Multi-Agency Policy and Procedures to Safeguard Adults at Risk of Abuse and Neglect

Introduction  

October 2017

Welcome to Darlington multi-agency safeguarding adults procedures which have been developed by Darlington Safeguarding Adults Partnership Board (DSAPB).  The procedures are applicable to all those working in the Darlington locality, whether in paid employment or as a volunteer in DSAPB organisations and in private or voluntary sector organisations with responsibility for adults with care and support needs. They are also relevant to those who commission services to adults with care and support needs.  These procedures replace all previous procedure manuals.

The development of the procedures is one of the core functions of DSAPB in its role to co-ordinate local work to safeguard and promote the welfare of adults with care and support needs.  The procedures reflect current legislation The Care Act 2014  [external link] and comply with government guidance.

Safeguarding is the process of protecting an adult with care and support needs from abuse or neglect and promoting their wellbeing whilst at the same time placing the adult at risk at the centre of the process and through consultation taking into account their views and wishes and their desired outcomes.   

Safeguarding is everyone's responsibility and for services to be effective each individual and organisation should play a part. These procedures should be used in conjunction with organisational guidelines.

If you are in any doubt about what you should do you need to consult with safeguarding specialists within your organisation and/or visit the Darlington Safeguarding Boards’ website [link] for further guidance and support.

 

CONTENTS

Section 1: Policy

Section 2: Recognising Abuse and Neglect

Section 3: Safeguarding Procedures and Practice Guidance: The Four Key Stages

Glossary

SECTION 1- POLICY

The Principles and Legal Framework of Adult Safeguarding

The Care Act 2014  [external link] established a legislative framework for Adult Safeguarding. 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 and includes where appropriate having regard to their views, wishes, feelings and beliefs in deciding on the best course of 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 well-being, as defined in Section 1 of the Care Act.

The aims of Adult Safeguarding are to:

  • prevent harm and reduce the risk of abuse or neglect to adults with care and support needs
  • stop abuse or neglect wherever possible
  • 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 life for the adults 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 in accessible ways to help people understand the different types of abuse, how to stay safe and what to do to raise a concern about the safety or well-being of an adult
  • address what has caused the abuse or neglect

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The Care Act 2014 outlines the six key principles of Safeguarding: Making Safeguarding Personal (MSP) which form the basis of adult safeguarding:

  1. Empowerment: people being supported and encouraged to make their own decisions and informed consent
  2. Prevention: It is better to take action before harm occurs
  3. Proportionality: the least intrusive response appropriate to the risk presented
  4. Protection: support and representation for those in greatest need
  5. Partnership: local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse.
  6. Accountability: accountability and transparency in the delivery of safeguarding

 The six principles ensure the following:  

  • the needs and interests of adults at risk are always respected and upheld
  • the human rights of adults at risk are respected and upheld
  • a proportionate, timely, professional and ethical response is made to any adult at risk who may be experiencing abuse
  • all decisions and actions are taken in line with the Mental Capacity Act 2005

 The procedures also aim to ensure that each adult at risk maintains:

  • choice and control
  • safety
  • health
  • quality of life
  • dignity and respect

These six principles 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.

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The Principle of Wellbeing:

The principle of wellbeing should be at the heart of care and support and applies in all cases where a Local Authority is carrying out a care and support function or making a decision in relation to an individual.  It applies equally to adults with care and support needs and their carers. In some specific circumstances, it also applies to children, their carers and to young carers when they are subject to transition assessments.  The wellbeing principle in the Care Act also applies to parent carer assessments.  A vital aspect in considering an individual’s wellbeing is the context in which they live, their domestic and family relationships and the importance of achieving a balance between their wellbeing and that of any family or friends who are involved in caring for them.

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Working Together

Safeguarding is everyone’s responsibility and effective safeguarding practice can only be achieved when organisations work together and ensure that adults with care and support needs are protected and that the outcome of the safeguarding process is life enhancing.  This policy is intended for all agencies and individuals involved in safeguarding adults including managers, professionals, volunteers and staff working in public, voluntary and private sector organisations.  The procedures represent the commitment of organisations to:

  • work together to prevent and protect adults at risk from abuse
  • empower and support people to make their own choices
  • investigate actual or suspected abuse and neglect
  • support adults and provide a service to adults at risk who are experiencing abuse, neglect and exploitation.
  • achieve the best possible outcome for the person at the centre of the enquiry.

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Preventing Abuse and Neglect

The provisions of the Care Act 2014 are intended to promote and secure wellbeing. Under the definition it is made clear that protection from abuse and neglect is a fundamental part of promoting wellbeing. Identification and management of risk is an essential part of the assessment process and must be taken into consideration.

Organisations should promote the requirement to prevent abuse and neglect wherever possible.  Observant professionals making early, positive interventions with individuals and families can make a huge difference to their lives, preventing the deterioration of a situation or breakdown of a support network.  It is often when people become increasingly isolated and cut off from families and friends that they become extremely vulnerable to abuse and neglect.  Agencies should implement robust risk management processes in order to prevent concerns escalating to a crisis point and requiring intervention under safeguarding adult procedures.

Partners should ensure that they have the mechanisms in place that enable early identification and assessment of risk through timely information sharing and targeted multi-agency intervention. Policies and strategies for safeguarding adults should include measures to minimise the circumstances which make adults vulnerable to abuse.

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The Principles of the Mental Capacity Act 2005

The Mental Capacity Act 2005 [external link] provides a statutory framework to empower and protect people who may lack capacity to make decisions and establishes a framework for making decisions on their behalf. This applies whether the decisions are life-changing events or everyday matters.  All decisions taken in the Safeguarding Adults process must comply with the Act.

The Mental Capacity Act 2005 states: 

“a person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or disturbance in the functioning of the mind or brain”.

Furthermore a person is not able to make a decision if they are unable to:

  • understand the information relevant to the decision or
  • retain that information long enough for them to make the decision or
  • use or assess that information as part of the process of making the decision or
  • use language or communicate by any other means such as muscle movements, blinking an eye or squeezing a hand.

Mental capacity is time and decision specific. This means that a person may be able to make some decisions but not others at a particular point in time.  The principles of the Mental Capacity Act 2005 are as follows:

  • An adult at risk has the right to make their own decisions and must be assumed to have capacity to make decisions about their own safety unless it is proved (on a balance of probabilities) otherwise
  • Adults at risk must receive all appropriate help and support to make decisions before anyone concludes that they cannot make their own decisions.
  • Adults at risk have the right to make decisions that others might regard as being unwise or eccentric and a person cannot be treated as lacking capacity for these reasons.
  • Decisions made on behalf of a person who lacks mental capacity must be done in their best interests and should be the least restrictive of their basic rights and freedoms.

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Independent Advocacy under the Care Act 2014

Advocacy and the duty to involve: Local Authorities must involve people in decisions made about their care and support.  No matter how complex a person’s needs, Local Authorities are required to help people express their wishes and feelings, support them in assessing their options and assist them in making their own decisions.  The advocacy duty will apply from the point of first contact with the local authority and at any subsequent stage of the assessment, planning, care review, safeguarding enquiry or safeguarding adult review.  If it appears to the authority that a person has care and support needs, then a judgement must be made as to whether that person has substantial difficulty in being involved and if there is not an appropriate individual to support them.  An independent advocate must be appointed to support and represent the person for the purpose of assisting their involvement if these two conditions are met and if the individual is required to take part in one or more of the following processes described in the Care Act:

  • a needs assessment
  • a carer’s assessment
  • the preparation of a care and support or support plan
  • a review of a care and support or support plan
  • a child’s needs assessment
  • a child’s carer’s assessment
  • a young carer’s assessment
  • a safeguarding enquiry
  • a safeguarding adult review
  • an appeal against a local authority decision under Part 1 of the Care Act [external link]

For further guidance see SCIE: Advocacy and the duty to involve  [external link].

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Partnership cooperation and responsibilities of all organisations

The provisions of the Care Act 2014 Care and Support Statutory Guidance are intended to promote and secure wellbeing and ensure that adults with care and support needs are protected from abuse and neglect.  Preventing abuse and neglect is one of the principles of safeguarding. Early identification and positive interventions with individuals and families can make a significant difference to the wellbeing of an adult at risk and prevent the deterioration of a situation or the breakdown of a support network.  It is often when people become isolated from their families and friends that they become vulnerable to abuse and neglect. Agencies must implement robust risk management processes in order to prevent concerns escalating to a crisis point where intervention under safeguarding procedures is required.

All organisations which provide care and support to adults at risk have the responsibility to safeguard adults at risk within this policy and should have Adult Safeguarding procedures which reflect the statutory guidance within the care Act 2014 and the Darlington Safeguarding Adults Partnership Board (DSAPB) Multi-Agency Policy and Procedures.

The Care Act 2014 imposes a duty on all public bodies to cooperate in order to ensure that care and support is well coordinated. 

Local Authorities must work in partnership with relevant partner agencies  as outlined in section 6(7) of the Care Act  2014 and those partners must also cooperate with the Local Authority, in the exercise of their functions relevant to care and support including those to protect adults. Relevant partners of a Local Authority include any other Local Authority with whom they agree it would be appropriate to co-operate (for example, neighbouring authorities with whom they provide joint shared services) and the following agencies or bodies which operate within the Local Authority area in Darlington:

  • NHS England
  • County Durham and Darlington NHS Foundation Trust
  • Tees Esk and Wear Valley NHS Foundation Trust
  • Darlington Clinical Commissioning Group
  • Durham Constabulary
  • Care Quality Commission
  • Healthwatch
  • National Probation Service
  • Community Rehabilitation Company
  • Co Durham and Darlington Fire and Rescue Service
  • North East Ambulance Service
  • British Transport Police

Local Authorities must also co-operate with such other agencies or bodies as it considers appropriate in the exercise of its adult safeguarding functions such as:

  • pharmacists
  • dentists
  • housing departments
  • GP practices

The Care Act 2014 Care and Support Statutory Guidance stresses the importance of each Local Authority making the necessary arrangements to ensure that its officers with responsibility for adult care and support, housing, public health and children’s services work collaboratively.  Under the principles of well-being, prevention and Making Safeguarding Personal (MSP), it is crucial to ensure that all of the care and support needs of an individual are considered alongside the personal views and wishes of the individual to ensure that the approach taken is person centred.

Protecting vulnerable people from all types of abuse forms part of the Durham Police and Crime Commissioners plan 2016 – 2021 [external link].   

Community, voluntary and private sector organisations provide a diverse range of services to adults at risk and provide services which assist in both preventing and responding to abuse and neglect.   Community, voluntary and private sector organisations must work closely with statutory agencies, in the interests of adults at risk in accordance with the multi- agency procedures.

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Organisations working together in safeguarding adults

  • Partner organisations will contribute to effective inter-agency working and effective multi-disciplinary assessments and joint working partnerships in order to provide the most effective means of safeguarding adults.
  • Action taken under these procedures does not affect the obligations on partner organisations to comply with their statutory responsibilities such as notification to regulatory authorities under the Health and Social Care Act 2008 [external link] or to comply with employment legislation.
  • Organisations continue to have a duty of care to adults who purchase their own care through personal budgets and are required to ensure that reasonable care is taken to avoid acts or omissions that are likely to cause harm to the adult at risk.
  • Partner organisations will have information about individuals who may be at risk from abuse and may be asked to share this where appropriate, with due regard to confidentiality.

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Information sharing

Early sharing of information is the key to providing an effective response and all organisations must have arrangements in place which clearly set out the processes and principles for information sharing between agencies and the DSAPB. All information sharing must comply with the Data Protection Act 2018 [external link] and the Human Rights Act 1988 [external link] and the Caldicott Principles [external link]. For further guidance see the Darlington Safeguarding Boards Information Sharing Protocol [PDF document] and SCIE: The Legal Requirements of Information Sharing [external link]. 

Safeguarding is everybody's responsibility and professionals should not assume that that someone else will pass on information which may be critical to the safety and well being of an adult at risk. HM Government has published (2018) Information Sharing Advice for practitioners providing safeguarding services services to children, young people, parents and carers  [external link] which has been updated to reflect the general Data Protection Regulation (GDPR) and Data Protection Act 2018. This guidance may be helpful to practitioners working with adults who are responsible for children in need. 

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Local Authority

Local Authorities are statutory members of Safeguarding Adults Boards and the lead agency in respect of safeguarding.

Where a Local Authority has reasonable cause to suspect that an adult (aged 18 years or over) in its area (whether or not ordinarily resident there):

 has needs for care and support (whether or not the authority is meeting any of those needs)

  • is experiencing, or is at risk of, abuse or neglect and
  • as a result of those needs is unable to protect himself or herself against the abuse or neglect

the Local Authority must make (or cause to be made) whatever enquiries are necessary to decide what action is needed to help and protect the adult at risk.  

The decision to carry out a safeguarding enquiry does not depend on the person’s eligibility for Local Authority services

The Care Act 2014 requires that the Local Authority:   

  • when an adult with care and support needs has suffered or is at risk of suffering abuse or neglect the Care Act 2014 and Care and Support Statutory Guidance requires that Local Authority undertake an Initial Enquiry to determine the appropriate response. An enquiry is any action that is taken (or instigated) by a Local Authority under Section 42 of the Care Act 2014 in response to indications of abuse or neglect in relation to an adult with care and support needs who is at risk and is unable to protect themselves because of those needs receive the findings of any enquiry and determine with the adult what if any further action is necessary.
  • where appropriate arrange for an independent advocate to represent and support an adult who is the subject of a safeguarding enquiry or Safeguarding Adults Review (SAR) where the adult has ‘substantial difficulty in being involved in the process and where there is no other appropriate adult to help them’.
  • must consider whether it would be possible to provide support that prevents abuse or neglect from occurring. Where this is necessary the Local Authority should make arrangements for providing it
  • establish a Safeguarding Adults Board (SAB) with core membership from the Local Authority, the police and clinical commissioning groups
  • the Local Authority is also responsible for the management and oversight of individual complex cases and coordination of cases where allegations are made or concerns raised about an employee, volunteer or student, paid or unpaid staff. See Roles & Responsibilities. For further guidance see DSAPB Managing Allegations Policy and Guidance [link].

