Summer 2018: Newsletter INSIDE THIS EDITION Welcome to latest edition of

the joint safeguarding boards’

newsletter.

Each edition will have a

particular theme and this

edition has a focus on:

physical abuse/recognition

& response to injury

Safeguarding Reviews:

learning

Physical abuse in adults

Bruising on children

FGM

The Mews Nursing Home: CQC

report

Safe After School campaign

Modern slavery

React to red skin

GM Victims’ services

Check your safeguarding

knowledge

New Allegations Management

Procedures

Are we getting it right at the

right door?

Just Someone

Safe Car Wash

Homeless

It’s not okay

Private fostering

Events

Follow Us!

Facebook: find us @LSCBRochdale

Twitter: find us @LSCB_Rochdale

The Rochdale Safeguarding Adults

Board is on Facebook @rochdalesab

Important information The NHS Heywood, Middleton and Rochdale CCG (HMR CCG) lead for Safeguarding is Dr Imran Ghafoor: i.ghafoor1@nhs.net The named Doctor for Safeguarding is Dr Robin Rifkin rob.rifkin@nhs.net

Learning from Safeguarding Reviews and Audits / Scoping The HMR CCG Quality and Safeguarding team has undertaken GP training on the learning from Serious Case Reviews. The presentation provides awareness of safeguarding cases in the Rochdale borough and details how to identify and respond appropriately to safeguarding concerns and how to follow Greater Manchester policies and procedures / RBSAB procedures when dealing with a safeguarding concern. To view the presentation in full, click here

Prevent Prevent is part of the governments counter terrorism strategy “contest” aimed at people being involved in or supporting terrorism. E learning available here

The Caring Together Forum The Caring Together network was established two years ago by HMR CCG and has gone from strength to strength, and numbers of those attending continues to grow. The network is designed as a forum to share information and provide updates to all residential and nursing homes across HMR. There have been a number of work streams that have been instrumental in changing practice in the care homes. For further information please contact Karen McCormick karen.mccormick@nhs.net

Speaking at the 3rd International Skin Conference HMR CCG Designated Nurse Adult Safeguarding Karen McCormick was invited to speak at the International Skin Conference at Huddersfield University on Monday 11th June 2018. The presentation was delivered to over 100 delegates and was entitled Safeguarding and Pressure ulcers. For more information click here

Managing Allegations Procedures Managing Allegations Procedures have been introduced by adult care supported by HMR CCG. This radically changes how concerns around poor practice and safeguarding are managed when allegations are made against staff. For further details please contact Jayne Todd, Advanced Practitioner, Adult Care and Support Jayne.todd@rochdale.gov.uk. More information can be found on page 13.

Physical abuse of adults with care and

support needs

Physical abuse is deliberate, physical harm to an individual, or the wilful and ne-glectful failure to prevent physical harm or suffering. It often causes physical discom-fort, pain or injury, but the person doesn't have to have an injury to have experienced physical abuse.

It includes: hitting, slapping, punching, kicking, hair-pulling, biting, shaking, poisoning, drowning, suffocating, rough handling, scalding and burning, or the appliance of cold water, spitting, tripping, pushing or shoving, physical punishments, making someone purposefully uncomfortable (e.g. opening a window and removing blankets), involun-tary isolation or confinement, misuse of medication (e.g. withholding medication or over-sedation), forcible feeding or withholding food, unauthorised restraint, restricting movement (forcing them to remain in a bed or chair).

Possible indicators of physical abuse in adults: Cuts, lacerations, puncture wounds, open wounds, bruises, welts, discolouration,

black eyes, burns, bone fractures, broken bones or loss of hair in clumps No explanation for injuries or inconsistency with the account of what happened.

Injuries are inconsistent with the person’s lifestyle

Frequent injuries, unexplained falls Subdued or changed behaviour in the presence of a particular person

Signs of malnutrition and loss of weight Failure to seek medical treatment or frequent changes of GP

Report of a person taking too much of their medicines or not taking their medi-cines regularly (a prescription has more remaining than it should).

