Adult 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 also promoting the adult’s wellbeing.
Where appropriate, safeguarding should have regard to the adult’s views, wishes, feelings and beliefs when deciding what action may be needed. Safeguarding should be person-centred, proportionate, rights-based and focused on the outcomes that matter to the adult.
Safeguarding is not only about formal statutory services. It may include advice, information, signposting, community support, practical help, risk management, or a safeguarding enquiry where the legal criteria are met. The aim is to support adults to be safe, promote wellbeing, and uphold rights, dignity and autonomy.
What do we mean by abuse or neglect?
Abuse or neglect can be a single incident or repeated acts. It may be intentional or unintentional. It can happen in any relationship or setting, including at home, in the community, in a care or health setting, in a service setting, in a public place, or online.
Abuse and neglect should always be considered in the circumstances of the individual situation. This includes considering whether other people may also be at risk, whether there appears to be a pattern of abuse, whether other people have witnessed abuse, and whether the risk involves family members, unpaid carers, paid staff, professionals, volunteers, organisations or other people.
The Care and Support Statutory Guidance identifies ten main types of abuse and neglect used in adult safeguarding practice. These are:
- physical abuse;
- domestic abuse;
- sexual abuse;
- psychological or emotional abuse;
- financial or material abuse;
- modern slavery;
- discriminatory abuse;
- organisational abuse;
- neglect and acts of omission;
- self-neglect.
Abuse types can overlap. An adult may experience more than one form of abuse or neglect at the same time.
When does adult safeguarding apply?
Under Section 42 of the Care Act 2014, the local authority’s statutory safeguarding duty applies where it has reasonable cause to suspect that an adult in its area:
- has needs for care and support, whether or not the local authority is meeting any of those needs;
- is experiencing, or is at risk of, abuse or neglect; and
- as a result of those care and support needs, is unable to protect themselves from the abuse or neglect, or the risk of it.
Where these criteria are met, the local authority must make, or cause to be made, whatever enquiries it thinks necessary to decide whether any action should be taken, and if so, what action and by whom.
A safeguarding concern is information that an adult with care and support needs may be experiencing, or may be at risk of, abuse or neglect. When a concern is raised, the local authority considers whether the Section 42 duty applies and what action, if any, is needed.
Who may be at risk?
“Adult at risk” means an adult who may have care and support needs and may be experiencing, or may be at risk of, abuse or neglect. The legally important test is the Section 42 Care Act test set out above.
Some adults may be at increased risk because of their circumstances, care and support needs, environment, relationships, communication needs, isolation, mental or physical health, disability, age-related frailty, acquired brain injury, substance misuse, coercion, exploitation, or barriers to accessing help.
The focus should be on the adult’s circumstances and support needs, not on labelling people as inherently vulnerable.
Where can abuse or neglect happen?
Abuse or neglect can happen anywhere. This may include:
- in the adult’s own home;
- in another person’s home;
- in a care home, supported living setting, hospital or other health or care environment;
- in a public place;
- in a workplace, education, community or faith setting;
- in a custodial or secure setting;
- through services, organisations or professional practice;
- online or through digital technology.
Places that appear safe can still be places where abuse, neglect, exploitation or poor practice occurs. Abuse may also happen alongside other risks, such as domestic abuse, exploitation, coercion, self-neglect, hoarding, hate crime, modern slavery or organisational abuse.
Who can cause abuse or neglect?
Anyone can cause abuse or neglect. This may include:
- a spouse, partner or ex-partner;
- another family member or relative;
- a friend, neighbour or acquaintance;
- an unpaid carer;
- a paid member of staff, professional or volunteer;
- another person using a service;
- a person who deliberately targets, grooms, coerces or exploits adults;
- an organisation or service where poor systems, unsafe cultures or poor practice cause harm;
- a stranger.
The primary focus of adult safeguarding should remain on the adult with care and support needs who is experiencing, or is at risk of, abuse or neglect.
Types of abuse and neglect
Evidence of one possible indicator should not automatically be treated as proof that abuse is happening, but it should prompt consideration of the adult’s circumstances, risks, wishes and support needs.
The examples below are not exhaustive. If you are worried that abuse or neglect may be happening, you should seek advice or raise a safeguarding concern.
Physical abuse
Physical abuse includes assault, hitting, slapping, pushing, kicking, misuse of medication, inappropriate or unlawful restraint, forcible feeding, withholding food, or other actions that cause physical harm.
Possible signs may include unexplained injuries, injuries that do not fit with the explanation given, repeated injuries, signs of restraint, fearfulness, or changes in behaviour around a particular person.
Domestic abuse
Domestic abuse is defined in the Domestic Abuse Act 2021. Behaviour is domestic abuse where both people are aged 16 or over, are personally connected to each other, and the behaviour is abusive.
Abusive behaviour includes:
- physical or sexual abuse;
- violent or threatening behaviour;
- controlling or coercive behaviour;
- economic abuse;
- psychological, emotional or other abuse.
It does not matter whether the behaviour is a single incident or a course of conduct.
Economic abuse means behaviour that has a substantial adverse effect on a person’s ability to acquire, use or maintain money or other property, or to obtain goods or services.
Domestic abuse can affect anyone, regardless of sex, gender identity, age, disability, ethnicity, religion, sexuality, financial circumstances or background. It may also be relevant to adult safeguarding where the adult has care and support needs and is unable to protect themselves from the abuse or risk of it.
Sexual abuse
Sexual abuse includes sexual activity, contact or behaviour where the adult has not consented, has been pressured into consenting, or lacks capacity to consent to the specific decision at the relevant time.
