Guidance One - Prevention and Minimising

Introduction

Nottingham and Nottinghamshire take a proactive approach to safeguarding adults from abuse and expect this approach to be adopted by all agencies and organisations. This guidance provides information and ideas that may help you safeguard adults more effectively from abuse and neglect.

Strategic Planning

Nottingham(shire) provides multi-agency policy, procedures and guidance that should be used when concerns or allegations of abuse are made. However, one of the key values of this multi agency policy is that all individuals have a right to live free from abuse in accordance with the principles of respect, dignity, autonomy, privacy and equity.

Work undertaken at a strategic level should include:

• Safeguarding Adults Policy, Procedures and Guidance which are regularly reviewed and updated. These should include; preventative measures, and how to alert, refer, record, investigate and review in the event that abuse does occur;
• Good interagency working, information sharing and an understanding of the roles each agency has;
  
• Developing and utilising safeguarding adults audits for use by agencies and organisations to assess the level of protection services provide, and ensure continuous improvement;
  
• Ensuring that training strategies are directed not only towards what to do if abuse has taken place but target prevention, minimising risk and indicators of abuse;
  
• A Safeguarding Adults serious case review protocol where lessons learned can prevent similar abuse happening again;
  
• Developing awareness of adult abuse and practical advice on how to report concerns via publicity campaigns and other media types.

Commissioners of Services

• Reflect the Policy and Procedures for Safeguarding Adults;
  
• Specify expectations of providers to meet the requirements of the policy and procedures.

They also need to:

• Provide organisations from which they acquire services with relevant, updated policies, procedures and information material such as Safeguarding Adults Policy and Procedures, and Protection of Vulnerable Adults (PoVA) scheme information;
  
• Ensure contracts specify rigorous recruitment practices for both paid staff and volunteers;
  
• Ensure that contract monitoring arrangements include terms and conditions that reflect safeguarding adults issues.

Agencies Responsibilities

• Carry out Safeguarding Adults audits to minimise risk and ensure continuous improvement;
• Communicate effectively across agencies, sharing information which may help to prevent abuse from taking place;
• Identify senior staff with lead responsibilities for Safeguarding Adults work;
  
• Reflect Safeguarding Adults policies in other relevant areas of work;
  
• Have internal Policy and Procedures for dealing with Safeguarding Adults issues;
• Make staff aware of both internal and external Policies and Procedures for Safeguarding Adults from abuse and neglect;
  
• Make service users and the public aware of both internal and external Policies and Procedures for Safeguarding Adults from abuse;
  
• Have contractual arrangements in place reflecting the requirement to adhere to relevant Safeguarding Adults Policy and Procedures;
  
• Have a written policy on confidentiality;
  
• Have a written ‘Whistleblowing’ Policy in line with The Public Interest Disclosure Act 1998;
  
• Have effective communication between staff and service users;
  
• Provide robust supervision where time is spent discussing Safeguarding Adults issues and reflecting on cases where abuse has taken place;
  
• Are able to provide access to advocacy schemes;
  
• Are aware of the support available to victims of crime and the support available to vulnerable witnesses;
• Have a rigorous recruitment process that includes Criminal Records Bureau, reference and PoVA checks where applicable;
  
• Make Safeguarding Adults an integral part of staff induction;
  
• Encourage staff to report any concern that they have about the safety and wellbeing of a service user;
  
• Include Safeguarding Adults training within their training strategy;
  
• Provide a person centred approach to care and support;
  
• Have a clear complaints procedure easily accessible to service users, relatives, staff and the public;
  
• Make staff aware of anti-discriminatory practice;
  
• Make staff aware of support relating to their employment such as:
  - Occupational health advisers
  - Internal and inter agency counselling schemes
  - Trade union membership
  - Professional organisations
  - Harassment Advisors
  - Entitlement to special leave/ carers leave
  - Entitlement to paid holidays
  - European Work Time Directive
  - Whistleblowing
  - Codes of Practice for staff;
  
