204 abuse booklet

Types of abuse...
Physical – Punching, Kicking, Scratching, slapping, biting, scalding, hair pulling, poking, pushing, pinching, burning, shoving, tripping over, binding limbs, choking, beating, cutting, starvation, imprisonment, force feeding, deliberate dehydration, twisting arms, sleep deprivation, torture, drowning, bruising,
Signs or Symptoms:-Injuries that have not received medical attention, frequent or regular falls and injuries, “pepper-pot bruising” finger-marks, bruising in areas not normally bruised (inside of thighs or arms) burns or scalds in unusual places, ulcers, sores or rashes caused by bed wetting, loss of confidence, lack of interest in appearance, sleeping problems, feeling depressed.
Financial – Stealing money or property or allowing or encouraging others to do so, persuading others to make financial decisions which are not in their interest, withdrawing or refusing access to money , refusing to allow individuals to manage their own financial affairs, failing to support individuals to manage their financial affairs.
Signs or Symptoms:-Missing cash or belongings, missing bank account records, sleeping problems, feeling depressed, sudden change of attitude towards financial matters, unpaid bills, basic needs not being met, lack of cash on a day to day basis.
Emotional/Psychological – Humiliation, bullying, making threats, shouting or swearing, racial abuse, constant teasing or poking fun
Signs or Symptoms:- Sleeping problems, feeling depressed, becoming afraid of making decisions, sudden change in behaviour, becoming quiet and withdrawn.
For further information or advice
Care Quality Commission – www.cqc.org.uk – 0300 061 6161
City of York Saferguarding Adults – www.safeguardingadultsyork.org.uk – 01904 555111
Emergency Duty Team – 0845 034 9417
North Yorkshire Police – 0845 606 0247

The Care Standards Act 2000 – came into effect in April 2002, replacing the Residential Homes Act 1984 and the Residential Homes Amendment Act 1991. The Act set up a new system of national minimum standards for services it established a major regulatory framework for social care to ensure high standards of care and will improve protection of vulnerable people. Implementation led to the establishment of the independent National Care Standards Commission (NCSC).

