The Safeguarding Process
What is Safeguarding?
Safeguarding an adult is defined as:
'Protecting a person’s rights to live in safety, free from abuse and neglect'
Source: Care Act 2014
Who is an adult at risk?
The Care Act 2014 places a legal duty for safeguarding adults at risk when someone 18 years and over, meets the following criteria:
- Has needs for care and support (whether or not a local authority is meeting any of those needs) and
- is experiencing ,or at risk of, abuse or neglect, and
- as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse and neglect.
This definition replaces the No Secrets guidance (DH2000) where the term ‘vulnerable’ was used.
If an adult meets the above criteria they will be assessed and considered for support through the safeguarding procedures.
It is key to remember that:
- Anyone can be a source of harm, including family members, partners, friends, neighbours, someone who works for the individual e.g. a personal assistant, strangers or people who work for or volunteer in health or social care services. It is very often though that the source of harm is in a position of trust and known to the person.
- Abuse can happen anywhere. It can happen in the home, in a workplace, in a nursing or residential home, in hospital or in the street.
- Abuse can happen once, a few times or lots of times. It can be deliberate or unintentional perhaps as a result of a lack of training, knowledge or understanding.
Categories of abuse
The following are categories of abuse within the Care Act:
- Physical - Hitting, slapping, pushing, kicking, misuse of medication, restraint, or inappropriate sanctions.
- Sexual - Rape and sexual assault or sexual acts to which the vulnerable adult has not consented, or could not consent, or was pressured into consenting.
- Psychological - Emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, isolation or withdrawal from services or supportive networks.
- Financial or material - Theft, fraud, exploitation, pressure in connection with wills, property or inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.
- Neglect and acts of omission - Ignoring medical or physical care needs, failure to provide access to appropriate health, social care or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating.
- Discriminatory - Racist, sexist, that based on a person’s disability, and other forms of harassment, slurs or similar treatment.
- Hate crime – Hate crimes and incidents are taken to mean any crime or incident where the perpetrator’s hostility or prejudice against an identifiable group of people is a factor in determining who is victimised. A person may be targeted because of hostility or prejudice towards that person’s: disability, race or ethnicity, religion or belief, sexual orientation or transgender identity. The crime can be committed against a person or property and a victim does not have to be a member of the group at which the hostility is targeted. In fact, anyone could be a victim of a hate crime.
- Mate crime – is similar to hate crime other than a perpetrator purports to be a friend or mate of the victim.
- Organisational (replaces institutional) – including neglect and poor care practice within an institution or specific care setting such as a hospital or care home, for example or in relation to care provided in one’s own home. This may range from one off incidents to ongoing ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practice within an organisation.
- Self-Neglect - this covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding. Because Self-Neglect is now a category of abuse, the former process of Vulnerable Adults Risk Management Model (VARMM) is now included within the safeguarding process but is now termed Self Neglect Adults Risk Management Model (SNARMM). For further information on how to manage cases within this model please refer to the Sheffield Safeguarding Adult Procedures.
- Modern slavery - encompasses slavery, human trafficking, forced labour and domestic servitude. Slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment.
- Domestic Abuse - including psychological, physical, sexual, financial, emotional and so called honour based violence .
This covers a wide range of behaviours, including neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding. Self-Neglect is now a category of abuse identified in the Care Act. The process of Vulnerable Adults Risk Management Model (VARMM) is now included within the safeguarding process.
The VARMM model involves planning a multi-agency meeting to discuss the involvement of and the knowledge held by each agency and develop an action plan that aims to reduce the risks.
The VARMM model can be used:
- Where an adult has capacity to make the decision(s) that is creating significant concern for agencies about the adults safety and/or wellbeing (risk of serious injury/death) and the adult is making that decision of their own free will.
- Where there is no external source of harm – the risk arises from the individual's refusal to engage with services and/or self-neglect in one or more areas of their lives.
- Where existing care management and health and social care involvement has failed to resolve the issues.
For further information on how to manage cases within this model please refer to the Sheffield Safeguarding Adult Procedures.