The Safeguarding Process
What is Safeguarding?
Safeguarding an adult is defined as:
'Protecting a person’s rights to live in safety, free from abuse and neglect'
Source: Care Act 2014
Who is an adult at risk?
The Care Act 2014 places a legal duty for safeguarding adults at risk when someone 18 years and over, meets the following three point test:
- Has needs for care and support (whether or not a 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 and neglect
This definition replaces the No Secrets guidance (DH2000) where the term ‘vulnerable’ was used.
If an adult meets the above criteria they will be assessed and considered for support through the safeguarding procedures.
It is key to remember that:
- Anyone can be a source of harm, including family members, partners, friends, neighbours, someone who works for the individual e.g. a personal assistant, strangers or people who work for or volunteer in health or social care services. It is very often though that the source of harm is in a position of trust and known to the person.
- Abuse can happen anywhere. It can happen in the home, in a workplace, in a nursing or residential home, in hospital or in the street.
- Abuse can happen once, a few times or lots of times. It can be deliberate or unintentional perhaps as a result of a lack of training, knowledge or understanding.
Categories of abuse
The following are categories of abuse within the Care Act:
- Physical - Hitting, slapping, pushing, kicking, misuse of medication, restraint, or inappropriate sanctions
- Sexual - Rape and sexual assault or sexual acts to which the vulnerable adult has not consented, or could not consent, or was pressured into consenting
- Psychological - Emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, isolation or withdrawal from services or supportive networks
- Financial or material - Theft, fraud, exploitation, pressure in connection with wills, property or inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits
- Neglect and acts of omission - Ignoring medical or physical care needs, failure to provide access to appropriate health, social care or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating
- Discriminatory - Racist, sexist, that based on a person’s disability, and other forms of harassment, slurs or similar treatment
- Organisational (replaces institutional) – including neglect and poor care practice within an institution or specific care setting such as a hospital or care home, for example or in relation to care provided in one’s own home. This may range from one off incidents to ongoing ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practice within an organisation
- Self-Neglect - this covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding. Because Self-Neglect is now a category of abuse, the former process of Vulnerable Adults Risk Management Model (VARMM) is now included within the safeguarding process but is now termed Self Neglect Adults Risk Management Model (SNARMM). For further information on how to manage cases within this model please refer to the Sheffield Safeguarding Adult Procedures
- Modern slavery - encompasses slavery, human trafficking, forced labour and domestic servitude. Slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment
- Domestic Violence - including psychological, physical, sexual, financial, emotional and so called honour based violence
It is also recognised that the following areas can be seen as abuse, however they are not recognised within the Care Act:
- Hate crime – Hate crimes and incidents are taken to mean any crime or incident where the perpetrator’s hostility or prejudice against an identifiable group of people is a factor in determining who is victimised. A person may be targeted because of hostility or prejudice towards that person’s: disability, race or ethnicity, religion or belief, sexual orientation or transgender identity. The crime can be committed against a person or property and a victim does not have to be a member of the group at which the hostility is targeted. In fact, anyone could be a victim of a hate crime.
- Mate crime – is similar to hate crime other than a perpetrator purports to be a friend or mate of the victim
- Internet abuse – adults exposed to abuse through digital media
This covers a wide range of behaviours, including neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding. Self-Neglect is now a category of abuse identified in the Care Act. The former process of Vulnerable Adults Risk Management Model (VARMM) is now included within the safeguarding process but is now termed Self Neglect Adults Risk Management Model (SNARMM).
The SNARMM model involves planning a multi-agency meeting to discuss the involvement of and the knowledge held by each agency and develop an action plan that aims to reduce the risks.
The SNARMM model can be used:
- Where an adult has capacity to make the decision(s) that is creating significant concern for agencies about the adults safety and/or wellbeing (risk of serious injury/death) and the adult is making that decision of their own free will.
- Where there is no external source of harm – the risk arises from the individual's refusal to engage with services and/or self-neglect in one or more areas of their lives.
- Where existing care management and health and social care involvement has failed to resolve the issues.
For further information on how to manage cases within this model please refer to the Sheffield Safeguarding Adult Procedures.
There are already established processes to deal with these concerns in Sheffield. If you need further information please contact Sheffield City Council’s Adult Access Team on 0114 2734908.
Identifying a Concern
Please click here for more information on what to do if a concern is identified, and the process after a 'concern' is made.
