Frank McHugh and Tim Hanly Principal Social Workers. IASW Ashling Hotel October 9th, 2015

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1 Frank McHugh and Tim Hanly Principal Social Workers IASW Ashling Hotel October 9th, 2015.

2 To provide a consistent approach to safeguard and protect clients of Disability Services and Older Persons Services from abuse and neglect.

3 A Vulnerable Person is an adult who may be restricted in capacity to guard himself / herself against harm or exploitation or to report such harm or exploitation. Restriction of capacity may arise as a result of physical or intellectual impairment. Vulnerability to abuse is influenced by both context and individual circumstances.

4 All statutory service providers and public funded non-statutory service providers (including for-profit organisations) with responsibility for the provision of health and social care services to vulnerable persons. It applies to all staff and volunteers. Across all service settings, including domestic, alternative family placements, residential care, respite services, day care and independent living (associated support services such as transport are also included). All other relevant directly provided HSE services In situations where formal health or social care services are not in place but where concerns have been raised.

5 Four Sections Policy Procedure Self Neglect Implementation.

6 Publicly declared No Tolerance Principles Human Rights; Person-Centeredness; Advocacy; Confidentiality; Empowerment; Collaboration.

7 Importance that service providers : Have in place safeguarding policy statement Create and nurture open culture Nothing corrupts like loyalty and friendship What we permit we promote

8 Importance that service providers : Have policies and procedures for recruitment Intimate and personal care Safe administration of medication Management of service users money Behaviour management and restraint Working alone Complaints Incident reporting Confidentiality and limits of confidentiality Bullying and harassment Personal development of service users including friendship and relationships

9 Every effort must be made to promote the well being, security and safety of vulnerable adults consistent with their rights, mental capacity and personal choices Presumption of capacity needs to be established there is lack of capacity to guard himself / herself against harm or exploitation or to report such harm or exploitation Importance of prevention strategies in services Importance of ongoing risk management

10 Everyone has the right to live a life free from abuse, exploitation and neglect Corresponding with their level of understanding Vulnerable adults made aware of their rights and given information, advice and support Vulnerable Adults should be supported in bringing a complaint Vulnerable adults to be encouraged and enabled to utilise protection from the law and legal process In most cases, the vulnerable adult should be the person who decides the course of action whilst given all possible support Every person should have alleged, suspected or confirmed cases of abuse investigated promptly and appropriately Every person should receive support, education and counselling following abuse and opportunity to seek redress

11 Physical Sexual Psychological Financial or Material Neglect & Acts of omission Discriminatory e.g Race, age, disability etc Institutional e.g. rigid routines, poor standards of care

12 Anyone who has contact with a Vulnerable Adult Family member Professional failure to act, poor practice, misuse of power. Peer Abuse Stranger Abuse

13 Stage 1 A concern or allegation arises via observation, disclosure, third party, via complaint, via family, via anon phone call etc. Immediate protection Listen, reassure and support Detection and prevention of crime Record and preserve evidence Report and inform

14 Establish and document the following: What is the concern? Who is making the report? Mental capacity and of their wishes of vulnerable in relation to the abuse/neglect? Who is involved, how and are there risks to others. What actions have been taken to date? Biographical information of those involved, What is known of their mental capacity and of their wishes in relation to the abuse/neglect? Any immediate risks identified, or actions already taken, to address immediate risks. Establish the current safety status of the victim. Arrange medical treatment if required. Establish if An Garda Síochána have been notified and ensure referral to TUSLA where a child is identified as being at risk of harm. 14

15 Stage 2 What is a preliminary screening? What are the stages of a preliminary screening? Ensuring Immediate safety and support Information gathering Involvement of staff Involvement of service user Submit within 3 working days to the Safeguarding and Protection Team (SPT)

16 No grounds for reasonable concern Additional information required Reasonable grounds for concern

17 What is a safeguarding plan? Outline of planned actions to address needs and minimise risks Safeguarding plan co-ordinator appointed by service manager Timescale drafted and implemented with 3 weeks of preliminary screening being completed Plan agreed with safeguarding and protection team ( SPT) Formulation- positive actions re safeguarding and prevention Support and therapeutic intervention for vulnerable person Update the plan Reviewing, evaluating and closing plan

18 What are options? Local Informal process Internal or Independent Inquiry Case directly assessed and managed by SPT Outcome to be agreed with safeguarding and protection team ( SPT) If abuse allegation in respect of staff member then policy for managing allegations against staff i.e. Trust in Care

19 Receive concerns or allegations of abuse re vulnerable persons Collate basic relevant information Ensure the appropriate manager is informed and collaboratively ensure necessary actions are identified Ensure all reporting obligations are met (internally to the service and externally to the statutory authorities) Support the manager and other personnel in addressing the issues arising Maintain appropriate records. Consult with Safeguarding and Protection Teams ( SPT ) as required Carry out preliminary screenings Report findings to Service manager Submit Preliminary Screening to the Safeguarding and Protection Teams 19

20 Promote culture of Zero Tolerance for any type of Abuse or abusive practice

21 Ensure the following : Local policy/procedures complies with national policy concerns/allegations managed as per policy Designated Officer ( DO) in place All staff/ volunteers receive appropriate Induction training with regard to the implementation of this policy Record maintained that at all staff/volunteers sign off on safeguarding policies/ procedures/ guidelines If preliminary screening says reasonable grounds for concern exist that a safe guarding plan be developed that designated officer/appropriate staff member co-ordinates the safeguarding procedure and process

22 Ensure immediate safety of service user Inform line manager Contact Gardai if necessary Outline in writing all relevant information

23 Co-ordinate with Safeguarding and protection teams around the carrying out of the preliminary screening Purpose is to establish if there is reasonable grounds for concern

24 Receive preliminary screening and concerns Support services and professional to assess and investigate concerns/ complaint Review and agree preliminary screening and safeguarding plan outcomes with services Develop intervention and protection plans as required Directly assess complex cases/cases with conflict of interest and co-ordinate service responses Support best practice and positive culture around the welfare of vulnerable person via training etc. Maintain records and data

25 Stage 1- Concern Arises. Flow Chart 1 Concern/complaint arises or is raised (e.g. member of public/staff member/other agency, etc.) Community Setting Service Setting NOTE: At any stage in the procedure, if there are significant concerns in relation to a vulnerable person, the Chief Officer (CO) of the Community Healthcare Organisation must be notified immediately. The CO must immediately notify the Director of Social Care. Notification to, and advice from, the National Incident Management Team should be considered in such circumstances and consideration as to whether the concern should be investigated using the HSE Safety Incident Management Policy (2014). Staff (HSE, Primary Care, other Agency) immediately ensures safety of client Staff informs Line Manager / Safeguarding and Protection Team Contact An Garda Síochána as appropriate Staff outlines in writing all relevant information Line Manager/ Safeguarding and Protection Team will ensure that the preliminary screening is undertaken and all necessary actions are taken DAY 1 Staff immediately ensure safety of client Staff informs Designated Officer and Line Manager Line Manager assesses the need for support and/or intervention Contact An Garda Síochána as appropriate Staff outlines in writing all relevant information Line Manager, Director of Services and Designated Officer will meet to ensure that the preliminary screening is undertaken and all necessary actions are taken The Line Manager will notify the Safeguarding and Protection Team WITHIN 3 WORKING DAYS If a Designated Centre, Person in Charge will give notice, in writing, to the Chief Inspector (HIQA) Proceed to Stage 2 - Preliminary Screening - Section 11.0

26 Flow Chart 2 Concern Arises (Stage 2) Community Setting Service Setting Line Manager/Safeguarding & Protection Team will carry out a preliminary screening. The purpose of this is to establish if there are reasonable grounds for concern. Designated Officer will carry out a preliminary screening and report findings to the Service Manager. The purpose of this is to establish if there are reasonable grounds for concern. The outcome of the preliminary screening must be notified to the HSE Safeguarding and Protection Team and actions after this point must be agreed with the HSE Preliminary Screening 3 WORKING DAYS No grounds for further investigation Additional information required Reasonable grounds for concern exist. Immediate safety issues addressed Lessons for clinical/care service Immediate safety issues addressed Safeguarding Plan The outcome of any assessment/inquiry following preliminary screening must be reviewed with the Safeguarding and Protection Team (Vulnerable Persons) and a plan to address necessary actions approved.

27 Flow Chart 3 Local informal process Internal Inquiry Independent Inquiry Assessment and management by the Safeguarding and Protection Team

28 Policy has been in place since December Establishment of national safeguarding office to support implementation of the Policy Establishment of database of Designated Officers within CHOs Recruitment of Principal Social Worker and establishment of a Safeguarding and Protection Team in each Community Healthcare Organisation. Develop staff training strategy to support implementation of the policy. Work to set up IT case management system and collate data on concerns of abuse and neglect. Plan to develop a practice handbook, screening tools, and documentation Reference group between National Safeguarding Office and National Federations

29 Training A training plan for staff on the Safeguarding Policy has been developed. The initial priorities for training plan will be the members of the Safeguarding and Protection Teams and the Designated Officers.

30 Safeguarding is everyone s business Environmental factors can create vulnerability If supported older people and persons with disabilities are more likely to speak out about concerns

31 Thank You.