Sexual abuse may include:
- rape or sexual assault;
- sexual harassment;
- inappropriate looking or touching;
- sexual teasing or innuendo;
- sexual photography;
- being made to watch sexual acts;
- being exposed to pornography against the person’s wishes;
- any sexual act to which the adult has not consented or was pressured into consenting.
Psychological or emotional abuse
Psychological or emotional abuse may include intimidation, coercion, threats, humiliation, harassment, bullying, isolation, verbal abuse, controlling behaviour, cyber bullying, or actions that undermine a person’s dignity, confidence, independence or sense of safety.
It may include preventing someone from seeing friends or family, stopping them from making choices, restricting their access to services or support, threatening harm or abandonment, or repeatedly treating them in a degrading, patronising or frightening way.
Financial or material abuse
Financial or material abuse can include theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements, pressure about wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions, benefits or other assets.
The Care Act 2014 states that abuse includes financial abuse. This includes:
- having money or other property stolen;
- being defrauded;
- being put under pressure in relation to money or other property;
- having money or other property misused.
Financial or material abuse may also amount to economic abuse within domestic abuse where the Domestic Abuse Act 2021 criteria are met.
Modern slavery
Modern slavery may include slavery, servitude, forced or compulsory labour, human trafficking and exploitation.
It may involve a person being controlled, coerced, deceived, threatened or forced into labour, services or other exploitation. This can include domestic servitude, forced labour, sexual exploitation, criminal exploitation, or situations where a person is unable to leave because of threats, debt, fear, control, deception or abuse of power.
Discriminatory abuse
Discriminatory abuse includes harassment, slurs, exclusion or unequal treatment because of a protected characteristic.
The protected characteristics under the Equality Act 2010 are:
- age;
- disability;
- gender reassignment;
- marriage and civil partnership;
- pregnancy and maternity;
- race;
- religion or belief;
- sex;
- sexual orientation.
Discriminatory abuse may include verbal abuse, derogatory remarks, inappropriate language, harassment, deliberate exclusion, denial of rights or services, or failure to make reasonable adjustments or provide accessible support where required.
Organisational abuse
Organisational abuse is abuse, neglect or poor care practice within an organisation, institution or specific care setting. This may include care homes, hospitals, supported living services, home care providers or other services.
It may be a one-off incident or ongoing poor practice. It may arise from poor leadership, unsafe culture, inadequate staffing, poor supervision, rigid routines, lack of dignity or privacy, inappropriate restraint, or failure to respond to concerns or complaints.
Organisational abuse can happen when systems, processes or cultures place adults at risk or fail to protect people from harm.
Neglect and acts of omission
Neglect and acts of omission include ignoring medical, physical care, emotional or other support needs linked to the adult’s ability to remain safe and well.
Examples may include failure to provide or allow access to:
- food or drink;
- shelter, clothing or heating;
- personal care;
- medical care or medication;
- social contact or meaningful activity;
- communication support;
- equipment or aids needed for daily living;
- support needed to promote safety, dignity and wellbeing.
Neglect may be deliberate, but it may also happen because a carer, service or organisation is struggling or failing to provide appropriate support.
Self-neglect
Self-neglect includes a wide range of behaviours where an adult is not caring for their personal care, health, wellbeing or environment, and this places them at risk.
Self-neglect can include:
- neglecting personal hygiene;
- neglecting health needs;
- living in unsafe or unsanitary conditions;
- hoarding;
- not seeking help or not accessing services;
- difficulty managing personal affairs;
- inability or unwillingness to manage risks to safety and wellbeing.
Where self-neglect creates significant risk, practitioners should consider whether the Section 42 criteria are met. Where the statutory criteria are not met, other proportionate multi-agency risk management routes may still be appropriate.
Making Safeguarding Personal
Adult safeguarding should be person-centred, proportionate and outcomes-focused. Making Safeguarding Personal means working with the adult, listening to their views and wishes, and involving them as fully as possible in decisions about what should happen next to improve their quality of life, wellbeing and safety.
The six adult safeguarding principles are:
- Empowerment – people are supported and encouraged to make their own decisions and give informed consent.
- Prevention – it is better to take action before harm occurs.
- Proportionality – the least intrusive response appropriate to the risk presented.
- Protection – support and representation for those in greatest need.
- Partnership – local solutions through services working with their communities.
- Accountability – accountability and transparency in safeguarding practice.
Safeguarding responses should seek to stop abuse or neglect, reduce risk, promote wellbeing, protect rights, and, wherever possible, support the adult to achieve the outcomes that matter to them.
What should I do if I am worried?
Everyone has a role in recognising and responding to abuse or neglect.
If you are worried that an adult with care and support needs may be experiencing, or may be at risk of, abuse or neglect, you should seek advice or raise a safeguarding concern through Warrington’s adult safeguarding reporting route.
You should:
- listen to the adult and take what they say seriously;
- consider whether anyone is in immediate danger;
- preserve evidence where a crime may have occurred;
- seek emergency help where there is immediate risk of harm;
- consider the adult’s views, wishes, feelings and desired outcomes;
- share relevant information where there is a lawful basis to prevent harm or protect others;
- raise a safeguarding concern where an adult with care and support needs may be experiencing, or may be at risk of, abuse or neglect;
- record what has been seen, heard, disclosed or reported, and what action has been taken.
If someone is in immediate danger, or a crime is happening now, contact the emergency services.
If there is no immediate danger but you are worried that an adult with care and support needs is experiencing, or is at risk of, abuse or neglect, raise an adult safeguarding concern using Warrington’s current adult safeguarding reporting route.
Local practice and statutory duties
Local safeguarding pathways and multi-agency processes can support effective partnership working and risk management. They should be used alongside, not instead of, statutory duties.
Statutory duties must always be applied in accordance with legislation and statutory guidance, including the Care Act 2014 and the Care and Support Statutory Guidance.