Safeguarding Flashcards
What is the Care Act 2014?
- Legal framework for safeguarding adults
- Adult safeguarding = working with an individual to protect their right to live free from abuse, harm and neglect
- Respecting their rights and choices
- Right are underpinned by the Human Rights Act 1998
What does ‘making safeguarding personal’ mean?
- Person-centred approach which achieves the outcomes that the adult wants
What are Safeguarding Adult Reviews?
- Multi-Agency process
- Determines what relevant agencies and individuals could have done differently to prevent the serious harm or death of an adult from taking place
What is a safeguarding adult board?
- They provide leadership and oversight of adult safeguarding in their area
- Includes providing local guidance and procedures for safeguarding adults
Who does the Care Act 2014 apply to?
Any adult, aged 18 or over, who
- Has needs for care and support (whether or not the local authority is meeting any of those needs)
and
- Is experiencing, or at risk of, abuse and neglect
and
- As a result of those care and support needs is unable to protect themselves from either the risk of, or experience of, abuse and neglect
What are the 6 key principles of Safeguarding defined by the Care Act 2014
- Empowerment
- Prevention
- Proportionality
- Protection
- Partnership
- Accountability
What is the trilogy of risk?
Mental health, domestic abuse, substance misuse
General actions if you have an adult safeguarding concern?
- Is there an acute medical need
- Explain concerns to patient
- Involve senior staff (i.e. consultant, nurse-in-charge, matron etc)
- Do the police need to be called (i.e. immediate danger, a crime has been committed
- Safeguarding referral as per local protocol (call the team for advice, follow-up with online referral / email)
- Speak to adult social care?
What is a safeguarding adults enquiry?
- Performed after a safeguarding concern / flag has been raised in response to abuse or neglect
- ‘Section 42 enquiry’ of the Care Act 2014
- Instigated by the local authority
Can an enquiry be done without consent of the person involved?
Yes
- When the adult lacks the mental capacity to consent to an enquiry, even after all practicable measures to maximise capacity have been carried out
- When it’s in the best interests of the adult
- When there is an overriding public interest due to others being at risk
What is MARAC?
Multi-Agency Risk Assessment Conference
- Risk management meeting where professionals discuss a case of domestic abuse
What is the Mental Capacity Act 2005?
- Presumption in law that anyone over the age of 16 is able to make their own decisions about their lives, regardless of their medical conditions, age or appearance
- Just because we make a decision that other people think is unwise, that cannot itself be used to say we lack capacity, although unwise decisions may indicate that an assessment of capacity is required
What is the Liberty Protection Safeguards 2020?
- The old DOLS (deprivation of liberty safeguards)
If there is an adult who is subject to a safeguarding enquiry, who must be assigned to them?
Independent advocate
What are your responsibilities when you have a safeguarding concern?
- Are emergency services required?
- Ensure safety and wellbeing of the individual
- Establish the wishes of the individual about the safeguarding concern and procedure
- Maintain any evidence / good documentation
- Follow local procedures for reporting
- ## Inform the person you are required to report, what it is you’re reporting and why
If you suspect someone may lack mental capacity, what are the 4 checks you need to do to assess their capacity?
Is the person able to:
* Understand the decision they need to make and why they need to make it?
* Understand, retain, use and weigh information relevant to the decision?
* Understand the consequences of making, or not making, this decision?
* Communicate their decision by any means (i.e. speech, sign language)?
Failure on one point will determine lack of capacity
How do you act in someone’s best interest?
- Involve the person who lacks capacity to the fullest extent possible
- Have regard for past wishes, if known
- Consult with others involved in their care
- Not be discriminatory
- Choose the least restrictive option
- Take into account the benefits and burden on the person
What is PREVENT?
- Govt’s counter terrorism strategy (CONTEST)
- Working with individuals who may be at risk of being exploited by radicalism
- If you have concerns, raise with local safeguarding team as per local protocol
Re. Domestic Violence, what things can be considered re. routine enquiry of service users?
Ensure it is safe to ask
- Consider the environment (is it conducive or safe to ask? Never ask in the presence of someone else, and use an independent interpreter)
- Create the opportunity to ask the question
Re. Domestic violence, what is the ‘ask, validate, assess, action, document’ framework?
Ask
- Frame the topic and ask “as violence and abuse in the home is so common now, we ask routinely about this”
Validate
- “you do not deserve to be treated this way”
- “you are not to be blamed for what is happening to you”
Assess
- “Is your partner here with you?”
