Safeguarding adults
Safeguarding Adults Handbook
This policy is for all Karo employees, contract staff and shift workers and details the policies and procedure for safeguarding vulnerable adults and to ensure full compliance with the HSE.
1. Purpose
1.1 The purpose of this policy and procedure is to clearly set out Karo’s policy and procedure with regard to safeguarding vulnerable adults and to ensure full compliance with HSE “Safeguarding Vulnerable Persons at Risk of Abuse National Policy” (2014).
2. Aim
2.1 Karo is committed to ensuring all staff hired are aware of this policy in relation to the safeguarding of vulnerable adults from abuse. It recognises that abuse can and does take place and that vulnerable persons in particular may become at risk of abuse.
2.2 Karo is committed to policy and practices which promote the welfare of vulnerable adults and safeguards them from abuse, in line with the Health Service Executive “Safeguarding Vulnerable Persons at Risk of Abuse National Policy and Procedures” (2014).
2.3 Karo has a no tolerance approach to any form of abuse and promotes a culture which supports this ethos.
2.4 Karo is committed to ensuring that all staff treat clients and their customers with respect and dignity, have their welfare promoted and receive support in an environment in which every effort is made to promote welfare and to prevent abuse.
2.5 Karo is committed to promoting a culture of trust, respect, dignity, honest communication, and positive risk management for all in receipt of services.
3. Scope
3.1 This policy and procedure apply to all employees (inclusive of Karo Directors, work placements and students) of Karo services.
4. Glossary of Terms and Definitions:
4.1 Vulnerable Person: Vulnerable Person may be defined as “an adult who is restricted in capacity to guard himself/herself against harm or exploitation or to report such harm or exploitation. This may arise as a result of physical or intellectual impairment and risk of abuse may be influenced by both context and individual circumstances”. (HSE 2014).
4.2 Abuse: Abuse may be defined as “any act, or failure to act, which results in a breach of a vulnerable person’s human rights, civil liberties, physical and mental integrity, dignity or general well-being, whether intended or through negligence, including sexual relationships or financial transactions to which the person does not or cannot validly consent, or which are deliberately exploitative. Abuse may take a variety of forms.” (HSE 2014).This definition excludes self-neglect which is an inability or unwillingness to provide for oneself. However, Karo acknowledges that people may come into contact with individuals living in conditions of extreme self-neglect. Where a Karo staff member encounters self-neglect, they should immediately report this to their Clinical Nurse Manager on location.
4.3 Categories/Types of Abuse: There are several forms of abuse, any or all of which may be perpetrated as the result of deliberate intent, negligence or lack of insight and ignorance. An individual may experience more than one form of abuse at one time. The following are the main categories/types of abuse:
4.3.1 Physical abuse includes hitting, slapping, pushing, kicking, and misuse of medication, restraint or inappropriate sanctions.
4.3.2 Sexual abuse includes rape and sexual assault, or sexual acts to which the vulnerable person has not consented, or could not consent, or into which he or she was compelled to consent.
4.3.3 Psychological abuse includes emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, isolation or withdrawal from services or supportive networks.
4.3.4 Financial or material abuse includes theft, fraud, exploitation, pressure in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.
4.3.5 Neglect and acts of omission includes ignoring medical or physical care needs, failure to provide access to appropriate health, social care or educational services, the withholding of the necessities of life such as medication, adequate nutrition and heating.
4.3.6 Discriminatory abuse includes ageism, racism, sexism, that based on a person's disability, and other forms of harassment, slurs or similar treatment.
4.3.7 Institutional abuse may occur within residential care and acute settings including nursing homes, acute hospitals and any other in-patient settings, and may involve poor standards of care, rigid routines and inadequate responses to complex needs.
4.4 Protected Disclosure: If an employee reports a workplace concern in good faith and on reasonable grounds in accordance with the procedures outlined in legislation it will be treated as “protected disclosure.” This means that if an employee feels that they have been subjected to detrimental treatment in relation to any aspect of their employment as a result of reporting their concern, they may seek redress. In addition, employees are not liable for damages as a consequence of making a protected disclosure. The exception is where an employee has made a report which he/she could reasonably have known to be false.
5. Legislation/other related policies:
Assisted Decision Making Act 2015, Irish Statute Book, Dublin
General Data Protection act 2018
The HSE Safeguarding Vulnerable Persons at Risk of Abuse National Policy & Procedures. (2014). Health Service Executive Social Care Division.
Health Information and Quality Authority. (2013). The National Standards for Residential Services for Children and Adults with Disabilities, Dublin
Health Information and Quality Authority. (2013). The National Standards for Residential Services for Children and Adults with Disabilities, Dublin.
