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Title:<br />

Document author:<br />

Document type:<br />

Document library section:<br />

Sub Section:<br />

Document status:<br />

Approved by:<br />

Can this document be published<br />

to <strong>the</strong> internet (publicly<br />

available)<br />

Brief summary of document<br />

This document replaces (exact<br />

title of previous document or<br />

NA)<br />

Approved Equality Impact<br />

Assessment attached<br />

Cross referenced to:<br />

Document reference code:<br />

NHS <strong>Cornwall</strong> and Isles of Scilly <strong>Safeguarding</strong> <strong>Vulnerable</strong><br />

<strong>Adults</strong> <strong>Policy</strong><br />

Chris Parish<br />

<strong>Policy</strong><br />

<strong>Cornwall</strong> and Isles of Scilly PCT<br />

Governance<br />

Ratified<br />

<strong>Safeguarding</strong> Children and <strong>Adults</strong> Executive Group<br />

Yes<br />

This policy has been written to provide staff working for NHS<br />

CIOS with a guide to <strong>the</strong>ir responsibilities in <strong>the</strong> management<br />

of vulnerable adults. It should be read in conjunction with <strong>the</strong><br />

<strong>Cornwall</strong> and Isles of Scilly Multiagency <strong>Safeguarding</strong> <strong>Adults</strong><br />

<strong>Policy</strong><br />

New <strong>Policy</strong><br />

Yes<br />

<strong>Cornwall</strong> and Isles of Scilly Multi-agency <strong>Safeguarding</strong> <strong>Adults</strong><br />

<strong>Policy</strong><br />

Ratified by:<br />

<strong>Safeguarding</strong> Children and <strong>Adults</strong> Executive Group<br />

Date of ratification October 2011<br />

Name of Executive signing Carol Williams<br />

policy<br />

Review date October 2014<br />

Suggested key words (to be<br />

completed by Governance<br />

Administrator)<br />

Expired documents should be<br />

retained for 10 years from <strong>the</strong><br />

date of expiry<br />

Version control table<br />

Yes<br />

Date Version number Summary of changes Changes made by<br />

This document should not be photocopied or o<strong>the</strong>rwise reproduced.<br />

If you have any questions about this policy, please contact <strong>the</strong> Governance Administrator, Telephone<br />

01726 627811, or via email to Policies.PCT@<strong>Cornwall</strong>.nhs.uk<br />

This document is available in o<strong>the</strong>r formats such as large print, Braille &/or cassette/CD<br />

or in any o<strong>the</strong>r<br />

1


Page 2<br />

Consultation<br />

List <strong>the</strong> individuals (use titles only)/groups consulted. This<br />

must include <strong>the</strong> Counter Fraud Local Security Management<br />

Specialist<br />

Multiagency <strong>Safeguarding</strong> <strong>Adults</strong> Unit<br />

Cluster Director of Nursing<br />

<strong>Safeguarding</strong> Children and <strong>Adults</strong> Executive Group<br />

Indicate which of <strong>the</strong><br />

consultees in <strong>the</strong> left hand<br />

column have responded<br />

Yes<br />

Yes<br />

Yes<br />

Consultation comments received<br />

None<br />

Comments<br />

Accepted<br />

Comments<br />

rejected<br />

Reason for rejection<br />

Disseminate to: Please use titles or groups of staff<br />

GP’s, Continuing Healthcare, Commissioning and Prescribing<br />

Dissemination methods: Please details how dissemination will be undertaken and by whom<br />

Electronically Via Tracey Coles<br />

Aim:<br />

To ensure that NHS <strong>Cornwall</strong> and Isles of Scilly Staff comply with national and local<br />

guidance on safeguarding vulnerable adults<br />

Purpose:<br />

To provide NHS <strong>Cornwall</strong> and Isles of Scilly staff with guidance on safeguarding vulnerable<br />

adults<br />

Objectives: List <strong>the</strong> objectives to be achieved. They must be Specific, Measurable, Realistic<br />

and Timebound (SMART)<br />

Staff to be able to identify abuse or neglect<br />

Staff to know where to access advice and support<br />

Staff to know how to raise a safeguarding adults alert<br />

Responsibilities: Detail <strong>the</strong> responsibilities of all in this section<br />

All NHS <strong>Cornwall</strong> and Isles of Scilly Staff to work to <strong>the</strong> guidance in this policy<br />

Definitions/Glossary:<br />

None<br />

2


Introduction:<br />

This policy has been written to provide staff working for NHS CIOS with a guide to <strong>the</strong>ir<br />

responsibilities in <strong>the</strong> management of vulnerable adults. It should be read in conjunction with <strong>the</strong><br />

<strong>Cornwall</strong> and Isles of Scilly Multiagency <strong>Safeguarding</strong> <strong>Adults</strong> <strong>Policy</strong><br />

Text of document (remember to refer to organisational format requirements)<br />

Training: Has a training need been identified? If so what is it and how will it be addressed<br />

No<br />

Key Performance Indicators: List how you, as <strong>the</strong> policy author, will measure <strong>the</strong> success<br />

of achievement against <strong>the</strong> objectives<br />

Monitoring quality and number of safeguarding alerts made by NHS <strong>Cornwall</strong> and Isles of<br />

