16.1 Safeguarding Adults at Risk Policy & Procedure

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A. Introduction

B. Context

C. Definitions

D. Categories of Abuse: Signs and Possible Indicators

E. Key Principles

F. Responsibilities

G. Training

A. Introduction

The Safeguarding Adults at Risk Policy and Procedure represent Luminary’s commitment to safeguard adults at risk of harm.

The policy and procedure apply to ALL Luminary staff and volunteers. They represent Luminary’s commitment to:

working together with other agencies to prevent and protect adults at risk of abuse
empower and support people to make their own choices
investigate actual or suspected abuse or neglect
support adults and provide a service to adults at risk who are experiencing exploitation, abuse or neglect

B. Context

Unlike Child Protection, there is no statutory protection for, or definition of adults at risk of abuse.

There is a presumption that adults have the mental capacity to make informed decisions about their lives. If someone has been assessed as not having mental capacity, then decisions should be made in their best interests as set out in the Mental Capacity Act 2005.

Adults at risk should be given information, advice and support in a form they can understand and have their views included when decisions are being taken about their lives. All decisions taken about another person’s life should be timely, reasonable, justified, proportionate and ethical.

All staff have a duty to report any concerns or suspicions that an adult at risk is being, or is at risk of being, abused.
Actions to protect the adult from abuse should always be given a high priority by all organisations involved. Concerns or allegations should be reported without delay and given high priority.
Luminary will work to safeguard adults at risk, making their dignity, safety and well-being a high priority.
All staff have a duty to understand their role and responsibilities in regard to this policy and procedure.
Every effort should be made to ensure that adults at risk are afforded appropriate protection under the law.
As far as possible Luminary staff and volunteers must respect the rights of the person causing harm. If that person is also an adult at risk, they must receive support and their needs should be addressed.
Luminary staff will work effectively with interagency working in order to provide the most effective means of safeguarding adults.

C. Definitions

'Adult At Risk'

‘Adult at risk’ means adults who need community care services because of mental or other disability, age or illness and who is, or may be, unable to take care of themselves against significant harm or exploitation.

An adult at risk may therefore be a person who:

is unable to look after their own wellbeing, property, rights or other interests
misuses substances or alcohol
has a learning disability
has a physical disability and/or a sensory impairment
has mental health needs including dementia or a personality disorder
has been groomed, trafficked or exploited
has a long term illness or condition
is in need of care and support but is unable to demonstrate the capacity to make an informed decision about themselves
is elderly and frail due to ill health, physical disability, or cognitive impairment

Actions to protect the adult from abuse should always be given high priority. The dignity, safety and wellbeing of an individual should be a priority within any action taken.
In the context of safeguarding adults, the extent to which the adult is at risk is related to how able they are to make and exercise their own informed choices free from duress, pressure or undue influence of any sort, and to protect themselves from abuse, neglect and exploitation. It is important to note that people with capacity can also still be ‘at risk’.
It is always essential in safeguarding to consider whether the adult at risk is capable of giving informed consent. If they are, their consent to any course of action should be obtained. This may be in relation to whether they give their consent to:

An activity that may be abusive – if consent to abuse or neglect was given under duress, for example, as a result of exploitation, pressure, fear, intimidation – this apparent consent should be. disregarded.
A Safeguarding Adults investigation going ahead in response to a concern that has been raised. Where an adult at risk with capacity has made a decision that they do not want action to be taken and there are no public interest considerations, their wishes must be respected. The person should be given information and have the opportunity to consider all the risks and fully understand the likely consequences of their decision over the short and long term.

If after discussion with the adult at risk who has mental capacity, they refuse any intervention, their wishes must be respected unless:

there is a public interest – eg not acting will put other adults or children at risk
there is a duty of care to intervene eg a crime has been, or will be, committed

We recognise that there are often complex issues and factors that many of the individuals may have experienced throughout some point in their lives. Such factors should be taken into consideration when looking at who an adult at risk may be. Many of the women that we will encounter will have various experiences of being homeless, fleeing exploitation and/or trafficking, prostitution, suffering from low self esteem, self harm, substance misuse, learning difficulties, emotional wellbeing needs or mental health issues such as Borderline Personality Disorder.
At all times Luminary will consider the welfare of the Adult at Risk to be of high importance. We are committed to achieving this by:

Actively striving to promote the empowerment and wellbeing of adults at risk through respectful and responsive high quality service provision.
Helping to prevent the physical, sexual, emotional or psychological, financial and discriminatory abuse and neglect of adults at risk and to report any such abuse that is discovered or suspected.
Believing and promoting that all individuals have the right to be able to live their lives free from exploitation, fear, abuse, harm or degrading treatment. All individuals have the right to protection from any such mistreatment and harm.
Believing and promoting that all individuals have the right to make choices and that their right to independence is actively encouraged. We acknowledge that such choices may at times involve an element of risk. We are committed to ensuring that any such risks are formally acknowledged and understood by all concerned, taking all reasonable measures to ensure risks are minimized wherever possible.
Being committed to respecting equal opportunities, anti -discriminatory practise and diversity issues.
All staff and volunteers are required not to share any private information or photos about the service users in any context.
Ensuring that the law and statutory requirements which relate to adults at risk are known and put into practice.
Safe recruitment, supervision and training for all those working with adults at risk within Luminary.

