Adult Safeguarding Policy

Adult Safeguarding Policy – The Avenue Surgery

Introduction

This policy should be read in conjunction with the following policies / reference points:

  • Wiltshire Safeguarding Adults Board (WSAB) [http://www.wiltshiresab.org.uk/wp-content/uploads/2019/10/WSAB-Policy-and-Procedures-2019.pdf]
  • Wiltshire’s Safeguarding Partnership [http://www.wiltshirescb.org.uk/wp-content/uploads/2019/02/Wiltshire-Safeguarding-Plan-PDF.pdf]
  • Mental Health Act

 

The Care Act 2014 states that health organizations now have a statutory duty to cooperate with Social Services in safeguarding individuals.

 

This policy applies to all staff working for the practice and outlines the process The Avenue Surgery will follow to ensure that adults at risk will be protected from abuse and where necessary staff will be competent in identifying abuse, escalating concerns and reporting abuse in line with the Multi Agency Safeguarding Hub procedure (outlined below).

Safeguarding Adult Lead – Dr Charlotte Holliday

Safeguarding Adult Deputy – Dr Nicola Jones

Administrative Lead – Miss Annabelle Hind

All staff should discuss concerns with Dr Charlotte Holliday and if a referral is submitted, to inform Annabelle so that the patient can be coded accurately and added to the safeguarding tracker for monitoring.

Our Commitment / Roles and Responsibilities

The Avenue Surgery has a responsibility to safeguard and promote the welfare of adults at risk of harm or abuse and also to cooperate with other agencies to protect individuals from harm and abuse. Safeguarding our patients will always include consideration of children and young people; the importance of this approach is emphasized in Wiltshire’s Safeguarding Plan – Working Together to Protect the Vulnerable (link at beginning of policy). We will ensure all of our employees have access to safeguarding training to understand and carry out the following points:

 

  • Be aware of the risks of abuse and neglect that vulnerable adults can face
  • Knowing what help is available
  • Understanding their responsibilities and remaining alert at all times to the possibility of
  • Working together to report and investigate concerns
  • Working collaboratively with other agencies to prevent abuse and neglect
  • Recognising the impact of diversity, beliefs & values of people
  • Accurately document all issues, discussions, actions & decisions with regards to adult protection
  • Report suspicions / allegations of abuse against staff to the safeguarding lead utilising the whistleblowing policy

 

The Avenue Surgery practices safe recruitment polices in line with the Disclosure and Barring Scheme.

 

The practice lead (Dr Holliday) will:

 

  • Hold meetings every 8 to 10 weeks with others in the primary healthcare team (our care co-ordinator and TCOP nurse) to discuss particular concerns
  • Implement the practice’s safeguarding adults policy
  • Ensure that the practice meets contractual guidance
  • Ensure safe recruitment procedures are in place
  • Support reporting and complaints procedures
  • Discuss any concerns with employees at weekly Monday Management meeting
  • Ensure that employees receive adequate support when dealing with safeguarding adults concerns
  • Lead on analysis of relevant significant events
  • Determine training needs and ensure they are met
  • Make recommendations for change or improvements in practice procedural policy
  • Act as a focus for external contacts

 

 

Recording Information and Coding

 

Concerns and information about vulnerable adults should be recorded in the medical records using recognised computer codes, in line with guidance from RCGP Safeguarding Coding Information (Y drive – Safeguarding – Safeguarding Adults – Adult Safeguarding Policies).

 

Annabelle Hind, Administrative Lead, is responsible for coding and scanning relevant documents into the electronic patient record. She should be notified via task of adults at risk and safeguarding concerns. All relevant documents should be sent to Annabelle Hind by the scanning department.  Adults at risk and requiring monitoring and follow up will be placed on the Adult Safeguarding Tracker, kept securely on the Y drive in the safeguarding adults folder.

Email should only be used when secure, (bswccg.avenuesurgery.safeguarding@nhs.net)

Conversations with and referrals to outside agencies should be recorded under an appropriate computer code. Case conference summaries and minutes will be scanned into the patient’s electronic record under attachments.
What is Adult Safeguarding?

 

Protecting an adult’s right to live in safety, free from abuse and neglect. It applies when an adult:

  • has needs for care and support
  • is experiencing, or is at risk of, abuse or neglect, and
  • as a result of those needs is unable to protect him / herself against the abuse / neglect or the risk of it

Effective safeguarding involves organisations working together to prevent the risks and experience of abuse or neglect, while ensuring that the views and wishes of an individual are at the heart of decisions that affect them wherever it’s possible.

