Social isolation is an increasing risk factor in relation to abuse and neglect. It can be a contributing factor to a rise in incidents of domestic abuse, self-neglect and carer stress. With more people self-isolating as a result Covid-19 this needs to be factored in when undertaking Section 42 enquiries.
Social isolation can mean:
- Abuse/neglect is hidden from professionals or others
- People do not get the support they need
- People feel reluctant to ask for help for fear of being an added burden
- Increased household stress and tension
- People ask for help from those who might take advantage of their vulnerability
Some advice to consider:
- Use existing tools and guidance to assess risk.
- Go to www.hertfordshire.gov.uk/hsab for safeguarding resources.
- Ensure you factor in Covid-19 pressures to any risk assessments.
- As always, consider mental capacity, control and coercion on a person’s ability to make decisions and keep themselves safe.
- Seek advice from your manager and peers and escalate issues if required.
- Risk management might include:
- Referring the case to safeguarding adults team
- Undertaking the MARAC checklist and subsequent referral to MARAC. If you are asking another agency to do this, check that this has been done.
- Referral to domestic abuse or carer support agencies.
- Undertaking an assessment for the person and/or carer.
- Identifying informal support network and ways in which this can operate via phone/internet
- Contingency arrangements for the person’s care should the person’s informal support need to self-isolate or be unable to provide care;
- Mental capacity assessments and best interest decisions;
Be mindful that some organisations might be operating differently due to coronavirus so check what they able to offer at this time.
New safeguarding guidance on medication errors
Hertfordshire County Council’s Adult Safeguarding teams will no longer progress safeguarding concerns for individual medication errors where there are no other safeguarding issues.
This decision has been made given the significant pressure on ACS staff due to COVID-19
Safeguarding referrals should not be raised where:
- There is an error in recording(for example a signature is missed but medicine was correctly administered)
- Medication is missed on one occasion and no harm occurs
- Medication is not given on more than one occasion and no harm occurs(for example recurring missed medication or administration errors identified through observation or audit and swift action taken)
- Medication was given late(for example an unforeseen event meant that some people received their medication later than scheduled) and GP/111 confirms no harm has occurred, incident has been recorded and action taken/advice given)
Safeguarding referrals should still be raised via the Adult Safeguarding Referral Portal where:
- Medication error triggers a notification to CQC (this would happen in the event of a death, an injury, an allegation of abuse, report or investigation by the police)
- The adult at risk came to harm (an impairment to health which results in an increase to a person’s care and support needs)
- Medication is given as a form of unlawful restraint
- A deliberate action is taken to incorrectly administer or neglect to administer medication
- Medication is administered covertly where no specific approved covert medication protocol is in place
- Single medication incident involving multiple clients (e.g. a whole medication round missed or delayed)
Whether or not a medication error triggers raising a Safeguarding concern, any identified poor practice in administration of medication requires a management response from the provider service and the usual monitoring through our commissioning frameworks will continue to apply.
If you are not sure if you should report a concern, speak to your manager or telephone ACS on 0300 123 40 42.
Advanced Care Planning
Joint Statement on Advance Care Planning from National Care Forum
Look after people who lack mental capacity
The Mental Capacity Act (2005) and Deprivation of Liberty Safeguards during the coronavirus pandemic
For updates from the local health services visit:
Visit Age UK website for advice
People with learning disabilities
Visit Mencap for resources, including easy-read factsheets
Visit HSCP website for resources on keeping children safe
Visit HCPA for resources for care providers.