Safeguarding
Safeguarding of adults and children.
Introduction
This policy sets out the requirements for Freehab Ltd to discharge its appropriate accountability for safeguarding children, young people and adults at risk of harm or abuse. As providers of healthcare, we may, during the fulfilment of our job role, come into contact with children, young people, vulnerable adults and their families. When we come into contact with these groups, you have a duty to safeguard and protect their welfare.
The legislation underpinning this guidance is: The Children Act 1989, The Children and Social Work Act 2017, Working Together to Safeguard Children 2018, The Care Act 2014, Safeguarding Vulnerable Groups Act 2006, The Mental Capacity Act 2005, The Mental Health Act 2007, The National Health Service and Community Care Act 1990, Human Rights Act 1998 and the Equality Act 2010.
Equality and diversity are important to both NHS England and NHS Improvement’s values. Throughout the development of this document, we have given due regard to the need to eliminate discrimination, harassment and victimisation, to advance equality of opportunity, and to foster good relations between people who share a relevant protected characteristic (as cited in the Equality Act 2010). This policy will not discriminate, either directly or indirectly, on the grounds of the nine protected characteristics (age; disability; gender reassignment; marriage and civil partnership; pregnancy and maternity; race; religion and belief; sex; and sexual orientation).
Application and Scope
This policy applies to all employees and workers of Freehab Ltd, including secondees into and out of the organisation, volunteers and Patient and Public Voice (PPV) partners, students, honorary appointees, trainees, contractors, and temporary workers, including those working on an associate contracted basis. For ease of reference, all employees and workers who fall under these groups will be uniformly referred to as ‘staff’ in this document.
Definitions and Terminology
Safeguarding means protecting a person's health, wellbeing and human rights; enabling them to live free from harm, abuse and neglect.
A child is a person aged under 18 years; young people aged 16 or 17 who are living independently are still defined as ‘children’.
A vulnerable adult is a person aged 18 years or above who may be in need of care because of a physical, learning or other disability, or because of their age or a physical or mental illness. This definition also applies to an adult who is unable to take care of him or herself properly, or who is unable to protect him or herself from significant harm or exploitation. This state of vulnerability may be permanent or temporary.
Definition of harm: Children
The purpose of outlining various types of harm is to bring to your attention the potential issues that may constitute a safeguarding concern. This list and the definitions are not exhaustive and should be considered as a general guide.
Physical Harm
Physical harm is defined as physical contact that results in discomfort, pain or injury It may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating, or otherwise causing physical harm. Supplying drugs to children, or the use of inappropriate or unauthorised methods of restraint, also falls under this definition.
Emotional and Psychological Harm
Emotional harm is defined as an action or inaction by others that causes mental anguish. It involves the repeated mistreatment of a child, such as conveying that they are worthless or unloved, inadequate, or not valued. Other examples of emotional and psychological harm may be:
Bullying.
Age or developmentally inappropriate expectations being imposed.
Preventing normal social interaction.
Causing a child to witness violence or harm to another individual (e.g. domestic violence).
Causing a child to feel frightened or in danger.
Exploitation.
Sexual Harm and Exploitation
Sexual harm is defined as any form of sexual activity involving a child under the age of consent. It involves forcing or enticing a child or young person to take part in sexual activities, whether or not the child is aware of what is happening. It may also involve non-contact activities, such as involving children in looking at, or production of, pornographic material, causing them to watch sexual activities, or encouraging them to behave in sexually inappropriate ways.
Child Neglect
Neglect is a persistent failure to meet a child’s basic physical and/or psychological needs, which is likely to result in serious impairment of the child’s health or development.
Definitions of harm: Vulnerable adults
The purpose of outlining various types of harm is to bring to your attention the potential issues that may constitute a safeguarding concern. This list and the definitions are not exhaustive and should be considered as a general guide.
Physical Harm
Physical harm is any physical contact that results in discomfort, pain or injury. Examples may include:
Assault, rough handling, hitting, slapping, punching, pushing, pinching, shaking, bruising or scalding.
Exposure to excessive heat or cold.
A failure to treat sores or wounds.
Inappropriate use of medication (e.g. under- or overuse of medication, or the use of unprescribed medication).
The use of inappropriate sanctions.
The unlawful or inappropriate use of restraint or physical interventions.
The deprivation of liberty.
Emotional and Psychological Harm
Emotional harm is defined as an action or inaction by others that causes mental anguish. It involves the repeated mistreatment of a child, such as conveying that they are worthless or unloved, inadequate, or not valued. Other examples of emotional and psychological harm may be:
Bullying.
Preventing normal social interaction.
Causing somebody to witness violence or harm to another individual (e.g. domestic violence).
Causing a person to feel frightened or in danger.
Exploitation.
