The policy is to be read in conjunction with the whistle blowing, staff recruitment and behaviour management policies

  1. ADULT PROTECTION

Alderwood’s Vulnerable Adult Protection Policy refers to all service users aged 18+.

This policy is regularly monitored, evaluated and updated by Alderwood’s Designated Person for Safeguarding.

CONTENTS:

 Index

 Key Contacts

 What is a Vulnerable Adult?     

 Introduction

 Recognition                                                                                    

 Possible Indicators of Abuse                                                                 

 What To Do If a Vulnerable Adult Discloses Abuse/Confidentiality                                              

What To Do If You Think a Vulnerable Adult is Being Abused

 Making a Referral                                                                               

Role of CQC                        

 Death or Serious Injury of a Vulnerable Adult                                                                    

 

APPENDICES:

 Aims of Adult Care

 Charter of Adults Rights

 Promoting Vulnerable Adult Protection

 Promoting Vulnerable Adult Protection in the Recruitment and Training of Staff

 Deprivation of Liberty Safeguards (DOLS)

  

KEY CONTACT WITHIN ALDERWOOD LLA

 DESIGNATED PERSON FOR SAFEGUARDING:

 NAME:    LINDA FISH

CONTACT NUMBER:        01604 811838

OUT OF HOURS CONTACT NUMBER:       07917 708430

 KEY CONTACTS WITHIN THE LOCAL AUTHORITY

THE ADULT CARE TEAM, NORTHAMPTONSHIRE COUNTY COUNCIL

TEL:     0300 126 1000 (EXTENDED OPENING HOURS)

  

NORTHAMPTONSHIRE SOCIAL SERVICES

OUT OF HOURS TEAM:     01604 626938

(DUTY DESK) DIRECT DIAL:    01604 362900

FAX:    01604 326828

MINICOM:    01604 652334

TEXT:    07850830463

EMAIL:  adultcarenorthamptonshire.gov.uk

THE POLICE:    03000111222

You could also contact the Care Quality Commission (CQC) on 0300 616616

 ANY OF THE ABOVE SERVICES WILL BE ABLE TO HELP YOU

 

WHAT IS A VULNERABLE ADULT?

 A vulnerable adult is anyone over the age of eighteen who is unable to take care of him or herself or protect him or herself against harm or exploitation.

INTRODUCTION

 Alderwood takes very seriously its responsibility to protect and safeguard the welfare of vulnerable adults in its care.

We aim to provide a comfortable home for each service user, a safe environment where their individual needs and abilities can be met and a provision which will promote their physical, emotional, social, cultural and spiritual development. This includes protecting our service users from exposure to harm.

As part of this commitment, Alderwood has produced these guidelines so that all members of staff, parents and others who have a valid interest in the service users welfare are clear about the policy and procedure to be followed if abuse of a vulnerable adult is alleged, suspected or observed.

It is vital that everyone involved in the care of the service users is alert to the possibility of abuse. Our policy and procedures recognise this possibility and aim to promote an environment in which abuse is unlikely to occur or continue and in which staff are clear about the action to take if abuse is suspected, alleged either within or outside of the Alderwood home.

Alderwood homes, The Chestnuts, Cransley, Ecton Park, Irchester, Irchester 2, Rushden & Westfield, provide care and education to service users who have not been able to continue visiting or living in their previous placements and/or home environments.  All service users residing at the provisions have a diagnosis of Autism and present with very challenging behaviour which in some cases includes violence towards others, self-injury and damage to property. All our service users display a lack of social awareness, communication deficits and moderate to severe learning difficulties.

 All service users at The Chestnuts, Cransley, Ecton Park, Hayway, Irchester, Irchester 2, Rushden and Westfield have demonstrated a high level of need.  Those with a valid interest in the vulnerable adult’s welfare have deemed it appropriate that they receive the specialist support Alderwood can provide.

The above introduction to the Alderwood homes affords the reader an understanding of the client group’s difficulties and vulnerability and identifies why a Policy for Protection is in action.

Abuse happens to people of both sexes, at all ages and all cultures, religions and social classes and to people with and to people without disabilities.  Vulnerable adults may also be abused by other vulnerable adults.

 

Alderwood Aims of Care

The aims of Alderwood are:­

  • To help our service users to live as independently as they are able.
  • To help residents to integrate into the community as far as possible.
  • To enable residents to have as rich a quality of life as is achievable.
  • To enable residents to maintain their integrity as individuals in their own right.
  • To enable residents to progress educationally to their full potential.
  • To give residents access to their own culture.

