Practice Advice: Adults who are Vulnerable 2013

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Practice Advice:

Adults who are

Vulnerable

2013

Methodist Church and Church of England Safeguarding Practice Advice

Paper 2013

Foreword

The Church of England and the Methodist Church of Great Britain entered into a covenant commitment in November 2003 after conversations lasting several years 1 .

One of the expressions of this covenant is to develop joint safeguarding arrangements. This includes the appointment of a joint national safeguarding adviser and the establishment of a Joint

Safeguarding Liaison Group whose members are regional safeguarding advisers from both churches.

Methodist Church and Church of England Practice Advice Papers are approved by the Joint Safeguarding Liaison Group of the Methodist

Church and the Church of England to assist in the development of local safeguarding arrangements.

1 http://www.anglican-methodist.org.uk/index.htm

.

1.

Statement of Safeguarding Principles

The Church of England and the Methodist Church works in partnership with other Christian Churches and other agencies in delivering safeguarding. The following statement of principles appears at the head of each safeguarding policy:

We are committed to:

 The care, nurture of, and respectful pastoral ministry with, all children, young people and all adults;

 The safeguarding and protection of all children, young people and all adults

 The establishing of safe, caring communities which provide a loving environment where victims of abuse can report or disclose abuse and where they can find support and best practice that contributes to the prevention of abuse

To this end

 We will carefully select, support and train all those with any responsibility within the Church, in line with Safer Recruitment principles, including the use of criminal records disclosures and registration/membership of the relevant vetting and barring schemes

 We will respond without delay to every complaint made, that any adult, child or young person may have been harmed, cooperating with the police and local authority in any investigation

 We will seek to offer informed pastoral care and support to anyone who has suffered abuse, developing with them an appropriate ministry that recognises the importance of understanding the needs of those who have been abused, including their feelings of alienation and/or isolation

 We will seek to protect survivors of sexual abuse from the possibility of further harm and abuse

 We will seek to challenge any abuse of power, especially by anyone in a position of trust

 We will seek to offer pastoral care and support, including supervision, and referral to the appropriate authorities, to any member of our church community known to have offended against a child, young person or vulnerable adult

In all these principles we will follow legislation, guidance and recognised good practice.

2.

Introduction

2.1.

This practice guidance expands upon the Church of England policy Promoting a safe church: policy for safeguarding adults

in the Church of England (2006) and the Methodist Church policy Safeguarding Adults: a Methodist response to the

protection of adults when they are vulnerable (2010), and should be read in conjunction with both documents. Where possible there is a cross reference to relevant sections of the policies. (yet to be done and check for duplication and ordering)

2.2.

The guidance derives from work done in recent years in

Dioceses and Districts whose advisers and churches have been putting these policies into practice (always work in progress). It moves towards guidelines for best practice in the church context.

2.3.

It offers tools for churches in their care for adults who are vulnerable, and for Diocese and District Safeguarding

Advisers in response to allegations and concerns raised. The final section signposts to other resources in the Church of

England, the Methodist Church and Dioceses and Districts relating to specific areas of vulnerability, which can be used for practice and training.

2.4 On 16 May 2011 the government issued advice that it would not be updating No secrets until at least 2013. This practice advice is intended to bridge the gap until new statutory guidance is issued and the implications understood. http://www.dh.gov.uk/en/Publicationsandstatistics/Publication s/PublicationsPolicyAndGuidance/DH_126748.

3.

Definition of Adults who are Vulnerable

3.1.

The current legal definition of vulnerable adults is defined within the Freedom Act 2012. The Methodist Church and the

Church of England has set out the definition in a briefing paper 2 However, this statutory definition does not adequately describe the work undertaken by the churches in relation to adults who are vulnerable.

3.2.

One definition that has stood the test of time is one used by many Local Safeguarding Adults Boards. It was first suggested by the Lord Chancellor’s department in 1997 3 .

Amended it reads:

“A vulnerable person is someone of 16 years or over who is or may be in need by reason of mental or other disability, age or illness; and who is or may be unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation.”

