Introduction: about coronavirus (COVID-19) and adult protection
With the coronavirus (COVID-19) pandemic and self-isolation, some people will be at greater risk of harm. As a social service worker, you have a legal and moral duty to make sure the adults you work with are safe and protected. Adult protection is everyone’s responsibility.
We've developed this brief guide to help new or redeployed staff quickly understand the following areas.
Adult support and protection: what is it and who might need protection?
Harm: what are the signs to look for?
What to do: what should you do if you identify a concern?
If you’re new to the workforce, please use this information and speak with a line manager or supervisor if you need support. If you’re an existing social service professional, we hope there's information here to enhance your confidence and help you share learning with others.
Before you read the rest of this resource, watch this video from the Act Against Harm website.The website was created for the general public to help them understand more about adult support and protection.
If you’re a member of the public and have a concern please contact your local authority.
If you have a concern to report as a social service worker, you should follow your organisation’s policy and procedures.
Adult support and protection: what is it and who might need protection?
People in Scotland, no matter what their age, gender or ethnicity have the right to be safe and protected from the risk of harm.
The Adult Support and Protection (Scotland) Act 2007 aims to protect adults who are unable to safeguard their own wellbeing, property, rights or other interests and who are at risk of harm because they are affected by disability, mental disorder, illness, physical or mental infirmity. Harm means all harm including self-harm and neglect.
Local authorities in partnership with other public bodies have a duty to make inquiries about a person's wellbeing, property or financial affairs if they know or believe that person could be ‘at risk’ and they might need to intervene.
Everyone working in the social service workforce has a responsibility to contribute to protecting adults at risk of harm.
are unable to safeguard their own wellbeing, property, rights or other interests
are at risk of harm, and
because they are affected by disability, mental disorder, illness or physical or mental infirmity, are more vulnerable to being harmed than adults who are not so affected.
All three elements of this definition must be met. This is known as the three-point test and is applied by local authorities to determine whether an adult meets the criteria of an ‘adult at risk’.
An adult with a disability or illness is not automatically an ‘adult at risk’.
An adult is at risk of harm if another person’s conduct is causing (or is likely to cause) the adult to be harmed or the adult is engaging (or is likely to engage) in conduct which causes (or is likely to cause) self-harm.
Harm can be anything that has a detrimental effect on the wellbeing of a person. If you think a person may be at risk of any type of harm, you must report without delay so it can be investigated by the local authority. They will determine if it meets the three-point test. Please refer to the What you should do section for information.
Human rights do not alter during this pandemic, nor do professional responsibilities in relation to adult support and protection.
Many of the decisions taken by local authorities and other public bodies, particularly in respect of adult support and protection, will be done with reference to human rights.
Examples of human rights include:
the right to life
the right to respect for private and family life
the right to freedom of religion and beliefs.
In Scotland, human rights are recognised and incorporated into the Health and Social Care Standards (2018).
These Standards are underpinned by five principles.
Dignity and respect
Responsive care and support
You can learn more about the Standards by watching the video.
As a result of the pandemic both the UK and Scottish Governments have passed emergency legislation which introduces some restrictions to human rights such as the prohibition of public gathering. There are also other provisions relating to care of adults with incapacity, some of which have yet to be enacted. This short guide to the Coronavirus (Scotland) Act 2020 published by the Scottish Government gives an overview of the provisions of the Coronavirus (Scotland) Act 2020.
It's vital that any social service worker involved in adult support and protection considers the legal and ethical issues from a human rights-based approach. The UK Government (Department of Health and Social Care) has released an ethical framework for adult social care in response to the pandemic. It provides a useful set of principles to consider in all cases but especially where the threshold for intervention under adult support and protection is not met.
Fuller details on legislation is available in the SSSC Adult Support and Protection App which you can download on Google Play or the App Store.
The Human Rights Act gives further effect to rights and freedoms guaranteed under the European Convention on Human Rights. In care settings, the Human Rights Act supports and strengthens the other Acts listed here. Everyone, wherever they live in Scotland, is entitled to have their human rights protected and as a social service worker you can play a key role.
The Adults with Incapacity (Scotland) Act provides a legal framework for making decisions on behalf of another person (if it's agreed they do not have the capacity to decide). It can cover welfare, property, financial affairs and medical treatment. It recognises that, as far as possible, people should have autonomy and be able to control their own lives, and another person can only make decisions on their behalf when it is justified and necessary.