Broken eye glasses or frames Staff in a care home refusing to allow you to see the adult alone

History of similar injuries and or numerous or suspicious hospitalisations Victims being brought to different medical facilities for treatment to prevent medi-

cal practitioners from observing a pattern of abuse

Delays in presentation - untreated injuries in various stages of recovery Dehydration and/or malnourishment without illness-related cause

A person telling you that they have been hit, slapped, kicked or mistreated Abrasions on arms, legs, or torso, which resemble rope or strap marks

Bruises that wrap around or encircle an older person’s torso arms or legs may indi-cate that the person has been shaken, grabbed or restrained, that the person has been physically restrained.

Particular issues for older people

From AGE UK: Perpetrators of abuse or neglect are often people who are trusted and relied on by an older person, such as family members or care staff. It is important to be aware that anyone can commit abuse or neglect. Women over the age of 70 who are dependent, frail and alone are particularly vulnerable to abuse. Home care agencies providing personal care must be registered with the Care Quality Commission which monitors them. However, directly employed personal assistants do not have to register. As such, there is a greater responsibility on a local authority funding such services through direct payments in terms of its safeguarding duties and provision of in-formation on how to seek support and assistance if abuse occurs.

Support through safeguarding enquiries, investigations or reviews If the adult at risk of abuse or neglect needs to take part in safeguarding adult reviews or safeguarding enquiries (under the Care Act 2014), and the local authority deems the per-son to have care and support needs, then they will make a judgement on two things: 1. Does the person have substantial difficulty in being involved? 2. Do they lack an appropriate individual to support them? If the answer to both of these is ‘yes’, an independent advocate must be appointed to support and represent the person.

What does ‘substantial difficulty’ mean? The Care Act defines four areas where people may experience substantial difficulty: Understanding relevant information Retaining information Using or weighing information Communicating views, wishes and feelings. This is not the same as lacking mental capacity and is an entirely different concept. Some-body with full mental capacity may still have substantial difficulty being involved in a safe-guarding review or enquiry.

What does an ‘appropriate individual’ mean? The local authority will consider whether there is an appropriate individual to support the adult, instead of appointing an independent advocate. There are four specific considera-tions. Individuals are considered inappropriate if they are: Already providing care or treatment to the person in a professional capacity or on a

paid basis Someone the person does not want to support them Someone who is unlikely to be able to, or available to, adequately support the per-

son’s involvement Someone implicated in an enquiry into abuse or neglect, or who has failed to prevent

abuse or neglect as judged by a safeguarding adult review.

FREE safeguarding training available! Training on all aspects of safeguarding - both adults and children's - is avail-

able free of charge from the Rochdale Safeguarding Boards. A variety of courses are available, all presented by experienced front-line practitioners. New courses are being added all the time so be sure to check the list regu-

larly.

The training courses can be viewed and booked at https://www.rbscb.org/multi-agency-training-courses/courses/

Please be aware that although the courses are free,

there is a £50 non-attendance fee.

Bruising on children

The NSPCC has already published a very useful information leaflet based on world literature systematic reviews about bruising on children. We know that: Bruising is strongly related to mobility and that

once children are mobile, they sustain bruises from everyday activities/accidents. Mobile toddlers sustain bruises mostly over bony prominences such as forehead,

knees and shins i.e. mostly on the front of the body. Infants, just starting to walk, may bump their heads / forehead, nose, or chin.

