Adult at risk as alleged perpetrator
There are times when the actions of one adult at risk towards another will be abusive. It is important to establish who the alleged victim is and who the alleged perpetrator is.
It is the alleged victim who has been abused and who needs protection. As in any abusive situation there will be a power imbalance and advantage taken by the individual who has power over the other either by reason of intellectual capability or physical superiority.
The nature of the abuse can be any or a combination of the different types found here. As with all forms of abuse crimes may be committed and the police involved.
Prevention is always the preferred option and services should plan their interventions and support with individuals to minimise the likelihood of individuals abusing other adults at risk. People in services such as day centres, residential homes, supported tenancies etc can usually expect to be supported or cared for in a safe environment. Abuse by other adults using the service, is every bit as serious as any form of abuse regardless of who is the perpetrator.
Services should have anti-bullying policies in place to address issues of inappropriate interactions between adults at risk (and carers/staff). Anti-bullying policies should include guidance about discrimination and harassment on the grounds of age, disability, gender, gender reassignment, race, religion or belief and sexuality. Issues of individual rights and responsibilities should be discussed with service users no matter what their level of ability or impairment.
Services should plan via assessment of needs and risk how best to support individuals in service. Individuals with known behavioural management problems should have their needs identified and measures put in place to properly support them and maximise their life opportunities.
Early intervention with all adults who abuse is important in the protection of other adults by the prevention of the continuation or escalation of abusive behaviour.
The line manager with responsibility for the service must at the earliest opportunity:
- Ensure that a risk assessment is undertaken with regard to the immediate safety of all adults using the service. This will contribute to the protection plan that will need to be documented by the assessment or enquiry team.
- Review the management and the support/care of the alleged abuser.
- Make referral to the relevant assessment/investigation team. If any uncertainty who to refer to, the referral should go to the adult social care contact team (ASCCT).
The responsible team receiving the referral/alert e.g. ASCCT or on call worker/allocated worker or duty officer will:
- Take relevant details, request SG1, and confirm/clarify which team will be responsible for any further enquiry/action if required.
- Undertake initial liaison with the Service Line Manager to ensure:
- Any forensic evidence is not contaminated.
- That any essential immediate safeguarding actions have occurred i.e. medical help sought.
- That the police are alerted where a crime may have been committed.
The responsible team receiving the referral/concern e.g. ASCCT or on call worker/allocated worker or duty officer will also discuss and complete the following actions in consultation with the Service provider:
- Clarify whether the victim's support/care plan need to be formally reviewed.
- Clarify whether the needs of the alleged perpetrator require re-assessment.
- Confirm whether the situation should be dealt with as a safeguarding enquiry.
- Ensure a documented protection plan (on Carefirst Adult Safeguarding Document or on PARIS for GMMH staff).
- Ensure distribution of protection plan to the parties/services responsible for its implementation and others as appropriate.
Safeguarding meetings must focus on the protection of the victim. There may well need to be a separate meeting arranged to focus on the needs of the perpetrator. Information will need to pass between these two meetings but individuals must be dealt with separately and their individual needs met.
If the police need to interview the alleged abuser consideration must be given as to whether an appropriate adult should be present in accordance with the Police and Criminal Evidence Act (1984), and if any special measures are required under Achieving Best Evidence guidance (2002).
If it is decided that a safeguarding enquiry is not necessary the reasons for this should be recorded in the relevant files of the assessment/enquiry team, the service agency and the local office of CQC.
There are times when individual abusive behaviours may occur because support staff have not fully or properly implemented the requirements of the care plan. In such cases consideration should be made of the contribution to the situation by the relevant staff members. Their lack of action may have precipitated or allowed the abuse to occur. This could potentially involve disciplinary or other action.
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