Scilly staff<br />

Monitoring: To which Board/sub-committee/committee will <strong>the</strong> results of <strong>the</strong> outcome of <strong>the</strong><br />

assessment against <strong>the</strong> key performance indicators be reported<br />

<strong>Safeguarding</strong> Children and <strong>Adults</strong> Executive Group<br />

Equality Impact Assessment: Attach a completed EIA prior to submitting for<br />

approval/ratification<br />

3


NHS <strong>Cornwall</strong> and Isles of Scilly<br />

<strong>Safeguarding</strong> <strong>Vulnerable</strong> <strong>Adults</strong> <strong>Policy</strong><br />

11 th July 2011<br />

Chris Parish, Designated Nurse for <strong>Safeguarding</strong> <strong>Adults</strong><br />

4


Contents Page<br />

Page 3<br />

Page 5<br />

Page 5<br />

Page 6<br />

Page 7<br />

Page 7<br />

Page 8<br />

Page 8<br />

Page 9<br />

Page 11<br />

Page 12<br />

Introduction and Scope<br />

What should you do if you suspect someone is being abused?<br />

Reporting suspected abuse<br />

Reporting suspected abuse that involves a member of NHS CIOS<br />

staff<br />

Mental Capacity<br />

Self-Neglect or Consent to Intervention<br />

Commissioning Responsibilities<br />

Staff development<br />

<strong>Safeguarding</strong> <strong>Adults</strong> Strategy Process<br />

Appendix One Flow Chart –How to make a safeguarding adults alert<br />

Where to find an <strong>Safeguarding</strong> <strong>Adults</strong> Alert Form (SA22)<br />

5


1. Introduction and scope of <strong>the</strong> policy<br />

NHS <strong>Cornwall</strong> and Isles of Scilly (NHS CIOS) works in partnership with o<strong>the</strong>r agencies in<br />

<strong>Cornwall</strong> to safeguard <strong>the</strong> dignity, quality of life and safety of vulnerable adults in <strong>Cornwall</strong>.<br />

This policy has been written to provide staff working for NHS CIOS with a guide to <strong>the</strong>ir<br />

responsibilities in <strong>the</strong> management of vulnerable adults. It should be read in conjunction<br />

with <strong>the</strong> <strong>Cornwall</strong> and Isles of Scilly Multiagency <strong>Safeguarding</strong> <strong>Adults</strong> <strong>Policy</strong><br />

http://www.cornwall.gov.uk/Default.aspx?page=5519<br />

The policy applies to all staff working in NHS <strong>Cornwall</strong> and Isles of Scilly including those on<br />

temporary or honorary contracts, bank staff, students, and independent contractors such as<br />

GPs.<br />

All services will be provided in a manner that respects <strong>the</strong> rights, dignity, privacy and beliefs<br />

of all individuals concerned and does not discriminate on <strong>the</strong> basis of race, culture, religion,<br />

language, gender, disability age, or sexual orientation<br />

2. Definitions and Requirements<br />

A vulnerable adult is a person ‘who is or may be in need of community care services by<br />

reason of<br />

mental or o<strong>the</strong>r disability, age or illness, and who is or may be unable to take care of him or<br />

herself, or<br />

unable to protect him or herself against significant harm or exploitation’<br />

(‘No Secrets’ section 2.4)<br />

Abuse can be defined as ‘a violation of an individual’s human and civil rights by any o<strong>the</strong>r<br />

person or persons’<br />

(‘No Secrets’ section 2.5)<br />

Abuse can consist of a single act or repeated acts over time. It may be physical, verbal or<br />

psychological. It may be an act of neglect or an omission to act, or it may occur when a<br />

vulnerable person is persuaded to enter into a financial or sexual transaction to which he or<br />

she has not consented or cannot consent.<br />

Regulation 11 of <strong>the</strong> Health and Social Care Act 2008 (Regulated Activities)<br />

Regulations 2009-11 state;<br />

The registered person must make suitable arrangements to ensure that service users are<br />

safeguarded against <strong>the</strong> risk of abuse by means of—<br />

(a) Taking reasonable steps to identify <strong>the</strong> possibility of abuse and prevent it before it<br />

occurs; and<br />

(b) Responding appropriately to any allegation of abuse.<br />

(2) Where any form of control or restraint is used in <strong>the</strong> carrying on of <strong>the</strong> regulated activity,<br />

<strong>the</strong> registered person must have suitable arrangements in place to protect service users<br />

against <strong>the</strong> risk of such control or restraint being—<br />

(a) Unlawful; or<br />

(b) O<strong>the</strong>rwise excessive.<br />

6


(3) The registered person must have regard to any guidance issued by <strong>the</strong> Secretary of<br />

State or an appropriate expert body, in relation to—<br />

(a) The protection of children and vulnerable adults generally; and<br />

(b) in particular, <strong>the</strong> appropriate use of methods of control or restraint.<br />

(4) For <strong>the</strong> purposes of paragraph (1), “abuse”, in relation to a service user, means—<br />

(a) sexual abuse;<br />

(b) physical or psychological ill-treatment;<br />

(c) <strong>the</strong>ft, misuse or misappropriation of money or property; or<br />

