At a glance 44: Protecting adults at risk: London multi-agency policy and procedures to safeguard adults from abuse

Published: August 2011

Review date: August 2014

Key messages

Introduction

Living a life that is free from harm and abuse is a fundamental right of every person. All of us need to act as good neighbours and citizens in looking out for one another and seeking to prevent the isolation which can easily lead to abusive situations and put adults at risk of harm.

In London, as elsewhere, the main statutory agencies – local councils, the police and NHS organisations – need to work together to promote safer communities, to prevent harm and abuse and to deal with suspected or actual cases. That is why the key agencies in London have come together to produce Protecting adults at risk: London multi-agency policy and procedures. It is their firm belief that adults at risk are best protected when procedures between statutory agencies are consistent across London. The policy and procedures will help:

• improve inter-agency working
• avoid people falling between the gaps in services
• reduce duplication of work
• gain a better understanding of safeguarding across all agencies
• ensure alignment of language used across agencies.

The procedures aim to make sure that the safety, needs and interests of adults at risk are always respected and upheld. This includes upholding human rights.

The policy and procedures set out in Protecting adults at risk are designed to explain simply and clearly how agencies and individuals should work together to protect adults at risk.

All staff, in whatever setting and role, are the frontline in preventing harm or abuse occurring and empowering the person at risk to take action where concerns arise. The policy and procedures set out in Protecting adults at risk are designed to explain simply and clearly how agencies and individuals should work together to protect adults at risk. This At a glance briefing provides a summary of the policy and procedures.

Who is an 'adult at risk'?

An 'adult at risk' is someone who is 18 years or over who may be in need of community care due to a mental health problem, learning disability, physical disability, age or illness. As a result, they may find it difficult to protect themselves from abuse.

What is abuse?

There are many different types of abuse, including:

• Physical – this is 'the use of force which results in pain or 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'.
  
  
• Sexual – examples of sexual abuse include the direct or indirect involvement of the adult at risk in sexual activity or relationships which they do not want or have not consented to.
  
  
• Emotional and psychological – this is behaviour that has a harmful effect on the person's emotional health and development, or any form of mental cruelty that results in mental distress, the denial of basic human and civil rights such as self-expression, privacy and dignity.
  
  
• Institutional – institutional abuse is the mistreatment or neglect of an adult at risk by a regime, or individuals within settings and services, that adults at risk live in or use. Such abuse violates the person's dignity, resulting in lack of respect for their human rights.
  
  
• Discrimination – discriminatory abuse exists when values, beliefs or culture result in a misuse of power that denies opportunities to some groups or individuals.
  
  
• Financial and material – this is the use of a person's property, assets, income, funds or any other resources without their informed consent or authorisation. It includes theft, fraud, exploitation and the misuse or misappropriation of property, possessions or benefits.

What to do if an adult experiencing abuse tells you about it

If an adult experiencing abuse or neglect speaks to you about this, assure them that you are taking them seriously. Listen carefully to what they are saying, stay calm and get a clear and factual picture of the concern.

Be honest and avoid making assurances that you may not be able to keep, for example, complete

If an adult experiencing abuse or neglect speaks to you about this, assure them that you are taking them seriously.

All staff (professionals and volunteers) of any service involved with adults at risk should inform the relevant manager if they are concerned that an adult has been abused or may be at risk of harm.'

confidentiality. Be clear and say that you need to report the abuse. Do not be judgemental and try to keep an open mind.

If you hear about an incident of abuse from a third party (this is when someone else tells you about what they have heard or seen happen to a vulnerable adult at risk), encourage them to report it themselves or help them to report the facts of what they know.

What to do if you suspect abuse

Everyone with a duty of care to an adult at risk should:

• act to protect the adult at risk
• deal with immediate needs and ensure the person is, as far as possible, central to the decision making process
• report the abuse to an appropriate person or service (e.g. your line manager)
• if a crime has or may have been committed, contact the police to discuss or report it
• record the events.

A concern may be a direct disclosure by the adult at risk, or a concern raised by staff or volunteers, others using the service, a carer or member of the public, or an observation of the behaviour of the adult at risk, or the behaviour of another.

All staff (professionals and volunteers) of any service involved with adults at risk should inform the relevant manager if they are concerned that an adult has been abused or may be at risk of harm.

How to make a report of suspected abuse

All concerns of abuse or neglect of a vulnerable adult at risk can be reported to the relevant local safeguarding adults referral point. This is usually the appropriate local authority/Northern Ireland health and social care trust social services department. However, if a serious crime has taken place or there is a need for an immediate police response to protect the adult at risk, consider dialling 999.

What happens when I make a report of suspected abuse?

Referrals to the relevant safeguarding adults referral point will be taken from anyone who has a concern that an adult is at risk. The relevant local referral process should be used. This may be a specific referral form or a telephone call. Check with local authority/Northern Ireland health and social care trust websites for details. Details from the referrer about the allegation of abuse will be needed so it is helpful to have the facts of the circumstances ready to hand.

All concerns of abuse or neglect of a vulnerable adult at risk can be reported to the relevant local safeguarding adults referral point. This is usually the appropriate local authority/Northern Ireland health and social care trust social services department.

Protecting adults at risk is the responsibility of all the agencies working together.

The referral may be passed to the local safeguarding adults team or allocated to a worker who will seek to:

• clarify the circumstances of the alleged abuse or neglect
• take any immediate steps to protect the adult at risk, if needed
• decide if the safeguarding adult procedures are the required and appropriate response to the situation
• work in partnership with other agencies, like the police or health services, where necessary.

The allocated worker will call a multi-agency strategy meeting where details of the investigation and responsibilities will be agreed. Protecting adults at risk is the responsibility of all the agencies working together and they will all follow the 'Protecting adults at risk: London multi-agency policy and procedures to safeguard adults from abuse.'

Further information

SCIE report 39: Protecting adults at risk: London multi-agency policy and procedures to safeguard adults from abuse

SCIE report 41: Prevention in adult safeguarding

Personalisation briefings

• Implications for commissioners
• Implications for home care providers
• Implications for housing providers
• Implications for carers
• Implications for advocacy workers
• Implications for voluntary sector service providers
• Implications for personal assistants (PAs)
• Implications for user-led organisations (ULOs)
• Implications for residential care homes
• Implications for community mental health services
• Implications for for nursing homes
• Implications for people with autistic spectrum conditions and their family carers
• Implications for community learning disability staff
• Implications for occupational therapists
• Implications for social workers in adults’ services
• Implications for NHS staff
• Personalisation and mental capacity
• Implications of the Equality Act 2010
• Implications for lesbian, gay, bisexual and transgendered (LGBT) people

What is personalisation?

Personalisation means recognising people as individuals who have strengths and preferences and putting them at the centre of their own care and support. The traditional service-led approach has often meant that people have not been able to shape the kind of support they need, or received the right help. Personalised approaches like self directed support and personal budgets involve enabling people to identify their own needs and make choices about how and when they are supported to live their lives. People need access to information, advocacy and advice so they can make informed decisions. Personalisation is also about making sure there is an integrated, community-based approach for everyone. This involves building community capacity and local strategic commissioning so that people have a good choice of support, including that provided by user-led organisations. It means ensuring people can access universal services such as transport, leisure, education, housing, health and employment opportunities. All systems, processes, staff and services need to put people at the centre.

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