Overarching Aims, Duties and Principles

The duty to safeguard an adult applies when all of the following criteria is met:

1. The adult has needs for Care and Support (whether these have been assessed or are being met by the local authority or not);
2. They are experiencing, or at risk of experiencing abuse or neglect; and
3. As a result of Care and Support needs they are unable to protect themselves against the abuse or neglect.

Therefore, an adult at risk could:

• Be old and frail due to ill health, physical disability or cognitive impairment;
• Have a learning disability;
• Have a physical disability and/or a sensory impairment;
• Have mental health needs including dementia or a personality disorder;
• Have a long term illness/condition;
• Misuse substances or alcohol;
• Be a carer such as a family member/friend who provides personal assistance and care to adults and is subject to abuse;
• Be unable to demonstrate the capacity to make a decision and is in need of care and support.

Note: An adult is a person aged 18 or above.

1. The adult has needs for Care and Support

The term 'needs for care and support' is not precisely defined within legislation or statutory guidance. Within Gateshead, we adopt the suggested definition contained within Understanding what constitutes a safeguarding concern and how to support effective outcomes (Local Government Association).

Safeguarding duties apply regardless of whether a person's care and support needs are being met, whether by the local authority or anyone else. They also apply to people who pay for their own care and support services.

An adult with care and support needs may be:

• An older person;
• Someone with mental health needs, including dementia or a personality disorder;
• A person with a long-term health condition;
• Someone who misuses substances or alcohol to the extent that it affects their ability to manage day-to-day living.

Consideration of this need for care and support must be person-centred (for example, not all older people will be in need of care and support but those who are 'frail due to ill health, physical disability or cognitive impairment' may be). The above is not an exhaustive list and it must be considered alongside the impact of needs on the adult's individual wellbeing.

There are 10 areas of potential need (outcomes) set out in the Care Act:

• Manage and maintain nutrition;
• Maintain personal hygiene;
• Manage toilet needs;
• Being appropriately clothed;
• Be able to make use of their home safely;
• Maintain a habitable home environment;
• Develop/maintain family and other personal relationships;
• Access/engage in work, training, education or volunteering;
• Make use of community services;
• Carry out caring responsibilities for a child.

It must be noted that an individual does not have to be eligible for care and support under the Care and Support (Eligibility Criteria) Regulations 2014 for a safeguarding concern to be raised or for the local authority S42 duty to apply.

If there is reasonable cause to suspect that the adult has needs for care and support then this condition should be deemed as met.

2. The adult is experiencing, or at risk of experiencing abuse or neglect

Partners should not limit their view of what constitutes abuse or neglect, as they can take many forms and the circumstances of individual cases should always be considered.

Responses and decisions should be based on personal circumstances and take into consideration the actual or potential impact on the adult's wellbeing together with their view on the impact that the abuse or neglect has had upon them.

The Care Act 2014 sets out 10 specific categories of abuse and neglect.

For information about these categories, and examples of how the accompanying abuse or neglect may be experienced, see: The Care Act 2014, Categories of Abuse and Neglect.

The diagram below sets out factors that might be considered in making the necessary judgements about 'reasonable cause to suspect'; and whether the situation reflects the statutory criteria:

Diagram source: Making decisions on the duty to carry out Safeguarding Adults enquiries (Local Government Association).

3. As a result of Care and Support needs, the adult is unable to protect themselves against the abuse or neglect

Potential barriers to an adult's ability to protect themselves might include:

• They do not have the skills, means or opportunity to self-protect;
• They may have a disability which impairs their capacity to make decisions about protecting themselves or may need support to enact decisions;
• They live in a group setting where they lack control over the way they are treated or the environment;
• There is a power imbalance;
• They may not understand an intention to harm them;
• They may be trapped in a domestic situation which they are unable to leave, or where coercion and control means they cannot make a decision about making change;
• Their resilience and resourcefulness to protect themselves from harm is eroded by, for example, coercive control and / or a high risk environment.

An adult's risk of harm is determined by a range of interconnected factors, including personal characteristics, factors associated with their situation or environment and social factors.

Some of these factors are described below:

Wellbeing is the single most important concept of the Care Act. The duty to promote individual wellbeing applies at all times; in every single process, conversation or decision that is made and you must be able to demonstrate that you have done so.

Promoting wellbeing means actively seeking improvements in aspects of wellbeing when carrying out any care and support function. This includes safeguarding.

There are 9 wellbeing domains:

1. Personal dignity;
2. Physical or mental health;
3. Protection from abuse and neglect;
4. Control over day to day life;
5. Participation in work, education, training or recreation;
6. Social and economic wellbeing;
7. Domestic, family and personal relationships;
8. Suitability of living accommodation;
9. Contribution to society.

Under the Care Act the wellbeing domains are all as important as each other. Any hierarchy can only be determined or described by the adult whose wellbeing it is. This means that, even though the process is safeguarding, the 'Protection from abuse and neglect' wellbeing domain may not be the most dominant area of concern for the adult.

It is vital that you understand your duties in relation to promoting individual wellbeing. 

See: The Care Act 2014, Promoting Individual Wellbeing.

As part of the safeguarding process you must understand:

1. Which areas of wellbeing are most important to the adult at that moment in time;
2. Which areas of wellbeing are least important at that time;
3. Whether there are other areas of the adult's life important to them but not listed as a domain (the domains under the Act are not definitive as wellbeing is personal);
4. Which areas of wellbeing are causing the adult concern or worry;
5. What impact any concern or worry is having (or could have) across the wellbeing domains (is there a destabilising effect?); and
6. How the adult thinks any Care and Support needs interact and impact on wellbeing.

1. Always assume that the adult is best placed to judge their own wellbeing;
2. Enable the adult to participate as fully as possible in the process and in decision making;
3. Always seek and take into account the views, wishes and feelings of the adult before making any decision or taking any action;
4. If a person is unable to express a present view, wish or feeling always take into account any past views, wishes or feelings they have expressed;
5. Ensure that decisions made have regard for the things that are important to the person and are not based on assumptions, preconceptions or judgements;
6. Never advocate risk management measures that do not take account of individual Wellbeing;
7. Work together with other professionals to ensure wellbeing is promoted throughout the safeguarding process;
8. Work to achieve a balance between the wellbeing of the adult and the wellbeing of any other adults with care and support needs, or any carers;
9. Minimise restrictions on individual rights or freedoms of the adult.

Gateshead Safeguarding Children's Partnership and Safeguarding Adults Board have published a Joint Information Sharing Protocol. This can be found in the Contacts and Practice Resources area.

The Seven golden rules for information sharing provide a useful framework for practitioners. Sharing of information between practitioners and organisations is essential for effective identification, assessment, risk management and service provision. Early sharing of information is the key to providing effective early help where there are emerging problems. Fears about sharing information cannot be allowed to stand in the way of the need to promote the welfare and protect the safety of children and adults.