Safeguarding Adults
Amendment
In August 2024, Section 9, Practice Guidance regarding Frequent Attenders, was added. This locally developed section was added in response to recent Lincolnshire Safeguarding Adults Partnership Board (LSAB) action.
“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.” (Care and Support Statutory Guidance, DHSC/GOV.UK, updated March 2024).
KEY POINTS
- Safeguarding is everyone’s business and all Adult Care practitioners will contribute to the response to safeguarding concerns including enquiries;
- Safeguarding is underpinned by the principles of Making Safeguarding Personal and our response should be person centred to ensure the best outcome is defined as far as possible by the person;
- Safeguarding should adopt a whole family approach, understanding the impact of harm on families and exploring the strengths in families and support networks to provide safety and support.
The quality of our front-line assessment and case management practice is promoted and measured by the Quality Practice Standards framework. Positive promotion of safety, risk and wellbeing is underpinned throughout these standards.
Quality Practice Standard 3 – ‘Safeguarding everyone’ specifically defines the best practice in how practitioners should respond to safeguarding concerns.
- Safeguarding concerns are addressed effectively to support everyone to live safely (Adult Care Safeguarding Policy and Procedures), with safeguarding concerns recorded and safeguarding referrals made where appropriate.
In addition to the Quality Practice Standards framework for assessment and case management teams, the specialist safeguarding enquiry and coordination practice undertaken by the Safeguarding Team is underpinned by Safeguarding Quality Practice Standards.
All of our Quality Practice Standards can be found in section 1 of the Local Resource Library.
Use the links below to access sections of the Care Act 2014 resource for information about the legal requirements of all safeguarding under the Act.
- Aims and Principles of all Adult Safeguarding;
- When Safeguarding Duties Apply;
- Identifying and Reporting Abuse and Neglect;
- The Response to a Concern about Abuse and Neglect.
The Care Act 2014 places a duty on Local Authorities and therefore Lincolnshire County Council (LCC) to take lead responsibility for ensuring that the obligations set out in the Act are carried out in partnership with all agencies and organisations that may come into contact with those people.
Under section 42 of the Care Act 2014, the safeguarding duties apply to an adult who:
- has needs for care and support (whether or not the 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 either the risk of, or the experience of, abuse or neglect.
See: Identifying and Reporting Abuse and Neglect, which is part of the larger Care Act 2014 resource.
Adults and children (member of the public and external organisations)
Concerns should be raised via telephone:
Children’s: 01522 782111 (Monday to Friday, 8am-6pm)
Adults: 01522 782155 (Monday to Friday, 8am to 6pm)
Outside of office hours: 01522 782333
For further guidance see: Report a safeguarding concern
If you are concerned that an adult or child is in imminent danger from abuse or neglect, or that a criminal act has taken place, you should contact the police by dialling 999.
Adults and Children (LCC Internal use)
Where there is cause to suspect a child or adult at risk is suffering or likely to suffer significant harm, the relevant safeguarding procedures must be followed.
A telephone referral must be made as soon as possible:
Children's: 01522 782111 (Monday to Friday, 8am-6pm)
Adults': 01522 782155 (Monday to Friday, 8am-6pm)
For further guidance see the 'Raising Concerns about a Vulnerable Child or Adult at Risk Joint Protocol for Children’s Services and Adult Care'. This can be found in section 2 of the Local Resource Library.
A Police Information Sharing Procedure (Lincolnshire County Council intranet) is in place between Adult Care and Community Wellbeing (ACCW) and the Police, which now allows staff to request information to support their assessments around safeguarding risks and concerns. Generally requests will fall into two categories: those linked to Section 42 Enquiries (including urgent enquiries), and those that support ongoing assessments and risk considerations. The process map for the two methods of making requests can be found in section 2 of the Local Resource Library along with forms. Recording a request for information and responses should be recorded on the social care record as appropriate when considering information governance and/or disclosure.
If you are concerned that an adult or child is in imminent danger from abuse or neglect, or that a criminal act has taken place, you should contact the police by dialling 999.
Adult Care safeguarding policy and procedures
See: Adult Safeguarding Policy and Procedures
Multi-agency safeguarding policy and procedures
See: LSAB Multi-Agency Safeguarding Adults Policy and Procedure
These policies and procedures set out specifically how the Local Authority works with other organisations in the area, such as the police and the NHS Lincolnshire Integrated Care Board (ICB) to fulfil the requirements of the Care Act, including how they:
- prevent and protect adults at risk from abuse;
- empower and support adults to make their own choices;
- investigate actual (or suspected) abuse or neglect; and
- support adults who are at risk of, or are experiencing, abuse or neglect.
