Clinical Matters: Adult Support and Protection
The Adult Support and Protection Act 2007 gives greater protection to adults at risk of harm or neglect. The act defines adults at risk as those aged 16 years and over who are affected by disability, mental disorder, illness or physical or mental infirmity, are more vulnerable to being harmed than adults who are not so affected.
Having a particular condition, such as a learning disability or a mental illness, 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. Adult Support and Protection Act (2007) defines an ‘adult at risk’ as someone who:
Is unable to safeguard their own well-being, property, rights or other interests.
Is at risk of harm, and
Because they are affected by disability, mental disorder, illness or physical or mental infirmity, is more vulnerable to being harmed than adults who are not so affected.
Note that the presence of one or two criteria does not automatically mean an adult is an adult at risk – all three of these elements must be met.
1. At risk of harm
Note that the presence of a particular condition does not automatically mean an adult is an adult at risk of harm. Someone could have a disability but be able to safeguard their well-being, property, rights and other interests.
2. More vulnerable to being harmed
The person may have learning or physical disabilities or mental health issues. Or they may be at risk of harm because of their age, frailty or illness. A person's vulnerability and risk of being abused also depends upon their circumstances.
3 Unable to safeguard
This criteria relates to whether the adult is unable to safeguard their own well-being, property, rights and other interests.
'Unable' is not further defined in the Act or guidance but is defined in the Oxford English Dictionary as 'lacking the skill, means or opportunity to do something'.
A distinction should therefore be drawn between an adult who lacks these skills and is unable to safeguard themselves, and one who is deemed to have the skill, means or opportunity to keep themselves safe, but chooses not to do so.
An inability to safeguard oneself is not the same as an adult not having capacity. An adult may be considered unwilling rather than unable to safeguard themselves and so may not be considered an adult at risk.
Who monitors these:
Adult Protection Committees (APC)
The Adult Support and Protection (Scotland) Act 2007 set up multi-agency Adult Protection Committees (APCs) in every council area. The Committee monitors and reviews what is happening locally to safeguard adults. It is made up of senior staff from many of the agencies involved in protecting adults who may be at risk.
These include staff from the council social services, the NHS and the police.
APCs are chaired by independent convenors, who cannot be members or officers of the council. APCs have a central role to play in taking an overview of adult protection activity in each council area and making recommendations to ensure that adult protection activity is effective. APCs have a range of duties, which include:
Reviewing adult protection practices
Improving skills and knowledge
Providing information and advice
Promoting good communication
Adult Protection Committees are required to submit a report to Scottish Ministers every two years. We have produced guidance for Adult Protection Committees.
What is meant by 'harm?'
For the purposes of the Act, 'harm' includes all harmful conduct and, in particular, includes:
Conduct which causes physical harm;
Conduct which causes psychological harm ( e.g. by causing fear, alarm or distress);
unlawful conduct which appropriates or adversely affects property, rights or interests ( e.g. theft, fraud, embezzlement or extortion); and
Conduct which causes self-harm.
Each legislation policy procedure is set to provide and protect/ guide each the client and the carer, these give clear guidance into the required standards these include:
Health and social care standards
Care Inspectorate - how care is regulated
Complaints and feedback
Patient Advice and Support Service (PASS)
Caring for an adult with incapacity
Adult support and protection
Power of attorney
Advocacy Your safety is protected by a variety of laws covering the provision of community care.
Some legislation relates to the whole UK, but much legislation differs in Scotland from similar legislation in England.
Principles underlying the Act
The overarching principle underlying Part 1 of the Act is that any intervention in an individual's affairs should provide benefit to the individual, and should be the least restrictive option of those that are available which will meet the purpose of the intervention.
This is supported by a set of guiding principles which, together with the overarching principle, must be taken account of when performing functions under Part 1 of the Act.
The wishes and feelings of the adult at risk (past and present);
The views of other significant individuals, such as the adult's nearest relative; their primary carer, guardian, or attorney; or any other person with an interest in the adult's well-being or property;
The importance of the adult taking an active part in the performance of the function under the Act;
providing the adult with the relevant information and support to enable them to participate as fully as possible;
The importance of ensuring that the adult is not treated less favourably than another adult in a comparable situation; and
The adult's abilities, background and characteristics (including their age, sex, sexual orientation, religious persuasion, racial origin, ethnic group and cultural and linguistic heritage).
The importance of recording
Recording is an integral and important part of social work and social care. It is not simply an administrative burden to go through as quickly as possible, but is central to good, person-centered support. Recording is vital:
It supports good care and support
It is a legal requirement and part of staff’s professional duty
It promotes continuity of care and communication with other agencies
It is a tool to help identify themes and challenges in a person’s life
It is key to accountability – to people who use services, to managers, to inspections and audits
It is evidence – for court, complaints and investigations
It will enhance your practice and the support you can offer people if you can make good recording a central part of your work.
Why is reporting so important?
To safeguard adults who have need for care and support and are experiencing, or at risk of, abuse or neglect.
To help adults who are unable to protect themselves from abuse or neglect or the risk of it due to their care and support needs.
To prevent harm from anyone who could cause abuse or neglect such as family, friends, staff, volunteers, staff or strangers.
To identify adults who ae more at risk because of a disability, illness, health condition or other factors such as being dependent, controlled or suppressed by others.
Responding to service users disclosure:
Responding to Disclosure, Suspicion or Witnessing of Harm Where an adult at risk discloses or discusses potential harm, the staff member or volunteer must be able to:
Recognise: identify that the adult at risk may be describing harm, even when they may not be explicit
Respond: stay calm, listen and show empathy
Reassure them that it will be taken seriously and explain that there is a duty to report the issues internally and what may happen next
Record: write up notes of the conversation clearly and factually as soon as possible
All staff have a duty to report any suspicion or concern to the person in charge of their shift.
The person in charge is responsible for contacting Social Work Scotland immediately using the out-of-hours service if the event occurs in the evenings or at weekends. The on call manager must be contacted no matter what time of night it is.
The person in charge completes an AP1 form and ensures that an allegation of harm notification is sent to the Scottish Commission for the Regulation of Care - Care Inspectorate via the e-form system. Both these documents must be completed within 24 hours of the incident and only within 48 hours in exceptional circumstances.
Willful neglect and ill-treatment is a criminal offence. An offence of willful neglect or ill-treatment may be committed against an adult receiving health or social care. A care worker can commit a criminal offence if they willfully neglect or ill-treat an adult receiving health or social care.