'Abuse'

‘Abuse’ is an emotive term and can be subject to interpretation, Luminary recognises that abuse can be “a violation of an individual’s human and civil rights by any other person or persons” (“No Secrets”, Department of Health 2000).

Abuse may be:

A single or repeated act
An act of neglect; lack of appropriate action taking place
Multiple acts; an adult at risk may be neglected and also financially abused

'The Abuser'

It is important to recognise that the ‘abuser’ could be anyone, including friends, relatives, family members, other Service Users, professional paid staff, volunteers and persons unknown to the adult at risk. They may also themselves be an adult at risk.

'Exploitation'

Exploitation is exerting undue influence or forcing an adult at risk to perform services for the benefit of others.

'SIGNIFICANT HARM’

The Law Commissioner’s Green Paper ‘Who Decides’ 1997 builds on the concept introduced in the Children Act, 1989 and suggests:

"Harm should be taken to include not only ill treatment (including sexual abuse and forms of ill treatment that are not physical); but also the impairment of, or an unavoidable deterioration in physical or mental health, and the impairment of physical, intellectual, emotional social or behavioural development.”

'No Secrets' also uses the concept of significant harm. This refers to:

Ill treatment
Impairment of physical or mental health
Impairment of physical, intellectual, emotional social or behavioural development

'No Secrets' puts forward the following factors to be taken into account when making an assessment of the seriousness of the risk to the person:

Vulnerability of the person
Nature and extent of the abuse or neglect
Length of time the abuse or neglect has been occurring
Impact of the alleged abuse
Impact of the alleged abuse
Risk of repeated or increasingly serious acts of abuse or neglect
Risk that serious harm could result if no action is taken
Illegality of the act

D. Categories of abuse: signs and possible indicators

Physical Abuse

Is the physical mistreatment or non-accidental injury of an adult. Some possible signs of abuse are detailed as follows:

Slapping
Kicking
Punching
Shaking
Bruising
Burns
Cutting

Indicators of possible physical abuse may include, but are not limited to:

An injury not fitting the explanation given
Unexplained or unusual fractures in various stages of healing
Bruises or burns in the shape of objects e.g. cigarette burns, belt buckles or water
Bruising in well protected areas e.g. behind the ears, on face, inside of the upper arms or thighs, buttocks, breasts, genital or rectal area
Lacerations
Unlawful or inappropriate use of restraint and/or deprivation of liberty is physical abuse

Neglect or Acts of Omission

This includes deliberate refusal to meet basic needs. Signs of neglect can include individuals experiencing the following:

Lack of choice, denied diversity
Poor judgemental attitudes
Derogatory terms used about the adult or their situation
Failure to ensure appropriate privacy and dignity
Poor surroundings e.g. neglect of repairs, inadequate heating
Over or under protective practices

Behaviour that can lead to neglect includes:

Ignoring medical or physical needs
failing to allow access to appropriate health, social and educational services

Indicators of possible neglect or omission may include, but are not limited to:

Loss of weight
Clothing in a poor condition
Failure to access appropriate health, educational services or social care

Unintentional neglect could result from a professional failing to meet the needs of the adult at risk because they do not understand the needs or may not know about the services available. It may also occur if the individuals are unaware of or do not understand the possible effect of the lack of action on the adult at risk.

Psychological or Emotional Abuse

This includes threats of harm, abandonment, isolation or humiliation which may result in the adult feeling in low mood, undervalued and perhaps unnecessarily dependant.

Some ways in which psychological/emotional abuse can take the form of are detailed below:

Failure to respond adequately to emotional needs
Failure to protect from the emotional abuse of others
Harassment or humiliation (bullying)
Intimidation
Failure to meet cultural requirements
Unreasonable demands
Denial of choice
Controlling or creating over dependence
Verbal abuse
Cyber bullying
Mental distress
Negating the right of the adult at risk to make choices and undermining their self esteem
Isolation and over dependence

Indicators of possible psychological or emotional abuse may include, but are not limited to:

Low self esteem
Tearfulness
Alteration in psychological state e.g. may appear to be withdrawn, agitated or anxious in general
Aggressive or challenging behaviour
Attention seeking behaviour
Self harm
Depression
Insomnia
Unexplained paranoia

Sexual Abuse

This is the involvement of any individual in any sexual activity to which they either cannot or have not given their consent or does not truly comprehend and so cannot give consent. Or where the other party is in a position of trust, power or authority and uses this to override or overcome lack of consent. Sexual abuse includes:

