safeguarding is all about protecting those at risk from harm

safeguarding is all about protecting those at risk from harm.! it involves identifying abuse and taking action whenever someone is being abused or harmed. a vulnerable adult is a person aged 18 years or over who is or may need care services by reason of mental illness, disability or age and sometime circumstance and who is or may be unable to take care of themselves or unable to protect themselves against significant harm or exploitation. There are types of individuals and groups that are most vulnerable to abuse or harm. some of the individuals may include young people, elderly people, people with mental health issues, people with dementia, people with learning or physical disabilities and children.
1.3 Define the Following terms
PHYSICAL ABUSE – Physical abuse is any intentional act causing injury or trauma to another person or animal by way of bodily contact.
DOMESTIC ABUSE -Any incident of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality.
SEXUAL ABUSE- Sexual abuse, also referred to as molestation, is usually undesired sexual behaviour by one person upon another
EMOTIONAL/PSYCHOLOGICAL ABUSE – Psychological abuse also referred to as psychological violence, emotional abuse, or mental abuse is a form of abuse, characterized by a person subjecting, or exposing, another person to behaviour that may result in psychological trauma, including anxiety, chronic depression, or post-traumatic stress disorder.
FINANCIAL/MATERIAL ABUSE- a form of mistreatment and fraud in which someone forcibly controls another person’s money or other assets.
MODERN SLAVERY- The condition in which one person is owned as property by another and is under the owner’s control.
DISCRIMINATORY ABUSE- when someone picks on you or treats you unfairly because something about you is different. This can include unfair or less favourable treatment due to a person’s race, gender, age, disability, religion, sexuality, appearance, or cultural background.
INSTITUTIONAL/ORGANISATIONAL ABUSE – is the mistreatment of people brought about by poor or inadequate care or support, or systematic poor practice that affects the whole care setting.
SELF NEGLECT – is any failure of an adult to take care of himself or herself that causes or is reasonably likely to cause within a short period of time, serious physical, mental or emotional harm or substantial damage to or loss of assets.
NEGLECT BY OTHERS- a form of abuse where the perpetrator, who is responsible for caring for someone who is unable to care for themselves, fails to do so. Neglect may include the failure to provide sufficient supervision, nourishment, or medical care, or the failure to fulfil other needs for which the victim cannot provide themselves

1.4 describe harm
According to the oxford dictionary harm is:
NOUN
1. physical injury, especially that which is deliberately inflicted.
“I didn’t mean to cause him any harm”
synonyms: injury · hurt · pain · suffering · distress · anguish · trauma · torment · grief · damage · impairment · destruction · loss · ruin · defacement · defilement · mischief

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A person can be at harm anywhere this could be in their home, where they work, in a public place and sometimes it’s by the people closest to them.
It can even happen in the very places that are involved with the responsibility of protecting them such as a care home. respite home, work placement or day services that the adults attend. This could be due to another person, or people whether staff or peers, deliberately taking advantage of the adult. But this can also turn the other way and it can be the vulnerable adult who is unintentionally putting themselves at risk, simply because they don’t have the right level of support in place. Harm can take some of the following forms: financial, physical, psychological, sexual or neglect

1.5 describe restrictive practices
Making someone do something they don’t want to do or stopping someone doing something they want to do
Containment – this is when an adult cannot physically leave the place where they live/stay. This includes locking doors, windows, or gates. But It is not considered containment if an adult has a lack of road safety skills and a door is locked to prevent them wandering close to a road where they can injury themselves or result in death.

Seclusion – according to CQC Secluding a person can be a traumatic experience and may lead to harm for the patient involved. This is recognised by the Mental Health Act (MHA) Code of Practice 2015, which also highlights that inadequate seclusion facilities can make the experience worse.
Seclusion is when an adult cannot physically leave a room or area where they receive disability services like a care home. This may include locking doors, windows, or gates. The adult is placed on their own, at any time of the day or night.