The Mental Health (Care and Treatment) Act sets out when and how people can be treated if they have a mental illness, learning disability or related condition (called a 'mental disorder' in the Act) and when they can be treated or taken into hospital against their will. The Act contains ten principles and a range of safeguards (such as 'Advance Statements') to help professionals protect and promote the rights of people receiving care.
The Adult Support and Protection (Scotland) Act 2007 aims to protect those adults who are unable to safeguard their own wellbeing, property, rights or other interests and they are at risk of harm because they are affected by disability, mental disorder, illness, physical or mental infirmity. Harm means all harm including self-harm and neglect.
The Equality Act aims to protect people from discrimination, harassment and victimisation. There are nine protected characteristics described. The Act requires public bodies (like local authorities and NHS boards) to consider how their decisions and policies affect people with different protected characteristics.
This Act introduced a duty of candour for organisations following serious incidents in care settings which result in death or harm. It also introduced offences for care providers and workers found to have ill-treated or wilfully neglected individuals in their care.
The Domestic Abuse Act recognises the multiple ways in which people can be abused by a partner or ex partner. Domestic abuse is a crime. It does not have to be sexual or physical; domestic abuse can be any action that is violent, threatening or intimidating. This includes psychological and emotional abuse by a partner or ex-partner (commonly known as 'coercive control').
Modern Slavery is a serious crime in which individuals are exploited for little or no pay. The Modern Slavery Act brought together and simplified existing legislation, and gave law enforcement new powers. It increased sentencing powers and strengthened protection for survivors.
The Human Trafficking and Exploitation (Scotland) Act makes provisions about human trafficking and slavery, servitude and forced or compulsory labour. This includes provision about offences and sentencing, and provisions for victim support.
Harm: what are the signs to look for?
It's more important than ever that we are alert and looking for potential signs and indicators of harm as a result of the pandemic.
The main categories of harm are:
financial like theft, fraud, scams, exploitation and misuse of benefits or property
physical like hitting, force-feeding, burning or the misuse of medication or inappropriate use of restraints
neglect or acts of omission like ignoring or withholding medical or physical care
psychological or emotional like humiliation, verbal abuse, coercion such as persuading or manipulating someone to do something by use of force or threats, keeping people away from friends and family
sexual like rape, sexual assault and grooming
discriminatory abuse like bullying or making offensive remarks against a person’s race, disability etc
self-harm like injuring or poisoning self
self-neglect like hoarding, or neglecting personal or medical care
organisational/institutional like removing a person’s individuality by adhering to strict regimes such as lack of choice over clothes or food.
It's not possible to include all types of harm and it's important to remember that harm can be anything that has a detrimental effect on the wellbeing of a person. Many forms of harm are also criminal offences.
In the course of your work, if you think a person may be at risk of any type of harm, you must report this in line with your duty of care and your organisation’s adult support and protection policy.
Some people might be at greater risk of harm during the pandemic therefore we've highlighted some specific signs and issues it might be useful to be aware of.
There are many types and potential indicators of harm that social service workers should look out for.
Harm is not always easy to spot. Often the clearest sign that something is wrong will be a remark from the adult suggesting all is not well but may also be reflected in body language or physical presentation.
Signs and indicators you should look out for include:
general lack of interest and withdrawal
lack of personal care which may affect personal health
poor eating and nutrition
misuse of drug and/or alcohol
failure to seek help or access services for health and social care needs
loss of motivation, inability or unwillingness to manage personal affairs
loss of confidence
unexplained debts or an inability to pay for things as usual
inability to avoid harm as a result of social isolation
unusual injuries such as bruising or cuts
changes in usual behaviour
unexplained weight loss.
This is not an exhaustive list so above all trust your instincts. If something feels wrong, say something to your line manager or adult protection contact.
Due to self-isolation, shielding and social distancing requirements, more and more people are increasingly at home and socially isolated. Social isolation can be a major risk factor in relation to harm, for example, the number and severity of incidents of self-neglect, carer stress and domestic abuse can increase with social isolation. Specifically, isolation can mean people:
feel increased stress and tension from staying indoors
feel that they can’t ask for help as they fear being a burden to stretched services
hide harm from others
do not get the support they need
can be taken advantage of by others who know that they are vulnerable
are at a greater risk of experiencing undue pressure for example when someone they trust is harming them or influencing them to make harmful decisions.