2 http://www.churchofengland.org/media/1524414/info_sheet_no_2_regulated_activity_june_2012.pdf

3 The Law Commission have suggested a broad definition of a vulnerable person, as someone of 16 years or over who: is or may be in need of community care services by reason of mental or other disability, age or illness; and who is or may be unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation. http://webarchive.nationalarchives.gov.uk/+/http://www.dca.gov.uk/menincap/ch8.htm

4.

The context for safeguarding adults

4.1.Pastoral care

Working with adults in their vulnerability is rooted in care. That includes:

 how we treat each other – valued, with respect, included

 enabling all people, especially those who are vulnerable, to worship and pursue their faith journeys with encouragement and in safety

 giving people choices, independence, and the opportunity to contribute their gifts

 keeping safe and protecting from harm all who may be vulnerable

 ensuring ‘all are welcome’, and therefore sometimes setting boundaries for some in order to ensure the safety of others

 taking especial care where relationships are unequal, with the capacity for dependency .

4.2 Working co-operatively

This field is very wide, and none of us holds all the expertise. The most vulnerable adults are likely to be receiving care from a range of providers, some statutory and some informal and familial. For the good of the person it is therefore essential that work done by the church forms part of that wider package of care. We therefore need to work:

 in collaboration with other Diocesan/District Advisers, in

Disability, Mental Health, Pastoral Care

 Where we don’t have such resources, seek people with specific experience and skills in these fields as consultants

 liaising with next of kin and carers

 working with and referring on to existing statutory and voluntary support services, Adult Social Care, Mental Health,

Police.

5 Work with adults who are vulnerable

5.1 Considerations

 A vulnerable adult is difficult to define in a church context

 Vulnerability is often not a permanent state

 Vulnerability is not always visible

 A person with apparent visible vulnerabilities may not perceive themselves as such

 We are all vulnerable at different stages of life

 Vulnerable people may also pose risk and cause harm.

5.2 Creating a safer space for adults

We need take the following preventative measures to ensure environments of care and safety:

 recruiting, training and supporting for leaders/those in caring roles

 risk assessing ongoing and new activities, including worship

 exploring what inclusion, choice and independence means for communities and individuals

 creating and supporting environments of mutual care and responsibility

 having policies and procedures set up for complaints and allegations

 sharing information appropriately.

5.3 Responding to situations of harm

In response to concerns raised, we need to consider:

 assessing who is vulnerable in a situation, and by what definition

 identifying appropriate support, for perpetrators and victims

 considering the vulnerability of clergy and those in prominent roles

 working with statutory agencies

 setting up circles of support and appropriate boundaries for vulnerable adults who pose risk to children or other adults, if necessary with an agreement/contract of care

 offering specialist advice and support, for consultation or referral (for instance human resources, harassment/bullying, disability, mental illness, domestic abuse)

 offering vulnerable adults the space to be heard and facilitated to take steps where they have a grievance or complaint, if necessary by an independent listener.

6 The nature of adult vulnerability

6.1 In the church we want to have a culture of safety for both

Adults and Children. Many people have a better understanding of

Child protection in our community than they do of Adult protection.

Adults may be vulnerable because of conditions which may affect them permanently or temporarily. Factors which may make an adult vulnerable include (not an exhaustive list):

 Age (alongside other factors)

 Physical or mental illness

 Physical or learning disability

 Being abused, having a history of abuse, or offending

 Being dependent on substance or alcohol.

6.2 Some adults may already be known to Adult Social Care

Services or Mental Health Services, and some may need referral to statutory agencies. However, adults are deemed to be independent and able to make choices, unless it can be demonstrated that they cannot (see section 10); so unlike children, in almost all cases the consent of the adult is required before a referral will be accepted. A referral can also be made if deemed a public interest concern (see section 6.7).

6.3 Adults may also be vulnerable because of their life situation, or a specific context. For instance, through:

 bereavement and relationship breakdown

 being unemployed, in hospital, in prison, homeless

 being a stranger, refugee, asylum seeker

 being harassed or bullied

 being abused in a relationship of trust.