Chemical restraint – this is the use of medication to control the adult’s behaviour. This does not include using medication for treating a diagnosed mental illness or physical condition.

Physical restraint – the use of any part of another person’s body to restrict the free movement of the adult with the aim of controlling the adult’s behaviour.

Restricting access to an object
Limiting the adult’s access to an object, for example a kitchen drawer with knives, at a place where the adult receives disability services. This can prevent the adult using the object to cause harm to themselves or others.
In some care home service users can have behaviours that can challenge this can be down to their disability their communication or even sometimes it appears for no reason that you can see or understand but can be relevant to the service user. Our care plans will fully document such behaviours and how to support the individual in a safe calm least restrictive manner the care plans will have information on:
behaviour, escalation, de-escalation, guidelines {team teach plan}, professional guidelines such as IST {intensive support team },Prn medication ,Behaviour charts /sleep charts , positive behavioural support
As a support worker we need to understand people’s behaviours and allow their unique needs, wants, life experiences and their own strengths need to be recognised and most important is to enhance their quality of life. We need the continuing Involvement and participation of our service users in their care and support needs and their families input is essential, but of course this is if it’s the service users wishes.
All People must be treated with compassion, dignity, and kindness and grow Positive relationships between the staff who deliver services and the service users that we support
But unfortunately restrictive practises are common in some care settings but they should be manged by the policy’s in the work place to ensure the safety of the service user and their legal rights we all have to work in Compliance with the law such as the Care Act 2014, the Act’s “wellbeing principle” spells out a local authority’s duty to ensure people’s wellbeing is at the centre of all it does. we have Deprivation of Liberty {DOLs} and in line with DOLs Any restrictive intervention must be legally and ethically justified, be necessary to prevent serious harm and be the least restrictive option.
Norman Lamb who served most recently as Minister of State for Care and Support in the Department of Health, said in a report on winterbourne view
“Investigations into abuses at Winterbourne View Hospital and Mind’s Mental Health Crisis in Care: physical restraint in crisis (2013) showed that restrictive interventions have not always been used only as a last resort in health and care. They have even been used to inflict pain, humiliate, or punish. Restrictive interventions are often a major contribution to delaying recovery, and have been linked with causing serious trauma, both physical and psychological, to people who use services and staff. These interventions have been used too much, for too long. Department of health guidelines 2014 stated that staff must not deliberately restrain people in a way that impacts on their airway, breathing or circulation such as a face down restraint.
2.1 identify the signs and/or symptoms associated with each of the following types of abuse
Physical abuse
• Assault, hitting, slapping, punching, pinching, pushing, kicking, hair-pulling, biting, pushing
• Involuntary isolation or confinement
• Force feeding and /or withholding food
• Rough handling, pulling, pushing using clothes to turn
• Scalding and burning
• Physical punishments
• Inappropriate or unlawful use of restraint
• Making someone purposefully uncomfortable e.g. opening a window and removing blankets, turning on/off heating
• Misuse of medication e.g. over-sedation with Prn medication
• Unlawful use of restraint, restricting movement (e.g. tying someone to a chair)
Possible indicators
• No explanation for injuries or inconsistency with the account of what happened
• Injuries are inconsistent with the person’s lifestyle
• Bruising, cuts, welts, burns and/or marks on the body or loss of hair in clumps
• Frequent injuries
• Unexplained falls
• Subdued or changed behaviour in the presence of a certain person
• Signs of malnutrition
• Failure to seek medical treatment
• Withdrawn
• suddenly behaves differently anxious, clingy, aggressive
• problems sleeping, eating
• wets the bed, soils clothes, nightmares
Domestic Abuse
• Domestic abuse is any type of controlling, bullying, threatening or violent behaviour between people in a relationship. But it isn’t just physical violence –
• domestic abuse includes emotional, physical, sexual, financial or psychological abuse. It also includes so called ‘honor’ -based violence, female genital mutilation and forced marriage
• controlling behavior is a core part of domestic violence.
• Coercive behavior can include: acts of assault, threats, humiliation and intimidation, harming, punishing, or frightening the person, isolating the person from sources of support
• exploitation of resources or money preventing the person from escaping abuse regulating everyday behaviour.

