Safeguarding Adults at Risk

This information webpage has been funded by MHCLG through the VCFS programme.

What is safeguarding?

Safeguarding refers to the actions, policies, and procedures designed to protect individuals who are unable to protect themselves from abuse or neglect due factors such as age, disability, physical or mental illness. Experiencing homelessness may exacerbate physical and/or mental ill-health and impact negatively upon individuals’ ability to care for and protect themselves.

Who is an ‘adult at risk’?

In safeguarding terms, an adult as risk is defined as a person aged 18 and over who:

• Has care and support needs (whether or not the local authority is meeting any of those needs) and;
• Is experiencing, or at risk of, abuse or neglect (including self-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.

Care and support needs arise from or are related to physical or mental impairment or illness. This can include conditions as a result of physical, mental, sensory, learning or cognitive disabilities or illnesses, substance use or brain injury.

What is abuse?

Types of abuse can include:

• Sexual abuse
• Psychological or emotional abuse
• Physical abuse
• Financial or material abuse
• Neglect
• Self-neglect
• Modern slavery
• Domestic abuse
• Discriminatory abuse
• Institutional abuse

Other forms of abuse are sometimes described, e.g, bullying, hate crime, cyber abuse, and coercive and controlling behaviour. Abuse can happen anywhere and can consist of single or repeated acts. An abuser can be anyone that comes into contact with an adult at risk and is often someone well known or close to them, or someone who is employed to care for them.

Why are people experiencing homelessness at risk of abuse?

People experiencing homelessness often present with a range of risks and needs which, if not addressed, increase the risk of abuse. Indicative examples are:

Interpersonal and Personal

• Mental health needs
• Dependency on alcohol and/or drugs
• Brain damage
• Difficulty in communicating
• Impact of trauma and adverse experiences
• Poverty

External

• Staff working in isolation
• Unconscious bias, stereotyping and prejudice
• Community disengagement, fear and resentment
• Lack of access to safe and adequate housing
• Lack of access to support to address health and social care needs
• Victim of gatekeeping and inflexible policies

What is a Safeguarding Adults Board (SAB)?

As per the Care Act 2014, there is a legal obligation that each local authority must have a Safeguarding Adults Board. Members of SABs comprise of senior leaders from various fields such as physical and mental health commissioners/providers, police, social care services, housing, substance misuse providers, DWP, Ambulance Trust, Fire and Rescue Service, probation, and voluntary agencies.

The purpose of SABs are to help and protect adults in cases of abuse and neglect by coordinating and ensuring the effectiveness of what each of its partners does. This may include:

• Commissioning Safeguarding Adult Reviews
• Developing and disseminating multi-agency policies and procedures
• Monitoring the performance of agencies and services
• Providing multi-agency training
• Sharing good practice and
• Suggesting service improvements and enhancements.

Each local authority will have mechanisms in place to respond to referrals of adult safeguarding concerns. These should be communicated to all local statutory, voluntary and community agencies and include clear policies and procedures for agencies to refer to.

SABs will carry out Safeguarding Adult Reviews where an adult with care and support needs has died or suffered significant harm as a result of abuse or neglect, including self-neglect, and there is concern about how agencies worked together.

How can workers raise a safeguarding alert?

As well as following local authority procedures, your organisation should have their own internal policies and procedures relating to adult safeguarding. These should go hand in hand with guidance from the local authority.

While safeguarding procedures may vary slightly between agencies and local authorities, they should all follow the same fundamental process:

1. Make sure the adult at risk is not in immediate danger. If necessary, seek urgent medical treatment.
2. Contact the police if you think a crime has been committed or if someone is in immediate danger.
3. Make safeguarding personal (see below section).
4. Raise a ‘safeguarding alert’ by informing your line manager or another manager within your organisation.
5. Make a written report recording your concerns and detailing anything you have seen including dates, times, people involved and any observed injuries.

Your organisation’s first priority should always be to ensure the safety and protection of an adult at risk. It is the responsibility of all staff to act on any suspicion or evidence of abuse or neglect and to pass on their concerns to a responsible person/agency.

Once a safeguarding alert has been raised, service managers will decide how to proceed with the concern. While an incident may fall within internal safeguarding procedures, it will not necessarily fall within local authority procedures. It is usually a managerial decision whether to report to local authority safeguarding teams or not.

Action must be taken as soon as possible to minimise any risk of harm or exploitation to individuals concerned. In the absence of management support, raise an alert to the local authority rather than doing nothing. In the first instance this will often be via the local Social Services helpline or emergency duty team.

• Make sure you know where your safeguarding policies and procedures are saved and that they are accessible.
• Ensure that you have an up-to-date list of relevant local contact details to be used if necessary.
• Make sure you know where to find your organisation’s whistleblowing policies and procedures, to be followed when reporting any safeguarding concern involving a colleague.

What happens after raising a safeguarding alert?

All safeguarding concerns should be fully investigated by the appropriate person i.e. Adult Social Care and/or the responsible manager within your organisation. Where it is suspected that a criminal act has taken place, the Police should be involved immediately as they may conduct their own investigations. If the suspected abuser is another member of staff, suspension or disciplinary proceedings may ensue.

The stages to be followed when conducting an adult safeguarding enquiry are:

• Establish the facts through robust information gathering
• Ascertain the adult’s wishes and views; if the person declines safeguarding support, ways should still be considered for managing or mitigating risks
• Assess the adult’s needs for protection, support and redress, and how these needs should be met
• Protect the adult from abuse and/or neglect in accordance with their wishes
• Make decisions on follow-up action regarding the individual or organisation responsible for the abuse or neglect
• Enable the adult to achieve resolution and redress.

Making safeguarding personal

Where the adult at risk would have substantial difficulty in engaging and participating in a safeguarding enquiry, advocacy to support them should be provided.

There are six principles that should inform all decision-making:

• Empowerment – look beyond the presenting problem to the backstory; listen, hear and acknowledge, see and build on the person’s strengths; consider the need for advocacy; involve the person and their circle of support.
• Prevention – commissioning to avoid revolving doors and to provide integrated wrap-around support; transitions out of prison or hospital as opportunities to plan for meeting needs; building family and community circles of support.
• Protection – address risks of abuse and neglect, and of premature mortality; in-reach and outreach to build up and sustain a relationship through which to provide practical assistance and emotional support.
• Partnership – no wrong door; make every contact count; be flexible about how to engage; build a team around the person.
• Proportionality – minimise risk; judge the level of intervention required.
• Accountability – get the governance right; system-wide leadership; clearly explain and record decisions.

Staff should be mindful of client confidentiality during the investigation. Support plans and risk assessments should be revised. Staff should look out for any consequences of the investigation on other clients in the service, and take action as a team to manage emerging risks or support needs. The investigation should result in an action plan to stop the abuse and/or to manage the risks that have been identified. The Care Act statutory guidance requires staff to listen to and take account of the wishes of a competent client, even if the client’s decisions appear unwise. If there is any doubt about mental capacity, an assessment must be completed.

VOICES (Voices Of Independence, Change & Empowerment in Stoke-on-Trent) have produced a safeguarding homelessness toolkit which can be downloaded below. The aim of this toolkit is to aid fact-finding and decision-making in the context of adults experiencing multiple exclusion homelessness.