Quality Care Commission –aim‘s to promote improvements in care via its triple functions of inspection, regulation and review of all social care services. It provides a comprehensive overview of social care in England and works at a local level, at a national level, and across all sectors. Regular reviews of social care provision are published.
General Social Care Council (GSCC) – The first ever UK-wide codes of practice for social workers and employers were launched in September 2002. It is the regulatory body for the social care workforce in England. Their codes of practice provide a clear guide for all those who work in social work, setting out the standards of practice and conduct workers and their employers should meet. They are a critical part of regulating the workforce and helping improve levels of professionalism and public protection.
Safeguarding Vulnerable Groups Act (2006) barring scheme - The Safeguarding Vulnerable Groups Act (2006) introduced a new vetting and barring scheme for those who work with children and vulnerable adults. The scheme covers health and social care services. All new job applicants who will be working with children or vulnerable adults must have a Criminal Records Bureau (CRB Disclosure) which gives prospective employers information about any criminal records history guiding their decision on the applicant’s suitability to work with children or vulnerable adults.
Sexual – Sexual penetration of any part of the body, touching inappropriate parts of the body without informed agreement, sexual exploitation, and threats about sexual activity.
Signs or Symptoms:-Unusual sexual behaviour, blood or marks on underclothes, recurrent genital/urinary infections, loss of confidence, lack of interest in appearance, sleeping problems, feeling depressed, frequent complaints of abdominal pain.
Institutional –Not given choices regarding meals bedtime etc, freedom to go out is limited, privacy and dignity are not respected, personal correspondence is opened by staff, excessive doses of medication, access to advice restricted, complaints procedures made unavailable.
Signs or Symptoms:- Inability to make choices or decisions, Agitation if routine broken, disorientation, patterns of challenging behaviour.
Self Neglect – Lack of personal hygiene, lack of care in regards to appearance, failure to eat or buy food, failure to maintain a clean living environment, refusing or not obtaining medical help, unwilling to accept support, unwilling to see people or go out.
Signs or Symptoms:-Poor personal hygiene, no food in cupboards or fridge, rapid weight loss.
Neglect by Others – Not assisting with eating when required, not ensuring receiving personal care or adequately clothed, leaving individual alone, not assisting individual with communication and mobility needs, not maintaining a clean, hygienic, safe and secure environment, failing to obtain necessary medical help, not supporting social interactions/contacts.
Signs or Symptoms:-Become ill, hungry, cold, dirty, injured, deprived of their rights, rapid weight loss.
Actions to be taken...
...If you suspect an individual is being abused –
Observe the person
Ask if they are ok
Record the concerns
Don’t ask leading questions e.g. “Did Mr X punch you?”
Inform/ report it to our line manager following the whistle blowing policy and procedures put in place by Mencap
Or go above line manager if it directly involves them (e.g. union or company manager)
...If an individual alleges that they are being abused –
Listen
Ask open questions. Do not ask detailed or probing questions
Remain calm. Do not express shock or dismay
Allow person to express their feelings including their fear
Ask for information about what they are scared of and when they might be most at risk
Acknowledgement regret and concern for what has taken place
Help them to minimise the abuse they are experiencing and recognise the impact that living with abuse can have on physical and emotional wellbeing
Tell them the abuse is not their fault
Reassure them that there is help available and that what they say will be taken seriously
Summarise what you think they have said and ask if you have got it right
Roles of different agencies and professions in safeguarding adults...
The Independent Safeguarding Authority’s (ISA) - role is to help prevent unsuitable people from working with vulnerable adults. We assess those individuals working or wishing to work in regulated activity that are referred to us on the grounds that they pose a possible risk of harm to vulnerable groups. There are two principal routes by which referrals are made to the ISA. Firstly, when a person applies for ISA registration, any cautions which are considered relevant would trigger a referral. The other way a referral would be made is where an employer or an organisation, for example, a regulatory body, has concerns that a person poses a future risk of harm to vulnerable adults. In these circumstances the employer or regulatory body must make a referral to the ISA.
No Secrets - Provides guidance to local agencies that have a responsibility to investigate and take action when a vulnerable adult is believed to be suffering from abuse. It offers a structure and content for the development of local Inter-agency policies, procedures and joint protocols which will draw on good practice nationally and locally; and encourages partnership working between all statutory, voluntary and private agencies that work with vulnerable adults.
P.O.V.A List – The Care Standards Act 2000 introduced a list for the protection of vulnerable adults known as ‘the POVA list’ which listed care workers who were considered unsuitable to work with vulnerable adults. Section 82(1) of the Act provides that a person who provided care for vulnerable adults must refer a care worker to the Secretary of State if the provider had dismissed a care worker on the grounds of misconduct which harmed or placed at risk of harm a vulnerable adult.
National policies and local systems that relate to safeguarding and protection from abuse...
No Secrets (Department of Health 2000)
Safeguarding of Vulnerable Adults policy, (SOVA)
Care Quality Commission (CQC)
Mental Capacity Act
Independent Safeguarding Authority (ISA)
National Occupational Standards
General Social Care Commission
In Safe Hands

Clarify details where appropriate – especially names and contact details, but remember you are not investigating at this point in time
Tell them that you will have to tell your manager what they have told you
Tell them if the circumstances mean you will have to share information with other agencies because they or someone else are at serious risk
Tell them what will happen next and when they can expect to hear what actions will be taken
Make sure they will be safe while you take any actions you need to take
Report the allegation immediately Hand over to a senior person to investigate further, and inform the Authorities.
Write down what is said at the time, as a reminder of the details. Your manager may request you to complete an official report with full details. This will become a legal document and the details contained in it must be accurate, concise, dated and signed. I t should not have anything added or deleted and any errors should be initialled. This information is confidential and should not be discussed with others.

Ways to ensure that evidence of abuse is preserved...
Incidents of physical and/or sexual assault –
Following allegations of physical and/or sexual assault, consideration will be given to organising with the abused adults consent, a medical examination. Any examination will be carried out by a forensic medical examiner who will be contacted by the police.
If the abused person has a physical injury and it is appropriate for you to examine, always obtain their consent first
Only touch what you have to. Wherever possible, leave things as they are
Strongly advise the abused person not to wash or remove clothing
Preserve the abused person’s clothing and footwear, do not wash or wipe them. Handle them as little as possible
Preserve anything that is used to comfort the abused person, for example, a blanket
Do not clean up, do not wash anything or in any way remove fibres, blood and the like
Try not to touch items/weapons. If you have to, as before keep handling to a minimum. Put them in a clean dry place until the police collect them
The room should be secured and no-one allowed to enter unless necessary to support you, the abused person and/or the alleged perpetrator, until the police arrive
If the alleged perpetrator is also a service user, a separate member of staff needs to be assigned to them

Incidents of Theft/Financial Abuse –
With the person’s consent, secure all receipts, bank statements, benefit books and the like.