STAGE 1: CONCERNS
What is an adult safeguarding concern?
An adult safeguarding concern is any worry about an adult who has or appears to have care and support needs, that they may be subject to, or may be at risk of, abuse and neglect and may be unable to protect themselves against this. The adult does not need to be already in receipt of care and support.
A concern may be raised by anyone, and can be:
- An active disclosure of abuse by the adult, where the adult tells a member of staff that they are experiencing abuse and/or neglect;
- A passive disclosure of abuse where someone has noticed signs of abuse or neglect, for example clinical staff who notice unexplained injuries;
- An allegation of abuse by a third party, for example a family/friend or neighbour who have observed abuse or neglect or have been told of it by the adult;
- A complaint or concern raised by an adult or a third party who doesn't perceive that it is abuse or neglect. Complaint officers should consider whether there are safeguarding matters;
- A concern raised by staff or volunteers, others using the service, a carer or a member of the public;
- An observation of the behaviour of the adult at risk;
- An observation of the behaviour of another;
- Patterns of concerns or risks that emerge through reviews, audits and complaints or regulatory inspections or monitoring visits (CQC, Monitor etc.).
Concerns can be raised in a variety of ways.
Some concerns may not sit under adult safeguarding processes, but remain concerns that may require other action. All concerns should be responded to, and SABs should be satisfied that concerns are being addressed appropriately through their oversight of safeguarding practice.
Police Engagement Staff contact with the police will fall into four main areas:
A. Reporting a crime – if an individual witnesses a crime, they have a duty to report it to the police;
B. Third party reporting of a crime – if an individual is made aware of a crime, they should support the adult at risk to report to the police, or make a best interest decision to do so (refer to Mental Capacity Act section 3.1). In domestic abuse situations practitioners should be aware of the principles of ‘Safe Enquires’ (see adult safeguarding and domestic abuse);
C. Consultation with the police – seeking advice;
D. Sharing intelligence and managing risk – where there is an integrated MASH, this will be the channel for information sharing, in addition to agreed information sharing protocols.
Where the safeguarding concerns arise from abuse or neglect deliberately intended to cause harm, then it will not only be necessary to immediately consider what steps are needed to protect the adult but also how best to report as a possible crime. Early engagement with the police is vital to support the criminal investigation.
PRIOR TO RAISING A CONCERN WITH THE LOCAL AUTHORITY:
IMMEDIATE ACTION BY THE PERSON RAISING THE CONCERN
The person who raises the concern has a responsibility to first and foremost safeguard the adult at risk:
|THE SAFEGUARDING MANAGER/LEAD SHOULD REVIEW ACTION TAKEN, AND:|
Considerations prior to raising a concern with the Local Authority
The organisation’s safeguarding representative or lead will usually lead on decision making. Where such support is unavailable, consultation with other more senior staff should take place. In the event that these are unavailable, seeking the advice of the Local Authority should be considered.
Staff should also take action without the immediate authority of a line manager:
- If discussion with the manager would involve delay in an apparently high-risk situation;
- If the person has raised concerns with their manager and they have not taken appropriate action (whistleblowing).
Decisions need to take into account all relevant information that is available, including the views of the adult in all circumstances where it is possible and safe to seek their views. If the adult does not want to pursue matters through safeguarding action, staff should be sure that the adult is fully aware of the consequences of their decisions, and that all options have been explored and that not proceeding further is consistent with legal duties.
There may be some occasions when the adult at risk does not want to pursue a referral to the Local Authority. It is best practice to gain the adult’s consent but when this cannot be gained, the concern can still be raised where necessary. Be specific about the adult’s views. Where there is a potentially high risk situation, staff should be vigilant of possible coercion and the emotional or psychological impact that the abuse may have had on the adult.
Decision makers also need to take account of whether or not there is a public or vital interest to refer the concern to the Local Authority. Where there is a risk to other adults, children or young people or there is a public interest to take action because a criminal offence had occurred and the view is that it is a safeguarding matter, the wishes of the adult may be overridden. Where the sharing of information to prevent harm is necessary, lack of consent to information sharing can also be overridden. For further information, refer to Berkshire’s Information Sharing Protocol and Appendix 2 Information Governance. This should include where the adult at risk is deceased or the alleged perpetrator is a professional.
In the event that people lack the capacity to provide consent, action should be taken in line with the Mental Capacity Act 2005. (See Section 3.1). Where a possible crime has been committed people should always be encouraged to report the matter to the police.
Some local areas may have a Threshold Guidance Document for practitioners to refer to.
|GOOD PRACTICE GUIDANCE – DISCLOSURE|
Referral to the Local Authority
If, on the basis of the information available, it appears that the following three steps are met a referral must be made to the Local Authority.
Information the referral might contain
Organisations that refer to the Local Authority should include the following information:
- Demographic and contact details for the adult at risk, the person who raised the concern and for any other relevant individual, specifically carers and next of kin;
- Basic facts, focussing on whether or not the person has care and support needs including communication and on-going health needs;
- Factual details of what the concern is about: what, when, who, where;
- Immediate risks and action taken to address risk;
- Preferred method of communication;
- If reported as a crime, details of which police station/officer, crime reference number etc.;
- Whether the adult at risk has any cognitive impairment which may impede their ability to protect themselves;
- Any information on the person alleged to have caused harm;
- Wishes and views of the adult at risk, in particular consent;
- Advocacy involvement (includes family/friends);
- Information from other relevant organisations for example, the Care Quality Commission;
- Any recent history (if known) about previous concerns of a similar nature or concerns raised about the same person, or someone within the same household.