Safeguarding Adults and Children: Laws and Rights
Safeguarding adults and children involves protecting their right to live safely, free from abuse and neglect. This includes recognizing signs of abuse, understanding relevant laws such as the Mental Capacity Act and Children Act, and ensuring individuals are empowered and supported. Key legislation like the Human Rights Act and Data Protection Act play a crucial role in safeguarding vulnerable individuals. By upholding these laws and principles, we can create a safer environment for all.
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Safeguarding Adults and Children 1
Safeguarding is protecting a persons right to live in safety, free from abuse and neglect. Abuse is a single or repeated act or lack of appropriate action occurring within any relationship where there is an expectation of trust which causes harm or distress to a person The abuser will always be in the more powerful position. Abuse can happen anywhere: their own homes nursing home residential home hospital sheltered housing schools other Abusers can be anyone: relative paid worker friend or neighbour Other carer (family member) LAWS THAT PROTECT OLDER PEOPLE:- LAWS THAT PROTECT CHILDREN:- MENTAL CAPACITY ACT 2005 THE HUMAN RIGHTS ACT 1998 THE DATA PROTECTION ACT 2018 THE EQUALITY ACT 2010 THE CARE ACT 2014 THE CARE ACT 2014 (AMENDED APRIL 2015) THE CHILDREN ACT 1989 THE CHILDREN ACT 2004 THE SEXUAL OFFENCES ACT 2003 THE CHILDREN & FAMILIES ACT 2014 The Mental Capacity Act (MCA2005) is designed to protect and empower individuals who may lack the mental capacity to make their own decisions about their care and treatment. It is a law that applies to individuals aged 16 and over. 2
Human Rights Act 1998 Gives specific rights to every person living in the UK, for example the right to life and freedom from torture and degrading treatment. Data Protection Act 2018 (inc GDPR 2018) Regulates the way in which personal data needs to be handled and therefore protect people s data from being placed in the wrong hands, which may increase the risk or abuse or neglect. The Equality Act 2010 Protects people from discrimination and disadvantage due to protected characteristics including race, gender, disability, sexual orientation, gender reassignment, religion and age. The Care Act 2014 Makes it the duty of local authorities to make enquiries if someone is being abused or neglected, or is at risk of abuse or neglect in their area. They must also set up multiagency safeguarding adult boards to review cases when people died as a result of neglect or abuse and where it is suspected that agencies could have done more to safeguard them. The Care Act 2014 (amended2015) Children who care for their parents in their own home are being made part of their parent s needs assessment in order to establish the support and help they need. The Children Act 1989 Protects the welfare of children who are at risk and also children who may be in need of services. It instructs what to do if a it is suspected that a child or young person is at risk of harm or in need of support. The Children Act 2004 Places a duty on local authorities and their partners to work together and have a joint partnership with the parents. The acts also encouraged the establishment of local Safeguarding Children Boards and joint databases. The Sexual Offences Act 2003 This act has two parts. Firstly it states what is considered to be a sexual offence, including physical and non-physical contact. It defines sexual offences against children. The age of consent id 16, unless you hold a position of trust in relation to that young person, for example as their teacher, worker, trainer etc. In that case the age is 18. The second part deals with the sex offenders register and civil protection orders. The Children and Families Act 2014 Provides young carers with the same help and support as adult carers. All carers under the age of 18 have the right to have their support needs assessed and local authorities will help them caring for a family member as best they can. 3
What is child abuse? Child abuse is any wrongdoing that causes, or is able to cause, significant emotional or physical harm to a child. The following signs, symptoms and behaviours or indicators do not necessarily mean that a child is being abused, but may mean you have a reason to be concerned The Human Rights Act 1998 gives a number of fundamental rights to every person living in the UK. Some of these rights include: The right to life Freedom from torture or degrading treatment The right to education The right to liberty and security Protection from discrimination. Some of the rights relating to child protection are: The right to life The right to live a healthy life The right to not be separated from their parents unless they are at risk of harm The right of protection from drugs, sexual abuse or any harm to their development. Types of abuse Signs/indicators Physical abuse is an individual s body being injured or hurt due for, for example to assault, hitting, slapping or pushing. It can also be the wrong use of restrictive practices. Examples could be the misuse of medication or using inappropriate restraint such as locking someone in a room, tying them to a chair or using inappropriate physical sanctions. Injuries that are unexplained or haven t been treated. They could be a number of injuries of different ages and in different places. Examples include: broken bones bruises unexplained loss of clumps of hair bite, burn or scald marks. Domestic violence is any incident of threatening behaviour, violence or abuse (psychological, physical, sexual, financial or emotional) between adults who are or have been intimate partners or family members, regardless of gender or sexuality. It includes psychological, physical, sexual, financial and emotional abuse, and so-called honour-based violence. Signs of domestic violence can be any of those relating to the different types of abuse or neglect that can occur in any incident. 4
Modern slavery encompasses slavery, human trafficking, and forced labour in domestic servitude. Traffickers and slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment. signs of physical or psychological abuse, malnourished or unkempt, appearing withdrawn rarely allowed to travel on their own, seem under the control and influence of others, rarely interact or appear unfamiliar with the neighbourhood where they work few or no personal belongings or documents they avoid eye contact, appear frightened or hesitant to talk to strangers and law enforcers. Financial or material abuse is the use of the person s funds and belongings without their permission. This could be theft, fraud, Internet scamming, coercion in relation to an adult s financial affairs or arrangements, including in connection to Wills, property, inheritance, or financial transactions, or the misuse or misappropriation of property, possessions or benefits. bills not being paid loss of assets such as a house being sold and the money from the sale disappearing expenditure higher than the living conditions suggest not having enough food or clothing Sexual abuse is when a person becomes involved in sexual relationships or activities that they do not want to be involved in. They may have said that they do not want to be involved or they may be unable to give consent. Sexual abuse includes rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography subjection to pornography or witnessing sexual acts, indecent exposure and sexual assault and sexual acts to which the adult has not consented or was pressured into consenting to. pain, sores and bruising around the inner thighs and genital, anal or breast areas bloodstained underwear pain and discomfort when walking or sitting sexually transmitted infections and pregnancy are indicators for sexual activity and can indicate abuse if the person does not have the capacity to provide consent. 5
Self-neglect is the term used to refer to those who fail or refuse to take care of their own basic needs. Neglecting to care for one s personal hygiene, health or surroundings can include a wide range of behaviours such as hoarding. Indicators of neglect by others and self- neglect are similar. They include: malnutrition dehydration bed sores dirty clothing and bedding taking the wrong dosage of medication Psychological abuse results in a person feeling worthless, unloved or uncared for. It includes emotional abuse, threats of harm abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyber bullying, isolation or unreasonable and unjustified withdrawal of services or supportive networks. anxiety lack of confidence low self-esteem disturbed sleep Organisational abuse happens were services provided are focused on the needs of the organisation. For example, not providing choice over mealtimes or when someone can go to bed because this is easier for the organisation. It includes neglect and poor practice within an institution or specific care setting such as a hospital or care home, or in relation to care provided in one s own home. This may range from one-off incidents to ongoing ill-treatment. It can be through neglect or poor professional practice as a result of structure, processes, policies and practices of the organisation. poor care standards rigid routines lack of staff learning, development and support Discriminatory abuse refers to an individual or group being treated unequally because of characteristics identified in the Equality Act 2010. It involves ignoring a person s values, beliefs and culture and includes forms of harassment, slurs or similar treatment because of race, gender and gender identity, age, disability, sexual orientation or religion. poor service that does not meet the person s needs verbal abuse and disrespect exclusion of people from activities and/or services. 6
Neglect is also known as the omission to act or failure to act . It is a failure to meet the basic needs of the individual. It includes ignoring medical, emotional or physical care needs, failure to provide access to appropriate health, care and support or educational services and the withholding of the necessities of life, such as medication, adequate nutrition and heating. Indicators of neglect by others and self- neglect are similar. They include: malnutrition dehydration bed sores dirty clothing and bedding taking the wrong dosage of medication RADICALISATION This is where children and young people are taught extreme, often violent, ideas based on political, social or religious beliefs. Signs of exposure to radicalisation could be behaviour changes in the way they speak with others or having a new circle of friends, use of extremist terminology, reading material or messages. FEMALE GENITAL MUTILATION (FGM) Means to remove, constrict or otherwise disfigure a girl s labia or clitoris for non-medical reasons, in most cases before they reach the age of 8. Some communities may use religious, social and cultural reasons to justify FGM , but it is a form of abuse. Signs and symptoms could range from severe pain, bleedingand chronic infections to psychological, mental health and sexual problems, or damage to the reproductive system and infertility. You need to be aware of the risk to girls who may be taken abroad for FGM to be carried out overseas, and so should be alert to the possibility if they are taken on extended holidays. 7
Factors which may lead to Abuse: social isolation fewer social contacts more likely to be abused where no relationship present poor quality long term relationship husband/wife/mother/daughter pattern of family violence accepted as normal dependency support accommodation, financial, emotional care expectancy levels - parent relying on child (role reversal) - illness affecting memory/physically unpredictable alcohol, drug and mental health problems The Code of Conduct states that workers must: Always make sure that your actions or omissions do not harm an individual s health or well-being. You must never abuse, neglect, harm or exploit those who use health and care services, their carers or your colleagues . The six Key Principles that underpin all adult safeguarding work The following 6 principles apply to all care and support services as well as other settings that provide services to those whose circumstances put them at risk. The principles should inform the ways in which you work: Empowerment people being supported and encouraged to make their own decisions and informed consent. I am asked what I want as the outcomes from the safeguarding process and these directly inform what happens. Prevention it is better to take action before harm occurs. I receive clear and simple information about what abuse is, how to recognise the signs and what I can do to seek help Proportionality the least intrusive response appropriate to the risk presented. I am sure that the professionals will work in my interest, as I see them and they will only get involved as much as needed. Protection support and representation for those in greatest need. I get help and support to report abuse and neglect. I get help so that I m able to take part in the safeguarding process to the extent to which I want. Partnership local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse. I know that staff treat any personal and sensitive information in confidence, only sharing what is helpful and necessary. I am confident that professionals will work together and with me to get the best result for me. Accountability accountability and transparency in delivering safeguarding. I understand the role of everyone involved in my life and so do they. 8
