Adult Safeguarding - the Pharmacist role + perspective

Legislation + Process

MCA - assessing and making decisions on behalf of individuals who lack the mental capacity to make decisions for themselves. The MCA applies to all individuals aged 16 and above.

Safeguarding: Types of abuse

Neglect indicators – Poor hygiene, untreated medical issues, malnutrition

Self-neglect – an individual is unable or unwilling to take care of their on basic needs, leading to harm or danger to their health or well-being. The individual neglecting themselves may not seek help or fail to recognise the need for it ie do not know what the basic needs are, or the usual/expected care is

Physical indicators – A client suddenly starts showing visible bruising in areas that are difficult to explain

Behavioural indicators – An adult with learning disabilities becomes withdrawn when their caregiver enters the room

Domestic violence (DV) – broader term that encompasses not just physical abuse, but also emotional, psychological, sexual, + financial abuse within an intimate or domestic relationship ie between partners, spouses, or family members. Pattern of power + control

Modern slavery – Human trafficking, forced labour, child labour, sexual exploitation, debt bondage, domestic servitude

Discriminatory abuse – targets protected characteristics, such as race, gender or gender identity, age, sexual orientation, religion, disability + can take lots of forms such as verbal abuse, physical abuse, social exclusion

Levels of safeguarding for professionals

Level 1-2 Safeguarding

Level 1: All staff working in health and care settings

Level 2: All practitioners that have regular contact with patients, their families or carers, or the public

Level 3 Safeguarding

Registered health and care staff who engage in assessing, planning, intervening and evaluating the needs of adults where there are safeguarding concerns (as appropriate to their role)

Level 4 Safeguarding

Specialist roles, named professionals, lead doctors, heads of adult safeguarding, name GPs/doctors in primary care

Level 4 (gap analysis, self-neglect, fabricated illness, induced illness, homeless health etc)

Adults at risk of harm

Adults at risk of harm vs. vulnerable adults

Aged 18 or over

Have care or support needs

Experience or are at risk of abuse/neglect

Unable to protect themselves

May lack understanding and/or capacity for decision-making

Steven Hoskin

Actions to take if concerned

Consent? Informed consent?

Report ALL concerns

Immediate action

→ Are they safe? Options for engaging with that adult around risk, safety and wellbeing

→ Who is best to report to?

Documentation

→ What happened, individuals involved, actions taken

Protocols and policy to support

→ Organisational policy and protocol

Person centred support mechanisms

→ Access to emotional and practical support

Managing safeguarding concerns

Do not press the person for more details

Do not stop someone who is freely recalling significant events

Do not dismiss what you have been told

Do not promise to keep secrets; but do explain that the information will only be passed to those who "need to know", and try to be specific about who these might be

Do not be judgmental e.g. "why didn't you run away? “

Do not make promises that you cannot keep

Do not contact the alleged abuser or anyone who might be in touch with him / her

Do not ask leading questions

Do not tell anybody who doesn't need to know – remember the rules of confidentiality

What do safeguarding adult boards do?

Authorise the policy, process, strategy and guidance required to support Board priorities and effective safeguarding

Publish a strategic plan that sets out how it will meet its main objectives

Scrutinise, challenge and maintain an overview of adult safeguarding

Ensure that Safeguarding Adult Reviews (SARs) are undertaken in accordance (S44 )the Care Act 2014

Assess whether partner agencies are fulfilling statutory obligations in relation to safeguarding adults at risk

Quality assure practice through joint audits of case files and identifying lessons to be learned

Monitor and evaluate effectiveness of training, including multi-agency training