6.4 The difference between vulnerability of children and adults:

 Children are deemed vulnerable because of their age

 Some children have additional vulnerabilities

 Adults are deemed able to be independent and to have capacity unless it can be demonstrated that they have not.

6.5

In the church context, what counts as a safeguarding issue for an adult?

An abuse of power in any form falls within the safeguarding remit.

Examples may include:

 an allegation or observation of abuse of an adult (see section 6.6 for categories)

 a vulnerable adult harming or threatening harm to others

 someone holding an authorized ministry (such as clergy, reader) being made vulnerable (through stalking, harassment)

 a member of a congregation being made vulnerable, as above

 an adult made vulnerable by abuse of a relationship of trust.

7 Referral to statutory services

7.1 Categories for assessment

These categories are common to children and adults:

 Spiritual

 Emotional

 Physical

 Sexual

 Neglect

These categories relate to adults only:

 Financial

 Institutional

Psychological

Verbal.

7.2 Definition of spiritual abuse

As members of the Church this is something that we feel may be alien to us. The quote “It never happens here” is a dangerous stance. Awareness, Education and good practice is the best prevention.

The house of Bishops document ‘Promoting a Safe Church’, defines

Spiritual abuse as ‘An attempt to ‘force’ religious values or ideas onto people, particularly those who may be vulnerable to such practices. Within faith communities harm can be caused by the inappropriate use of religious belief or practice; this can include the misuse of the authority of leadership or penitential discipline, oppressive teaching, or intrusive healing and deliverance ministries, which may result in vulnerable people experiencing physical, emotional or sexual harm.

Examples of practical unintentional spiritual abuse:

• keeping a person under 18 with a learning disability in the

Crèche because they cannot read.

• parish Visitor saying if a person prays hard enough God will heal them.

• including people on the church intercessions list without asking for their consent. Making people feel they are Ungodly if they do not wish to comply with the request for their name to be included in the intercessions.

• using your position in the Church to make people feel inferior with relation to their walk with God

• exorcising demons from an adult with mental health problems.

Clergy may be asked to do House blessings and exorcisms, and should always seek advice from the Diocesan specialists in this field if they are unsure. It may be appropriate too include the

Safeguarding Adviser especially where children may be resident.

Clergy should also be aware of Mental Health issues and seek other health professionals if they have concerns.

Where you are dealing with people who have carers, always try to have open channels of communication with them. Some people because of their disability or illness can be over compliant and easily manipulated and power abuse is a real danger within this pastoral situation. Clergy should be aware of the guidance in

Clergy Code of Conduct in pastoral situations.

Clergy should monitor and educate members of their lay pastoral teams. Members of the team should not be afraid to ask for guidance in this area. Open honest communication in a Parish is safe communication.

Golden Rules

• Beware of your own power even if you sometimes don’t feel powerful. (It is an interesting exercise to find out what you have control over in your Church and faith.)

• Ask for help if you feel out of your depth

• Think before you act

• Listen to your instincts.

7.3 Dual Role Cases

In some situations, both a child and a Vulnerable Adult may be at risk of harm (for instance, a person with a learning disability is accused of touching a child inappropriately). There is a clear requirement to refer the child to statutory services, but it may also be appropriate to refer the adult to statutory services, for assessment and assistance with their behaviour, and for support through a criminal justice process. It is important to work wherever possible with carers, but their care for a person must not block the other person’s development, however well meaning.

Decisions in complex cases such as these should not be taken alone; confidentiality can be extended to take advice from specialists in the field, or from the Diocesan/District Safeguarding

Adviser (see section 4.2).

7.4

Reporting Abuse That Has Been Reported By An

Adult

Is the abuse Is the person .......

 as a child?

of the adult ........