The Health Act. (2007). The Irish Statute Book. Dublin.
The Health Act. (2007). (Care and Support of Residents in Designated Centres for Persons (Children and Adults with Disabilities) Regulations 2013. The Irish Statute Book. Dublin.
The Health Act. (2007). (Care and Support of Residents in Designated Centres for Older Persons), Regulations 2013. The Irish Statute Book. Dublin.
The Health Act. (2004). Houses of the Oireachtas. Dublin.
The Criminal Justice (withholding of information on offences against children and vulnerable persons) Act. (2012). Houses of the Oireachtas. Dublin.
The National Vetting Bureau (Children and Vulnerable Persons) Act. (2012). Houses of the Oireachtas. Dublin.
United Nations. (2006). UN Convention on the Rights of Persons with Disabilities. 2006. United Nations, Geneva.
Health Service Employers on Upholding the Dignity and Welfare of Patients/Clients and the Procedure for Managing Allegations of Abuse against Staff Members (Trust in Care 2005) Health Service Executive, Employers Assistance Division, Dublin.
Karo Child Safeguarding Statement. (2023)
Karo Disciplinary Policy and Procedure. (2023)
KARO Data Protection Policy (2023)
Karo Recruitment Policy and Procedure (2023)
6. Roles and Responsibilities:
6.1 All staff need to:
6.1.1 Be aware of circumstances that may leave a vulnerable person open to abuse and must be able to recognise the possible early signs of abuse. They need to be alert to the demeanour and behaviour of adults who may become vulnerable and to the changes that may indicate that something is wrong.
6.1.2 Avail of any relevant training and educational
6.1.3 All staff must report concerns of adult abuse to their onsite Managing Director.
6.2 Karo CEO or an appointee by the Board must:
6.2.1 Ensure that local procedures are in place to support the implementation of the policy.
6.2.2 Promote a culture of zero tolerance for any type of abuse or abusive practices.
6.2.3 Ensure that policy is made available to all staff.
6.2.4 Ensure that staff are aware that failure to record, disclose and share information in accordance with this policy is a failure to discharge a duty of care and may be subject to disciplinary procedure.
7.0 Procedure:
7.1 All concerns or allegations of abuse must be assessed, regardless of the source or date of occurrence.
7.2 Management of an Allegation of Abuse against a Staff Member: In situations where the allegation of abuse arises in respect of a staff member, the policy for Health Service Employers on Upholding the Dignity and Welfare of Patients/Clients and the Procedure for Managing Allegations of Abuse against Staff Members (Trust in Care 2005) must be followed. In any such situation, the Karo Director should contact H.R. for specialist advice..
7.3 All information concerned with the reporting and subsequent assessment of concerns or allegations of alleged abuse are subject to Karo policy on confidentiality. However, information regarding allegation(s) of abuse cannot be received with a promise of secrecy.
7.4 It is essential to keep detailed and accurate records of concerns of allegations of abuse and of any subsequent action taken.
7.5 An employee who reports genuine concerns of fraud or malpractice will be supported by their employer.
7.6 In general, employees’ identities will not be disclosed without their prior consent. Where concerns cannot be resolved without revealing the identity of the employee raising the concern, this will be discussed with the employee as to how this issue can be advanced.
7.7 Reporting procedures:
7.7.1 A staff member who receives a complaint of an allegation of abuse pertaining to another staff member from a customer, relative/ guardian or member of the public, must ensure that the details of the alleged abuse are fully documented including dates, times and any witnesses to the alleged incident. The statement should be checked with the person making the complaint to ensure accuracy. The staff member immediately reports this to the Managing Director
7.7.2 A staff member who suspects that a colleague (another staff member) may be abusing a customer should advise the Designated Officer without delay. The staff member must outline in writing the grounds on which his/ her concerns are based. This report must be submitted to the Managing Director without delay. The staff member making the allegation must not question the staff member against whom the allegation is made.
7.7.3 A staff member who witnesses another staff member engaging in inappropriate behaviour towards a customer must intervene or seek assistance to stop the behaviour. The staff member must ensure that the customer is not in any immediate danger and receives the necessary treatment and support. The staff member should then immediately report the incident to the Managing Director, and complete a written report before going off duty or within a fixed time frame.
7.8 ALLEGATION OF ABUSE AGAINST A KARO STAFF MEMBER
7.8.1 In the event of an allegation of abuse against a staff member or the Karo organisation, Karo must undertake a Preliminary Screening as per the service setting approach outlined in the HSE National Policy Vulnerable Persons at Risk of Abuse, National Policy and Procedures (2014). This process (Process one) is to ensure the safety of the customer.