Possible indicators
• Low self-esteem
• Feeling that the abuse is their fault when it is not
• Physical evidence of violence such as bruising, cuts, broken bones
• Verbal abuse and humiliation in front of others
• Fear of outside intervention
• Damage to home or property
• Isolation – not seeing friends and family
• Limited access to money
Sexual abuse
• Rape, attempted rape or sexual assault
• Inappropriate touch anywhere
• Non- consensual masturbation of either or both persons
• Non- consensual sexual penetration or attempted penetration of the vagina, anus or mouth
• Any sexual activity that the person lacks the capacity to consent to
• Inappropriate looking, sexual teasing or innuendo or sexual harassment
• Sexual photography or forced use of pornography or witnessing of sexual acts
• Indecent exposure
Possible indicators
• Bruising, particularly to the thighs, buttocks and upper arms and marks on the neck
• Torn, stained or bloody underclothing
• Bleeding, pain or itching in the genital area
• Unusual difficulty in walking or sitting
• Foreign bodies in genital or rectal openings
• Infections, unexplained genital discharge, or sexually transmitted diseases
• Pregnancy in a woman who is unable to consent to sexual intercourse
• The uncharacteristic use of explicit sexual language or significant changes in sexual behaviour or attitude
• Incontinence not related to any medical diagnosis
• Self-harming
• Poor concentration, withdrawal, sleep disturbance
• Excessive fear/apprehension of, or withdrawal from, relationships
• Fear of receiving help with personal care
• Reluctance to be alone with a certain person
Psychological or emotional abuse
• enforced social isolation – preventing someone accessing services, educational and social opportunities and seeing friends
• Removing mobility or communication aids or intentionally leaving someone unattended when they need assistance
• Preventing someone from meeting their religious and cultural needs
• Preventing the expression of choice and opinion
• Failure to respect privacy
• Preventing stimulation, meaningful occupation or activities
• Intimidation, coercion, harassment, use of threats, humiliation, bullying, swearing or verbal abuse
• Addressing a person in a condescending way
• Threats of harm or abandonment
Possible indicators
• silence when a certain person is present
• Withdrawal or change in the psychological state of the person
• Insomnia
• Low self-esteem
• Uncooperative and aggressive behaviour
• A change of appetite, weight loss/gain
• Signs of distress: tearfulness, anger
• Apparent false claims, by someone involved with the person, to attract unnecessary treatment
Financial or material abuse
• Theft of money or possessions
• Preventing a person from accessing their own money, benefits or assets
• Employees taking a loan from a person using the service
• Undue pressure, duress, threat or undue influence put on the person in connection with loans, wills, property, inheritance or financial transactions
• Arranging less care than is needed to save money to maximize inheritance
• Denying assistance to manage financial affairs
• Denying assistance to access benefits
• Misuse of personal allowance in a care home
• Misuse of benefits or direct payments in a family home
• Someone moving into a person’s home and living rent free without agreement or under duress
• False representation, using another person’s bank account, cards or documents
• Exploitation of a person’s money or assets, e.g. unauthorized use of a car
• Misuse of a power of attorney, deputy, appointeeship or other legal authority
Possible indicators
• Missing personal possessions
• Unexplained lack of money or inability to maintain lifestyle
• Unexplained withdrawal of funds from accounts
• Power of attorney or lasting power of attorney (LPA) being obtained after the person has ceased to have mental capacity
• The person allocated to manage financial affairs is evasive or uncooperative
• The family or others show unusual interest in the assets of the person
• Recent changes in deeds or title to property
• Rent arrears and eviction notices
• A lack of clear financial accounts held by a care home or service
• Failure to provide receipts for shopping or other financial transactions carried out on behalf of the person
• Disparity between the person’s living conditions and their financial resources, e.g. insufficient food in the house
• Unnecessary property repairs