 

These aims are pursued by the provision of a supportive and highly structured total environment with a high staff ratio and professional support, based on a family group home living situation.

RECOGNITION

 Abuse can be difficult to identify and even more so when the client group you support are people who have communication deficits, problems with social interactions and thought processes such is the case with the vulnerable people living at Alderwood, Chestnuts, Ecton Park, Hayway, Irchester, Irchester 2, Rushden and Westfield.  All our service users have a diagnosis of Autism and challenging behaviour.  You will recognise that some of the indicators listed below are characteristic of many service users supported at Alderwood, hence they must be regarded in the context of the vulnerable adult’s life and should be considered in relation to the following:

  • Always listen to our service users, particularly to what is said spontaneously.
  • Look at whether the behaviour of the person has changed.
  • Note if there is any history or pattern of unexplained injury or illness.
  • Be aware of any delay in seeking medical assistance, or failure to meet medical needs.
  • Be aware of explanations that are inconsistent with what you observe or know, especially of the persons behaviour.
  • Be aware that the vulnerable adult may seem compliant, unafraid and attached to their abusers or unresponsive, frightened and fearful.
  • Take note of any inappropriate responses from carers.
  • Remember that your records should be confidential and kept in a safe place.

 

POSSIBLE INDICATORS OF ABUSE

 General signs of abuse

The following may occur to any service user who is being abused, but are particularly significant in cases of sexual or emotional abuse where outward physical signs may not be present.  This is not a definitive list.  The absence of such indicators does not mean that abuse or neglect has not occurred.  Not all indicators need to be present.

  • Aggressive behaviour
  • Appear frightened of their care staff or others
  • Unexplained change in attitude or behaviour
  • Social withdrawal
  • Restlessness and aimlessness
  • Sleeping and eating disturbance
  • Poor trust
  • Unexplained bullying or aggressive behaviour to others
  • Onset of enuresis (bedwetting) or daytime wetting
  • Smearing faeces
  • Forms of self-harm
  • Indiscriminate and careless sexual behaviour
  • Recurrent abdominal pains
  • Recurrent headaches
  • Hysterical fits or fainting
  • Running away

 

Possible indicators of physical abuse  

 Bruises:

  • Two simultaneous bruised eyes, without bruising to the forehead (rarely accidental, though a single bruised eye can be accidental or abusive)
  • Repeated or multiple bruising on the head or on sites unlikely to be injured accidently
  • Multiple bruises of uniform shape
  • Multiple bruises in clusters
  • Bruises that carry the outline of an object used e.g. belt marks, hand prints or a hair brush
  • Bruising or tears around, behind or to the earlobe/s indicating injury by pulling or twisting
  • Bruising around the face, back and abdomen
  • Bruises away from bony prominences
  • Bruising on the arms, buttocks and thighs may be an indicator of sexual abuse

 

Burns, Bites and Scars:

  • Clear impressions of teeth (human bite marks are oval or crescent shaped those over 3cm are more likely to have been caused by an adult or older child)
  • Burns or scalds (especially with clear outlines such as a line indicating immersion or poured liquid)
  • Small round burns which may be from cigarettes
  • Linear burns from hot metal rods or electrical fire elements
  • Burns of uniform depth over a large area
  • Large numbers of different aged scars
  • Old scars that indicate the service user did not receive medical treatment
  • Friction burns

 

Fractures:

  • Swelling and lack of normal use of limbs
  • The history provided is vague, non-existent or inconsistent with the fracture type
  • Alleged unnoticed fractures: Fractures cause pain and it would be difficult for a carer to be unaware of the service user’s distress at the time of the injury.

 

Other Concerns and Injuries:

 Abnormal attachment between a vulnerable adult and Carer/other (anxious, indiscriminate or no attachment)

  • Indiscriminate attachment or failure to attach
  • Developmental delay
  • Aggressive behaviour towards others
  • Low self- esteem and lack of confidence
  • Frozen watchfulness

 

Possible Indicators of Sexual Abuse:

  • Inappropriate sexualised conduct
  • Sexually explicit behaviour
  • Continual and inappropriate or excessive masturbation
  • Self-harm, self-mutilation and suicide attempts
  • An anxious unwillingness to remove clothes for – e.g. sports events (but this may be related to cultural norms or physical difficulties)
  • Pain or itching of genital area
  • Blood on underclothes
  • Physical symptoms such as injuries to the genital or anal area, bruising to buttocks, abdomen and thighs, sexually transmitted disease, presence of semen on vagina, anus, external genitalia or clothing

 

Possible Indicators of Neglect:

  • Failure by carers to meet the basic essential needs e.g. adequate and nutritional food, clothes, warmth, hygiene and medical care
  • A service seen to be listless, apathetic and unresponsive with no apparent medical cause
  • Possible weight loss or weight gain

 

There is an element of emotional abuse in all categories of abuse.

