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Inspection report

Date of Inspection: 15 March and 13 April 2011
Date of Publication: 6 June 2011
Inspection Report published 6 June 2011 PDF

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People should be protected from abuse and staff should respect their human rights (outcome 7)

Meeting this standard

We checked that people who use this service

  • Are protected from abuse, or the risk of abuse, and their human rights are respected and upheld.

How this check was done

Our judgement

People who use services are protected from abuse or the risk of abuse and their human rights are respected and upheld.

User experience

We spoke with three patients on a medical ward and they told us they felt safe and protected. They said that staff were respectful when supporting them and maintained their dignity, and we observed this when staff provided personal and medical care. Patients told us staff listened to them and acted on any concerns they expressed.

Other evidence

The hospital matron visits each ward and department daily to discuss any concerns staff may have regarding vulnerable adults. There is also a paediatric safeguarding lead who meets with minor injuries staff regarding issues such as non accidental injury. The local primary care trust (PCT) told us the trust works constructively with them on safeguarding issues and the appointment of safeguarding leads has been beneficial in working with the PCT and other providers, providing a focus for staff training, education and support.

We spoke with four staff who told us they received training in safeguarding adults and children, with mandatory updates. They all said the training helped them recognise signs of abuse and they understood what to do if they suspected it. They told us how they consider people’s behaviour and try to reduce the negative effects some patients’ behaviour may have on others. The trust’s Safeguarding Adults Policy (Jan 2010) sets out staff responsibilities in preventing and minimising the risk of abuse to vulnerable adults; the staff we spoke with showed commitment to maximising people’s choice and control, and protecting their rights.

The trust produces a newsletter reminding staff of the importance of safeguarding and their duty of care to report any concerns they may have regarding vulnerable adults. We also saw up to date policies and procedures on safeguarding for staff to follow.

The Mental Capacity Act (2005) (MCA) provides guidance for when a decision is made in the best interests of a person lacking capacity. Deprivation of Liberty Safeguards (DoLS) are intended to protect people from being deprived of their liberty unless it is in their best interests to protect them from harm and there is no other less restrictive alternative. Hospitals need to obtain authorisation to deprive someone of their liberty, lawfully. We looked at the records of one person who had fluctuating capacity to make choices regarding their care. Staff had referred the patient to the social worker for an urgent best interest assessment under the MCA and subsequent application for DoLS. The hospital matron showed us records of comprehensive communication with all parties involved including the person’s relatives. In this case, a person was deprived of their liberty only after a “best interests” assessment and the involvement of relevant member of the multidisciplinary team.

We saw staff liaising with families and the mental health liaison nurse, and in patient care plans we saw records of face to face and telephone conversations with relatives about people’s care. Staff also provided easy read guidance on the MCA and DoLS, which provides information in a format that is accessible to people with a learning disability. The local PCT told us the hospital has robust systems in place to manage DoLS, producing detailed records and supporting staff well.

The trust has a multidisciplinary Safeguarding Adults Board that meets monthly and leads on all safeguarding issues including policy implementation and training. They held an awareness day last November and are arranging future training in safeguarding for all staff. A laminated poster “Safeguarding Adults Quick Reference Guide” is displayed in wards and departments, and provides staff with a checklist of what to do if they have safeguarding concerns. Staff also have a small “quick reference” card that attaches to their name badge and contains all relevant urgent contacts for safeguarding vulnerable people.