What may help me decide?

What is Abuse?

‘Abuse is a violation of an individual’s human and civil rights by any other person or persons’ – Abuse may be perpetrated as the result of deliberate intent, negligence or ignorance’ (No Secrets 2000)

Who is a Vulnerable Adult?

‘A person aged 18 or over who is or maybe in need of community care services by reason of mental or other disability, age or illness; and who may be unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation. It may include an individual who may be vulnerable as a consequence of their role as a carer. It may also include victims of domestic abuse, hate crime and anti-social behaviour.’

Responding to disclosures

Do

• Remain calm and try not to show any shock or disbelief

• Listen very carefully to what you are being told.

• Demonstrate a sympathetic approach by acknowledging concern that this has happened to them.

• Reassure the person by telling them:

  • they have done the right thing by sharing the information with you

  • you are treating the information seriously

  • abuse is not their fault.

• Be aware of the possibility of forensic evidence

• Explain that you are required to share this information with your line manager.

• Reassure the person that any further investigation will be conducted sensitively and with their full involvement whenever possible.

• Reassure the person that the service takes steps to support, and where appropriate protect them in the future.

• Report the information to your line manager at the earliest opportunity.

• Make a written record of what the person has told you

Do not

• Stop someone who is freely recalling significant event; allow them to share whatever is important to them.

• Do not ask questions or press the person for more details (This may be done during subsequent investigation so it is important to avoid unnecessary stress and repetition for the person concerned).

• Do not promise to keep secrets.

• Do not make promises you are unable to keep.

• Do not contact the alleged ‘abuser’ or alleged ‘victim’ (depending on who is sharing the information.

• Do not be judgmental (e.g. “why didn’t you try to stop them?”)

• Do not break the confidentiality agreed between the person disclosing the information, yourself and your line manager. Do not talk to other staff members or service users about the information shared with you.

Confidentiality

• Staff have a clear DUTY  to report concerns regarding adult abuse to their line manager.

• Agencies cannot guarantee a fully confidential service – in certain circumstances our duty to protect the public may outweigh the responsibilities to one individual.

• Information should be shared on ‘need to know’ basis.

• Decisions to share information with other agencies without the consent of the person should be made by the agency.

• Where there are no wider duties to consider, the persons preferences should always be respected.

Accountability

• As a Professional you are personally accountable for actions and omissions in your practice and must always be able to justify your decisions (NMC 2008).

• Health and social care professionals in exercising their duty of care are ultimately accountable to:

  • PATIENT – Civil Law

  • PUBLIC – Criminal Law

  • EMPLOYER – Contract law

  • PROFESSION – Professional regulation

  • Themselves – moral responsibility/accountability

HUMAN RIGHTS – through valuing and demonstrating:

• Fairness

• Respect

• Equality

• Dignity

• Autonomy.

Legislation

• National Assistance Act 1948 – Section 47

• Mental Capacity Act 2005 –

• Mental Capacity Act Deprivation of Liberty Safeguards 2009

• Human Rights Act 1998 – Article 3: 5 and 8.

• NHS & Community Care Act 1990 – Section 47

• The Health Services and Public Health Act 1968

• Safeguarding Vulnerable Groups Act 2006 : Vetting and Barring Scheme

• The Mental Health Act 1983 – Section 115; 135; 136; 13(4); 2, 3, 4, 7. Section 127

• The Care Standards Act 2000 (& Associated Regulations)

• Common Law – save life or prevent serious harm ; Declaratory Relief

• Data protection Act 1998

• Public health Act 1936 – Section 287

• Police & Criminal Evidence Act 1984 – Section 17; 24 and 25

• Youth Justice and Criminal Evidence Act 1999 – Section 16. 17

• Sexual Offences Act 2003

• The Housing Act 1985 Part iii

• Public Interest Disclosure Act  1998 (Whistle blowing)

• Domestic Violence, Crime and Victims Act 2004.

Types of Abuse

The following categories of abuse are not mutually exclusive and a vulnerable adult may be subjected to more than one type of abuse at the same time, whatever the setting.

It is important to recognise that some vulnerable adults may reveal abuse themselves by talking about or drawing attention to physical signs or displaying certain actions/gestures. This may be their only means of communication. It is important for carers to be alert to these signs and to consider what they might mean.

Further information about indicators of abuse under each of these main headings can be found in the guidance section 3.

4.1 Physical abuse

• Hitting, slapping, scratching.

• Pushing or rough handling.

• Assault and battery.

• Restraining without justifiable reasons.

• Inappropriate and unauthorised use of medication.

• Using medication as a chemical form of restraint.

• Inappropriate sanctions including deprivation of food, clothing, warmth and health care needs.

4.2 Sexual abuse

• Sexual activity which an adult client cannot or has not consented to or has been

• pressured into.

• Sexual activity which takes place when the adult client is unaware of the consequences or risks involved.

• Rape or attempted rape.

• Sexual assault and harassment.

• Non contact abuse e.g. voyeurism, pornography.

4.3 Psychological abuse

• Emotional abuse.

• Verbal abuse.

• Humiliation and ridicule.

• Threats of punishment, abandonment, intimidation or exclusion from services.

• Isolation or withdrawal from services or supportive networks.

• Deliberate denial of religious or cultural needs.

• Failure to provide access to appropriate social skills and educational development training.

4.4 Financial abuse

• Misuse or theft of money.

• Fraud and/or extortion of material assets.

• Misuse or misappropriation of property, possessions or benefits.

• Exploitation, pressure in connection with wills, property or inheritance.

• Safeguarding adults AP1 form

If a Practitioner has concerns about a vulnerable adult, record information accurately in records and complete a body map if required.