7.8.2 As this is a service setting approach, Karo has up to three working days to undertake a preliminary screening under the HSE National Policy Vulnerable Persons at Risk of Abuse, National Policy and Procedures (2014) and forward the outcome of same to the HSE Safeguarding and Protection Team in the relevant CHO using the HSE Preliminary Screening documentation provided.(Appendix 1)
7.8.3 In addition, this matter may also require the support of other organisational/ national policies such as the Trust in Care Policy for Health Service Employers on upholding the Dignity and Welfare of Patients / Clients and the Procedure for Managing Allegations of Abuse against a staff member (2005).
7.8.4 In line with Trust in Care, a parallel process is undertaken (process two) to appropriately manage an allegation of abuse against a staff member and to afford him/her natural justice.
7.8.5 It is advisable that the Karo Director identifies and allocates senior staff to the management of each parallel process. Please note Trust in Care (Process 2) requires the Managing Director of the staff member about whom the concern has been raised or the allegation of abuse made, to undertake the Preliminary Screening (under Trust in Care)
7.8.6 DAY ONE: The Managing Director on Day One will where possible:
Meet with the staff member and inform him / her of the allegation
Inform the staff member that at this time there is no blame apportioned to him / her, and that Karo are required by the HSE to follow Trust in Care - Policy for Health Service Employers on upholding the Dignity and Welfare of Patients / Clients and the Procedure for Managing Allegations of Abuse against a staff member (2005) in the event of an allegation against a staff member, a) to ensure the safety of the customer and b) to afford the staff member natural justice.
Inform the staff member that protective measures have been considered i.e. he / she will be reassigned to the office, or reassigned to work with another work colleague / other duty, until such time as the preliminary outcome is known. Advise the staff member that none of these are disciplinary measures.
Advise the staff member if a decision is reached to put him or her off duty with full pay, that it is without prejudice, and is a precautionary measure only and not a disciplinary sanction.
Inform the staff member that a preliminary screening is being undertaken, the outcome of which will be made known to him/her.
7.9 In the event of a formal investigation, the Managing Director must:
7.9.1 Arrange a meeting with the staff member to advise him / her of his / her intention to carry out an investigation.
7.9.2 Advise the staff member of his/ her right to be accompanied to any meeting by a work colleague.
7.9.3 Provide the staff member with the details of the allegation at the meeting and afford him / her an opportunity to make an initial response if he/ she so wishes.
7.9.4 Inform the staff member as to what happens next and advise him / her not to make contact with the complainant.
7.9.5 Advise the staff member with regard to any support and counselling services that are available.
7.10 Principles Governing the Investigation Process:
7.10.1 The investigation will be conducted thoroughly and objectively in strict accordance with the terms of reference and with due respect for the rights of the complainant and the rights of the staff member to be treated in accordance with the principles of natural justice.
7.10.2 The investigation team will have the necessary expertise to conduct an investigation impartially and expeditiously. Where appropriate, the investigation team may request appropriately qualified persons to carry out clinical assessments, validation exercises etc. Please note external expertise may be required.
7.10.3 Confidentiality will be maintained throughout the investigation to the greatest extent possible, consistent with the requirements of a fair investigation. It is not possible however to guarantee the anonymity of the complainant or any person who participates in the investigation.
7.10.4 A written record will be kept of all meetings and treated in the strictest of confidence.
7.10.5 The investigation team may interview any person who they feel can assist with the investigation. Staff are obliged to co – operate fully with the investigation process and will be fully supported throughout the process.
7.10.6 Staff who participate in the investigation process will be required to respect the privacy of the parties involved by refraining from discussing the matter with other work colleagues or persons outside the organisation.
7.10.7 It will be considered a disciplinary offence to intimidate or exert pressure on any person who may be required to attend as a witness or to attempt to obstruct the investigation process in any way.
7.11 INVESTIGATION OUTCOME - Abuse has not occurred:
7.11.1 If the complaint is not upheld, the Karo Director must ensure that the reputation of and career prospects of the staff member concerned are not adversely affected by reason of the complaint having been brought against him/her.
7.11.2 The staff member may be offered counselling and any other support necessary to restore his/ her confidence and morale.
7.11.3 The staff member who made the complaint must be reassured that management appreciated that the complaint was made in good faith.
7.11.4 A review of systems must be carried out where deficiencies have been identified.
7.12 Abuse has occurred.
7.12.1 If the complaint is upheld, the matter will be referred to the Karo Director who is authorised to take disciplinary action up to and including dismissal.