Rape or sexual assault
Inappropriate touching
Fondling
Sexual intercourse/buggery or attempted sexual intercourse/buggery
Inflicting pornography on an individual
Offensive or inappropriate language including sexual innuendos and sexual teasing

Indicators of possible sexual abuse may include, but are not limited to:

Change in usual behaviour
Overt sexual behaviour/language
Bleeding or pain in the genital/rectal area
Disturbed sleep pattern
Torn, stained or bloody underwear
Self‐harming

Financial or Material Abuse

This can be considered as unauthorised extraction of the adult at risk’s resources or their resources being withheld or misused by someone else and including:

Misuse, embezzlement or theft of a person’s money, property or possessions
Failing to account satisfactorily for the use of a person’s money, property or possessions, fraudulent use of money
Extortion of money, property, possessions through theft

Indicators of possible financial or material abuse may include, but are not limited to:

Lifestyle does not reflect known income
Unexplained withdrawals from account
Unexplained/sudden inability to pay service charge/bills etc.

Financial abuse is a crime.

Discriminatory Abuse

The inappropriate treatment of an adult at risk because of their age, gender, race, religion, cultural background, sexuality, disability, etc.

Discriminatory abuse exists when values, belief or culture result in a misuse of power that denies opportunity to some groups or individuals.

Discriminatory abuse links to all other forms of abuse and can include:

Unequal treatment
Inappropriate use of language:
- Racist remarks
- Sexist remarks
- Derogatory remarks or verbal abuse
- Comments about disability
- Bullying or other forms of harassment
- Deliberate exclusion

Indicators of possible discriminatory abuse may include, but are not limited to:

Inappropriate remarks or comments
Lack of respect shown to people
Staff member/volunteer may avoid being with certain groups of people

Institutional Abuse

Institutional abuse is the mistreatment or abuse or neglect of an adult at risk by individuals within an organisational setting where routines, systems and practices result in denying, restricting or curtailing the dignity, privacy, choice, independence or fulfilment of an adult at risk.

A number of inquiries into institutional abuse have shown that abuse is most likely to occur when staff:

Receive little support from management
Are inadequately trained
Are poorly supervised
Receive inadequate guidance

E. Key Principles

The most important priority is to ensure that the most urgent medical and welfare requirements of the adult at risk are met.

Preserve any potential forensic opportunities, record verbatim the disclosure made by the adult at risk.

Any sexual activity that is not freely consented to is criminal and should be reported to the police immediately, before any internal investigation.

Sexual relationships, or inappropriate sexual behaviour between a member of staff (or volunteer) and a service user are always abusive and will lead to disciplinary hearings. This will be in addition to any criminal actions taken.

A sexual relationship between the service user and a care worker is a criminal offence under Sections 38-42 of the Sexual Offences Act 2003.

There may be Safeguarding Adults referrals that involve sexual innuendo or remarks that will not result in a criminal investigation; however, all Safeguarding Adults referrals that indicate any form of sexual abuse require a risk assessment, intelligence gathering and appropriate information sharing with relevant partners.

F. Responsibilities

Duty Of Care

All staff & volunteers of Luminary have a ‘duty of care’ towards those who use our services.

This means taking action whenever there is a concern of possible mistreatment or abuse to an adult at risk. The procedural guidelines supporting this Policy are intended to provide a good practice framework and to support staff; staff are therefore expected to comply with them.

Failure to report any concerns may be viewed as being negligent or agreeing with the abuse, which in some cases could lead to disciplinary action.

All staff should:

Be aware that they must call the police/ambulance where appropriate
Share their concerns with appropriate colleagues and seek advice and support unless they are implicated in the abuse
Know they must inform the appropriate safeguarding officer as per escalation chart
Know that they must make a clear, factual record of their concern and the action taken using the Safeguarding Incident Reporting Form

In addition, Support Workers & Safeguarding Staff should:

Know what services are available and how to access help and advice
Know how and where to make a referral via Adult Social Care

Responsibility of Managers:

To ensure that the alleged victim is safe
To ensure that any staff or volunteer who may have caused the harm is not in contact with service users and others who may be at risk
To ensure that information is provided in a timely manner
Operate safe recruitment practices and ensure reference checks are made
Support staff who raise concerns

Monitoring

Safer Recruitment

All staff who work in a support-work capacity with our service users are subject to an enhanced disclosure check from the Disclosure and Barring Service.

For any team recruitment, an interview should be conducted, and two satisfactory references received, to assess an applicant’s suitability prior to an offer of employment or volunteering being made. On appointment staff and volunteers serve a probationary period for performance monitoring.

Volunteers within projects are recruited within the same processes as those for paid members of staff.

