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Adult Safeguarding and Mental Capacity in the UK: Key Insights Case Study
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Safeguarding an adult refers to the rights of an adult person to live with safety and security. Adults should be free from the abuse of society, however the person is and the person should not be neglected in their universities and workplaces. Adults also need care and support so that they can prevent any risk in their lives themselves and can ignore negligence in different places. Mental capacity refers to protecting or helping people who need help to make their own life decisions, and there are many acts regarding this in the UK. In this report, the facts regarding safeguarding and mental capacity will be discussed and a discussion will be made on how the legislative practices and frameworks can be applied to the specific issues.
The current legislative framework in mental capacity is a structure that helps individuals to take the right decision in their life as needed. This framework also protects the people who are not able to make their own decisions. There are a lot of acts regarding this framework which will be discussed below.
Every local authority should have a responsibility to establish a SAB or Safeguarding Adult Board in their locality. The local authority has to make sure that the SAB contains at least a representative from the local authority and commission group of clinical (Board, 2021). The SAB leads adult safeguarding in their locality and they must have to publish an annual report regarding this. SAB must also report to Safeguarding Adult Review for serious cases of negligence (Hamilton, 2021). Social services have to investigate any issue regarding negligence or safeguarding of adults. The power to implement interventions is also given to them. Although social services are basically split into children care and adult care.
Guidelines:
Safeguarding national guidelines require that all the individuals who are working or in touch with a person who has a criminal record.
Policy:
Procedure:
The procedure of local police has some additional rules to follow such as they have to check against the Disclosure and Barring Services (DBS) (Policy et al., 2021). These laws are there to protect the people from any harm.
Own responsibility:
In terms of my own responsibility, it can be said that I should work together with my team members or friends, and in this way, we can reduce negligence and abuse in a work culture or in a school or university. All of us should give a response in time to the person whom we need and this way helps to manage the negative effects in time. A continuous process of this can help to reduce the negative effects and can give us assurance that the world is going to be a better place for adults (England.nhs.uk, 2023). We have to remember that there must not always be time for an emergency situation or a situation to investigate, at that time we need to take action by ourselves.
The investigator has to face the person in face-to-face contact and then understand all the problems. The person who is in charge of the investigation, if the person has any doubt that an individual may need help or the individual is at any risk, the investigator has to take some important steps. The steps included at first are alerts where the alert will identify safeguarding issues and can take immediate action or may inform adult care and support. In a workplace, a team leader will take the alert and then can decide if the alert should be received or not. Multi-agency takes the decision on how to manage the difficult situation and they decide on a plan for emergency protection. They carry full support strategies all the time and use them as when or where needed. The investigation officer will also carry out the investigation into safeguarding and also determine the level of risk and outcome.
Case conferences should be held within 20 days of getting a complaint and moreover to consider the evidence which has been submitted during the case and then they have to determine what is the risk level and only then can they prepare a report (Scie-social care online.org.uk, 2023). The review should be given within six months and the report should consist of the plan of protection and the risk assessment. All persons have the right to live with freedom without any risk of harm. At the end of the process, it can be said that all the processes should be followed carefully and the investigating officer must have to ensure that all stages have been done completely.
An individual may be bound by law if anyone reports a criminal offence or fraud case against them. There is a law in the UK regarding these cases that will be discussed below:
These acts state to protect whistleblowing, such as if a person makes an interest in public disclosure, which is related to misuse of power, corruption act, criminal offences, and many more. People who are working as public servants or in an organisation that is non-governmental can make such a disclosure to the central or state government.
The complainant who is going to complain has to include the requirement to disclose their identity, but the commission of vigilance will not disclose the identity to the public, although in exceptional cases the identity may be disclosed. The act will punish anybody except the authority who has disclosed the identity. Even the authorities will punish someone if they complains about a false case. A trainee (as an example, a student nurse), an employee, a Limited Liability Partnership worker, or an agency worker is bound by this law.