It's important you look for signs arising from the pandemic when undertaking your work as you might be the only person someone has contact with.
The Social Care Institute for Excellence (SCIE) guide Safeguarding adults during the COVID-19 crisis highlights the increased risks of financial and cyber scams, neglect and abuse that adults with care and support needs might face. This guide was created for England so some of the references are not applicable in Scotland.
Some types of abuse can be hard to identify, and often victims feel they are unable to seek help. Help is available for everyone.
If services need help, advice or information about any modern slavery issue they can contact the Modern Slavery Helpline.
The Scottish Government's human trafficking policy page provides links to resources to raise awareness of the issue and the support available to victims.
What you should do: what to do if you identify a concern
It's important to report any concerns you have including the following.
General concerns about someone’s wellbeing.
You see or hear about something which could be harmful.
You feel someone has done something to an individual which makes you uncomfortable.
Someone tells you that something harmful has happened or is happening to them.
Your organisation will have procedures for reporting adult support and protection concerns to the local authority. Your employer has a duty to make sure you have access to these. You have a responsibility to make sure you are familiar with them and know who you should contact about such concerns. This will often be your line manager or supervisor but you also need to know who to contact if they are not available.
You should report any concerns without delay.
If someone is in imminent danger or needs urgent medical attention, then you may also need to call 999 to contact Police Scotland or the Scottish Ambulance Service. It's also important you minimise any risks to you and do not put yourself in danger.
If someone is in imminent danger you may need to call 999.
Although you may be facing a stressful situation, it's important you act calmly. This will help to reassure the person and can give you more confidence to deal with the situation appropriately.
All local authority and health board staff (under Section 5 of the Adult Support and Protection (Scotland) Act 2007) have a duty to share and report their concerns. You should always try to obtain the consent of the person to share information about a concern wherever possible.
Reporting a concern
Adult support and protection legislation allows for ‘potential’ harm as well as ‘actual’ harm, so you do not have to provide evidence for your concerns to be taken seriously. If you believe an adult is at risk of harm your professional judgment based on your knowledge and understanding of the person’s situation is enough to report your concern.
If it turns out the person is not experiencing any harm, it's better for you to have had this checked than not report your concerns.
If you feel that the person continues to be at risk of harm, you have a responsibility to report this to the appropriate person (your line manager or supervisor) in line with your adult support and protection policies and procedures.
Under Code 3, social service workers must promote the independence of people who use services while protecting them, as far as possible, from danger and harm.
Your employer also has a responsibility to support you to understand your responsibilities.
Local authorities and other public bodies will continue to prioritise adult protection during the pandemic.
Your own organisation might not carry out investigations. Local authorities have the duty to lead investigations and may carry out the investigation process directly. Once you report your concerns, you may not have much further involvement in the process. You may be interviewed or need to submit a statement as part of the investigation process.
Investigators must uphold the confidentiality of the person, so you may not be aware of any action that has been taken to protect the person.
If you think your concerns are not being taken seriously, they have not been passed on for investigation or if the concerns relate to your line manager, you may need to use your organisation’s whistleblowing procedures. While it is unlikely you will ever need to use these, it is important you are familiar with the whistleblowing procedures in case you do.
Adult Protection Committees
Adult Protection Committees (APCs) were created under the Adult Support and Protection (Scotland) Act 2007 and each local authority area in Scotland must have one. APCs are a good source of guidance and training. To find your local APC, type the name of your local authority and 'Adult Protection Committee' into your internet search.
Adult Support and Protection App
This App from the SSSC is available on Google Play or the App Store. The App is a useful source of information. Please note it is not intended to be used as a stand-alone learning resource.
Scottish Government adult protection resources
On the Scottish Government home page, type 'adult protection' in the search bar and you will be directed to the appropriate pages.
SCIE have produced a guide Safeguarding adults with dementia during the COVID-19 crisis in partnership with the Alzheimer’s Society. This guide aims to support care providers and staff to safeguard people with dementia during the crisis. It was created for England so some of the references are not applicable in Scotland.