County of Northumberland‟s
for the Protection
of Vulnerable Adults
This document has been produced by a multi-agency group and is for the use of any workers, in statutory,
voluntary and private agencies, in their work with
The original practice guidelines, dated Feb. 2000, were written by the multiagency group and were supported by
“No Secrets”, a Department of Health guidance document which was published later that year. The following guidelines have been written following two years’ experience of using the original document and
have been influenced by practice.
The following agencies have agreed to the
implementation of the Practice Guidelines:
Northumberland Care Trust
Northumbria Healthcare NHS Trust
Northgate and Prudhoe NHS Trust
Newcastle, North Tyneside and Northumberland
Mental Health NHS Trust
Representatives from the Voluntary Sector
Northumberland County Council
1. INTRODUCTION Page Nos.
1.1 The Policy 1
1.2 Prevention of Abuse 3
1.3 Pre-disposing Factors 4
1.4 Types of Abuse 5
1.5 Signs of Potential Abuse 6
2. INVESTIGATION AND IMPLEMENTATION
2.1 Flowchart of Procedure 7
2.2 Key Points for Action 8
2.3 Prompts to Aid Decision-making 11
2.4 Referrals 12
2.5 Response (including different settings) 13
2.6 Investigation Process 16
2.7 Subsequent Action/Intervention 18
2.8 Checklist for Process 20
2.9 Data Collection Form 21
Legal Framework I
Training and Education Strategy II
Police Guidance III
Strategy Document IV
Terms of Reference of VA Committee V
Communications Strategy VI
Contact Numbers VII
Glossary of Terms VIII
1.1 The Policy
The agencies involved in developing these guidelines are committed to work together to uphold the rights of vulnerable adults to protection from harm and exploitation.
We aim to:
; Increase awareness and recognition of the problem.
; Prevent the abuse of vulnerable adults.
; Take action, when abuse is suspected, to safeguard the vulnerable adult
from further harm.
; Look to empower people. There is a role for advocacy in this process.
These Guidelines apply in all settings, including residential, day, community and hospital settings. The setting will help to determine the course of any investigation, which will proceed in conjunction with any other action necessary because of the setting. These Guidelines are intended to be complementary to Agencies investigations of critical incidents and accident reporting and will often operate in parallel.
Where a member of staff of any organisation has reasonable cause to believe, whether through disclosure, allegation or suspicion, that a vulnerable adult is being abused it must be reported to his/her line manager as soon as possible, unless that person is himself under scrutiny.
In that case the matter must be reported to a higher management level. The manager will then ensure that it is brought to the attention of appropriate Care Management and other relevant staff.
Every effort should be made to ensure that vulnerable adults are aware of their rights and know how to report abusive situations.
In all of the above, the well-being of the vulnerable adult is paramount. The main focus will be to improve the situation of that person.
1.2 Prevention of Abuse
The following are considered to be important elements of a strategy of prevention:
1.2.1 Recognising that carers and vulnerable adults may at times have
differing or conflicting needs and rights and that separate
assessments of those needs may be required.
1.2.2 Having an awareness of the needs of the client and carers and of
potentially vulnerable situations.
1.2.3 Having knowledge of each individual’s strengths and weaknesses
relating to others.
1.2.4 Having knowledge of carers’ capacity to cope with stress.
1.2.5 Ensuring an adequate level of support is available at all times.
1.2.6 Ensuring any concerns are communicated clearly and quickly to the
1.2.7 Involving significant others in determining how best the client can be
1.2.8 Ensuring that no action or omission is detrimental to the health and
safety of clients.
1.2.9 Ensuring prompt and accurate reporting of disclosure, suspected
abuse and self-neglect.
1.2.10 Providing an ongoing programme of professional and public
1.2.11 Ensuring high standards of practice are achieved and maintained.
1.2.12 Having clear Guidelines within partner Agencies for risk
management, critical incidents and accidents, violence and
1.2.13 Clear Whistle-blowing guidelines and policies.
1.3 Pre-disposing Factors
The following situations may lead to the abuse of a client. This list has not been prioritised.