7.12.2 Where abuse is found to have occurred, this can have an adverse effect on staff morale. Assistance should be made available to staff who have been affected by the allegation to help them to come to terms with what has happened and to restore a normal working environment.
7.12.3 A review of systems must be carried out where deficiencies have been identified. The Karo Director will provide a copy of the investigation report to the staff member and an opportunity is given for him / her to comment prior to any action being decided upon.
7.12.4 The staff member whom the allegation was made against, must be advised of what will happen next, including where necessary, progressing the issue through the Disciplinary Process
7.13 Karo Staff member informed of concern or allegation of abuse during his / her working day when working with another service provider.
7.13.1 In this scenario, the Karo staff member must report the concern immediately to the Manager where he or she is working and comply fully with that service provider’s internal reporting process for concerns raised or allegations pertaining to abuse made.
7.13.2 In addition, the staff member must also report this concern /allegation to the Karo Managing Director and advise him / her of the internal process he / she followed with regard to this concern. Any such reports from Karo staff must be recorded and dated with the signature of the Designated Officer / Clinical Nurse Manager in receipt of such reports.
7.14 Out of Hours
7.14.1 In the event of a concern raised or an allegation pertaining to abuse made during out of hours, the staff member will immediately inform the Karo out of hour’s person on call for the specific franchise. This staff member may guide the process or immediately contact the Karo Director / Nominee. Please note local arrangements must be put in place in relation to this scenario.
Please note in the event of an emergency Gardaí may be contacted by any Karo Staff member
8.0 References
Assisted Decision Making Act 2015, Irish Statute Book, Dublin
General Data Protection act 2018
The HSE Safeguarding Vulnerable Persons at Risk of Abuse National Policy & Procedures. (2014). Health Service Executive Social Care Division.
Health Information and Quality Authority. (2013). The National Standards for Residential Services for Children and Adults with Disabilities, Dublin
Health Information and Quality Authority. (2013). The National Standards for Residential Services for Children and Adults with Disabilities, Dublin.
The Health Act. (2007). The Irish Statute Book. Dublin.
The Health Act. (2007). (Care and Support of Residents in Designated Centres for Persons (Children and Adults with Disabilities) Regulations 2013. The Irish Statute Book. Dublin.
The Health Act. (2007). (Care and Support of Residents in Designated Centres for Older Persons), Regulations 2013. The Irish Statute Book. Dublin.
The Health Act. (2004). Houses of the Oireachtas. Dublin.
The Criminal Justice (withholding of information on offences against children and vulnerable persons) Act. (2012). Houses of the Oireachtas. Dublin.
The National Vetting Bureau (Children and Vulnerable Persons) Act. (2012). Houses of the Oireachtas. Dublin.
United Nations. (2006). UN Convention on the Rights of Persons with Disabilities. 2006. United Nations, Geneva.
Health Service Employers on Upholding the Dignity and Welfare of Patients/Clients and the Procedure for Managing Allegations of Abuse against Staff Members (Trust in Care 2005) Health Service Executive, Employers Assistance Division, Dublin.
Karo Child Safeguarding Statement. (2023)
Karo Disciplinary Policy and Procedure. (2023)
KARO Data Protection Policy (2023)
Karo Recruitment Policy and Procedure (2023)
9.0 Appendices
Appendix 1 Allegation of Abuse Notification Form Internal
The form should be completed to record any allegation of suspected abuse.
To be completed by the person who (a) observes or suspects the alleged abuse OR (b) whom it is initially reported to.
PART A - REPORT DETAILS (to be completed by person who observed/suspected or was in receipt of allegation report.
Customer’s /Staff Name/ID:
Address:
Date of Birth:
Date of Alleged Abuse:
Time of Alleged Abuse:
Location of Alleged Abuse:
Record the Detail of the Alleged Abuse (include witnesses if applicable. Be as descriptive as possible): (Please use Continuation Sheet if necessary)
Name, Job Title, and Signature of Person completing this form.
Full Name:
Job Title:
Signature:
Date:
Part B - To be completed by the Managing Director
Time and date I was notified of alleged abuse:
Time and date that I verbally notified Designated Officer:
Name, Job Title and Signature of Clinical Nurse Manager/Line Manager who has received this form
Full Name:
Job Title:
Signature:
Date:
Part C - To be completed by Designated Officer
Date and Time I was notified of alleged abuse:
Date and Time I received this form:
Name, Job Title and Signature of Designated Officer who has received this form
Full Name:
Job Title:
Signature:
Date and Time:
10 Revision History
Version:
Date Approved:
List section numbers changed:
Author: