Safeguarding means protecting an adult’s right to live in safety, free from abuse and neglect. It is about people and organisations working together to prevent and stop both the risks and experience of abuse or neglect, while at the same time making sure that the adult’s wellbeing is promoted including, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action. This must recognise that adults sometimes have complex interpersonal relationships and may be ambivalent, unclear or unrealistic about their personal circumstances.
Organisations should always promote the adult’s wellbeing in their safeguarding arrangements. People have complex lives and being safe is only one of the things they want for themselves. Professionals should work with the adult to establish what being safe means to them and how that can be best achieved. Professionals and other staff should not be advocating “safety” measures that do not take account of individual wellbeing (see Promoting Wellbeing).
2. Adults and Adult Abuse
The safeguarding duties apply to an adult who:
- has the needs for care and support (whether or not the local authority is meeting any of those needs) and;
- is experiencing, or at risk of, abuse or neglect; and
- as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect.
The adult experiencing, or at risk of abuse or neglect will hereafter be referred to as the adult throughout these procedures.
Where someone is 18 or over but is still receiving services from children’s social care and a safeguarding issue is raised, the matter should be dealt with through adult safeguarding arrangements.
Local authority statutory adult safeguarding duties apply equally to those adults with care and support needs regardless of whether those needs are being met, regardless of whether the adult lacks mental capacity or not, and regardless of setting other than prisons and approved premises where prison governors and National Offender Management Service respectively have responsibility. However senior representatives of those services may sit on the Safeguarding Adult Board.
Prevention of abuse and neglect is one of the key ways of securing someone’s well-being, and this should be considered as part of an assessment of someone’s care and support needs, even when this is not the presenting need.
It is important to remember that just because someone is old, frail or has a disability, this does not mean they are inevitably ‘at risk’. For example, a person with a disability who has mental capacity to make decisions about their own safety may be perfectly able to make informed choices and protect themselves from harm. In the context of safeguarding adults, the vulnerability of the adult is related to how able they are to make and exercise their own informed choices free from duress, pressure or undue influence of any sort, and the extent to which they can protect themselves from abuse, neglect and exploitation. It is equally important to note that people with capacity can also be vulnerable.
An adult’s vulnerability is determined by a range of interconnected factors including personal characteristics, factors associated with their situation or environment, and social factors (see Table 1 below).
Table 1: Factors determining vulnerability
|Personal characteristics of the adult that increase vulnerability may include:||Personal characteristics of the adult that decrease vulnerability may include:|
|Not having mental capacity to make decisions about their own safety including fluctuating mental capacity associated with mental illness and other conditions||Having mental capacity to make decisions about their own safety|
|Communication difficulties||Having no communication difficulties or if so, having the right equipment / support|
|Physical dependency – being dependent on others for personal care and activities of daily life||Good physical and mental health; no physical dependency or, if needing help, able to self-direct care|
|Low self-esteem; experience of abuse; childhood experience of abuse||Positive former life experiences; self-confidence and high self-esteem|
|Social / situational factors that increase the risk of abuse may include||Social / situational factors that decrease the risk of abuse may include|
|Being cared for in a care setting, that is more or less dependent on others; not receiving the right amount or the right kind of care||Remaining independent and active|
|Isolation and social exclusion||Good family relationships; active social life and a circle of friends; Able to participate in the wider community|
|Stigma and discrimination; being the focus of anti-social behaviour|
|Lack of access to information and support||Good knowledge and access to a range of community facilities; access to sources of relevant information|
|Carers lack of awareness or acceptance of impact of care need|
Please note: prison governors and National Offender Management Service have respective responsibility. Senior representatives of these services may sit on the Safeguarding Adults Board and play an important role in the strategic development of adult safeguarding locally. They may alternatively ask for advice from the local authority when faced with a safeguarding issue that they are finding particularly challenging.
See also Consent in Safeguarding Enquiries
It is always essential in safeguarding to consider whether the adult is capable of giving informed consent in all aspects of their life. If they are able, their consent should be sought and where appropriate recorded.
2.3 Young adults
See also Transition to Adult Services
Where a person is 18 or over but is still receiving children’s services and a safeguarding issue is raised, the matter should be dealt with through adult safeguarding arrangements. This may be, for example, when a young person with substantial and complex needs continues to be supported in a residential educational setting until the age of 25.
Where appropriate, adult safeguarding services should involve the local authority’s children’s safeguarding colleagues as well as any relevant partners(for example, the police or NHS) or other people relevant to the case.
It is not the level of needs that is relevant where there is a safeguarding concern. The young adult does not need to have eligible needs for care and support or be receiving any particular service from the local authority, in order for the safeguarding duty to apply, so long as the set conditions are met.
3. Principles of Adult Safeguarding
There are six principles which apply to all sectors and settings including care and support services, further education colleges, commissioning, regulation and provision of health and care services, social work, healthcare, welfare benefits, housing, wider local authority functions and the criminal justice system.
The principles should inform the ways in which professionals and other staff work with adults. The principles can also help SABs, and organisations more widely, by using them to examine and improve their local arrangements.
- Empowerment: People being supported and encouraged to make their own decisions and informed consent. “I am asked what I want as the outcomes from the safeguarding process and these directly inform what happens.”
- Prevention: It is better to take action before harm occurs. “I receive clear and simple information about what abuse is, how to recognise the signs and what I can do to seek help.”
- Proportionality: The least intrusive response appropriate to the risk presented. “I am sure that the professionals will work in my interest, as I see them and they will only get involved as much as needed.”
- Protection: Support and representation for those in greatest need. “I get help and support to report abuse and neglect. I get help so that I am able to take part in the safeguarding process to the extent to which I want.”
- Partnership: Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse. “I know that staff treat any personal and sensitive information in confidence, only sharing what is helpful and necessary. I am confident that professionals will work together and with me to get the best result for me.”
- Accountability: Accountability and transparency in delivering safeguarding. “I understand the role of everyone involved in my life and so do they.”
4. Aims of Adult Safeguarding
The aims of adult safeguarding are to:
- stop abuse or neglect wherever possible;
- prevent harm and reduce risk of abuse and neglect for those adults with care and support needs;
- safeguard adults in a way that supports them in making choices and having control about how they want to live;
- promote an approach that concentrates on improving the life of the adult concerned;
- raise public awareness so that communities as a whole, alongside professionals, play their part in preventing, identifying and responding to abuse and neglect;
- provide information and support to help people understand abuse, how to stay safe and how to raise concerns;
- address the causes of abuse.
Safeguarding is not a substitute for:
- providers’ responsibilities to provide safe and high quality care and support;
- commissioners regularly assuring themselves of the safety and effectiveness of commissioned services;
- the Care Quality Commission (CQC) ensuring regulated providers comply with the fundamental standards of care or by taking enforcement action; and
- the core duties of the police to prevent and detect crime and protect life and property.
5. Making Safeguarding Personal
See also Making Safeguarding Personal
In addition to the above principles, it is also important that all safeguarding partners take a broad, community approach to establishing safeguarding arrangements. It is vital that all organisations recognise that adult safeguarding arrangements are there to protect individuals. Everyone has different preferences, life histories, circumstances and lifestyles, so it is unhelpful to prescribe a process that must be followed whenever a concern is raised.
Making safeguarding personal means it should be person led and outcome focused. The adult should be engaged in a conversation about how best to respond to their situation in a way that helps them to:
- be involved;
- have choice and control;
- improve the quality of their life, wellbeing and safety.
There are, however, key issues that local authorities and their partners should consider (see also Making Safeguarding Personal).