Safeguarding Policy

Purpose of this Policy:

To make clear how youTherapy Services respond to concerns raised about abuse and neglect of adults at risk and those at risk of serious and probable harm.

Safeguarding adults is central to our work and in our practice to prevent abuse and promote wellbeing of adults (and their children) with care and support needs. It requires us to work closely with other organisations in partnership, to support and safeguard adults at risk of abuse and neglect.

Before taking any actions, we will make every effort to discuss with our clients our intentions and what these actions would be. We will also seek our client’s explicit consent to take action and would only act without consent if there was an ethical or legal reason to do so.

This ensures that we work together in partnership with adults so that they are:

  • Safe and able to protect themselves from abuse and neglect

  • Treated fairly and with dignity and respect

  • Protected when they need to be

  • Able easily to get the support, protection and services that they need.

Definitions

Safeguarding: protecting an adult’s right to live in safety, free from abuse and neglect.

This is a collaborative process, supporting the adult to make decisions about the risks they face in their own lives and protecting those who lack the mental capacity to make these decisions.

An individual has the right to develop and maintain a ‘private life’ which includes the right of a person to define the ‘inner circle’ in which they choose to live their life including more specifically the right to choose those with whom they do and those with whom they do not wish to establish, develop or continue a relationship. Safeguarding may involve supporting this process.

Adult ‘at risk’: a person aged 18 or over who has needs for care and support (whether or not the local authority is meeting any of those care and support needs) and as a result of those care and support needs is unable to protect themselves from either the risk of or the experience of abuse or neglect.

Wellbeing: A broad concept described in relation to:

  • Personal dignity (including treatment of the individual with respect)

  • Physical and mental health and emotional wellbeing

  • Protection from abuse and neglect

  • Individual control over day-to-day life (including care/support provided and the way it is provided)

  • Participation in work, education, training or recreation

  • Social and economic wellbeing

  • Domestic, family and personal

  • Suitability of accommodation

  • The individual’s contribution to society.

Abuse

Abuse can take many forms; it can be physical, psychological, sexual, neglect, discriminatory, organisational and financial. Abuse also includes domestic abuse, Modern Slavery, organisational and self-neglect, exploitation. Abuse is a violation of an individual's

human and civil rights by any other persons or person.

Examples of abuse are:

  • Hitting, slapping, rough handling

  • Giving medication incorrectly

  • Deprivation of warmth, food, clothing health care etc.

  • Any kind of sexual activity that the person has not consented to or cannot consent to

  • Misuse or theft of money or property

  • Shouting, swearing

  • Neglect of medical or physical need

  • Discrimination or harassment

Patterns of abuse may reflect very different dynamics, such as:

  • Serial abuse in which someone seeks out and ‘grooms’ individuals. Sexual abuse sometimes falls into this pattern as do some forms of financial abuse;

  • Long term abuse – may occur in the context of an ongoing relationship such as domestic violence between partners or generations or persistent psychological abuse;

  • Opportunistic abuse - such as theft occurring because money or jewellery has been left lying around;

  • Self-neglect – where a person declines support and assistance with their care and support needs, impacting on their individual wellbeing.

  • Compulsive Hoarding – the excessive acquisition of, and inability or unwillingness to discard, large quantities of objects that cover the living areas of the home and cause significant distress.

Abuse may consist of:

  • Single or repeated acts;

  • An act of commission or omission;

  • Multiple acts, for example, an adult at risk may be neglected and also being financially abused.

Abuse may be intentional or unintentional. It can happen anywhere, in any context and by anyone, however it is usually someone the vulnerable adult knows. Some kinds of abuse are a criminal offence.

Abuse by Another Adult at Risk

It is the nature of the incident and its impact, rather than the nature of the relationship between those concerned that are the important factors in determining the need for the Safeguarding Adult’s Policy to be followed. Where such an incident occurs within a service, for example where both people are living in a care setting, the risk of harm may be compounded by the emotional distress of living with an abusive person.

The safety of the adult will be of primary importance. However, where the person alleged to have caused harm is also an adult with care and support needs, there may also be ongoing responsibilities for their welfare. Consideration may be required as to how their care and

support needs are being provided for, and whether the incident reveals unmet needs. Such an assessment should be undertaken separately from the person experiencing abuse. It will be necessary for such an assessment to consider:

  • Whether the person causing the harm is able to understand his/her actions;

  • Whether actions reflect the unmet needs of the person causing the harm;

  • The risk that the person causing the harm will further abuse the adult or others;

  • The support/care needs of that individual.

youTherapy will work in partnership with those who provide the care and support.

