Date: November 2020
Staffordshire and Stoke-on-Trent Adult Safeguarding Partnership Board
In this edition
- Learning lessons from Safeguarding Adult Reviews
- When to blow the whistle
- Raising a adult safeguarding concern
It seems that for much of this year that we have all in our various working capacities been bombarded with masses of information and guidance related to COVID-19 with the expectation that it be read, absorbed and complied with. This newsletter is sympathetic to those reading pressures and is intentionally brief, easy to read and be put into practice as applicable, on currently topical themes.
In March this year adult safeguarding came under the spotlight as the United Kingdom went into lockdown due to the spread of the coronavirus. Care homes and adults with care and support needs who were not visible, or unable to receive their usual support, were of huge concern. The declared pandemic has underlined just how important adult safeguarding is – more than at any time since the Care Act was enacted.
In these challenging times it is important to remind ourselves that when adults with care and support needs have experienced abuse or neglect it usually occurs in their home, whether their own or a care home, and perpetrated by someone who they know and should be able to trust, either a member of their own family, or friend, or someone working in a position of trust.
From experience, safeguarding concerns are often hidden and when they do come to light are difficult to substantiate due to the capacity and vulnerabilities of the adult concerned. These experiences should remind us of the need to be particularly vigilant and to look for the signs of closed cultures. If you are not already looking for signs of a closed culture and how to respond I would encourage you to read on through this newsletter.
I conclude by mentioning that the Annual Report of the Safeguarding Adults Board has just been published and can be accessed through the link. I would encourage you to read it and welcome any comments that you may have to SSASPB.firstname.lastname@example.org
John Wood, Independent Chair
2. Learning Lessons from Safeguarding Adult Reviews
An article on Safeguarding Adult Reviews (SARs) was included in the March 2020 edition of the SSASPB newsletter. However, the distribution may have been affected by response to the first wave of the COVID-19 pandemic. The messages are so important and also there has been more recent work on the lessons we need to learn from SARs therefore it has been expanded upon in this edition.
Safeguarding Adult Boards have a statutory responsibility to conduct reviews in certain circumstances. For more information about the criteria please click here. The purpose of undertaking the reviews is to determine what the relevant agencies and individuals involved in the case might have done differently that could have prevented harm or death. This is so that lessons can be learned from the case and those lessons applied to future cases to prevent similar harm occurring again. Its purpose is not to hold any individual or organisation to account as other processes exist for that.
Since 2013 there have been several SARS and Multi-agency Learning Reviews conducted by the SSASPB. There are three recurring lessons to learn:
- Practitioners should expect their decisions to be challenged and, in turn, challenge others - whether they are part of their own or another organisation. Challenge is healthy and will be encouraged. If agreement cannot be reached, the Board has an Escalation Policy explaining how to escalate professional disagreement.
- Complex cases which involve the engagement of many organisations benefit from the appointment of a ‘lead professional’ to assist with clear focus and multi-agency planning. This person may be from any organisation connected with the adult about whom there are concerns and will usually be the one who is best placed to achieve the engagement of the adult.
- Practitioners should always fully document the reasons for their decisions. These must be recorded in clear language and acronyms explained when first used.
Professor Michael Preston-Shoot has recently distributed his findings following extensive research into over 200 SARs. His findings were difficult to hear, saying that there is little evidence to suggest that lessons have been learned from the Serious Case Review of the murder of Steven Hoskins (Cornwall, 2006). One of his findings supports the recurring lesson to learn from local SARs i.e. the need to appoint a lead professional in plans to safeguard an adult. This doesn’t always have to be a Social Worker, there are many good examples where the lead has been taken by the Fire Service, Housing or Police. The importance of a multi-agency response and appropriate information sharing is paramount to keeping adults with care and support needs safe from abuse and neglect.
The SSASPB Information Sharing Guidance is a useful document to help you understand when and how to share information.
He also says that there must be a plan (including contingencies) to reduce risk to an adult who is believed to need help to protect themselves from abuse and neglect and that the adult must be at the centre of everything we do – this reinforces the Making Safeguarding Personal (MSP) principles.
Awareness of Adult Safeguarding, what it is and how to report it must be raised, which is why it features in this newsletter. Please don’t assume that everyone knows what it means. The SSASPB website contains much useful information for anyone who needs to find out more. Make sure you know who your own organisation’s Adult Safeguarding lead is, they will be able to tell you where to find out more information or put you in touch with someone who can help.