Over 18? If so, the information belongs to them

A ‘public interest concern’ - how to decide

Other important points to remember

Take as much time as possible, to enable the adult to develop some trust, so, the information belongs to them and they make the decision - unless there is a ‘public interest’ concern.

capacity to decide? If so , you have to

decide what is in their best interests.

necessity and proportionality, i.e. whether the proposed sharing is likely to make an effective contribution to preventing the risk and whether the public interest in sharing information overrides the interest in maintaining confidentiality. In making against what might happen if it is not and make a decision based on professional judgement.”

 by another adult? by a child (usually domestic violence)? by someone in a church role?

 and they make the decision - unless there is a

‘public interest’ concern, see below.

A vulnerable adult with capacity to decide? If

A vulnerable adult who does not have

The key factors in deciding whether or not to share confidential information are the decision you must weigh up what might happen if the information is shared

Section 3.40 Information Sharing: Guidance for practitioners and managers

Never make these decisions alone. If necessary, consult without

HMSO 2010 identifying the individual/s involved - but always consult. This can be within the church/Diocesan or District Safeguarding Adviser, but also with the police / adult services.

Always record your decision, the reasons for it, and who you consulted.

Whenever possible, make these decisions alongside the adult who is most directly involved - working together rather than enforcing a solution.

The adult has the absolute right to remain silent even if you do make a referral. confidence, and hopefully a willingness to agree to the referral.

 If a referral is made, the adult may need significant support for a long time.

 Don’t overlook your own need for support .

8.

Vulnerable Adults who do not cross the threshold for Adult

Services referral or assessment

8.1 Adults who are vulnerable because of their life situation, or a specific context (see section 6.4) may not need a referral to Adult

Services, or may not be accepted by Adult Services. The first decision is whether the situation can be counted as a safeguarding issue (see section 6.5). If so, other procedures should be used, such as:

 grievance and complaint

 acceptable behaviour (excluding criminal)

 vulnerable adults who pose risks to others (not criminal)

8.2 If there has been a suspected criminal offence committed, the victim should be given the option of reporting the mater to the police, and if appropriate supported to do so.

8.3

Tools available in response may be:

 an independent authorised listener to assist the adult to tell the story and work out their next steps, with appropriate support

 referral to counselling or other agencies, including advocacy

 mediation

 written agreements/contracts of care.

8.4 Such work can sometimes usefully be undertaken by the archdeacon/....../parish priest or local minister working in collaboration with the Diocesan/District Safeguarding Adviser, especially where an ordained person is made vulnerable.

8.5 Clergy are required to follow the Guidelines for Professional

Conduct of Clergy 4 . If abuse is inflicted by clergy, then disciplinary measures will be taken.

4 insert reference

9 Mental capacity

Capacity to make choices:

• Is always presumed to exist

• Care should be taken to understand, however communicated, what choices are being made

• If the vulnerability prevents the ability to make some choices, it should be assumed that other choices are not so limited unless it is clear that this is so.

Risks of self harm and harm to others

Lasting Power of Attorney, cross reference section 12 to be written

Safeguarding Children and Vulnerable Adults

10 Potential roles for the Diocesan/District Safeguarding Adviser

(Adults)

These may include:

 enabling specialist advice and support

 referring to statutory services or other professional service, regarding both vulnerable adults as victims, and as perpetrators

 as an initial listener, with a view to setting up ongoing pastoral support

 as a referrer to an independent listener

 as mediator, to ensure fair process which takes into account need

 as educator and trainer, for example in:

creating safer space for adults, including o home visiting o lone working o safeguarding in the pastoral relationship

responding to situations of harm, including o adult and domestic abuse o survivors of abuse o sexual offenders.

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Safeguarding Children and Vulnerable Adults

11 Pastoral Visiting Team& Lay people who are authorised to administer Holy Communion to the housebound

The following guidance is to ensure the safety of the pastoral visitor, authorised administers of Holy Communion and the Vulnerable Adult.

11.1 Recruitment

Pastoral teams and those who are authorised to administer Holy Communion to the housebound should be recruited safely according to guidance of safe recruitment, trained, given role descriptions and monitored by the incumbent.

