Safeguarding Flashcards
What is the GMC guidance about when to break confidentiality if a domestic abuse victim declines help/ referral?
usually abied by refusal to consent to disclosure, even if decision leaves them (but no one else) at risk of death or serious harm
but if child in environment: legally you can disclose information about (potentially at risk even though not actively being abused) - local authorities have responsibility to investigate where child thought to be at risk
What are 6 aspects of the safeguarding procedures for children in which there is a household where domestic abuse occurs but mother declining consent for disclosure?
- Call police if immediate risk
- Discuss with safeguarding lead in practice
- Contact local safeguarding team - usually via social service
- Explain to person whose confidentiality will be broken (unless compelling reasons not to)
- Ask for consent (unless reaon not to)
- Can share info without consent if justified in public interest or required by law
What is a key part of legislature supporting disclosing information about domestic abuse in a household if a child is at risk?
Children Act 1989
What is a useful way to help a patient idetnify if they’re in an abusive situation?
Duluth Wheels
What are 4 things to consider if a patient refuses help for domestic abuse (and no others at risk)?
- Explore reasons for refusing help
- Encourage to consider how they could benefit from it
- Prompt to consider potential consequences of not taking action
- Provide information about sources of support - or offer to see them again
What are 3 laws/rules regarding the breaking of confidentiality?
- Common law - principles that guide doctor/patient confidentiality
- Data protection - GDPR and DPA 2018 - guides what can be done with personal info
- Professional duty outlined in GMC - only if others at risk e.g. someone prepared to use weapons, children at risk
What is an example of support available that should be highlighted to victims of domestic abuse?
National domestic violence helpline 0808 2000 247 (won’t show up onlandline bills - may on mobiles so dial 141 first)
What action should be taken if the victim of domestic abuse is pregnanct?
potential child abuse once child born - if think there’s sufficient evidence of risk to unborn and then born child, confidentiality should be broken and safeguarding procedures initiated
should ideally tell parent this is happening - think about safety of mother too
What legislation is there regarding vulnerable adults?
Care Act 2014 Section 42 - even if have capacity and therefore autonomy, if classed as vulnerable have a duty to look at safeguarding
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A local authority has a duty to make enquiries itself or cause other to make enquiries in cases where it has reasonable cause to suspect that an adult:
- Has needs to care and support (whether or not the local authority is meeting any of those needs)
- is experiencing, or at risk of, abuse or neglect
- as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of, abuse or neglect.
What should you do if a vulnerable adult refuses consent to disclosure even if their decision puts them at risk of harm?
if puts them but no one else at harm, usually abide by their refusal
give information and support for them to make decisions in their own interests e.g. by arranging contact with agencies to support people who experience domestic violence
What are the 6 principles of adult safeguarding?
- empowerment: presumption of person-led decisions and informed consent
- protection: support and representation for those in greatest need
- prevention: taking action before harm occurs
- proportionate and least intrusive responses: appropriate to the risk presented
- partnership: local solutions through services working with their communities
- accountability: accountability and transparency in delivering safeguarding.
When does the out of hours time officially begin?
after 6:30pm (doesn’t apply on weekends and bank holiday)
What is the core contract legislation regarding GP povision of primary medical services and the hours they’re provided?
- must provide primary medical services required in core hours for the immediately necessary treatment of patients
- only required to provide OOH serviec if in their reasonable opinion, would not be reasonable for patient to wait to obtain those services
What is a mnemonic to help patients identify if they’re being abused (in addition to duluth wheels)?
HARKS:
- Humiliate – Do you feel like you have done something wrong?
- Afraid – Do you feel afraid?
- Rape – have you ever had sex against your will, or done anything that you did not want to do sexually?
- Kick – have you been hurt? Have you been threatened? Have they caused damage to your house, possessions?
- Safety – Do you feel safe? Can you go home?
What will happen if an abuse victim contacts the National Domestic Abuse Helpline?
- The national helpline will arrange a DOMESTIC VIOLENCE ADVISOR (DVA) to arrange an initial assessment.
- If the victim scores highly on the assessment they will arrange a MARAC (multiagency risk assessment conference)
- The DVA can provide an alarm that is linked to the police with a 12 min response time.