Concerns should be raised and acted on, when a non-mobile child (defined as those who are under the age of 1, or have not started to roll or crawl), present with bruises. There may be medical reasons for such bruises, such as coagulation disorders or sepsis, that may explain their presence but decisions should be made by paediatric doctors who would then investigate appropriately. It should be noted that a seemingly small, insignificantly sized bruise may be the marker for more serious injuries that may not be visible or apparent at presentation. These bruises, known as sentinel as harbinger injuries, need to be assessed and investigated thoroughly, especially in infants who cannot verbalise what has happened. The term ‘harbinger’ means an event which announces or signals the approach of some-thing sinister. Studies reveal that 28 % – 64 % children who sustained subsequent severe physical abuse injuries had prior sentinel (harbinger) bruising that was overlooked or dismissed as insignificant by a professional providing care for a child. In older children, the pattern and site of bruising may give an indication of accidental v’s non-accidental injury. An example would be injuries/bruises which occur within the Safe-ty Triangle from the prominence on the side of the head (parietal) to the shoulder, with the neck/side of face as the inner border. Bruising within this triangle to the side part of the cheek the ear or the neck should be regarded with suspicion of having been inflicted. Less than 6% of accidental bruises to the face are found on the cheeks or the tissues around the mouth (perioral area). Ageing of bruising is based on the assessment of colour but research evidence indicates that accuracy and reliability is limited. Finally, a study by Hibberd Etal (2017) has shown that 81.7% of injury incidents resulted in a single bruise, regardless of mechanisms, the exception being motor vehicle acci-dents. Even a fall down stairs resulted in injury to more than the body part in only 3% of cases. Multiple bruises following a single injury mechanism (the method by which dam-age to skin, muscles, organs, and bones happens), were rare.

Bruising on children: Implications for practice A bruise should never be interpreted in isolation and must always be assessed in context of the child’s medical and social history, development stage and explanation given. Bruising that suggests the possibility of physical child abuse includes:

Bruising in children who are not individually mobile (this includes children who are disabled)

Bruising in babies

Bruises that are seen away from bony prominences

Bruises to the face, back, abdomen, arms, buttocks and hands

multiple bruises in clusters of uniforms shape,

Bruises that carry an imprint of an implement or cord Bruises with petechiae (dots of blood under the skin) around them

Further information click here

FGM—Possible signs to look out for

For more information, the link for the National FGM centre resources is here

Further reading

Difficult conversations Talking about difficult topics: how to start conversations about ‘difficult’ subjects that you need to have to keep your children safe. For more information, click here. Helping or hindering in adult safeguarding: an investigation of practice This study examines current safeguarding practice in England where access to an adult at risk is obstructed by a third party. To read the study, click here.

Top marks as Rochdale nursing home praised for outstanding care delivery

Rochdale nursing home The Mews has been praised by RBC cabinet member for adult care after its outstanding inspection report. Councillor Iftikhar Ahmed visited the home, along with assistant cabinet member Councillor Billy Sheerin, to personally congratulate managers and staff on their success after achieving the highest possible inspection rating.

The report by the Care Quality Commission (CQC) praised the home for its exceptional quality of care, innovative delivery of services and supportive team of dedicated staff. Inspectors also hailed the home’s excellent use of modern technology to support people’s independence and privacy. In a further boost, inspectors also lauded staff for their kind, caring and patient approach with residents and for creating a safe and welcoming environment. The nursing home, in Fenton Street, provides nursing care and accommodation for up to 50 residents with disabilities. It is owned by East and West Healthcare who took over the running of the home 18 months ago. For more information on this article, click here.

Safe after school—Ask the Right questions

Rochdale Safeguarding Children’s Board and the Local Authority Designated Officer (LADO) have been working together with partner agencies to identify non-regulated groups in the community and raise awareness to parents about being vigilant and asking the right questions before sending children to establishments.

The Safe after School’s campaign launched when and included sessions for providers, information disseminated to parents/carers, billboards throughout the borough along with information on social media.

For further information, advice or assistance please contact:

Louise Hurst: lado@rochdale.gov.uk, Alyson Harvey: Alyson.harvey@rochdale.gov.uk, Claire Heap: Claire.heap@rochdale.gov.uk

As part of the campaign a video has been produced to help parents choose safe after school activities for their children. To view the video click here

Spot the signs of modern slavery

Physical appearance Show signs of physical or psychological abuse, look malnourished or unkempt, anxious/ agitated or appear withdrawn and neglected. They may have untreated injuries Isolation Rarely allowed to travel on their own, seem under the control, influence of others, rarely interact or appear unfamiliar with their neighbourhood or where they work Relationships which don’t seem right – for example a young teenager appearing to be the boyfriend/girlfriend of an older adult.

