Quick guide to understanding what constitutes a safeguarding concern

Is this a safeguarding concern?
The person raising the safeguarding concern and the local authority to consider:
a) The definitions central to the decision
i) Does this person have need for care and support? S42 (1) a, Care Act, 2014.
ii) ‘Is this person ‘experiencing, or …at risk of, abuse or neglect’? S42 (1) b, Care Act, 2014.
b) Consider differentiating between safeguarding concerns and quality of care concerns 4
Care and health provision require a particular focus in partnership development and support in defining safeguarding concerns.
See section 5 of the concerns framework

Care and Support Statutory Guidance (DHSC 2020)
14.6
14.16, 14.173, 14.99
Care and Support (Eligibility Criteria) Regulations, 2014
Care and Support Statutory Guidance (DHSC 2020)
14.16, 14.17 - 14.24
14.33, 14.36
Care and Support Statutory Guidance (DHSC 2020)
14.7, 14.9, 14.68 - 14.74, 14.92

14.6 Local authority statutory adult safeguarding duties apply equally to those adults with care and support needs regardless of whether those needs are being met, regardless of whether the adult lacks mental capacity or not, and regardless of setting, other than prisons and approved premises.

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

Developing cultures of collaboration, parity of esteem, trust, honesty, transparency is vital. Examples supporting such a culture are set out in appendix 4 and 5, concerns framework

This encourages conversations to enable informed decisions about the range of pathways rather than defaulting to raising a safeguarding concern.

The Oxfordshire decision support tool (see appendix 4, concerns framework) and the local support offered alongside this has helped in this regard. (Other localities have based tools on this.)

Develop across sectors clear and consistent definitions of key terms which appear in S42 (1) a and b, Care Act, 2014. For example, through formal training and local guidelines.

Use these definitions in constructive mutual challenge across the partnership.

Develop a partnership culture that supports all partners’ understanding and participation in decision making. See appendix 4 and 5 of the safeguarding concerns framework

Protocols support best practice where they emphasise core considerations set out in this framework rather than just offering lists of examples or ‘thresholds’ that must be met to receive safeguarding support.

Refer to specialist advice/decision making protocols on specific issues, for example national guidance on pressure areas5.

Horizon scanning for forthcoming cross sector support should be ongoing in the context of developing decision making on safeguarding concerns.

For example, CQC has indicated forthcoming revised guidance on statutory notifications.

Base decisions on a shared understanding and application of fundamental principles 6

These are at the heart of the Care Act (2014) and the associated Care and Support Statutory Guidance (DHSC,2020).

This includes a duty to promote wellbeing and to adopt a flexible approach, focusing on what matters most to the individual.7

Care and Support Statutory Guidance (DHSC 2020)
14.8, 14.13 - 14.15, 14.17
14.92 (principles for local decision-making process) 14.99

Care Act (2014)
Sections 1, 6, 7, 9, 10, 11,
68

Mental Capacity Act 2014 Human Rights Act 1998
Data Protection Act 2018

The six statutory safeguarding adults principles8 in the context of the Human Rights Act (1998) are central to decisions/actions.

Alongside this application of the five principles of the Mental Capacity Act (2005).

There must be a strong focus on the person and their wishes, offering support for decision making where the adult has a ‘substantial difficulty’ in being involved.

There should be transparency about the decisions made.

There should be partnership cooperation to address wellbeing issues of which abuse/neglect is one such issue.

Records of the rationale for decision making include reference to the six statutory safeguarding adults principles and other core principles.

Establish the wishes and views of the adult/their representative.

Does the adult want a safeguarding concern to be raised?

Consider the need for an independent advocate.

However, if someone declines safeguarding support, there is still a duty to consider how to reduce or manage risk.

Those who have raised concerns should receive feedback about the decisions made (consistent with data protection legislation).

Consider the broad range of safeguarding responsibilities where there is risk of abuse/neglect. This includes prevention and early intervention.

Care and Support Statutory Guidance (DHSC 2020)

Chapter 2

Chapter 14: 14.7, 14.9, 14.11

A safeguarding concern can relate to risk of abuse or neglect.

There must be a focus on the prevention of abuse and neglect.

Formal local pathways with a focus on identifying and mitigating risk (in the form of multi-agency meetings, panels, forums) create a common framework that can be activated and used by any concerned organisation, they do not rely on adult safeguarding services to initiate actions or convene meetings.

Joint responsibility and working alongside the person are at the heart of a partnership approach that seeks to address risk, whether or not as a safeguarding concern.

Consider the range of possible responses that may contribute to keeping an individual safe and/or to an individual’s wellbeing9. For example, there might be a need for an assessment of need for care and support (Section 9, Care Act, 2014) or a response from commissioners about quality of care issues, or multi- agency support for people experiencing domestic abuse or hate crime.

4. a) Decide what should be reported as a safeguarding concern in the Safeguarding Adults Collection (SAC)

The framework supports a view that where the referring worker/organisation believes that the circumstances amount to a safeguarding concern because it appears that criteria a and b of S42 (1) are met then, where the local authority agrees that there is a clear case set out to show this, it will be reported in the SAC as a safeguarding concern.

b) Promote and develop local recording across organisations to support practice and its development.

Section 42, Care Act (2014)10

Care and Support Statutory Guidance (DHSC 2020)

14.16, 14.17

Care and Support (Eligibility Criteria) Regulations, 2014

Guidance for completing the Safeguarding adults Collection (SAC), NHS Digital. (This will be further developed in light of the safeguarding concerns framework).

The SAC data will reflect the range of activity across sectors within the scope of safeguarding responsibilities (from the start of activity), including early intervention and prevention, whether or not concerns go on to be the subject of a safeguarding enquiry.

Robust recording of decisions and the rationale for them is the means through which defensible decision making11 can be worked through and evidenced. It supports practice development.

The Safeguarding Adults Collection (SAC) data can be used as a ‘can opener’ and should be supplemented with other local information (such as audits, peer reviews).

Local authorities will report a safeguarding concern in the SAC where referrer and local authority agree S42(1) (a) and (b) are met.

Clear recording of issues not pursued as a safeguarding concern facilitates identification of cumulative patterns. It helps identify organisations where support is needed in defining safeguarding concerns.

All organisations should audit decision making, using recording and data to understand where organisations need support in defining safeguarding concerns.

Safeguarding Adults Boards seek assurance on the quality of decision making across the partnerships.