Raising Awareness Training

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Context

• Human Rights Legislation
• No Secrets - Section 7 DoH Guidance
• Essex Joint Policy and Operational Procedures -
  Guidelines for the Protection of Vulnerable
  Adults from Abuse
• Essex Vulnerable Adults Protection Committee

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No Secrets

• No Secrets is a policy document to help
  organisations and staff deal with concerns of
  abuse of vulnerable adults
• It is called No Secrets because many believe
  for years that vulnerable adults have been abused
  and kept secret
• All organisations in England and Wales must put
  the No Secrets policy into practice - no one
  organisation or individual can opt out!

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• EVAPC is responsible for ensuring all staff in
  all organisations that work with vulnerable
  people follow the local policy and procedures
• EVAPC has representation from Social Services,
  Police, Health, Voluntary Organisations,
  Independent Organisations, Private Care
  Organisations and People who use our services

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What does EVAPC do?

• Makes sure the policy and procedures are
  implemented
• Monitors practice on how we deal with concerns of
  abuse
• Plans training for all staff in Essex
• Undertakes research
• Appointed a full time Project Manager to help and
  support all organisations

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Purpose of an Adult Protection System

• To prevent abuse before it happens
• To stop abuse as soon as its known about
• To prevent further abuse for victims and by
  perpetrators
• To help a vulnerable victim consider options for
• ACCESS TO SUPPORT PROTECTION
• REDUCING VULNERABILITY
• REDRESS ACCESS TO JUSTICE

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Vulnerability

• A vulnerable adult refers to any person aged
  of 18 years and over who
• is or maybe in need of community care
  services by reason of mental, physical or
  learning disability, age or illness and who is or
  may be unable to take care of himself or herself,
  or unable to protect himself or herself against
  significant harm or serious exploitation which
  maybe occasioned by actions or inactions of other
  people
• Law Commission 1995

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Vulnerable Person

• Social isolation
• Emotional dependence
• Cognitive difficulties
• Mental health difficulties
• Poor relationships with care givers
• Financial dependence
• Limited support

• Limited communication
• Unpredictable behaviour
• Lack information
• Abused in the past
• Lacking capacity
• Interpersonal family problems

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Definitions

• Abuse
• is a violation of an individuals human and
  civil rights by any other person or persons
• It may involve
• a single or repeated act or omission, occurring
  within a personal or closed relationship where
  there is an expectation of trust, which causes
  harm to a vulnerable adult
• (No Secrets Department of Health 2000)

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Who Abuses?

• A member of staff in residential or nursing home
• Another service user
• Any other person with access and intent

• A partner,relative or other household member
• A friend or neighbour
• A volunteer worker
• A health or social care worker

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Who is Abusing?
In the main they tend to be the relatives or paid
workers. On the whole they are not the hands on
carer
They are the next one out ie the son or daughter
or the carers spouse, or they are those trusted
by society to be paid carers
The fact that a person might have a profession or
title or vocation doesnt mean they are safe or
can automatically be trusted.
Acting alone they are mainly men
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Why does it happen?

• While the causes are not fully known the risks
  are known to be greater when
• The vulnerable person is socially isolated
• A pattern of family violence exists
• Drug or Alcohol misuse
• Relationships are placed under stress
• Poorly training, supervised and supported staff
• Staff working in isolation
• Failure of organisations/agencies to recognise
  responsibilities

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Care Giver

• Poor past relationships
• A blamer
• Inexperience
• Poor present relationships
• Family problems
• Reluctance to role
• Lacks understanding
• Drug use
• Alcohol use

• Sleep disturbance
• Relationships are placed under stress
• Lack support
• Forced change in lifestyle
• Isolation
• Pattern of family violence
• Financial concerns

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Where?
Most calls were about abuse in peoples own homes
but a quarter of calls referred to abuse in
hospitals, nursing and residential homes.
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How?
Two fifths of the calls reported psychological
abuse, one fifth each physical and financial
abuse, one call in ten was about neglect and
nearly 2 of calls were about sexual abuse
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Defining Adult Abuse
Sexual
Physical
Neglect
Abuse
Emotional
Institutional
Financial
Discriminatory
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Physical Abuse

• Physical assault
• Rough or inappropriate handling
• Careless handling
• result in falls, injuries
• Bruising, abrasions, burns scalds sores wounds
• Dislocations or fractures

• Medical mistreatment such as withholding
  medication
• Inappropriately altering medication
• Inappropriate use of restraint
• Inappropriate treatment regimes or sanctions

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Sexual Abuse

• Rape
• Sexual Assault
• Sexual Acts the vulnerable person has not
  consented to, or could not consent to, or was
  pressurised into consenting to
• Contact abuse, e.g touching inappropriately
• Non-contact abuse - looking, indecent exposure,
  photographs, internet etc.

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Psychological/Emotional Abuse

• Verbal or non verbal harassment
• Bullying
• Insulting
• Intimidating
• Threatening behaviour
• Deprivation
• Abandonment
• Neglect

• Controlling behaviour
• Coercion
• Involuntary isolation
• Confinement
• Control of access (telephone, post visitors)
• Enforcement of unnecessary dependence

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Deprivation, Neglect and Acts of Omission

• Careless or deliberate withholding or inadequate
  provision of food or medication
• Withholding assistance to use toilet, keep clean,
  warm and comfortable
• Failure to give access to appropriate services
  e.g. Health, Social Services, Police or other
• Failure to safeguard and protect from harm or
  abuse

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Discriminatory Abuse

• Racism
• Sexism
• Homophobic or other discriminatory abuse that
  relates to age, illness or disability
• Harassment
• Incitements of others to commit abusive acts or
  make abusive comments
• Discrimination based on medical conditions

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Financial or Material Abuse

• Exploitation of dependence for personal gain
• Abuse of legal rights
• Misappropriation of funds
• Unauthorised benefits of property
• Fraud, extortion, theft
• Threat of deprivation, assault or neglect to
  obtain money or other material gain
• Misuse of consent to obtain inheritance rights

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Institutional Abuse

• No flexibility in bedtime and/ or deliberate
  waking
• One commode used by a number of people, people
  left on commode for long periods
• Dirty clothing and bed linen, only changed when
  staff consider it necessary
• Lack of personal clothing and possessions

• Inappropriate use of tip-back chairs and
  excessive use of cot sides
• Inappropriate use of power or control
• Deprived environment and lack of stimulation
• Batch care lack of individual care plans,
  ritualized care

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Accountability

• IGNORING ABUSE IS NOT AN OPTION
• Never prevent or persuade another person from
  expressing their concerns about abuse
• Not the responsibility of that concerned person
  to prove any allegations before sharing their
  suspicions
• Recognised as a priority work area in all
  settings and organisations

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Operational Responsibilities

• Social Services is the agency with lead
  co-ordinating responsibility
• Social Services teams have the responsibility to
  undertake the assessments and investigations
• Key responsibility to work closely with other
  agencies and organisations
• All staff in all organisations have specific
  responsibilities within the policy

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