Safeguarding roles and responsibilities: Safeguarding is everybody’s business

Apart from adult social care, there are many individuals and organisations involved in safeguarding adults, including integrated care services, neighbours, the voluntary, community and social enterprise sector partners, council departments such as housing, as well as local and national businesses like banks, the police and government organisations such as the Department of Work and Pensions.

This guide is aimed at people who are not adult safeguarding specialists but want to grow their understanding and knowledge about safeguarding adults.

Safeguarding adults is everybody’s business. We all have a role to play in ensuring that everyone in our communities is treated with dignity and respect, can make informed decisions about their lives without being subject to undue pressure and will be protected from harm and abuse wherever possible.

This document aims to support people involved in safeguarding efforts to understand how adult safeguarding works (whether social workers, police officers, commissioners, care staff, probation staff, immigration officers, medical staff, financial staff or people who draw on care and support services). This document will help define what their role is within the safeguarding process, what to look out for, be concerned about and act on. It has been developed by a combination of representatives of people with lived experience, Directors of Adult Social Services, Care and Health Improvement Programme leads, social workers, the police, and the NHS.

It also seeks to focus on the purpose of safeguarding practice – to uphold the multiplicity of our rights and needs, the priorities we have as individuals and to go beyond ‘making people safe,’ to a place where anyone who has been abused, neglected, or exploited can expect resolution and recovery and is able to achieve ’justice' in whatever way works for them.

It includes a glossary of terms and links to resources to provide a one stop shop to support colleagues and ensure clarity. As such, we hope it will become an invaluable resource.

These resources were developed with the help and support of many people from within the safeguarding and adult social care community, and we would like to thank them for their generosity and time.

The brief guide (which replaces a document developed before the Care Act 2014) summarises the responsibilities of the key statutory safeguarding partners as set out in the Care Act 2014.

This guide:

• summarises how the adult safeguarding system works in England, the legal and policy background, and the importance of making safeguarding personal to people’s individual situations and wishes
• sets out who does what and what key services are available to support effective and appropriate safeguarding adults’ services
• describes the role of the regulator of health and social care (CQC)
• describes the role of people who work in organisations which provide health or care services in the public, private and voluntary sector in safeguarding practice.

The aim of safeguarding adults is to:

• prevent harm and reduce the risk of abuse to adults with care and support needs
• stop abuse or neglect wherever possible
• ensure people have access to resolution and recovery, including criminal, civil, social and restorative justice)
• support families and communities to understand how to reduce the risk of abuse and safeguard adults in a way that supports them in making choices and having control about how they want to live
• promote an approach that concentrates on improving life for the adults concerned and address what has caused the abuse or neglect
• provide information and support in accessible ways to help people understand the different types of abuse, how to stay safe and what to do to raise a concern about the safety or wellbeing of an adult
• raise public awareness so that communities, alongside professionals, play their part in preventing, identifying and responding to abuse and neglect.

Additionally, safeguarding adults is about:

• commissioning care and support in ways which promote good quality of care that prevents abuse or neglect
• learning lessons and making changes that could prevent similar abuse or neglect happening to other people through learning and development programmes for staff and through reflective practice and/or change of policy.

This guide seeks to provide clarity and support from a national level to inform local approaches. Regardless of your seniority at work there should be a focus on good practice, multi-disciplinary working and knowing when to escalate a situation to allow more formal intervention.

This document has been developed with help from TLAP drawing on Making It Real statements to highlight the importance of Making Safeguarding Personal, which aims to work alongside the person who needs support so that plans are developed with focus on their desired outcomes. 

A glossary of useful links and an explanation of phrases can be found at the end of this page. Wherever you see a word or phrase in bold this means there is an explanation or further information in the glossary.

What is the legal and policy context?

The Care Act 2014 is the legislation and sets out a series of duties and responsibilities placed on local authorities to provide support and services for people who have care and support needs. The Act includes duties and responsibilities in relation to safeguarding people who are experiencing or at risk of abuse or neglect. That abuse or neglect could be from people they live with, people in the community, online, or from paid or unpaid carers; at home, in care homes, hospitals or other institutions.

This guide does not replace formal Care Act statutory guidance. It encourages collective leadership and partnership, supporting people locally to understand that safeguarding is everybody’s business. This includes situations where someone pays for their own care. The aim is to ensure that the right things are done by the right people at the right time, working within their own agency and with partners.

