Holistic/Direct Observation/Witness Statement Professional Discussion/ Questioning Record
Training Adviser Name: Lissa Hughes
Learner Name: Flavia MaiorWitness Name and relationship to learner:
Setting: Barton Lodge Residential Care Home
Unit Outcomes & Evidence
Outcome 1.5: Explain the protocols and referral procedures when harm or abuse is alleged or suspected
As a manager you should first judge the gravity of an incident. If considered minor, with no apparent harm or potential for significant harm having occurred, then the procedures for incident reporting in line with the regulatory requirements should be followed. This would be the case if an incident occurred which could be addressed via internal procedures, for example a one-off incident of poor practice with no significant harm. This should of course all be documented and actioned. On the other hand, if you have more serious concerns then an alert should be made and the following protocols followed:
Ensure the adult at risk is made safe and medical attention sought if needed.
Consider if the police need to be called if a criminal offence might have occurred (in which case preservation of evidence is paramount).
Ensure any person who may have caused harm has no contact with the adult at risk.
Consider issues of consent.
Raise an alert at the earliest opportunity, which should be no later than the end of the day on which the incident happened.
Details of the appropriate Adult Social Care department to contact to seek advice regarding alerts or to raise an alert must be easily accessible.
It is the manager’s responsibility to have clear internal reporting procedures for staff with safeguarding concerns, detailing which staffs are responsible for deciding whether or not to alert the local authority. This is mainly significant for services where the formal manager may not be available during out-of-office hours. When an alert is raised, the Safeguarding Adult Manager will plan with others a proportionate response based on the available information in line with local procedures.
Outcome 4.1: Explain how you would support the participation of vulnerable adults in a review of systems ; procedures
With the development of person-centered care, it follows that service users should be fully involved in reviewing safeguarding procedures. This was initially highlighted in the Health and Social Care Act 2001, then more specifically in ‘Safeguarding Adults’ in 2005 under Section 11 and again in ‘Putting People First’ in 2007.
At the same time as a lot of the focus is on what services can do in relation to their systems for safeguarding, an vital aspect is actually to inform and train vulnerable adults to recognize abuse.
SCIE has undertaken significant research into this area and has produced a report called ‘User Involvement in Adult Safeguarding’ (SCIE2011). Possible barriers to increased involvement have been fears about the appropriateness of discussing abuse in case this generated difficult feelings for individuals and maybe caused additional harm.
Other aspects might be explaining the complexities of safeguarding when looking at individual choice versus duty of care or public safety or even legal requirements.
There are examples of individuals having increased involvement in safeguarding issues. For example within learning disabilities, user groups have been directly involved in staff training or producing a DVD/film for ‘Keeping Safe’ training. Research does, however, conclude that this training is untested as yet in real life situations. Accessibility is also a key issue for some individuals (SCIE 2011b). Many services have little in place in this respect; a good starting point is discussing the issues in one-to-one sessions or as part of a service user meeting.
The ‘Adult Social Care Outcomes Framework’ was published in March 2012 by the Department of Health and details a simple framework for asking service users how ‘safe they feel’.
Outcome 4.2: evaluate the effectiveness of systems and procedures to protect vulnerable adults in your own service setting
It is beneficial to have set criteria to evaluate your systems against.
The next are areas to reflect:
Service user involvement in reviews;
Complaints and comments;
Whether all support/care plans are current;
Whether risk assessments reflect service user needs and choices.
It is vital that as an organization we assess our policies and improve and develop them as new criteria and legislation comes into place and is to be followed. All staff will receive updates and changes as to when these become in place and receive yearly ‘safeguarding alerts training’ upon assessment service users are explained the complaints and compliments process and this is also available in print format in their provider file which stays in their home.
A manager’s responsibility is to explain that as our duty of care as a care provider, safeguarding is a huge role in our responsibility and that any signs or evidence that things are out of the ordinary will be reported to the necessary professionals. Service users are to sign an authorisation form upon assessment to agree with the process and that they consent to information sharing on a need to know basis.
A manager’s responsibility is for all staff to have fully DBS checked and they are all trained to the same standard, this ensures that where reporting and whistle blowing is concerned everyone is familiar with the same policies.
As an organization there are certain national policies that we must stand by and some guidelines that have been recommended.
For instance- No secrets guidelines, influences us as an organization that we have a duty to investigate and take immediate action whenever we believe a vulnerable adult is at risk or is at harm. That we have a duty to report it to the appropriate people and take their lead if necessary.
Outcome 4.3: How would you challenge ineffective practice in the promotion of the safeguarding of vulnerable adults?
Unsuccessful practice must be challenged.
There may be many different reasons why it happens, but each case must be fully examined to determine what has occurred. This could come in the form of a complaint or a safeguarding alert, or else it might be the result of whistle blowing or even what you observe. Everything must be documented according to your own policies and procedures. It might also be suitable to record on a supervision record in a staff file, depending on the nature of the situation. As well as the potential for a safeguarding alert, a situation could also end up as a staff disciplinary action so accurate recording is essential.
Should practice need to be challenged, the situation should be approached in an assertive manner and the following areas considered in advance:
Are you clear about the facts of the situation?
What policies and procedures guide the practice in question?
Has adequate training been delivered?
Are there any other factors that led to the poor practice?
It is significant to listen to the employee’s explanation. It is good practice to have a ‘no blame’ culture but it is still your responsibility to address the situation.
Outcome 4.4: Identify any proposed improvements in your work place systems and procedures relating to the safeguarding and protection of vulnerable adults
It is valuable to have set criteria to assess your systems against.
The following are areas to consider:
Complaints and comments.
Service user participation in reviews.
Whether risk assessments reflect service user needs and choices.
Whether all support/care plans are up-to-date.
Precise monitoring of these systems would highpoint areas of concern and promotes continual and appropriate development within the service generally and personally for each service user.
In my personal opinion, I feel that Aspects policy and procedures in regards to Safeguarding and complaints are effective, consequently I feel that I do need to make any recommendations although if I felt that I did need to make recommendations to our policies and procedures then the factors I will need to deliberate as it follows:
To found whether there are lessons to be learned from the case about the way in which professionals and agencies work together to safeguard service users;
To establish what those lessons are, how they will be represented upon and what is expected to change as a outcome;
To develop interagency working and better safeguard vulnerable adults although when a serious case review happens, policies and procedures are altered to confirm the same situations do not get repeated.