Risk of repeated abuse on others Others not at risk Possibly at risk Others at serious risk Are others (adults and/or children) at risk of being abused: Very unlikely? Less likely if significant changes are made? This perpetrator/setting represents a threat to other vulnerable adults or children. Types of abuse and seriousness Concerns may be notified to the Local Authority but these are likely to be managed at Initial Enquiry stage only. Professional judgement or concerns of repeated low level harm will progress to further stages in the safeguarding adults process. Concerns of a significant or critical nature should be referred to the local authority (with consent of the alleged victim where this is relevant and appropriate to do so). They will receive additional scrutiny, and progress further, under safeguarding adults procedures. Where a criminal offence is alleged to have been committed, the Police will be contacted. Other emergency services should be contacted as required. Low Significant or critical Physical error causing no/little harm e.g. friction mark on skin due to ill-fitting hoist sling. events that still meet criteria for ‘incident reporting’ accidents. Medication does not receive prescribed medication (missed/wrong dose) on one occasion – no harm occurs. incident involving service on service user. marking found on one occasion. event where users lack capacity. Medication missed medication or administration errors that no harm. Inexplicable marking or lesions, cuts or grip marks on a number of occasions. Accumulations of minor incidents. Recurring missed medication or errors that affect more than one adult and/or result in harm. Deliberate maladministration of medications. Covert administration without proper medical authorisation. Inappropriate restraint. Withholding of food, drinks or aids to independence. Inexplicable fractures/injuries. Assault. bodily harm/assault with a weapon leading to irreversible damage or death. of recurring errors or an incident of deliberate maladministration that results in ill-health or death. Sexual (including sexual exploitation) incident of teasing or low-level unwanted sexualised attention (verbal or touching) directed at one adult by another whether verbal sexualised teasing or banter. Recurring sexualised touching or isolated or recurring masturbation without consent. Voyeurism without consent Being subject to indecent Attempted penetration by any means (whether or not it occurs within a relationship) without consent. Being made to look at in a relationship characterised by authority inequality or exploitation e.g. receiving something in return for carrying out a sexual act.
or not capacity exists. exposure. Grooming including via the internet and social media. pornographic material against will/where consent cannot be given. without consent (rape). incident adult is spoken to in a rude or inappropriate way – respect is undermined but no/little distress caused. taunts or verbal outburst. of information to disempower. Treatment that undermines dignity and esteem. Denying or failing to recognise adult’s choice or opinion. Humiliation. Emotional blackmail e.g. threats or abandonment/harm. Frequent and frightening verbal outbursts or harassment. of basic human rights/civil liberties, over-riding advance directive. intimidation. verbal attacks. Low Significant or critical Financial personally benefit from users funds e.g. accrue ‘reward’ points on their own store loyalty cards when shopping. not recorded safely and properly. not routinely involved in decisions about how their money is spent or kept safe – capacity in this respect is not properly considered. of care fees not impacting on care. Adult’s monies kept in a joint bank account – unclear arrangements for equitable sharing of interest. Adult denied access to his/her own funds or possessions. of property or possessions of benefits by a person in a position of trust or control. finance removed from adult’s control. non-payment of care fees putting a person’s care at risk. relating to benefits, income, property or will. Neglect missed home care visit where no harm occurs. is not assisted with a meal/drink on one occasion and no harm occurs. not bathed as often as would like – possible complaint. in care provision that lead to discomfort or inconvenience- no harm occurs e.g. being left wet occasionally. having access to aids to independence. missed home care visits where risk of harm escalates, or one miss where harm occurs. discharge without adequate planning and harm occurs. Ongoing lack of care to the extent that health and wellbeing deteriorate significantly e.g. pressure wounds, dehydration, malnutrition, loss of independence/confidence. to arrange access to lifesaving services or medical care. to intervene in dangerous situations where the adult lacks the capacity to assess risk. Self-Neglect Incontinence leading to health concerns occasional reports about unkempt Multiple reports of concerns from multiple agencies lack of care or behaviour to the extent that health and to seek lifesaving services or medical care