Resources

The HSE Safeguarding and Vulnerable Adults Section on the HSE website has the contact details for each Safeguarding and Protection Teams in each of the 9 CHO areas, links to training, advice and information on safeguarding. 

The HSE launched their making safeguarding personal toolkit in 2024. Making Safeguarding Personal (MSP) is part of a growing practice re-orientation from risk averse cultures towards more collaborative, strengths-based and person-centred cultures, enabling positive risk-taking.

Making Safeguarding Personal means it should be person-led and outcomes focused. It engages the person in a conversation about how best to respond to their safeguarding situation in a way that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety

What is MSP Toolkit of Resources?

To support the adoption and implementation of this model, a Design and Education Support Group from the National Safeguarding Office has developed a MSP toolkit of resources for an Irish context. The toolkit contains 12 practice tools based on the work originally undertaken in this area by the UK Local Government Association. The toolkit guides social workers and other health care professionals on how to focus on the user and their perception of what is happening. The focus is on what is important to the user to enhance their engagement, choice and control, with an overall aim of resolution and recovery

Tools

• Tool 1: Information and Advice Audit
• Tool 2: Information and Advice - What's Working, What's Not
• Tool 3: Anti-Oppressive Practice
• Tool 4: Solution-Focused Communication
• Tool 5: Communication Tools
• Tool 6: Six Core Principles – 'I' Statements
• Tool 7: Promoting Less Restrictive Practice
• Tool 8: Characteristics of Good Recording Checklist
• Tool 9: Risk Enablement
• Tool 10: Restorative Questions
• Tool 11: Doughnut
• Tool 12: What to Do If You Suspect Domestic Abuse or a Pattern of Coercive Control

Watch the HSE training tool for staff on YouTube here. The tool being used here is the Restorative Practice tool, which is one of a suite of tools produced by the National Safeguarding Office.

Safeguarding Ireland was established to promote the safeguarding of adults who may be vulnerable, protect them from all forms of abuse by persons, organisations and institutions and develop a national plan for promoting their welfare. This will be achieved by promoting inter-sectoral collaboration, developing public and professional awareness and education, and undertaking research to inform policy, practice and legislation in the Republic of Ireland. In December 2017, Safeguarding Ireland published its first Strategic Plan which spans a five‐year period until the end of 2021.

It is now possible to report concerns of abuse and neglect electronically to the HSE Safeguarding and Protection Teams. Professionals working in health and social care should now submit community referrals to the HSE Safeguarding and Protection Teams via the Adult Safeguarding Portal. Organisations and services who are required to submit Preliminary Screenings (PSFs) to the HSE Safeguarding and Protection Teams should also use this portal with actions from this point forward in terms of oversight assigned via engagement with the HSE Safeguarding Teams on the delegation portal.

Sage is the National Advocacy Service for Older People. It also supports vulnerable adults and healthcare patients in certain situations where no other service is available. It responds according to a person's needs with Information – Support – Advocacy – Safeguarding and often a combination of all these approaches. It also identifies, analyses and highlights issues which require systems changes through Systemic Advocacy. 

The HSE (Health Service Executive) defines self-neglect in vulnerable adults as a spectrum of behaviours where an individual:

(a) Fails to engage in self-care acts that adequately regulate independent living, OR

(b) Fails to take actions to prevent conditions or situations that adversely affect their health and safety, or the health and safety of others.

This definition highlights that self-neglect isn't just about personal hygiene but also encompasses the ability to manage one's life in a way that maintains safety and well-being.

The HSE policy emphasizes several key aspects of self-neglect:

• Spectrum of Behaviours: Self-neglect is not a single act but a range of behaviours that can vary in severity.
• Impact on Independent Living: It affects the person's ability to live independently in a safe and healthy manner.
• Risk to Self and Others: The neglect can create risks not only for the individual but also for those around them.
• Underlying Issues: Self-neglect is often associated with underlying problems that require evaluation and treatment.
• Professional Responsibility: Recognizing and considering the possibility of extreme self-neglect is a professional responsibility.
• Threshold for Intervention: A threshold of severity needs to be exceeded before labeling behaviour as self-neglect and warranting intervention from health and social services. Many common behaviours do not necessitate action.
• Cultural Context: The definition of self-neglect is influenced by cultural understandings of cleanliness, hygiene, and care.

