Most adults who might be deemed vulnerable, such as older persons and those with dementia, people with physical or learning disabilities or mental health problems, manage to live their lives without experiencing harm. Often this is with the assistance of caring relatives, friends, paid carers, professional agencies or volunteers. However, for some, the nature of their impairment or dependence on another may result in exploitation or harm.Legislation designed to support vulnerable adults already exists in the form of the Adults with Incapacity (Scotland) Act 2000 and the Mental Health (Care and Treatment) (Scotland) Act 2003. The addition of the Adult Support and Protection (Scotland) Act 2007 (the Act) now means there is a legal framework to further protect adults at risk of harm through measures contained in Part 1 of the Act.
The 2004 report into the Scottish Borders Council/NHS Borders Services for Learning Disability contributed to shaping the Act by highlighting the need for a multi- agency response to adults at risk of harm. The report emphasised that protection of adults at risk is the responsibility of all statutory agencies, voluntary and private providers and that good communication is key to prevention of harm.
We all have a responsibility to ensure that those adults we support in our communities are, to the best of our ability, safe from harm. To do this we need to ensure that adults are empowered and supported to make their own choices about their lives and to live as independently as possible in relation to their personal circumstances.
Changes in the way community care services are provided has resulted in a greater range of options available to those requiring help and assistance. This has allowed people who make use of our services greater choice and decision-making in relation to the nature of support provided. However, these changes, for example the shift of services from institutions to the community, can in themselves increase the potential for harm by creating additional pressures on families or, through the provision of increasingly complex care packages with involvement of statutory, voluntary and private providers. Good communication and effective joint working is therefore vital both for service users and carers, and for service providers to encourage sharing of information, early reporting and appropriate responses.
Demographic factors are also of significance. The population of older people is growing through longer life expectancy and as disability and dependency may increase with age this means that the population of potentially vulnerable people will continue to grow. This makes it vitally important to ensure that those responsible for the support and protection of adults at risk of harm have a clear sense of what signifies harm and what should happen when harm is suspected or discovered.
makes new provisions intended to protect those adults who are unable to safeguard their owninterests, such as those affected by disability, mental disorder, illness or physical or mental infirmity, and who are at risk of harm or self-harm’.
The aim of intervention under the Act is to achieve a balance between respecting the adult at risk’s right to self-determination while ensuring their right to be protected from harm. The Act itself balances the need for ‘support’ through provision of information and support services, with ‘protection’ in the form of statutory orders when required.
All public agencies will have in place a set of procedures to guide their staff in response to situations of harm. However, procedures themselves do not replace the need to exercise judgement in relation to the appropriate response to specific circumstances in order to ensure both the protection and welfare of an adult at risk.
Multi-agency training is available in both North & South local authority areas in Lanarkshire but not everybody can access this activity. With this in mind single agency awareness sessions will be available for all staff who cannot attend due to the nature of their work not fitting with the agreed schedule.
Please contact me to arrange a one hour session which can be delivered at a convenient location.
Regards
Jim Grierson Practice Improvement & Development Nurse (Mental Health)
James.grierson@lanarkshire.scot.nhs.uk
01698 361100 Ext 7006
This is because some people may find it more difficult to stop harm happening to them. The Act calls people in this situation ‘adults at risk’.
their rights or other interests;
Having a particular condition such as a learning disability or a mental health problem does not automatically mean an adult is at risk. Someone can have a disability and be perfectly able to look after themselves. For an adult to be considered at risk, all three parts of the definition must be met.
The Act introduces new measures to identify and protect individuals who fall into the category of adults at risk. These measures include:
Do you know someone who is being harmed?
If you think you know someone who is being harmed, or is at risk of being harmed, you must tell someone. Remember, the person being harmed may not be able to report it.
Pleae find booking form and Training day information below:
Local Act awareness raising and training has been established to assist practitioners in their everyday practice. If you are interested in finding out more about training opportunities please contact:
·James Grierson, NHS Lanarkshire, 01698 366011, or e-mail
N.E.S "e-learning" Training Package
The N.E.S "e-learning" training package for the Mental Health (Care & Treatment) (Scotland) Act 2003 is available to all staff, carers, service users & anybody with an interest who needs to be aware of the Act and how it will impact on their everyday practice.
It is important to recognise that this resource is not guidance and should not be used to inform legal decision making. Codes of Practice for the Act are available to assist decision making
It is very simple to register on line and navigate the NES site at home or in the workplace.
Go to: http://www.nes.scot.nhs.uk/mha/elearning
Learning can be done at your own pace whenever and however you want to progress and to the level most appropriate to your sphere of practice.
The training program recognizes the need to move from "one-off " training from specific sections towards general good practice and recognize the need to be influenced by people who may have experienced periods of detention..
The main aims of training will be for staff to;
·"Know what"- staff must have an overview of intent - capturing and embedding the Millan Principles and other key features
·"Know how" - staff must be able to make day to day decisions of implementation fit with responsibilities under other compliance requirements ( freedom of information, human rights)
"Know best" - staff must promote best practice ( information management , risk assessment )
Training Levels
There are 5 levels available to staff, most will only require levels 1 & 2. More specialised levels exist (levels 3-5) for staff who require a more in depth knowledge of the Act. Level 1 - Introduction & Foundations of 2003 Act. Level 2 - Safeguards & Rights of Review & Appeal process. Level 3 - Compulsory Powers Level 4 - People with mental disorder within the criminal justice system. Level 5 - Training for Trainers.
Levels 1- 5 are the recognized training levels adopted by NHS Education for Scotland.
Mr G Enquiry "Not My Problem"
This investigation by the Mental Welfare Commission (MWC) involved the examination of practices in 4 Health Boards, three local authorities two private care sector providers, two prisons, the State Hospital and a range of voluntary services. The investigation concludes with 25 recommendations for all health services and local authorities involved with Mr G.
Mr G was a 61 year old man seen by the MWC in Prison in July 2004. The prison health services and the visiting psychiatrists were very concerned about his condition. He had been charged with assault and was thought to have a personality disorder. The MWC disagreed and intervened to make sure he received hospital care. He was found to have a form of dementia (fronto-temporal dementia) that affects behaviour and judgement but in the early stages does not affect memory. Mr G died in April 2006 in hospital care.
There is evidence from research that people with a diagnosis of personality get poor care from mental health services The MWC found this in Mr G’s case when they interviewed staff and examined records. With this in mind the following material was used to raise awareness of Mr G deficiencies in care report with all staff working in NHS Lanarkshire mental health services:
The summary report “Not My Problem” MWC(pdf44)
Power point presentation Jim Grierson, practice development Nurse(ppt72)