Safeguarding Adults Policy (POL-048)

Introduction

Purpose

The purpose of this policy is to provide guidance to ensure that our statutory duty to safeguard adults at risk is fulfilled, in line with legislation. The policy aims to support staff to:

• Recognise signs of abuse and respond effectively.
• Support adults at risk in ways which are aligned with ‘making safeguarding personal’.
• Understand the interface between adult safeguarding and mental capacity.
• Respect the rights of any alleged perpetrators who have their own care and support needs, raising concerns where these needs are not being met or addressed.

Scope

This policy applies to anyone working on behalf of Healios UK, and Melios. This includes dynamic capacity model staff and agency staff.

Associated processes, policies or legislation

• Being open and the duty of candour policy
• Clinical supervision policy
• Data security and protection policy
• Freedom to speak up policy
• Safeguarding children and young people
• Capacity and competence to consent policy
• Safer recruitment policy

Definitions of Keywords

The definition of what constitutes an adult at risk is defined within legislation. This policy and associated standard operating procedure, only apply to adults at risk. Further information about what constitutes an adult at risk can be found here:

England
An adult who has needs for care and support (whether or not the local authority is meeting any of those needs) (b) is experiencing, or at risk of, abuse or neglect (c) as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect.

Scotland
Adults who: (a) are unable to safeguard their own well-being, property, rights or other interests, (b) are at risk of harm, and (c) because they are affected by disability, mental disorder, illness or physical or mental infirmity, are more vulnerable to being harmed than adults who are not so affected.

Wales
An adult who is experiencing or is at risk of abuse or neglect, (b) has needs for care and support (whether or not the authority is meeting any of those needs), and (c) as a result of those needs is unable to protect himself or herself against the abuse or neglect or the risk of it.

Northern Ireland
An adult at risk of harm’ is a person aged 18 or over, whose exposure to harm through abuse, exploitation or neglect may be increased by their: (a) personal characteristics and/or (b) life circumstances An ‘Adult in need of protection’ is a person aged 18 or over, whose exposure to harm through abuse, exploitation or neglect may be increased by their: (a) personal characteristics and/or (b) life circumstances and (c) who is unable to protect their own well-being, property, assets, rights or other interests; (d) where the action or inaction of another person or persons is causing, or is likely to cause, him/her to be harmed.

Legal Framework

This policy has been developed on the basis of legislation and guidance that seeks to protect adults at risk in England, Scotland, Wales and Northern Ireland. A table summary of the legislation covering the countries and statutory guidance is detailed below:

England
The Care Act 2014

Scotland
The Adult Support and Protection Act (Scotland) Act 2007

Wales
The Social Services and Wellbeing (Wales) Act 2014.

Northern Ireland
The Safeguarding Vulnerable Groups (Northern Ireland) Order 2007

Six Principles of Safeguarding Adults

The six principles, outlined in the Care Act 2014, that underpin all safeguarding work are:

(i) Empowerment

People being supported and encouraged to make their own decisions and informed consent.

(ii) Prevention

It is better to take action before harm occurs.

(iii) Proportionality

The least intrusive response appropriate to the risk presented.

(iv) Protection

Support and representation for those in greatest need.

(v) Partnership

Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse.

(vi) Accountability

Accountability and transparency in safeguarding practice.

All staff members have a responsibility to adhere to, and be guided by these safeguarding principles when dealing with a safeguarding concern.

Categories of abuse and neglect

There are ten types of abuse defined within The Care Act 2014. All staff members should be aware of these types of abuse, in order to recognise when a safeguarding referral is required.  See appendix 2 for further details.

Transitional safeguarding

Healios recognise and support staff to understand the risks associated with the developmental phase of adolescence, and the specific safeguarding risks for young people as they emerge into adulthood, including greater exposure to risks outside the home, such as criminal or sexual exploitation, drug trafficking and community violence. We recognise that every young person experiences their transition into adulthood differently, and at different ages, according to their individual circumstances, life history, experiences and maturation. This can be a particularly vulnerable life stage. Transitional safeguarding is an area covered in the Healios safeguarding training competences.

Think Family

Healios recognise and support staff to adopt a ‘Think Family’ approach. When working with adults, we  recognise that in families certain issues and hostilities occur and these events can adversely impact on the development and resilience of infants, children, teenagers and young people. This is taken into account at all stages of risk assessment. Healios safeguarding team work closely with families and with the relevant services to ensure that holistic support, is provided, where needed, for the whole family. When working with adults Healios clinicians should be curious about the make up of the family home and any dependents, to enable us to adopt this approach.

Responding to allegations, disclosures or suspicions of abuse.

All staff members have a responsibility to recognise, respond and report concerns, when they believe that an ‘adult at risk’ is experiencing, or is at risk of, significant harm. The competency to be able to do this is achieved through the level 1 safeguarding training that all staff at Healios are required to complete on induction

Every person that Healios provides support to, will have a risk assessment completed within the first clinical session. This is an opportunity to discuss and identify any risks to the adults safety or welfare. Safeguarding concerns may become evident at this point or at any stage during our interactions with the person.

There is a detailed standard operating procedure in place that provides guidance to staff on how to respond to and report a safeguarding adult concern.

Prevent

Prevent forms part of the home office national strategy to tackle extremism.

Section 26 of the Counter Terrorism and Security Act 2015 (CT&SA) places responsibilities on specified authorities to “have due regard to the need to prevent people from becoming drawn into terrorism”. This duty applies to all healthcare organisations. Further information on the Prevent Duty can be found here: Home Office Prevent Duty Guidance. (Updated March 2024).