- “Where are your children?”
- “Do you have any immediate concerns?”
- “Do you have a place of safety?”
Action
- Be aware of your local domestic violence agency
- Do you need to contact local independent domestic violence advisor (IDVA)
- Offer leaflet and suggest referral
- Action any local safeguarding procedures
Document
- Document carefully as well as all discussions had with other agencies / professionals
What is a ‘child in need’ ?
- Section 17 of The Children’s Act
- Unlikely to achieve or maintain or to have the opportunity to achieve or maintain a reasonable standard of health or development without provision of services from the Local Authority.
- Their health or development is likely to be significantly impaired, or further impaired, without the provision of services from the Local Authority.
- They have a disability
What is a looked after child?
- In the care of foster parents
- Being cared for in a residential Children’s home
- Living in a residential setting such as a school of secure unit.
A child stops being a looked after child when they turn 18 years, are returned home or they are adopted.
In the UK all children leaving care at the age of 18 years old are supported by the local authority until they are at least 21 years old
Who forms the local safeguarding children’s board?
- Local authorities
- The Police, Probation Service, British Transport Police
- NHS bodies
- Education
- Organisations such as the Connexions Service
- Youth offending teams, Prisons/Young Offender Institutions/Secure Training Centres
A 12 year-old comes in to discuss contraception, what is the law around this?
- You should usually share information about sexual activity involving children under 13 as they are considered in law to be unable to consent
You have a concern that a young person has raised, what phrase can you use to let them know you wish to discuss with a senior colleague?
“We need to make sure that you are safe and I’m concerned that this situation isn’t very safe for you”
“I’m going to need to speak with another doctor about this”
What are Fraser Guidelines?
The Fraser guidelines apply specifically to advice and treatment about contraception and sexual health
Following a legal ruling in 2006, Fraser guidelines can also be applied to advice and treatment for sexually transmitted infections and the termination of pregnancy (Axton v The Secretary of State for Health, 2006)
Practitioners using the Fraser guidelines should be satisfied of the following:
- The young person cannot be persuaded to inform their parents or carers that they are seeking this advice or treatment (or to allow the practitioner to inform their parents or carers).
- The young person understands the advice being given.
- The young person’s physical or mental health or both are likely to suffer unless they receive the advice or treatment.
- It is in the young person’s best interests to receive the advice, treatment or both without their parents’ or carers’ consent.
the young person is very likely to continue having sex with or without contraceptive treatment.
(Gillick v West Norfolk, 1985)
What is Gillick Competence?
Gillick competency applies mainly to medical advice but it is also used by practitioners in other settings
Medical professionals need to consider Gillick competency if a young person under the age of 16 wishes to receive treatment without their parents’ or carers’ consent or, in some cases, knowledge
Professionals need to consider several things when assessing a child’s capacity to consent, including:
- The child’s age, maturity and mental capacity
- Their understanding of the issue and what it involves - including advantages, disadvantages and potential long-term impact
- Their understanding of the risks, implications and consequences that may arise from their decision
- How well they understand any advice or information they have been given
- Their understanding of any alternative options, if available
their ability to explain a rationale around their reasoning and decision making.
What does the BASHH young persons and STI guidance say all young people under 18 years should have an assessment for?
- Holistic sexual risk assessment including history of recreational drug and alcohol use
- Vulnerability assessment for self-harm, mental health, special educational needs and physical disabilities
- ‘Spotting the Signs’ CSE pro-forma completed
What age does BASHH recommend should have face-to-face services rather than remote?
- Under 16s
What does BASHH say about diagnosis of STI in a person aged 13-15?
- May be considered a marker for CSE
- Consider CSE, perform in-depth assessment and discuss referral to social services with named / designated safeguarding doctor for any children under 16 years old
- Still consider CSE in those aged 16-17, but consider risk/benefit of discussion with multi-agencies and undermining the confidentiality of YP
What is an advanced decision?
Creation of rules prior to losing capacity, allowing refusal of medical treatment
If someone doesn’t have a lasting power of attorney, who else can make health and financial decisions for someone who lacks capacity?
Court appointed deputy
What’s an IMCA?
Independent Mental Capacity Advocate
- advocates for the patient and can challenge medical decisions
What is the court of protection?
Deals with decisions re. property, welfare and health for a person who lacks capacity
What is the Office of Public Guardian?
Helps people manage health and financial decisions for those who lack capacity