1.3.1 The carer has a physical or mental illness.
1.3.2 Previous domestic violence/abuse within the family.
1.3.3 The client has a physical or mental illness, which impairs physical,
psychological or social functioning and leads to their increased
dependence on others.
1.3.4 The responsibility for the care of the client is carried by one carer. 1.3.5 Family relationships have been poor in the past, or are experiencing
1.3.6 The family is under stress due to low income or poor housing. 1.3.7 The carer has experienced an enforced and unexpected change in
1.3.8 The carer is isolated from other family members and professional
1.3.9 The carer has become dependent on alcohol or drugs.
1.3.10 The carer may have other dependants and responsibilities. 1.3.11 The roles of carer and dependant are reversed.
1.3.12 The carer has no time free of care responsibilities. 1.3.13 The level of stress generated becomes intolerable.
1.3.14 There are inadequate support mechanisms.
All relationships are potentially volatile, and therefore those involved should be alert to the complexities and variations of each situation.
1.4 Types of Abuse
1.4.1 Physical Abuse
; Bodily assaults
; Medical/health maltreatment
; Bodily neglect
1.4.2 Sexual Abuse
; Any sexual act committed without consent or by force
; Sexual harassment
1.4.3 Psychological Abuse
; Sensory deprivation
; Emotional abuse
; Spiritual abuse (related to the cultural norms and values of ethnic
; Self-neglect has been found to be indicative of abuse by others as well
as of psychological disturbance.
; That based on a person’s disability
; Other forms of harassment, slurs or similar treatment
1.5 Signs of Potential Abuse
Research studies have highlighted warning signs that indicate a client may have been abused. The following list of signs is be no means definitive and each sign should not, in isolation be taken as evidence of abuse. The signs are equally applicable in all care settings and across categories of abuse.
1.5.1 Physical/Sexual Abuse
A history of:
; Unexplained falls
; Physical injuries
; Bruises or burns
; Bruises on the upper arms
; Cluster of bruises on the chest
; The presence of old and new bruises at the same time
; Burns in unusual places
; Personal neglect
; Poor hygiene
; Excessive repeat prescriptions or under-use of medication
; Frequent consultation with GP
1.5.2 Psychological Abuse
The client presents as:
; Anxious, withdrawn or agitated
; They may be isolated in one room
; They may be unkempt
; Professionals and other visitors may experience difficulty gaining
; The carer or other relative insist on being present during interviews
; Reluctance to discuss financial circumstances
; Recent poverty
; Unexplained inability to pay bills or buy food or other essentials
; Missing belongings and money
2.1 *Protection of Vulnerable Adults – Flow Chart
Abuse alleged, disclosed, suspected
Referral or report made to Care Trust District Office or any service for the 3N‟s Trust
Is there immediate physical danger NO YES
Take steps to remove person from danger Is a crime suspected/been committed
YES NO There may be a number of Strategy
Meetings/discussions throughout this Preserve evidence, consult process. This would take account of with Police and decide upon any new information or evidence appropriate action which may emerge
Strategy meeting/discussion to decide who leads the investigation
Can client make an informed decision YES NO
Does client want help Consult with senior and other
Professionals and advocates and make Decision how to proceed YES NO
Refer to criteria in document where we do not have client consent to make
decision about whether to proceed and consult with senior staff PROCEED WITH INVESTIGATION
Criteria not met Criteria met If abuse proven or still suspected
If abuse not proven N.F.A.
Care Management Case Conference where practicable No Further within 7 working days Intervention/Monitoring Action Case Conference decides:-
Action Care Management Take appropriate Intervention/Monitoring alternative action Northumbria Healthcare and 3N’s Trusts staff must also refer to and implement covering policies such as Serious Untoward Incidence Policy and Accidents and Incidents Review with all persons in three months Reporting Policy.
*This whole process takes place in consultation with Lead Care manager, Locality/Operations Managers and in serious