(d) neglect and acts of omission which cause harm or place at risk of harm.<br />

Regulation 18 of <strong>the</strong> Health and Social Care Act 2008 (Regulated Activities)<br />

Regulations 2009-11 state;<br />

(1) Subject to paragraphs (3) and (4), <strong>the</strong> registered person must notify <strong>the</strong> Commission<br />

without delay of <strong>the</strong> incidents specified in paragraph (2) which occur whilst services are<br />

being provided in <strong>the</strong> carrying on of a regulated activity, or as a consequence of <strong>the</strong> carrying<br />

on of a regulated activity.<br />

(2) The incidents referred to in paragraph (1) are—<br />

Document Reference Code:AP/003/11Page 5 of 16<br />

(e) any abuse or allegation of abuse in relation to a service user;<br />

(f) any incident which is reported to, or investigated by, <strong>the</strong> police;<br />

Paragraph (2)(f) does not apply where <strong>the</strong> service provider is an English NHS body.<br />

(4) Where <strong>the</strong> service provider is a health service body, paragraph (1) does not apply if, and<br />

to <strong>the</strong> extent that, <strong>the</strong> registered person has reported <strong>the</strong> incident to <strong>the</strong> National Patient<br />

Safety Agency.<br />

(5) In this regulation—<br />

(a) “The 2005 Act” means <strong>the</strong> Mental Capacity Act 2005;<br />

(b) “Abuse”, in relation to a service user, means—<br />

(i) Sexual abuse,<br />

(ii) Physical or psychological ill-treatment,<br />

(iii) Theft, misuse or misappropriation of money or property, or<br />

(iv) Neglect and acts of omission which cause harm or place at risk of harm;<br />

3. Who may be an abuser?<br />

Anybody can be an abuser and abuse can occur in any setting. Often, people who abuse<br />

vulnerable adults are well known to <strong>the</strong> person. For example, <strong>the</strong>y may be:<br />

• A paid carer or volunteer<br />

• A partner, relative or friend<br />

• A health, social care or o<strong>the</strong>r worker<br />

• A visitor or o<strong>the</strong>r contact<br />

• Ano<strong>the</strong>r vulnerable adult<br />

4. What should you do if you suspect someone is being abused?<br />

If you are informed or suspect that an individual for whom you commission or provide care<br />

to is being abused, you must make sure <strong>the</strong> person is not in danger and protect <strong>the</strong>m from<br />

immediate harm.<br />

7


You should <strong>the</strong>n make a written record in <strong>the</strong>ir notes identifying what you have been told or<br />

witnessed and any immediate actions you have taken. You must include <strong>the</strong> date and time,<br />

details of any observed injuries (use of body maps to record injuries is recommended) and<br />

<strong>the</strong> setting in which <strong>the</strong> allegation has occurred.<br />

It is important to ei<strong>the</strong>r raise an alert immediately (or for commissioners to ensure that alert<br />

has been raised) and to inform <strong>the</strong> Corporate Risk Manager at <strong>the</strong> same time as making <strong>the</strong><br />

alert.<br />

It is good practice to discuss your intention to make a safeguarding adults alert with <strong>the</strong><br />

service user involved. If <strong>the</strong>y ask you to keep <strong>the</strong> information ‘a secret’ you should inform<br />

<strong>the</strong>m that you cannot do this as it is your duty to pass <strong>the</strong> information to <strong>the</strong> Access Team.<br />

Even if <strong>the</strong> patient does not give consent, you have a duty of care to make a safeguarding<br />

adults alert where <strong>the</strong> patient may be exposed to significant harm or where o<strong>the</strong>r vulnerable<br />

adults may be at risk.<br />

If <strong>the</strong> suspected abuse involves a colleague (or a member of staff more senior to you) and<br />

you are anxious about raising this, you may find it helpful to refer to <strong>the</strong> Trust Whistle<br />

Blowing <strong>Policy</strong> and/or to consult with <strong>the</strong> Designated Nurse/Associate Designated Nurse for<br />

<strong>Safeguarding</strong> <strong>Adults</strong>.<br />

4.2 Reporting suspected abuse<br />

All <strong>Cornwall</strong> <strong>Safeguarding</strong> Adult alerts should be made through <strong>the</strong> Access Team on 0300<br />

1234 131.<br />

Telephone Contact must be followed up by faxing or emailing a completed SA22 within 48<br />

hours to 01872 326613 /email accessteam.referral@cornwall.gov.uk<br />

Isles of Scilly <strong>Safeguarding</strong> Adult alerts should be made to 01720 422148.<br />

A copy of <strong>the</strong> alert form (SA22) should be faxed to <strong>the</strong> Designated Nurse/Associate<br />

Designated Nurse for <strong>Safeguarding</strong> <strong>Adults</strong> for NHS CIOS on 01726 627829.<br />

The Access Team will make a decision at this stage as to whe<strong>the</strong>r this is a safeguarding<br />

issue and if so <strong>the</strong> information will be passed from <strong>the</strong> access team to <strong>the</strong> relevant<br />

coordinating manager for action.<br />

Alerters will be notified in writing whe<strong>the</strong>r <strong>the</strong> alert has been accepted into <strong>the</strong> safeguarding<br />

process. If it has not staff will be informed in writing of any o<strong>the</strong>r action taken.<br />