Finally, please make yourself aware of the impact of closed cultures on Adult Safeguarding, the CQC published a report in January 2020 which is an essential read on this subject. We must encourage openness and transparency, remember that we are all have a responsibility to challenge and to expect to be challenged in a professional manner. Openness will lead to better outcomes for the adults for whom we have a responsibility to protect from abuse and neglect.
3. When to blow the whistle
As a professional working in the public sector if you have concerns about a wrong-doing you have a professional duty to take prompt action. Shouting up is commonly referred to as “whistleblowing”.
Complaints that count as whistleblowing include breaches in the law including criminal offences, if someone's health and safety is in danger, risk or actual damage to the environment or you have grounds to believe someone is covering up a wrong-doing.
If you are providing health or social care and you witness unsafe work practices or lack of care by other professionals, you have a professional duty to take prompt action. It is essential to raise concerns if you that believe patients’ or clients’ safety is at risk, or that their care or dignity is being compromised. You must make your manager aware and follow the Whistle blower policy of your organisation.
Abuse and neglect thrive in closed cultures which is why we actively promote all agencies create an open, transparent and safe working environment where workers feel able to speak up. All agencies should have a whistleblowing policy in place evidencing the commitment to listen to the concerns of workers. By having clear policies and procedures for dealing with whistleblowing, an organisation demonstrates that it welcomes information being brought to the attention of management, as workers are effective eyes and ears.
If your manager advises you not to raise or follow up a concern, you should never agree to stay silent. You must report the matter following the guidance of your workplace “Whistleblowing Policy” or contact your professional or regulatory body.
To make a disclosure, your manager should explain the process and confirm how to make your concerns known. It is the responsibility of your organisation to be satisfied that the disclosure is acted upon appropriately, the issue has been resolved and you are given timely feedback.
If you still have concerns but you are not sure how to escalate them or want advice about good practice, you can call the NHS and Social Care Whistleblowing Helpline on: 08000 724 725. They can advise on the whistleblowing process but they are not a disclosure line.
You can also disclose concerns for registered health or social care services to The Care Quality Commission (CQC) independent body whom are responsible for monitoring and inspecting hospitals, GPs practices, dentists, community health services, care homes and agencies that provide care to people in their own homes. You can ring their disclosure line on 03000 616161 to report concerns in these places.
4. Raising an Adult Safeguarding Concern
What is adult safeguarding?
Adult Safeguarding is about stopping or preventing abuse or neglect of adults with care and support needs.
Who are adults with care and support needs?
Adults with Care and support needs could be someone over the age of 18 years who:
- has a learning disability
- has mental health needs including dementia or other mental disorders
- has a long term illness/condition/ disability
- is elderly and frail due to ill health, disability or cognitive impairment, or example dementia
Whose job is it to safeguard adults with care and support needs?
Anyone could be the first person to identify or suspect abuse, including family members, carers, neighbours, remember that suspicion is enough. Professionals have a duty to take appropriate action if they become aware of an adult with care and support needs who may be experiencing or at risk of abuse or neglect.
The Care Act 2014 says that safeguarding an adult from abuse or neglect has to be done with their involvement to the greatest extent possible. Everyone has the right to be involved in the decisions made about their lives. This approach is known as ‘making safeguarding personal’.
What is adult abuse and neglect?
Adults with care and support needs can be victims of many different types of abuse or neglect. The Care Act 2014 identifies 10 types of abuse:
- Physical abuse
- Sexual abuse
- Financial abuse
- Discriminatory abuse
- Emotional/Psychological abuse
- Neglect (and acts of omission)
- Self neglect
- Organisational/institutional abuse
- Domestic abuse
- Modern slavery
More information about the types of abuse including examples can be found on the SSASPB website.
If you think that an adult with care and support needs is being abused or neglected:
If the adult lives in Stoke:
Telephone: 0800 561 0015 at any time
Minicom: 01782 236037
If the adult lives in Staffordshire:
Telephone: 0345 604 2719
Monday to Thursday 8:30am to 5pm, Fridays 8:30am to 4:30pm, excluding Bank Holidays
0345 604 2886 at any other time