Safeguarding encompasses the following core elements:

  • Prevention of harm and abuse through provision of high quality care
  • Effective responses to allegations of harm and abuse, responses that are in line with local multi agency procedures
  • Using learning to improve service to patients

Abuse includes any mistreatment, exploitation or neglect in the form of one or more of the below categories:

  • Physical abuse
  • Emotional abuse
  • Sexual abuse
  • Neglect and acts of omission
  • Financial abuse
  • Discriminatory abuse
  • Organisational abuse
  • Domestic Abuse
  • Self-Neglect
  • Modern Day Slavery

 

Safeguarding Principles

 

Empowerment Presumption of person led decisions and informed consent.
Protection Support and representation for those in greatest need.
Prevention It is better to take action before harm occurs.
Proportionality Proportionate and least intrusive response appropriate to the risk presented.
Partnerships Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse.
Accountability Accountability and transparency in delivering safeguarding.

 

 Reporting an Adult Safeguarding Concern

 

If there is an imminent risk of serious harm inform the Police. In an emergency, ring 999. In a non-emergency, ring 101.

 

If an employee has concerns regarding an adult at risk of harm or abuse they should notify the GP Safeguarding Lead, Dr Charlotte Holliday, or deputy Dr Nicola Jones.

The patient in question can then be discussed and referred onwards by a GP or referring clinician to Wiltshire Council’s Safeguarding Adults Team either directly or through the Adult’s Multi-Agency Safeguarding Hub (MASH);
Referral: 0300 456 0111

Triage Advice Line: 01380 826510

Out of hours: 0300 456 0100 or 0300 456 0115

Email: bswccgwiltshire.safeguarding@nhs.net

 

A written record of the referral should be made including the advice given and triage decision. Notice of the referral should be given to admin lead Annabelle Hind to document on the tracker.

The flowchart on the following page provides a framework to support decision making.

Safeguarding Adult Contacts:
Designated Professional for Safeguarding Adults:

Colette O’Neill: 01380 728899 (CCG Switchboard)

Mobile: 07776 636432.

colette.o’neill@nhs.net

 

MULTI-AGENCY SAFEGUARDING HUB (MASH) – FOR REFERRALS TO ADULTS SOCIAL CARE:
0300 456 0111

Out of Hours: 0300 456 0100

Email: adviceandcontact@wiltshire.gov.uk / wcouncil.customeradvisor@nhs.net

bswccg.wiltshiresafeguarding@nhs.net

 

 

WILTSHIRE COUNCIL CUSTOMER ADVISORS

Referrals 0300 456 0111

8.30am to 5.20pm Monday to Thursday 8.30am to 4.20pm Friday

Out of hours 0845 607 0888 (including weekends and bank holidays Emergency Duty Service 5.00pm to 9.00am)

 

POLICE OUT OF HOURS

Police out of hours 101 (request control room)

 

Multi-Agency Risk Assessment Conference (MARAC)

MARAC Co-ordinator, Wiltshire Council – 01225 716611

MARAC@wiltshire.gov.uk

 

Multi Agency Public Protection Arrangements (MAPPA)

MAPPA co-ordinator 07732 647369

Ruth.lumber@justice.gov.uk

 

SPLITZ

01225 775276 (Helpdesk number open from 9am to 5pm)

 

 

 

Abuse / Neglect of Adult at Risk is Suspected, Disclosed or Discovered

Document your concerns


 

  1. Assess situation for immediate risk

 

  1. Call for emergency support if required

 

  1. Do not investigate

 

  1. Clarify basic information

 

  1. Record details of concern

 

  1. Do not promise ‘not to tell anyone’

 

  1. Preserve any evidence

 

  1. Inform / discuss with appropriate manager

 

 

If allegation concerns an employee:

 

Inform appropriate manager / Safeguarding

Adults Lead

Discuss next steps

Initiate company incident reporting policy Continue with this flowchart as for all referrals

Abuse /Neglect Still Suspected or confirmed?

Consider:

Are there other adults or

children at risk?

 

Document concerns /

 

outcome

Make a referral to Wiltshire Council

 

Referral: 0300 456 0111

 

Out of Hours: 0300 456 0100

 

1.    For discussion, guidance or advice please call Wiltshire Council, Safeguarding Adults Teams (Triage Line – 01380 826510)

 

2.    Keep a written record of your actions

 

3.    Record the referral including advice given and triage decision

 

Consider if other services needed? Emergency – 999, CQC – 03000 616161

 

Refer on for additional support e.g. social services, CMHT, respite services

 

REMEMBER… DOING NOTHING IS NOT AN OPTION

 

The Care Act 2014 s.42 enquiry duty remains in place until all necessary action has been taken to resolves the risks, all action and decisions must be documented.

