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National and local guidance and agreed ways of working

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This page is designed to answer the following questions:

NOTE: This page has been quality assured for 2023 as per our Quality Assurance policy.

For this assessment criterion, you will be required to explain current national and local guidance and agreed ways of working relating to safeguarding in adult care services.

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Local guidance

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National guidance provides general information and responsibilities relating to safeguarding, however, each local area is given autonomy with regard to how safeguarding is specifically implemented in their region. Therefore, each local area operates slightly differently.

You will need to know the current systems and processes that are used in your local area as well as the agencies and organisations that have roles and responsibilities in local safeguarding. You could perhaps obtain this information from your organisation’s safeguarding or by contacting your local authority.

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Importance of partnership working

Local partnership working (also known as integrated working) is essential to ensure that vulnerable individuals are protected from abuse. Previous cases have indicated that if agencies shared information and worked together more closely, some tragedies may have been averted.

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Safeguarding Adult Boards

Safeguarding Adult Boards (SABs) oversee adult safeguarding within a local area. They can comprise representatives from the local authority, local Clinical Commissioning Groups (CCGs), other NHS departments, police, fire service, colleges, probation services etc. They are also responsible for commissioning Safeguarding Adult Reviews (SARs), which are investigations into serious cases of abuse and neglect in their jurisdiction to identify what lessons can be learned.

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Vulnerable Adults Risk Management

Vulnerable Adults Risk Management (VARM) is a multi-agency process that is used to identify risks associated with high-risk individuals and formulate an action plan to reduce those risks. This could be, for example, an individual that is self-neglecting to the point that it has become a severe health risk to themselves. You could think about it as a multiagency risks assessment process. The individual themselves should be invited to the meeting and encouraged to participate (VARM meetings are only for individuals that have the mental capacity to make their own decisions).

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Multi-agency Safeguarding Hubs (where operative)

Multi-agency Safeguarding Hubs (also known as MASH teams) are designed to facilitate information-sharing and decision-making between different organisations. MASH teams will be made up of the same organisations as the SABs above – they are usually set up by children’s safeguarding agencies and so have representatives from organisations that work with children. They are not a statutory requirement but they are a way to support and promote integrated working within a local area.

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Shared training opportunities

Shared training opportunities are a way for several agencies to provide integrated training. This can ensure that all agencies understand their roles and responsibilities as well as the roles and responsibilities of others. It can also strengthen the professional relationships between individuals from different organisations and be more cost-effective than in-house training.

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National guidance

National safeguarding guidance includes systems, processes, initiatives, policies and procedures that are applicable to the entire country. Some examples of national guidance are provided below.

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Dignity in care

The purpose of the Dignity in Care campaign is to encourage care workers to have an individual’s dignity at the forefront of their mind when planning and providing care services. It is led by the National Dignity Council and one of their initiatives was to launch the 10-point dignity challenge, which is a list of ‘Dos’ that respect an individual’s dignity. They are:

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  1. Have a zero tolerance of all forms of abuse
  2. Support people with the same respect you would want for yourself or a member of your family
  3. Treat each person as an individual by offering a personalised service
  4. Enable people to maintain the maximum possible level of independence, choice and control.
  5. Listen and support people to express their needs and wants
  6. Respect people’s right to privacy
  7. Ensure people feel able to complain without fear of retribution
  8. Engage with family members and carers as care partners
  9. Assist people to maintain confidence and a positive self-esteem
  10. Act to alleviate people’s loneliness and isolation

These values and behaviours also promote safeguarding because they ensure individuals that are receiving care services are listened to and respected.

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Adult Social Care Outcomes Framework

The Adult Social Care Outcomes Framework (ASCOF) is a way to measure how successful care services are at achieving the outcomes that matter most to individuals receiving care. Measures, such as the number of reported safeguarding concerns and section 42 investigations (both nationally and locally) are included. The latest data (2020/2021 at the time of writing) can be found here.