The Mental Capacity Act 2005, Human Rights Act 1998 and Equality Act 2010, alongside the Care Act 2014, are important in the delivery of effective safeguarding practice.

How the adult safeguarding system works

All councils with adult social service responsibilities have set up a Safeguarding Adults Board (SAB), often with an Independent Chair. Each SAB will provide local information, generally on its website, which sets out local adult safeguarding processes, roles, and responsibilities. The Act says that the SAB must:

• include the local authority, the NHS, and the police, who should meet regularly to discuss and act upon local safeguarding issues
• develop shared plans for safeguarding, working with local people to decide how best to protect adults in vulnerable situations
• publish this safeguarding plan and report to the public annually on its progress, so that different organisations can make sure they are working together in the best way.

The lead organisation for safeguarding work in each area remains the local council with responsibility for social services. In areas with county councils and local councils, it is the county council that is responsible for adult social care and safeguarding. In other areas (for example in towns and cities) one council covers all services, including adult social care and safeguarding.

Care Act Guidance on raising safeguarding concerns and carrying out enquiries

If someone is concerned that a person with care and support needs is experiencing or at risk of abuse or neglect, they should raise a concern with the council responsible for adult social services in their area. It is best practice to obtain consent from the adult, however if this is not possible, the professional should ensure that the adult has made an informed decision (if possible). If consent is not given, this should not stop a concern being raised. The council will then arrange for its staff to gather more information and decide what to do next.

Since the Care Act Guidance has been produced, the LGA and ADASS have also produced helpful frameworks and tools on ‘What constitutes a Safeguarding Concern’’ and how to support effective outcomes, as well as ‘Making Decisions on the duty to carry out safeguarding adult enquiries’. The aim of these documents is to ensure that there is the widest possible shared understanding of the Care Act section 42 (1) regarding raising safeguarding concerns and section 42 (2) regarding what needs to be considered when conducting a safeguarding enquiry.

Mental Capacity Act 2005

The Mental Capacity Act 2005 (MCA) is a significant piece of legislation. It sets in place key rights in relation to decision making including the right to make unwise decisions. People’s views should always be taken into account, even if they lack the capacity to make a specific decision. The following principles from the MCA framework and guidance sets out what to do. 

A person must be assumed to have capacity unless it has been established that he lacks capacity.

A person is not to be treated as unable to make a decision unless all practical steps to help him do so have been taken without success.

A person is not to be treated as unable to make a decision merely because he makes an unwise decision.

An act done, or a decision made, under this Act for or on behalf of a person who lacks capacity must be done or made in his best interests.

Before the act is done, or the decision is made, regard must be had to whether the purpose [can be] effectively achieved in a way which is less restrictive of the person’s rights and freedom of action."
MCA Section 1

You should start by assuming that people do have the capacity to make decisions, unless something suggests that is not the case. It is important to remember that people may have capacity for some decisions, but not others; and that in some situations people’s decision making can also be compromised by other things, like the coercive control of someone else.

The Deprivation of Liberty Safeguards (DoLS)are the processes used to authorise a deprivation of liberty caused by the way in which the person needs to be cared for or supported. Needing to deprive someone of their liberty in order to provide them with essential care or support is not automatically a safeguarding matter.

But if people are deprived of their liberty WITHOUT the right processes being followed, it could be a safeguarding matter because it means that they don’t have the protection of someone independent visiting and making sure the restrictions on them are necessary and proportionate.

So, if you come across someone who is being cared for in a restrictive way, without a Deprivation of Liberty Safeguarding Order being in place, get in contact with your local safeguarding team.

When people don’t have control of their care and support, life can feel hopeless, meaningless, depressing, frustrating; so its important people have as much control as possible. When people need help to plan their care and support, services should find someone who genuinely cares about the person and wants the best for them so that the person feels they have someone on their side who is invested in a better future for them. If people have someone like this, who they can trust, they are more likely to make effective choices about their care and support.

A fundamental principle is that individuals should be treated with dignity and respect, receive high quality, compassionate care and be safe from harm, abuse, neglect and exploitation. Life is, however, complicated.