One can speak about this to their employee if they have any concern and the organisation have a policy of whistleblowing and they can even speak about it if the organisation does not have this particular policy. The Commission of Equality and Human right is a body that is prescribed for whistleblowing for the equality of human rights.
The first thing that I can do when I suspect anyone to be mentally unstable or need some help, I can show some care to them. Attention is one of the most important things that can help a person who is being abused for a long time or being neglected by society. Giving attention to them may bring some positive changes to their point of view towards society. I believe that the body language of a person defines the attitude of the person, therefore we should focus on our body language if that is going in a positive way or in a negative way to the other person who is standing in front of us. Therefore, our body language should be open to all and we have to notice whether it is showing encouragement to the other person or not. Moreover, if I consider that the person is really in serious condition, I can consult someone or report that matter.
Time is another important thing that we should take care of as we have to keep our patience while listening to another person and have to understand what are the problems they are facing now. As an individual, I never ask someone to complete their saying quickly, but I listen to them with patience as it gives them the vibe that they are also important to us. During the time they are talking to us, they may take a pause as they are not mentally stable at that time, we always have to respect their pause and have keep our patience and the time when they start talking about the phase they are going to, we should not interrupt them. As a result of interruption, they may feel disturbed and this can affect their mental health negatively. Therefore, we should let them be at their own peace and try our best to bring positive vibes to them.
There is always a risk that an adult may be abused day by day or get neglected by the society which harms the person’s mental health in a very bad way and negatively. Moreover, if it is possible that I get in touch with a person like that, I have to take care of that person in a good way and take the following steps if the condition of the person is really serious.
The problem of mental health can be cured by proper treatment and guidance of a doctor. Therefore, whenever a person is not feeling well or sick, one has to call on the number 111, which is the number of urgent medical health services (Ladds et al., 2020). The urgent medical health service provides urgent services for a patient who is in a bad condition. Moreover, if there are any adults who have good mental health, I can talk to that person, discuss the sick person and make the right decision.
Working as a team can also help those who need mental support and care. The team should work in such a way that they feel comfortable while communicating with others. Every team member should be aware of the signs of being abused and neglected. They should recognize whether any person is feeling uncomfortable or being neglected. Although I don’t think we should always try to solve our problems by ourselves, if the problem seems really tough then we should consult with the doctors and get medical help.
Consent to share information refers to understanding when the person giving consent, has to understand why the information is going to be shared with anyone else (Kamleitner and Mitchell, 2019). The person who will see their information are medical professionals and going to study on the information and cure them completely. Adult care and protection of safeguarding contain a lot of sensitive information about the patients. Moreover, to keep the adults safe the information needs to be shared with the doctors who are going to do treatment of them. Local authority contacts social workers who work especially with cases of neglect and abuse. Consent safeguarding helps to enable the professionals so that they can assess to the information that has a risk of harm and it will help the professionals to be sure about the mental condition of the patient and it will also help the professionals to be sure about the decision made by them.
First of all, we have to talk to an organization or an agency if we have a concern about any individual who is suffering from negligence or abuse. We can ive some positive advice to the person so that it can help the person to get rid of such terrible mental conditions. But we should not believe that adult is in such a condition that they can make significant harm to themselves as it can bring negative effect. We should always ask for consent before sharing the saying of the patient with another. But in critical conditions, we may need to share the information only with the doctor.
In England, The Department for Education (DfE), is the agency who is responsible for the safeguarding of children. There are laws in place that are implemented to prevent any kind of harm to children and actions to prevent any harm that can happen to them. There are certain agencies and authorities who work together to uphold a safe environment for the children. There are three kinds of organizations at a local level working to provide protection from unnecessary danger: the local authorities, the police and clinical commissioning groups.
The Children Act of 1989, amended in 2004, is one of the main laws protecting children from danger. The original act placed a focus on parental responsibility for the children and the role of the family in their life. In contrast, the amended act added some more important aspects of child protection framework, such as the duty of the local authorities and agencies in England to look after the welfare of a child and cooperate with similar agencies to provide a safe environment for the child to grow up in (gov.uk, 2022). there are strict guidelines in place in case any suspicious activity regarding a child’s welfare goes unreported by any such agencies. If any child is found to be in a dangerous situation, a child protection plan is set out. Often, in the case of an unreliable home where the parent or the guardian is deemed to be not fit to take care of the child, the agency can decide to place the child in care services away from their parents.
