Protecting Adults at Risk: Ensuring Rights and Preventing Harm, Interagency guidelines: a Quick Guide

This is a summary for staff and carers about (1) how to recogniseharm and (2) what to do immediately when harm is suspected, witnessed or reported. It is still essential to refer to the full guidelines: Ayrshire Multi-agency Adult Protection Procedures 2008.

What is abuse?

/ It is the violation of a person’s human rights. This happens through the misuse of power by someone in a dominant position. It also includes neglect: things that are notdone to ensure someone’s well-being.

Who is an adult at risk?

/ Persons aged 16 years or over who are unable to safeguard their own well-being, property, rights or other interests; are at risk of harm and because they are affected by disability, mental disorder, illness or physical or mental infirmity, are more vulnerable to being harmed than adults who are not so affected.

Who can be an abuser?

/ Abuser or perpetrator can be a professional carer, informal carer, relative, spouse/partner, volunteer, other ‘adults at risk’ or any other person.

Where can abuse happen?

/ In any social or health care setting e.g. the family home, hospital ward, care home, day services, social clubs, activities etc.

Main types of abuse

/

Signs of these types of HARM

Physical: hitting, slapping, pushing, kicking, holding the person down (restraint), inappropriate sanctions. /
  • Unusual or unexplained injuries
  • Misuse of medication: giving too much, too little or withholding medication.
  • Fear of another person, disturbed behaviour

Sexual: includes rape and sexual assault /
  • Acts or actions they did to which the adult at risk could not, or did not, consent

Financialor material: theft, fraud, exploitation, pressure to hand-over or sign-over property or money, financial transactions, misuse of property, possessions or welfare benefits, reduction in assets /
  • Unexplained debt, not paying bills for services
  • Sale of property, possessions, misuse of bank account by the perpetrator
  • Pressure over wills, property, inheritance, money

Psychological: emotional abuse, threats, abandonment, humiliation, intimidation, harassment, verbal abuse, controlling, not allowed contact with other people or services, /
  • Pressure by family or professional to have someone moved into or taken out or care
  • Fear of another person
  • Hostile or rejecting behaviour by the care-giver

Neglect and acts of omission: failure to provide: medical or physical care; access to medical, social or educational services; appropriate medication, food or heating. /
  • Person is found alone at home or in a care setting in a situation of serious risk
  • Unexplained deterioration in health
  • Long gap between illness/injury and getting medical care
  • Deprived of adequate food or heating

Discriminatory: making an unjust distinction on the basis of race, colour, age or gender etc. /
  • Prejudicial actions or remarks to the adult at risk about age, gender, disability, race, colour, sexual or religious orientation

Information abuse: denial of information or advice /
  • Failure to provide adequate information
  • Being misinformed

Human Rights: as included in the 14 Articles of the Human Rights Act 1998. See for details. /
  • Absence of information or not knowing rights
  • Being misinformed about rights

WHAT TO DO IMMEDIATELY

when harm is suspected, witnessed or reported

ALWAYSRECORD EVERYTHING IN WRITING:actions, discussions, referrals, decisions etc.
You have a duty to report. You must immediately report suspected or actual harm to your line-manager or supervisor. A ‘plan of action’ should be agreed in this discussion.
Get the person’sconsent to action being taken where there is danger, suspicion or evidence of harm /
  • If you are satisfied that the person can consent and doesn’t want any action taken their wishes may be respected but you must discuss the matter with your line manager. But if abuse that is a criminal offence is suspected a referral must be made to the Police regardless of whether they consent or not – see step below. Discuss with your line-manager. Where the person is a patient, tenant or resident and does or does not consent, action must be taken. .

  • If you are unsure of the person’s capacity to decide, discuss with your line manager or supervisor and refer to the Social Work Service.

  • If the person lacks the capacityto make this decision then you must take action. See details about the Adults with Incapacity Act (Scotland) 2000,.

Contact the appropriate emergency service especially if the person is in immediate physical danger or there is evidence of physical or sexual harm. The emergency services are Police, hospital, Social Work Services (and outside office hours, the Emergency Social Work Service.) / Consent and when to contact the police
If abuse that is a criminal offence is suspected or reported then if the person:
  • Can consent, the Police must be contacted immediately. In the case of physical or sexual abuse, immediate referral is essential to ensure vital evidence is not lost.
  • Does or does not consent and they are a patient, tenant or resident in a statutory, voluntary or private institutional setting, contact the police.
  • Does not consent and they are not a patient, tenant or resident as above, you must speak with your line-manager who will refer the matter to the Police.
  • Record in detail the events and action taken..
  • NB Line-managers and supervisors can at anytime contact the relevant Detective Inspector in the local Public Protection Unit to discuss or get advice.

 Refer to the local Social Work Services as soon as possible and within 24 hours
 Next steps Adult Protection Case Conference Ongoing work with the vulnerable adult Support for Staff
Relevant procedures and legislation;
Ayrshire Multi-Agency Adult Protection Procedures 2008, incorporating
The Risk Assessment & Protection Plan
Assessment and Care Management Procedures
Adult Support and Protection (Scotland) Act 2007
Adults with Incapacity (Scotland) Act 2000
Mental Health (Care and Treatment)(Scotland) Act 2003
Social Work (Scotland) Act 1968 as amended by NHS and Community Care Act 1990

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