Safeguarding means protecting an adults’ life to live in safety and 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 the adults wellbeing is promoted, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action (The Care Act 2014)
Safeguarding at risk adults is the responsibility of all staff (employed, contracted and who volunteer) who during the course of their job come directly or indirectly into contact with at risk adults.
The CCG Safeguarding team encompasses the six safeguarding principles as part of the multi-agency approach to safeguarding: prevention, protection, empowerment, proportionate responses, partnership and accountability. Our guidance and procedures are based on the principle that people should be enabled and supported to make their own decisions about their lives and should be made aware of any choices and options available to help them make decisions.
The six principles and the Care Act (2014) highlight the concept of promoting the individual’s wellbeing and ensuring that Safeguarding is person-led and outcome-focused. The statutory guidance advocates that local authorities in conjunction with their partner agencies make safeguarding a personalised experience, aiming to achieve the outcomes identified by adults at risk of harm and abuse, rather than a people being taken through a process:
- The CCG will support people to be in control of decisions about their own lives.
- The CCG will support services and staff to recognise abuse, know how to seek advice and report concerns. Making safeguarding personal involves supporting those at risk to identify, assess and make informed decisions about situations of risk.
- The CCG will support carers to understand their rights, ensure their needs are recognised and are supported in fulfilling their role.
- Those patients funded by the CCG for Continuing Healthcare or Funded Nursing Care will be involved wherever possible in discussions about safeguarding referrals, and any strategy meetings or case conferences about them.
What is abuse?
Types of Abuse
The board recognises that abuse may take many forms and its impact on the person concerned is what matters. It is the duty of anyone suspecting abuse to report it appropriately. Abuse may include:
Including assault, hitting, slapping, pushing, misuse of medication, restraint or inappropriate physical sanctions.
Including psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence.
Including rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography or witnessing sexual acts, indecent exposure and sexual assault or sexual acts to which the adult has not consented or was pressured into consenting.
Including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyber bullying, isolation or unreasonable and unjustified withdrawal of services or supportive networks.
Including theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.
Encompasses slavery, human trafficking, forced labour and domestic servitude. Traffickers and slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment.
Including forms of harassment, slurs or similar treatment; because of race, gender and gender identity, age, disability, sexual orientation or religion.
Including neglect and poor care practice within an institution or specific care setting such as a hospital or care home, for example, or in relation to care provided in one’s own home. This may range from one off incidents to on-going ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation.
Including ignoring medical, emotional or physical care needs, failure to provide access to appropriate health, care and support or educational.
Self-neglect is defined as covering a wide range of behaviours – failure to meet own personal hygiene, health or surroundings and includes behaviour such as hoarding.
Examples of self-neglect include:
- Lack of self-care – examples: neglect of personal hygiene, nutrition, hydration, health, thereby endangering safety and well-being,
- Lack of care of one’s environment – examples: squalor and hoarding,
- Refusal of services that may lessen the risk of potential harm.
Who is an adult at risk?
An adult at risk is a person aged 18 or over, who is or may be unable to protect themselves against significant harm due to age, illness or disability (e.g. physical impairment, learning disability, mental health condition).
An adult with care and support needs may be for example:
- An older person
- A person with a physical disability, a learning difficulty or a sensory impairment
- Someone with mental health needs, including dementia or a personality disorder
- A person with a long-term health condition
- Someone who misuses substances or alcohol to the extent that it affects their ability to manage day-to-day living.
- Someone who may be isolated, feel victimised, coerced, and unable to prevent potential abuse or neglect because of such factors.
It is important to remember that a person's disability or age does not in itself make the adult at risk. The majority of adults who could be considered as 'at risk' will never experience abuse and with the right support in place can safeguard themselves.
An adult's ability to protect themselves and safeguard their wellbeing will be affected by:
- Personal circumstance AND
- Risks arising from their environment COUNTERED BY
- Resilience factors
It's important to see the person and not just the disability or illness as safeguarding is about working with people to help keep them safe.
Everyone is different and will have different needs so speak to them and their carers/families about how we can help them.
Safeguarding Adults Boards
A Safeguarding Adults Board is a group of partner organisations made up of a wide range of statutory (Local Authority, Police and CCG), independent and voluntary agencies and organisations. These all work together to keep adults, particularly those who are more at risk, safe from the possibility of abuse, harm or exploitation.
Safeguarding Adult Boards also promote the wellbeing of adults, ensuring that safeguarding activities are of a high quality and in line with the Care Act 2014.
Safeguarding Adults Boards in Cheshire East and Cheshire West and Chester help and support individual agencies in meeting their responsibilities by:
- Producing a business plan to provide a framework for all multi-agency activities within safeguarding
- Producing a comprehensive range of publicity information in accordance with the marketing strategy
- Producing a multi-agency training strategy
- Producing an Annual Report
Safeguarding Adults Reviews (SARs)
A Safeguarding Adult Review (SAR) is a multi-agency process that considers whether or not serious harm experienced by an adult, or group of adults at risk of abuse or neglect, could have been predicted or prevented. The process identifies learning that enables the partnership to improve services and prevent abuse and neglect in the future.
Please note that if you have current safeguarding concerns you will need to refer to the relevant Local Authority Safeguarding Team (see the what to do if I suspect abuse page/link).
The SAR process is only relevant to an adult with care and support needs in the area if:
a) There is reasonable cause for concern about how the Safeguarding Adults Board (SAB), members of it or other persons with relevant functions worked together to safeguard the adult
and either of the following conditions are met—
b) The adult has died, and the SAB 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)
c) The adult is still alive, and the SAB knows or suspects that the adult has experienced serious abuse or neglect.
Please follow the links below for more information and referral pathway:
Cheshire East Local Safeguarding Adult Board have published a Serious Adult Review linked to self-neglect and a fire risk. Our Independent Author for the review, Professor Michael Preston-Shoot, also did a 40 minute video that explores the national learning to date and evidence around self-neglect. We would highly recommend watching this via the link below and reading the review.
Making safeguarding personal
The Care Act (2014) emphasises the importance of ‘Making Safeguarding Personal’ which aims to develop an outcomes focus to safeguarding work, and a range of responses to support people to improve or resolve their circumstances. It is about engaging with people about the outcomes they want at the beginning and middle of working with them, and then ascertaining the extent to which those outcomes were realised at the end.
MSP means that the process of safeguarding adults at risk should be person-led and outcome focussed; it engages the person in a conversation about how best to respond to his/her safeguarding situation in a way that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety (Appendix 1 Care Act Statutory Guidance 14.15).
All adults should be supported to take control of their lives. The right balance needs to be sought between protecting adults and enabling them to manage their own risks. In order to do these, the adult involved need to be at the centre of any decision making around their own safety and wellbeing.
At the earliest opportunity, the adult at risk should be asked what they want to happen now, and what their desired outcomes are.