People must have a clear understanding when they are acting on behalf of the church and when they may act out of previous relationship or friendship.

People should not be recruited to Pastoral teams or be authorised to administer

Holy Communion to the housebound until they attended a church for at least six months. This enables them to get to know the Church who they are representing and the church to get to know them.

11.2 Arranging Visits

Whenever possible, contact the person in advance, by telephone, email or letter, to find a mutually convenient time to visit. It is helpful if you say why you are visiting. This will enable the person visited to understand the reasons behind the visit – and give them the opportunity to consent (or not) to the arrangement.

11.3 Recording

A record of a pastoral visits and home communions must be kept by the church, including any reference to safeguarding concerns, decisions made, and actions taken.

11.4 Identity Cards

Always take an identity card or letter of authorisation from the church when visiting – even if you know the person you are visiting well. There may be someone present, e.g. a family member or a health or social care worker, who needs to be reassured that you are a genuine visitor from the church

11.5 Food and drink

Don’t offer sweets, drinks or other food items to people you are visiting. You don’t know what they are able to have and they may not want to refuse for fear of offending you.

11.6 Medication

Never offer ‘over the counter’ medicines to the people you visit. Painkillers, cough medicines, throat pastilles, etc. can all have side effects and may not be compatible with other prescribed medicines the person may be taking. Never administer prescribed prescriptions, even if you are asked to do so by the person you are visiting.

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Safeguarding Children and Vulnerable Adults

11.7 Handling Money and Gifts

It can be very easy for someone to be confused about money. Ensure that if you are part of a visiting team you check your church’s policy with regards to handling money.

If you are asked to go shopping for someone you should again check with your church regarding its policy on shopping for people and handling money.

Always keep a paper trail of receipts and transactions.

If someone wants to give money to the church, always put it in an envelope and mark it on the outside as a donation – and get the Treasurer to acknowledge receipt or get them to sign up to the envelope scheme so that monies can be traced.

If someone wants to give you possessions that they own for a church fete/Christmas Fayre etc ensure that the person giving you the possession must have the mental capacity to understand the size and the value of the gift they are giving.

You should never take something yourself for visiting, or accept gifts offered to you.

11.8 Physical Movements & Contact

If someone in a residential establishment or hospital wants to be moved, find a member of staff - don’t try and do it yourself. If a person is at home do not do any specialist movement eg help to bath someone or toilet someone.

Avoid physical contact with people in nightclothes – they can be less concealing than normal day clothes and it can cause embarrassment.

11.9 Confidentiality

It is vital that things said to you remain confidential however if there are safeguarding issues you should ensure that people are aware that you have duty to report safeguarding issues if you are concerned about the welfare of a child, an adult who may be vulnerable or the person you are visiting.

11.10 Working co-operatively

Check out who else may be visiting or have responsibilities for the person’s care, and communicate with them, for instance:

Relatives/next of kin

Professionals involved

Other voluntary visitors, from church or other agencies

11.11 Boundaries

There is potential for over-dependency, which may emerge over a period of time, and put at risk the visitor as well as being unhealthy for the person visited. It is therefore helpful to set boundaries at the outset, and monitor them from time to time. For example:

 Time: when you visit, how frequently and for how long

 Place: is the person’s own home the only option

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Safeguarding Children and Vulnerable Adults

 Setting a pattern for visiting, and expectations for communication between visits (beware of over-frequent texting or emailing, and late at night exchanges)

When church visitors become friends:

If the visiting continues over a long period, and the boundaries of whether you are visiting in the name of the church, or as a friend may become blurred. It is helpful to be transparent and clear about this, and to check out how the relationship is perceived by the person visited, yourself as visitor, the person’s family and professionals. Confusion about this can risk harm to the person visited, risks to yourself and can affect the reputation of church.

11.12 Supervision and support

If you are part of a formal visiting team, ensure there are procedures in place for your own supervision and support, such as:

 who you are accountable to

 who you can extend confidentiality to (eg peer supervision) for routine monitoring of your visits

 meeting as a team to check out processes

 knowing who to tell if you have safeguarding concerns.

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Safeguarding Children and Vulnerable Adults

12 Legal matters

Those who help by providing pastoral care will often find themselves in the powerful position of meeting people at the limits of their vulnerability. It will always be wrong to exploit or manipulate. So while helping and support to the vulnerable considering taking legal action is appropriate, the making of a will and registering a Lasting Power of Attorney are very important acts that should only be completed by a competent person.

Government advice on making wills can be found at https://www.gov.uk/make-will

Lasting power of attorney (as attorney, as witness) Government advice on

Lasting Power of attorney can be found at https://www.gov.uk/power-ofattorney.

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Safeguarding Children and Vulnerable Adults

Sections 13 - 20 to be considered and written

13 Transport

 Offering lifts

 Consent

 The driver

 Escorts

 Lifting/handling

14 Running activities for vulnerable adults

 Respect

 Choice

 Language/visual resources

 Premises

 Leadership

 Needs of carers

15 Physical contact

 Restraint

 Adults in distress

 Intimate/personal care

 Relationships of trust

16 Holidays and residential trips

 Consent and involvement

 Leadership

 Accommodation and travel

 Health and behavioural needs

17 Acceptable behaviour

 What is acceptable

 Who is at risk

 Precautions

 Managing violence and aggression

18 Safeguarding in the pastoral relationship

From other sources

19 Use of images/sharing of personal data

 Informed consent

 Risks of sharing addresses in directories etc

20 Lone working

 Contexts (eg visiting, in church office, at vicarage doorstep)

 Risks

 Precautions

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Safeguarding Children and Vulnerable Adults

21 Information and training resources

Mental Health http://www.mentalhealthmatters-cofe.org/: includes as downloads:

 Chester Pack (i in 4); Understanding Mental Health – a guide to parishes from Oxford Diocese; Planning Church events around mental health

 Worship resources

 Resources on dementia.

Out of Solitary Places – The Methodist Church, www.methodist.org.uk/downloads/life_pc_mental_health_0707.pdf

Physical Disability

Access:

Diocese of Blackburn Access Audit Checklist http://www.blackburn.anglican.org/more_info.asp?current_id=293

Diocese of Manchester Disability and Inclusion Resources, http://www.manchester.anglican.org/diocesan-advisory-committee/disabilityinclusion-resources

The Disability Discrimination Act – The Methodist Church, www.methodist.org.uk/static/rm/disability-act.pdf

Learning disability

Opening the Doors: Ministry with people with learning disabilities and on the autistic spectrum – Church of England. www.churchofengland.org/media/39672/gs1725.pdf

Welcoming those with Autism and Asperger Syndrome in our churches and communities, Diocese of Oxford

Sensory disability deafchurch.co.uk

Abuse of vulnerable adults

From Surrey Safeguarding Adults Board: “Because you said something”

A free 6 minute film which aims to raise awareness of Safeguarding Adults and to remind us of our role in ensuring their safety. Copies are available from Surrey Safeguarding Adults Board on 01372 833099, or email

Pamela.Laidman@surreycc.gov.uk.

Downloadable material – for example:

You Tube

NHS Choices: Domestic Violence

NHS Choices: Attitudes to Mental

Health

Grace: the path of Alzheimer’s

Handling Customer Complaints in the Library

Social Care TV: www.scie.org.uk/socialcaretv

Safeguarding Adults

Mental capacity (stories)

Disabled children and young people

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20.

Acknowledgements

We would wish to acknowledge the contributions from the Methodist

Church and the Church of England as well as the statutory and voluntary sectors.

21.

Commissioning group

Elizabeth Hall: National Safeguarding Adviser (Child & Adult

Protection) for the Church of England & Methodist Church

Ruth Reed, Diocesan Vulnerable Adults Adviser, Diocese of Liverpool

Jill Sandham, Diocesan Safeguarding Adviser, Diocese of Southwark

Simon Payne: Safeguarding Adviser (Children & Adults), Diocese of

Lincoln

Download