Safeguarding means protecting an adult’s right to live in safety, 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 that the adult’s wellbeing is promoted including, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action. This must recognise that adults sometimes have complex interpersonal relationships and may be ambivalent, unclear or unrealistic about their personal circumstances.
Organisations should always promote the adult’s wellbeing in their safeguarding arrangements. People have complex lives and being safe is only one of the things they want for themselves. Professionals should work with the adult to establish what being safe means to them and how that can be best achieved. Professionals and other staff should not be advocating “safety” measures that do not take account of individual wellbeing (see Promoting Wellbeing).
Safeguarding duties of the local authority apply to adults who:
- have needs for care and support (whether or not the local authority is meeting any of those needs); and
- is experiencing, or at risk of, abuse or 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.
Regardless of whether the local authority is providing any services, it must follow up any concerns about either actual or suspected adult abuse.
The adult experiencing, or at risk of abuse or neglect will hereafter be referred to as the ‘adult’ throughout this APPP, replacing previous terms of adult at risk or vulnerable adult.
Local authority statutory adult safeguarding duties apply equally to adults with care and support needs:
- regardless of whether those needs are being met, including those whose needs for care have not been assessed as eligible or which have been assessed as below the eligibility level for support;
- regardless of whether the adult lacks mental capacity or not in relation to decisions about their own safety or other decisions relating to safeguarding processes and activities (see Mental Capacity);
- regardless of setting, except prisons and approved premises.
The duties also apply to adults funding their own care arrangement and those who manage their own care through personal or health budgets.
1.1.1 Young adults
Where a person is 18 or over but is still receiving children’s services and a safeguarding issue is raised, the matter should be dealt with through adult safeguarding arrangements. This may be, for example, when a young person with substantial and complex needs continues to be supported in a residential educational setting until the age of 25.
Where appropriate, adult safeguarding services should involve the local authority’s children’s safeguarding colleagues as well as any relevant partners (for example, the police or NHS) or other people relevant to the case.
It is not the level of needs that is relevant where there is a safeguarding concern. The young adult does not need to have eligible needs for care and support or be receiving any particular service from the local authority, in order for the safeguarding duty to apply, so long as the conditions set out in Section 1.1, Eligibility are met.
1.1.2 Prisoners and persons in approved premises
Prison governors and the National Offender Management Service have respective responsibility for prisoners and those in approved premises. Senior representatives of these services may sit on the Safeguarding Adults Board and play an important role in the strategic development of adult safeguarding locally. They may alternatively ask for advice from the local authority when faced with a safeguarding issue that they are finding particularly challenging.
Authorities do have a duty under the Care Act to undertake needs assessments for adults who are prisoners or who live in approved premises. The Safeguarding Adults Board can act as a forum for members to exchange advice and expertise to assist prison and probation staff in ensuring that all people in custodial settings are safeguarded.
1.1.3 Personal budgets and self-directed care
Increasingly, people are deciding to use less traditional ways of having their eligible social care and health care needs met. Many are taking the opportunity to exercise greater choice and control over what kinds of services they receive, who provides them and the way in which they are delivered. This transformation brings with it opportunities and challenges from the perspective of risk enablement and safeguarding.
Regardless of the person’s preferred method of managing a personal budget (for example local authority managed account, direct payment, individual service account or a combination of these), the local authority still retains its duty of care with regard to the person and their protection from abuse. However, the balance of power and consequently how risk is managed can be significantly different from previous, traditional models of social care management. This model is more about the co-production of risk enablement, with the person having a greater say and therefore greater control over how risk is managed. This is therefore an inherently less risk averse arrangement than before.
Throughout the process, from self-assessment (supported or otherwise) through to personal budget setting, arranging direct payments or other management arrangements, to final signoff of a support plan, appropriate risk assessment should be taking place with the individual and their supporters.
At the various key stages in the process, risk and safety should be considered:
- self-assessment: initial identification of any safeguarding issues, either one-off or ongoing. If these needs are being met, how is this being done? If they are not being met, they need to be clearly identified;
- budget setting: if significant safeguarding risks are identified as unmet needs, will the amount of the PB be sufficient to reduce or mitigate them?
- support planning: how will the support plan meet the safeguarding needs in outcome terms? What services are best suited to meet the adult’s needs and how will they be delivered in a person-centred way?
- sign off: authorisation of the support to ensure it is safe, legal, cost efficient and meets assessed needs.
In this arrangement people using personal budgets, to a greater or lesser degree, are the commissioners of their own services, particularly where they are using direct payments to manage them. Different arrangements exist to support people through the process of setting up a support package. In some areas, this may be the responsibility of local authority adult social care staff, independent brokerage services or User-Led Organisations (ULOs).
The kinds of support available may include:
- advice about safe recruitment;
- advice about safeguarding and dignity;
- using approved or accredited providers of employment services;
- advice and support in relation to the quality of services and contractual issues.
It should be remembered that, where someone has capacity to make their own decisions in these matters, they may choose not to seek or use such advice or support.
2. Principles of Adult Safeguarding
The Care and Support Statutory Guidance (Department of Health and Social Care) states that safeguarding should be based upon a community approach from all partners and providers and engage the person from the start, throughout and at the end to address their desired outcomes. See also Section 5, Making Safeguarding Personal. This policy and procedures are based on the following principles of safeguarding that should underpin all adult safeguarding work.