WHAT TO DO IF A SERVICE USER DISCLOSES ABUSE/CONFIDENTIALITY

 Those caring for or supporting the service user at Alderwood should never give absolute guarantees of confidentiality to the informant. There are certain things which will have to be passed on to others.

However, they should be given a guarantee that the information will only be passed on to the minimum of people who need to know and that all possible steps will be taken to protect them from any retaliation or unnecessary stress following their allegation.

You may be the first person that the service user has trusted and it has probably taken a great deal of courage to tell you about the abuse

  • Listen carefully and reassure the service user they have done the right thing in talking to you
  • Take seriously what the person is saying or showing you
  • Remain calm and do not demonstrate your own emotions
  • Do not criticise or make judgements about the alleged abuser
  • Do not promise confidentiality
  • Do not ask leading questions or ask a service user to undress to show you injuries

 

WHAT TO DO IF YOU THINK A VULNERABLE ADULT IS BEING ABUSED                                                                             

 Any person who works with vulnerable adults has a responsibility to report concern they have about them. Individual factors or indicators of abuse may not be particularly worrying in isolation, but in combination they can suggest that there is serious cause for concern.

If you encounter any of the indicators listed:

ALWAYS discuss your concerns with your Manager, ‘On Call’ manager or Linda Fish (Alderwood’s designated person for safeguarding).  Do not work alone.

If you believe any of the above senior staff are involved with abuse in any way then you must consult or seek the advice of the Adult Care Team, Northamptonshire County Council or one of the other services listed at the beginning of this policy. These services will help decide whether a referral should be made. You should be prepared to follow the advice of these professionals. They have a duty to act if they consider that the concerns are serious.

You must keep a written record of your concerns noting dates, times, places and so on. As a minimum you should include discussions with the vulnerable adult, colleagues and Managers, information provided to the adult care team and decisions taken.  Records must be clearly written, timed, dated and signed.

All referrals and concerns should be made to your local referral team Duty Social Worker, however:

If you think a vulnerable adult is in immediate danger – call the Police.

 If you think a vulnerable adult needs emergency medical attention – seek medical advice without delay.

 

MAKING A REFERRAL

 Northampton Adult Care Team

TEL: 0300 126 1000 (EXTENDED OPENING HOURS)

OUT OF HOURS TEL: 01604 626938

  • Northamptonshire Social Services

Duty Desk Direct Dial: 01604 362900

  • POLICE: 03000111222
  • You could also contact the Care Quality Commission (CQC) on 0300 616616

 

If available, the following information should be provided with the referral (absence of information must not delay referral)

  • Is your information first-hand or did someone tell you about the incident/situation, who else have you spoken to?
  • Full names, date of birth and gender of vulnerable adult
  • Home address
  • Identity of those with responsibility of vulnerable adult’s welfare
  • Any special needs of vulnerable adult
  • Any significant/important recent or historical events/incidents in the person’s life of any allegations, their sources, timing and location
  • Cause for concern including details
  • Vulnerable adult’s current location and emotional and physical condition
  • Referrer’s relationship and knowledge of vulnerable adult and others with an interest in their welfare
  • Known current or previous involvement of other agencies/professionals

 

Formal referrals from named professionals cannot be treated as anonymous, so the alleged perpetrator will ultimately become aware of the identity of the referrer.

You must complete an SA1 Referral Form found on the Northampton Safeguarding Adults website (Copies of these forms may also be found attached to this to ensure that all the relevant information is gathered as quickly as possible. Telephone referrals should be followed up by completing the SA1 referral form within 24 hours. All sections of the form, must be completed in full.

You may be requested to find out more information at this stage.

The Adult Care Team will pass your concern to the Safeguarding Adults Team who should acknowledge referrals within one working day of receipt. If this does not occur within three working days, the referrer should contact the Adult Care referral team again.

 

The Care Quality Commission (CQC) should also be informed as soon as possible.

