All NHS service and commissioned services have a key role to play in Adult Safeguarding. It is a fundamental in any civilised society that the most vulnerable people are protected from abuse and neglect when they cannot safeguard themselves. However, safeguarding is much wider than protecting adults, it is about allowing, enabling and empowering adults to live their lives as they wish, make decisions and choices, take risks, be in control, promote independence and maintain wellbeing.
The Care Act 2014 came into force on 1 April 2015, and its underlining principle is that of promoting the wellbeing of individuals, and of making sure professionals recognise that each person’s needs are different, and respond accordingly.
The framework of the Care Act and its statutory guidance also sets out the general responsibilities and key duties for organisations for example:
- A duty to co-operate, including integration. Local authorities must co-operate with a number of statutory organisations. Cooperation with health must be delivered in the context of improving care and support, in line with the duty to promote wellbeing, prevent or delay the development of needs and improve the quality of care. There is a reciprocal duty placed on the NHS body within the authority’s area including CCGs, hospital trusts and NHS England.
- New duties – advocacy, safeguarding and transitions. For example, a duty to arrange independent advocacy if a person is unable to participate in or understand the care and support system.
- Duty to assess young people and their carers in advance of transition from children’s to adult services, where likely to need care and support as an adult.
- New statutory framework for protecting adults from neglect and abuse.
- Duty on local authorities to investigate suspected abuse or neglect, past or present, experienced by adults still living and deceased.
All those working in adult safeguarding have a difficult task in understanding risk, assessing the levels of risk for the individual and formulating a plan to manage those risks, which works for the person concerned and is understood by those around them.
The Multi-agency policy and procedures for the protection of adults with care & support needs in the West Midlands sets out the approach across the West Midlands and explains how agencies and individuals should work together to put the West Midlands procedures into practice.
Central to the Care Act and West Midlands procedures is Making Safeguarding Personal (MSP). Making safeguarding personal aims to facilitate a shift in emphasis in safeguarding from undertaking a process to improving outcomes alongside people experiencing abuse or neglect. The central focus is on developing an understanding of what people wish to achieve, agreeing, negotiating and recording their desired outcomes, working out with them (and their representatives or advocates if the person lacks capacity) how best those outcomes might be realised and then reviewing the extent to which desired outcomes have been achieved.
Adult safeguarding Concerns:
Certain situations make people more at risk of abuse and neglect:
- People living with domestic abuse
- People who have carers under stress
- People who abuse drugs and alcohol
- People living in unsafe communities
- People subject to unauthorised deprivation of liberty.
Some adults may need extra help to stop abuse because:
- They are an adult with a learning or physical disability
- They are frail because of their age or illness
- They have mental ill health.
Safeguarding adults is a fundamental part of patient safety and wellbeing and the outcomes expected of the NHS. All healthcare staff have a responsibility to follow the 6 safeguarding principles:
- Principle 1 - Empowerment- Presumption of person led decisions and consent
- Principle 2 - Protection – Support and representation for those in the greatest of need
- Principle 3 - Prevention
- Principle 4 - Proportionality and least intrusive response appropriate to the risk presented
- Principle 5 - Partnership – Local solutions through services working with their communities
- Principle 6 - Accountability and transparency in delivering safeguarding
Safeguarding adults is also integral to complying with legislation, regulations and delivering cost effective care.
NHS Solihull CCG has a Strategic Designated Nurse and Lead for the Mental Capacity Act to advise and support the Practice Safeguarding Leads and Health Providers Named Professionals. Working closely with the Local Safeguarding Adults Boards, Solihull Metropolitan Borough Council, NHS England and CQC to ensure Solihull CCG provide excellent healthcare to its population in a safe environment with dignity.