Historical Abuse

Abuse that took place when a person was under 18 years old is not an Adult Safeguarding issue but dependant on the concern, could be a child safeguarding issue, irrespective of how old that person is now. In certain cases, the relevant Children’s Social Care department may need to be informed, if for example, the person who caused harm, is considered as a continued risk to other children.

Adults who disclose historical childhood abuse can be advised that this is a crime and that they can still report this to the Police, if they want to do this.

Radicalisation

It is often not one specific cause which would put a person at risk of radicalisation, but the below list is some of the more frequent reasons why people have followed a specific path to radicalisation:

  • Feelings of loss or bereavement.

  • Social isolation.

  • Confusion over personal identity.

  • Experience of discrimination, inequality or harassment leading to a sense of grievance.

  • Family breakdown or community tensions.

  • Having family members or friends who are already radicalised.

This is not an exhaustive list but some of the signs to look out for are:

  • Out of character changes in behaviour, dress and beliefs

  • Changes in their friendship groups or associating with people who hold extremist views

  • Digital interaction with inappropriate online sites

  • Showing sympathy for extremist causes

  • Advocating extremist messages

  • Glorifying violence

  • Accessing extremist literature and imagery

At youTherapy Services we will be vigilant in recognising the potential signs of radicalisation and will act appropriately in both recording and reporting the concern.

What constitutes ‘risk of serious and probable harm’:

Serious: significantly damaging physical or emotional harm that may or may not also be illegal (see list of legal obligations below).

Probable: where the practitioner has reason to believe that the harm is likely to happen or to have happened, e.g. many clients in distress express a wish to end their own lives which is ‘serious’ but action would only be taken if it is also highly likely or ‘probable’ that a client would end their own life.

Legal obligations to breach confidentiality for safeguarding reasons:

  • Where co-operation is needed to help investigate/protect a child/ adult at risk

  • Legal orders where serious crime has taken place (murder, manslaughter, rape, treason, kidnapping, child/ adult at risk abuse, threats to public security)

  • Terrorism threats, which includes information that might help prevent an act of terrorism or bring a terrorist to justice

Principles

This policy is based on The Six Principles of Safeguarding (Care Act 2014) that underpin all

adult safeguarding work:

1. Empowerment

Adults are encouraged to make their own decisions and are provided with support and information.

I am consulted about the outcomes I want from the safeguarding process and these directly inform what happens.

2. Prevention

Strategies are developed to prevent abuse and neglect that promote resilience and self-determination.

I am provided with easily understood information about what abuse is, how to recognise the signs and what I can do to seek help.

3. Proportionate

A proportionate and least intrusive response is made balanced with the level of risk.

I am confident that the professionals will work in my best interests and only get involved as much as needed.

4. Protection

Adults are offered ways to protect themselves; there is a coordinated response to adult safeguarding.

I am provided with help and support to report abuse. I am supported to take part in the safeguarding process to the extent to which I want and to which I am able.

5. Partnerships

Local solutions through services working together within their communities.

I am confident information will be appropriately shared in a way that takes into account its personal and sensitive nature. I am confident that agencies will work together to find the most effective responses for my own situation.

6. Accountable

Accountability and transparency in delivering a safeguarding response.

I am clear about the roles and responsibilities of all those involved in the solution to the problem.

Risk

The identification and management of risk is an essential part of any assessment process; the risk to an adult of abuse or neglect should be considered during all assessments. Where it is believed an adult at risk is experiencing or at risk of experiencing abuse or neglect enquiries must be made (this is not necessarily an investigation), or cause others to do so.

This is a duty under s.42 of The Care Act 2014. An enquiry should establish whether any action needs to be taken to prevent or stop abuse or neglect, and if so, by whom.

The objectives of an adult safeguarding enquiry are to:

  • Establish facts

  • Ascertain the adult’s views and wishes

  • Assess and address the adult’s need for protection and support, in accordance with their wishes

  • Make decisions as to what follow-up action should be taken

  • Enable the adult to achieve resolution and recovery

Sources of risk might fall into one of four categories:

  • Private and family life: The source of risk might be someone like an intimate partner or a family member

  • Community based risks: This includes issues like ‘mate crime’, anti-social behaviour, and gang-related issues

  • Risks associated with service provision: This might be concerns about poor care which could be neglect or organisational abuse, or where a person in a position of trust because of the job they do financially or sexually exploits someone

  • Self-neglect: Where the source of risk is the person themselves

Risk Assessment

This involves collecting and sharing information through observation, communication and investigation. It is an on-going process that involves persistence and skill to assemble and manage relevant information in ways that are meaningful to all concerned.

