OXFORDSHIRE VULNERABLE ADULT PROTECTION …



ITEM SC9

OXFORDSHIRE VULNERABLE ADULT PROTECTION COMMITTEE ANNUAL REPORT

January – December 2005

Agreed by Oxfordshire Vulnerable Adult Protection Committee: 21st July 2006

Writer of Report: Hugh Ellis

1. Introduction:

1. The Oxfordshire Adult Protection Committee is now in its third year of operation. This is its third annual report and covers the period January – December 2005.

2. A full list of committee members is attached at Annex 1 (page 9).

3. The agreed central role and purpose of the committee is defined as:

To promote the safety and well being of vulnerable people in Oxfordshire by:

• Encouraging the development of, and developing and agreeing local policies and procedures for inter agency work to protect vulnerable adults within the framework established by 'No Secrets'.

• Developing and providing training and information dissemination strategies that reflect and support agreed local policies and procedures for safeguarding adults.

• Providing advice and information on matters relating to adult protection and guidance on the implementation of adult protection policies and procedures in Oxfordshire and resources to facilitate this.

• Providing information to people in Oxfordshire on how to stay safe.

4. In addition Oxfordshire County Council has certain statutory obligations under section 7 of The Local Authorities (social services) Act 1971. These are outlined in ‘No Secrets’ (Department of Health, March 2000) and include in addition to that outlined in paragraph 1.3 the routine gathering of information about vulnerable adult abuse in Oxfordshire. This is now also a requirement of the annual Commission for Social Care Inspection (CSCI) Delivery and Improvement Statement (DIS).

2. Prevalence and Trends:

1. The information presented in this report is obtained from concerns, disclosures or allegations of vulnerable adult abuse reported to the Oxfordshire Vulnerable Adult Protection Worker.

2. The definitions of abuse used are included in Annex 2 (page 10).

3. Reporting rates for 2005 continue to show an increase on previous years [ref. Table 1].

Table 1 [pic]

4. The majority of concerns, 62%, relate to people over 65 years of age. However, people with a learning disability appear per capita to be the most vulnerable group with reporting rates of approximately 5% of adults with a learning disability receiving services from S&CS.

5. Table 2 illustrates the proportion of concerns expressed in relation to the total number of clients receiving a service from S&CS for the period 01/04/05 to 31/03/06. Figures for people with learning disabilities, physical disabilities and mental health needs are for those between the ages of 18-64. Extrapolated figures for 2006 are included and are based on the period 01/01/06 to 30/06/07.

Table 2

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6. Table 3 illustrates the age distribution of vulnerable adults reported to be at risk of harm as a result of abuse.

Table 3

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7. There has been no statistically significant change in the percentage of concerns relating to people over 65 (63% in 2004 cf. 62% in 2005). However, there has been a marked increase in the number of concerns relating to people between the ages of 85-94.

8. Reports of physical and emotional abuse continue to be the most prevalent with physical abuse being reported in 47% and emotional abuse being reported in 43% of cases. More than one type of abuse may be cited in each case [Table 4].

Table 4

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9. There is no significant change overall in the relative frequency of abuse types reported. However, 10 fewer cases of financial abuse of older people were reported in 2005 with a proportional increase in the number of similar cases reported among under 65’s.

10. In 44% of reported concerns the alleged abuser was a relative, friend or acquaintance of the victim compared with 35% of cases that involved paid staff [Table 5].

Table 5

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11. There has been a small decrease in the proportion of concerns in which the alleged perpetrator was a relative, friend or acquaintance. The most significant increase over the period related to the number of concerns of abuse by another service user/vulnerable adult.

12. Financial abuse was reported as a concern in 30% of cases.

13. However, financial abuse was identified as a concern in over 40% of cases where the alleged perpetrator was a family member, friend or acquaintance compared with only 11% of concerns relating to paid staff [Table 6].

Table 6

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3. Priorities and Actions 2005 and implications for 2006

1. These are outlined in Annex 3 (page 10).

2. Of the actions set out in last years plans 7 were achieved, 2 partially achieved, 2 not achieved and 1 discontinued.

3. The introduction of the new S&CS Safeguarding Adults/Adult protection procedures introduces the new role of ‘safeguarding manager’ in line with “Safeguarding Adults” [ADSS, 2005]. This role clearly locates the responsibility for coordinating the response to safeguarding adults/adult protection alerts/referrals with senior practitioners and managers within the purchasing and commissioning teams in S&CS. The launch of the new procedures has been supported by the introduction of mandatory training for this group.

4. All adult protection alerts/referrals should now be directed to the responsible team and a ‘safeguarding manager’ should be identified to coordinate the response.

