Support for community organisations who are working with "Adults at Risk"​

In the last number of weeks, I have noticed an increase in requests from community organisations for support to implement their Adult Safeguarding Policy and provide Safeguarding Training for staff in their organisation. I believe this increase is directly related to the fact that Ireland, and specifically community groups in rural parts of Ireland, are now supporting large numbers of persons who have come here to flee War be it in Ukraine, the Middle East, or Africa.

Traditionally Adult Safeguarding has always been recognised as an essential elment of working with the elderly, persons with an intellectual disability and those who have limited capacity. The term “vulnerable” adult is the most commonly referred to term to identify those at most risk of abuse. According to the HSE 2014’s Safeguarding Vulnerable Persons At Risk of Abuse National Policy described vulnerable persons as:

“an adult who may be restricted in capacity to guard himself / herself against harm or exploitation or to report such harm or exploitation. Restriction of capacity may arise as a result of physical or intellectual impairment. Vulnerability to abuse is influenced by both context and individual circumstances”.

However according to the Governments discussion paper on Safeguarding there is a growing consensus both in Ireland and internationally that the use of the term vulnerable is insensitive and may stigmatise those affected. It also implies that the persons characteristics cause them to be at risk of being harmed, rather than those who cause harm. There is now a move towards the term "Adult at Risk" rather than focusing on their vulnerablility. The HSE are currently working on a revised definition of adult at risk in their new safeguarding policy (unpublished) which is as follows:

“an adult aged 18 years or over, who is at risk of experiencing abuse, neglect, or exploitation by a third party and lacks mental or physical capacity to protect themselves from harm at this time in their lives”

This shows a better understanding of both the situational nature of being “at risk” as well as demonstrating that it is the actions of a 3rd party rather than an inherent “vulnerability” due to the individuals characteristics and circumstances which cause the person to be at risk of abuse.

If you are working with Adults at Risk and are beginning to observe that they are experiencing vulnerability at this time in their lives and are concerned that your organisation needs to implement a robust safeguarding policy and procedure or revise your existing policies and procedures then please do get in touch at maighread@maighreadkelly.ie to discuss further.

In 2021 I partnered with Best Practice Healthcare Ltd. to deliver an online training course in "Safeguarding of Vulnerable Adults at Risk of Abuse". For further information see https://bestpracticehealthcare.ie/safeguarding-vulnerable-adult-risk-abuse/

by Maighread Kelly

Why is the reporting of accidents, incidents and near misses so important for Safeguarding?

Across all sections in society, those involved in the provision of care can learn from any near miss, incident, complaint or accident. Any one of these can be a learning experience for all involved, particularly if there are certain situations that are recurring. It can unfortunately also be an indicator of abuse, including risk to safeguarding in the organisation, a situation that needs to be examined immediately.

A poor or toxic culture in an organisation may manifest itself in a culture of fear; fear of speaking out about issues like understaffing or the lack of necessary resources for the safe provision of care. This can increase the chances of safeguarding risks and the likelihood of abuse occurring. Every person working within an organisation contributes to the culture in that organisation, but if there is a systemic problem within the leadership of the organisation, it can be difficult for a positive and proactive safeguarding culture to exist. Those of us who are most vulnerable rely on those who are supporting us to be constantly aware of our safety and raise the alarm if they believe we are unsafe or are participating in activities which could put us in harms way. They also rely on us to report to those in authority if they suspect we are being ill treated.

What is safeguarding?

All adults have a right to be safe and to live a life free from abuse. According to the HSE, safeguarding means putting in place measures that promote and protect people’s human rights, their health and well-being whilst empowering people to protect themselves. Most adults can protect themselves and may only require advice or guidance from the people who support them. Others may require support to protect themselves and may in some cases require a health or care plan to help them feel safe. A minority of people cannot protect themselves adequately from abuse and will require additional protection. Safeguarding should also be viewed as responding to concerns to prevent abuse across a continuum of care.

Safeguarding focuses on the:

  • Prevention of abuse.
  • Identification of abuse.
  • Identification and implementation of measures that reduce/eliminate the risk of recurrence of abuse.

A Safeguarding Ireland Survey Found…

  • 1 in 2 Irish adults claim experience of vulnerable adult abuse.
  • Physical abuse of vulnerable adults has been witnessed, or suspected, by 1 in 3 adults.
  • Emotional abuse is the most common type with over 1 in 3 having experienced it.
  • More than 10,000 cases of alleged abuse are reported to the HSE Safeguarding and Protection Teams each year.

Ireland's first Adult Safeguarding Day public awareness event takes place on Friday November 19, 2021. The event is being coordinated by Safeguarding Ireland – in partnership with organisations across the health, social, financial and justice sectors. The aim is to raise a greater awareness and understanding of safeguarding with respect to

  1. Rights
  2. Services and
  3. Empowerment.

In celebration of Ireland's 1st ever Adult Safeguarding Day we will be giving away 5 vouchers (worth €50 each) to attend our Safeguarding Vulnerable Adults at Risk of Abuse training course. Designed for Healthcare Workers, Social Care Workers, Residential Service Providers, Home Care and Disability Sector employees. Our online Safeguarding Vulnerable Adults at Risk of Abuse course helps you clearly identify safeguarding risks, and understand when and how to report a safeguarding concern including allegations or concerns of abuse.

If you would like to be in with a chance to get a voucher the first 5 people to email me will get their free training voucher maighread@maighreadkelly.com

by Maighread Kelly

COVID-19: Guidance for Homecare Providers

This guidance takes account of latest government advice on COVID-19 and how to support people in their own homes.

Provision of care and support in people’s home is a high priority service, in that most care and support cannot be deferred to another day without putting clients at risk of harm.

1.  Steps for Homecare providers to maintain delivery of care:

  • We advise all providers to review their list of clients, and ensure that it is up to date, including levels of informal support available to those clients, who is in their circle of support and if the next of kin details are accurate.
  • Link in with the HSE and other homecare providers in your area to establish plans for mutual aid, taking account of their business continuity plans, and consider arrangements to support sharing of the workforce between homecare providers, and with local primary care services providers; and with deployment of volunteers where that is safe to do so.
  • Link in with your clients to enquire if there are any neighbours or friends who might be able to support them, should the situation worsen in the coming weeks.
  • Home care providers should check their stocks of personal protective equipment (PPE) such as gloves and aprons are adequate and link in with other agencies to share resources in the event that the situation worsens in the coming weeks.

2.   If a Health Care Assistant is concerned, they have COVID-19

  • If a member of your staff is concerned they have COVID-19 they should follow the HSE’s advice which is regularly updated.
  • If they are advised to self-isolate at home they should follow the HSE’s guidance on self-isolation.
  • If advised to self-isolate at home, the Health Care Assistant should not visit and care for clients until safe to do so.

3.   If the client being cared is displaying symptoms of COVID-19

If the client receiving care and support has symptoms of COVID-19, then the risk of transmission should be minimised through safe working procedures.

3.1.   Personal protective equipment

  • Health Care Assistants should use personal protective equipment (PPE) for activities that bring them into close personal contact, such as providing intimate care, washing and bathing, and contact with bodily fluids.
  • Aprons, gloves and fluid repellent surgical masks should be used in these situations. If there is a risk of splashing, then eye protection will minimise risk.
  • New personal protective equipment must be used for each episode of care. It is essential that personal protective equipment is stored securely within disposable rubbish bags.
  • These bags should be placed into another bag, tied securely and kept separate from other waste within the room. This should be put aside for at least 72 hours before being put in the usual household waste bin.

3.2.   Cleaning

  • If Health Care Assistants undertake cleaning duties, then they should use usual household products, such as detergents and bleach as these will be very effective at getting rid of the virus on surfaces. Frequently touched surfaces should be cleaned regularly.
  • Personal waste (for example, used tissues, continence pads and other items soiled with bodily fluids) and disposable cleaning cloths can be stored securely within disposable rubbish bags.
  • These bags should be placed into another bag, tied securely and kept separate from other waste within your own room. This should be put aside for at least 72 hours before being put in the usual household waste bin for disposal as normal.

3.3.   Laundry

  • If Health Care Assistants support the client with laundry, then they should not shake dirty laundry. This minimises the possibility of dispersing virus through the air.
  • Wash items as appropriate, in accordance with the manufacturer’s instructions.
  • Dirty laundry that has been in contact with an ill person can be washed with other people’s items. If the client does not have a washing machine, wait a further 72 hours after the 7-day isolation period has ended; the laundry can then be taken to a public laundromat.
  • Items heavily soiled with body fluids, for example, vomit or diarrhoea, or items that cannot be washed, should be disposed of, with the owner’s consent.

4.  If neither the client nor the care worker have symptoms of COVID-19

  • If neither the care worker nor the client receiving care and support is symptomatic, then no personal protective equipment is required above and beyond normal good hygiene practices.
  • General interventions may include increased cleaning activity and keeping property properly ventilated by opening windows whenever safe and appropriate.
  • Health Care Assistants should follow the HSE guide on how to wash your hands

The HSE and HPSC brought out Guidance for Health and Social Care Workers who visit homes on the 19th March 2020.

Maighréad Kelly is a management consultant and offers a range of supports to employers in the area of HR and Operations.  For more information on the services that Maighréad provides go to www.maighreadkelly.com or check out her experience on https://www.linkedin.com/in/maighreadkelly/

by Maighread Kelly