewellery, cash, deeds etc

 Third party cashing benefits which do not appear to benefit the person

 Power of attorney obtained illegally

 Carers taking financial control and excluding other services or people

 Carer, family, friends who control person or finances; being evasive regarding

financial assessment

Neglect

 Withdrawal of basic needs

 Food
 Heat
 Inadequate accommodation
 Allowing pressure ulcers or wounds to remain untreated
 Malnutrition
 Preventing access to medical care
 Poor personal care
 Inadequate clothing / bedding etc

Discriminatory Abuse:

 Racist
 Sexist
 Ageist
 Based on a person’s disability
 Slurs or similar treatment

Institutional Abuse 

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Institutional abuse can occur in a care home, nursing home, acute hospital or in-patient

setting and can be any of the following types of abuse:

 Neglect.

 Physical abuse.

 Sexual abuse.

 Verbal abuse.

 Discriminatory abuse.

 Psychological and emotional abuse.

 Financial abuse.

Institutional abuse occurs when the lifestyles of individuals are sacrificed in favour of the

rituals, routines and/or restrictive practices of the home or care setting.

Examples of behaviour: lack of individualised care, inappropriate confinement or

restrictions, sensory deprivation, inappropriate use of rules, custom and practice, no

flexibility of bedtimes or waking times, dirty clothing or bed linen, lack of personal

possessions or clothing, deprived environment or lack of stimulation, misuse of medical

procedures

What happens if you discover abuse has occurred? 

 Keep the person and yourself safe

 Get help if needed

 Preserve evidence in case of police investigation e.g. when considering sexual abuse do

not wash vulnerable people or change clothes or bed clothes

 Write down what you have heard and seen

 Report to your manager

Responsibilities 

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All Staff (paid or unpaid) who work with vulnerable adults have a responsibility to report

actual incidents or suspicions of abuse.

All Agencies have a responsibility to take action if they suspect abuse by reporting and

investigating concerns in accordance with Policy and Procedures to ensure the most

effective response and the safety of the person concerned.

Reporting 

To report actual incidents or suspicions of abuse, telephone the Safeguarding Service on

01983-823340.

 Report concerns to line manager or other senior person who may advise you

to contact the Isle of Wight Council Safeguarding Service on 01983 823340

or, after 8pm and weekends/Bank Holidays, 01983 821105.

 Report accurately and immediately in writing in the vulnerable person's own

words as in the multi-agency safeguarding adults policy (to be found on the

intranet under policies).

 For the health service the deputy chief nurse is the operationally accountable

person.

Key Messages 

As you have worked through the previous pages you will have built a picture of the wide

ranging abuse and how to protect vulnerable adults. It's important now that you consider

the 5R's as you go about your daily life so that together we can reduce adult abuse.

Always

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 Respond appropriately and accurately.

 Recognise safeguarding needs and signs and symptoms of abuse with

vulnerable adults.
 Responsibilities - understand your responsibilities.

 Record important and relevant material accurately and in a timely fashion.

 Report to the appropriate manager.

ACKNOWLEDGEMENTS:

 Development & Training would like to thank Pat McCamley, Louise

Backhouse, Sandie Paice and Lyn Turner for their time, assistance and

support in creating this course..

Joan Armitage - A Case Scenario 

The next two pages relate to a case scenario. The final 3 questions in the short test at the

end of this module refer to this scenario.

Joan Armitage is an 84 year old lady who has resided at The Gables Residential Home

since her discharge from hospital 3 months ago. Mrs Armitage is mobile with a Zimmer

frame but does get confused very easily, believing she is at her parent's house.

Mrs Armitage’s son, Henry, wants his mother to return home to live with him; however the

Care Manager does not feel this would be in Mrs Armitage's best interests as Henry do not

work and spends most of his day in the betting shop.

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After his last visit, the care staff noticed some bruising to Mrs Armitage's arm. Henry also

reported that some money was missing from his mother's drawer.

Case Scenario (continued) 

Mrs Armitage is getting more and more agitated and has tried on several occasions to

open the front door which is locked.

You are a new carer at the home and one morning you witness a senior carer restraining

Mrs Armitage and preventing her from leaving the building. You can see that she is

grabbing Mrs Armitage’s arm and speaking harshly to her.

You raise your concerns with a colleague who tells you that it is necessary to be forceful

with Mrs Armitage as she has dementia and you need to make her understand. You are

aware that the senior carer will act up in the Registered Managers absence.

You have received information that Mrs Armitage is behind with her payment fees. The last

cheque was returned. A cheque book and card are kept in the office. Mrs Armitage’s son is

now insisting that his mother returns home where he feels he can look after her. However
Mrs Armitage is now becoming frailer and needs more support.

What do I do now? –

Access Training Tracker to take your test

If you already have a username and password you can log into training tracker
and start your test via this link http://iow.trainingtracker.co.uk that can be found
on:

 Intranet Homepage
 Learning Zone
 E- Learning

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To obtain a username and password, please contact Development & Training

on extension 5409, and we will ensure that the details are e-mailed to you as
soon as possible, usually within 24 hours.

If you have any difficulties with logging in please do not hesitate to contact us on
the above number.

IF YOU DO NOT FEEL CONFIDENT USING A COMPUTER AND WOULD LIKE

ONE TO ONE SUPPORT AND GUIDANCE PLEASE CONTACT US ON THE
ABOVE NUMBER AND WE CAN ARRANGE FOR AN IT TRAINER TO HELP
YOU TO LOG ON AND TAKE YOUR TEST.

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