5. To further support the new procedures recording and monitoring forms have been rationalised and made generally available on the intranet. Future data analysis should be able to identify which teams are responding to concerns in accordance with the procedures and by implication where training/development needs to be focussed.

6. There will also be greater reliance on teams for ensuring that information about adult protection is copied to the Adult Protection Worker for the required analysis.

7. To counteract this we will be working with the committee to explore ways of developing the safeguarding manager role in the other statutory agencies.

8. To further support the new procedures a further level of training is required to address the needs of provider managers, social workers and other professionals in carrying out investigations and assessments in adult protection cases.

9. A framework of levels, standards and competencies for the delivery of adult protection training in Oxfordshire is to be completed by September 06.

4. Action Plan for 2006

1. The action plan for 2006 is outlined overleaf.

Action Plan for 2006

|Objectives |2006 Targets |Strategies |

|To have in place effective local policies and procedures for|Final ratification of S&CS procedures |Review initial implementation of S&CS Adult |

|inter- agency work to protect vulnerable adults within the |Commence implementation of recommendations from APC membership review |Protection/Safeguarding Adults procedures |

|framework established by 'No Secrets'. |Request ratification of Information Exchange protocol by APC |To consult with partner agencies regarding implementation of |

| |Ensure requirements of annual Delivery and Improvement Statement (DIS) are met |agency procedures |

| | |Conduct review of adult protection committee membership and |

| | |strategic links in context of ‘Safeguarding Adults’ [ADSS, 2005] |

| | |Establish process for following up initial alert/referrals to |

| | |obtain outcome data |

|To provide training and information that reflect and support|Agree framework of levels, standards and competencies for delivery of adult |Establish adult protection/safeguarding adults training subgroup |

|agreed local policies and procedures for safeguarding |protection/safeguarding adults training |Monitor feedback from current training and report back to APC |

|adults. |Continue implementation of multi agency training in: |Consult with key groups on content of training for investigation |

| |Identifying and responding to abuse (levels 1 & 2) |and assessment |

| |Coordinating and managing adult protection alerts, referrals and investigations |Report to Adult protection Committee and implement |

| |(level 3) |Consult with key groups on information and development strategy |

| |Commence implementation of training for investigation and assessment |Report to Adult protection Committee and implement |

| |Develop and implement information and development strategy | |

|To provide useful advice, support and information on matters|Develop and implement information and development strategy |Adult Protection Worker continue to provide advice and support |

|relating to adult protection and the implementation of adult| | |

|protection policies and procedures in Oxfordshire. | | |

|To provide accessible information to people in Oxfordshire |Commence implementation of public awareness and information strategy |Undertake review of other available web sites and information |

|on how to stay safe | |sources. |

| | |Present proposals to APC |

| | |Implement agreed recommendations |

ANNEX 1

Adult Protection Committee Membership

|Name |Title |Representing |

|Alan Sinclair |Operations Manager (Chair) |Oxfordshire Social & Community Services |

|DI Kath Lowe |Detective Inspector |Thames Valley Police |

|Jill Brookes |Head of Continuing Care Services for |RNCC |

| |Oxfordshire | |

|Sula Wiltshire |Director of Quality & Professional |Oxfordshire PCT’s |

| |Development | |

| |Oxford City PCT | |

|Linda Whitehead |Clinical Risk Manager, Oxfordshire & |Oxfordshire Mental Healthcare NHS Trust |

| |Buckinghamshire Mental Health Trust | |

|Helen Lewis |Operations and Development Director |Oxfordshire Learning Disability NHS Trust |

|Rachel Tams |Chartered Clinical Psychologist |The Nuffield Orthopaedic Centre NHS Trust |

| | |Oxford Centre for Enablement |

| | |The Nuffield Orthopaedic Centre |

|Fiona Turner |Head of Nursing |The Nuffield Orthopaedic Centre NHS Trust |

|Michael Fannings |Deputy Chief Nurse, |Oxford Radcliffe Hospitals NHS Trust, |

|Jean Ware-Morphy | |Lay member – representing the voluntary sector |

|Sandra Lemon |Regulation Manager |Commission for Care Standards Inspection |

|Gillian Impey |Legal services |Oxfordshire County Council |

|Trish O’Leary |Nursing Home Manager |Oarnh (Oxon. Association for Nursing Homes) |

|Vicky Field |Operations Manager Human Resources |Oxfordshire Social & Community Services |

|Alice Runnicles | |Age Concern Oxfordshire |

|Tarquin May |Team manager, Money Management |Oxfordshire Social & Community Services |

ANNEX 2

Definitions of abuse:

Abuse is defined as:

“…a violation of an individuals civil or human rights by another person or persons …”

“… it may consist of a single or repeated acts. It may be physical, verbal or psychological, it may be an act of neglect or an omission to act, or it may occur when a vulnerable person is persuaded to enter into a transaction to which he or she has not consented, or cannot consent. Abuse may occur in any relationship and may result in significant harm to, or exploitation of, the person subjected to it.”