What to do if you suspect Abuse Always talk to the person in a safe and private place. Listen sensitively but be careful you don t ask leading questions Record any bruising or other marks on the body map Report immediately to your line manager or on-call if out of hours Understand the consequences of no action If abuse has been disclosed to you: Listen and take notice of body language Take it seriously Try not to show you are shocked Explain about confidentiality Confirm the victim s version of the story take notes Remember you are a representative of your organisation Ask the person what they want to do Report to your manager or on call if out of hours Remember it s not your responsibility to handle the situation on your own Don t take it lightly or make a joke about it Don t dismiss or disbelieve what you have been told Don t change the subject because you feel uncomfortable with it Don t ignore what has been said Don t say things like: this can t be true, I don t believe it, that is ridiculous Don t make assumptions: John wouldn t do that Safeguarding Process Always report to your manager if you suspect abuse or it has been disclosed by the client. Your manager will then take the appropriate action e.g. reporting to local council safeguarding triage or direct to the CQC (Care Quality Commission) It is important that this information is shared so that the individual s wellbeing and safety are promoted protected 9
Common Safeguarding Issues: Pressure Ulcers: Pressure Ulcers normally start with skin discoloration, and if left untreated, these can develop into extensive wounds, which could become very deep and infected. In the worst cases they can become life threatening. With appropriate management and care, these pressure ulcers can be avoided in most cases. Pressure ulcers are not always due to poor care and neglect, so each individual case should be considered independently, taking into account the person s medical condition, prognosis and any underlying skin conditions. All of the above issues, alongside the stage, grading or category of the pressure ulcers should determine whether a safeguarding alert is appropriate. Other signs of personal or self neglect, such as poor personal hygiene and living environment, poor nutrition and hydration may help to influence this decision. Altogthercare s policy on pressure ulcers state that once a grade 3 has been achieved, this must immediately be notified to CQC. 10
Poor Nutritional Care: The provision of poor nutritional care within care homes, hospitals and a person s home has bee frequently highlighted in recent years. 1 in 3 people admitted to hospital suffer from malnourishment and every ten minutes someone dies with malnourishment in hospitals nationally. 37% of those admitted to care homes suffer from malnutrition and 45% of those admitted to nursing homes suffer from malnourishment. Care plans should reflect the individual s needs and outcomes, and risk assessments should be carried out to identify those at risk of poor nutrition, including safe swallow plans. Poor nutrition leads to poor wound healing, increased risk of falls, weakened immunity against infections, dehydration, and general weakness. Steps should be made to identify where a client is losing weight or regularly refusing nutrition. These symptoms should be recorded in the care notes and reported to management as soon as possible to prevent deterioration of the client and put in place steps to improve the situation. If it is found that inadequate or negligent nutritional care is given, this could lead to safeguarding issues. Falls: Individuals should be supported to stay as active and independently mobile as possible and any additional support they should be identified and recorded in their care plans. Some people who are frail or have mobility problems may be at greater risk of falling. The consequences of falls can be very costly for both the individual in terms of their health, well-being and mobility and for services they may be receiving. Following a fall the individual may require more intensive services for longer and, in some cases, may never return to the previous level of mobility. A fall does not automatically indicate neglect and each individual case should be examined in order to determine whether there is a safeguarding concern. The risk of falls should be identified in their care plans. Individuals who lack capacity to manage their own risk, need to be assessed for the requirement of any restrictions or restraint to reduce the risk of falls. This may require an application for DoLS. If a client is regularly having falls, it must be reported and if necessary a referral to a falls clinic made. Falls prevention is the best way to ensure the safety of individuals in care. Good nutritional care will also help in the prevention of falls. Information on safeguarding issues in the care environment taken from Bournemouth & Poole and Dorset Safeguarding Adults Board Policy and Procedures Group. 11
Contractures: A contracture is a change to a person s ability to move their joints and limbs freely. Abnormal shortening of muscle tissue, rendering the muscle highly resistant to stretching: this can lead to permanent disability. It can be caused by fibrosis of the tissues supporting the muscle or the joint, or by disorders of the fibres themselves. Contractures develop when people don t move or are not encouraged to move often enough, when they remain in their bed or chair for long periods, when someone is unable to mobilise independently, poor positioning or support in bed and/or chair. The impact may be pain, poor motor function and mobility, reduced range of movement, social participation/isolation, poor quality of life. Prevention or contractures includes physiotherapy, ensuring good seating /lying position, splinting hands or feet, supporting with pillow, cushions etc. Restoration is possible but painful, difficult and takes up to a year. Pressure relief when sleeping can also help. It is important to report to management if an individual shows signs of contracture development so that the correct equipment and treatment is given. Failure to act could result in safeguarding concerns. 12