If staff are not happy with <strong>the</strong> decision taken by <strong>the</strong> access team regarding <strong>the</strong> safeguarding<br />

adults threshold <strong>the</strong>y should discuss this with <strong>the</strong>ir team leader / line manager and <strong>the</strong><br />

Designated Nurse/Associate Designated Nurse for <strong>Safeguarding</strong> <strong>Adults</strong>.<br />

4.3 Role of <strong>the</strong> Coordinating Manager<br />

The term ‘coordinating manager’ refers to <strong>the</strong> managers within <strong>Cornwall</strong> Partnership NHS<br />

Foundation Trust or Department of Adult Care and Support who have <strong>the</strong> responsibility for<br />

coordinating <strong>the</strong> response to an individual <strong>Safeguarding</strong> Adult alert.<br />

The coordinating manager has overall responsibility for ensuring that <strong>the</strong> correct procedures<br />

are followed according to <strong>the</strong> multi agency policy and practice guidance.<br />

Ensure <strong>the</strong> service user remains in a place of safety until fur<strong>the</strong>r advice is received from <strong>the</strong><br />

coordinating manager.<br />

8


4.4 What Happens next<br />

The safeguarding manager at <strong>the</strong> ACS Access Team will look at <strong>the</strong> referral and decide<br />

whe<strong>the</strong>r <strong>the</strong>re is a need for this to be looked at under <strong>the</strong> <strong>Safeguarding</strong> procedures. They<br />

will liaise with <strong>the</strong> relevant Coordinating Manager and decide on <strong>the</strong> need for fur<strong>the</strong>r action.<br />

This may be an investigation. Depending on <strong>the</strong> outcome of interagency discussion, staff<br />

may need to provide additional information, attend Adult Protection Strategy meetings/Case<br />

Conferences, and participate in <strong>the</strong> investigation, needs assessment and future protection<br />

plan. If, following <strong>the</strong> interagency discussion, it is decided that no Adult Social<br />

Care/<strong>Cornwall</strong> Partnership Trust/Police involvement is necessary, <strong>the</strong> multi-disciplinary<br />

team responsible for care will need to decide whe<strong>the</strong>r fur<strong>the</strong>r internal<br />

proceedings/investigation are required.<br />

Often <strong>the</strong>re will be a need for a complex care plan to support <strong>the</strong> situation, which will<br />

sometimes need a multi agency approach.<br />

5. Reporting suspected abuse that involves a member of NHS CIOS staff<br />

Make an adult protection alert as detailed in section 4.2<br />

Ensure that form SA22 is completed<br />

Inform <strong>the</strong> HR department and take advice as to whe<strong>the</strong>r <strong>the</strong> Professional<br />

Body of <strong>the</strong> alleged abuser should be informed. This decision should be taken at Executive<br />

level of NHS CIOS.<br />

The member of staff should be suspended from duty pending an investigation under <strong>the</strong><br />

trust’s disciplinary procedure. The timing of this should form part of <strong>the</strong> strategy discussion<br />

at <strong>the</strong> earliest possible opportunity.<br />

If you are not <strong>the</strong> staff member’s line manager, ensure <strong>the</strong>ir line manager is informed as<br />

soon as possible.<br />

A decision will be made at Executive NHS CIOS level, advised by <strong>the</strong> HR department, about<br />

when to inform <strong>the</strong> Independent <strong>Safeguarding</strong> Authority.<br />

9


6 Mental Capacity Act<br />

The Mental Capacity Act 2005 is underpinned by a set of five key principles<br />

• A presumption of capacity – every adult has <strong>the</strong> right to make his or her own decisions and<br />

must be assumed to have capacity to do so unless it is proved o<strong>the</strong>rwise<br />

• The right for individuals to be supported to make <strong>the</strong>ir own decisions – people must be<br />

given all appropriate help before anyone concludes that <strong>the</strong>y cannot make <strong>the</strong>ir own<br />

decisions<br />

• That individuals must retain <strong>the</strong> right to make what might be seen as eccentric or unwise<br />

decisions<br />

• Best interests – anything done for or on behalf of people without capacity must be in <strong>the</strong>ir<br />

best interests<br />

• Least restrictive intervention – anything done for or on behalf of people without capacity<br />

should be <strong>the</strong> least restrictive of <strong>the</strong>ir basic rights and freedoms.<br />

• The Act introduces a new criminal offence of ill treatment or neglect of a person who lacks<br />

capacity. A person found guilty of such an offence may be liable to imprisonment for a term<br />

of up to five years.<br />

Where an individual is deemed to lack capacity it is imperative that, if <strong>the</strong>y do not<br />

have family or friends to act on <strong>the</strong>ir behalf, an Independent Mental Capacity<br />

