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Case Scenarios

Safeguarding Adult Concerns are raised on a daily basis. Case Scenarios show outcomes for adults at risk of abuse. Partner organisations have worked together to support adults through the safeguarding adults process.

Scenario 1: Mr X

Mr X moved into a homemaker property in December 2010. Mr X previously lived in another property with a co-tenant, who was not compatible with him. There were safeguarding adult issues and the process supported Mr X to achieve a positive outcome by moving to his current address.

When Mr X first came to live in his new property, he seemed quite nervous and did not use skills to full potential.

Now Mr X smiles all the time and is a lot more independent. At first Mr X would sit in the chair and ask for a coffee, his favourite drink. Now Mr X doesn’t ask, he gets up and makes his own coffee independently with no assistance.

Mr X is now also able to strip and remake his bed and seems to like looking after his home.

Mr X has also now got a new friendship with a man who lives at another homemaker property.

Mr X also seems to really like going to a social group on Mondays. Mr X calls it party! He enjoys drawing pictures and dancing when he is there. Lots of people who knew Mr X some time ago say he looks happier and more settled.

Scenario 2: Mr A

Mr A is in his sixties and has a mild learning disability. Mr A lived alone in a sheltered housing scheme after a lifestyle of living in various temporary accommodation and shelters.

Concerns were raised about the number of times Mr A called an ambulance over a month and conflict that was occurring on the estate he was living. Mr A was presenting with behaviours that were impacting on his neighbours and as a result they were reacting in a very hostile manner. The community police were involved and there was a risk that Mr A was going to be evicted by the housing provider.

The Safeguarding Adult Manager agreed that Mr A should be supported in this situation through the safeguarding adult process.

Through joint working with the ambulance service, Tameside Hospital NHS Foundation Trust, Greater Manchester Police, Pennine NHS Foundation Trust, People First, New Charter and Adult Services the care work was completed to ensure Mr A was not evicted and he moved into 24 hour Learning Disability accommodation. This has greatly improved his quality of life and anxiety and behaviours have reduced.

Scenario 3: Mrs B

Mrs B is a younger Adult who lives alone independently.

A safeguarding adult concern was raised via the Anti-Social Behaviour Risk Assessment Conference meeting. Mrs B was a victim of hate crime where she lived due to her learning disability and sexuality. Mrs B was very vulnerable and had been targeted by one particular person who was possibly financially abusing her. Through the safeguarding Adults Process, joint working with housing, housing support team,adult services and advocacy Mrs B was moved to a different area.

Scenario 4: Mr Z

Mr Z was admitted to hospital from a mental health ward.  Mr Z had a history of depression and psychosis and was largely dependent on staff for all aspects of care due to long term mental illness and isolation. He became acutely physically unwell and required medical intervention.

Whilst on the medical ward required a level of support that on occasion resulted in the mental health staff accompanying, having to assert a degree of control to ensure safety and that medical care was delivered by moving him on the bed. This was observed by other members of the public who were visiting relatives, to be a disproportionate response. They raised a concern to the ward staff thus resulting in the safeguarding process being implemented. This included a strategy meeting and investigation being undertaken.

The outcome of the investigation concluded that whilst the allegation of abuse was not substantiated, the patients’ mental health and physical health needs were not fully understood by all staff delivering care. This was promptly redressed with senior staff revising the care plan to ensure that both mental and physical health needs were identified in one plan and communicated across both the hospital and the mental health trust. This included that where possible; the same staff provided the continuous observations.

In addition, training around the Moving and Handling of patients on mental health wards transferring to medical wards would be further considered as not all mental health ward staff required the same level of training to medical ward colleagues.

Key points from this case identified:

  • Challenges around the interface between the mental and physical health needs of patients and the need for staff to understand fully and communicate about each other’s roles and responsibilities.
  • Differences in organisations training requirements of staff in relation to the “Moving and Handling” of patients.
  • Challenges around attitudes of some staff and need for practitioners to be skilled in managing both the health and mental health needs of complex patients.
  • Difficulties with changes of agency staff and the potential impact on patient care
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