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Managing allegations and concerns about employees and volunteers working with adults with care and support needs ‘in a position of trust’

  • all organisations are required to comply with the Care Act 2014 in respect of managing allegations against employees (including volunteers) who work with adults with care and support needs. 
  • in accordance with the Care Act 2014 and Statutory Guidance there is a responsibility for the Local Authority to support employers and professionals within partner agencies to respond appropriately and proportionately to allegations of abuse or neglect perpetrated by individuals who work with adults with care and support needs in a position of trust.  This will include individuals about whom there is a concern regarding their suitability to work with adults because of concerns within either their professional or private life and includes students and voluntary workers.
  • a relationship of trust is one in which one person is in a position of power or influence over the other person because of their work or the nature of their activity. There is a particular concern when abuse is caused by the actions or omissions of someone who is in a position of power or authority and who uses their position to the detriment of the health and well-being of a person at risk, who in many cases could be dependent on their care. There is always a power imbalance in a relationship of trust.
  • where the person who is alleged to have caused harm is in a position of trust with the adult at risk, they may be deterred from making a complaint or taking action out of a sense of loyalty, fear, of abandonment or other repercussions.
  • where the person who is alleged to have caused the abuse or neglect has a relationship of trust with the adult at risk because they are a member of staff, a paid employee, a paid carer, a volunteer or a manager or proprietor of an establishment the Local Authority is required to follow the DSAPB Managing Allegations policy. For further guidance see DSAPB Management of Allegations procedures [link]
  • where the allegations are substantiated and the employee is dismissed or the employee resigns prior to the completion of the discipline process there is a statutory requirement for the employer to inform the Disclosure and Barring Service (DBS) [external link]. If necessary the Local Authority can make the disclosure.

Employers and Safeguarding Adults Leads in all organisations must have a strategic overview of safeguarding adults across their respective organisations and support all activity required to ensure that the organisation meets its responsibilities in relation to safeguarding adults and effectively managing concerns and allegations  in respect of people in a position of trust. The Safeguarding Adult Leads will oversee the regular provision of staff training and will be a source of expertise and advice to those working in their respective organisations and will be able to advise organisations other organisations matters in relation to Adult Safeguarding.  In instances where an employee (including volunteers) are believed to pose a risk of harm or to have caused harm to an adult with care and support needs there is a duty for the appropriate person within the organisation to refer the matter to the Local Authority for management oversight.  The referral should be made to the First Point of Contact Team  on 01325 406111. For further guidance see DSAPB Managing Allegations Policy and Guidance [PDF document].

All organisations which provide services to adults at risk have a responsibility to make sure that all their staff are fit to work with such individuals (including volunteer roles and students) In particular, Human Resources (HR) departments (or equivalent) should make ensure:

  • HR strategies, systems, policies and procedures take account of and include information relating to Safeguarding Adults
  • national safe recruitment and employment practices include the legal requirement for the employer to notify the Disclosure and Barring Service (as outlined above) and professional bodies where appropriate. Where the allegations are substantiated and the employee is dismissed or the employee resigns prior to the completion of the discipline process there is a statutory requirement for the employer to inform the Disclosure and Barring Service (DBS) [external link]. If necessary the Local Authority should make the disclosure.  
  • staff and volunteers in contact with adults with adults at risk have regular supervision and receive support to help them identify and respond to possible abuse and neglect.

All organisations are required to comply with the Care Act 2014 in respect of Managing Allegations against employees (including volunteers) who work in a position of trust. For further guidance see DSAPB Managing Allegations Policy and Guidance [PDF document].

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Whole Family Approach: when children are at risk of abuse and neglect

  • ‘Think Family’ (early intervention and prevention) is a whole system approach. The Care Act 2014 introduced a number of reforms to the way that care and support for adults with care needs are met. It requires Local Authorities to adopt a whole system, whole council, whole-family approach, coordinating services and support around the person and their family and considering the impact of the care needs of an adult on their family, including children.  The intention of the 'whole family' approach is for local authorities to take a holistic view of the person’s needs and to identify how the adult’s needs for care and support impact on family members or others in their support network.’
  • the provisions for young carers included in the Care Act 2014 are intended to link with provisions in the Children and Families Act 2014. This is to provide a clear framework for Local Authorities to take a whole-family approach to assessing and supporting adults and young carers and deliver support in a coordinated way.

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Safeguarding Adults Review (SAR) procedures

In cases where it is believed that an adult at risk suffered a serious adverse consequence as a result of abuse or neglect and that there is concern that agencies did not work together effectively to protect the adult at risk then consideration must be given to the DSAPB Safeguarding Adult Review (SAR) procedures [PDF Document]. Where any individual or agency believes there may have been circumstances where the threshold for holding a SAR has been met, they may refer a case to the Chair of the DSAPB via the Safeguarding Board’s Business Manager to establish if there are important lessons for multi-agency work to be learnt from a case.

The Care Act 2014 and Care and Support Guidance created a statutory requirement for Safeguarding Adults Boards to consider a Safeguarding Adult Review (SAR) in the following circumstances:

The DSAPB must arrange a review of a case involving an adult in its area with needs for care and support (whether or not the Local Authority has been meeting any of those needs) if:

1. there is reasonable cause for concern about how the SAB, members of it or other persons with relevant functions worked together to safeguard the adult AND 

a) the adult has died, and the DSAPB knows or suspects that the death resulted from abuse or neglect (whether or not it knew about or suspected the abuse or neglect before the adult died) OR

b) the adult is still alive and the DSAPB knows or suspects that the adult has experienced serious abuse or neglect.

The DSAPB may also arrange for there to be a review of any other case involving an adult in its area with needs for care and support (whether or not the local authority has been meeting any of those needs).  SARs may also be used to explore examples of good practice where this is likely to identify lessons that can be applied to future cases.

Each member of the DSAPB must co-operate with and contribute to the carrying out of a SAR.

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Whistleblowing Policy

The Government expects public sector bodies to have Whistleblowing Arrangements (BSI 2008) [external link]. Health and Social Care commissioners may extend this expectation to service providers. Staff should be encouraged to raise concerns, at first internally, so that they can be dealt with promptly.  Organisations that do not respond to such concerns put themselves at risk to exposure of any wrongdoing through employees blowing the whistle externally.

For further guidance see SCIE: Whistleblowing Policies [external link].

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Multi-Agency Public Protection Arrangements (MAPPA)

The purpose of the MAPPA framework is to reduce the risks posed by sexual and violent offenders in order to protect the public, including previous victims, from serious harm.  The responsible authorities in respect of MAPPA are the police, prison and probation services who have a duty to ensure that MAPPA is established in each of their geographic areas to ensure the risk assessment and management of all identified MAPPA offenders (primarily violent offenders on licence or mental health orders and all registered sex offenders).  The police, prison and probation services have a clear statutory duty to share information for MAPPA purposes. Further guidance is contained in National Probation Service Multi Agency Public Protection Arrangements  [external link].  Other organisations have a duty to cooperate with the responsible authority, including the sharing of information.

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Multi Agency Risk Assessment Conference (MARAC)

MARACs are multi-agency meetings where statutory and voluntary agency representatives share information about high risk victims of domestic abuse in order to produce a coordinated action plan to increase victim safety.

The police, Independent Domestic Violence Advisors (IDVAs), health professionals, child protection social workers, adult protection social workers and housing practitioners and other specialists from voluntary and statutory agencies participate in the conferences.    

The role of the MARAC is to provide a forum for effective information sharing and partnership working amongst a diverse range of adult and child focussed services in order to enhance the safety of high risk victims and their children.

After sharing relevant information about a victim, perpetrator and children the representatives discuss options for increasing the safety of all involved and turn these into a co-ordinated action plan. The primary focus of the MARAC is to safeguard the victim and their family.  The MARAC will also make links with other agencies to safeguard children and adults with care and support needs and manage the behaviour of the perpetrator. For further information see practitioner guidance for referring to MARAC [external link] and the MARAC referral forms and DASH risk assessment guidance  [Word document]. 

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Prevent/Channel: Extremism

The Counter-Terrorism and Security Act 2015 [external link] places a duty on specified authorities which must have ’due regard to the need to prevent people from being drawn into terrorism’. The focus of Prevent is on the significant threat posed by all forms of terrorism and those in the UK who are inspired by it. It is also concerned with reducing threats, risks and vulnerabilities posed by domestic extremists such as those from the far right/Neo Nazi/White Supremist ideology, Irish Nationalist and Loyalist paramilitary groups and extremist animal rights activists.  There is a clear framework for professionals who are concerned about an adult or a child who may be vulnerable to the messages of extremism in all its forms which outlines details of the inter agency process and expectations in respect of managing concerns about adults and children within these criteria. 

For further guidance see DSCB/DSAPB Joint Practice Guidance: Prevent Practice Guidance and Channel process [PDF document].

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Restorative Justice (RJ) approach

Restorative approaches have been shown to reduce demand on services and save money. This approach seeks to repair past harm but also includes agreement about future behaviour and therefore has a long term impact.  The Restorative approach can also help in cases where there is insufficient evidence for a criminal prosecution or the result of a prosecution is unsatisfactory. Involvement in the Restorative Approach is voluntary for all parties.  For further guidance see Restorative Hub Referrals Guidance [PDF document] for more information and how to make a referral. 

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Organisational Abuse/Complex Cases and the Executive Strategy Meeting Process

Executive Strategy Meetings are required to address all concerns and issues relating to unusual, organised or large scale abuse. Allegations of Organisational Abuse may result in a complex case investigation with implications for resources.  Managers must consult the DSAPB Executive Strategy Process [external link] for guidance in all cases where Organisational Abuse may be an issue.

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Out of Area Procedures

There is an increased safeguarding risk and complexity associated with adults whose care and support arrangements cross Local Authority boundaries.  These may arise where funding/commissioning responsibility for an adult lies with an authority in one area and where concerns about potential abuse and/or exploitation arise in another area.

In cases where a safeguarding enquiry involves cross boundary considerations see the DSAPB Out of Area Safeguarding Adults Arrangements- Guidance for Inter Authority Safeguarding Adults Enquiry and Protection Arrangements [PDF document].

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Single agency case closure: inform other agencies involved with the adult

When single agencies close a case involving an adult with care and support needs this information should be communicated to all other agencies involved in the case. This includes cases across adult and children’s services where the service user is a parent.

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Disagreements and Professional Challenge

It is important to establish a culture which promotes professional challenge across all agencies; national and local Safeguarding Adults Reviews (SARs) continue to draw attention to the importance of inter-agency communication and reviews have identified an apparent reluctance to challenge inter-agency decision making.  If during the course of a Safeguarding Enquiry a consensus view cannot be achieved, or it is inconsistent with the evidence, the Chair of the Strategy Discussion/Meeting may, where appropriate, propose a decision on behalf of those attending the meeting.  Any person disagreeing with the proposed decision would have their disagreement recorded in the minutes.

Any disagreements that cannot be resolved should be dealt with in accordance with the DSAPB Professional Challenge guidelines [link].

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SECTION 2: RECOGNISING ABUSE AND NEGLECT

Categories of Abuse and Neglect

People with care and support needs, such as older people or people with disabilities, are more likely to be abused or neglected. They may be seen as an easy target and may be less likely to identify abuse themselves or to report it. People with communication difficulties can be particularly at risk because they may not be able to alert others. Sometimes people may not even be aware that they are being abused, and this is especially likely if they have a cognitive impairment.  Abusers may try to prevent access to the person they abuse.

There are ten categories of abuse and neglect.  Signs of abuse can often be difficult to detect. Many types of abuse are also criminal offences and in circumstances where the abuse involves the commission of criminal offences the police must be informed.

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Physical Abuse

Physical abuse may be defined as ‘the use of force which results in pain of injury or a change in a person’s natural physical state’ or the ‘non-accidental infliction of physical force that results in bodily injury, pain or impairment’ (Brent Council 2010)

See SCIE: types and indicators of physical abuse [external link].

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Domestic Abuse/Honour Based Violence/Forced Marriage

Domestic abuse includes any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been, intimate partners or family members regardless of gender or sexuality.  It also includes so called 'honour’ based violence, female genital mutilation and forced marriage. Domestic Abuse occurs across society irrespective of age, gender, race, sexuality, wealth and geography.

Domestic Abuse can affect both men and women over the age of 16 regardless of gender or sexuality within the context of intimate or familial relationships. Children living in a household where domestic abuse occurs are affected both directly and indirectly and there is a strong correlation between domestic abuse and child abuse.

Domestic violence or abuse can be characterised by any of the indicators of abuse relating to:

  • psychological
  • physical
  • sexual
  • financial
  • emotional
  • coercion and control 
  • honour based violence and forced marriage

See ADASS Adult Safeguarding and Domestic Abuse: A guide to support practitioners and managers  [external link].

Coercive or controlling behaviour is a core part of domestic violence.  The Serious Crime Act 2015 created a new offence of Coercive and Controlling Behaviour in intimate and familial relationships.

Honour Based Violence and Forced Marriage are included in the category of Domestic Abuse.

A forced marriage is where one or both people do not (or in cases of people with learning difficulties, cannot) consent to the marriage and where duress is used.  ‘Duress’ includes psychological, sexual, financial or emotional pressure and physical violence.

Forced marriage is a violation of human rights and is seen in the UK as a form of domestic violence and/or child abuse.  It may affect girls, boys, women and men from any community or background. However, existing statistics show that greater numbers of women are affected.  Forcing someone to marry without their consent is a criminal offence and the police must be consulted in respect of all cases which potentially involve a risk of forced marriage or honour based violence. 