Assessment of risk is dynamic and on-going and a flexible approach to changing circumstances is needed. The primary aim of a safeguarding adults risk assessment is to assess current risks that people face and potential risks that they and other adults may face.

Specific to safeguarding, risk assessments should encompass:

  • The views and wishes of the adult

  • The person’s ability to protect themselves

  • Factors that contribute to the risk, for example, personal, environmental

  • The risk of future harm from the source

  • Identification of the person causing the harm and establishing if the person causing the harm is also someone who needs care and support

  • Deciding if domestic abuse is indicated and the need for a referral to a MARAC

  • Identify people causing harm who should be referred to MAPPA

  • It may increase risk where information is not shared

Risk Management

The focus must be on the management of risks not just a description of risks. A plan to manage the identified risk and put in place safeguarding measures includes:

  • What immediate action must be taken to safeguard the adult and/others

  • Who else needs to contribute and support decisions and actions

  • What the adult sees as proportionate and acceptable

  • What options there are to address risks

  • When action needs to be taken and by whom

  • What the strengths, resilience and resources of the adult are

  • What needs to be put in place to meet the on-going support needs of the adult

  • What the contingency arrangements are

  • How will the plan be monitored?

Effective risk management requires exploration with the adult using a person-centred approach, asking the right questions to build up a full picture. Not all risks will be immediately apparent; therefore, risk assessments need to be regularly updated as part of the safeguarding response and possibly beyond.

Individual need will determine how frequently risk assessments are reviewed and wherever possible there should be multi-agency input. These should always be in consultation with the adult.

Response to an adult safeguarding concern

If a therapist has reason to believe that abuse is or may be taking place they have a responsibility to act on this information. Doing nothing is not an option.

Responsibilities of all therapists:

If any therapist has reason to believe that abuse is or may be taking place they have a responsibility to act on this information. Doing nothing is not an option.

If an adult discloses any experience of abuse or neglect, the therapist will:

  • Assure the person their concerns are taken seriously

  • Listen carefully to what the person is saying. Stay calm. Get as clear a picture as possible

  • Explain their duty to discuss this information with their supervisor

  • Reassure the person they will be involved in all decisions made about them

Therapists will not:

  • Be judgmental or jump to any conclusions

  • Start to investigate or ask detailed, leading or probing questions

  • Promise to keep secrets

  • Destroy any evidence

  • Confront the alleged abuser

  • Make decisions on their own

Therapists will establish:

  • The current level of risk and what immediate steps are needed to ensure safety

  • The individual’s wishes and views about the safeguarding issue including their views regarding sharing information with other agencies i.e. the local authority or the police

  • Wherever possible, safeguarding concerns should be raised with the consent of the client (however consent is not required to raise a safeguarding concern)

  • Where there are issues of mental capacity, whether the client has capacity to make specific decisions regarding their own protection and to understand the safeguarding process

Therapist responsibilities are to:

  • Act to keep the person safe if possible

  • Consult with their supervisor

  • Clearly record what they have witnessed or been told, and any responses or actions taken

  • If a crime has occurred, be mindful of the need to provide evidence

If urgent police presence is needed to keep someone safe or if the person needs urgent medical assistance, call 999.

It is important when a situation is reported to the Police, that wherever possible the person or organisation alleged to have caused harm is not questioned by anyone, so as not to undermine any required Police investigation. Early engagement with the Police is vital to support the criminal investigation.

If consulting with the supervisor will lead to an undue delay and thereby leave a person in a position of risk, referral should be made to the relevant Local Authority.

Sharing information without consent

The priority in safeguarding is to ensure the safety and well-being of the adult. However, there may be some occasions when the adult at risk does not want to pursue a referral to the Local Authority such as social care or the police.

If the decision is to act without the adult’s consent, then unless it is unsafe to do so, the adult should be informed that this is being done and of the reasons why. For example, where you believe there is a threat to someone’s life, and you believe the person is unable to protect themselves because of their physical or mental health vulnerabilities. Where such decisions have been taken, staff should work closely with their supervisor and keep a careful record of the decision-making process.

There are only a limited number of circumstances where it would be acceptable to not share information pertinent to safeguarding with the Local Authority. These would be where the person involved has the mental capacity to make the decision about sharing information, does not want their information shared and:

  • Nobody else is at risk

  • No serious crime has been or may be committed

  • The alleged abuser has no care and support needs

  • No staff are implicated

  • No coercion or duress is suspected

  • The public interest served by disclosure does not outweigh the public interest served by protecting confidentiality

  • The risk is not high enough to warrant a multi-agency risk assessment conference referral

  • No other legal authority has requested the information

Therapists should be vigilant of possible coercion and the emotional or psychological impact that the abuse may have had on the adult and should:

  • Explore the reasons for the adult’s objections (what are they worried about?)

  • Explain the concern and why it might be important to share the information

  • Tell the adult with whom information might be shared and why

  • Discuss the benefits, to them or others, of sharing information (access to better help and support?)

  • Discuss the consequences of not sharing the information (could someone come to harm?)

  • Reassure them that the information will not be shared with anyone who does not need to know

  • Reassure them that they are not alone and support is available to them

If, after this, the adult requests that information about them is not shared with the local authority or if there is a clinical reason that their information should not be shared with the local authority, this should be discussed with the supervisor.

Recording Adult Safeguarding Work

Safeguarding concerns should be fully documented by the first person to report the suspected abuse, and at all subsequent stages by those involved with the adult. Therapists are responsible for recording concerns and should be completed as soon as possible after a concern (an appearance of abuse/neglect) is identified, whether it becomes substantiated or not.

The therapist must monitor and record the ongoing care and wellbeing of the client during any adult safeguarding enquiry. Safeguarding supervision during the assessment or treatment of a client must also be recorded.

Therapists are accountable for their actions or omissions. They must make a legible, factual, timely and accurate record of what they did and why, to demonstrate transparent, defensible decision making e.g. capacity assessment made, best interest decision, any restraint which was required which must be proportionate to the situation.

The outcome of the safeguarding enquiry should be clearly documented in the client’s records.

Dealing with Repeat Allegations

All concerns should be considered on their own merit. An adult who makes repeated allegations that have been investigated and decided to be unfounded should be treated without prejudice. Where there are patterns of similar concerns being raised by the adult within a short time period, a risk assessment and risk management plan should be developed and a process agreed for responding to further concerns of this nature from the adult. Information sharing to assess and analyse data is essential to ensure that adults are safeguarded, and an appropriate response is made. Therapists should also be mindful of public interest issues.

In considering how to respond to repeated concerns the following factors need to be considered:

  • The mental capacity and safety of the adult who the concern is about

  • The strength of the support networks available to the adult at risk

  • Wishes of the adult and impact of the concern on them

  • Impact on important relationships

  • Level of risk

Prevention – Safety plan

The most effective way to safeguard adults from abuse is to enable them to safeguard themselves. For some people this may involve their own support networks, or support or care services, depending on their individual circumstances.

In order to safeguard themselves, adults and people who support them should consider the following:

  • What kind of harm or exploitation they may be at risk of

  • Where the risk might arise

  • Who might potentially exploit or harm them

There are many ways in which people can reduce the risks they may face, including:

  • Considering how they can reduce the risks of being harmed or exploited

  • Identifying what strengths, skills, supports and networks they could use to avoid potentially abusive situations

  • Being aware of what to do if an abusive situation arises e.g. how to get help, how to report concerns

Prevention should be discussed at every stage of safeguarding and is especially important at the closure stage (which can happen at any time) when working with adults on resilience and recovery. Discussions between therapist and adults, their personal network and the wider community (if appropriate) help build up resilience as part of the recovery process. Where support is needed to prevent abuse, this must be identified and put into future planning.

Actions that might be taken to reduce or prevent risk of serious and probable harm to the client:

If a therapist assesses that a client is at risk of serious harm to themselves, e.g. severe self-harm or suicide, some or all of the following actions might be taken:

  • Contact made with the client’s GP to inform them of the risk and to include their support

  • An agreement put in place between the therapist and client about how to best reduce or prevent the risk to you, e.g. permission for the designated ‘emergency contact’ to be made

  • A safety plan to be created collaboratively between the therapist and client as outlined above

In cases of risk of harm to others that directly involve the client:

  • An additional clause may be added to the Counselling Agreement before counselling can recommence

  • Suspend or terminate the counselling process