As responsible citizens of the United Kingdom, we must provide a safe environment for the children to grow up in. We can do our best and let the agencies know if we ever encounter suspicious activities where a child might be in danger, or they are in a home with unreliable parents who are abusive or cannot care for the child.
Protecting the rights and welfare of people who might not be able to make decisions for themselves requires legislation, rules of conduct, and policies governing mental capacity. These clauses establish a legal framework that directs service providers to assist and protecting people with diminished capacity. An individual shall assess the main clauses and their applicability to the service here.
Service providers can ensure they work within a moral and legal framework by abiding by laws, codes of conduct, and policies on mental ability. These rules provide precise instructions for determining capacity, making choices in people's best interests, and including concerned parties in decision-making. Service providers must put the rights, interests, and well-being of people with limited mental capacity first, fostering their autonomy and protecting them from abuse or possible damage.
As of March 2020, the US Congress had passed three sizable relief measures in response to the COVID-19 problem, and further legislation is anticipated. These laws include several elements that are important to mental health legislation (Goldman et al. 2020). They consist of allocating money for mental health services, approving new projects, and establishing standards for reporting and oversight. The current legislative effort underscores the need for continued support and resources in this area. It shows that addressing mental health issues in the context of the epidemic is important.
An individual’s role is essential in safeguarding the protection and rights of people who may lack ability because they are in charge of applying and upholding fundamental elements of mental capacity laws and codes of practice. I'll evaluate one’s contribution to these concepts in this section.
In conclusion, one must assist with capacity assessments, encourage autonomy and informed decision-making, carry out best interests analysis, maintain records, and engage in ongoing professional development to apply and uphold key principles of mental capacity laws and codes of practice.
This study looked at the opinions of peer workers before implementing recovery-oriented practice (ROP) in a mental health service. The results show peer workers are crucial for training clinicians, representing service users, fostering cultural and institutional changes, and exercising leadership. Because they contribute a lived experience perspective to practice and policy changes, their inclusion improves the implementation of ROP (Chisholm et al. 2020).
The COVID-19 pandemic and associated measures have increased the risk of mental health problems and worsened health inequalities. Efforts have been made to adapt mental health care, focusing on infection control, access to diagnosis and treatment, continuity of care, and addressing high-risk populations. Sustainable adaptations should be developed to mitigate disparities, and continuous assessment is crucial. The pandemic presents an opportunity to improve mental health services globally (Moreno et al., 2020).
The evaluation process can be understood and navigated with the help of advocacy services, such as independent mental capacity advocates (IMCAs) or mental health advocacy groups. They can help ensure people's voices are heard during the assessment, offer support, and explain their rights.
According to Satinsky et al. (2019), in the countries that make up the European Union Single Market, this systematic study looked at how frequently refugees and asylum seekers used and had access to mental health and psychosocial support (MHPSS) services. The conclusions drawn from 27 papers point to a subpar use of MHPSS services by this group. Language problems, help-seeking habits, a lack of information, stigma, and unfavourable attitudes toward and by healthcare professionals are some of the obstacles to receiving care. Increasing treatment demand and guaranteeing proper care for refugees and asylum seekers depend on addressing culturally specific hurdles and enhancing healthcare practitioner training on cultural models of mental illness (Satinsky et al. 2019).
The work is essential to ensuring the subject's safety and well-being since, as an individual who is involved in risk assessment in circumstances where a person's capacity is taken into account,. The role of this process is discussed here.
Recognising Capacity Indicators Finding circumstances under which a person's capacity may be affected is one of the key duties. This requires being alert for symptoms such as confusion, disorientation, impaired decision-making, and difficulty comprehending facts.
