Guidance

Annex B: vulnerable adult care plan and toolkit (accessible)

Updated 10 January 2025

Version 1.3

Instructions

1. In accordance with Detention Services Order (DSO) 08/2016 Management of Adults at Risk in Immigration Detention, all Home Office staff, contracted service provider and Healthcare staff working with detained individuals in Immigration Removal Centres (IRCs), or Residential Short Term Hold Facilities (RSTHF) must be alert to any changes to the physical or mental health of a detained individual, or a change in the nature or severity of any previously identified vulnerability.

2. At STHFs, any vulnerabilities identified and the immediate actions taken to mitigate them, must be documented in the Vulnerable Adult Warning Form (VAWF). When an individual is transferred, any VAWF completed at STHFs must travel with the individual as part of their transfer records and be fully considered by the receiving IRC.

3. At IRCs, any such vulnerabilities that may impact on the safety and wellbeing of an individual must be addressed and reasonable adjustments put in place and documented in a Vulnerable Adult Care Plan (VACP).

4. Any newly identified vulnerability or changes to their nature or severity must be notified to the Home Office by way of a IS91 RA Part C.

5. There are a number of factors or experiences which will indicate that an individual may be particularly vulnerable to harm in detention and may require extra support. These include risk factors such as suffering from a mental health condition; having been a victim of torture, sexual violence or modern slavery; suffering from PTSD; being pregnant; being elderly; suffering from a serious physical health condition or disability; or being a transgender or intersex person.

6. By completing a VACP, you should identify any reasonable adjustments that can be made to mitigate any identified risks or vulnerabilities. Extra support provided to the individual can include assistance with mobility, assistance with medication or attending medical appointments, regular observations or any other adjustment that will help the individual overcome the impact that such vulnerabilities may have on his or her experience of detention.

7. For families detained at Gatwick Pre Departure Accommodation (PDA), please refer to the specific support plan detailed at the PDA Operating Standards.

8. The VACP should be used to document additional support provided to adult individuals only. DSO 19/2012 – Safeguarding Children and DSO 14/2012 – Age Dispute Cases in Immigration Detention provide guidance on the safeguarding and wellbeing of children in detention.

Reasons for opening the Vulnerable Adult Care Plan

Why are you opening a VACP for this individual?

Isthe individual suicidal or liable to self-harm?

Open an ACDT, not a VACP.

Did the individual arrive with a VAWF?

Consider the need for a VACP. Keep the VAWF with the care plan and document the risks assessed. Contact the original centre if you need further information on any vulnerabilities.

Is the individual being bullied?

Refer the case under local Violence Reduction and Safer Detention policies. Do not open a VACP unless further vulnerabilities are identified.

Do you think the individual may have mental health problems?

Seek advice from the mental health team in healthcare or complete a referral, open a VACP if required and appropriate.

Do you think the individual may be under the influence of illicit substances?

Stay with the individual. Contact a manager & Healthcare and ask them to attend the scene. If Healthcare suspect the individual may be under the influence open a VACP, complete a Part C and IR. Notify the Home Office Intel Team.

On reception of detained individual transferred on a VACP or VAWF

Individual’s Name:

ATLAS/HO Ref:

Previous Case Manager name and contact details:

VACP / VAWF provided to centre and handover completed?:

Immediate actions or adjustments required:

Reception Officer name and signature:

Escorting Officer name and signature:

Vulnerable Adult Care Plan

Insert individual’s picture:

Plan REF Number (for local use only):

Individual’s name:

ATLAS/HO reference:

Location (if transferred please indicate dates and new location):

Language/Comprehension of English

English - Ability to speak/understand: Good, Some, None

First language:

Interpreter required: No. Yes - provide details:

Staff member opening the VACP:

Date and time opened:

Case manager, name and grade:

Part C sent to DEPMU and DET, date and time:

Sent to case owner (DET only), date and time:

Immediate action plan and CAREMAP completed

Duty Manager / Orderly Officer, date and time:

Required frequency (day and night) of conversations and observations

1. From //_

2. From //_

3. From //_

Date of next case review:

Date:

Signed:

Initial assessment and immediate action plan

The Immediate Action Plan must be completed by a Manager (Orderly Officer or Duty Manager) in the first 24h hours upon notification of a VACP being open and must involve a multi-disciplinary approach. This will determine any actions required and the correct level of support for the individual. A case review sheet must be completed, and the CARE MAP updated at each review. A manager must check the booklet daily to ensure the appropriate level of support is being maintained. When closing the document, the front cover of the document must be completed, a part C completed, and the individual file and ATLAS updated.

