Safeguarding Adults
Camden and Islington NHS Foundation Trust (C&I) is committed to putting the service user and carer at the centre of everything we do and strives to improve patients' and service users' experience of our service.
The Trust takes all issues of abuse or neglect of adults and children at risk very seriously. It is committed to dealing with them effectively to minimise the risk of harm to all its service users, including those who are at risk of domestic abuse.
The Trust works in partnership with three local authorities to safeguard adults at risk of abuse and neglect: Camden Council, London Borough of Islington and two mental health teams in Kingston. Each of the three boroughs and C&I work in line with the Pan-London Safeguarding procedures and Care Act (2014).
Safeguarding Adults and why it matters?
The Care Act (2014) defines Safeguarding adults as, protecting a person’s right to live in safety, free from abuse and neglect. The Care Act 2014 defines an adult at risk as a person:
- Who is 18 years and over
- Who has needs for care and support (whether or not the local authority is meeting any of those needs)
- Is experiencing, or at risk of abuse or neglect
- Who 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.
The Care Act promotes ‘Making Safeguarding Personal’ which means that the adult at risk should be at the centre of all enquiries and decisions being made throughout the safeguarding process.
What is abuse?
Abuse of individual rights is a violation of human and civil rights by any other person or persons. Abuse may consist of single or repeated acts and can be carried out by anyone, in any setting. It may result in significant harm to or exploitation of, the individual.
Abuse can include one or more of the following:
- Domestic Abuse: The government defines domestic violence and abuse as ‘any incidents or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over, who are or have been, intimate partners or family members regardless of gender or sexuality. The abuse can encompass, but is not limited to psychological, sexual, financial or emotional abuse’. In addition, the Serious Crime Act 2015 includes a new offence of coercive and controlling behaviour which can impose a maximum sentence of 5 years imprisonment, a fine or both.
Why does it matter to our services?
There is a very close link between domestic violence and mental ill health. Abused women are "more likely to suffer from depression, anxiety, psychosomatic systems, eating problems and sexual dysfunction" (WHO 2000).
If there is any domestic violence going on right now, recently, or in the past, it's important that we know so we can begin to help the service user live a safer and healthier life.
- Physical Abuse: This includes hitting, pinching, deliberately giving too much medication or physically restraining someone in an inappropriate way - for example, being locked in or force-fed.
- Financial Abuse: This includes taking another person's money or possessions - for example, having money or property stolen, being pressured into giving people money or changing a will, misuse of benefits, not being allowed access to money.
- Sexual Abuse: This includes any sexual act to which the vulnerable adult has not consented and may not understand. For example, being touched or kissed when it is not wanted, being made to touch or kiss someone else, being raped, being made to listen to sexual comments or forced to look at sexual acts or materials
- Psychological Abuse: This can happen where someone is isolated, verbally abused or threatened.
- Discrimination: This includes racism, sexism or acts based on a person’s disability, age or sexual orientation. It also includes other forms of harassment, slurs or similar treatment such as disability hate crime.
- Organisational: Neglect and poor care practice within a care setting such as a hospital or care home or in relation to care provided in someone’s own home ranging from one-off incidents to on-going ill-treatment. It can be neglect or poor practice as a result of the structure, policies, processes and practices within a care setting.
- Neglect and Acts of Omission: This includes ignoring or withholding physical or medical care needs. Examples are failing to provide appropriate food, shelter, heating, clothing, medical care, hygiene, personal care; inappropriate use of medication or over-medication.
- Self-neglect: Self-neglect covers a wide range of behaviour including neglecting to care for one’s personal hygiene, health or surroundings and behaviour such as hoarding.
- Abuse of Individual Rights/discriminatory abuse/racial abuse: Abuse of individual rights is a violation of human and civil rights by any other person or persons. Discriminatory abuse consists of abusive or derisive attitudes or behaviour based on a person’s sex, sexuality, ethnic origin, race, culture, age, disability or any other discriminatory abuse - this includes hate crime. Forced marriage is also an abuse of human rights and falls within the definition of adult abuse.
- Modern Slavery: Encompasses slavery, human trafficking, forced labour and domestic servitude of the adult at risk.
- Hate and Mate Crime: Hate crime is where a crime is committed against a person specifically because of their gender, ethnicity, disability, religious belief or sexual orientation. If an adult at risk is specifically targeted as a victim of crime this is a hate crime.
- Mate Crime is where someone befriends an adult at risk with the intention of exploiting or abusing them. The person often believes they are their ‘friend’ but will go on to be abused e.g. financially, physically or psychologically.
- Forced Marriage: Forced Marriage is where one or both people do not or cannot consent to the marriage and pressure or abuse is used to make sure the marriage takes place. Under The Anti-Social Behaviour, Crime and Policing Act 2014 Forced Marriage is now a criminal offence to force someone to marry; therefore the Police must always be contacted as quickly as possible.
- Honour Based Violence: Honour Based Violence is a crime; therefore if it is suspected or the person discloses abuse, the Police must always be contacted as quickly as possible. Honour Based Violence is used by people who want to defend the reputation of their family or community. It can also include enforced isolation from their community.
- FGM (Female Genital Mutilation): FGM involves procedures that involve total or partial removal of the female external genitalia or other injuries to the female genitalia for non-medical reasons. Predominantly carried out on young girls, it is considered child abuse and is illegal in the UK.
Raising a Safeguarding concern
If it it an emergency and you need immediate police support, please dial 999.
Raise your concern with the Borough where the abuse or neglect has taken place.
You can find out more about what kinds of harm or abuse adults can suffer from, and how that person can be helped and protected on the local authority websites listed below and by contacting the Camden and Islington NHS Foundation Trust Safeguarding Team.
Borough Specific Information and Services
C&I Safeguarding Adults Team
For further information, advice and support contact the Trust Safeguarding Hub:
Tel: 020 3317 7171
Secure email: Safeguarding@candi.nhs.uk
Address: St Pancras Hospital, 4 St Pancras Way, 1st Floor, East Wing, London. NW1 0PE
Head of Safeguarding and Mental Health Law
Women’s Lead and Team Manager
Shirley McNicholas
Tel: 020 7607 2777
Governance Structure
The Trust Safeguarding Committee oversees the safeguarding activity in the Trust. This is chaired by the Executive Director of Nursing & Quality. A Safeguarding Operational Group meeting is held monthly and submit bi-monthly reports to the Trust Board via the Quality Committee.
DBS Disclosure and Barring
Camden and Islington NHS Foundation Trust meets statutory requirements in relation to safer recruitment practice. All Trust job descriptions include a statement on safeguarding adults at risk.
Policies and Procedures
The Trust works to ensure that there are robust systems, policies and procedures in place to guide and support staff. Relevant policies include those relating to Safeguarding Adult at Risk, Managing Allegations against Staff and PREVENT. All policies are available on the Trust intranet site for all staff to access.
Training
The Trust has a robust training strategy in place. Currently, all staff have been assigned a level from 1 to 4 to ensure they receive the appropriate training to meet competencies for the job in accordance with the Safeguarding Adults: Roles and competencies for healthcare staff – Intercollegiate Document. A training database for all staff is maintained and regular compliance reports are provided to the Trust Board.
Partnership Working
Camden and Islington NHS Foundation Trust actively engages with partner agencies, organisations and contributes to the Local Safeguarding Adult Board and multi-agency partnership arrangements.
Safeguarding is everyone’s business.