Imagine an older person with care and support needs who lives with a beloved (but abusive) son or daughter. They may want the abuse to stop but do not want to lose the person as a result of the safeguarding process. Perhaps that son or daughter has become addicted to drugs and steals from them, leaving them without money for food and heat, but they feel responsible for their adult child."

Someone with a learning disability may have been persuaded by local youths that they are best friends and allowed them to move in with them, taking over control their housing, money and who they see. Or one of a couple may develop dementia as they get older and become violent or abusive. If someone is unable to get out of the house and is isolated, they may also be especially vulnerable to scams."

In each case, professionals will need to make sensitive enquiries that take account of the person’s whole situation, and what they want to happen, whilst avoiding simplistic judgements about what the person does or does not want to happen next.

The vision for safe care and support services is one where the person has real choice and control over what happens. Actions taken therefore need to be shaped by the best outcome for the person who has suffered abuse and neglect; fully involving that person, or their representative or advocate, in decisions.

Achieving this in practice can be helped by adopting a way of working with people set out in Making it Real. This describes what good citizen focused personalised care and support looks like through a series of ‘I’ statements from the person’s perspective, linked to 'We’ statements that express what organisations should be doing to make sure people’s actual experience of care and support lives up to the I statements. All of Making it Real supports a person-centered approach to safeguarding. In a safeguarding context, the I statement ‘I feel safe and am supported to understand and manage any risks’ stands out. The ‘We’ statements are helpful reference points to inform strong effective safeguarding policy and practice at a personal and organisational level. 
 

People who are subject to coercive control may not be able to have the free and open conversations we would like. Their thinking patterns and decision making may have been compromised by the people around them or their environment. For example, they may blame themselves for the abuse, feel they deserve it, or worry about losing the support they do have (however inadequate it is).

For some people, the only person they see is the person who is abusing them. Sometimes, the windows of opportunity to see the reality of people’s lives and intervene are brief. Achieving this in practice can be helped by adopting a way of working with people set out in Making it Real. This describes what good citizen focused personalised care and support looks like through a series of ‘I’ statements from the person’s perspective, linked to 'We’ statements that express what organisations should be doing to make sure people’s actual experience of care and support lives up to the I statements. All of Making it Real supports a person-centered approach to safeguarding. In a safeguarding context, the I statement ‘I feel safe and am supported to understand and manage any risks’ stands out. The ‘We’ statements are helpful reference points to inform strong effective safeguarding policy and practice at a personal and organisational level.

People who lack mental capacity or have impaired mental capacity may need support to ensure their views are represented. In these cases, the principles set out in the Making it Real framework can help support best interest decision making in line with the requirement of the Mental Capacity Act. Trauma informed and strengths-based approaches to practice are also essential underpinnings to delivering person-centered approaches to safeguarding.

Good safeguarding practice: more than just words

Conversations

A conversation means people talking as equals, so people feel valued, respected and in control of their own lives. It’s about figuring out, together, how someone can take responsibility for their own wellbeing and safety as much as possible. Support should enable the person, not take over. If someone needs to change something or do things differently, the conversation should help them understand what, why and how so they can make informed decisions and genuinely commit to their own future wellbeing and safety.

We know how to have conversations with people that explore what matters most to them - how they can achieve their goals, where and how they live, and how they can manage their health, keep safe and be part of the local community."

Equal partners

Professionals bring a wealth of knowledge and experience which are valuable to people drawing on services. But people are the experts on themselves and their family members. When considering options for action, people will bring their own knowledge and experience of what is likely to work best for them as individuals. Being told to do (or not do) something by a professional will not necessarily be effective, if it doesn’t take account of someone’s circumstances, personality, motivation. ‘I am in control of planning my care and support, if I need help with this, people who know and care about me are involved’.

We work with people as equal partners and combine our respective knowledge and experience to support joint decision-making."

Working in partnership

We work in partnership with others to make sure that all our services work seamlessly together from the perspective of the person accessing services."

On one level this is about the right people doing the right things at the right time and good sharing of information so that people don’t have to tell their story over and over to different professionals. On another level, it’s about what story the professionals are telling each other – what language they use to describe people and how much they all share an understanding of who the person is as a unique individual. It’s about being concerned for the person, not managing a case.