Individual’s name:

ATLAS/HO reference:

Case Manager:

Date and Time:

Location:

Grade:

Signed:

Consulted:

• Role:
• In person/Telephone/Email:
• Healthcare:
• Home Office:
• Activities:
• Other:

Vulnerabilities identified:

On a daily basis how does the condition affect the individual?

Will the issues identified exclude the individual from any of the centre’s activities? (please specify)

What kind of support does the individual need to carry out normal day to day activities? (e.g. access to the lift, Hearing Loop, new location, out of hours medication.)

CAREMAP completed? Yes, No.

If yes, a copy needs to be given to the individual. If no, detail reasons why.

Does the Care Plan need to remain open? Yes, No.

If yes, update front cover of Care Plan scheduling the next review, the individual file and local IT systems, complete a part C and make a note on the daily briefing. If no, detail reasons why.

Immediate care actions

Room Share Risk Assessment Review: Yes/No

Individual’s location assessed and agreed: Yes/No

ACDT opened? Or review required? Yes/No

Individual’s regime access agreed: Yes/No

Special arrangements required (expand above: Yes/No

Personal Emergency Evacuation Plan needed? Yes/No

Part C to DEPMU and DETs: Yes/No

Other:

Closing the care plan

Individual’s name:

ATLAS/HO reference:

Case manager:

Date and time:

Location:

Grade:

Signed:

Consulted:

• Role: healthcare (mandatory), Home Office, other
• In person/Telephone/Email

Details of why you are closing this Care Plan and contributions from those consulted:

• Identify immediate risks, behaviours or triggers that can affect the individual after the Care Plan being closed
• Room sharing risk assessment.
• Record any action put in place to help the reintegration of the individual , where appropriate (e.g. when the individual was residing in a care suite or healthcare environment)
• Make individual aware of support available (welfare, chaplaincy, local Immigration team etc.).

Issues identified requiring ongoing support and type of support required:

Added by:

Signed/dated:

Date completed:

On discharge of an individual being transferred on a VACP

Care plan provided to escorts and handover completed?

Actions of adjustments agreed to facilitate transfer, details:

Reception Officer name and signature:

Escorting Officer name and signature:

Vulnerable adult care plan - support record

You should consider the following areas when preparing the support record:

• Does this individual have a disability?
• Does the individual need medical advice or support?
• Is the individual at risk of self-harm?
• Why are they vulnerable or becoming vulnerable?
• Does the individual have friends or family to support them?
• Does the individual need faith support?
• Is the individual integrated into all activities within the centre?
• Does the individual have mobility Issues? Does he or she need a PEEP.

Case review:

Issues:

Actions required:

By whom and when:

Status:

Date completed:

Reviewing manager signature and date:

Detainee:

• Signature:
• Print name:
• Date:

Case manager:

• Signature:
• Print name:
• Date:

Multidisciplinary case review No:

All departments who may be involved in supporting the individual must attend where possible, for example Home Office, the faith team, healthcare, welfare staff, activities and education etc. A verbal contribution may be obtained over telephone when they are not available to attend. If the review is conducted by a manager other than the Case Manager, the Case Manager must be updated as soon as possible to schedule the next case review or close the VACP.

Detainee’s Name:

ATLAS/HO Ref:

Case Manager:

Other Attendees/Contributors:

Date and Time:

Review how the individual is coping now, have there been any changes in their circumstances?

Are they receiving the correct level of support?

Complete/update Care map – copy to be given to individual if requested:

Does the Vulnerable Adult Care Plan need to remain open? If yes, the Case Manager must schedule the next review, update front cover of Care Plan, the individual file and local IT systems, complete a part C and make a note on the daily briefing.

Print name:

Position:

Date and Time:

Signed:

Level/frequency of observations/conversations to be recorded:

Obs:

Date:

Date/Time:

Observations:

Staff name, position and signature: