This document is intended for use by those working within organisations, everyone else should call the Buckinghamshire Safeguarding Adults Team on 0800 137 915 Types of abuse and seriousness Low level concerns do not require a safeguarding referral, but MUST receive a proactive response that is clearly documented. All concerns MUST be reported in line with your organisation’s policies and procedures. Other reporting procedures still apply e.g. CQC, commissioning organisations. If any concern occurs more than once, advice should be sought from the Local Authority Safeguarding Team. Concerns of a significant nature MUST be referred to the Local Authority Safeguarding Team. Some examples of significant harm include criminal offences or concerns about radicalisation which MUST be referred to the Police via Concerns of a critical nature MUST be referred to the Local Authority Safeguarding Team and Police. LOW SIGNIFICANT CRITICAL Financial Money not recorded safely and properly Adult is routinely sending money to competitions/charity Adult not routinely involved in decisions about how their money is spent or kept safe capacity in relation to finance is not properly considered Adult denied access to own funds or possessions Ongoing non-payment of care fees putting a person’s care at risk Misuse of Lasting Power of Attorney or Deputyship for Finance Misuse/ Misappropriation of property or possessions of benefits by a person in a position of trust or control or to coerce Personal finances removed from adult’s control Fraud / scamming and/or exploitation including cybercrimes relating to benefits, income, property or wills Theft Physical Staff error causing no/little harm, e.g. skin friction mark due to ill-fitting hoist sling Minor events that still meet criteria for ‘incident reporting’ Isolated incident between service users resulting in no harm Inexplicable marking or lesions, cuts or grip marks on a number of occasions Accumulations of minor incidents Deliberate maladministration of medications Inappropriate restraint Withholding of food, drinks or aids to independence Inexplicable fractures/injuries Assault Covert administration without proper medical authorisation Grievous bodily harm/assault with weapon leading to irreversible damage or death Pattern of recurring errors or an incident of deliberate maladministration that results in or death Over-medication and/or inappropriate restraint used to manage behaviour health
Sexual (including sexual exploitation) All incidents of a sexual nature must be reported to the Local Authority Safeguarding Team for assessment. Sexualised touch or masturbation without valid consent Being subject to indecent exposure Contact or verbal sexualized behaviour which causes distress to the person at risk Voyeurism Attempted penetration by any means (whether or not it occurs within a relationship) without valid consent Being made to look at pornographic material against will/where valid consent cannot be given Sex in a relationship characterised by authority, inequality or exploitation, e.g. staff and service user Any sexualized behavior by a member of staff/volunteer/person in a position of trust Sex without valid consent (rape) Psychological Isolated incident where adult is spoken to in a rude or inappropriate way – respect is undermined but no or little distress caused Occasional taunts or verbal outbursts through an informal relationship The withholding of information to disempower Treatment that undermines dignity and damages esteem Denying or failing to recognise an adult’s choice or opinion Frequent verbal abuse, taunting, belittling Radicalisation Humiliation Emotional blackmail e.g. threats of abandonment/ harm Frequent and frightening verbal outbursts Denial of basic human rights/civil liberties, over-riding advance directive, forced marriage Prolonged intimidation Vicious/personalized verbal attacks Neglect One missed home care visit where no harm occurs Adult is not assisted with a meal/drink on one occasion and no harm occurs Adult not bathed as often as would like – possible complaint Adult does not receive prescribed medication (missed/wrong dose) on one occasion – no harm occurs Recent missed home care visits where risk of harm escalates, or one miss where harm occurs Hospital discharge without adequate planning and harm occurs Ongoing lack of care to the extent that and wellbeing deteriorate significantly e.g. pressure wounds, dehydration, malnutrition, loss of independence / confidence More than one missed medication or errors affecting one or more individual(s) Recurring missed medication or errors affecting one or more individual(s) Failure to arrange access to lifesaving services or medical care Failure to intervene in dangerous situations where the adult lacks the capacity to assess risk
Domestic Abuse Isolated incident of abusive nature between adults without care and support needs. If there are children in the household, always refer to Children’s Social Care First Response Unexplained marking or lesions, cuts or grip marks on a number of occasions Alleged perpetrator exhibits controlling behaviour Limited access to medical and dental care Accumulations of minor incidents Repeated verbal / physical incidents No access / control over finances Stalking Relationship characterised by imbalance of power Threats to kill, attempts to strangle, choke or suffocate Imprisonment/confinement Sex without valid consent (rape) Forced marriage Female Genital Mutilation (FGM) Honour-based violence The CAADA DASH Risk Assessment Checklist should be used to determine the level of risk in domestic abuse cases and a referral made into MARAC where appropriate What should I do Next? Use the Buckinghamshire County Council information pages and clearly RECORD the actions and outcomes Make a referral to Safeguarding Adults at Buckinghamshire County Council Contact Police on 101 if crime suspected Contact Police on 999 Make a referral to Safeguarding Adults at Buckinghamshire Levels of assessment Assessment by management of provider Assessment by universal service Quality in Care Team consultation Mental Capacity Assessment Section 9 or 10 assessment under the Care Act 2014 Continuing health Care or Funded nursing Care assessment if appropriate DoLS Assessment if required Mental Health assessment if appropriate Commissioning/contracts audit CQC Inspection CAADA DASH Section 42 Enquiry Section 44 MCA Section 20/21 Criminal Court and Justice Act Section 127 MHA CQC Inspection Examples of Services who provide support Quality in care Team Primary Health Services (GPs, Pharmacy, Optician, Dentist) Trading Standards Bucks Floating Support Connexions for transition from child to adult services Funding authority PALS/Patient Advice and Liaison Service Safeguarding Care Management Quality in Care Team Specialist Nurses GPs Best Interests Assessors Contracts/Commissioners Trading standards Women’s Aid Advocacy services Mental Health National Referral Mechanism (Slavery) Disclosure and Barring Service National Referral Mechanism (Slavery) Women’s Aid Mental Health Care Management Office of the Public Guardian Rape Crisis SARC Disclosure & Barring Service