 

 

Inform adult of your concerns and proposed actions, including the duty to report concerns to manager – consider:

 

  1. Do you have the adult’s informed consent to continue?
  2. Does the adult have capacity to make an informed decision to

 

Lacks capacity to make this decision – document your belief.

Record the best interest decision.

Consider: is an IMCA / or other

 

advocate required?

 

 

Are other adults at
risk?
Informed consent not
given

 

  • consent to the ref

 

Confidentiality & Information Sharing 

The Avenue Surgery recognises that when it is in the public interest, the law permits the disclosure of confidential information in order to safeguard an adult at risk. Confidential information about an adult at risk should never be used casually in conversation or shared with any person other than on a “need to know basis”.

 

There are some circumstances when employees may be expected to share information about an adult at risk, for example when abuse is alleged or suspected. In such cases individuals have a duty to pass information on without delay in line with WSAB updated Guidance for Staff. Employees must document when, with whom and for what purpose information was shared.

The main restrictions within the legal framework to disclosure are:

  • Common law duty of confidence
  • Human Rights Act 1998
  • Data Protection Act 1998

 

Disclosure should be justified in each case and guidance should be sought from the adult safeguarding lead in cases of uncertainty.

 

In some circumstances the sharing of confidential information without consent would normally be justified in the public interest. These circumstances would be:

 

  • When there is evidence that the adult at risk is suffering or is at risk of suffering significant harm
  • Where there is justifiable cause to believe that an adult at risk may be suffering or at risk of significant harm
  • To prevent significant harm arising to the adult at risk including through the prevention, detection and prosecution of serious crime likely to cause significant harm to the adult at

Information could also be shared without consent in the following circumstances:

 

  • If the adult at risk is at greater risk
  • If you or another health care professional is at risk
  • If it would alert the perpetrator (in cases of sexual abuse or fabricated illness)
  • If specific forensic evidence is needed

 

 

At all times the safety and wellbeing of the adult at risk is paramount when considering the likely outcome of sharing or not sharing information.

 

Reasons for decisions to share or not share must be recorded. All decisions require professional, informed judgment. If in doubt this should be discussed with the Safeguarding Lead.

 

The Avenue Surgery employees have a duty to cooperate with safeguarding enquiries and share relevant information in line with the Care Act 2014. Requests for information for Case Conferences and Strategy Meetings will be prioritised and reports provided in a timely manner, with attendance, where possible.

Communications

 

Consideration needs to be given to the potential for media interest. Any contact from the media relating to an adult safeguarding issue must be immediately referred to the practice manager.

 

Prevention

 

Prevention of abuse is the responsibility of everyone. Organisations which embed safeguarding in all aspects of its core business and promote an open culture where staff feel able to raise concerns will support the prevention of abuse.

 

The Avenue Surgery will minimise risk of abuse by:

 

  • Ensuring staff are trained to meet the needs of the service users
  • Encouraging and maintaining good communication between staff and managers and service users
  • Reviewing complaints for safeguarding concerns and learning from the subsequent investigations
  • Having efficient reporting and recording systems in place
  • Having a whistle-blowing policy
  • Having policies to ensure new employees are appropriately checked and safe to work with vulnerable people

 

Allegations against Staff

 

The Avenue Surgery will ensure that any allegations made against members or a member of staff will be dealt with swiftly. Where a member of staff is thought to have committed a criminal offence the police will be informed. If a crime has been witnessed the police should be contacted immediately.

 

The safety of the individual(s) concerned is paramount. A risk assessment must be undertaken immediately to assess the level of risk to all service users posed by the alleged perpetrator. This will include whether it is safe for them to continue in their role or any other role within the service whilst the investigation is undertaken.

 

The designated named person will liaise with Adult Social Care Direct to discuss the best course of action and to ensure that the name of organisation’s disciplinary procedures are coordinated with any other enquiries taking place as part of the ongoing management of the allegation.

 

The Avenue Surgery has a whistle blowing policy and staff are aware of this policy. Staff will be supported to use this policy.

 

 

Training

 

It is the duty of The Avenue Surgery to ensure that all staff has access to the appropriate safeguarding training and development, learning opportunities and support to facilitate understanding of the aspects of adult welfare and information sharing. The majority of training will be offered through Bluestream.

 

Level 1: all staff working in a health care organization

 

Level 2: All staff that have regular contact with patients, their families or carers or the public. This is a minimum level of competence for all professionally qualified health care staff.

 

Level 3: All staff who regularly contribute in the investigation of adults at risk of harm or abuse and/or their families or carers, (through the multi-agency safeguarding procedures, and assessing, planning, intervening and evaluating the needs of an adult that there are safeguarding concerns about). (Safeguarding Adults: Roles and competences for health care staff – Intercollegiate Document 2016)