Poor living conditions Be living in dirty, cramped or overcrowded accommodation, and / or living and working at the

same address Restricted freedom of movement Have no identification documents, have few personal possessions and always wear the same

clothes day in day out. The clothes they wear may not be suitable for their work Have little opportunity to move freely and may have had their travel documents retained, e.g.

passports Unusual travel times Be dropped off / collected for work on a regular basis either very early or late at night Unusual travel arrangements- children being dropped off/ picked up in private cars/ taxis at

unusual times and in places where it isn’t clear why they’d be there Reluctant to seek help Avoid eye contact, appear frightened or hesitant to talk to strangers and fear law enforcers for

many reasons, such as not knowing who to trust or where to get help, fear of deportation, fear of violence to them or their family.

If you believe a person is being trafficked and is in immediate danger, you should call 999 straight away. You can also report suspicions of trafficking by calling 101 or visiting your local police station. You may also report a modern slavery crime anonymously to Crimestoppers on 0800 555 111. You can also contact The Salvation Army, who run a 24-hour confidential Referral Helpline on 0300 3038151—available 24 hours a day, seven days a week. To view the modern slavery seven minute briefing click here

Safe Car Wash

Modern slavery is hidden in plain sight on our high streets. The National Crime Agency thinks there are tens of thousands of people being exploited in the UK, forced to work long hours, for little or no pay, and under threat of violence. Some of those people are being exploited in hand car washes, which in recent years have sprung up across the country in their thousands. Many of those hand car washes are legitimate businesses, but some of them are not. Police raids in hand car washes in towns and cities up and down the country have unearthed victims living in horrendous condi-tions. The Safe Car Wash app has been developed to allow the general public to engage with the problem, it is a new tool that will enable the largest community intelligence gathering exercise ever attempted in the United Kingdom.

Download the free app onto your smartphone and then when you are using a hand car wash, simply open the app and complete a short survey about the working conditions of the car wash. Click here for more information and to download the app.

React to Red skin is a pressure ulcer

prevention campaign that is

committed to educating as many

people as possible about the dangers

of pressure ulcers and the simple

steps that can be taken to avoid

them. For more information

click here

Check your Safeguarding Knowledge!

SCIE (the Social Care Institute of

Excellence) has an adult safeguarding quiz as part of its online resources.

This is part of a set

of resources including learning packages and life

stories.

The site can be accessed here

NEW Allegations Management Procedures Here’s what you need to know!

New Allegations Management Procedures and Safer Working Practices guidelines have been introduced by the RBSAB. These procedures and guidelines impact on how allegations of abuse or neglect made against employees or volunteers should be dealt with. Safeguarding concerns about adults with care and support needs should continue to be raised in the normal way so that an appropriate safeguarding response to the adult is given. However, if the safeguarding concern relates to the actions of a professional, paid employee or volunteer, then the Allegation Management Procedures should also be considered. The Allegations Management Procedures should also be considered where there is any incident that may indicate that employees or volunteers may pose a risk to adults with care and support needs. The Allegations Management Procedure provide thresholds for when the process should be used, explains your organisational responsibilities and the actions that should be taken, and also gives details of how the system works once a report is made and the involvement of other agencies such as the police. The Allegation Management Procedure and the Initial Consideration Form and Referral Form can be found here Accompanying the Allegations Management procedures are Safer Working Practices guidelines. These have been produced to help employees and volunteers establish the safest possible working environments which safeguard individuals and reduce the risk of being falsely accused of improper or unprofessional conduct. The RBSAB recommends everyone working or volunteering in your organisation reads the Safer Working Practices document and signs the back page to confirm they have understood it and will comply. It is imperative that your organisation understands and adheres to the Allegations Management process. As this is a new system, the RBSAB has arranged several free training sessions for service providers and voluntary organisations to introduce the system and explain how it works, and what your responsibilities are. Details of the training are available here where you are also able to book places. Should you have any queries or concerns about any of the above please contact the Allegations Management Lead on 01706 922925 or 0300 303 8886 or at AML@rochdale.gov.uk