All of the policies and procedures must be adhered to by people employed directly by Adult Care and also by people employed by Lincolnshire Partnership NHS Foundation Trust (LPFT), who undertake social care duties on behalf of LCC.
All safeguarding processes, forms and guidance can be found in section 2 of the Local Resource Library.
This includes, but is not limited to:
- Adult Safeguarding Process Map;
- Hospitals Safeguarding Adults Process;
- Safeguarding Risk Assessment Tool;
- Poor Practice Concern Form, Flowchart and Guidance.
The Lincolnshire Safeguarding Adults Board (LSAB) is a multi-agency partnership, comprising of a range of organisations that all have stakeholder interest in the Safeguarding Adults agenda. The LSAB steers safeguarding activity and promotes partnership working across agencies to promote safer communities and prevent abuse and neglect.
The main objective of the LSAB is to assure itself that local safeguarding arrangements and partners act to help and protect adults in Lincolnshire.
It is the Board’s firm belief that adults at risk are best protected when we work closely and consistently together in responding to people at risk or suffering harm.
See the Safeguarding Adults Board section of The Care Act 2014 and find out more about:
- the aim of Safeguarding Adults Boards;
- their role and statutory duties;
- when boards must carry out a Safeguarding Adults Review (SAR).
All partner members of the LSAB are required to adhere to the LSAB multi-agency Safeguarding policies and procedures. In addition, each partner agency is required to have in place its own policies and procedures for safeguarding adults under the umbrella of the multi–agency procedures.
For further information about our Safeguarding Adults Board, see the Lincolnshire Safeguarding Adults Board website. The website also contains further information and resources to support safeguarding adults activity across Lincolnshire.
The Mental Capacity Act 2005 should be effectively applied when an adult that is experiencing, or is at risk of experiencing, abuse or neglect lacks capacity to either recognise the abuse, protect themselves, or make decisions under the safeguarding process.
For detailed information and guidance around applying the Mental Capacity Act 2005 in practice, and the Court of Protection see: The Mental Capacity Act 2005 Resource and Practice Toolkit.
Just because someone has capacity, it is not always the case that we cannot and should not intervene to support them to live safely.
At times, we may work with adults in need of safeguarding, who may be reluctant to accept support. Complex cases may feature complex mental health needs, fluctuating capacity, coercive control, alcohol misuse and substance misuse, autism, learning disabilities and/or self-neglecting behaviour. It is often that these cases are well known to one or more agencies and there are challenges for services in keeping the person engaged as they may be unwilling or unable to accept help. As a result, there may be no multi-agency plan to manage the presenting needs and risks to the person.
‘The multi-agency partnership will not always be able to achieve positive outcomes where individuals are not able or ready to accept help. Nonetheless, such challenging and high-risk situations are when the multi-agency partnerships should be working hard together, exploring every avenue to try and reduce risks.’ (Lincolnshire SAR). National SAR Analysis found in some cases, there was insufficient persistence – sometimes agencies were noted to take refusal at face value and too quickly cease their attempts.
Professionals should seek to understand the person’s lived experience, rather than just focusing on their current presentation, to help understand their current circumstances. The skills of professional curiosity, perseverance, persistence, tenacity, and recognising the time needed to build trust along with a multi-agency approach are noted as playing an important role when people were reluctant to engage. A multi-agency, collaborative approach is evidenced as the most effective approach to working with these cases; a multi-agency meeting, inclusive of the adult, carer and/or family, can be convened by any agency.
If all of the above has been tried and remains unsuccessful in engaging the person in the process, it is important to understand the reason for the person's decision and accept this, unless doing so would put others at risk. However, it is important to ensure that the person is clear that 'the door is always open' and is provided with appropriate contact details, so they can re-engage when they choose to. Any organisation who has contact with the individual should be involved in the multi-agency plan and they can be used to remind the person of the support available, and alert the multiagency partnership if the situation deteriorates, this should be carefully documented in the protection plan risk assessment.
For cases where adults are not attending planned appointments or are not being supported to attend, please see LSAB’s ‘Did Not Attend or Was Not Supported to Attend’ guidance.
The Mental Capacity Act 2005 and the Court of Protection cannot be used where the person has capacity to make decisions, but, in exceptional circumstances, the High Court has the power to intervene using its inherent jurisdiction.