There are six principles which apply to all sectors and settings including care and support services, further education colleges, commissioning, regulation and provision of health and care services, social work, healthcare, welfare benefits, housing, wider local authority functions and the criminal justice system.
The principles should inform the ways in which professionals and other staff work with adults. The principles can also help SABs, and organisations more widely, by using them to examine and improve their local arrangements.
- Empowerment: People being supported and encouraged to make their own decisions and informed consent. “I am asked what I want as the outcomes from the safeguarding process and these directly inform what happens.”
- Prevention: It is better to take action before harm occurs. “I receive clear and simple information about what abuse is, how to recognise the signs and what I can do to seek help.”
- Proportionality: The least intrusive response appropriate to the risk presented. “I am sure that the professionals will work in my interest, as I see them and they will only get involved as much as needed.”
- Protection: Support and representation for those in greatest need. “I get help and support to report abuse and neglect. I get help so that I am able to take part in the safeguarding process to the extent to which I want.”
- Partnership: Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse. “I know that staff treat any personal and sensitive information in confidence, only sharing what is helpful and necessary. I am confident that professionals will work together and with me to get the best result for me.”
- Accountability: Accountability and transparency in delivering safeguarding. “I understand the role of everyone involved in my life and so do they.”
3. Aims of Adult Safeguarding
The aims of adult safeguarding are to:
- stop abuse or neglect wherever possible;
- prevent harm and reduce risk of abuse and neglect for those adults with care and support needs;
- safeguard adults in a way that supports them in making choices and having control about how they want to live;
- promote an approach that concentrates on improving the life of the adult concerned;
- raise public awareness so that communities as a whole, alongside professionals, play their part in preventing, identifying and responding to abuse and neglect;
- provide information and support to help people understand abuse, how to stay safe and how to raise concerns;
- address the causes of abuse.
Safeguarding is not a substitute for:
- providers’ responsibilities to provide safe and high quality care and support;
- commissioners regularly assuring themselves of the safety and effectiveness of commissioned services;
- the Care Quality Commission (CQC) ensuring regulated providers comply with the fundamental standards of care or by taking enforcement action; and
- the core duties of the police to prevent and detect crime and protect life and property.
All people in the communities of Trafford Council have a right to:
- live a life that is free from violence, fear and abuse;
- be protected from harm and exploitation;
- independence which may involve a degree of risk.
In order to achieve this, partners should work together based on the safeguarding principles above and by sharing the following values:
- organisations working to protect an adult from experiencing or at risk of abuse or neglect will make the dignity, safety, and wellbeing of that individual a priority in their actions;
- appropriate safeguarding options should be discussed with the adult according to their wishes and preferences. They should take proper account of any additional factors associated with the individual’s disability, age, gender, sexual orientation, ‘race’, ethnicity, religion, culture or lifestyle;
- adults should be given information, advice and support in a form that they can understand and be supported to be included in all forums that are making decisions about their lives. They should be offered contact with independent organisations and advocacy services, where appropriate. The maxim ‘no decision about me without me’ should govern all decision making;
- all safeguarding activity should aim to enable adults to retain as much control as possible over their own lives. The adult should be the primary focus of decision making, determining what safeguards they want in place and provided with options so that they maintain choice and control;
- there is a presumption that adults have mental capacity to make informed decisions about their lives. If someone has been assessed as not having mental capacity, to make decisions about their safety, decision making will be made in their best interests as prescribed by the Mental Capacity Act 2005 and Mental Capacity Act Code of Practice (see Mental Capacity);
- all decisions should be made with the adult that promote their wellbeing and are reasonable, justified, proportionate and ethical;
- timeliness should be determined by the personal circumstances of the adult;
- every effort should be made to ensure that adults are afforded appropriate protection under the law and have full access to the criminal justice system when a crime has been committed;
- every consideration should be given as to how to support unpaid carers who may be struggling to care appropriately.
5. Making Safeguarding Personal
Making Safeguarding Personal is a person centred approach that aims to facilitate a shift in emphasis on applying rigid processes to a commitment to improving outcomes for adults experiencing, or at risk of, abuse or neglect. The key focus is recognising that people are experts in their own lives and by developing a real understanding of what people wish to achieve will afford the person greater control over their lives. It involves working with the adult (and their representatives) to determine how best their outcomes might be realised and regularly evaluating the extent of which desired outcomes have been met. This approach involves adults being encouraged to define their own meaningful improvements to change their circumstances and then to be involved throughout the safeguarding process, support planning and response.
Individuals need to be encouraged to make their own decisions as far as practicably possible and are provided with support and information to empower them to do so. This approach recognises that adults have a general right to independence, choice and self-determination including control over information about themselves.
Making safeguarding personal means it should be person led and outcome focused. It engages the person in a conversation about how best to respond to their safeguarding situation in a way that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety.
Staff should strive to deliver effective safeguarding consistently in line with the six principles of safeguarding (see Section 2, Principles). They should ensure that the adult has accessible information so that the adult can make informed choices about safeguarding: what it means, risks and benefits and possible consequences. Staff will need to clearly define the various options to help support them to make a decision about their safety.
There are, however, key issues that local authorities and their partners should consider (see Stage 2: Screening and Initial Decision Making, Section 2, Information Gathering).