Or:

“… a single or repeated act or lack of appropriate action occurring within any relationship where there is an expectation of trust which causes harm or distress to a vulnerable person.”

It may include:

Physical abuse, including hitting, slapping, pushing, kicking, misuse of medication, misuse of restraint, or inappropriate sanctions, unsafe practice including misuse of lifting and handling equipment;

Sexual abuse, including rape and sexual assault or sexual acts to which the vulnerable adult has not consented, or could not consent or was pressured into consenting;

Psychological abuse, including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, isolation or withdrawal from services or supportive networks;

Financial or material abuse, including theft, fraud, exploitation, pressure in connection with wills, property or inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits

Neglect and acts of omission, including ignoring medical or physical care needs, failure to provide access to appropriate health, social care or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating;

Discriminatory abuse, including racist or sexist remarks or comments based on a person’s impairment, disability, age or illness, and other forms of harassment, slurs or similar treatment. This may also include isolation or withdrawal from religious or cultural activity, services or supportive networks; and

Institutional abuse involves the collective failure of an organisation to provide an appropriate and professional service to vulnerable people. It can be seen or detected in processes, attitudes and behaviour that amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and stereotyping. It includes a failure to ensure the necessary safeguards are in place to protect vulnerable adults and maintain good standards of care in accordance with individual needs, including training of staff, supervision and management, record keeping and liaising with other providers of care.

ANNEX 3

Summary of Priorities and Actions 2005

|Proposed Priorities |Actions |Outcomes |

|To promote and encourage the development and adoption of shorter/summary policy |To prepare an exemplar policy for registered care providers. |Action achieved. |

|or guidance that addresses the differing individual and operational needs of |To prepare adult protection procedures for social work and care |The publication of Safeguarding Adults meant that the target date of|

|organisations and individuals. |management teams responsible for co-ordinating the response to |September 05 could not be meant. However, the new procedures were |

| |vulnerable adult abuse concerns. To be implemented by September 05. |implemented in January 06. They are subject to review in June/July |

| | |2006. Action achieved. |

|To develop a library of available training resources for the use of all |To identify and collate a list of current available resources. |Action outstanding. |

|agencies. To be included within OCC website. |Create OCC adult protection web-page |Action partially met. The new OCC website now includes information |

| | |on adult protection. In addition the S&CS intranet has now been |

| | |rationalised and includes the new procedures, electronic monitoring |

| | |forms and useful information. |

| | |Recommend: Actions to be retained for 2006. |

|To raise awareness through training, briefing etc of key professional groups. |To continue the development of lead groups within the main statutory|Action discontinued. However, a total of 287 S&CS staff are known to|

| |agencies, S&HC, PCT’s and Acute Trusts. |have received training in adult protection at levels 1,2 or 3. |

| |Training to levels 1,2 & 3. |In addition the new S&CS procedures for adult protection now places |

| | |responsibility for the management of all adult protection |

| | |alerts/concerns received by S&CS with key managers (known as |

| | |safeguarding managers). This is supported by the introduction of the|

| | |level 3 training that is mandatory for senior practitioners and |

| | |above working with adult purchasing and commissioning teams. |

| | |Recommend: Action not retained for 2006. |

| | |Action achieved. |

|To continue the monitoring of adult protection information. |Quarterly reports to APC. |Action achieved. |

| |Annual report to SMT. |Recommend: Target to be retained for 2006. |

|To address concerns that staff may not be recognising either adult protection |To commence level 3 adult protection training for service managers, |Action achieved. S&CS level 3 training commence November 05. |

|concerns or their own responsibility in terms of responding to it. |unit/team managers and senior practitioners. |Action partially achieved. |

| |Improving public awareness strategy. |Recommend: Outstanding action to be retained for 2006. |

|To monitor and analyse both the adult protection work undertaken and the |To prepare and agree monitoring form. |Action achieved. |

|outcomes of adult protection interventions in 2005. |To send monitoring forms to responsible individuals. |Monitoring forms available on S&CS intranet and form part of new |

| |To collate and analyse information returned. |S&CS procedures. |

| | |Action not achieved. |

| | |Recommend: Outstanding Action to be retained for 2006. |

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