Safeguarding Adults | James Paget University Hospitals NHS Foundation Trust

This information may be of assistance if you think someone may be vulnerable or is being abused.

It explains how to spot adult abuse, what you can do if you are being abused or you suspect somebody else is, and what the James Paget University Hospitals NHS Foundation Trust does to prevent it happening.

We recognise that the abuse of adults is a reality. We don't believe that this is acceptable and are committed to confronting and eliminating adult abuse whenever it comes to our notice and involves people to whom we provide services.

We ensure that our staff are trained to be alert in detecting signs or symptoms of adult abuse;

it is everyone's responsibility to report abuse, if known to be occurring
it is every adult's right to live free from abuse in accordance with the principles of respect, dignity, autonomy, privacy and equality

Our Safeguarding Adults team works in partnership with other local statutory bodies, ensuring that appropriate policies, procedures, and practices are in place and implemented.

More information about Safeguarding

Who are adults who may need safeguarding?

Who is at risk of abuse?

Categories of abuse

The main categories of abuse are listed below:

· Physical abuse – including assault, hitting, slapping, pushing, misuse of medication, restraint or inappropriate physical sanctions.

· Domestic Violence – including psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence.

· Sexual abuse – including rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography or witnessing sexual acts, indecent exposure and sexual assault or sexual acts to which the adult has not consented or was pressured into consenting.

· Psychological abuse – including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyber-bullying, isolation or unreasonable and unjustified withdrawal of services or supportive networks.

· Financial or Material abuse – including theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.

· Modern Slavery – encompasses slavery, human trafficking, forced labour and domestic servitude. Traffickers and slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment.

· Discriminatory abuse – including forms of harassment, slurs or similar treatment; because of race, gender and gender identity, age, disability, sexual orientation or religion.

· Organisational abuse – including neglect and poor care practice within an institution or specific care setting such as a hospital or care home, for example, or in relation to care provided in one’s own home. This may range from one off incidents to on-going ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation.

· Neglect and acts of omission – including ignoring medical, emotional or physical care needs, failure to provide access to appropriate health, care and support or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating.

· Self-neglect – this covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding.

General indicators of abuse

Why does it happen?

How to report abuse

Mental Capacity Act

The Mental Capacity Act (MCA) is designed to protect and empower individuals who may lack the mental capacity to make their own decisions about their care and treatment. You can read more below.

Deprivation of Liberty Safeguards

Deprivation of Liberty Safeguards are a part of the Mental Capacity Act and relate to people who are placed in care homes or hospitals for their care or treatment and who lack mental capacity. You can read more below.

Mental Health Act

In most cases when people are treated in hospital or another mental health facility, they have agreed or volunteered to be there. However there are cases when a person can be detained, also known as sectioned, under the Mental Health Act (1983) and treated without their agreement. You can read more below.

The Mental Capacity Act

The Mental Capacity Act (MCA) is designed to protect and empower individuals who may lack the mental capacity to make their own decisions about their care and treatment.

It is a law that applies to individuals aged 16 and over.

Examples of people who may lack capacity include those with:

• dementia

• a severe learning disability

• a brain injury

• a mental health condition

• a stroke

• unconsciousness caused by an anaesthetic or sudden accident

However, just because a person has one of these conditions does not necessarily mean they lack the capacity to make a specific decision.

Someone can lack capacity to make some decisions (for example, to decide on complex financial issues) but still have the capacity to make other decisions (for example, to decide what items to buy at the local shop).

The MCA says:

• Everyone has the right to make his or her own decisions. Health and care professionals should always assume an individual has the capacity to make a decision themselves, unless it is proved otherwise through a capacity assessment.

• Individuals must be given help to make a decision themselves. This might include, for example, providing the person with information in a format that is easier for them to understand.

• Just because someone makes what those caring for them consider to be an "unwise" decision, they should not be treated as lacking the capacity to make that decision. Everyone has the right to make their own life choices, where they have the capacity to do so.

• Where someone is judged not to have the capacity to make a specific decision (following a capacity assessment), that decision can be taken for them, but it must be in their best interests.

• Treatment and care provided to someone who lacks capacity should be the least restrictive of their basic rights and freedoms possible, while still providing the required treatment and care.

The MCA also allows people to express their preferences for care and treatment in case they lack capacity to make these decisions. It also allows them to appoint a trusted person to make a decision on their behalf should they lack capacity in the future.

People should also be provided with an independent advocate who will support them to make decisions in certain situations, such as serious treatment or where the individual might have significant restrictions placed on their freedom and rights in their best interests.

You can find out more about MCA here; https://www.nhs.uk/conditions/social-care-and-support-guide/making-decisions-for-someone-else/mental-capacity-act/

Deprivation of Liberty Safeguards

The Mental Health Act

Safeguarding Adults - Policies and further reading

Please see below for more information about adult safeguarding subjects including our Modern Slavery Act statement.

Independent Mental Capacity Advocates (IMCA)

About Your Independent Mental Capacity Advocate Easy Read

Modern Slavery Act

Modern Slavery Act Statement

James Paget Safeguarding strategy

Safeguarding Strategy

James Paget Mental Health Act Policy

MHA Policy

James Paget Mental Capacity Act and Deprivation of Liberty Safeguards Policy

MCA Dols Policy

James Paget Prevent Policy

Prevent Policy

James Paget Domestic Violence and Abuse Policy

Domestic Violence And Abuse Policy Patients And Staff

Ask for James

Our 'Ask for James' campaign urges anyone in need of help to talk to our team.

This is particularly aimed at anyone in an abusive relationship, whether that is domestic abuse or coercive control or linked to modern slavery, adult or child safeguarding.

It could be that you are with someone who is abusing or controlling you - if so please Ask for James and our team should take you somewhere private where you can talk and be offered support.