The named Safeguarding Adults Co-ordinator (SAC)- Alice Williams (Luminary CEO) will monitor any concerns and keep a record of safeguarding prompt logs compiled by staff. The SAC will report to the Charity Board on a quarterly basis.

G. Training

This policy and associated procedures are to be rolled out across Luminary through in- house training and in addition staff may access local authority Safeguarding Adult training.

Go Back To Safeguarding Page

16.1 Safeguarding Adults at Risk Policy & Procedure

Page Navigation

A. Introduction

B. Context

C. Definitions

D. Categories of Abuse: Signs and Possible Indicators

E. Key Principles

F. Responsibilities

G. Training

A. Introduction

The Safeguarding Adults at Risk Policy and Procedure represent Luminary’s commitment to safeguard adults at risk of harm.

The policy and procedure apply to ALL Luminary staff and volunteers. They represent Luminary’s commitment to:

working together with other agencies to prevent and protect adults at risk of abuse
empower and support people to make their own choices
investigate actual or suspected abuse or neglect
support adults and provide a service to adults at risk who are experiencing exploitation, abuse or neglect

B. Context

Unlike Child Protection, there is no statutory protection for, or definition of adults at risk of abuse.

All staff have a duty to report any concerns or suspicions that an adult at risk is being, or is at risk of being, abused.
Actions to protect the adult from abuse should always be given a high priority by all organisations involved. Concerns or allegations should be reported without delay and given high priority.
Luminary will work to safeguard adults at risk, making their dignity, safety and well-being a high priority.
All staff have a duty to understand their role and responsibilities in regard to this policy and procedure.
Every effort should be made to ensure that adults at risk are afforded appropriate protection under the law.
As far as possible Luminary staff and volunteers must respect the rights of the person causing harm. If that person is also an adult at risk, they must receive support and their needs should be addressed.
Luminary staff will work effectively with interagency working in order to provide the most effective means of safeguarding adults.

C. Definitions

'Adult At Risk'

An adult at risk may therefore be a person who:

is unable to look after their own wellbeing, property, rights or other interests
misuses substances or alcohol
has a learning disability
has a physical disability and/or a sensory impairment
has mental health needs including dementia or a personality disorder
has been groomed, trafficked or exploited
has a long term illness or condition
is in need of care and support but is unable to demonstrate the capacity to make an informed decision about themselves
is elderly and frail due to ill health, physical disability, or cognitive impairment

Actions to protect the adult from abuse should always be given high priority. The dignity, safety and wellbeing of an individual should be a priority within any action taken.
In the context of safeguarding adults, the extent to which the adult is at risk is related to how able they are to make and exercise their own informed choices free from duress, pressure or undue influence of any sort, and to protect themselves from abuse, neglect and exploitation. It is important to note that people with capacity can also still be ‘at risk’.
It is always essential in safeguarding to consider whether the adult at risk is capable of giving informed consent. If they are, their consent to any course of action should be obtained. This may be in relation to whether they give their consent to:

An activity that may be abusive – if consent to abuse or neglect was given under duress, for example, as a result of exploitation, pressure, fear, intimidation – this apparent consent should be. disregarded.
A Safeguarding Adults investigation going ahead in response to a concern that has been raised. Where an adult at risk with capacity has made a decision that they do not want action to be taken and there are no public interest considerations, their wishes must be respected. The person should be given information and have the opportunity to consider all the risks and fully understand the likely consequences of their decision over the short and long term.

If after discussion with the adult at risk who has mental capacity, they refuse any intervention, their wishes must be respected unless:

there is a public interest – eg not acting will put other adults or children at risk
there is a duty of care to intervene eg a crime has been, or will be, committed

We recognise that there are often complex issues and factors that many of the individuals may have experienced throughout some point in their lives. Such factors should be taken into consideration when looking at who an adult at risk may be. Many of the women that we will encounter will have various experiences of being homeless, fleeing exploitation and/or trafficking, prostitution, suffering from low self esteem, self harm, substance misuse, learning difficulties, emotional wellbeing needs or mental health issues such as Borderline Personality Disorder.
At all times Luminary will consider the welfare of the Adult at Risk to be of high importance. We are committed to achieving this by:

Actively striving to promote the empowerment and wellbeing of adults at risk through respectful and responsive high quality service provision.
Helping to prevent the physical, sexual, emotional or psychological, financial and discriminatory abuse and neglect of adults at risk and to report any such abuse that is discovered or suspected.
Believing and promoting that all individuals have the right to be able to live their lives free from exploitation, fear, abuse, harm or degrading treatment. All individuals have the right to protection from any such mistreatment and harm.
Believing and promoting that all individuals have the right to make choices and that their right to independence is actively encouraged. We acknowledge that such choices may at times involve an element of risk. We are committed to ensuring that any such risks are formally acknowledged and understood by all concerned, taking all reasonable measures to ensure risks are minimized wherever possible.
Being committed to respecting equal opportunities, anti -discriminatory practise and diversity issues.
All staff and volunteers are required not to share any private information or photos about the service users in any context.
Ensuring that the law and statutory requirements which relate to adults at risk are known and put into practice.
Safe recruitment, supervision and training for all those working with adults at risk within Luminary.