If a child is at risk of Honour Based Violence/Forced Marriage then refer to the DSCB multi agency procedures and practice guidance Forced Marriage [link] and Honour Based Violence  [link].

For further guidance see SCIE: Investigating Adult Abuse: Forced Marriage [external link].

A significant number of homicides are related to domestic abuse and it is important that agencies are as robust in interventions with interfamilial domestic abuse as intimate/ex- partner relationships.  Effective safeguarding is achieved when agencies share information to obtain an accurate picture of risk and then work together to ensure the safety of the adult at risk.

Whilst the adult at risk should always remain at the centre of the safeguarding process and be involved in their own safety planning this does not preclude the sharing of information without their consent in high risk cases. 

The MARAC (Multi Agency Risk Assessment Conference) can assist practitioners with the assessment of risk and safeguarding and the MARAC co-ordinator should be informed of all medium and high risk cases of domestic abuse involving adults with care and support needs.  For further information see practitioner guidance for referring to MARAC [external link] and the MARAC referral forms and DASH risk assessment guidance  [external link].

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Sexual Abuse and Sexual Exploitation

Sexual Abuse includes the direct or indirect involvement of the adult at risk in sexual activity or relationships which:

  • They do not want or to which they have not consented
  • They lack the mental capacity to consent to the sexual activity
  • They have been coerced into sexual activity by a person in a position of trust, power or authority

See SCIE: types and indicators of sexual abuse [external link].

All circumstances where an adult with care and support needs is believed to have experienced or be at risk of sexual assault should be reported to the police and consideration should be given to preserving evidence including forensic evidence.

Sexual abuse may also include instances of sexual exploitation whereby an adult with care and support needs may be in situations whereby they receive something in return (usually a basic need such as accommodation or food) for performing sexual acts.  Adults can be victims of sexual exploitation even when they consent to the sexual activity and this is particularly relevant to adults with care and support needs as vulnerability greatly increases the risk.

Sexual exploitation can co-exist with other categories of abuse such as Modern Slavery and Domestic Abuse.  In many cases individuals do not self-identify as victims and may be reluctant to engage with the authorities.    All such concerns should be reported to Durham Constabulary on 101 and the Safeguarding Adult Team.  Multi–Agency working is essential when addressing sexual exploitation in children, young people and adults and it has been highlighted that sexual exploitation involving adults is evident in all towns throughout the UK.  For research based information see Changing Lives [external link].

For further guidance see Darlington Safeguarding Boards Joint Procedures and Practice Guidance: Modern Slavery incorporating Human Trafficking [PDF document] (document in development).

Research has highlighted that children approaching the age of 18 (transitional age) who have been sexually exploited are particularly vulnerable as they approach adulthood with the risk that the exploitation will continue or they will engage in survival sex work.

For further guidance on sexual exploitation see Darlington Safeguarding Adults Partnership Board Procedures and Practice Guidance: Sexual Exploitation referral pathway [PDF document].  

Whilst the adult at risk should always remain at the centre of the safeguarding process and be involved in their own safety planning this does not preclude the sharing of information without their consent in high risk cases. For further guidance see SCIE: Responding without consent [external link].  

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Modern Slavery incorporating Human Trafficking

Modern Slavery encompasses a wide range of criminal offences and includes human trafficking, forced labour, domestic servitude, organ harvesting, debt bondage and sexual exploitation.  Human trafficking takes place within the borders of the United Kingdom as well as internationally and includes the trafficking of people for the purpose of sexual exploitation.  Traffickers and their associates coerce, force and deceive children and adults into a life of servitude, abuse and inhuman treatment.

Modern slavery is a safeguarding issue and practitioners have an important role to play.  If someone identified as being a victim of human trafficking is an adult with care and support needs the response should be co-ordinated under the multi-agency safeguarding procedures and should involve police, health trusts and immigration officials in accordance with the multi-agency procedures outlined within this document.  

The Modern Slavery Act 2015 places a duty on specified public authorities to report suspected cases of modern slavery to the National Crime Agency. This is achieved through the National Referral mechanism (NRM) and the ‘duty to notify’. Section 52 of the Modern Slavery Act 2015 [external link] places a statutory duty on the specified public authorities to respond to suspected incidents of modern slavery and human trafficking. This is called the ‘duty to notify’. The UK Human Trafficking Centre (UKHTC) takes referrals of both adults and children identified as victims of trafficking.

If children are identified as victims the matter must be dealt with under the Darlington Safeguarding Children Board Multi-Agency Child Protection Procedures  [external link]. 

Early intervention is vital to ending the abuse and providing the assistance which is necessary. Practitioners need to be able to identify the signs that someone is a victim of human trafficking. It should be noted that many individuals will not self-identify as a victim of crime and may be distrustful of the authorities.

Modern Slavery can co-exist with other categories of abuse including Domestic Abuse and Sexual Abuse.

A potential victim of modern slavery is a potential victim of crime. All instances where an individual is identified as a potential victim of modern slavery must be reported to Durham Constabulary on 101.  If a victim or others are at risk of immediate significant harm inform the emergency services on 999.

Non urgent cases can be referred by professionals to Durham Constabulary using an Information Sharing report which should be submitted to force.intelligence@durham.pnn.police.uk [external link].

For in depth guidance on this subject, how to identify potential victims of modern slavery, how to refer suspected cases to Durham Constabulary and Adult Social Care and how to notify the UKHTC see Darlington Safeguarding Boards Joint Procedures and Practice Guidance see Modern Slavery incorporating Human Trafficking [PDF document] (document in development).

For in depth guidance on modern slavery and the responsibilities of local authorities see Local Government Association Modern Slavery: A Council Guide [external link]

See also: Modern Slavery at a glance [PDF document]

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Psychological or Emotional Abuse

Psychological abuse is the wilful infliction of mental suffering by a person who is in a position of power or trust or within the context of a close relationship.  This type of harm involves threats of abandonment, enforced social isolation, humiliation, name calling, blaming, controlling, intimidation, coercion and bullying.

It undermines the adult’s self-esteem and results in the adult being less able to protect themselves and exercise choice. It can cause serious psychological harm and often accompanies other forms of abusive behaviour. 

See SCIE: indicators of psychological abuse [external link].

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Financial Abuse

Financial Abuse is defined as ‘the unauthorised and improper use of funds, property or any resources belonging to an individual’.

Financial Abuse is widespread and is the main form of abuse investigated by the office of the Public Guardian in respect of both adults and children at risk.  It is therefore important that practitioners do not underestimate the scale and the impact of financial abuse.

Financial Abuse can occur in isolation but research suggests that where other forms of abuse are evident financial abuse is likely to occur.

Financial Abuse in most cases amounts to theft or fraud and the adult at risk can be persuaded to part with large sums of money.  This type of abuse covers a wide spectrum and it can also include:

  • cyber crime/internet scamming
  • doorstep crime
  • exploitation
  • coercion in respect of wills/property/inheritance
  • misuse of property/possessions/benefits
  • misuse of power or attorney or appointeeship
  • ‘mate’ crime
  • ‘romance’ crime

Adults at risk are often targeted for internet or telephone scams and doorstep crimes and the methods are becoming increasingly sophisticated.

As Financial Abuse usually involves the commission of a criminal offence the incident should always be reported to Durham Constabulary on 101 if it is suspected that a crime has been committed.  Multi Agency working is often required to protect the adult at risk and sometimes it is necessary to conduct a joint investigation.

Where the abuse is perpetrated by someone who has power of attorney the Office of Public Guardian should be informed and in the case of appointeeship the Department of Work and Pensions (DWP) should be informed.

If there are concerns that a DWP appointee is acting incorrectly the DWP should be informed immediately and if the adult at risk is known to the Local Authority the DWP should inform the relevant Safeguarding Adults team.    

See SCIE: indicators of Financial Abuse [external link].

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Discriminatory Abuse/Hate Crime

Discriminatory Abuse exists when values, beliefs or culture result in a misuse of power that denies opportunity to groups or individuals.  It can be a feature of any form of abuse of an adult with needs for care and support and it can be motivated because of age, gender, sexuality, disability, religion, class, culture, language, race or ethnic origin.

It can result from situations that exploit a person’s vulnerability by treating the person in a way that excludes them from opportunities they should have as equal citizens, for example, education, health, justice and access to services and protection.

The impact of hate crime on an individual and their family can be devastating, affecting social, psychological and physical well-being.  Where individuals are targeted because of a personal characteristic they often feel fearful of further incidents and become withdrawn and isolated. It can also affect others who may share that characteristic, leading to impacts across the wider community.

The most commonly used definition of Hate Crime is that agreed by the Association of Chief Police Officers (ACPO) (now National Police Chief’s Council NPCC) and the Crown Prosecution Service (CPS):

“Hate crimes and incidents are taken to mean any crime or incident where the perpetrators hostility or prejudice against an identifiable group of people is a factor in determining who is victimised.”

Individuals may be targeted because of their actual or perceived:

  • disability
  • gender identity (transphobic)
  • race or ethnicity (racist)
  • religion or belief
  • sexual orientation (homophobic)

Individuals may also be targeted due to other issues which identify them as ‘different’.

Hate Crime forms part of the Durham Police and Crime Commissioners plan 2016 – 2021  [external link]. 

See SCIE: Types and Indicators of Discriminatory Abuse [external link]. 

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Organisational Abuse

Organisational Abuse is the mistreatment, abuse or neglect of an adult at risk by processes or individuals within services which violate the individual’s dignity and human rights.

Organisational Abuse occurs when the routines, systems and regimes of an organisation result in poor or inadequate standards of care and poor practice which affects the setting and denies, restricts the dignity, privacy, choice, independence or fulfilment of adults at risk.

Organisational Abuse can occur in any setting providing health and social care. Characteristics that may infer Organisational Abuse include:

  • it is widespread within the setting (the abusive practice is not confined to the practice of a single staff member)
  • it is evidenced by repeated instances
  • it is generally accepted – it is not seen as poor practice
  • it is sanctioned – it is encouraged or condoned by line managers
  • there is an absence of effective monitoring or management oversight by managers that has allowed the practice to have occurred
  • there are environmental factors (unsuitable buildings, lack of equipment, reliance on temporary staff) that adversely affects the quality of care
  • it is systemic (factors such as a lack of training, poor operational procedures, poor supervision and management all significantly contribute to the development of organisationally abusive practice)

See SCIE: Types and Indicators of Organisational Abuse [external link].

Allegations of Organisational Abuse may result in a complex case investigation with implications for resources.

Practitioners must consult the DSAPB Executive Strategy Process [PDF document] for guidance in all cases where Organisational Abuse may be an issue.

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Neglect and Acts of Omission

Neglect is the failure of any person who has responsibility for the charge, care or custody of an adult with needs for care and support to provide the amount and type of care that a reasonable person would be expected to provide.

Behaviour that can lead to neglect includes including ignoring medical, emotional or physical needs, failing to allow access to appropriate health, social care and educational services, and withholding the necessities of life such as medication, adequate nutrition, hydration or heating.

Neglect can be intentional or unintentional.

Intentional neglect would result from:

  • wilfully failing to provide care
  • wilfully preventing the adult(s) with needs for care and support from getting that care and support
  • reckless about the consequences of the person not getting the care they need.

See SCIE: Definition of Wilful Neglect [external link].

See SCIE: Indicators of Neglect [external link].

If the individual committing the neglect is aware of the consequences and the potential for harm to result due to the lack of action(s) then the neglect is intentional in nature.

Section 20 of the Criminal Justice and Courts Act 2015 [external link] creates a criminal offence in respect of circumstances where “an individual who has the care of another individual by virtue of being a care worker ill-treats or willfully neglects that individual."

The offence focuses on the conduct of the individual not the outcome of the neglect and is concerned with the actions or omissions of the care worker rather than any harm that resulted.

A care provider can also commit an offence under Section 21 of the Criminal Justice and Courts Act 2015 [external link] if:

  • an individual who has the care of another individual by virtue of being part of the care provider’s arrangements ill-treats or willfully neglects that individual
  • the care provider’s activities are managed or organised in a way which amounts to a gross breach of a relevant duty of care owed by the care provider to the individual who is ill-treated or neglected and
  • in the absence of the breach, the ill-treatment or wilful neglect would not have occurred or would have been less likely to occur.

Unintentional neglect could result from a carer failing to meet the needs of the adult at risk because they do not understand the needs of the adult at risk, may not know about services that are available or because their own needs prevent them from being able to give the care the person needs.  It may also occur if the individuals are unaware of or do not understand the possible effect of the lack of action on the adult at risk.

For guidance on skin damage and safeguarding see DSAPB Skin Damage and Safeguarding Protocol [PDF document]  

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Self-Neglect

For detailed guidance in respect of Self–Neglect and Hoarding see:  

DSAPB Multi-Agency Practice Guidance: Self Neglect and Hoarding [PDF document] 

Self–Neglect Toolkit: A Guide for Practitioners [PDF document]

Hoarding Chart: clutter image rating [PDF document]

SCIE: Tenants who self-neglect. Guidance for frontline housing staff and contractors [external link].   

The Care Act 2014 and Care and Support Statutory Guidance includes Self-Neglect in the categories of abuse relevant to safeguarding adults with care and support needs. 

Self-Neglect covers a wide range of behaviours such as an individual neglecting to care for personal hygiene, health or surroundings and includes ‘hoarding’. 

See SCIE Indicators of Self –Neglect [external link].

Prevention, assessment and early intervention are usually the best courses of action when dealing with Self-Neglect.

Where a person lacks mental capacity in relation their care and support needs, decisions should be made in the person’s best interests as required under the Mental Capacity Act 2005.

However, if a person has mental capacity in relation to their care and support needs, or where issues of capacity have been difficult to assess or the individual is not compliant with the process a response within the Safeguarding Adults Procedures may sometimes be appropriate and it may be necessary to make a vital interest or public interest decision. 

Self-Neglect can be a complex and challenging issue for practitioners to address as it is important to achieve a balance between the individual’s right to self-determination with the need to protect them from harm particularly if they are vulnerable.  Self-Neglect may also impact on the safety and wellbeing being of others and attempts to intervene must take into account other people’s rights and wellbeing.

It is vital to conduct a robust capacity assessment to establish whether the person has capacity to make decisions about their own wellbeing and whether or not they are able or willing to care for themselves.  An adult who is able to make choices may make decisions that others think of as self-neglect.  However, people who self-neglect may present as making a capacitated choice when refusing to engage with services or accept help but a more detailed assessment may indicate that the person’s decision making or executive capacity is impaired.

If the person who is assessed as having capacity does not want any safeguarding action to be taken it may be reasonable not to intervene further provided that:

  • ‘public interests’ are not compromised and no other individual is at risk (this includes members of the wider community)
  • their 'vital interests' are not compromised and there is no immediate risk of death or significant harm
  • managers have been informed and have been involved in the decision making process
  • all decisions recorded and include a rationale for the decision
  • partner agencies have been informed and involved as necessary

If the individual is assessed as having capacity to make a decision in respect of consent to the safeguarding process but is considered to be at risk of harm or to pose a risk of harm to others then a vital interest or public interest decision must be considered.

When dealing with adults who are experiencing Self–Neglect practitioners must also consider the risks to other individuals in the household including children and must make the appropriate referral to children’s services under the DSCB safeguarding policy and procedures.  The safety of individuals in the wider community must also be considered.  

When working with individuals who are difficult to engage (especially those with chronic mental health conditions) strong multi agency protocols and collaboration are required with a view to promoting robust and consistent joint agency work with action plans and strategies and programmed follow up of the outcomes of interventions.

Where possible family members and friends should be consulted and assessments should consider non-recent information which has been shared previously with services.

Practitioners must challenge (and must be supported by managers) individuals who fail to engage where their self- neglect poses a risk to either themselves or others. 

Practitioners must also challenge each other where necessary. See DSAPB Professional Challenge [PDF Document].  

Practitioners have a duty to inform managers of cases involving Self-Neglect and to involve managers in the decision making process.

Managers have a duty to support practitioners in the assessment of risk and decision making in cases involving Self-Neglect and to have oversight of the recording of the decision making rationale.

Signs of abuse and neglect: additional information

For more information about how to recognise signs of abuse and neglect see SCIE signs of abuse and neglect [external link] and SCIE a quick guide to abuse and neglect [external link].

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SECTION 3: SAFEGUARDING PROCEDURES AND PRACTICE GUIDANCE: THE FOUR KEY STAGES 

Introduction

This Multi-Agency Procedure is the agreed framework for responding to issues of abuse and neglect of an adult.

Any person may report a concern to the Local Authority where they are concerned that an adult with care and support needs is experiencing or is at risk of abuse or neglect (including self-neglect) in line with Section 42 of the Care Act 2014 [external link].

In these circumstances, the Local Authority as the lead agency will undertake an Initial Enquiry to determine how to respond.  This includes working to understand the adult’s desired outcomes and agreeing with the adult (or their appropriate representative or advocate) how their concerns will be acted upon.

Where the concern is not resolved by the Initial Enquiries, the Local Authority will need to decide on the most proportionate response.  This may include either a Risk Management Response (the term given to a range of actions that may be required to safeguard the adult from the risk of abuse and neglect) or a Formal Enquiry to establish the facts and gather evidence to support a Safeguarding Plan. This will involve a Safeguarding Planning/Discussion meeting.

Risk assessment, safeguarding planning, and the provision of support to enable the adult at risk to be in control of decisions about their own life are core elements throughout.

The following procedure explains how to raise a Safeguarding Concern and the expected processes that can subsequently follow.

The six key principles of Making Safeguarding Personal (MSP) [link] should be considered in all instances: SCIE: Making Safeguarding Personal (MSP) [external link].  

There are four key stages to the process:

  • Stage 1: Safeguarding Concern: Making a Safeguarding Referral
  • Stage 2: Initial Enquiry 
  • Stage 3: Decision Making 
  • Stage 4: Conclusion

For a quick guide (for practitioners) to the four stages of an investigation see: DSAPB Four Stages of a Safeguarding Enquiry [PDF Document].

STAGE 1: CONCERNS ABOUT AN ADULT: MAKING A SAFEGUARDING REFERRAL

Safeguarding is everyone’s responsibility and any person who believes that someone is experiencing or is at risk of abuse and neglect can raise a concern with the Local Authority and make a safeguarding referral. 

The duty of staff and volunteers to raise safeguarding concerns:

Step 1:  Action required when made aware of abuse or neglect

There is a duty of care for all staff (professionals and volunteers) working with adults with care and support needs to report concerns.

Within organisations staff and volunteers must always inform the Safeguarding Reporting Manager (SRM) without delay.

The SRM is a person within the organisation who will ordinarily be responsible for:

  •  deciding whether to raise a safeguarding concern with the Local Authority
  • taking immediate actions to ensure the adult at risk is safe from abuse or neglect

If the concerns relate to the SRM inform an alternative manager or a more senior manager within your organisation of the concerns for example, a manager based an alternative setting such as an area manager (staff should also refer to internal policy and procedures).

In emergency situations any member of staff (or volunteer) may need to undertake these actions particularly where:

  • contacting the SRM would result in undue delay and thereby place someone at risk or further risk
  • the SRM has been contacted and they have not taken action
  • the concern relates to the SRM and there is no other appropriate alternative manager to contact
  • staff and volunteers have individual authority to decide whether to raise a safeguarding concern and professional/service practice allows for this.

Employees without access to a SRM (such as those working outside office hours) need to be aware of the circumstances under which the police should be called in an emergency (see paragraph below: Emergency situations and contacting police [link].

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Step 2: The decision to raise a concern

There are a number of considerations when deciding whether it is appropriate to raise a safeguarding concern.  Refer to the Practice Tool [link] to aid decision making.  This tool provides guidance on whether a concern should be submitted to the Local Authority or whether it is appropriate for it to be managed by the organisation.

Safeguarding responsibilities apply where an adult (aged 18 years or more) has needs for care and support (regardless of whether the Local Authority is meeting any needs) and:

  •  is experiencing, or is at risk of, abuse or neglect and
  • as a result of those needs is unable to protect himself or herself against the abuse or neglect or the risk of it

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Mental capacity and consent:

When and adult at risk is assessed as having capacity to consent to the safeguarding process and safeguarding adults procedures are being considered, the consent of the adult believed to be at risk should always be sought.  Consent should be obtained as early as possible and if appropriate by the alerting agency so that the concerns can be progressed to ensure the safety of the adult at risk.  The fact that consent has been granted must be recorded.  If consent has not been granted the reason for this must also be recorded.  Only the individual can give consent and no-one else can consent on their behalf.

If there is concern that the adult at risk may lack the capacity to consent to the safeguarding process a mental capacity assessment should be carried out.

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Five key principles of assessing Mental Capacity:

  • Principle 1: A person will be presumed to have capacity unless proved otherwise
  • Principle 2: A person has a right to be supported to make their own decisions
  • Principle 3: A person has the right to make what might be seen as eccentric or unwise decisions
  • Principle 4: Anything done for or on behalf of a person who lacks capacity must be done in their best interests
  • Principle 5: Anything done for or on behalf of a person who lacks capacity should be should be the least restrictive intervention

There should be clear reasons for overriding the wishes of a person with mental capacity to make a decision about the safeguarding process.  However, sometimes it is necessary to proceed without consent.  A decision needs to be based on the information available and judgement will be based on an analysis of the information taking into account the particular circumstances.  In these situations the public or vital interest criteria must apply. 

For further information and guidance see Mental Capacity Act 2005 Code of Practice [external link].

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Responding without consent

Consent should be sought where possible.  Sometimes consent cannot be obtained or it may be necessary to proceed without consent.  These situations would fall under either: best interests, public interests or vital interests. Examples include:

 Best Interests decision:

  •  the adult at risk lacks the capacity to consent. 

For guidance see see SCIE: Best Interests Principles [external link].

 Public Interests decision:

  • action may be taken to safeguard other adults or children (safeguarding concerns should be submitted for any other individuals who are at risk of abuse or neglect)
  • there is organisational or systemic abuse
  • the concern relates to an employee/volunteer providing services
  • a crime has been committed and other people could be at risk 

Vital Interests decision:

  • the adult at risk is subject to coercion or undue influence
  • there is a need to prevent serious harm or distress where taking no action could result in significant harm which could be life threatening.

Consent in an emergency situation

In an emergency situation the views of the individual should still be sought where possible and where possible the individual should be informed of the action which will be taken.  However, in certain situations it is sometimes necessary to take action without obtaining consent or where the individual has declined to give consent. See SCIE: Responding without consent [external link].

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Step 3: Gather Information

Gather information from the adult at risk and other relevant people and consult records to assess whether there is any information which is relevant to the concerns.  This will involve speaking directly to the individual.  Seek the views of the individual about what happened and what they would like to happen and seek consent to raise a safeguarding concern and share information.  Be aware that it is sometimes necessary to proceed without consent. (See Step 4: The decision to raise a concern: SCIE: Responding without consent [external link]).  

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 Step 4: Ensure Immediate Safety of Adult at Risk

There is a duty to ensure that the adult at risk is safe from further harm. This duty extends to considering the safety of other adults and children who may be at risk from harm arising from the same situation. 

All reasonable and practical steps must be taken to ensure that the adult at risk and any others who may be at risk do not come into contact with the person who has caused the harm.

Do not discuss the concern with the person alleged to have caused harm unless it is necessary to ensure the welfare of the adult at risk or others.

It may be necessary to inform the police (if a crime has taken place or is taking place) or seek medical attention in an emergency.

Where the person causing harm is an employee or volunteer the employer has statutory duties in responding to the allegation and in certain circumstances informing the Disclosure and Barring Service (DBS). Refer to the  DSAPB Managing Allegations Policy and Guidance [PDF document]. The Managing Allegations Procedures also apply when an individual acts in a way in their personal life and they are employed to work in either a paid or voluntary capacity with adults at risk and their actions would raise concerns about them working with adults at risk.

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Emergency situations and contacting the Police:

If it is suspected that a criminal offence has or may have been committed or that a criminal offence may be committed and that an adult with care or support needs may be at risk of imminent harm there is a duty to inform the police.

In an emergency situation the views of the individual should still be sought where possible and the individual should be informed of the action which will be taken.  However in certain situations it is sometimes necessary to take action without obtaining consent or where the individual has declined to give consent. See SCIE: responding without consent [link].

In the event that a criminal offence has recently occurred and an immediate response is required to obtain immediate medical assistance, secure and preserve evidence or to prevent further harm call 999.

If the situation is non- urgent contact 101 and ask for Durham Constabulary.

Alternatively, contact the First Point of Contact Team (Darlington Borough Council Adult Social Care) on 01325 406111 or  Minicom 01325 468504 or out of hours contact the Emergency Duty Team on 01642 524552 or Minicom 01642 602346.  Local out-of-hours teams within Social Care and Health operate out of normal working hours, at weekends and statutory holidays. Contact details can be found on the Safeguarding Boards website: darlingtonsafeguardingboards.co.uk [link].

If a concern is reported to the Emergency Duty Team which indicates an immediate or urgent risk the officer will take any immediate steps necessary to protect the adult at risk including arranging emergency medical treatment, contacting the police and taking any other action to ensure their safety. 

When a situation is reported to the police it is important that wherever possible the person alleged to have caused harm is not questioned by anyone, so as not to undermine any future police investigation.  Whilst the preservation of life and the welfare of an adult who may need immediate medical attention is the priority it is also important that forensic and other evidence is not contaminated.  Evidence may be present even if you cannot actually see anything.

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Whole Family Approach: Adult safeguarding concerns where children may be at risk

Everyone must be aware that in situations where there is a concern that an Adult at Risk is or could be being abused or neglected (including self-neglect) and there are children in the same household they too could be at risk.  This includes circumstances where a child is living in a household with an adult who self neglects.  In these circumstances reference should be made to the Darlington Safeguarding Children Board Child Protection Procedures [link] 

  • When making a referral it is helpful to have as much information about the children as possible to ensure that the right advice is given and the appropriate actions are taken.
  • All referrals from professionals must be made in writing (using the referral form on the DSCB website).
  • Advice and support for professionals and members of the public can also be provided by a Social Worker within the Children’s Access Point: see Darlington Safeguarding Boards website [link] for contact details.
  • On occasions where there are concerns about the immediate risk of harm the referring agency should act quickly and contact Children’s Access Point (and the
  • police where necessary) by telephone and follow the referral up in writing within 24 hours.
  • A Continuum of Need Level Indicators [link] framework has been produced as a guide to help determine at what level or by what agency any additional needs can be met.
  • Further advice on what to do if you are worried about a child is available on the Safeguarding Boards website [link]

In these circumstances The Safeguarding Adults Team must ensure that all information is shared with the Children’s Access Point (CAP) and that the appropriate referral is submitted. See the Safeguarding Boards website [external link] for contact details. 

Single agency case closure: inform other agencies involved with the adult: When single agencies close a case involving an adult with care and support needs this information should be communicated to all other agencies involved in the case. This includes cases across adult and children’s services where the service user is a parent.

Step 5: How to Make a Referral

Anyone can make a safeguarding referral.  Telephone enquiries about a Safeguarding concern can be made by contacting the First Point of Contact Team on 01325 406111 or  Minicom 01325 468504.

Members of the public can submit a concern verbally to the First Point of Contact on the number above.