To ascertain a person's capacity to make particular decisions, capacity evaluations are conducted. This necessitates abiding by the moral and legal guidelines set forth by the pertinent laws and professional ethics standards.
It is frequently necessary to collaborate with other professionals, such as medical staff, social workers, lawyers, and family members, when assessing risk in circumstances when capacity issues are present. We can gather various viewpoints, share knowledge, and collectively assess the risks by cooperating.
It is crucial for me to accurately and completely record the results of capacity assessments and risk evaluations. Documenting the assessment process, the variables taken into account, the judgements made, and any suggested courses of action or interventions are all part of this.
One must pursue ongoing professional development given the dynamic nature of risk assessment techniques and mental capacity evaluations. He/she can improve his or her abilities and knowledge in capacity assessment and risk evaluation by keeping up with changes in laws, research, and best practices. This makes sure one has all they need to do the job well and by current regulations.
Procedures that assist individuals in granting legal permission are required for encounters to be moral and polite. These practices promote individuality, intelligent decision-making, and respect for personal space. In order to support legal consent, the following essential activities must be taken:
Consideration Time should be given to people so they may consider their options and make a decision (Bartlett et al., 2020). Rushing or pressuring someone to provide their assent immediately interferes with their ability to fully understand the implications and appreciate their liberty.
To deliver competent and moral care, it is important to evaluate one's own practice needs as well as those of the team members. Keep the following crucial considerations in mind while examining the development needs in this industry:
Analyse the level of your awareness and understanding of the mental ability-related laws rules and suggested methods. The mental capacity act and other legislation, concepts and guidelines are related to one's mental capacity and decision-making must be understood to achieve the goal.
Verify your aptitude for completing an assessment on the basis of mental capacity by using assessment techniques. This will allow people to understand the factors that influence aptitude and the use of assessment tools.
Assess people’s ability to engage in productive communication with people who may have limited mental ability. This involves the ability to communicate effectively through the use of clear, understandable language, the use of nonverbal cues, and the modification of communication methods to accommodate those with various levels of cognitive ability.
Encourage introspection on one's own behaviour as well as the behaviour of other members. This entails frequently analysing case studies, requesting input from co-workers or superiors, and participating in reflection activities to pinpoint areas that require development.
It is crucial to identify unique growth requirements for oneself and other team members based on these evaluations. In order to encourage continual learning and progress, this may entail developing individual development goals, looking for pertinent training options, providing mentoring or training, and providing resources. Professionals can deliver the best care if development requirements are regularly monitored and reevaluated.
Measures taken to restrict someone's freedom of motion, autonomy, or choice are known as restrictive practices (Younossi et al., 2021). They are frequently employed to ensure someone's safety or when they engage in problematic behaviour. However, it is important to use caution because these practices can potentially limit a person's rights and liberties. Restrictive practices are used rarely and only when absolutely essential at my workplace to guarantee the welfare of the clients we help.
Physically holding, immobilising, or limiting someone's movement are all examples of restraint. It is regarded as a last option and ought to only be applied when there is an urgent danger to the person or others. Physical restrictions like straps or belts or the use of gadgets that limit movement are examples of restraint measures. We follow tight rules and procedures surrounding the use of restraints at my place of employment. These guidelines describe the precise situations in which restraint could be required and place a focus on the requirement for minimal force, suitable training, and routine re-evaluations of the individual's health.
In the event that someone's freedom is completely restricted, their liberty is being robbed. This type of situation refers to the healthcare environment. In such cases, patients need to be under strict observation (Pugh, 2020). It is very crucial that everyone's freedom be justified to keep a person's rights. The workplace needs to give proper care to the matter that if any restrictions on employee’s freedom are carried out in accordance with the appropriate laws.
The use of restrictive practices, constraint, and loss of freedom is carefully evaluated and put into practice as part of an all-encompassing risk management approach in the workplace where I work. Alternative strategies that uplift people, encourage their independence, and uphold their rights are given priority. The value of person-centred care, de-escalation tactics, and positive behaviour support are all topics covered in specialised training for staff workers. To pinpoint the underlying reasons for troublesome behaviours and create personalised assistance programmes, assessments are carried out on a regular basis. By taking pre-emptive steps, communicating clearly, and fostering an atmosphere that supports autonomy and choice, we want to reduce the need for restrictive measures.
