Agencies and services that provide support to adults who present a wide range of challenging behaviours have a responsibility to safeguard them from abuse as well as preventing them from abusing other Adults at Risk.
Many provider organisations have become accustomed to responding internally to incidents of vulnerable service users who abuse other service users. This has meant that regulatory, contract and commissioning agencies, for both the victim and the perpetrator may not have been informed of the concerns, or been given an opportunity to engage in decision making around the issues. It has also resulted in multi-agency Safeguarding Adults Procedures being ignored and abuse that may also constitute a criminal offence not being addressed.
When a person has been placed with a service that service has an obligation to ensure that they are provided with the appropriate support to meet their needs.
Organisations that aim to provide support to service users who have challenging behaviours need to have an understanding of the history and needs of the person to ensure that they are able to both safeguard them from abuse and prevent them from abusing other Adults at Risk within the service. The organisation must ensure that the appropriate assessments are carried out accordingly and that they are able to meet the needs of the service user and develop a care plan to meet those needs.
An acceptance by the service of low level abuse / bullying from whatever source will ultimately, if allowed to continue, lead to a culture that is damaging to all service users and staff in that service. It is important, therefore, that all instances of abuse are recognised and reported to the Local Authority's Safeguarding Adults Team via a referral which clearly indicates the level of harm as assessed using the Safeguarding Threshold Risk Assessment Guidance. This is in itself insufficient to safeguard. Measures taken by the organisation to safeguard the individual(s) should be clearly identified on the Safeguarding Adults Concern (SAC) Form.
Clearly it is not always necessary for every instance where one service user abuses another to be investigated formally using the Safeguarding Adults process. It is however, important that such instances are recognised and dealt with appropriately and efficiently by the organisation caring for the individuals and that the individual who has been abused is fully involved in any decision about what they want to happen next and what outcome they want. It is important that, even if the incident is dealt with internally, all actions have been taken to safeguard and that risks have been brought down to the lowest level possible and that the Local Authority are notified via a Safeguarding Adults Concern (SAC) Form (available from Sunderland Council's Safeguarding Adults webpage 'Report a Safeguarding Concern - Professionals & Volunteers') as soon as possible after the incident has occurred or concern has been raised. This will ensure that all incidents of abuse, including those perpetrated by Adults at Risk, are recorded in accordance with the Care Act (2014) and brought to the attention of the Local Authority so that they can assess and manage their statutory Duty to Make Enquiries, or to cause Enquiries to be made. What the person wants should be clearly recorded on the referral form. In some cases it may be that the Local Authority decide to convene a Strategy Discussion / Meeting or request additional action be taken, for example if the alleged abuse also constitutes a criminal act or if the matter is particularly complex or requires further investigation. It may also be the case if there has been more than one incident involving the same perpetrator or victim (referred in the past). In other instances it may be considered appropriate that the situation can be dealt with by implementing internal procedures, reviewing care plans and/or arranging multidisciplinary meetings, requesting re-assessments or altering service provision.
If there are any doubts about the course of action to take in these particular matters, the Responsible Person or Safeguarding Adults Lead in the worker’s own organisation should be contacted for advice. Who these individuals are should be clearly stated in the organisations’ Individual Agency Guidance, or as part of their Safeguarding Adults policy and procedures.