'Abuse'

Abuse may be:

A single or repeated act
An act of neglect; lack of appropriate action taking place
Multiple acts; an adult at risk may be neglected and also financially abused

'The Abuser'

'Exploitation'

Exploitation is exerting undue influence or forcing an adult at risk to perform services for the benefit of others.

'SIGNIFICANT HARM’

The Law Commissioner’s Green Paper ‘Who Decides’ 1997 builds on the concept introduced in the Children Act, 1989 and suggests:

'No Secrets' also uses the concept of significant harm. This refers to:

Ill treatment
Impairment of physical or mental health
Impairment of physical, intellectual, emotional social or behavioural development

'No Secrets' puts forward the following factors to be taken into account when making an assessment of the seriousness of the risk to the person:

Vulnerability of the person
Nature and extent of the abuse or neglect
Length of time the abuse or neglect has been occurring
Impact of the alleged abuse
Impact of the alleged abuse
Risk of repeated or increasingly serious acts of abuse or neglect
Risk that serious harm could result if no action is taken
Illegality of the act

D. Categories of abuse: signs and possible indicators

Physical Abuse

Is the physical mistreatment or non-accidental injury of an adult. Some possible signs of abuse are detailed as follows:

Slapping
Kicking
Punching
Shaking
Bruising
Burns
Cutting

Indicators of possible physical abuse may include, but are not limited to:

An injury not fitting the explanation given
Unexplained or unusual fractures in various stages of healing
Bruises or burns in the shape of objects e.g. cigarette burns, belt buckles or water
Bruising in well protected areas e.g. behind the ears, on face, inside of the upper arms or thighs, buttocks, breasts, genital or rectal area
Lacerations
Unlawful or inappropriate use of restraint and/or deprivation of liberty is physical abuse

Neglect or Acts of Omission

This includes deliberate refusal to meet basic needs. Signs of neglect can include individuals experiencing the following:

Lack of choice, denied diversity
Poor judgemental attitudes
Derogatory terms used about the adult or their situation
Failure to ensure appropriate privacy and dignity
Poor surroundings e.g. neglect of repairs, inadequate heating
Over or under protective practices

Behaviour that can lead to neglect includes:

Ignoring medical or physical needs
failing to allow access to appropriate health, social and educational services

Indicators of possible neglect or omission may include, but are not limited to:

Loss of weight
Clothing in a poor condition
Failure to access appropriate health, educational services or social care

Psychological or Emotional Abuse

This includes threats of harm, abandonment, isolation or humiliation which may result in the adult feeling in low mood, undervalued and perhaps unnecessarily dependant.

Some ways in which psychological/emotional abuse can take the form of are detailed below:

Failure to respond adequately to emotional needs
Failure to protect from the emotional abuse of others
Harassment or humiliation (bullying)
Intimidation
Failure to meet cultural requirements
Unreasonable demands
Denial of choice
Controlling or creating over dependence
Verbal abuse
Cyber bullying
Mental distress
Negating the right of the adult at risk to make choices and undermining their self esteem
Isolation and over dependence

Indicators of possible psychological or emotional abuse may include, but are not limited to:

Low self esteem
Tearfulness
Alteration in psychological state e.g. may appear to be withdrawn, agitated or anxious in general
Aggressive or challenging behaviour
Attention seeking behaviour
Self harm
Depression
Insomnia
Unexplained paranoia

Sexual Abuse

Rape or sexual assault
Inappropriate touching
Fondling
Sexual intercourse/buggery or attempted sexual intercourse/buggery
Inflicting pornography on an individual
Offensive or inappropriate language including sexual innuendos and sexual teasing

Indicators of possible sexual abuse may include, but are not limited to:

Change in usual behaviour
Overt sexual behaviour/language
Bleeding or pain in the genital/rectal area
Disturbed sleep pattern
Torn, stained or bloody underwear
Self‐harming

Financial or Material Abuse

This can be considered as unauthorised extraction of the adult at risk’s resources or their resources being withheld or misused by someone else and including:

Misuse, embezzlement or theft of a person’s money, property or possessions
Failing to account satisfactorily for the use of a person’s money, property or possessions, fraudulent use of money
Extortion of money, property, possessions through theft

Indicators of possible financial or material abuse may include, but are not limited to:

Lifestyle does not reflect known income
Unexplained withdrawals from account
Unexplained/sudden inability to pay service charge/bills etc.

Financial abuse is a crime.

Discriminatory Abuse

The inappropriate treatment of an adult at risk because of their age, gender, race, religion, cultural background, sexuality, disability, etc.

Discriminatory abuse exists when values, belief or culture result in a misuse of power that denies opportunity to some groups or individuals.

Discriminatory abuse links to all other forms of abuse and can include:

Unequal treatment
Inappropriate use of language:
- Racist remarks
- Sexist remarks
- Derogatory remarks or verbal abuse
- Comments about disability
- Bullying or other forms of harassment
- Deliberate exclusion

Indicators of possible discriminatory abuse may include, but are not limited to:

Inappropriate remarks or comments
Lack of respect shown to people
Staff member/volunteer may avoid being with certain groups of people

Institutional Abuse

A number of inquiries into institutional abuse have shown that abuse is most likely to occur when staff:

Receive little support from management
Are inadequately trained
Are poorly supervised
Receive inadequate guidance

E. Key Principles

The most important priority is to ensure that the most urgent medical and welfare requirements of the adult at risk are met.

Preserve any potential forensic opportunities, record verbatim the disclosure made by the adult at risk.

Any sexual activity that is not freely consented to is criminal and should be reported to the police immediately, before any internal investigation.

A sexual relationship between the service user and a care worker is a criminal offence under Sections 38-42 of the Sexual Offences Act 2003.

F. Responsibilities

Duty Of Care

All staff & volunteers of Luminary have a ‘duty of care’ towards those who use our services.

Failure to report any concerns may be viewed as being negligent or agreeing with the abuse, which in some cases could lead to disciplinary action.

All staff should:

Be aware that they must call the police/ambulance where appropriate
Share their concerns with appropriate colleagues and seek advice and support unless they are implicated in the abuse
Know they must inform the appropriate safeguarding officer as per escalation chart
Know that they must make a clear, factual record of their concern and the action taken using the Safeguarding Incident Reporting Form

In addition, Support Workers & Safeguarding Staff should:

Know what services are available and how to access help and advice
Know how and where to make a referral via Adult Social Care

Responsibility of Managers:

To ensure that the alleged victim is safe
To ensure that any staff or volunteer who may have caused the harm is not in contact with service users and others who may be at risk
To ensure that information is provided in a timely manner
Operate safe recruitment practices and ensure reference checks are made
Support staff who raise concerns

Monitoring

Safer Recruitment

All staff who work in a support-work capacity with our service users are subject to an enhanced disclosure check from the Disclosure and Barring Service.

Volunteers within projects are recruited within the same processes as those for paid members of staff.

G. Training

This policy and associated procedures are to be rolled out across Luminary through in- house training and in addition staff may access local authority Safeguarding Adult training.

Go Back to Safeguarding Page

16.1 Safeguarding Adults at Risk Policy & Procedure

Page Navigation

A. Introduction

B. Context

C. Definitions

D. Categories of Abuse: Signs and Possible Indicators

E. Key Principles

F. Responsibilities

G. Training

A. Introduction

The Safeguarding Adults at Risk Policy and Procedure represent Luminary’s commitment to safeguard adults at risk of harm.

The policy and procedure apply to ALL Luminary staff and volunteers. They represent Luminary’s commitment to:

working together with other agencies to prevent and protect adults at risk of abuse
empower and support people to make their own choices
investigate actual or suspected abuse or neglect
support adults and provide a service to adults at risk who are experiencing exploitation, abuse or neglect

B. Context

Unlike Child Protection, there is no statutory protection for, or definition of adults at risk of abuse.

All staff have a duty to report any concerns or suspicions that an adult at risk is being, or is at risk of being, abused.
Actions to protect the adult from abuse should always be given a high priority by all organisations involved. Concerns or allegations should be reported without delay and given high priority.
Luminary will work to safeguard adults at risk, making their dignity, safety and well-being a high priority.
All staff have a duty to understand their role and responsibilities in regard to this policy and procedure.
Every effort should be made to ensure that adults at risk are afforded appropriate protection under the law.
As far as possible Luminary staff and volunteers must respect the rights of the person causing harm. If that person is also an adult at risk, they must receive support and their needs should be addressed.
Luminary staff will work effectively with interagency working in order to provide the most effective means of safeguarding adults.