Organisations and professionals must complete the Safeguarding Concern form and submit the concern electronically to ssact@darlington.gcsx.gov.uk  

If there is uncertainty as to whether a concern should be raised or any other issues advice should be sought from the appropriate line manager or the Safeguarding Adults Team as above.

Out of hours advice can be sought from the Emergency Duty Team on 01642 524552 or Minicom 01642 602346. 

All contact details are available at Safeguarding Boards website [link].

The accurate recording of actions and decisions is an important aspect of the safeguarding process. All decisions must be recorded and must include the rationale for the decision.

Where necessary the rationale for raising a concern without the consent of the individual must be recorded. 

Decisions regarding capacity assessments must be recorded.

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STAGE 2:  INITIAL ENQUIRIES

When should an enquiry take place?

Where a Local Authority has reasonable cause to suspect that an adult (aged 18 years or over) in its area (whether or not ordinarily resident there): 

  • has needs for care and support (whether or not the authority is meeting any of those needs)
  • is experiencing or is at risk of abuse or neglect and
  • as a result of those needs is unable to protect himself or herself against the abuse or neglect

The Local Authority must make (or cause to be made) whatever enquiries are necessary to decide what action is needed to help and protect the adult at risk.  The decision to carry out a safeguarding enquiry does not depend on the person’s eligibility for Local Authority services. 

The scope of the enquiry will depend on the particular circumstances.  It will usually start with asking the adult their views and wishes and this will often determine what next steps to take. Everyone involved in an enquiry must focus on improving the adult’s well-being and work together towards that shared aim.  At this stage the Local Authority has a duty to consider whether the adult requires the support and representation of an independent advocate.

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Timescales for approving contact- the responsibility of the Safeguarding Adult Manager (SAM)

Once a safeguarding concern has been received by the Local Authority it is the responsibility of the Safeguarding Adult Manager (SAM) to record the case within Liquid Logic and to assess the information and either approve or reject the contact within 24 hours (or the next working day). 

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Advocacy and the Duty to Involve

Local Authorities must involve people in decisions made about their care and support.  No matter how complex a person’s needs, Local Authorities are required to help people express their wishes and feelings, support them in assessing their options and assist them in making their own decisions. The adult at risk must be supported and enabled to contribute their views and wishes with consideration being given to their communication needs. An independent advocate must be provided when an adult at risk lacks mental capacity or has a substantial difficulty in being involved in the safeguarding process and there is no representative to support them. See SCIE: Independent Advocacy under the Care Act [external link].

Establishing the views and desired outcome of the adult at risk

Establishing the views of the adult at risk and their desired outcomes must be considered at every stage of the safeguarding process.  Views and wishes and desired outcomes must be obtained from an advocate or family member/representative if the adult at risk is unable to provide these.

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Objectives/actions of an Initial Enquiry

The objectives of an Initial Enquiry into abuse or neglect are to:

  • establish facts by gathering information
  • ascertain the adult’s views and wishes
  • conduct an assessment of risk
  • check if consent has been given or if best interests, public interests or vital interests apply.
  • consider whether capacity assessment(s) are required
  • protect the adult and others from abuse and neglect taking into consideration the views and wishes of the adult
  • establish the need for representation/advocate
  • make decisions as to what follow-up action should be taken with regard to the person or organisation responsible for the abuse or neglect
  • enable the adult to achieve resolution and recovery
  • decide whether the case needs to progress to a safeguarding strategy planning/discussion meeting or requires a risk management response
  • determine if S42 criteria applies

The first priority should always be to ensure the safety and well-being of the adult who should experience the safeguarding process as empowering and supportive.  Practitioners should wherever practicable seek the consent of the adult before taking action.

Initial enquiries should be undertaken within 5 working days of the reported concern wherever possible. Any delays to meeting this timescale should be recorded. All parties should be kept informed of any progress.

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Gathering information

Information gathering is a process of collecting enough information to enable a decision to be reached as to how the concerns should be responded to.  The person who raised the concern should always be contacted in relation to their concern in order to:

  • acknowledge the concerns and
  • clarify and/or gather more information about the allegation/concern

Consultation with other agencies should take place for example: 

  • a service providing care and support, for example the care home or housing provider
  • a GP or other health professional
  • a commissioner, Care Quality Commission or other regulator
  • the police
  • voluntary sector organisations
  • specialist services, for example Forced Marriage Unit
  • community safety partnerships
  • domestic violence services and MARAC
  • relatives and unpaid carers of the adult at risk (where appropriate).

The information gathered will include that gained from a discussion with the individual at risk or their representative.

Local Authorities may choose to undertake safeguarding enquiries for adults where there is not a S42 enquiry duty in cases where the Local Authority believes it is proportionate to do so and will enable the Local Authority to promote the person’s wellbeing and support a preventative agenda.

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Risk Assessment

In considering how to respond the following factors need to be considered:

  • the adult’s need for care and support
  • the adult’s risk of abuse or neglect
  • the adult’s ability to protect themselves or the ability of their networks to increase the support they offer
  • the impact on the adult
  • their wishes
  • the possible impact on important relationships
  • the potential increasing risk to the adult
  • the risk of repeated or increasingly serious acts involving children, or another adult at risk of abuse or neglect
  • the responsibility of the person or organisation that has caused the abuse or neglect
  • research evidence to support any intervention (see Practice Tool [link] to aid decision making)

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Factors to consider in the decision making process

Safeguarding is not a substitute for Provider’s responsibilities to provide safe and high quality care and support.  In any instances where a commissioner or the Care Quality Commission (CQC) are taking action in relation to a concern, consideration should be given to whether these actions already form an appropriate and proportionate response to the concerns raised. If possible abuse is identified including organisational abuse, the Local Authority will lead on those aspects. 

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Abuse by relatives/friends and unpaid carers

  • consider the specific circumstances nature of the issues and appropriate proportionate response
  • consider outcomes that supports or offers opportunity to develop/maintain a private life including who the adult at risk wishes to maintain/develop or continue relationships
  • consider where initial enquiries indicate unintentional harm or deliberate acts and whether a formal response is required to establish what has happened

It may also be appropriate to consider whether the demands exceed the carer’s ability or capacity, whether the adult’s care and supports needs are unmet, as well as any factors that may increase their vulnerability for example, social isolation, communication or financial difficulties. Other factors to consider may include:

  • whether the carer has a lasting power of attorney or appointeeship
  • a personal or family history of violent behaviour, alcoholism, substance misuse or mental illness
  • the physical and mental health and well-being of the carer
  • additional needs of carers 

Unpaid carers sometimes have care and support needs of their own. However, sometimes unpaid carers will only have support needs. In these circumstances this Multi-Agency Policy and Procedure may still be used as a proportionate response to the concerns where appropriate, using its duty to promote wellbeing. This may be appropriate if an unpaid carer experiences intentional or unintentional harm from the adult they are trying to support.

Assessment of both the carer and the adult they care for must include consideration of both their wellbeing. Section 1 of the Care Act 2014 [external link] includes protection from abuse and neglect as part of the definition of wellbeing. 

If it appears that the Carer has needs for care and support an assessment should take into account the following factors:

  • whether the adult for whom they care has a learning disability, mental health
  • problems or a chronic progressive disabling illness that creates caring needs which exceed the carer’s ability to meet them
  • the emotional and/or social isolation of the carer and the adult at risk
  • minimal or no communication between the adult at risk and the carer either through choice, mental incapacity or poor relationship
  • whether the carer is not in receipt of any practical and/or emotional support from other family members or professionals
  • financial difficulties
  • whether the carer has a lasting power of attorney or appointeeship
  • a personal or family history of violent behaviour, alcoholism, substance misuse or mental illness
  • the physical and mental health and well-being of the carer

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Abuse by another with care and support needs

Where the person causing the harm is also an adult with needs for care and support, the safety of the person who may have been abused is paramount.

Organisations may also have responsibilities towards the person causing the harm if they are together in a residential care setting or have contact because they attend the same setting.  The person causing the harm may be eligible for an assessment. In this situation it is essential that the needs of the adult at risk who is the alleged victim are addressed separately from the needs of the person causing the harm.

It may be necessary to reassess or review the adult allegedly causing the harm. This could involve a meeting where the following could be addressed:

  • the extent to which the person causing the harm is able to understand his/her actions
  • the fact that the person alleged to have caused harm has a particular diagnosis or condition does not preclude a safeguarding response within the safeguarding adult procedure. However, where this is the case, additional support or care planning actions may be required in order to address their support needs, alongside the safeguarding needs of the adult at risk
  • the extent to which the abuse or neglect reflects the needs of the person causing the harm
  • the likelihood that the person causing the harm will further abuse the victim or others
  • consideration should be given to where residing in the same setting the impact of an incident may be compounded by the emotional distress of living with an abusive person.

If the abuse involves the commission of a crime the matter must be reported to the police.

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Abuse and neglect when the adult does not have care and support needs

Where an initial enquiry has taken place and the individual is not an adult at risk as defined within this policy, but there is concern that there is an issue of abuse or neglect (including self-neglect) consideration should be given to the most appropriate support in relation to their needs. In some instances the Local Authority may deem it necessary and proportionate to undertake a safeguarding enquiry.

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Repeat allegations

An adult with care and support needs (or a representative such as a family member) who makes repeated allegations that have been proven to be unfounded should be treated without prejudice.  The following considerations should be taken into account:

  • each allegation must be considered in its own right
  • each incident must be recorded
  • organisations should have procedures for responding to such allegations. These will involve an assessment of risk, ensuring the rights of the individual are respected, while protecting staff from the risk of unfounded allegations

There may be occasions where a person lacks mental capacity, but there are complex circumstances that prevent actions being taken in the adult’s ‘best interests’, and a response within the safeguarding adults procedure is appropriate and proportionate to the concerns. Such actions can be addressed as a Risk Management Response rather than a Formal Enquiry, unless there are also allegations of neglect caused by another person.

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Abuse by children

If a child is causing harm to an adult with care and support needs this should be dealt with under the Darlington  Safeguarding Adults Multi-Agency Policy and Procedures but it is essential that Darlington Borough Council Children’s Services is informed and intelligence shared about the child with a view to assessing whether the child is at risk of abuse or neglect and whether a multi-agency response is required and children’s social care should be involved in the case and attend meetings as required.  

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Decisions and outcomes of the Initial Enquiry

Upon completion of the Initial Enquiry the Local Authority should determine with the adult what further action is necessary and acceptable.

The outcomes of each Initial Enquiry will differ and will depend upon a range of factors and the complexity of the reported concern.  The views and wishes of the adult and their desired outcomes should be considered but must be balanced with other issues such as the level of risk to the adult at the centre of the investigation and to others and public interest considerations particularly when criminal offences have been committed. The possible outcomes of the Initial Enquiry are:

(i)  Issues resolved after Initial Enquiries

This outcome refers to those concerns where there is or has been an issue of abuse or neglect but no further enquiries are needed and no further action is required to safeguard the adult at risk or others.  This may be because the Initial Enquiries have satisfied the Local Authority that all the necessary safeguards are in place.  Any agreed actions from the Initial Enquiry should be recorded and it will be the responsibility of the relevant agencies to implement the actions.

 (ii) Safeguarding Strategy Planning/Discussion Meeting

A meeting may be required to determine what type of response is necessary and whether a formal enquiry/investigation is required. In accordance with Making Safeguarding Personal the views and desired outcomes should always be sought at the earliest opportunity and the adult at risk (or their advocate or representative) should be offered the opportunity to attend the meeting. 

(iii) Risk Management Response

This response refers to those circumstances where there is or has been an issue of abuse or neglect but this would be best managed outside the formal safeguarding process.

At any time during the Risk Management Response the case can be referred back into safeguarding should the concerns escalate. The decision to use a Risk Management Response can be made either at the end of the Initial Enquiry  or at any point during the safeguarding process which should be flexible.  This is in line with Making Safeguarding Personal (MSP) and considering the views/wishes of the adult at risk and their desired outcomes which may change throughout the process. 

(iv) Formal Enquiry (S42 Enquiry)

Whether or not a Formal Enquiry/Investigation (S42 Enquiry) is required will be decided at the first Safeguarding Strategy Planning/Discussion Meeting. A Formal Enquiry/Investigation is usually required in more complex situations where there is insufficient information available to make a decision on how to proceed.  

The purpose of a Formal Enquiry is to: 

  • formally establish the facts regarding an incident or an allegation
  • establish the evidence on which to base interventions particularly those in relation to a person alleged to have caused harm
  • devise a Safeguarding Plan

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Recording

All actions and decision making undertaken during the Initial Enquiries should be recorded including the rationale for the decisions made and action taken. This is recorded in the Safeguarding Initial Enquiry in Liquid Logic.

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Feedback

The outcomes of the initial enquiry should be notified to the relevant people. This must include:

  • the Safeguarding Reporting Manager or person raising the concern. Where the person raising the concern is a member of the public no details of the subsequent action should be shared without the consent of the adult at risk or in their best interests if they lack capacity to consent.
  • the adult at risk/representative/advocate
  • if the adult at risk is from out of the area then the placing authority/funder should be informed

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STAGE 3: RISK MANAGEMENT RESPONSE

Risk Management Response

A Risk Management Response is an alternative response to progressing to a Safeguarding Strategy Planning/Discussion meeting. Risk Management Responses may be appropriate for those individuals who meet the definition of an adult at risk as outlined in this policy and in line with Making Safeguarding Personal (MSP).