  ROLE OF CARE QUALITY COMMISSION (CQC)

CQC will not interview or investigate allegations of abuse – they too will refer the investigation to specialist services and police staff.  CQC will be concerned about issues of safeguarding and promoting the welfare of the vulnerable adult in the home, rather than the specific details of interviewing during the investigation of the allegation itself.

He/she will therefore assess: ­

  • Whether the alleged incident/s indicates any significant failure by Alderwood to safeguard and promote the vulnerable adult’s welfare e.g. by failing to carry out required police checks on staff.
  • Whether Alderwood acted appropriately and in line with agreed protection procedures in responding to the allegation of abuse.
  • Whether the welfare of the vulnerable adult involved in the alleged abuse, or in giving information, is now safeguarded.
  • Whether there are any lessons to be learned or recommendations to be made for the future for Alderwood, in the light of the allegations and investigations.

 

DEATH OF A VULNERABLE ADULT/SERIOUS LIFE THREATENING INJURY

 In all cases which involve the death of, or serious harm to a vulnerable adult (where abuse is suspected or confirmed), Alderwood is to inform the Police and Northampton Adult Care Team TEL: 0300 126 1000 (EXTENDED OPENING HOURS).

Out of hours, at weekends or during Bank Holidays, notification should be made to the Northamptonshire Social Services Out of Hours Team on 01604 626938.

The manager should ensure that all records held at Alderwood in respect of the vulnerable adult (care, education and health) are kept secure for the purpose of any inquiry. The Police must be informed and the scene must be protected.

 Alderwood Aims Of Adult Care

The aims of Alderwood are:

1)        To help residents to live as independently as possible.

2)        To help residents to integrate into the community as far as possible.

3)        To enable residents to have as rich a quality of life as possible.

4)        To enable residents to maintain their integrity as individuals in their own right.

5)        To enable residents to progress educationally to their full potential.

6)        To give residents access to their own culture.

These aims are pursued by the provision of a supportive and highly structured total environment with a high staff ratio and professional support, based on a family group home living situation.

 

Charter of Adult’s Rights

THIS GUIDELINE ADHERES TO VALUES FIRMLY ROOTED WITHIN THE UNITED NATIONS DECLARTION OF HUMAN RIGHTS.

 1)       All adults with learning disability have the right to be treated with respect and dignity accorded to all adults.

2)       They have the right to have access to information about themselves, their bodies, their emotions and appropriate social behaviour.

3)       The right not to be abused.

4)       The right to humane and dignified environments.

5)       The right to make appropriate relationships.

6)       The right to make choices and keep safe.

7)       The right to ask about sex and relationships.

8)       The right to gain and have help to access information they need about sex and relationships.

9)       The right to understand what things need to be kept private and what things can’t.

10)     The right to be kept safe.

11)     The right to find out about good health and have access to appropriate service.

 

 Promoting Vulnerable Adult Protection

1)        Each vulnerable adult’s representative should be aware of the Charter of Rights.

2)        Each vulnerable adult’s representative should be aware of Alderwood’s Complaints Procedure.

3)        If a vulnerable adult’s representative is not satisfied about the way in which their complaint is handled, they may contact CQC.

 

Promoting Vulnerable Adult Protection in the Recruitment and Training of Staff

1)         All Alderwood staff employees will have been vetted with the necessary police checks and according to the guidance procedures of the Department of Education and Health respectively.

2)        Psychology students, for whom these procedures do not apply, have   no unsupervised contact with vulnerable adults at Alderwood.

3)        Alderwood is committed to the provision of training for its staff, in relation to vulnerable adult protection.

4)        All staff should be familiar with the above procedures and have a basic knowledge of what constitutes abuse, how to recognise abuse and what to do when abuse is reported or witnessed.

5)        Training will include the Good Practice Guidelines which have been prepared in order to protect vulnerable adults and reduce the possibility of false allegations of abuse.

 

 DOLS (Deprivation of Liberty Safeguards)

If any adult resident is in receipt of DoLS (Deprivation of Liberty Safeguards) Standard Authorisation and it is necessary to re-locate them to another residence within Alderwood it is a legal requirement that a further assessment be carried out.  Paragraph 5.14 to 5.17 of the Deprivation of Liberty Safeguards Code of Practice makes it clear that the authorisation relates to the specific placement and lapses if the person is moved.  In conjunction with the new assessment, CQC must be informed of the service user’s new address.