• Complete risk assessments for:
  - Assessment of vulnerability and risk of abuse
  - Moving and handling
  - Threats or assault by service users or members of the general public
  - Working in a stressful environment;
  
•  Provide comprehensive policies, procedures and staff training in relation to:
  - Challenging behaviour
  - Personal and intimate care
  - Physical intervention
  - The Mental Capacity Act 2005
  - Sexuality and personal relationships
  - Medication
  - Financial accountability
  - Risk assessment and management
  - Cultural awareness
  - Disability awareness
  - Moving and handling
  - Communication;
   
• Integrate Safeguarding Adults’ principles in all aspects of care and support.
  

Practical Guidance for Staff

Staff also have an important role to play in preventing abuse and safeguarding vulnerable adults. This means you should:

• Have an awareness of the Safeguarding Adults Policy and Procedures and your role and responsibilities within that process;
  
• Attend relevant training and seek support to implement the Policy and Procedures within your work environment;
  
• Include safeguarding issues in care plans;
  
• Have a working knowledge of the Mental Capacity Act 2005;
  
• Integrate Safeguarding Adults into all aspects of care and support that you provide;
  
• Discuss any concerns that you have with your line manager or the appropriate person within your organisation at the earliest opportunity;
  
• Provide services users and carers with the relevant information about prevention and minimising abuse.

Risk Assessment Tool

Some people with learning disabilities may be more at risk of becoming victims of abuse because of their individual characteristics, their social environment and their physical environment. Nottinghamshire Healthcare Trust Psychology Services have developed a risk assessment tool to assess an individual’s level of risk of being abused and enable staff to minimise those risks.  See Appendix 15 - Risk Assessment Tool

Smile, No Bullying Best Practice

The "Smile No Bullying" Best Practice Guidance was developed by the Positive Futures Team and Home Farm Trust (HFT) to ‘help stop people with a learning disability from being bullied when they are at home, out in the community, at college or at a day service.’  Its aim, along with a DVD on the subject, is to help staff to prevent and tackle bullying and to educate people with learning disabilities about the problem.

Included in the Best Practice Guide is a section called ‘Improving the Environmental Quality’ which offers practical advice to services and organisations. This section has been reproduced below with kind permission from the Positives Futures team and HFT:

"Many places could improve their environment and as a result reduce bullying. A poor environment may offer few places for educational, social, physical and creative activities.

Common problems are:

• Boredom – leading to teasing, fights or damage to the environment;
• Crowding – competition for space creating conflicts;
• Isolation – dominant activities exclude other people who have little opportunity to engage in smaller activities;
• Behaviour – people copying staff confrontational situations.

Then, think of ways to improve the situation, try them, and monitor and feedback success.

For more details of this practical guidance, visit www.positivefutures.me.uk or www.hft.org.uk.

Vulnerable Adults, Families and Carers

Staff should make vulnerable adults, families and carers aware of, and ensure that they have an understanding of, the following:

• Living and support options – including day care, respite, sitting services, personal alarms etc;
  
• Development of social networks:
  - keeping contact with family/ friends/ neighbours
  - access to social groups
  - access to support groups;
  
• Awareness of personal safety;
  
• Awareness of security for home and possessions;
  
• Assessment of needs;
  
• Access to mainstream and specialist services.

Accessible information about abuse and keeping safe should also be provided. Practitioners and staff should be innovative with formats and not restrict information to leaflets. Consideration should be given by agencies and organisations to providing information in different formats such as audio, Braille and symbols. Below are details of some leaflets, websites and organisations which may provide useful information for you to make accessible to vulnerable adults, families and carers in the most suitable way for the individual concerned:

Abuse is Bad. Speak Up Self-Advocacy

Available from Speak Up Self-Advocacy. Telephone 01709 710199, www.speakup.org.uk

A DVD for people with learning disabilities, containing information about abuse.

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