A Risk Management Response should be applied where there is no need to progress to a Safeguarding Strategy Planning/Discussion Meeting but where there are actions needed to safeguard an adult or individuals in the wider community from abuse or neglect.  Risk Management Response is the term used to reflect a broad range of different actions and approaches that may be used to respond to the risk of abuse or neglect. These options will continue to be developed and will consider the desired outcomes of individuals to continually improve these responses. There is no prescribed list of these actions which may include:

  • care and support needs assessment
  • carer’s assessment
  • review of care and support
  • mediation
  • multi-agency risk assessment
  • interventions regarding allegations against ‘persons in a position of trust’
  • multi-disciplinary input
  • family group conferences
  • commissioning actions
  • contracts enforcement actions
  • service, quality assurance actions
  • serious incident processes

Consider the individual needs and circumstances of the adult at risk in conjunction with any actions required in respect of the service provider.  The approach taken may include actions taken by the adult at risk to safeguard themselves from the risk of abuse and neglect. Whichever form the Risk Management Response takes it must be proportional to the nature of the concerns and include the following elements: 

  • evaluation of risk to the adult and others, including children
  • working towards wishes and desired outcomes of the adult at risk where possible
  • consideration of the need for representation/independent advocate
  • assessment of the need for additional safeguarding actions
  • actions taken in the adult’s best interests if they lack mental capacity in relation to relevant decisions
  • recording of issues, actions and decision making. 

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Agreeing actions to be taken

It is vital that the adult at risk be in control of decisions as to how risks they face in their life are managed. The desired outcomes are established at the point the concern was raised, however people’s views and wishes can change throughout the process of the enquiry so it is important that the desired outcomes are reviewed at all stages of the process

The adult at risk should experience the safeguarding process as empowering and supportive. The response taken should reflect the nature and seriousness of the risk, and wherever possible and appropriate, support the person to achieve their desired outcomes.

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Risk to others including children

Throughout any response within this procedure it is necessary to consider the safety and wellbeing of others, this may be those people living in the same family home, those in the same care environment or members of the wider public.

Some risk management responses will focus on managing the risk to others. Consent is not required to take actions which are necessary to ensure the safety and well-being of others. However, it would be good practice to inform the person of actions being taken, unless to do so would place any person at further risk

Where the risk involves a ‘person in a position of trust’ working with adults with care and support needs refer to the DSAPB Managing Allegations Policy and Guidance [PDF document] and report concerns to the First Contact Point.

Concerns regarding risk to children should be reported in accordance with DSCB Multi-Agency Child Protection Procedures [link].

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Review actions

The purpose of the review is to evaluate whether the safeguarding actions taken are effectively managing the risk, promoting wellbeing and responding to the desired outcomes of the adult at risk. A series of review meetings may be required. 

The format of the review will reflect the course of action undertaken.  If for example, an assessment of care and support has been undertaken to respond to the risk of abuse, then a review should take the format usually required for such reviews. 

Whichever format the review takes, it should include appropriate consideration of:

  • the current risk to the adult concerned
  • any ongoing risks to others, including children
  • whether the desired outcomes of the adult are being met
  • whether the actions are working to promote the overall individual wellbeing of the adult 

The adult at risk should be supported to participate within any such review, receiving support of a representative or advocate. If any point during a risk management response, circumstances change or the views/wishes and desired outcomes of an individual, the process may change accordingly, for example, where there is an escalation of risk of wider risk, it may be appropriate to undertake a strategy discussion/meeting and instigate a formal enquiry.

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STAGE 3:  FORMAL ENQUIRY/INVESTIGATION

The objectives of a Formal Enquiry/Investigation into abuse or neglect are to:

  • establish the facts
  • ascertain the adult’s views and wishes
  • assess the needs of the adult for protection, support and redress and how they might be met
  • protect the adult at risk from the abuse and neglect, in accordance with the wishes of the adult
  • consider risks to others including children and the wider community
  • make decisions as to what follow-up action should be taken with regard to the person or organisation responsible for the abuse or neglect
  • enable the adult to achieve resolution and recover 

A Safeguarding Adult Manager (SAM) will oversee a formal enquiry/investigation.

The SAM will always be a representative of Adult Social Care. The SAM will also chair the strategy discussion/meeting ensuring that minutes are taken and circulated.

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Action to be taken if the person causing harm is also an adult at risk

If the person causing abuse or neglect is also an adult at risk, it may be necessary to hold a separate meeting to address the needs of the person causing the harm and the risks that they may present. It may be appropriate for a separate care manager/care coordinator to be involved in order to respond to these issues.

In all cases, the care manager, care coordinator or link/key worker representing the adult at risk and the relevant staff working with the person causing harm must be involved/kept informed throughout the safeguarding adults procedure.

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Medical treatment and examination

In cases of physical abuse it may be unclear whether injuries have been caused by abuse or as a result of an accident. Medical advice may need to be sought. In all cases if there is the potential to obtain forensic evidence or photographic evidence of abuse the police should always be contacted and there will be the opportunity for a Forensic Medical Examiner (FME) to be involved. 

The consent of the adult at risk should be sought for medical examination or the taking of photographs. Where the person does not have mental capacity to consent to medical examination or the taking of photographs, a decision should be made on the basis of whether it is in the adult’s best interest.

Should it be necessary as part of the investigation/enquiry to arrange for a medical examination to be conducted, the following points should be considered:

  • the rights, issues of capacity and consent
  • the need to preserve forensic evidence
  • the need for support/representation from family members or unpaid carers
  • the need for independent advocacy
  • views and wishes of the adult at risk

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Strategy Planning Meeting/Discussion

An Initial Safeguarding Strategy Planning Meeting will be held. Where appropriate this can be a telephone Strategy Planning/Discussion. 

The Safeguarding Strategy Planning/Discussion Meeting should be arranged within 5 working days of the completion of the Initial Enquiry/Investigation.

The purpose of the Strategy Meeting is to discuss the information available and decide what further action is required. It may be possible at this meeting to end the safeguarding process if it is agreed that all actions have been completed and the risk addressed. If further information is required it may be necessary to arrange for a Formal Enquiry/Investigation to be carried out into the allegations to gather further information and to establish the facts and the actions required to safeguard the individual or others, this includes considering the wishes and desired outcomes of the adult at risk and/or their best interests where they lack capacity in relation to specific decisions. 

Formal Enquiries/Investigations are carried out by the most appropriate person(s) from any agency. 

With the exception of cases involving a police investigation, where vital evidence gathering is required, the Strategy Meeting/Discussion should take place before any safeguarding Formal Enquiry/Investigation. 

A Strategy Meeting is more likely to be needed when a multi-agency response/perspective is required to assess risk and determine the appropriate response as follows: 

  • a multi-agency perspective is required to assess the risk, inform or contribute to the Safeguarding Plan or inform the Formal Enquiry/Investigation
  • there is a need to coordinate the Formal Enquiry/Investigation
  • a large scale enquiry is being considered
  • there are concerns about the safety of the service or organisational abuse
  • a serious crime has occurred
  • a strategy meeting will assist the adult at risk/representatives to reach resolution and recovery from their experiences 

It is important to listen to the adult at risk, both in terms of the alleged abuse and the desired outcomes and resolution they want. What they have to say must be taken seriously and taken into consideration. Individuals have a right to privacy and to be treated with dignity. These values must be respected throughout the Formal Enquiry. 

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Who should be involved in the Strategy Meeting/Discussion?

The Safeguarding Adult Manager (SAM) will decide who to involve but should limit attendance to those who need to know or will be required to contribute to the process. This may include an appropriate representative of any organisation that has a specific role (for example the Safeguarding Adults Lead or the appropriate Safeguarding Adults Manager).

Where the allegation/concern involves abuse occurring within a regulated or contracted service the following must be invited to the Strategy Meeting: 

  • Care Quality Commission
  • Contract and Commissioning Services
  • when the support/placement is funded by the Clinical Commissioning Group (CCG)/ Continuing Health Care (CHC) they must be invited to the Strategy Meeting and this includes out of area CCG/CHC/Local Authority teams

The Strategy Meeting participants must provide and consider all relevant and non-recent information (including information from multiple referrals) in the decision making process.   

In circumstances where it is suspected that a criminal offence has been committed in order to ensure that the police investigation is not compromised the Chair must seek advice from the Detective Sergeant prior to the Strategy Meeting to agree who should be invited to attend the Strategy Meeting. In certain circumstances it may not be appropriate to invite the adult at risk or those who have been involved in the care of the adult at risk.  

It may be necessary to exclude family members from part of the meeting to allow for professional conversations and the Chair of the Strategy Meeting should make this decision in advance. 

Participants should be of sufficient seniority to make decisions concerning the organisation’s role within the Formal Enquiry/Investigation and the resources they may contribute to the safeguarding plan. Any organisation requested to participate in a Strategy Meeting should regard the request as a priority.  If no one from the organisation is able to attend a meeting, they should provide information as requested and make sure it is available to the SAM in advance. The SAM may also wish to plan ahead for a Safeguarding Planning Meeting which should take place 8 weeks from the decision to undertake a Formal Enquiry/Investigation. 

If the person invited to attend the Strategy Meeting wishes to bring anyone else along they must obtain permission to do this from the person who is chairing the meeting. 

Should it be determined during the Strategy Meeting that there is someone present who has been involved in the allegation then the meeting must be stopped immediately and the chair must asked them to leave. 

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Involving the adult at risk in the Safeguarding Strategy Planning/Discussion Meeting

The adult at risk should experience the safeguarding process as empowering and supportive. It is vital that the views, needs and desired outcomes of the adult at risk are central to the strategy discussion/meeting.  Whenever possible the adult at risk should be invited to attend the Strategy Meeting (or to part of it) to contribute their views and needs directly to the meeting.  It is vital that decisions about safeguarding arrangements are made in partnership with the adult at risk.  However, it is also important that the safeguarding process is fair and objective to all concerned and it may not be appropriate for the adult at risk to be present at meetings.

In the event that the adult at risk is not able or does not wish to attend, or it is not appropriate for them to attend, every effort should be made to explain its purpose to the adult at risk, to find out their concerns, what they want to happen, how they want to be involved and the support they feel they need in order to be safe.  The desired outcomes of the adult at risk should inform decision making.  

In circumstances where an adult at risk does not attend a meeting then an advocate/representative/family member should attend on their behalf unless the adult at risk has capacity and says they do not want anyone else to attend on their behalf.  The advocate/family member/representative present the views and wishes and desired outcomes on behalf of the adult at risk.

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Role of legal representatives at a Safeguarding Strategy Planning/Discussion Meeting

If the adult at risk, their representative or another interested party wishes to bring a legal representative with them to a Safeguarding Strategy Planning Meeting, the Chair of the meeting should be advised of this in advance.  Other invitees may need to be informed of the proposed attendance.

  • legal representatives attending should be advised before the meeting by the SEO or SAM that they are a ‘silent supporter’.
  • legal representatives will not actively participate or comment during this type of meeting.

Where the attendee who has requested that legal representative attend does not agree with the above the Chair should liaise with Local Authority Legal Services.

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Deciding whether to proceed to a Formal Enquiry/Investigation

With additional information obtained within the Safeguarding Planning/Discussion Meeting the decision will be made whether it is appropriate to proceed with a Formal Enquiry/Investigation. The decision should take into account the wishes and desired outcomes of the adult at risk, as well as assessment of the risks to others and the nature and seriousness of the concern.

Where abuse or neglect is no longer indicated, alternative sources of support may be appropriate considered outside of this procedure for example, signposting to another agency or support by a social worker. 

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Purpose of a Formal Enquiry /Investigation

A Safeguarding Formal Enquiry/Investigation is undertaken in order to: 

  • identify what actions are required to safeguard an adult from the risk of abuse and neglect
  • establish facts and gather evidence in relation to an allegation of abuse or neglect
  • support an ongoing assessment of risk
  • support the development of a Safeguarding Plan 

The plan for the Formal Enquiry/Investigation should be agreed during the safeguarding planning/discussion meeting.  This should include:.

  • clearly define the concerns or allegations to be addressed within the enquiry
  • distinguish any elements that do not need to part of the Formal Enquiry under the safeguarding procedure
  • identify who will carry out the Safeguarding Enquiry/Investigation
  • identify who the person(s) carrying out the enquiry/investigation need to speak to which may include the person alleged to have caused harm
  • identify any communication needs of the adult at risk
  • identify who will be representing adult at risk if this is required
  • provide wherever practicable for the person or organisation alleged to have caused harm to respond to allegations and the Formal Enquiry/Investigation findings The timing of such actions also needs to be considered, so that this does not prejudice an investigation or place any person at risk.
  • consider how the risk to any party in undertaking the Formal Enquiry/Investigation should be managed.
  • set provisional dates for completion of the Formal Enquiry report
  • set provisional dates for the Safeguarding Planning Meeting

The Formal Enquiry/Investigation should be carried out by the most appropriate person(s). This may be a nominated person from:

  • Adult Social Care
  • a service provider manager in regulated settings, including hospitals and other NHS providers. 

Where abuse or neglect is alleged to have occurred within a regulated service the service provider should investigate any concern unless there is a compelling reason why it is inappropriate or unsafe to do this.  The service provider should complete the Formal Enquiry/Investigation report provided by the Local Authority.

This will require a professional judgement based on the individual circumstances and the principle of proportionality. Examples of when it may be inappropriate or unsafe for the service provider to fulfill this role include:

  • there is a serious conflict of interest, such as where:
    • organisational abuse is alleged
    • the manager or owner of the service is implicated
    • service provider may not be impartial
    • there are regulatory or commissioning implications
  • concerns have been raised about non-effective past enquiries
  • there are serious or multiple concerns
  • a criminal offence has been committed and must be investigated by the police
  • other organisations need to undertake elements of the Formal Enquiry

Joint enquiries/investigations can also be carried out by people from different agencies. 