Advocate is requested.<br />

7. Self-Neglect or Consent to Intervention<br />

It is not unusual for people to refuse a particular form of care due to lack of insight into <strong>the</strong><br />

need for intervention. Examples may be<br />

• A person with dementia sends away a home care worker who is tasked to do cleaning or<br />

prepare a meal<br />

• A person who is incontinent but is reluctant to wear pads<br />

• A person with schizophrenia refuses <strong>the</strong>ir depot injection<br />

In <strong>the</strong>se situations <strong>the</strong> assessment of <strong>the</strong> person’s capacity to make <strong>the</strong>se decisions is key.<br />

If <strong>the</strong> person lacks capacity to consent to an intervention, <strong>the</strong> law permits actions to be<br />

taken in <strong>the</strong>ir best interests. In <strong>the</strong>se circumstances, skilled and sensitive responses from<br />

staff will frequently enable <strong>the</strong> task to be completed. However, a patient may have<br />

appointed a lasting power of Attorney under <strong>the</strong> Mental Capacity Act. If so, this person is<br />

legally empowered to make decisions on behalf of <strong>the</strong> patient and must be consulted.<br />

The effect of <strong>the</strong> failure to provide <strong>the</strong> particular intervention will vary with <strong>the</strong> nature of <strong>the</strong><br />

care or treatment. Consideration must always be given to <strong>the</strong> likely effect of <strong>the</strong> failure to<br />

provide <strong>the</strong> planned care or treatment, to <strong>the</strong> person, <strong>the</strong>ir environment and to those around<br />

<strong>the</strong>m. This will help determine <strong>the</strong> urgency of <strong>the</strong> decision-making needed regarding<br />

implementation of <strong>the</strong> care plan.<br />

It is imperative that in circumstances where an incapacitated person is refusing or resisting<br />

care or treatment, discussions are held with senior staff to consider how to ensure <strong>the</strong><br />

appropriate care is delivered.<br />

If necessary <strong>the</strong>se discussions should include <strong>the</strong> wider team and family/carers and be<br />

documented in <strong>the</strong> patient’s record.<br />

8. Commissioning Responsibility<br />

Where commissioners are made aware that a safeguarding alert has been made regarding<br />

a patient that <strong>the</strong>y fund <strong>the</strong>y should<br />

10


• Inform <strong>the</strong> Designated Nurse/Associate Designated Nurse for <strong>Safeguarding</strong> <strong>Adults</strong><br />

• Ensure commissioning is fully engaged in <strong>the</strong> safeguarding adults process includes<br />

participation in <strong>the</strong> strategy process and attendance at meetings.<br />

• Review <strong>the</strong> care of o<strong>the</strong>r patients being funded in <strong>the</strong> care setting<br />

• Record in full <strong>the</strong> nature of <strong>the</strong> alert and any action taken on <strong>the</strong> patient’s records.<br />

9. Staff Development<br />

9.1 Training<br />

There are different levels of adult protection training including:<br />

• Induction / Introductory level Training – provided as an e learning package (All new<br />

employees must complete on <strong>the</strong>ir first day at work)<br />

• Human rights one day training (All staff having direct patient contact must complete<br />

this course).<br />

• Provider Manager/Team Leader Training – one half day multi-agency training<br />

coordinated by Adult Care and Support Learning Training and Development Group.<br />

• Specific HR training around safe recruitment and management of allegations against<br />

staff.<br />

9.2 Staff Recruitment<br />

Rigorous recruitment practices will be applied for safeguarding vulnerable adults in line with<br />

relevant requirements including 'Safer Recruitment', Care Quality Commission Standards,<br />

National Health Litigation Authority. Accordingly <strong>the</strong> following will be completed when<br />

recruiting staff:<br />

Check of <strong>the</strong> relevant professional register to ensure <strong>the</strong>y are currently registered, on <strong>the</strong><br />

correct part of <strong>the</strong> register and not subject to any action by <strong>the</strong> registering body<br />

Confirmation of relevant educational qualifications/competencies<br />

Acquisition of at least two references satisfactory to <strong>the</strong> Trust including one from <strong>the</strong> line<br />

manager at <strong>the</strong>ir most recent or current employer. This must confirm whe<strong>the</strong>r or not <strong>the</strong>y are<br />

or have been subject to any fitness to practice proceedings<br />

Confirmation of career history, accounting for any gaps in employment<br />

Satisfactory Criminal Records Bureau check<br />

A fur<strong>the</strong>r level of assurance has been introduced with <strong>the</strong> Independent <strong>Safeguarding</strong><br />

Authority.<br />

10 Framework for <strong>Safeguarding</strong> <strong>Adults</strong> in <strong>Cornwall</strong><br />

10.1 <strong>Cornwall</strong> and Isles of Scilly <strong>Safeguarding</strong> <strong>Adults</strong> Board (Formerly Adult Protection<br />

Committee)<br />

This is a strategic multi-agency group responsible for ensuring that all agencies work<br />

toge<strong>the</strong>r to minimize <strong>the</strong> risks of abuse and to protect vulnerable adults when abuse has<br />

occurred. The NHS CIOS representative on this group is <strong>the</strong> Director of Nursing or <strong>the</strong>ir<br />

representative.<br />

11


10.2 <strong>Safeguarding</strong> <strong>Adults</strong> Quality and Improvement Sub Group<br />

This is a multi-agency sub-group of <strong>the</strong> <strong>Cornwall</strong> and Isles of Scilly <strong>Safeguarding</strong> <strong>Adults</strong><br />

Board. Its role is to report on and monitor progress of embedding adult protection practice<br />

into all agencies. The group shares examples of good and poor practice and resolves<br />

practice issues as <strong>the</strong>y are identified.<br />

The NHS CIOS representative on <strong>the</strong> Quality and Improvement Group is <strong>the</strong> Designated<br />

Nurse for <strong>Safeguarding</strong> <strong>Adults</strong>. .<br />

10.3 <strong>Safeguarding</strong> <strong>Adults</strong> Learning and Development Training Sub-Group<br />

This is a multi-agency sub-group of <strong>the</strong> <strong>Cornwall</strong> and Isles of Scilly <strong>Safeguarding</strong> <strong>Adults</strong><br />

Board which focuses on <strong>the</strong> development and implementation of training programme for<br />

adult protection.<br />

The NHS CIOS representative on <strong>the</strong> <strong>Safeguarding</strong> <strong>Adults</strong> learning and development<br />

training sub-group is Designated Nurse for <strong>Safeguarding</strong> <strong>Adults</strong>.<br />

10.4 <strong>Safeguarding</strong> <strong>Adults</strong> Strategy Process<br />

The adult protection strategy process requires that contact is made with <strong>the</strong> alerter and<br />

service providers when an alert regarding suspected abuse has been made. This may be in<br />

<strong>the</strong> form of a telephone call/conference. When contacted by telephone as part of <strong>the</strong><br />

strategy process you should be informed that it is part of <strong>the</strong> strategy process however staff<br />

should always clarify <strong>the</strong> status of telephone calls requesting patient/client information. The<br />

coordinating manager may decide that a face to face strategy meeting is necessary <strong>the</strong>y will<br />

identify who should attend this meeting. An outcome may be <strong>the</strong> decision to hold a case<br />

conference or it may be to take no fur<strong>the</strong>r action.<br />

10.5 Multi-Agency <strong>Safeguarding</strong> <strong>Adults</strong> Case Conference<br />

This is a multi-agency meeting where <strong>the</strong> ongoing protection of a vulnerable adult is<br />

considered. It is usually an outcome from a strategy meeting.<br />

The purpose is to consider <strong>the</strong> issues raised in <strong>the</strong> alert, agree on a course of action to<br />

safeguarding <strong>the</strong> individual and any o<strong>the</strong>r who are felt to be at risk of abuse and to ensure<br />

<strong>the</strong> agreed plan is monitored and reviewed. Consideration must be given to inviting <strong>the</strong><br />

vulnerable adult to this meeting.<br />

10.6 <strong>Safeguarding</strong> <strong>Adults</strong> Review Meeting<br />

This meeting should take place within six months of a case conference being held. It is<br />

arranged and convened by <strong>the</strong> coordinating manager. The review looks at <strong>the</strong> outcomes for<br />

<strong>the</strong> service user, revises <strong>the</strong> adult protection plan (if needed) and considers <strong>the</strong> need for<br />

fur<strong>the</strong>r action.<br />

10.7 <strong>Safeguarding</strong> <strong>Adults</strong> Independent chair<br />

Two independent chairs support co-ordinating managers in <strong>the</strong>ir role with chairing<br />

safeguarding adults strategy meetings and case conferences. They also assist in <strong>the</strong> work<br />

of <strong>the</strong> safeguarding adults unit, ensuring that <strong>the</strong> key principles of safeguarding vulnerable<br />

people are embedded across all groups and organisations in <strong>Cornwall</strong> and <strong>the</strong> Isles of Scilly<br />

12


11 Contact Telephone Numbers<br />

Access Team - To make alerts 0300 1234 131<br />

<strong>Safeguarding</strong> <strong>Adults</strong> Team for NHS CIOS – 01726 627971<br />

Multiagency <strong>Safeguarding</strong> <strong>Adults</strong> Unit<br />

<strong>Safeguarding</strong> <strong>Adults</strong> Coordinator 01872 323782<br />

<strong>Safeguarding</strong> <strong>Adults</strong> Unit Administrator 01872 324112<br />

<strong>Safeguarding</strong> <strong>Adults</strong> Training Coordinator 01872 323663<br />

13


Appendix One<br />

How to make a safeguarding adults alert<br />

Adult protection concern established following discussion with<br />

colleagues/line manager or accessing advice from Designated<br />

Professional on<br />

01726 627971<br />

Inform vulnerable adult of <strong>the</strong> need to make a referral to<br />

The Access Team<br />

NB: if you feel that informing <strong>the</strong>m of <strong>the</strong> referral will put ei<strong>the</strong>r you or <strong>the</strong><br />

vulnerable adult at greater risk do not do so.<br />

Ensure that <strong>the</strong> access team are aware that you have not informed <strong>the</strong><br />

vulnerable adult and record your reasons in your records.<br />

A <strong>Safeguarding</strong> <strong>Adults</strong> alert should be made by telephone to <strong>the</strong><br />

access team on<br />

0300 1234 131<br />

Within 48 hours of <strong>the</strong> telephone call, an SA22 Alert form should<br />

be completed and faxed to <strong>the</strong> access team on<br />

01872 326613<br />

or<br />

emailed to<br />

accessteam.referral@cornwall.gov.uk<br />

A copy of <strong>the</strong> SA22 should also be faxed to <strong>the</strong> <strong>Safeguarding</strong><br />

<strong>Adults</strong> team for NHS <strong>Cornwall</strong> &Isles of Scilly on 01726 627829<br />

The safeguarding <strong>Adults</strong> Manager will provide written feedback<br />

on <strong>the</strong> status of <strong>the</strong> alert this should be stored with records for<br />

future reference<br />

14


Appendix Two<br />

Where to access a <strong>Safeguarding</strong> <strong>Adults</strong> Alert Form<br />

A safeguarding adults alert form (SA22) can be accessed by clicking on one of <strong>the</strong> following<br />

two links.<br />

http://www.cornwall.gov.uk/index.aspx?page=5610<br />

http://intra.cornwall.nhs.uk/Intranet/AZServices/S/<strong>Safeguarding</strong><strong>Adults</strong>PCT/UsefulLinks.aspx<br />

15


Section Officer responsible for <strong>the</strong> assessment Chris Parish, Designated Nurse for <strong>Safeguarding</strong><br />

<strong>Adults</strong><br />

Name of <strong>Policy</strong> to<br />

be assessed<br />

NHS <strong>Cornwall</strong> and Isles of Scilly<br />

<strong>Safeguarding</strong> <strong>Vulnerable</strong> <strong>Adults</strong> <strong>Policy</strong><br />

Date of<br />

Assessment<br />

03/10/2011 Is this a new or existing<br />

policy?<br />

New<br />

1. Briefly describe <strong>the</strong> aims, objectives and<br />

purpose of <strong>the</strong> policy.<br />

2. Are <strong>the</strong>re any associated objectives of <strong>the</strong><br />

policy? Please explain.<br />

3. Who is intended to benefit from this policy,<br />

and in what way?<br />

No<br />

This procedure has been written to provide staff working for NHS CIOS with a guide<br />

to <strong>the</strong>ir responsibilities in <strong>the</strong> management of vulnerable adults. It should be read in<br />

conjunction with <strong>the</strong> <strong>Cornwall</strong> and Isles of Scilly Multiagency <strong>Safeguarding</strong> <strong>Adults</strong><br />

<strong>Policy</strong> http://www.cornwall.gov.uk/Default.aspx?page=5519<br />

The policy applies to all staff working in NHS <strong>Cornwall</strong> and Isles of Scilly including those on<br />

temporary or honorary contracts, bank staff, students, and independent contractors such as<br />

GPs.<br />

4. What outcomes are wanted from this policy? Employees of NHS <strong>Cornwall</strong> and Isles of Scilly to be aware of <strong>Safeguarding</strong> <strong>Adults</strong><br />

responsibilities, how to identify abuse and to report appropriately.<br />

5. What factors/forces could contribute/detract<br />

from <strong>the</strong> outcomes?<br />

6. Who are <strong>the</strong> main NHS <strong>Cornwall</strong> and Isles of Scilly and<br />

stakeholders in relation to <strong>Vulnerable</strong> adults.<br />

<strong>the</strong> policy?<br />

Multiagency <strong>Safeguarding</strong> Procedures will contribute to <strong>the</strong> outcome.<br />

7. Who implements <strong>the</strong> policy,<br />

and who is responsible for <strong>the</strong><br />

policy?<br />

Staff. NHS CIOS<br />

<strong>Safeguarding</strong> Children and<br />

<strong>Adults</strong> Executive Group<br />

8. Are <strong>the</strong>re concerns that <strong>the</strong> policy could have<br />

a differential impact on RACIAL groups?<br />

Y<br />

N<br />

Please explain<br />

16


What existing evidence (ei<strong>the</strong>r presumed or<br />

o<strong>the</strong>rwise) do you have for this?<br />

9. Are <strong>the</strong>re concerns that <strong>the</strong> policy could have<br />

a differential impact due to GENDER (including<br />

TRANSGENDER)?<br />

What existing evidence (ei<strong>the</strong>r presumed or<br />

o<strong>the</strong>rwise) do you have for this?<br />

10. Are <strong>the</strong>re concerns that <strong>the</strong> policy could<br />

have a differential impact due to DISABILITY?<br />

Y<br />

Y<br />

N<br />

N<br />

All services will be provided in a manner that respects <strong>the</strong> rights, dignity, privacy and<br />

beliefs of all individuals concerned and does not discriminate on <strong>the</strong> basis of race,<br />

culture, religion, language, gender, disability age, or sexual orientation<br />

All services will be provided in a manner that respects <strong>the</strong> rights, dignity, privacy and<br />

beliefs of all individuals concerned and does not discriminate on <strong>the</strong> basis of race,<br />

