The brief guide (which replaces a document developed before the Care Act 2014) summarises the responsibilities of the key statutory safeguarding partners as set out in the Care Act 2014.
This guide:
- summarises how the adult safeguarding system works in England, the legal and policy background, and the importance of making safeguarding personal to people’s individual situations and wishes
- sets out who does what and what key services are available to support effective and appropriate safeguarding adults’ services
- describes the role of the regulator of health and social care (CQC)
- describes the role of people who work in organisations which provide health or care services in the public, private and voluntary sector in safeguarding practice.
The aim of safeguarding adults is to:
- prevent harm and reduce the risk of abuse to adults with care and support needs
- stop abuse or neglect wherever possible
- ensure people have access to resolution and recovery, including criminal, civil, social and restorative justice)
- support families and communities to understand how to reduce the risk of abuse and 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 life for the adults concerned and address what has caused the abuse or neglect
- provide information and support in accessible ways to help people understand the different types of abuse, how to stay safe and what to do to raise a concern about the safety or wellbeing of an adult
- raise public awareness so that communities, alongside professionals, play their part in preventing, identifying and responding to abuse and neglect.
Additionally, safeguarding adults is about:
- commissioning care and support in ways which promote good quality of care that prevents abuse or neglect
- learning lessons and making changes that could prevent similar abuse or neglect happening to other people through learning and development programmes for staff and through reflective practice and/or change of policy.
This guide seeks to provide clarity and support from a national level to inform local approaches. Regardless of your seniority at work there should be a focus on good practice, multi-disciplinary working and knowing when to escalate a situation to allow more formal intervention.
This document has been developed with help from TLAP drawing on Making It Real statements to highlight the importance of Making Safeguarding Personal, which aims to work alongside the person who needs support so that plans are developed with focus on their desired outcomes.
A glossary of useful links and an explanation of phrases can be found at the end of this page. Wherever you see a word or phrase in bold this means there is an explanation or further information in the glossary.
What is the legal and policy context?
The Care Act 2014 is the legislation and sets out a series of duties and responsibilities placed on local authorities to provide support and services for people who have care and support needs. The Act includes duties and responsibilities in relation to safeguarding people who are experiencing or at risk of abuse or neglect. That abuse or neglect could be from people they live with, people in the community, online, or from paid or unpaid carers; at home, in care homes, hospitals or other institutions.
This guide does not replace formal Care Act statutory guidance. It encourages collective leadership and partnership, supporting people locally to understand that safeguarding is everybody’s business. This includes situations where someone pays for their own care. The aim is to ensure that the right things are done by the right people at the right time, working within their own agency and with partners.
The Mental Capacity Act 2005, Human Rights Act 1998 and Equality Act 2010, alongside the Care Act 2014, are important in the delivery of effective safeguarding practice.
How the adult safeguarding system works
All councils with adult social service responsibilities have set up a Safeguarding Adults Board (SAB), often with an Independent Chair. Each SAB will provide local information, generally on its website, which sets out local adult safeguarding processes, roles, and responsibilities. The Act says that the SAB must:
- include the local authority, the NHS, and the police, who should meet regularly to discuss and act upon local safeguarding issues
- develop shared plans for safeguarding, working with local people to decide how best to protect adults in vulnerable situations
- publish this safeguarding plan and report to the public annually on its progress, so that different organisations can make sure they are working together in the best way.
What the law says about making safeguarding enquiries: (1) This section applies where a local authority has reasonable cause to suspect that an adult in its area (whether or not ordinarily resident there) — (a) has needs for care and support (whether or not the authority is meeting any of those needs), (b) is experiencing, or is at risk of, abuse or neglect, and (c)as a result of those needs is unable to protect himself or herself against the abuse or neglect or the risk of it. (2)The local authority must make (or cause to be made) whatever enquiries it thinks necessary to enable it to decide whether any action should be taken in the adult’s case (whether under this part or otherwise) and, if so, what and by whom.
The lead organisation for safeguarding work in each area remains the local council with responsibility for social services. In areas with county councils and local councils, it is the county council that is responsible for adult social care and safeguarding. In other areas (for example in towns and cities) one council covers all services, including adult social care and safeguarding.
Care Act Guidance on raising safeguarding concerns and carrying out enquiries
If someone is concerned that a person with care and support needs is experiencing or at risk of abuse or neglect, they should raise a concern with the council responsible for adult social services in their area. It is best practice to obtain consent from the adult, however if this is not possible, the professional should ensure that the adult has made an informed decision (if possible). If consent is not given, this should not stop a concern being raised. The council will then arrange for its staff to gather more information and decide what to do next.
Since the Care Act Guidance has been produced, the LGA and ADASS have also produced helpful frameworks and tools on ‘What constitutes a Safeguarding Concern’’ and how to support effective outcomes, as well as ‘Making Decisions on the duty to carry out safeguarding adult enquiries’. The aim of these documents is to ensure that there is the widest possible shared understanding of the Care Act section 42 (1) regarding raising safeguarding concerns and section 42 (2) regarding what needs to be considered when conducting a safeguarding enquiry.
Mental Capacity Act 2005
The Mental Capacity Act 2005 (MCA) is a significant piece of legislation. It sets in place key rights in relation to decision making including the right to make unwise decisions. People’s views should always be taken into account, even if they lack the capacity to make a specific decision. The following principles from the MCA framework and guidance sets out what to do.
A person must be assumed to have capacity unless it has been established that he lacks capacity.
A person is not to be treated as unable to make a decision unless all practical steps to help him do so have been taken without success.
A person is not to be treated as unable to make a decision merely because he makes an unwise decision.
An act done, or a decision made, under this Act for or on behalf of a person who lacks capacity must be done or made in his best interests.
Before the act is done, or the decision is made, regard must be had to whether the purpose [can be] effectively achieved in a way which is less restrictive of the person’s rights and freedom of action."
MCA Section 1
You should start by assuming that people do have the capacity to make decisions, unless something suggests that is not the case. It is important to remember that people may have capacity for some decisions, but not others; and that in some situations people’s decision making can also be compromised by other things, like the coercive control of someone else.
People who are subject to coercive control may not be able to have the free and open conversations we would like. Their thinking patterns and decision making may have been compromised by the people around them or their environment. For example, they may blame themselves for the abuse, feel they deserve it, or worry about losing the support they do have (however inadequate it is). For some people, the only person they see is the person who is abusing them. Sometimes, the windows of opportunity to see the reality of people’s lives and intervene are brief.
The Deprivation of Liberty Safeguards (DoLS)are the processes used to authorise a deprivation of liberty caused by the way in which the person needs to be cared for or supported. Needing to deprive someone of their liberty in order to provide them with essential care or support is not automatically a safeguarding matter.
But if people are deprived of their liberty WITHOUT the right processes being followed, it could be a safeguarding matter because it means that they don’t have the protection of someone independent visiting and making sure the restrictions on them are necessary and proportionate.
So, if you come across someone who is being cared for in a restrictive way, without a Deprivation of Liberty Safeguarding Order being in place, get in contact with your local safeguarding team.
A Deprivation of Liberty describes a situation where someone is under continuous supervision, and control, and is not free to leave the place where they are living. Where this happens because someone needs care, and they don’t have the mental capacity to agree to the restrictions being used, people who provide care must apply for agreement to local authorities or Integrated Care Systems. (ICS).