The Safeguarding Formal Enquiry/Investigation report should be received by the SAM 7 working days in advance of the Safeguarding Planning Meeting

The SAM must ensure that the Formal Enquiry/Investigation has been undertaken thoroughly and has followed the Formal Enquiry Plan agreed in the Strategy Discussion/Meeting and ask for additional actions to be undertaken, where these have been omitted from the Formal Enquiry/Investigation or are subsequently indicated.  If the Local Authority has asked a service provider to carry out the Formal Enquiry/Investigation it is able to challenge the body undertaking the enquiry/investigation if it considers the process and/or outcome to be unsatisfactory. The Formal Enquiry/Investigation must be unbiased If the SAM finds that this is not achievable, an independent Safeguarding Enquiry/Investigation  Officer (SEO) may be asked to undertake a further Formal Enquiry/Investigation.

The Safeguarding Formal Enquiry/Investigation report should be received by the SAM 7 working days in advance of the Safeguarding Planning Meeting.

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Timescales for the Formal Enquiry

The Formal Enquiry/Investigation should be concluded within eight weeks of the strategy discussion/meeting being held.

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Risk assessment and Safeguarding Planning

During the period of the Formal Enquiry/Investigation, the Safeguarding Plan should be reviewed as agreed within the Safeguarding Planning/Discussion meeting.  New information or changes of circumstance may require the risk to the individual or others to be re-assessed and the Safeguarding Plan amended.  The SAM should always be informed as to potential changes in the level of risk or concerns about the effectiveness of the Safeguarding Plan. A further meeting will sometimes be required.

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Safeguarding Enquiry/Investigation Report

The Safeguarding Enquiry Officer (SEO- person appointed to carry out the enquiry/investigation) will draw together relevant information from various activities and produce a Safeguarding Formal Enquiry/Investigation Report for the Safeguarding Planning Meeting.  There is a specific template for this report which is available from the Safeguarding Adults Team at Darlington Borough Council.

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Compiling the safeguarding Formal Enquiry report

The Safeguarding Enquiry Officer (SEO) will write a Formal Enquiry Report. This report should provide a summary of enquiry activities and evidence obtained. The report may need to collate information from a range of sources and activities as follows:

  • the report should be based upon the facts established within the Formal Enquiry/Investigation
  • any opinions expressed within the report should be referenced
  • the Formal Enquiry report should be focused on the experience of abuse and what actions can safeguard the adult at risk from future harm
  • if any person could not be interviewed or if certain records could not be accessed, the Formal Enquiry Report should record this and the reasons why
  • the Formal Enquiry Report should make clear where evidence from different sources is contradictory
  • the report should evidence how conclusions or recommendations have been reached
  • Personal information concerning the adult at risk, the person alleged to have caused harm or any other parties, should be kept to the minimum necessary for the purposes of the report
  • The report may contain information that relates to different individuals. It may be necessary for reports to be written in a way that enables particular sections to be shared as appropriate or be anonymised through use of initials or removal of names
  • the Formal Enquiry Report should be signed off by the SAM prior to Safeguarding Planning Meeting
  • the report should include details of interview carried out
  • details of records/care plans and other documents examined
  • details of any reports received 

The Safeguarding Enquiry Officer’s (SEO) report should be sent to the Chair 7 working days prior to the meeting. 

The Chair should consider: 

  • local information sharing protocols and guidance
  • sharing with attendees 5 working days ahead of the Safeguarding Strategy Planning Review Meeting
  • if deemed sensitivity/confidentiality issues whether to share at the meeting
  • record all decisions
  • consider adjournment if information is not available.

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Principle of Fairness

In undertaking the Formal Enquiry/Investigation it is important that it is carried out impartially and with fairness to all concerned:

  • a Formal Enquiry/Investigation should be conducted without prejudging its outcome
  • the Formal Enquiry/Investigation should be undertaken objectively, based upon the finding of facts
  • a Formal Enquiry/Investigation should always be sufficiently thorough to ensure a balanced perspective is obtained in relation to the incident occurring (or alleged to have occurred)
  • the adult at risk should have the opportunity to give their account of what has happened to them and review the enquiry findings
  • wherever practicable a person alleged to have caused harm should be enabled to respond to allegations and the enquiry findings, in respect to their actions/conduct. However, there will need to be consideration as to the timing that a person is informed, so as not to prejudice any investigation/enquiry required or place any person at risk 

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Amendments to the Safeguarding Enquiry/Investigation

The SEO should immediately inform the SAM if during the course of a Formal Enquiry/Investigation:

  • new information comes to light that suggests new sources of evidence should be considered or additional interviews should be undertaken
  • new/additional safeguarding allegations/concerns are identified
  • the safeguarding concern is proving to be more or less serious than initially assessed 

The SAM may then need to review the Safeguarding Enquiry Plan. A Safeguarding Planning Review Meeting can be convened to review the information and any implications for the safeguarding arrangements.  A new Safeguarding Enquiry may be required if substantially new concerns or allegations emerge.

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Planning interviews

Any interview needs to take into account the particular needs of the person being interviewed, including:

  • consideration that the adult may wish to be accompanied during the interview for emotional support or personal assistance
  • communication needs
  • language, cultural, spiritual or gender issues or any particular support needs that requires forward planning
  • the cognitive abilities of the adult at risk 

Always ensure:

  • the purpose of the interview is fully explained
  • the venue for the interview is appropriate and private
  • the person is aware of how the information they are sharing will be used
  • that the individual understands what is taking place throughout the interview
  • the interview is conducted at the individual’s own pace; this may involve breaks or more than one interview to be conducted
  • the adult at risk is not interviewed in the presence of the person alleged to have caused harm
  • that everything is recorded as fully and accurately as possible
  • that interviews are carried out sensitively and without pre-judgement of the issues
  • to avoid wherever possible repeat interviews 

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Delays with the Formal Enquiry

The Formal Enquiry should be concluded within eight weeks of the strategy discussion/meeting being held and the Safeguarding Enquiry Officer (SEO) must keep the SAM informed of the progress of the Formal Enquiry/Investigation.  If the Formal Enquiry/Investigation is delayed, any necessary action(s) must be agreed with the SAM and other relevant organisations and recorded. Revised target timescales will ordinarily be communicated to the adult at risk and the person alleged to have caused harm. 

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Standards of proof

In determining whether abuse has occurred, the standard of evidence for a Formal Enquiry/Investigation is ‘on the balance of probability’. This is in contrast to the standard of proof for a criminal prosecution which is established as ‘beyond reasonable doubt’.

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Distribution of minutes

Safeguarding Strategy Planning/Discussion minutes or Safeguarding Planning Review minutes should be circulated within 5 working days of the meeting. Minutes should be provided in an accessible format for the adult at risk or representative.  If the timescale is not possible allocated actions should always be circulated within 5 working days so as not to delay progress.

The SAM should always decide who to include in the distribution of minutes. This will usually include:

  • all attendees and invitees to a Strategy Meeting (and those who did not attend but actions were allocated)
  • relevant persons contributing to the Safeguarding Plan or Formal Enquiry /investigation
  • contract/commissioning teams according to local arrangements
  • the Care Quality Commission where the Strategy Meeting relates to a service that it regulates
  • other relevant regulatory bodies, as appropriate 

If not present, a copy of the minutes should be sent to the adult at risk or (with their permission) to an advocate or representative.  This however may not always be appropriate, if to do so may increase the level of risk, breach confidentiality, or compromise the formal enquiry/investigation.  If the adult at risk does not have capacity, a decision should be made in their best interests about whether minutes should be sent to their representative.   

Where there is specific information that cannot be shared it should be redacted from documents prior to circulation.  

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Safeguarding Planning Review Meeting

The purpose of the Safeguarding Planning Review Meeting is to review the findings of the Formal Enquiry/Investigation, identify risks and agree safeguarding actions required to respond to the concerns.  Ideally, it should take place within 8 weeks of the decision to hold a Formal Enquiry/Investigation and earlier if possible.

The Safeguarding Planning Review Meeting involves: 

  • working towards wishes and desired outcomes of the adult at risk where possible
  • reviewing the formal enquiry/investigation report
  • determining whether abuse or neglect has occurred
  • assessing the level of any ongoing risk
  • agreeing a Safeguarding Plan where required
  • agreeing further actions to be taken
  • deciding how any Safeguarding Plan is reviewed and monitored 

The decision to hold a Safeguarding Planning Review Meeting is made by the Safeguarding Adult Manager (SAM).

A Safeguarding Planning Review Meeting will be chaired by a SAM and will ordinarily be required where: 

  • a multi-agency perspective is required to review the findings of the Formal Enquiry/Investigation and or advise on the Safeguarding Plan.
  • a large scale enquiry has been undertaken
  • there are concerns about the safety of the service or organisational abuse
  • formal actions may be required in relation to a ‘person in a position of trust’ e.g. referral to professional or the Disclosure and Barring Service (DBS)
  • the Formal Enquiry findings are detailed or complex or indicate a significant difference of opinion about the outcome
  • a Safeguarding Planning Meeting will assist the adult at risk/representatives to reach resolution and recovery from their experiences
  • a serious crime has occurred 

It is the responsibility of the Chair in any instances of decisions to hold/not hold meetings to ensure that that: 

  • decisions are always recorded;
  • consultation with the adult at risk or relevant parties takes place and is recorded (inclusive of any best interest decisions)
  • decisions are communicated 

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Review

Any subsequent review should be Chaired by the Safeguarding Adult Manager (SAM) or an appropriate alternative. Reviews should take place within three months of the Safeguarding Plan being agreed or as agreed at the Safeguarding Planning Review Meeting.  It is possible for any subsequent review to be undertaken at the same point of any assessment review if this is felt appropriate. 

The same principles apply to that of the Safeguarding Planning Meeting in that the adult at risk should be included, the plan should be reviewed with a review of any risks and an agreement reached for any changes amendments to the Safeguarding Plan. 

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Who should attend the Safeguarding Planning Review Meeting?

The Chair will identify and manage: 

  • who should attend
  • the most appropriate person for an organisation alleged to have caused harm that should attend (and always consider the role of CQC and Contracts/Commissioner).
  • any unexpected attendees and make decisions on whether it is appropriate for them to remain at the meeting. The Chair can prevent unexpected attendees from joining the meeting. 

Invitees may have a key role in: 

  • undertaking enquiries into the allegation of abuse or neglect
  • assessing the risk
  • developing or carrying out the Safeguarding Plan, or
  • taking action in relation to the person alleged to have caused harm 

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Involving the adult at risk and involving the person or organisation alleged to have caused harm

The same considerations should be given as for a Safeguarding Planning/Discussion meeting [link]. 

Role of legal representatives at a Safeguarding Safeguarding Planning Review Meeting

The same considerations apply as in the role of legal representatives at a Safeguarding Strategy Planning Meeting/Discussion Meeting [link].

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 Reviewing and assessing risk for Safeguarding Plans

Routine review of the risks should take place throughout the process and include feedback from the adult at risk, their representative or advocate.  If a decision that abuse has occurred has been reached the risks must be reviewed and included in the Safeguarding Plan. The Chair will need to ensure that agreed safeguarding plans are implemented.  Any party that is unable to complete an agreed action should notify the SAM at the earliest opportunity. 

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Agreeing a Safeguarding Plan with the Adult at Risk

Once enquiries are completed the Local Authority should then determine with the adult what further action (if any) is necessary and acceptable. 

  • any safeguarding plan that impacts on the welfare of the adult at risk should be devised in partnership with them; this may include actions the adult at risk is taking, as well as the actions of the Local Authority and other organisations.
  • the response taken should reflect the nature and seriousness of the risk, supporting the person to achieve their desired outcomes.
  • any intervention regarding family or personal relationships need to be carefully considered and how to support the adult.
  • where a person lacks capacity, decisions should be made in their best interests.
  • any risks to others should always be considered, in such instances, consent is not required. 

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Case conclusion

The purpose of the Safeguarding Adults Procedure is to safeguard people from abuse and neglect. Where actions are no longer needed within this procedure, it should be discontinued. 

The duty to make enquiries will be fulfilled where:

  • no further enquiries are needed to establish whether any action should be taken
  • no further safeguarding actions are required to keep the adult at risk or others with care and support needs, safe from abuse or neglect.

The safeguarding process can be concluded at any point where it is appropriate to do so. However, where a Formal Enquiry/Investigation has commenced but is discontinued this should be recorded in the Safeguarding Planning Review Meeting. This may happen because the adult at risk has decided that they no longer want this intervention and there are no other persons at risk. 

The person’s desired outcomes should be considered throughout the safeguarding procedure and where possible, the persons desired outcomes will be met. However these desired outcomes may not always be realistic or achievable, and there may be occasions where the duty to make enquiries is fulfilled without these being met. 

Although the safeguarding procedure has concluded there may continue to be plans and actions to be reviewed as part of the ongoing review, care management or care programme approach 

The Chair should ensure: 

  • if more than one type of abuse is alleged a discussion should take place and agreement reached on an outcome for each type
  • the burden of proof should be consistent with the civil standard of proof which is on the “balance of probabilities”
  • An overall case conclusion should be reached in discussion and liaison with attendees. These include: 
  1. Fully Substantiated
  2. Partially Substantiated
  3. Inconclusive
  4. Not substantiated
  5. Investigation ceased at individual’s request

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Key considerations for the Safeguarding Adult Manager (SAM) when closing the case

  • ensure records are accurate and up to date in line with internal policies and procedures and information sharing protocols
  • ensure evidence, decisions and outcomes are recorded
  • ensure the adult at risk is fully informed of any decisions and any conclusion
  • ensure the person/organisation alleged to have caused harm are informed of any decisions
  • ensure all agencies have been appropriately informed
  • ensure all relevant parties are informed of any conclusion and decisions reached

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Record keeping and confidentiality

There is a duty for all agencies to maintain a record of all decisions taken relating to the process and the rationale for the decisions.  Records may be disclosed in court as part of the evidence in a proceedings or may be required if the Care Quality Commission (CQC) decides to take legal action against a provider.  Therefore records maintained by providers of services should be proportionate and available to service commissioners and regulatory authorities.  

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Lessons learned and good practice

Consideration should always be given to any partnership lessons or good practice that can be cascaded as shared learning.

The Darlington Safeguarding Adults Partnership Board (DSAPB) reviews Learning and Improvement both locally and nationally. Good practice and lessons learned are reviewed within the Adult Learning and Improvement Group (ALIG) and reported to the DSAPB with consideration to wider learning for all agencies.

There is an expectation that all parties involved in the safeguarding process consider any lessons for how agencies have worked together but equally any areas of good practice are identified to share.  Good practice is deemed to be anything that is over and above the expected standards. 

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STAGE 4: CONCLUSION

Consulting the adult at risk or their advocate

The adult at the centre of the enquiry or their advocate must be updated with the outcome of the Safeguarding Enquiry and be consulted regarding their views of their experience of the safeguarding process with regard to the following:

  • have views been sought throughout the process
  • have appropriate representative views been sought or those of an advocate where required
  • have individuals been supported to have choice and control throughout the process and are their desired outcomes evident and have they been achieved
  • has their quality of life improved as a result of the safeguarding intervention 

Adult Social Care will seek feedback using the evaluation questionnaire and the responses should be recorded and considered to inform future practice.

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Evaluation

The feedback from the adult at the centre of the enquiry or their advocate (based on the seven questions which were shared with the adult at risk at the beginning of the process) obtained throughout the enquiry must be evaluated and any lessons learned which may inform future practice should be considered.

Agencies should undertake periodical audits to ensure that responses to safeguarding referrals have been appropriate and effective and that practitioners have worked effectively with partner agencies to achieve where possible the outcome desired by the adult at the centre of the enquiry.

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The Complaint process

Sometimes the adult at the centre of the enquiry or their advocate or a relative or friend may wish to appeal the outcome of a Strategy Meeting or the safeguarding process.  In this situation the adult at the centre of the enquiry or their advocate should be informed of the process that should be followed. Anyone who wishes to challenge the outcome of a Strategy Meeting should follow the Darlington Borough Council complaints procedure

If a practitioner or partner agency is dissatisfied with the outcome of the Strategy Meeting or the enquiry they should consider the need for a Professional Challenge. For guidance see the DSAPB Professional Challenge Guidance  [link].

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References

ADASS Adult Safeguarding and Domestic Abuse: A guide to support practitioners and managers  [external link]

The Care Act 2014   [external link] 

Section 1 of the Care Act 2014 [external link]

Section 42 of the Care Act 2014 [external link]

Continuum of Need Level Indicators [link] 

Counter-Terrorism and Security Act 2015 [external link]

Section 20 of the Criminal Justice and Courts Act 2015 [external link]

Section 21 of the Criminal Justice and Courts Act 2015 [external link]

Data Protection Act 1988 [external link]

Human Rights Act 1988 [external link]

The Mental Capacity Act 2005 [external link]

Darlington Safeguarding Boards Information Sharing Protocol [PDF document]

Darlington Safeguarding Boards website [link]                                                                            

Caldicott Principles [external link]

Changing Lives [external link]  

Disclosure and Barring Service (DBS)[external link].

DSAPB: Appealing the Decision of a Strategy Meeting [link]

DSAPB Executive Strategy Process [link]

DSAPB Out of Area Safeguarding Adults Arrangements- Guidance for Inter Authority Safeguarding Adults Enquiry and Protection Arrangements [PDF document] 

DSCB/DSAPB Joint Practice Guidance: Prevent Practice Guidance and Channel process [PDF document]

DSAPB Managing Allegations Policy and Guidance [PDF document]

DSAPB Self-Neglect and Hoarding Multi-Agency Practice Guidance [PDF document] 

DSAPB Professional Challenge Guidelines [link]

DSAPB Safeguarding Adult Review (SAR) procedures  [PDF Document].

DSCB Multi-Agency Child Protection Procedures [link]

Durham Police and Crime Commissioners plan 2016 – 2021 [external link]                      

Hoarding Chart: clutter image rating [PDF document] 

Local Government Association Modern Slavery: A Council Guide  [external link]

Making Safeguarding Personal (MSP) [external link]

Mental Capacity Act 2005 Code of Practice [external link]

National Probation Service Multi Agency Public Protection Arrangements  [external link]

Practitioner Guidance for referring to MARAC [external link]

Restorative Hub Referrals Guidance [PDF document]

SCIE: Best Interests Principles [external link]

SCIE: Definition of Willful Neglect [external link]

SCIE: Investigating Adult Abuse: Forced Marriage [external link]

SCIE: Independent Advocacy under the Care Act [external link] 

SCIE: Indicators of Financial Abuse [external link]

SCIE: Indicators of Psychological Abuse [external link]

SCIE: Indicators of Neglect [external link]

SCIE Indicators of Self –Neglect [external link]

SCIE: Modern Slavery [external link]

SCIE:  A quick guide to abuse and neglect [external link].

SCIE: Responding without consent [external link]  

SCIE Signs of abuse and neglect [external link]

SCIE: Tenants who self-neglect. Guidance for frontline housing staff and contractors [external link]

SCIE: The Legal Requirements of Information Sharing [external link] 

SCIE: Types and Indicators of Discriminatory Abuse [external link] 

SCIE: Types and Indicators of Organisational Abuse [external link]

SCIE: Types and indicators of Physical Abuse [external link]

SCIE: Types and indicators of Sexual Abuse [external link]

Whistleblowing Arrangements (BSI 2008) [external link]

Self –Neglect Toolkit: A Guide for Practitioners [PDF document]

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Glossary

ACPO- Association of Chief Police Officers – now replaced by National Police Chiefs Council (NPCC)  

ADASS (Association of Directors of Adult Social Services) - is the national leadership association for directors of Local Authority adult social care services.

Adult at Risk- is a person over 18 years of age who have 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.

ALIG- Adult Learning and Improvement sub-group

Appointeeship- the right to deal with the benefits of someone who cannot manage their affairs because of disability or mental incapacity 

ASC- Adult Social Care – is defined by the Law Commission ‘as care and support provided by local social services authorities pursuant to their responsibilities towards adults who need extra support. This includes older people, people with learning disabilities, physically disabled people, people with mental health problems, drug and alcohol misuse and carers.

Advocacy - is taking action to help people say what they want, secure their rights, represent their interests and obtain services they need.

Advocate - The Local Authority has a duty to arrange an advocate for someone who have substantial difficulty in participating in the safeguarding adults process and if there is not an appropriate representative (or representatives) to facilitate the adult’s involvement.

ARCC – Achieving Real Change in Communities is the private Community Rehabilitation Company for the locality.

Best Interest Decision – is one of the principles of the Mental Capacity Act 2005 (MCA). The Act states that if a person lacks mental capacity to make a particular decision then whoever is making that decision or taking any action on that person’s behalf must do so in the person’s best interests. 

Capacity (Mental Capacity) - relates to the ability to make a decision about a particular matter at the time the decision needs to be made.  Mental Capacity is time and decision specific.  This means a person may be able to make some decisions but not others at a particular point in time.

Carer - refers to unpaid carers, for example, relatives or friends of the adult at risk. Paid workers, including personal assistants, whose job title may be ‘carer’, are called ‘staff’.

CHANNEL is a key element of the Prevent strategy. It is a multi-agency approach to protect people at risk from radicalisation. Channel is about safeguarding children and adults from being drawn into committing terrorist-related activity. It is about early intervention to protect and divert people away from the risk they face before illegality occurs (see also PREVENT).

CCG- Clinical Commissioning Groups - are statutory NHS bodies with a range of statutory duties, including safeguarding adults and children.

CDDFT- County Durham and Darlington NHS Foundation Trust.  

CHC- Continuing Health Care- also known as fully funded health care this is free care outside of hospital which is arranged and funded by the NHS.

Consent – is the voluntary and continuing permission of the person to the intervention based on having the mental capacity to understand the purpose, nature, likely effects and risks of that intervention.  

CPS- Crown Prosecution Service prosecutes criminal cases investigated by the police in England and Wales 

CQC- Care Quality Commission is responsible for the registration and regulation of health and social care in England.

CSC- Children’s Social Care

DBS- Disclosure and Barring Service

DSAPB- Darlington Safeguarding Adults Partnership Board is the statutory board within a Local Authority area that provides strategic leadership for safeguarding adults.

DSCB- Darlington Safeguarding Children Board is the statutory board within a Local Authority area that provides strategic leadership for safeguarding children

DWP- Department of Work and Pensions

EDT - Emergency Duty Team social services teams that respond to out-of-hours referrals where intervention from the council is required to protect a vulnerable child or adult.  

Enquiry Duty stipulated by Section 42 of the Care Act, a duty on the Local Authority to make enquiries or cause others to do so to establish if any action is required in the case of an adult at risk.

FME- Forensic Medical Examiner 

Formal Enquiry is the process of establishing the facts and gathering evidence in relation to a safeguarding concern. A Safeguarding Adults Manager (SAM) will be appointed to oversee the Formal Enquiry.

Healthwatch Darlington- Healthwatch Darlington Limited is an independent consumer champion for health and social care in Darlington. The organisation helps to shape and improve local health and social care in our community. 

Independent Advocacy - Where appropriate representation is not available for an adult in accordance with the Care Act 2014 the Local Authority must ensure that an independent advocate is sought to support and represent the adult.

Initial Enquiry- is initial response of the Local Authority after a concern of abuse or neglect has been raised. It involves gathering information to determine what action, if any, should be taken. The subsequent action may involve a formal enquiry or risk management response.

Liquid Logic- Case Management System for Adults and Children's Social Care.  

LLR- lessons learned Review – where the criteria for a Safeguarding Adult Review (SAR) are not reached a LLR can be undertaken.

MAPPA - Multi-Agency Public Protection Arrangements are statutory arrangements for managing sexual and violent offenders.

MARAC - Multi-Agency Risk Assessment Conference is the multi-agency forum that manages high-risk cases of domestic abuse which could include, stalking, ‘honour’- based violence and forced marriage.

Mental Capacity see Capacity.

MSP – Making Safeguarding Personal is ensuring that safeguarding arrangements are person-led and outcome-focused.

NEAS –The North East Ambulance Service

NHS England - The general function of NHS England is to promote a comprehensive health service so as to improve the health outcomes for people in England. It also ensures that the health commissioning system as a whole is working effectively to safeguard adults vulnerable to abuse or neglect. 

NPCC- National Police Chief’s Council (formerly ACPO) 

NPS – National Probation Service - The National Probation Service work in partnership with Community Rehabilitation Companies, the police, Court, and both private and voluntary sector partners to manage offenders safely and effectively and to reduce reoffending 

PREVENT is one strand of the Governments Counter Terrorism Strategy CONTEST. Its aim is to stop individuals becoming terrorists or supporting terrorism.

Public Interests Decision- a decision about what is in the public interest needs to be made balancing the rights of the individual to privacy with the rights of others to protection

RJ- Restorative Justice- Restorative justice brings those harmed by crime or conflict and those responsible for the harm into communication, enabling everyone affected by a particular incident to play a part in repairing the harm and finding a positive way forward.

Safeguarding Concern is the first contact between a person concerned about abuse or neglect and the Local Authority when there is a concern that an adult at risk is or may be a victim of abuse or neglect.

SAL - Safeguarding Adults Lead – is the title given to the member of staff in an organisation who is given the lead for safeguarding adults. The role may be combined with that of Safeguarding Reporting Manager, depending on the size of the organisation.

SAMs – Safeguarding Adult Managers are professionals within adult social care, who have overall responsibility for managing the safeguarding arrangements in line with the Care Act 2014 as the lead agency.

TEWV- Tees Esk and Wear Valleys NHS Foundation Trust - provides a range of Mental Health, learning disability and eating disorder services in the North East of England   

SAR - Safeguarding Adult Reviews are a statutory function undertaken by Safeguarding Adults Boards.  They are reviews into the death or serious harm of an adult at risk  when it is suspected that abuse or neglect has played a part in the death or harm to the person and there is reasonable cause for concern about how the organisations worked together to safeguard the adult.

Safeguarding Adults Team - this is the team within Darlington Borough Council who support review and development of all safeguarding issues but also provide guidance and advice to professionals and the Safeguarding Adults Board.

SCIE- Social Care Institute for Excellence

SEO – Safeguarding Enquiry Officer - can be a member of Adult Social Care or any other organisation/provider who will make formal enquiries/investigations on the organisation behalf into the safeguarding concern.

Safeguarding Plan is a record of the arrangements to safeguard the adult at risk within a Formal Enquiry.

Self-Neglect- self-neglect covers a wide range of behaviours such as an individual neglecting to care for personal hygiene, health or surroundings and is included as a safeguarding category of abuse since the implementation of the Care Act 2014. 

SRM - Safeguarding Reporting Manager is the person within an organisation to whom staff are expected to report their concerns for example, a line manager (it may also be a designated Safeguarding Adults Lead within an organisation dependent upon the size of the organisation).

Strategy Discussion/Meeting – is a means of sharing information with relevant organisations and parties in order to agree how to proceed with a Formal Enquiry.

Safeguarding Review Meeting Review meetings are held after Safeguarding Strategy meetings, at least once every three months until actions are completed and an appropriate outcome is reached.

Safeguarding Planning Meeting - is a multi-agency meeting between relevant organisations involved with the Adult with needs for care and support to agree how to proceed with the enquiry.

UKHTC- UK Human Trafficking Centre which deals with referrals of modern slavery from police, local authorities and other non-governmental organisations.

Vital Interests Decision- is a term used within this procedure to describe actions critical to prevent serious harm or distress or in life-threatening situations.

Whistleblowing is when a worker reports suspected wrongdoing at work. 

Wilful neglect or ill treatment- is the intentional failure of any person who has responsibility for the charge, care or custody of an adult with needs for care and support to provide the amount and type of care that a reasonable person would be expected to provide.

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