Safeguarding. Stuart Harper-Reynolds Named Nurse Adult Safeguarding Julie Lane Deputy Director of Nursing

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1 Safeguarding Stuart Harper-Reynolds Named Nurse Adult Safeguarding Julie Lane Deputy Director of Nursing

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3 We re Passionate About Putting patients t first Quality, safety and patient t experience Transforming services to meet the health needs of future generations

4 Content t Principles/Categories Roles in safeguarding Mental Capacity Act Capacity/Deprivation i ti of Liberty Safeguards Learning Disabilities Prevent Planning ahead

5 Pi Principles i of fadult ltsafeguarding 1. Empowerment 2. Protection 3. Prevention 4. Proportionality 5. Partnership 6. Accountability (DOH 2011: Statement of policy on safeguarding : DH gateway )

6 Adult Safeguarding Activity it Roles Alerter Perpetrator Contributor Combined

7 Capacity The Mental Capacity Act 2005 Provides a legal framework to allow patients who lack capacity to be lawfully treated. Put existing common law principles on a statutory footing. MCA Code of Practice Applies to everyone working in health and social care involved in the treatment or support of people aged 16+ who are unable to make decisions for themselves.

8 MCA 5 Key Principles i A person must be assumed to have capacity unless it is established that he lacks capacity A person is not to be treated t as unable to make decisions i unless all practical steps have been taken to help him to do so A person may not be treated as unable to make a decision merely because he makes an unwise decision An act done, or decision make on behalf of a person who lacks capacity must be done in their best interests Consideration must be given to achieving the outcome in the least restrictive ti way

9 How is Capacity Assessed? STEP 1: Is there an impairment or disturbance in the functioning of a person s mind or brain (diagnostic test e.g. LD, Alzheimer's, alcohol)? Yes STEP 2: Has it made the person unable to make a particular decision (functional test)? Is he unable to; (a) Understand (b) Retain (c) Weigh up (d) Communicate his decision? No Patient t has capacity Yes Patient lacks capacity

10 What Happens Next if a Patient Does Lack Capacity? Consideration must be given to what is in that patient s best interests with reference to; Whether they might regain capacity in the future The best interests checklist Consultation

11 What Constitutes a Deprivation of Liberty (DoL)? P v Cheshire West Supreme Court decision March 2014 defined the acid test ; The person is under continuous supervision and control and is not free to leave, and the person lacks capacity to consent to these arrangements.

12 Who Can DoLApply to? The DoL safeguards will only apply to people who: Lack capacity to consent to care/ treatment Are over 18 Receive care in a hospital or care home and the care they receive deprives them of their liberty Are not detained under the Mental Health Act

13 What Happens If a Person is Being Deprived of Their Liberty? Consider whether the restriction can be safely removed so that person is no longer deprived of their liberty. If this is not possible, the DoLS needs to be legally authorised.

14 What Happens if the DoL isn t Legally Authorised? It is unlawful It may infringe Article 5 ECHR right to liberty May result in a claim under the Human Rights Act 1998 Criticism/ enforcement action by CQC

15 Best Interests t Meeting 1. Establish the lack of capacity. 2. Possibility of regaining. 3. Presence of patient/client at meeting 4. IMCA involvement 5. Reasonable adjustments

16 Learning Disabilities Learning Disability Nurse Passport Alerts/virtual wards Partnership working

17 Prevent CONTEST WRAP - radicalisation Channel referrals

18 Planning Ahead Training compliance with 100% target (95% amber) DoLS policy review Safeguarding Adults policy review Safeguarding Adults team to move Focussed training for staff Support and training for staff around best interests decisions. Continue to monitor performance and improve appropriate referrals. Gap analysis for the Savile Enquiry. Prompt cards Development of Domestic Abuse Policy

19 Any Questions?