Are we getting it right at the front door? Rochdale Case Study Are we getting it right at the front door? Examining re-referral rates of people signposted to community services and how we best optimise our strength based prevention approach. The following is a short paper published by the Association of Directors of Adult Social Services (North West) Introduction Rochdale Adult Care recently took part in the Greater Manchester Social Work Academy Teaching Partnership “HUB Model” research project which aspires to create a genuine ongoing interface linking academics to social work practice; the definition of a HUB being a team of staff around an area of practice. To continue reading this case study, please click here .

Just Someone

Just Someone is a short film commissioned by Rochdale Borough Council with Kingsway Park High School and M6 Theatre to raise awareness of children missing in education and child sexual exploitation. It aims to help prevent child sexual exploitation by educating young people about risk taking behaviour and how to stay safe. The learning is based around an eight minute film which helps young people avoid sexual exploitation. It educates young people to identify features of an exploitative relationship. It also offers opportunities to discuss peer influence and good and bad relationships. To view the film click here and for more information and the resource pack, click here

It’s not okay

June 2018 saw the start of the It’s not okay Greater Manchester week of action on child sexual exploitation (CSE). The theme for this year’s week of action was to provide parents and carers with information about keeping switched on to their children’s online and offline activity.

To mark the week Rochdale’s Sunrise team took part in a variety of events throughout the week to raise awareness of the signs of child exploitation and grooming.

The Sunrise Team is Rochdale's dedicated multi-agency team working to tackle and prevent CSE. The is made up of professionals from the children's social care, police, health, Early Break and Parents Against Child Sexual Exploitation (PACE). They provide a safe and confidential environment where young people can go for help, advice and support. Children are offered a range of therapeutic interventions including one-to-one counselling, group work sessions and drop-in support.

For more information on It’s not okay, click here

Private Fostering

Events

Looked After Children: Improving Life Chances Wednesday 5th December 2018, Manchester Conference Centre

The Looked After Children: Improving Life Chances conference will offer delegates the opportunity to be fully briefed on the current situation within the care system and gain an update on the latest developments in terms of policy and funding. Guided by a line-up of expert speakers, the agenda will address some of the major child protection issues facing those entering the care system and examine the support needed to ensure that looked after children receive the best possible care and can look forward to a bright future.

For more information click here

SAVE THE DATE - Complex Safeguarding Conference (RBSB)

The Rochdale Borough Safeguarding Children’s and Adult’s Board is pleased to announce that it will be facilitating a full-day conference on Wednesday 24th October. The main fo-cus of the conference will be emerging themes in complex safeguarding including child criminal exploitation and organised crime.

More details regarding booking arrangements and details of keynote speakers will be cir-culated in due course but for now – please save the date!

Working with Difficult to Engage Families Monday 17th September

The day-long course will enable professionals to: Explain the causes of difficult engagement with families Describe the barriers families may face when trying to engage with services Consider approaches to increase and improve engagement Recognise different behaviours that decrease engagement from families, workers

and service Understand strategies for encouraging and increasing engagement with families

A significant part of the day will be reflection and discussion of techniques and strategies to enhance engagement with resistant families. The course is therefore appropriate for practitioners who have experience of such work, and can bring their knowledge and un-derstanding to help contribute to the discussions. Places on the course can be booked here

Rochdale Borough Safeguarding Boards

Floor 4, No 1 Riverside

Smith Street

Rochdale

OL16 1XU

Telephone - 0300 303 0350

(The office is open Monday – Friday 08.30 - 16.45)

www.safeguarding4rochdale.com

If you have any queries about this newsletter or

wish to submit something for future edition please

contact Katie Gee, communications officer for

children’s services at Rochdale Borough Council

katie.gee@rochdale.gov.uk

01706 925681