Indicators of Severe/Serious Self-Neglect outlined by the HSE can include:

Personal Appearance:

• Matted, dirty hair
• Long, untrimmed, dirty nails
• Multiple or severe pressure ulcers or other injuries
• Very soiled clothing
• Multiple insect infestations

Functional Status:

• Impaired cognition
• Delusional state
• Inability to call for help or respond to emergencies

Medical Needs:

• Untreated medical conditions
• No documentation of a healthcare provider
• Appearing ill or in pain, or complaining of pain or discomfort

Environment:

• Poorly maintained environment with rubbish and debris
• Dilapidated dwelling with broken or missing windows and walls
• Severe structural damage, such as a leaking roof
• Pungent, unpleasant odours
• Presence of human or animal waste
• Rotting food
• Significant clutter making it difficult to move around or find things
• Multiple uncared for pets
• Problems with essential utilities like electricity, water, and telephone

Nutrition:

• Significant under or overweight
• Issues with food storage, expiry dates, and food preparation
• Lack of availability of essential food groups in the diet

Social:

• Lack of use of social support networks
• Social disengagement

The HSE policy provides guidance for professionals on how to approach concerns of self-neglect, including preliminary assessment, consultation with other professionals, meeting with the vulnerable person to ascertain their views, and potentially arranging multidisciplinary strategy meetings and comprehensive assessments, including mental capacity assessments when necessary.

It's important to note that the HSE emphasises balancing the need to protect vulnerable adults with respecting their right to self-determination, provided they have the capacity to make their own decisions. Building trust and negotiation are considered critical for successful intervention.

The Decision Support Service (DSS) has been established to promote the rights and interests of people who may need support with decision-making. The service registers decision support arrangements and supervise decision supporters. 

In April 2024 the Law Reform Commission launched their "Report on a Regulatory Framework for Adult Safeguarding". The comprehensive report recommends new structures, legislation and policies which would strengthen adult safeguarding in Ireland, particularly for adults at greater risk of harm due to a disability, age-related frailty, an acquired brain injury or serious illness.

The Department of Health has been working on developing legislation in regard to Adult Safeguarding. 

In April 2024, the Joint Committee on Disability Matters launched a report on ensuring rights based adult safeguarding in Ireland. This report focusses on two public meetings undertaken by the Committee; 31 March 2022 HIQA, Sage Advocacy, the Irish Association of Social Workers and Professor Brendan Kelly, professor of psychiatry at Trinity College Dublin attended. Safeguarding Ireland attended a public meeting on 21 February 2024. Several key findings and recommendations arose from the meetings.

• Women's Aid is a national, feminist organisation working to prevent and address the impact of domestic violence and abuse since 1974.
• Safe Ireland works to create confident, competent community-based responses to domestic, sex, gender, and sexuality-based violence, wherever it occurs. 
  
• Rape Crisis Network Ireland (RCNI) is a specialist information and resource centre on rape and all forms of sexual violence with a proven capacity in strategic leadership. We are the representative, umbrella body for our member Rape Crisis Centres.
• Men's Aid (formerly AMEN) provide a confidential service underpinned by a victim centric and human rights proofed approach aimed at ensuring all male victims of Domestic Violence / Coercive Control receive the required support to be safe.
• Ruhama is an Irish NGO and registered charity that offers nationwide support to women impacted by prostitution, sex trafficking and other forms of commercial sexual exploitation. 
  

In 2024 Safeguarding Ireland commissioned a study on Peer to Peer Abuse in Adults and a full copy can be found here. 

The report synthesises findings from research on peer-to-peer abuse within Irish care settings, aiming to identify crucial learnings for developing effective training programs for health and social care staff. The analysis of available literature underscores the significant need for enhanced understanding and specific guidance on addressing incidents of aggression and abuse occurring between adults receiving care.

 A central theme emerging from the research is the recommendation to clearly differentiate between peer-to-peer aggression and peer-to-peer abuse, enabling more appropriate responses and reporting mechanisms.

Furthermore, the review highlights a significant gap in current training provisions, with most safeguarding training lacking specific content on managing and responding to peer-to-peer incidents.

The key learnings identified in this report offer valuable insights into recognising, preventing, and responding to peer-to-peer abuse, which are essential for developing comprehensive training materials. These learnings emphasise the importance of establishing clear definitions, understanding the context and prevalence of such incidents, applying specific criteria for differentiation, and fostering a culture of safety and respect within care environments.

For more information on the study, please click on the following link.

INAR (the Irish Network Against Racism) is a national network of anti-racism civil society organisations which aims to work collectively to highlight and address the issue of racism in Ireland.

INAR provides a number of practical training focused on anti-racism, reporting and finding practical responses to racism, to support your professional development, organisational capacity and work with those affected by racism. Check below for the upcoming training dates and feel free to enquire about any of the training sessions listed below.

Apart from training listed below they also provide on demand training tailored to the specific requests and needs your organisation may have.