Modern slavery
• Human trafficking
• Forced labor
• Domestic servitude
• Sexual exploitation, such as escort work, prostitution and pornography
• Debt bondage – being forced to work to pay off debts that realistically they never will be able to
Possible indicators
• Appearing to be malnourished, unkempt or withdrawn
• Isolation from the community, seeming under the control or influence of others
• Living in dirty, cramped or overcrowded accommodation and or living and working at the same address
• Lack of personal effects
• Always wearing the same clothes
• Avoidance of eye contact, appearing frightened or hesitant to talk to strangers
• Fear of law enforcers
Discriminatory abuse
• Unequal treatment based on age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex or sexual orientation the are also known as ‘protected characteristics’ under the Equality Act 2010
• Verbal abuse, derogatory remarks or inappropriate use of language related to a protected characteristic
• Denying access to communication aids, not allowing access to an interpreter, signer or lip-reader
• Harassment or deliberate exclusion on the grounds of a protected characteristic
• Denying access to communication aids, not allowing access to an interpreter, signer or lip-reader
• Denying basic rights to healthcare, education, employment and criminal justice relating to a protected characteristic
• Substandard service provision relating to a protected characteristic
Possible indicators
• The person appears withdrawn and isolated
• Expressions of anger, frustration, fear or anxiety
• The support on offer does not take account of the person’s individual needs in terms of a protected characteristic
Organizational or institutional abuse
• Discouraging visits or the involvement of relatives or friends
• Run-down or overcrowded establishment
• Authoritarian management or rigid regimes
• Lack of leadership and supervision
• Insufficient staff or high turnover resulting in poor quality care
• Abusive and disrespectful attitudes towards people using the service
• Inappropriate use of restraints
• Lack of respect for dignity and privacy
• Failure to manage residents with abusive behaviour
• Not providing adequate food and drink, or assistance with eating
• Not offering choice or promoting independence
• Misuse of medication
• Failure to provide care with dentures, spectacles or hearing aids
• Not taking account of individuals’ cultural, religious or ethnic needs
• Failure to respond to abuse appropriately
• Interference with personal correspondence or communication
• Failure to respond to complaints
Possible indicators
• health or surroundings
• Inability to avoid self-harm Lack of flexibility and choice for people using the service
• Inadequate staffing levels
• People being hungry or dehydrated
• Poor standards of care
• Lack of personal clothing and possessions and communal use of personal items
• Lack of adequate procedures
• Poor record-keeping and missing documents
• Absence of visitors
• Few social, recreational and educational activities
• Public discussion of personal matters
• Unnecessary exposure during bathing or using the toilet
• Absence of individual care plans
• Lack of management overview and support
Neglect and acts of omission
• Failure to provide or allow access to food, shelter, clothing, heating, stimulation and activity, personal or medical care
• Providing care in a way that the person dislikes
• Failure to administer medication as prescribed
• Refusal of access to visitors
• Not taking account of individuals’ cultural, religious or ethnic needs
• Not taking account of educational, social and recreational needs
• Ignoring or isolating the person
• Preventing the person from making their own decisions
• Preventing access to glasses, hearing aids, dentures, etc.
• Failure to ensure privacy and dignity
Possible indicators
• Poor environment – dirty or unhygienic
• Poor physical condition and/or personal hygiene
• Pressure sores or ulcers
• Malnutrition or unexplained weight loss
• Untreated injuries and medical problems
• Inconsistent or reluctant contact with medical and social care organizations
• Accumulation of untaken medication
• Uncharacteristic failure to engage in social interaction
• Inappropriate or inadequate clothing

Self-neglect
• Lack of self-care to an extent that it threatens personal health and safety
• Neglecting to care for their own personal hygiene,
• Failure to seek help or access services to meet health and social care needs
• Inability or unwillingness to manage their own personal affairs
• Neglecting their household upkeep
• Portraying eccentric behaviours/lifestyles;
Indicators of self-neglect
• Very poor personal hygiene
• Unkempt appearance
• Lack of essential food, clothing or shelter
• Malnutrition and/or dehydration
• Living in squalid or unsanitary conditions
• Neglecting household maintenance
• Hoarding
• Collecting many animals in inappropriate conditions
• Non-compliance with health or care services
• Inability or unwillingness to take medication or treat illness or injury

Research
www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/
http://www.lwa.org.uk

Institutional Abuse


http://www.oneinfour.org.uk/
https://www.gov.uk/guidance/domestic-violence-and-abuse
https://www.scie.org.uk/care-act-2014/safeguarding-adults/sharing-information/ https://www.skillsforcare.org.uk/Topics/Safeguarding/Safeguarding.aspx
https://www.gov.uk/government/publications/
safeguarding-adults-the-role-of-health-services

2.2 describe factors that may contribute to an individual being more vulnerable to abuse
Adults with disabilities are some of our most vulnerable people. because most disabled adults either with a learning disability or physical disability can be vulnerable as they are mostly reliant upon support from family or staff, as most disabilities need support and guidance with personal and daily living activities such as bathing, dressing, personal hygiene and food shop/prep. Also due to the nature of the disability, an adult may be unable to physically remove themselves from an abusive situation. The care/family member becomes so important that they the service user are scared to say anything as they are scared of what would happen to them would they be believed ,who would look after them, where can they live .there are signs that professionals {social workers ,staff, managers , day centre staff}should look out for to help notice the of risk abuse these can include some of the below
• service users having needs that exceeded carers’ ability to meet them
• rejecting help and support from outside
• not meeting thresholds for support
• refusing to be left alone.
• Living alone
• Health issues
• Financial issues
• Religious differences
• Race differences
Carers issues
• young /immature carers
• drug or alcohol dependency
• Carers feeling under pressure and unable to cope
• Poor training
• Poor support
• Carers feeling frustrated or isolated
• Thinking you will not be discovered
Most people think that people with disabilities are not capable of relationships and not interested in or able to engage in sexual acts. Others may perceive that persons with disabilities do not have the capacity to understand or talk about what has happened to them, when a person discloses that he or she is a victim of abuse, they are frequently not believed. These situations are intricate and place the adults with disabilities at greater risk of more abuse. But adults may be unable to communicate easily with others. They might have a communication disorder, limited communication skills or need devices such as iPad which can break down, be used by the cares/family even though it’s the service user’s property. Lack of money may also limit the adult from getting the help and support to buy the equipment.
When abuse by a carer or a family member is witnessed by others, it may not always be reported for multiple reasons including:
• Shock of what the witnessed
• Fear for their own personal safety
• Reluctance to break the code of silence among fellow employees due to fear or abuse
• Reluctance to become involved.

3.1 Explain the actions to take if there are suspicions that an individual is being abused
If a service user alleges that they have been abused then we have to take the allegation seriously even if the service user does not realised that they are being abused .you will need to offer reassurance to the service user you will need to make a written account and a body map if there are visible marks and bruising then Cleary document all relevant paperwork. you will report to your manager and the adult team at borough hall if a Safeguarding needs to be raised then at George Beal House only the Management are allowed to raise a safeguarding .

3.2 Explain the actions to take if a individual alleges that they are being abused
At the first allegation of abuse then staff will need to remain calm and collected you must be non-judgmental and your personal feelings of panic, fear, worry and maybe Disgust will have to be put to one side.
Staff will need to be supportive and a member of staff will need to stay with alleged victim immediately after the disclosure to provide some sense of physical security. You will need to assure the individual that they did the right thing by telling you. Never say that you do not believe them.
The staff member supporting will have to ensure that the alleged abuser if present has no access to the service user. You will have to explain that you need to report this to management, adult team at Bedford borough, police, doctor as they may need first aid and more help to ensure their health and well-being needs are being met.
The supporting staff member will need to listen to the service user if they want to talk but must not ask leading questions for e.g. ‘what happened then ‘always use their own words and describe how they started talking to you note time, place, who else is present in the room . d any information freely given must be fully documented in a literal sense. Do ensure allegations are not repeated to others. if a Safeguarding is required then at George Beal House only the Management can raise a safeguarding.

