John A Safeguarding Adults Review The Care Act 2014 made - - PowerPoint PPT Presentation

“John” – A Safeguarding Adults Review

• The Care Act 2014 made Safeguarding Adults

Reviews a statutory requirement (section 44) in cases where:

– an adult [with care and support needs] in its area dies as a result of abuse or neglect, whether known or suspected, and there is concern that partner agencies could have worked more effectively to protect the adult. – if an adult in its area has not died, but the SAB knows

• r suspects that the adult has experienced serious

abuse or neglect.

Background

• John – 56 year old man (at the time), lived in a

privately rented 2nd floor flat with two of his adult sons

• Had mobility problems but no issues about his

mental capacity

• History of intermittent engagement with GP

Background

• June 2015 - Had a period of ill health, was admitted to
• hospital. Went home with some needs for care and support
• Social worker and Occupational Therapist made frequent

attempts to visit/contact John

• Eventually gained access and arranged Reablement service

(short term service designed to help people regain their independence)

• Reablement workers were unable to gain access to John
• Not able to physically access John’s flat because on the 2nd

floor

• Workers were told over the phone by sons that he was

away at a funeral

Background

• After a number of failed attempts,

Reablement closed the case and sent a letter to John advising him what to do if support required

• November 2015 – sons call 999 saying John

had had a suspected heart attack

• Paramedics arrived to find John “rotting in his

chair”

Background

• Full depth pressure sores to his groin area

which were infected with maggots

• Chair and surrounding area covered in faeces

and urine

• Living conditions in the property described as

“squalid”

• Fire Service had to assist in getting John out of

the building by removing a window

Outcome

• John admitted to hospital, not expected to

survive the night

• Sons arrested for wilful neglect under section

44 of the Mental Capacity Act but this did not proceed to a charge

• Against all expectations, John survived and is

currently continuing with rehabilitation in preparation to return home.

John’s views

• John took part in the review and described

how he had “just given up”

• He didn’t hold any professionals responsible

for what had happened to him

• Nevertheless, the review has uncovered some

learning for the multi agency safeguarding partnership

Learning

• The review found that none of the professionals

involved had “done anything wrong”, however there were some learning points:

• Raising awareness amongst private landlords re

hoarding and self-neglect, on the basis that safeguarding is everyone’s business

• Reviewing “out of contact” protocols for health

and social care (balance needed)

• Reviewing case closure decision points

Challenges

• This case was complex because it was a mixture of self-

neglect (by John of himself) and neglect (of John by his sons)

• How should professionals respond when a person with

capacity refuses all help and puts himself at serious risk as a result?

• The Mental Capacity Act 2005 enshrines the right of

adults with capacity to make “unwise decisions”

• Importance of human rights (Article 8 of the ECHR)
• BUT also duty of care. Where is the boundary?