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Francis report

The Francis Report (2013) was the result of a public inquiry into serious failings at the Mid Staffordshire NHS Foundation Trust. It contained almost 300 recommendations about how similar failings could happen in the future.

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CQC Fundamental Standards

The Care Quality Commission (CQC) Fundamental Standards are the minimum standards that a care recipient can expect from their care provider. Safeguarding from abuse is one of these standards.

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CQC Regulations

CQC regulations are rules that registered care providers must follow. Regulation 13 says that care providers must ensure that service users are safeguarded from abuse, neglect and improper treatment.

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Nothing Ventured Nothing Gained

Nothing Ventured, Nothing Gained (2010) provides guidance for care organisations that support individuals with dementia. It promotes a positive risk-taking approach that enables individuals to exercise greater choice, control and independence.

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Winterbourne View: Transforming Care

Winterbourne View: Transforming Care was the government’s in-depth review and response to the horrific abuse at Winterbourne Hospital unveiled on BBC’s Panorama programme in 2011. Section 13 of the executive summary states:

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We expect to see a fundamental change. This requires actions by many organisations
including government. In summary, this means:

  • all current placements will be reviewed by 1 June 2013, and everyone inappropriately
    in hospital will move to community-based support as quickly as possible, and no later
    than 1 June 2014;
  • by April 2014 each area will have a locally agreed joint plan to ensure high quality
    care and support services for all children, young people and adults with learning disabilities or autism and mental health conditions or behaviour described as challenging, in line with the model of good care set out at Annex A;
  • as a consequence, there will be a dramatic reduction in hospital placements for this
    group of people and the closure of large hospitals;
  • a new NHS and local government-led joint improvement team, with funding from the
    Department of Health, will be created to lead and support this transformation;
  • we will strengthen accountability of Boards of Directors and Managers for the safety
    and quality of care which their organisations provide, setting out proposals during
    Spring 2013 to close this gap;
  • CQC will strengthen inspections and regulation of hospitals and care homes for this
    group of people. This will include unannounced inspections involving people who use
    services and their families, and steps to ensure that services are in line with the
    agreed model of care;
  • and with the improvement team we will monitor and report on progress nationally.

Domestic Violence and Abuse Guidance

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Responding to Domestic abuse: a resource for health professionals (2017) provides guidance from the government about how health and care services can identify and respond to concerns about domestic abuse.

Care Certificate

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It is recommended (although not strictly compulsory) that the Care Certificate be completed by all care workers that are new to the role as part of their induction. It consists of 15 standards that ensure that care workers have the knowledge, skills and understanding that they need to perform their roles competently and confidently.

Standard 10 is related to Safeguarding Adults and Standard 11 relates to Safeguarding Children.

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Healthcare Professions Council – whistleblowing guidance

The Healthcare Professions Council provides support and guidance for whistleblowing, including information about when concerns should be reported in the public interest and a confidential advice hotline.

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Role of the court of protection

The court of protection makes decisions relating to the finances or welfare of individuals that do not have the mental capacity to make decisions for themselves. This can help to ensure that individuals that do not have the mental capacity to make decisions are protected and that decisions are made in their best interest.

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Assessment Criteria

Learners explain current national and local guidance and agreed ways of working in respect of safeguarding in adult care services.

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  • Role of the Court of Protection
  • National guidance
    • Dignity in care
    • Adult Social Care Outcomes Framework
    • Francis report
    • CQC Fundamental Standards
    • CQC Regulations
    • Nothing Ventured Noting Gained
    • Winterbourne View: Transforming Care
    • Domestic Violence and Abuse Guidance HMG
    • Care Certificate
    • Healthcare Professions Council – whistleblowing guidance
  • Importance of partnership working, showing an awareness of aspects such as:
    • Vulnerable Adults Risk Management
    • Multi-agency Safeguarding Hubs (where operative)
    • Shared training opportunities
    • Safeguarding Adult Boards
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