Having policies and procedures to safeguard adults is a legal requirement under the Care Act 2014. Safeguarding means protecting an adult’s right to live in safety, free from abuse and neglect.
It involves a leap of imagination to think that a family member or friend (or indeed a member of the Dementia Active team) might be mistreating someone attending a group. However there must always be an awareness that people with dementia are extremely vulnerable and that families often feel stressed and unable to ask for help when circumstances at home become very difficult. It is also the case that people who choose to work with people with dementia may very occasionally do so for malign reasons and therefore we all have a duty to monitor each other’s actions and report any concerns about a colleague to the safeguarding lead.
This policy must be read in conjunction with the Whistleblowing policy and the Code of Conduct, by all the charity’s trustees, employees and volunteers.
Dementia Active Safeguarding Principles in brief:
● Respond quickly to concerns/disclosures to minimise any further harm to an individual
● Record and store information securely
● Follow the safeguarding procedures identified in this policy
● Evaluate safeguarding procedures after an incident occurs
The Care Act 2014 identifies the following principles upon which safeguarding policies and procedures must be based:
People are supported and encouraged to make their own decisions in relation to a safeguarding concern.
“I am asked what I want as the outcomes from the safeguarding process and this directly informs what happens.”
It is better to take action before harm occurs.
The least intrusive response appropriate to the level of risk presented.
Support and representation for those in greatest need.
Services offer local solutions through working closely with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse. Dementia Active works with OSAB and the Adult Social Care Team, Oxfordshire County Council.
“I know that staff treat any personal and sensitive information in confidence, only sharing what is helpful and necessary. I am confident that professionals will work together and with me to get the best result for me.”
Accountability and transparency in delivering safeguarding.
Risks arising from a dementia diagnosis
People with dementia have cognitive deficits which may make them more at risk of abuse or neglect. They may experience:
● Memory loss
● Problems with concentrating, planning and organising – including making decisions and problem solving
● Communication difficulties
● Difficulties with orientation
All of these can make it harder for the person to protect themselves.
Most members of the Dementia Active team are involved in a voluntary capacity and have joined having had personal experience of dementia in their own families. They are required to sign a volunteer contract and employment and personal references are sought. At the end of every session volunteers receive support and feedback in a short debrief session at which they are also encouraged to share observations of the members' responses to activities. The debrief session is an opportunity for the group leader to monitor volunteers particularly in relation to maintenance of clear boundaries with members. Volunteers are required to have read all Dementia Active policies and sign a copy of the Safeguarding Policy as well as a volunteer agreement.
Volunteers whose role involves transporting members to and from sessions are given an informal interview and must fill out a volunteer application providing details of their licence/car insurance/MOT/road tax. They are also required to undertake an enhanced DBS check.
Group leaders are recruited via a formal application process. References are sought and they are interviewed. They have a 3 month probationary period during which they receive monthly supervisions, after which they receive regular planned supervision and appraisal. As they may be required to offer personal care to members they must also have an enhanced DBS check before taking up the post.
DBS (Disclosure and Barring Service)
Dementia Active employs the services of an umbrella organisation to manage its DBS checks…..www.adventureplus.org.uk
There are six categories of activity which are ‘regulated activity’ with vulnerable adults requiring enhanced DBS checks with access to barring lists. They are:
● providing health care
● providing personal care
● providing social work
● helping with general household matters
● helping with the conduct of a person’s own affairs
● conveying (transporting)
Currently three roles within Dementia Active involve regulated activity:
● Group leaders may need to offer personal care to members with continence issues and additionally may supervise someone carrying out a regulated activity;
● Volunteers may be required to assist a member with eating (either prompting or physical assistance)
● Volunteer drivers who transport members who may need assistance with getting ready.
Any member of the team who carries out one of these three activities must have undergone an enhanced DBS check with access to barring lists.
Trustees are also required to have an enhanced DBS check but unless they become involved in the day to day running/supervision of those carrying out regulated activity they do not require a check with access to barring lists.
Dementia Active’s policies are designed to support people who attend groups; its volunteer team and group leaders; the Board of Trustees; as well as families. Group leaders are required to attend training by Oxfordshire Safeguarding Adults Board (OSAB) and complete online dementia awareness training by SCIE (Social Care Institute for Training and Excellence). Volunteers are also encouraged to do the latter course in order to improve their skills and knowledge base.
Group leaders and volunteers have a joint responsibility to:
● Be aware of changes in a person’s behaviour. Do not assume this is dementia related. Does the person appear unhappy when they arrive and perhaps more significantly when they are about to leave?
● Notice any changes in their appearance, clothing or cleanliness from week to week.
● Notice any signs of injury and record these as soon as possible. Ask the person how this happened.
● Always report concerns immediately to the group leader/safeguarding lead (see below).
● Write down whatever the member said which raised concerns - as soon as possible and ensure that they feel understood and crucially that they have granted permission for their statement to be shared. (see below)
● If a person expresses fear about returning home there may be a need to contact the Oxfordshire County Council Adult Emergency Duty team - 0800 833 408. in order to seek advice.
Identify and define the main forms of abuse
Everyone involved with Dementia Active must be aware of the different categories of abuse which people with dementia are most likely to be at risk of:
Physical abuse including pushing, slapping, misuse of medication, restraint, or inappropriate physical sanctions.
Psychological abuse including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, verbal abuse, withdrawal of services or supportive networks.
Neglect and acts of omission including ignoring medical, emotional or physical care needs; failure to provide access to appropriate health care; omitting to provide adequate nutrition, medication and heating.
Organisational abuse, including neglect and poor care practice within a care setting or hospital or care provision at home. It may be as a result of poor professional practice within an organisation.
Discriminatory abuse including harassment, ill treatment because of race, gender or gender identity, age, disability, religion, sexual orientation and crucially. as a result of a diagnosis of dementia.
Financial or material abuse including theft, fraud, telephone scams, coercion in relation to financial arrangements, misappropriation of property, possessions or benefits.
Oxfordshire Safeguarding Adult Board policy document
This document has been developed by Oxfordshire Safeguarding Adult Board and it provides guidance for professionals to clarify the circumstances in which the Adult Safeguarding Team of Oxford County Council will assist in safeguarding adults.
It is a guide showing limited illustrations to help when deciding on the best course of action. The steps to be followed in the event of a disclosure are defined below.
Considerations prior to raising an adult safeguarding concern:
Does the concern meet the criteria for a Section 42 (S42) safeguarding inquiry under the requirements of The Care Act 2014?
The requirements are as follows:
● The adult is reported as having or appears to have needs for care and support?
● The adult is reported or appears to be experiencing or is at risk of abuse or neglect?
● As a result of care and support needs, is the adult unable to protect themselves from either the risk of, or the experience of abuse or neglect?
● Has the person given their consent to the information being shared and do they know a S42 inquiry may result?
Dementia Active reporting steps for concerns/disclosures:
● Initially - volunteer reports to group leader
● Group leader reports to Dementia Active safeguarding lead
● Safeguarding lead reports to Oxfordshire Safeguarding Adult Board (if the content of the disclosure falls within the ‘requires consultation’ or ‘reportable’ categories of the OSAB policy document (see link below)
● Safeguarding lead additionally communicates with the lead Trustee for safeguarding (if these two roles are separate).
● Safeguarding lead provides a written report of any disclosure involving consultation with the OSAB to the Board of Trustees along with further updates and resolution.
1 How to respond to concerns and what happens next:
● In the first instance, report concerns to the group leader, for example signs of neglect or an unusual change in mood.
● The group leader will communicate these to the Dementia Active safeguarding lead.
● The safeguarding lead will take action according to the guidelines presented in the Oxfordshire Safeguarding Adults Board policy document: https://www.osab.co.uk/wp-content/uploads/2020/02/OSAB-Threshold-of-Needs-Matrix.pdf
● Dementia Active’s policy is to report to OSAB if 3 concerns related to one member are raised in a 3 month period.
● Concerns are recorded by the safeguarding lead and action taken where appropriate to remediate the concern, for instance communicating with a family member regarding inadequate care being provided by a care agency.
● The safeguarding lead reports the concern to the lead trustee for safeguarding who communicates with the rest of the board.
2 How to respond to a disclosure:
● The overriding objective behind all the following actions is to ensure that the person making a disclosure feels safe and listened to.
● If a member tells someone in the team something which may indicate that abuse has taken place, wherever possible find a way of taking them aside and speaking to them away from the rest of the group.
● Reassure the person that what they have said is important and ask for their permission to write it down. The person to whom the disclosure was made should if possible be the person to do this.
● Explain that it may be necessary to speak to others about what has been said and gain the member’s verbal permission to do this.
● Write the exact words that were said and do this as soon as is practical following the disclosure.
● If the disclosure is about someone in the group, ensure that the person making the disclosure is given one to one support throughout the rest of the session and is kept separate from the subject of the disclosure. Depending upon the severity of the disclosure and/or the person’s emotional state, they may need to be taken home before the session ends.
● Report the conversation to the group leader who will immediately contact the Dementia Active safeguarding lead.
● Dementia Active will: respond to the disclosure as if the allegation were true; will report the disclosure to OSAB if it falls within the ‘requires consultation’ or ‘reportable’ categories of the OSAB policy document.
● If an incident took place within a session, the safeguarding lead will communicate with the person’s family regarding the incident, offering support and a home meeting if required by the family. The family will be given regular updates as to the progress and outcome of actions taken by OSAB.
● If the disclosure involves a member of the team either a volunteer or a group leader then the person who is the subject of the disclosure must be asked to leave the session as long as the group can be safely managed. If this is not possible then the person making the disclosure may need to be taken home. See below for emergency contact details.
● If the disclosure is about a family member or friend the Safeguarding Lead must consult with OSAB.
● The lead safeguarding trustee together with the chair of the board will be informed of the incident as soon as is possible. Depending upon the severity of the incident and the decisions that need to be taken it may be necessary to hold an emergency meeting of the board.
● Once matters have been concluded the safeguarding lead will provide a written report to the board.
Contact numbers in the event of an incident:
Melissa Fazackerley (Safeguarding Lead) - 07926133313
Andrew Gill - 07711891028
In an emergency, call either 999 or Oxfordshire - Adult Emergency Duty Team on 0800 833 408.
Melissa Fazackerley, Safeguarding Lead
Review date - 16/05/22