Vulnerable Adults

Introduction

The purpose of this document is to set out the policy of the Practice in relation to the protection of vulnerable adults. Further guidance may be available on local inter-agency procedures via the Primary Care Organisation and / or Social Services.

What is a vulnerable adult?

The definition is wide, however this may be regarded as anyone over the age of 18 years who may be unable to protect themselves from abuse, harm or exploitation, which may be by reason of illness, age, mental illness, disability or other types of physical or mental impairment.

Those at risk may live alone, be dependent on others (care homes etc.), elderly, or socially isolated.

Forms of Abuse

  • Neglect – ignoring mental or physical needs, care, education, or basic life necessities or rights
  • Bullying – family, carers, friends
  • Financial – theft or use of money or possessions
  • Sexual – assault, rape, non-consensual acts (including acts where unable to give consent), touching, indecent exposure
  • Physical – hitting, assault, man-handling, restraint, pain or forcing medication
  • Psychological – threats, fear, being controlled, taunts, isolation
  • Discrimination – abuse based on perceived differences and vulnerabilities
  • Institutional abuse – in hospitals, care homes, support services or individuals within them, including inappropriate behaviours, discrimination, prejudice, and lack of essential safeguards

Abuse may be deliberate or as a result of lack of attention or thought, and may involve combinations of all or any of the above forms. It may be regular or on an occasional or single event basis, however it will result in some degree of suffering to the individual concerned. Abuse may also take place between one vulnerable adult and another, for example between residents of care homes or other institutions.

Indications

  • Bruising
  • Burns
  • Falls
  • Apparent lack of personal care
  • Nervousness or withdrawn
  • Avoidance of topics of discussion
  • Inadequate living conditions or confinement to one room in their own home
  • Inappropriate controlling by carers or family members
  • Obstacles preventing personal visitors or one-to-one personal discussion
  • Sudden changes in personality
  • Lack of freedom to move outside the home, or to be on their own
  • Refusal by carers to allow the patient into further care or to change environs
  • Lack of access to own money
  • Lack of mobility aids when needed

Action Required

Where abuse of a vulnerable adult is suspected the welfare of the patient takes priority. In deciding whether to disclose concerns to a third party or other agency the GP will assess the risk to the patient.

  •  Ideally the matter should be discussed with the patient involved first, and attempt made to obtain consent to refer the matter to the appropriate agency. Where this is not possible, or in the case of emergency where serious harm is to be prevented, the patient’s doctor will balance the need to protect the patient with the duty of confidentiality before deciding whether to refer.
  • The patient should usually be informed that the doctor intends to disclose information, and advice and support should be offered.
  • Where time permits, the medical defence organisation will be telephoned before any action is taken.

Due regard will be taken of the patient’s capacity to provide a valid consent.

In assessing the risk to the individual, the following factors will be considered:

  • Nature of abuse, and severity
  • Chance of recurrence, and when
  • Frequency
  • Vulnerability of the adult (frailty, age, physical condition etc.)
  • Those involved – family, carers, strangers, visitors etc.
  • Whether other third parties are also at risk (other members of the same household may being abused at the same time)

Subject to the local procedures in force, consideration will be given to;

  • Report to Social Services Mental Health team
  • Report to Police
  • Report to PCT lead
Contact List
Service
Contact Number
Police (local) Ealing Police Station: 020 86493573 

Or national police service: 999
Community Mental Heath Avenue House: 020 8483 1720 

Out of Hour contact: 0300 1234244
Adult Support Services/ Safeguarding Adult 020 8825 8000
Adult Support Services (out of hours) 

Adult Protection Officer

 020 8825 5000
Age Concern 020 8567 8017
Social Services 020 8825 8000 / 020 8566 2360
MIND in Ealing 020 8992 0303
Ealing CAMHS 020 8354 8160
Drug Misuse RISE: 020 8843 5900 

020 8825 9888
Medical Defence Organisation MDU – via doctor/nurse or management membership details
Ealing CCG 

3rd Floor, Perceval House

14/16 Uxbridge Road

Ealing, W5 2HL

 020 8280 8080
NHS England 

North West London Area Team

 020 7322 3700