Staff at Healios may well come into contact with children and adults who are vulnerable to exploitation. All staff have a responsibility to safeguard children and adults at risk.

Information sharing and multi agency working

The care Act 2014 places the legal duty on Local Authorities to act as the lead coordinating organisation for safeguarding adults at risk. Robust information sharing is at the heart of safe and effective safeguarding practice.

The Data Protection Act 2018 does not prevent, or limit, the sharing of information for the purposes of keeping children, young people and adults safe. Healios cooperates with other partners on both a strategic and individual level to ensure effective safeguarding.

Healios have a national statutory reporting duty to share information related to female genital mutilation and radicalisation (prevent). Concerns in relation to these types of abuse should always be discussed with the internal safeguarding team who have a responsibility for ensuring that these statutory reporting duties are fulfilled.

Healios are committed to working closely with our safeguarding partners to ensure best safeguarding practice. Healios are contracted to follow local area multi agency safeguarding policies. There may be occasions when requests are made for clinical staff to attend multi agency meetings. The Healios safeguarding team are able to support this.

Duty of candour

Good safeguarding practice requires openness and transparency. This is vital in relation to any safeguarding concerns involving Healios’ staff or services. There is a duty of candour policy in place that outlines Healios statutory responsibility.

Escalation of concerns

All staff have a  professional responsibility to escalate a concern if they are dissatisfied with the outcome.

When communicating disagreement, professionals should remain respectful of each other at all times and this should be evidenced in both their direct and written communication, and throughout the escalation resolution process.

The Healios safeguarding team provide support with this process.

Managing allegations against staff

An allegation against staff may occur when an adult who has contact with adults as part of their employment or voluntary work may have:

• Behaved in a way that has harmed an adult or may have harmed an adult.
• Possibly committed a criminal offence against or related to an adult at risk.
• Behaved in a way that indicates they are unsuitable to work with adults at risk.

Where there is concern in relation to a staff member, this must be reported to the Healios Safeguarding Lead and the team manager immediately.

Training

All staff are expected to undertake training in accordance with the requirements described in the National Safeguarding Competencies. This framework identifies five levels of competence, and gives examples of groups that fall within each of these.

Safeguarding supervision

Staff are not expected to make safeguarding decisions in isolation, it is best practice in safeguarding to discuss concerns and reflect on different perspectives.

All staff members have access to safeguarding support and supervision through the internal safeguarding team.

Monitoring compliance and effectiveness

All staff members have a responsibility to familiarise themselves with this policy during their induction. This policy exists in interactive format throughout the level 1 safeguarding e learning, therefore completion of the training evidences their reading of the policy.

The internal safeguarding team have assurance processes in place to ensure that this policy and associated Standard operating procedures are being adhered to.

Safeguarding audits will be completed as part of the Healios Audit Cycle.

EIA

The Equality Impact Assessment helps to ensure that any new policy or policy changes are fair and don’t discriminate against or negatively impact any protected group. Using this tool helps to centre inclusion and equity when reviewing our policies, and consider the intentional and unintentional impact they have. Please click here for the full details of the EIA. An assessment concluded that this policy has a positive impact on all protected characteristic groups.

Appendix 1: Categories of abuse and neglect

There are ten types of abuse defined within The Care Act 2014. All staff members should be aware of these types of abuse, in order to recognise when a safeguarding referral is required.

(i) Physical Abuse

Hitting, pushing, pinching, shaking, scalding, misuse of medication, illegal use of restraint, inappropriate physical sanctions. This includes female genital mutilation (FGM).

(ii) Neglect and acts of omission

Ignoring medical or physical needs, failing to allow access to appropriate health, social care and educational services. Withholding the necessities of life such as medication, adequate nutrition, hydration or heating. Neglect can be intentional or unintentional.

(iii) Self Neglect

Lack of self-care to an extent that it threatens personal health and safety, Neglecting to care for one’s personal hygiene, health or surroundings, Inability to avoid self-harm, Failure to seek help or access services to meet health and social care needs, Inability or unwillingness to manage one’s personal affairs). Careful consideration must be given to the person’s mental capacity.

(iv) Sexual

Including rape and sexual assault or sexual acts to which the adult has not consented or was pressured into consenting. This can happen in person or online.

(v) Psychological

Including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, isolation or unreasonable and unjustified withdrawal of services or supportive networks. This can happen in person or online.

(vi) Domestic Abuse

Any incident of threatening behaviours, violence or abuse between adults who are or have been in a relationship together, or between family members, regardless of gender or sexuality. This includes emotional abuse and coercive control.

(vii) Financial or Material

Including theft, fraud, exploitation, coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.

(viii) Discriminatory abuse

Including discrimination on grounds of race, gender and gender identity, disability, sexual orientation, religion, and other forms of harm. The term ‘hate crime’ describes any criminal behaviour that is motivated by hostility towards disability, race, religion, sexual orientation or identity.

(ix) Organisational abuse

Including neglect and poor care practice within an institution or specific care setting like a hospital or care home, e.g. this may range from isolated incidents to continuing ill-treatment.

(x) Trafficking and Modern Slavery

Human Trafficking involves men, women and children being brought into a situation of exploitation through the use of violence, deception or coercion and forced to work against their will. People can be trafficked for many different forms of exploitation such as forced prostitution, forced labour, forced begging, and forced criminality, domestic servitude, forced marriage, forced organ removal. Exploitation can  happen in person or online.

(xi) Radicalisation is a type of exploitation. Whilst this is not defined as a category of abuse within the care act, adults at risk may be particularly vulnerable to be exploited to commit acts related to a specific agenda or ideology. This can happen in person or online.