Lead practitioners should seek management and legal advice about whether an application should be made to the Court where our assessments show a person with capacity is:
- experiencing or is at risk of abuse or neglect;
- making decisions under duress or coercion; or
- making repeated decisions that put them at grave risk.
See: Legal Services
These powers are increasingly being used to protect people with capacity where there is reason to believe decisions which put them at risk are being taken under duress or undue influence from others.
Team Around the Adult (TAA) commenced as a pilot in February 2021 and has continued. It offers District Council officers a pathway into additional support and bespoke intervention. The programme aims to offer support to particularly complex cases where a more creative approach is required in order to reach out to people in the community and ‘go to them’, particularly in situations where there has been a pattern of the person not wishing to engage with services.
The route into the TAA is through the Vulnerable Adult Panel, or similar Multi-Disciplinary meeting, hosted by the District Council. The coordinator will work with the case worker, to engage with the individual, promote multi-agency working, and utilise a shared IT system. The aim is to achieve change where more traditional engagement and intervention methods have not been as successful as anticipated, or change may not have been maintained.
The Vulnerable Adult Panel, or similar, will ensure a coordinated multi-agency response to the case, aiming to provide access to the appropriate accommodation, support and assistance. However, where the more complex needs and limited engagement of the individual with agencies are indicated, the support of the Team Around the Adult will be considered.
Each District Council operates slightly differently in terms of the arrangements that they have for dealing with vulnerable adults with complex needs. Some have a regular monthly meeting with a core group of attendees. Some District Councils establish a Multi-Disciplinary Meeting when the need arises. Some areas link in with other Networks already in place, such as the Neighbourhood Team. The ambition of the TAA is to encourage practitioners to be flexible and to work together in a way that best suits the needs of the area.
The Team Around the Adult can offer support through a case discussion where the case is complex and practitioners may be feeling ‘stuck and/or where individuals are in a ‘revolving door referral’ to agencies, and who have several inter-related needs. In such cases, with the agreement of their line manager, practitioners can contact the TAA coordinators to request a case discussion.
For more information about TAA, see the Lincolnshire County Council website.
The Lincolnshire Safeguarding Adults Partnership Board (LSAB) completed a Team Around the Adult (TAA) case audit, which identified the importance of agencies/organisations to appropriately respond to an individual with care and support needs, who frequently presents to them. When an adult frequently attends, this is an opportunity to explore if a conversation is required with partners to determine if everything possible has been undertaken or if a Multi-Disciplinary Team (MDT) meeting is required.
The following SCIE video proposed by LSAB Partnership serves as a reminder of the benefits of multi-agency meetings, particularly when working with adults who frequently present to services. To access the video, see: What are multidisciplinary teams? (Integrated care)
In line with good practice, practitioners should do the following:
- Review the history of a case when a new referral is received, and this would include understanding any previous referrals and the outcomes to them, consideration of risks and involvement of any other persons/agencies that may be able to help. This can help us to collectively build a picture and risk assess how best to support the person.
- Be professionally curious when engaging with people - use your communication and observational skills to explore and understand what is happening with a person (and their carer) rather than making assumptions or accepting things at face value.
- Professional curiosity requires practitioners to think ‘outside the box’ and consider a persons’ circumstances holistically, listening, asking direct questions and being able to hold difficult conversations.
- If an individual is repeatedly referring over a short period of time or has a high level of referrals, we would expect that practitioners would pause and reflect on a case and allow additional time to review the details of this individual and consider risks involved.
- Consider a review of support when a person attends frequently to see if we are meeting their needs effectively and look at alternatives.
- Make good use of supervision to discuss the person's situation and consideration of whether multi-agency working may collectively support them.
We do have practice guidance in place that supports the review of individuals who present to the service in a proactive rather than reactive way. Please find more information and guidance via the following links:
Deciding the Outcome of a Contact or Referral
Research in Practice: Professional curiosity in safeguarding adults: Strategic Briefing (2020)
PREVENT is part of the UK Government’s Counter-Terrorism strategy and its aim is to stop people being drawn towards terrorism or supporting terrorism. This involves supporting individuals who may be vulnerable to extreme ideologies and re-directing them to agencies who are able to offer bespoke support as opposed to criminalising them. PREVENT training aims to give frontline staff, community workers, and people in the community an understanding of PREVENT, how it works and crucially, how important their role is within the strategy.
PREVENT Training is mandatory for all LCC staff with a refresh of training required every 5 years.
The Counter-Terrorism and Security Act 2015 (Section 29) places a duty on specified authorities to have 'due regard to the need to prevent people from being drawn into terrorism'. The duty commenced on 1st July 2015 for authorities specified in Schedule 6 and outlines how the duty should be implemented within each authority. More details, including the PREVENT referral form, can be found on LCC’s Intranet.
It is a requirement of the Care Act 2014 Statutory Guidance that Safeguarding Adults Boards should establish and agree a framework and process for any agency to respond appropriately to allegations against anyone who works (in either a paid or an unpaid capacity) with adults with care and support needs. The framework and process are referred to as the “Protocol”.
See: People in a Position of Trust Protocol (PiPoT)
This Protocol applies to all partner agencies of LSAB, and agencies commissioned to provide services when they identify or become aware of allegations against People in a Position of Trust (PiPoT).
People can be considered to be in a ‘position of trust’ when:
- they are likely to have contact with adults at risk as part of their employment or voluntary work; and
- where the role carries an expectation of trust; and
- the person is in a position to exercise authority, power or control over an adult(s) at risk (as perceived by the adult at risk).
The protocol details the actions that should be taken in these circumstances and information of the service areas it applies to.
PiPoT referrals should be made using the PiPoT Referral form. This can be found in the Local Resource Library under Safeguarding.
Changes have been made to the DASH Form within Mosaic to bring it in line with the National Form and reporting requirements. This includes a new question relating to the outcome of the risk level from the DASH form.
Practitioners are reminded of the need to complete the DASH form within Mosaic. This ensures our Performance Team and the Domestic Abuse Partnership can accurately report on the number of DASH forms completed and the outcome of these.
If you need to complete the paper form whilst on visits, please then transfer this onto the form within Mosaic. A DASH form must be completed on Mosaic for all cases where required, even if the DASH does not result in a referral to MARAC.
Please note, we are unable to report from uploaded documents on Mosaic, therefore it is important all DASH’s are completed using the Mosaic form.
The DASH form is available within Mosaic as an optional form from the following forms:
- Adult Safeguarding Concern;
- Adult Safeguarding Triage;
- Adult Safeguarding Enquiry;
- Adult Safeguarding Serious Case Review;
- Adult End of Safeguarding Activity.
Lincolnshire Domestic Abuse Specialist Service provides specialist support and assistance to families and individuals in Lincolnshire experiencing domestic abuse.
The service includes:
- A support hub and helpline, offering advice and guidance on a range of situations and signposting to relevant services;
- Support service for adults, children and young people;
- Recovery support;
- Online support and advice for all domestic abuse victims;
- An outreach and engagement team that provide proactive early interventions, targeting communities and individuals who may face barriers to accessing domestic abuse services;
- IDVA support for victims at the highest risk of serious harm.
The support package also includes specialist assistance for adults undergoing experiences such as stalking, controlling and coercive behaviour, and honour-based violence.
See Lincolnshire Domestic Abuse Specialist Service (ldass.org.uk)
Online Professional Referrals
See I'm a professional wanting to make a referral to LDASS
All referrals should be made using the online referral form. The web link provided below will take you straight to the professional referral form.
https://phoenix.ecdesk.org/forms/pu...ce-ldass-professional-referral-form
Once you have submitted the online referral, the system will give you the option to receive a PDF copy of your completed referral which will be sent to you.
NOTE: As per the criteria of the service, you will not be able to submit the referral form online without a completed DASH being attached.
The DASH form and guidance notes can be accessed via the Professionals Hub (Domestic abuse – Professional resources (lincolnshire.gov.uk)). Alternatively, the DASH form can be downloaded (DASH-2023-FINAL-VERSION.docx (live.com)). Practitioners are reminded of the need to complete the DASH form within Mosaic – see: Dash forms in Mosaic (trixonline.co.uk).
The online referral form has been developed to ensure that the necessary information is received to enable the service to fully assess the risk and eligibility at point of entry; therefore, many fields on the referral form are now mandatory.
Further information
For more information regarding Domestic Abuse and the Domestic Abuse Partnership, please follow the links below:
Domestic Abuse - Home (sharepoint.com)
About Lincolnshire Domestic Abuse Partnership (sharepoint.com)
Domestic abuse – Professional resources (lincolnshire.gov.uk)
Last Updated: August 12, 2024
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