C. Definitions

'Adult At Risk'

An adult at risk may therefore be a person who:

is unable to look after their own wellbeing, property, rights or other interests
misuses substances or alcohol
has a learning disability
has a physical disability and/or a sensory impairment
has mental health needs including dementia or a personality disorder
has been groomed, trafficked or exploited
has a long term illness or condition
is in need of care and support but is unable to demonstrate the capacity to make an informed decision about themselves
is elderly and frail due to ill health, physical disability, or cognitive impairment

Actions to protect the adult from abuse should always be given high priority. The dignity, safety and wellbeing of an individual should be a priority within any action taken.
In the context of safeguarding adults, the extent to which the adult is at risk is related to how able they are to make and exercise their own informed choices free from duress, pressure or undue influence of any sort, and to protect themselves from abuse, neglect and exploitation. It is important to note that people with capacity can also still be ‘at risk’.
It is always essential in safeguarding to consider whether the adult at risk is capable of giving informed consent. If they are, their consent to any course of action should be obtained. This may be in relation to whether they give their consent to:

An activity that may be abusive – if consent to abuse or neglect was given under duress, for example, as a result of exploitation, pressure, fear, intimidation – this apparent consent should be. disregarded.
A Safeguarding Adults investigation going ahead in response to a concern that has been raised. Where an adult at risk with capacity has made a decision that they do not want action to be taken and there are no public interest considerations, their wishes must be respected. The person should be given information and have the opportunity to consider all the risks and fully understand the likely consequences of their decision over the short and long term.

If after discussion with the adult at risk who has mental capacity, they refuse any intervention, their wishes must be respected unless:

there is a public interest – eg not acting will put other adults or children at risk
there is a duty of care to intervene eg a crime has been, or will be, committed

We recognise that there are often complex issues and factors that many of the individuals may have experienced throughout some point in their lives. Such factors should be taken into consideration when looking at who an adult at risk may be. Many of the women that we will encounter will have various experiences of being homeless, fleeing exploitation and/or trafficking, prostitution, suffering from low self esteem, self harm, substance misuse, learning difficulties, emotional wellbeing needs or mental health issues such as Borderline Personality Disorder.
At all times Luminary will consider the welfare of the Adult at Risk to be of high importance. We are committed to achieving this by:

Actively striving to promote the empowerment and wellbeing of adults at risk through respectful and responsive high quality service provision.
Helping to prevent the physical, sexual, emotional or psychological, financial and discriminatory abuse and neglect of adults at risk and to report any such abuse that is discovered or suspected.
Believing and promoting that all individuals have the right to be able to live their lives free from exploitation, fear, abuse, harm or degrading treatment. All individuals have the right to protection from any such mistreatment and harm.
Believing and promoting that all individuals have the right to make choices and that their right to independence is actively encouraged. We acknowledge that such choices may at times involve an element of risk. We are committed to ensuring that any such risks are formally acknowledged and understood by all concerned, taking all reasonable measures to ensure risks are minimized wherever possible.
Being committed to respecting equal opportunities, anti -discriminatory practise and diversity issues.
All staff and volunteers are required not to share any private information or photos about the service users in any context.
Ensuring that the law and statutory requirements which relate to adults at risk are known and put into practice.
Safe recruitment, supervision and training for all those working with adults at risk within Luminary.

'Abuse'

Abuse may be:

A single or repeated act
An act of neglect; lack of appropriate action taking place
Multiple acts; an adult at risk may be neglected and also financially abused

'The Abuser'

'Exploitation'

Exploitation is exerting undue influence or forcing an adult at risk to perform services for the benefit of others.

'SIGNIFICANT HARM’

The Law Commissioner’s Green Paper ‘Who Decides’ 1997 builds on the concept introduced in the Children Act, 1989 and suggests:

'No Secrets' also uses the concept of significant harm. This refers to:

Ill treatment
Impairment of physical or mental health
Impairment of physical, intellectual, emotional social or behavioural development

'No Secrets' puts forward the following factors to be taken into account when making an assessment of the seriousness of the risk to the person:

Vulnerability of the person
Nature and extent of the abuse or neglect
Length of time the abuse or neglect has been occurring
Impact of the alleged abuse
Impact of the alleged abuse
Risk of repeated or increasingly serious acts of abuse or neglect
Risk that serious harm could result if no action is taken
Illegality of the act

D. Categories of abuse: signs and possible indicators

Physical Abuse

Is the physical mistreatment or non-accidental injury of an adult. Some possible signs of abuse are detailed as follows:

Slapping
Kicking
Punching
Shaking
Bruising
Burns
Cutting

Indicators of possible physical abuse may include, but are not limited to:

An injury not fitting the explanation given
Unexplained or unusual fractures in various stages of healing
Bruises or burns in the shape of objects e.g. cigarette burns, belt buckles or water
Bruising in well protected areas e.g. behind the ears, on face, inside of the upper arms or thighs, buttocks, breasts, genital or rectal area
Lacerations
Unlawful or inappropriate use of restraint and/or deprivation of liberty is physical abuse

Neglect or Acts of Omission

This includes deliberate refusal to meet basic needs. Signs of neglect can include individuals experiencing the following:

Lack of choice, denied diversity
Poor judgemental attitudes
Derogatory terms used about the adult or their situation
Failure to ensure appropriate privacy and dignity
Poor surroundings e.g. neglect of repairs, inadequate heating
Over or under protective practices

Behaviour that can lead to neglect includes:

Ignoring medical or physical needs
failing to allow access to appropriate health, social and educational services

Indicators of possible neglect or omission may include, but are not limited to:

Loss of weight
Clothing in a poor condition
Failure to access appropriate health, educational services or social care

Psychological or Emotional Abuse

This includes threats of harm, abandonment, isolation or humiliation which may result in the adult feeling in low mood, undervalued and perhaps unnecessarily dependant.

Some ways in which psychological/emotional abuse can take the form of are detailed below:

Failure to respond adequately to emotional needs
Failure to protect from the emotional abuse of others
Harassment or humiliation (bullying)
Intimidation
Failure to meet cultural requirements
Unreasonable demands
Denial of choice
Controlling or creating over dependence
Verbal abuse
Cyber bullying
Mental distress
Negating the right of the adult at risk to make choices and undermining their self esteem
Isolation and over dependence

Indicators of possible psychological or emotional abuse may include, but are not limited to:

Low self esteem
Tearfulness
Alteration in psychological state e.g. may appear to be withdrawn, agitated or anxious in general
Aggressive or challenging behaviour
Attention seeking behaviour
Self harm
Depression
Insomnia
Unexplained paranoia

Sexual Abuse

Rape or sexual assault
Inappropriate touching
Fondling
Sexual intercourse/buggery or attempted sexual intercourse/buggery
Inflicting pornography on an individual
Offensive or inappropriate language including sexual innuendos and sexual teasing

Indicators of possible sexual abuse may include, but are not limited to:

Change in usual behaviour
Overt sexual behaviour/language
Bleeding or pain in the genital/rectal area
Disturbed sleep pattern
Torn, stained or bloody underwear
Self‐harming

Financial or Material Abuse

This can be considered as unauthorised extraction of the adult at risk’s resources or their resources being withheld or misused by someone else and including:

Misuse, embezzlement or theft of a person’s money, property or possessions
Failing to account satisfactorily for the use of a person’s money, property or possessions, fraudulent use of money
Extortion of money, property, possessions through theft

Indicators of possible financial or material abuse may include, but are not limited to:

Lifestyle does not reflect known income
Unexplained withdrawals from account
Unexplained/sudden inability to pay service charge/bills etc.

Financial abuse is a crime.

Discriminatory Abuse

The inappropriate treatment of an adult at risk because of their age, gender, race, religion, cultural background, sexuality, disability, etc.

Discriminatory abuse exists when values, belief or culture result in a misuse of power that denies opportunity to some groups or individuals.

Discriminatory abuse links to all other forms of abuse and can include:

Unequal treatment
Inappropriate use of language:
- Racist remarks
- Sexist remarks
- Derogatory remarks or verbal abuse
- Comments about disability
- Bullying or other forms of harassment
- Deliberate exclusion

Indicators of possible discriminatory abuse may include, but are not limited to:

Inappropriate remarks or comments
Lack of respect shown to people
Staff member/volunteer may avoid being with certain groups of people

Institutional Abuse

A number of inquiries into institutional abuse have shown that abuse is most likely to occur when staff:

Receive little support from management
Are inadequately trained
Are poorly supervised
Receive inadequate guidance

E. Key Principles

The most important priority is to ensure that the most urgent medical and welfare requirements of the adult at risk are met.

Preserve any potential forensic opportunities, record verbatim the disclosure made by the adult at risk.

Any sexual activity that is not freely consented to is criminal and should be reported to the police immediately, before any internal investigation.

A sexual relationship between the service user and a care worker is a criminal offence under Sections 38-42 of the Sexual Offences Act 2003.

F. Responsibilities

Duty Of Care

All staff & volunteers of Luminary have a ‘duty of care’ towards those who use our services.

Failure to report any concerns may be viewed as being negligent or agreeing with the abuse, which in some cases could lead to disciplinary action.

All staff should:

Be aware that they must call the police/ambulance where appropriate
Share their concerns with appropriate colleagues and seek advice and support unless they are implicated in the abuse
Know they must inform the appropriate safeguarding officer as per escalation chart
Know that they must make a clear, factual record of their concern and the action taken using the Safeguarding Incident Reporting Form

In addition, Support Workers & Safeguarding Staff should:

Know what services are available and how to access help and advice
Know how and where to make a referral via Adult Social Care

Responsibility of Managers:

To ensure that the alleged victim is safe
To ensure that any staff or volunteer who may have caused the harm is not in contact with service users and others who may be at risk
To ensure that information is provided in a timely manner
Operate safe recruitment practices and ensure reference checks are made
Support staff who raise concerns

Monitoring

Safer Recruitment

All staff who work in a support-work capacity with our service users are subject to an enhanced disclosure check from the Disclosure and Barring Service.

Volunteers within projects are recruited within the same processes as those for paid members of staff.

G. Training

This policy and associated procedures are to be rolled out across Luminary through in- house training and in addition staff may access local authority Safeguarding Adult training.

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