Safeguarding Adult at Risk Policy

• Appendix 2

Making Safeguarding Personal

There has been a cultural shift towards Making Safeguarding Personal within the safeguarding process. This is a move from prioritising outcomes demanded by bureaucratic systems. The safeguarding process used to involve gathering a detailed account of what happened and determining who did what to whom. Now the outcomes are defined by the person at the centre of the safeguarding process.

The safeguarding process places a stronger emphasis on achieving satisfactory outcomes that take into account the individual choices and requirements of everyone involved.

“What good is it making someone safer if it merely makes them miserable?” – Lord Justice Mundy, “What Price Dignity?” (2010)

What this means in practice is that adults should be more involved in the safeguarding process. Their views, wishes, feelings and beliefs must be taken into account when decisions are made. We all have different preferences, histories, circumstances and lifestyles so it is unhelpful to prescribe a process that must be followed whenever a concern is raised. However, there are key issues that should be considered when abuse or neglect are suspected, and there should be clear guidelines regarding this.

Appendix 3

Capacity – Guidance on Making Decisions

England and Wales share the Mental Capacity Act of 2005. Scotland has the Adults With Incapacity (Scotland) Act 2000 and Ireland the Mental Capacity (Northern Ireland) Act 2016. The Acts all apply to people over the age of 16 years. The issue of capacity or decision-making is a key one in safeguarding adults across all legislatures. It is useful for organisations to have an overview of the concept of capacity.

We make many decisions every day, often without realising. We make so many decisions that it’s easy to take this ability for granted. But some people are only able to make some decisions, and a small number of people cannot make any decisions. Being unable to make a decision is called “lacking capacity”.

To make a decision we need to:

→  Understand information

→  Remember it for long enough

→  Think about the information

→  Communicate our decision

The various legislation sets out the principles for working with adults who lack capacity to make decisions. A person’s ability to do this may be affected by things like learning disability, dementia, mental health needs, acquired brain injury and physical ill health.

Good practice states that every individual has the right to make their own decisions and legislation provides the framework for this to happen.

The legislation is designed to ensure that people have the support they need to make as many decisions as possible. The legislation also protects people who need family, friends or paid support staff to make decisions for them because they lack capacity to make specific decisions.

Any intervention in the affairs of an adult should:

• • benefit the adult
  • take account of the adult’s wishes, so far as these can be ascertained
  • take account of the views of relevant others, as far as it is reasonable and practical to do so
  • restrict the adult’s freedom as little as possible while still achieving the desired benefit

Our ability to make decisions can change over the course of a day.

Here are some examples that demonstrate how the timing of a question can affect the response:

A person with epilepsy may not be able to make a decision following a seizure.

Someone who is anxious may not be able to make a decision at that point.

A person may not be able to respond as quickly if they have just taken some medication that causes fatigue.

In each of these examples, it may appear as though the person cannot make a decision. But later in the day, presented with the same decision, they may be able to at least be involved or to make an informed and measured decision.

Legislation recognises that capacity is decision-specific, so no one will be labelled as entirely lacking capacity. The legislation also recognises that decisions can be about big life-changing events, such as where to live, but equally about small events, such as what to wear on a cold day.

To help you to understand better, consider the following five points:

• • Assume that people are able to make decisions, unless it is shown that they are not. If you have concerns about a person’s level of understanding, you should check this with them, and if applicable, with the people supporting them.
  • Give people as much support as they need to make decisions. You may be involved in this – you might need to think about the way you communicate or provide information and you may be asked your opinion.
  • People have the right to make unwise decisions. The important thing is that they understand the implications. If they understand the implications, consider how risks might be minimised.
  • If someone is not able to make a decision, then the person helping them must only make decisions in their “best interests”. This means that the decision must be what is best for the person, not for anyone else. If someone was making a decision on your behalf, you would want it to reflect the decision you would make if you were able to.
  • Find the least restrictive way of doing what needs to be done.

Remember:

• • You should not discriminate or make assumptions about someone’s ability to make decisions, and you should not pre-empt a best interest’s decision merely on the basis of a person’s age, appearance, condition or behaviour.
  • As an organisation, when it comes to decision-making, you could be involved in a minor way, or asked to provide more detail. The way you provide information might influence a person’s ultimate decision. A person may be receiving support that is not inline with the principles of the legislation, so you must be prepared to address this.