Sexual Harm and Exploitation
Examples of sexual harm and exploitation can include the direct or indirect involvement of the vulnerable adult in sexual activity or relationships that they:
Do not want or have not consented to,
Cannot understand and cannot consent to, since they lack the mental capacity (subject to The Mental Capacity Act, 2005), or
They have been coerced into via grooming activities; or because the other person is in a position of trust, power or authority.
Neglect and/or Self Neglect
Neglect occurs when a person’s well-being is impaired because his or her care or social needs are not met. This may be as a result of poor assessment and provision of services from health and social care services when an assessed need has previously been identified. This may also be as a result of self-neglect when an individual is failing to meet their own basic care requirements such as maintaining their personal hygiene or personal environment. In this instance, the individual may require an assessment of their capacity by a relevant health or social care professional.
Discrimination
Discrimination exists when values, beliefs or culture result in a misuse of power, or the denial of rightful opportunities, so causing harm. Any psychological abuse that is racist, sexist, or linked to a person’s sexuality, disability, religion, ethnic origin, gender, culture, or age, is discriminatory
Financial Harm
Financial harm is the use of a person’s property, assets, income, funds or other resources without their informed consent or authorisation.
Reporting concerns
Freehab Ltd and it’s staff have a professional duty to report concerns if we have an honestly held belief that a person (vulnerable adult or child), is suffering, or is at risk of harm, or has been harmed. The local authority (social services) will be our first point of contact if we have concerns about the welfare of a child or vulnerable adult. If our concern is of such a nature that we believe a crime has been committed, we will also report our concerns to the police. If it is an emergency, we will call 999. If it is not an emergency it will be reported to 101.
A local authority must enquire whether it needs to take safeguarding action if it has reasonable cause to suspect a child in its area is suffering, or is at risk of, significant harm (Section 47 Children Act 1989).
Local Authorities must promote the adult’s ‘well-being’. Within this broad concept, the authority must have regard to the need to protect people from abuse and neglect’ (Section 1 (2) (c) Care Act 2014). If a local authority has reasonable cause to suspect that an adult in its area is suffering, or is at risk of abuse or neglect, and has needs which leave him or her unable to protect himself or herself, then it must ensure enquiries are made in order to decide what action (if any) should be taken, and by whom - this is the “Duty to Enquire” (Section 42 Care Act 2014).
When concerns are reported, the safeguarding form should be completed and saved on the patient electronic record. The form will detail all of the information about the concern and information about who it has been reported to.
Information sharing and data protection
Where we feel concerns need to be reported, we will attempt to obtain the consent of the patient to share the concerns with the local authority or police (as long as this will not introduce the risk of harm).
If it is not possible to obtain consent, we will contact the local authority for advice on the matter, keeping the patient's identity confidential. We will follow the advice provided by the local authority.
The General Data Protection Regulations and Data Protection Act 2018 allow the sharing of information without an individual's consent under certain circumstances. There are a number of circumstances where we can reasonably override a vulnerable adult or child’s wishes, including:
If the person lacks the mental capacity under the Mental Capacity Act 2005 to make such a decision. (Where we are unsure if the person lacks Mental Capacity but have reason to believe they might, we will report our concerns and allow capacity to be assessed by the relevant authorities);
If other people are, or may be, at risk, including children and/or other vulnerable adults;
If sharing the information could prevent a crime;
If the alleged abuser has care and support needs and may also be vulnerable or at risk;
If a serious crime has been committed;
If the person is, or you suspect them to be, under duress or being coerced; and
If a court order or other legal authority has requested the information.
Step by step reporting process
A safeguarding concern is identified about a child or vulnerable adult.
Decide whether the concern is in relation to potential criminal activity and should be reported to the police in addition to the local authority.
Attempt to obtain the consent of the patient to share information about the concern with the local authority.
If consent is obtained - report the concern to the local authority providing as much detail as possible. Record all of this information on the safeguarding form and save it to the electronic patient record.
Where consent is not obtained - Contact the local authority for advice about reporting the concern, ensuring the identity of the patient is kept confidential.
Follow the reporting advice provided by the local authority and record this on the safeguarding form, saved to the electronic patient record.
OR - if the concern is deemed to be urgent, or meets the conditions for sharing without consent outlined above, share the concerns with the relevant statutory authority.
Once the reporting is complete, ensure that all records are up to date on the electronic patient record.
Additional Resources
(England) Working Together to Safeguard Children, HM Government, 2013 - link
(Wales) Safeguarding Children: Working Together Under the Children Act 2004, Welsh Assembly Government - link
(Scotland) National Guidance for Child Protection in Scotland, Scottish Government - link
(Northern Ireland) Cooperating to safeguard children, Department of Health - link
The Social Care Institute for Excellence (SCIE) provides extensive information on safeguarding for adults - link
Adult safeguarding: statement of government policy 2013 - GOV.UK - link