Visit the webpage >>
Advice on whether to raise a concern can be sought from:
1)In the first instance please contact your organisational Safeguarding Lead, so if you are a GP this would be your Practice Safeguarding Lead, if you are a CCG employee this would be the CCG Safeguarding Team etc.;
2) If your Safeguarding Lead in unavailable or your Safeguarding Lead needs some advice or support then please contact:
Sue Mace, Head of Safeguarding / Designated Nurse Safeguarding Children on 0114 3051239 or email firstname.lastname@example.org
Dr Amy Lampard, Designated Doctor Safeguarding Adults, email: email@example.com
Kitty Reilly, Named Healthcare Professional-Safeguarding on 01143051229 or email firstname.lastname@example.org
3) Sheffield City Council’s Adult Access Team on 0114 2734908 or complete a Safeguarding Adults Concern Form. This should be emailed to Adult Access at email@example.com ONLY if you have a secure email (GCSX/gsi/pnn/cjsm/nhs.net etc).
N.B. Please note the email service operates Mon to Friday so any emails sent out of hours should also be supported by a telephone call to Adult Access on 0114 2734908.
Other useful contacts:
Mental Capacity Act 2005
The Mental Capacity Act 2005 came into force on 1 October 2007 and provides a statutory framework for people who lack capacity to make all or some decisions for themselves, or who have capacity and want to make preparations for a time when they may lack capacity in the future. It sets out who can take decisions, in which situations and how they should go about this.
The MCA applies to everyone who works in health and social care and is involved in the care, treatment and support of people aged 16 and over who are unable to make all or some decisions for themselves. See the information contained in the web pages and guidance for individuals, their families and professionals on what the MCA will mean to you.
IMCA number 01924454875- available for support and advice Monday to Friday 9 am to 5pm.
Mental Capacity Act >>
Mental Capacity Act Training >>
Deprivation of Liberty Safeguards >>
NHS Sheffield CCG safeguarding adults policy
Sheffield CCG’s safeguarding policy sets out the clear standards and requirements for staff employed by SCCG and services commissioned by it. It details SCCG’s governance arrangements for safeguarding and includes a generic section covering overall principles in relation to safeguarding. There are then separate sections covering each of the safeguarding topic areas:
- Safeguarding Adults (including Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS)
- Safeguarding Children
- Domestic Abuse
- Looked After Children
- Child Sexual Exploitation (CSE)
- Modern Slavery and Trafficking
- Female Genital Mutilation
- In respect of the services commissioned by SCCG, the Essential Standards Expected of Providers.
- GP Template Safeguarding Policy
A Safeguarding template policy has been developed by local safeguarding leads and NHS England, which you may wish to adopt and personalise within your organisation - click here to download the template.
The policy has been developed as a ‘one off’ and responsibility for updating it now lies with each practice.
If you have any queries re either the policy, please contact SCCGs relevant safeguarding lead.
Safeguarding Adults Glossary
Please click here to view the Safeguarding Adults Glossary.
The General Practitioner's Responsibility/Protocol for Safeguarding
The aim of this protocol is to provide GPs with a concise document that provides them with information that is needed to manage a situation where a child or vulnerable adult needs safeguarding and where to obtain advice and support.
The NHS Sheffield CCG Safeguarding Adults staff leaflet provides some essential information for NHS Sheffield CCG staff about Safeguarding Adults. It outlines that everyone has responsibilities in this area, and also gives details of how to seek further help or information on the following:
- recognise those individuals to whom safeguarding adults procedures apply
- take matters of potential abuse seriously and to discuss concerns with safeguarding leads
- actively listen to and record concerns without asking leading questions
- be timely, sensitive and maintain confidentiality as appropriate to each situation
- work in a coordinated way between organisations
- apply the service principles and practice of each organisation and the South Yorkshire Safeguarding Adults Policy and Procedures consistently
- promote human rights and every citizen’s access to the law
- support the rights of individuals by respecting self-determination and informed choice wherever possible
- acknowledge risk as an integral part of choice and decision-making
- act in ways which are proportionate to the perceived level of risk and seriousness
- ensure that risk assessments are completed and that these assessments are recorded and reviewed in order that risk can be minimised
- be effective in providing or negotiating solutions that are as simple and practical as possible and aim to prevent the risk of abuse recurring
- be sensitive to every individual’s identity including culture, beliefs and ethnic background, gender, disability, age and sexuality.
2019 training TBC.
Commissioned services have a contractual obligation, including independent providers, to evidence their assurance to Sheffield CCG, NHS England and the CQC their compliance around safeguarding. This is done using an audit tool where evidence is request to support your declaration of compliance.
If you require any support or information in relation to safeguarding assurance please contact NHS Sheffield CCG Safeguarding Team.
It is good practice to record on clinical systems when a patient is identified as being vulnerable or being managed within the safeguarding adults processes. Click here for suggested READ codes relating to vulnerability and, the safeguarding process.