Protecting adults at risk in London: Good practice resource

Situations and responses

The eight situations described below would produce decisions and actions under the pan-London multi-agency safeguarding procedures (2). It is not an exhaustive list, and other circumstances could also result in actions under the procedures.

In any safeguarding situation, remember the Department of Health’s key principles:

  1. Empowerment: a presumption of person-led decisions and informed consent.
  2. Protection: support and representation for those in greatest need.
  3. Prevention: it is better to take action before harm occurs.
  4. Proportionality: a proportionate and least intrusive response appropriate to the risk presented.
  5. Partnership: local solutions achieved via 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 delivering safeguarding.

Empowering people throughout the safeguarding process is key, whether or not they have mental capacity to make decisions about keeping safe. It is important, though, for practitioners to be confident when supporting person-led decision-making, that decisions are truly understood and led by the person at risk, and not by others. In the situations that follow, therefore, it is worth remembering that important decisions such as whether to report a matter to the police will require practitioners to work hard to establish that fully informed choices are being made, and that the adult at risk is really being empowered to make their own decisions.

Situation 1

A person with mental capacity to make decisions about their own safety is abused in their own home by a relative, partner, friend, neighbour, acquaintance or stranger, or neglected by a relative, partner or neighbour.

Click here to see the possible responses.

Situation 2

A person with mental capacity to make decisions about their own safety is abused or neglected in a care setting by a relative or friend, but there is no risk to other residents.

Click here to see the possible responses.

Situation 3

A person who is assessed not to have mental capacity to make decisions about their own safety is abused or neglected in their own home by a relative, partner, friend, neighbour, acquaintance or stranger, or neglected by a relative, partner or neighbour.

Click here to see the possible responses.

Situation 4

A person with mental capacity to make decisions about their own safety is abused or neglected in their own home by a paid carer, professional, support worker or volunteer providing services, or is abused or neglected in a care setting (e.g. hospital, day services, residential or nursing home).

Click here to see the possible responses.

Situation 5

A person who is assessed not to have mental capacity to make decisions about their own safety is abused or neglected in their own home by a paid carer, professional, support worker or volunteer providing services, or is abused or neglected in a care setting (e.g. hospital, day services, residential or nursing home).

Click here to see the possible responses.

Situation 6

A person with mental capacity to make decisions about their own safety is abused or neglected by a personal assistant who is paid from a personal budget that is wholly controlled by the adult at risk.

Click here to see the possible responses.

Situation 7

A person who does not have mental capacity to make decisions about their own safety, and is in receipt of a personal budget, is abused or neglected by a personal assistant who is employed by a person who is managing their budget on their behalf.

Click here to see the possible responses.

Situation 8

An adult at risk abuses another adult at risk who uses the same service.

Click here to see the possible responses.