Limiting someone's rights and freedoms poses significant ethical and legal issues that require serious examination. It is important to find a balance between guaranteeing safety and maintaining their fundamental rights, even if there may be instances where restrictions are required for the individual's or others' well-being.
A study of the moral and legal issues involved in limiting someone's rights and freedoms is provided below:
Periodic Review and Monitoring involves Any limitations placed on a person's rights and liberties that should be periodically examined to see if they continue to be necessary and effective. To find chances for lowering or removing limitations and to make sure that the rights of the individual are protected, monitoring and assessment should be carried out.
The Liberty Protection Safeguards (Amendment) 2019 provides protection for individuals aged 16 and above and in need of being deprived of their liberty so that their care can be enabled in case they cannot provide consent for it (gov.uk, 2021). The Act is authorised for people who are suffering from dementia, autism or some other mental disabilities and lack the mental capacity to give consent for their care. According to the Act, the responsible bodies for the individuals are local authorities and NHS bodies in England. Sometimes the authorization is handed over to the local hospitals or health centres if they find a patient who is in need of restriction.
As a responsible citizen of the United Kingdom, we have certain responsibilities regarding the restrictive practices and deprivations of liberty of certain individuals who cannot care for themselves. We have a responsibility to let some local authorities or responsible bodies know if we ever encounter an individual who needs desperate help. Oftentimes, the individual's family members are incapable of caring for the person who needs to be restricted. If we ever come across such family members, we must contact the nearest NGO or a local body for them to come and provide immediate assistance. These individuals might be at risk because they cannot understand what is good for them. As this act has been extended to domestic settings, enabling individuals to receive care wherever they reside, we might offer assistance to families who need to take care of the individuals constantly. It will be a welcome relief for them and assist the people assigned to take care of them.
The Mental Capacity (Amendment) Act 2019 protects the rights of those individuals who are under external care of the authorities and need restrictive practices for their own betterment (legislation.gov.uk, 2019). This Act is in place for a variety of reasons, ranging from use of unethical restrictive practices to patients or individuals feeling like they are being denied human rights due to the restriction of movement or their environment (Bartlett 2023). That’s why DOLs Deprivation of Liberty Safeguards was introduced as an amendment to the previous Act (Spreadbury and Hubbard 2020).
There is a simple test to determine whether a person is being deprived of their freedom and liberty, which answers the question of the person is under constant supervision and if they are allowed to leave. If the person faces constant negative reactions regarding their freedom of movement, then they will have chances of being agitated or be in emotional distress. In patients suffering from dementia, autism, schizophrenia, and other mental disorders, the symptoms of being agitated and emotional distress can lead to a lot of adverse effects. It may cause the patient to worsen their condition or trigger a traumatic episode. The feeling of being lost is also very common among patients who are facing restrictions of movement, which may also cause unnecessary distress. Patients who feel like their liberty is being denied often request to be moved to some other institution or request for a change of carer. However, there are many cases where the organisations engage in unethical restrictive practices, such as restricting the patient’s contact with other people and patients, using restraint when it is not necessary or using sedatives to change the behaviour of the patient. In these cases, the patient or whoever is in charge of them can authorise Deprivation of Liberty Safeguards, on behalf of the patient to protect their rights of liberty and freedom (McSorley 2020).
Restrictive practices can be very impactful for everyone involved in the process, be it the trained professionals, the individual, or the families involved. For the patient who needs restriction, it can feel like a violation of their freedom and rights. Oftentimes, in situations like these, when the patients are suffering from Dementia or some other mental disorders, they have bouts of consciousness where they feel like their movement and ability to make decisions are being restricted and might demand to have their own will. It might cause them more distress and increase their disruptive behaviour.