3.3 identify ways to ensure that the evidence of abuse is preserved
As with above you need to record incident as described by the service user and do not include your opinion do not touch or move anything from where the incident happened, in the case of serious injury use all P.P.E equipment available if required Call the police and emergency service Do not discuss about the incident in public Keep the report confidential and store it in safe and secure place Report immediately to Manager or Safeguarding Team . all documentation Must have name, signatures and valid date on report

4.1 Identify relevant legislation, national policies and local systems that relate to safeguarding and protection from abuse
CQC is the Care Quality Commission and is the independent regulator of health and adult social care in England. They ensure that the health and social services provided meet the peoples need in a safe ,effective, compassionate, high-quality care and we encourage care services to improve.
Below has been taken from the CQC website.
Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 13
The intention of this regulation is to safeguard people who use services from suffering any form of abuse or improper treatment while receiving care and treatment. Improper treatment includes discrimination or unlawful restraint, which includes inappropriate deprivation of liberty under the terms of the Mental Capacity Act 2005.
To meet the requirements of this regulation, providers must have a zero tolerance approach to abuse, unlawful discrimination and restraint. This includes:
• neglect
• subjecting people to degrading treatment
• unnecessary or disproportionate restraint
• deprivation of liberty.
Providers must have robust procedures and processes to prevent people using the service from being abused by staff or other people they may have contact with when using the service, including visitors. Abuse and improper treatment includes care or treatment that is degrading for people and care or treatment that significantly disregards their needs or that involves inappropriate recourse to restraint. For these purposes, ‘restraint’ includes the use or threat of force, and physical, chemical or mechanical methods of restricting liberty to overcome a person’s resistance to the treatment in question. Where any form of abuse is suspected, occurs, is discovered, or reported by a third party, the provider must take appropriate action without delay. The action they must take includes investigation and/or referral to the appropriate body. This applies whether the third party reporting an occurrence is internal or external to the provider. CQC must always be informed of a safeguarding adults concern if it is reported to a local authority then the local authority must notify CQC.
Deprivation of liberty safeguards
The Deprivation of Liberty safeguards are part of
the Mental Capacity Act 2005. They aim to make sure adults in care homes, respite, hospitals or supported living are looked after in a way that does not inappropriately restrict their freedom.
The safeguards should ensure that a care home, hospital or supported living arrangement only deprives someone of their liberty in a safe and correct way and is only done when it is in the best interests of the person and there is no other way to look after them.
These safeguards protect the interests of extremely vulnerable people, and to ensure they can be given the care they need and to prevent decisions that deprive vulnerable people of their rights

Mental Capacity ACT 2005
the Mental Capacity Act is a valuable act that is very important to people with a learning disability it helps ensure that the adults with disabilities who lack Capacity make their own decisions and are fully supported to with what they need to make them .when they are not able to make their own decisions the act it says a decision must be made that is in their ‘best interests’.
The 5 main principles of the Mental Capacity Act
• Everyone is believed to have capacity to make decisions unless it can be proved that they do not.
• A person should be supported to make their own decisions using all practicable steps before it is decided that they are unable to do so.
• A person should not be considered unable to make a decision simply because their decision is considered unwise or eccentric by others. (If capacity is in doubt at this stage and the person has a disorder of the mind, no matter how caused, use the four point capacity test below).
• Any decision made on behalf of someone who lacks capacity must be made in their best interests.
• Any best interests decision must take account of all the circumstances and take the least restrictive course of action available to maintain the person’s basic rights and freedom.
• {taken from .gov web page }
Office of the public guardian
• The Office of the Public Guardian (OPG) protects people in England and Wales who may not have the mental capacity to make certain decisions for themselves, such as about their health and finance.
Multi-agency adult protection