culture, religion, language, gender, disability age, or sexual orientation<br />

What existing evidence (ei<strong>the</strong>r presumed or<br />

o<strong>the</strong>rwise) do you have for this?<br />

11. Are <strong>the</strong>re concerns that <strong>the</strong> policy could<br />

have a differential impact due to SEXUAL<br />

ORIENTATION?<br />

What existing evidence (ei<strong>the</strong>r presumed or<br />

o<strong>the</strong>rwise) do you have for this?<br />

12. Are <strong>the</strong>re concerns that <strong>the</strong> policy could<br />

have a differential impact due to <strong>the</strong>ir AGE?<br />

Y<br />

N<br />

N<br />

All services will be provided in a manner that respects <strong>the</strong> rights, dignity, privacy and<br />

beliefs of all individuals concerned and does not discriminate on <strong>the</strong> basis of race,<br />

culture, religion, language, gender, disability age, or sexual orientation<br />

All services will be provided in a manner that respects <strong>the</strong> rights, dignity, privacy and<br />

beliefs of all individuals concerned and does not discriminate on <strong>the</strong> basis of race,<br />

culture, religion, language, gender, disability age, or sexual orientation<br />

17


What existing evidence (ei<strong>the</strong>r presumed or<br />

o<strong>the</strong>rwise) do you have for this?<br />

13. Are <strong>the</strong>re concerns that <strong>the</strong> policy could<br />

have a differential impact due to <strong>the</strong>ir<br />

RELIGIOUS BELIEF?<br />

What existing evidence (ei<strong>the</strong>r presumed or<br />

o<strong>the</strong>rwise) do you have for this?<br />

Y<br />

Y<br />

N<br />

All services will be provided in a manner that respects <strong>the</strong> rights, dignity, privacy and<br />

beliefs of all individuals concerned and does not discriminate on <strong>the</strong> basis of race,<br />

culture, religion, language, gender, disability age, or sexual orientation<br />

All services will be provided in a manner that respects <strong>the</strong> rights, dignity, privacy and<br />

beliefs of all individuals concerned and does not discriminate on <strong>the</strong> basis of race,<br />

culture, religion, language, gender, disability age, or sexual orientation<br />

14. How have <strong>the</strong> Core Human Rights Values<br />

of:<br />

All values fully considered by working party and during <strong>the</strong> consultation period<br />

Fairness;<br />

Respect;<br />

Equality;<br />

Dignity;<br />

Autonomy<br />

Been considered in <strong>the</strong> formulation of this<br />

policy/strategy<br />

If <strong>the</strong>y haven’t please reconsider <strong>the</strong> document<br />

and amend to incorporate <strong>the</strong>se values.<br />

18


15. Which of <strong>the</strong> Human Rights Articles does<br />

this document impact?<br />

What existing evidence (ei<strong>the</strong>r presumed or<br />

o<strong>the</strong>rwise) do you have for this?<br />

The right:<br />

• To life;<br />

• Not to be tortured or treated in an inhuman or degrading way;<br />

• To be free from slavery or forced labour;<br />

• To liberty and security;<br />

• To a fair trial;<br />

• To no punishment without law;<br />

• To respect for home and family life, home and correspondence;<br />

• To freedom of thought, conscience and religion;<br />

• To freedom of expression;<br />

• To freedom of assembly and association;<br />

• To marry and found a family;<br />

• Not to be discriminated against in relation to <strong>the</strong> enjoyment of any of<br />

<strong>the</strong> rights contained in <strong>the</strong> European Convention;<br />

• To peaceful enjoyment of possessions and education;<br />

• To free elections<br />

Consultation with Stakeholders<br />

Yes<br />

Yes<br />

Yes<br />

Yes<br />

Yes<br />

Yes<br />

Yes<br />

Yes<br />

Yes<br />

No<br />

No<br />

No<br />

No<br />

No<br />

No<br />

No<br />

16. Could <strong>the</strong> differential impact<br />

identified in 8 – 13 amount to<br />

<strong>the</strong>re being <strong>the</strong> potential for<br />

adverse impact in this policy? Y N<br />

Please explain<br />

These Guidelines have been designed to aid staff in identifying and challenging<br />

discrimination and <strong>the</strong>refore will only have a positive impact on staff and patients within <strong>the</strong><br />

<strong>Cornwall</strong> and Isles of Scilly.<br />

19


17. Can this adverse impact be<br />

justified on <strong>the</strong> grounds of<br />

promoting equality of<br />

opportunity for one group? Or<br />

any o<strong>the</strong>r reason?<br />

Y<br />

N<br />

Please explain for each equality heading (questions 8 –13) on a separate piece of paper.<br />

18. Should <strong>the</strong> policy proceed<br />

to a full equality impact<br />

assessment? Y N<br />

17. If Yes, describe why, <strong>the</strong>n proceed to a full EIA.<br />

18. If No, are <strong>the</strong>re any minor fur<strong>the</strong>r amendments that should take place?<br />

No<br />

19. If a need for minor amendments is identified, what date were <strong>the</strong>se completed and what<br />

actions were undertaken.<br />

Signed (completing officer) ……… …………………………………….. Date<br />

Signed (Head of Section) ……………………………………………………….. Date<br />

Please ensure that a signed copy of this form is sent to both <strong>the</strong> Policies Officer and <strong>the</strong> Equality and Diversity lead to be placed on<br />

<strong>the</strong> Primary Care Trust website<br />

20

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