*The Mental Capacity Act in England and Wales is currently under review and the legislation and process is likely to change. It is recommended that a review of policy/procedures to take this into account is carried out in 2020.

Appendix 4

Consent and Information Sharing

Although we want to make safeguarding personal there are some circumstances when we need to take action without an adult’s consent.

Sometimes an adult at risk may not want you to act on your concerns or their disclosure.

This may be because they are scared or fearful of the repercussions from you taking action.

It may also be because they are not aware abuse is taking place or have the mental capacity to make an informed decision and understand to remain in their current situation is unsafe.

Sharing information with the right people, is central to good practice in safeguarding adults.

You should not keep safeguarding concerns about adults at risk to yourself. Explain to the adult that you must pass the concern on to your Safeguarding Lead, as you have a duty of care.

You should reassure the adult that they will be fully included on what happens.

It is appropriate to report concerns without an adult’s consent when:

• • You have reason to believe the adult’s health and or wellbeing will be adversely affected by ongoing harm.
  • Other people are, or may be, at risk from the person causing harm, including children.
  • It is necessary to prevent a crime, or a serious crime has been committed.
  • Sharing the information could prevent a crime and help to stop abuse
  • The adult may be under duress or being coerced
  • The alleged abuser has care and support needs and may also be at risk.

Workers and volunteers within sports and physical activity organisations should always share safeguarding concerns in line with their organisation’s policy, usually with their safeguarding lead or welfare officer in the first instance, except in emergency situations. If it does not increase the risk to the individual, the worker or volunteer should explain to them that it is their duty to share their concern with their safeguarding lead or welfare officer.

The safeguarding lead or welfare officer will then consider the situation and plan the actions that need to be taken, in conjunction with the adult at risk and in line with the organisation’s policy and procedures and local safeguarding adults board policy and procedures.

To make an adult safeguarding referral you need to call the local safeguarding adults’ team. This may be part of a MASH (Multi-Agency Safeguarding Hub). A conversation can be had with the safeguarding adult’s team without disclosing the identity of the person in the first instance. If it is thought that a referral needs to be made to the safeguarding adult’s team, consent should be sought where possible from the adult at risk.

Individuals may not give their consent to the sharing of safeguarding information with the safeguarding adult’s team for a number of reasons. Reassurance, appropriate support and revisiting the issues at another time may help to change their view on whether it is best to share information.

If they still do not consent, then their wishes should usually be respected. However, there are circumstances where information can be shared without consent such as when the adult does not have the capacity to consent, it is in the public interest because it may affect other people, or a serious crime has been committed. This should always be discussed with your safeguarding lead and the local authority safeguarding adults’ team. This is repeat of above.

If someone does not want you to share information outside of the organisation or you do not have consent to share the information, ask yourself the following questions:

• • Is the adult placing themselves at further risk of harm?
  • Is someone else likely to get hurt? Repetitive again.
  • Has a criminal offence occurred? This includes: theft or burglary of items, physical abuse, sexual abuse, forced to give extra money for lessons (financial abuse) or harassment.
  • Is there suspicion that a crime has occurred?

If the answer to any of the questions above is ‘yes’ – then you can share without consent and need to share the information.

When sharing information there are seven Golden Rules that should always be followed:

• • Seek advice if in any doubt.
  • Be transparent – The Data Protection Act (DPA) is not a barrier to sharing information but to ensure that personal information is shared appropriately; except in circumstances where by doing so places the person at significant risk of harm.
  • Consider the public interest – Base all decisions to share information on the safety and well-being of that person or others who may be affected by their actions.
  • Share with consent where appropriate – Where possible, respond to the wishes of those who do not consent to share confidential information. You may still share information without consent, if this is in the public interest.
  • Keep a record – Record your decision and reasons to share or not share information.
  • Accurate, necessary, proportionate, relevant and secure – Ensure all information shared is accurate, up-to-date, necessary and share with only those who need to have it.
  • Remember the purpose of the Data Protection Act (DPA) is to ensure personal information is shared appropriately, except in circumstances where by doing so may place the person or others at significant harm. Repeated from above