For healthcare professionals and carers, it is mostly about the mental exhaustion of having to care for someone throughout the day. When they feel overwhelmed and unsupported, they might resort to more restrictive practices to solve the problem quicker. In the absence of a strict guideline regarding the patient’s behaviour and limited knowledge regarding the condition, the carers might accidentally end up causing trauma responses.
It might have a huge impact on the families of the patients, as they have been the primary carers of the patient before they could no longer care for them. Families of the patient often feel alienated because they are not involved in the decision-making of the patient’s restrictive practices. Families often feel that they are being denied connection to the patients and are not being able to have a functioning relationship with them. This problem can be solved by involving the family more in the decision-making process, as studies have suggested that it is actually beneficial for the practitioners to know the patient’s personal routine and activities (Kelley et al. 2019).
The Human Rights Act, 1998 declares that everyone has a right to liberty unless otherwise stated by the law. The Liberty Protection Safeguards (Amendment) 2019 somewhat restricts the human rights of the individual because they are deemed to be harmful to themselves and incapable of caring for themselves. There are certain ways in which the use of restrictive practices can be somewhat reduced so that there are fewer ethical implications involved in the process. The responsible bodies and the government should work together to mitigate and reduce the use of restrictive practices. They should adhere to The Human Rights Framework on Restraint released by Equality and Human Rights Commission (EHRC, 2019). Some of the ways they can implement this are by recording the data produced by the use of restrictive practices and improving upon the responses by the individuals. This outcome-based process includes evaluating how the individuals performed when the authorities used any restrictive practices.
There are effective person-centered practices that can be put to use, such as positive behavioural support (PBS). PBS is a system that has been studied and modified over 25 years and has evidence for supporting people who are at risk of these mental conditions, like dementia and autism. PBS aims to focus on improving the quality of life for the individual and having their needs met so that they don’t exhibit the same behaviours that need restricting. It works with a set of values that aim to deal with the individual with respect and dignity and uses a lot of reactive strategies to work with the triggers that cause the disruptive behaviour. Leadership and a good authorization structure to oversee person-centric approaches are crucial for the mitigation of restrictive practices. This method also implements proactive strategies, which include changing the environment of the individual and making it more comfortable and less challenging to navigate, so that they do not exhibit the same behaviours (Gov. Wales, 2022).
As mentioned in the Liberty Protection Safeguards (Amendment) 2019, the responsible bodies for the individuals are the local authorities and NHS bodies in England (Callaghan and Illsley, 2020). The team members of the said local authorities or hospital personnel might have some developmental needs to implement the restrictive practices better. All practitioners and other people taking care of individuals should be trained and updated according to the regulations of the preventative framework. They should be provided with value-based training and support for the skills required to work within a preventative framework. As mentioned in the previous point, the practitioners and carers should be knowledgeable about the PBS system, which is a person-based approach to improving the patient’s condition. They should practice PACE (Playfulness, Acceptance, Curiosity and Empathy), which is essential for any carer, to approach the patient with empathy and be patient with their needs. The practitioners should also be trained in Recovery-based approaches, which might help the individual have an improved life (James et al., 2021).
The training material for the team members should be crafted by people who have already had experience handling patients and are actively trying to improve their quality of life. It can also include insights from individuals who have been subjected to restricted practices. The practitioners should be trained in such a way so that they do not trigger any kind of trauma responses from the patients, as it could have a lot of adverse effects. As a responsible citizen, whenever we come across any individual under restriction, we can be kind and empathetic, treat them with respect, and contact the authorised personnel whenever they need assistance.
Conclusion
Conclusively, it can be said that it is imperative to uphold adults' fundamental right to live in safety and security. In a variety of contexts, including the community, educational institutions, and the workplace, adults must be safeguarded against abuse and neglect. Adults need appropriate care and guidance to be able to manage dangers and deal with any potential neglect. Since it requires assistance from those who need it to be able to make decisions for one's life, mental capacity is essential to protecting. To address these issues, the UK has introduced many pieces of legislation. This article has emphasised the significance of safeguarding, mental ability, and the application of legal frameworks and standards to particular problems.
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