Person centred care

This is about everything starting with and being about the person. Discover who they are and what they want to achieve and then talk about possibilities, with an open mind and a willingness to be creative, to try new things. It can be easier to send people down a particular treatment pathway, but there could be different, better opportunities. It’s about asking how services can support people to thrive and flourish and being aware of the potentially stifling impact of some standard approaches for some people. At heart, it’s absolutely about being person-centered.

We have conversations with people to discover what they want from life and the care, support and housing that will enable this, without restricting solutions to formal services and conventional.

Rights to advocacy

Apart from this being a legal right in some circumstances, when people are in tricky situations, having someone to listen to them and represent their views can help understanding and take some pressure off.

We tell people about their rights to advocacy and representation and make sure these services are available."

We get permission before sharing personal information."

Legal rights and responsibilities

This is part of seeing people as equals. If everyone knows what the law says, you are on an equal footing. It can help relationships between services and the people drawing on them if everyone understands why services have to act in certain ways. It will underpin meaningful conversations about people’s options, decisions, care and support and people are more likely to feel less ‘done to’ and more ‘done with’.

We make sure people know their legal rights and responsibilities."

Overall, safeguarding should be an approach that underpins all the work we do, regardless of whether formal powers under section 42 of the Care Act 2014 are used or not. It is about supporting people to make informed choices about risk and live lives free from unnecessary harm and abuse. In order to achieve these aims, multiagency partnerships need to be strong and support positive learning.

It is important to remain focused on the context and outcomes rather than just the process of safeguarding. The Care Act 2014 emphasises the need to work in partnership with people, and to intervene early on to empower people to protect themselves and so prevent situations escalating. Everyone should understand that concerns may be resolved in a number of ways and not necessarily through a formal process that can be recognised as ‘safeguarding’.

Whatever level people work at, they should focus on good practice, work in a multidisciplinary way, and know when to escalate a situation to allow more formal intervention.

Information sharing

Information sharing has been key to safeguarding adults well and lack of information sharing is a significant feature of many Safeguarding Adult Reviews.

Information sharing about care and support provision is essential. This is where collecting the right information about people and the services or support they need and receive becomes so crucial. significant feature of many Safeguarding Adult Reviews.

Information about low level concerns, where someone sustains a minor injury (or could have been hurt), may feel unimportant, but where comparison is possible between different areas or services, it can make it easier to spot problems as they arise and work out how to resolve them. Social Care Institute for Excellence (SCIE) has produced guidance that explains sharing the right information at the right time between local authorities and their safeguarding partners.

Information sharing between commissioners and safeguarding professionals significant feature of many Safeguarding Adult Reviews

An area where effective information sharing is essential is between staff responsible for monitoring the performance of care providers and those responsible for investigating safeguarding concerns. Information sharing is necessary to ensure that coordinated and proportionate action is taken to tackle poor quality care and support, and that safeguarding enquiries and other forms of investigation are undertaken appropriately.

Safeguarding is everybody’s business; it is essentially a partnership activity. Any safeguarding activity, including commissioning activity, whatever the roles and responsibilities needs to start with the person:

• What do they want?
• What is important to them?

This speaks to the key challenge of being led by the views of the person or people involved, whilst being conscious of the need to balance autonomy with protection, human rights with duties of care. Professional curiosity is important to enable appreciation of any factors influencing decision making, such as coercion and control. This then draws the focus onto someone’s decision making capacity. We must always be focused on the views of the person, whether they have the mental capacity to make the decision or not, working with carers/advocates as appropriate.

Summary of different roles with the safeguarding process

The following summarises the range of powers and responsibilities that statutory agencies should be using to address abuse and neglect. Reference should be made to more detailed Care and support statutory guidance, the statutory responsibilities of organisations and professionals, and local policies and procedures on adult safeguarding.

Safeguarding in ‘closed’ cultures

Since 2014, there have been continuing concerns about abuse uncovered in a few residential care and independent hospital settings, principally providing for people with learning disabilities and mental health needs. Safeguarding Adults Reviews and other Reviews such as the review of Winterbourne View Hospital show the importance of awareness of the issues which are associated with closed environments. Raising concerns early is essential, so that the provider, the local authority where the setting is based, and both health and social care commissioners who may have placed individuals in a service, may all take immediate action where appropriate. NHS Guidance has been issued in respect of host commissioning arrangements for people placed in independent hospitals and work is ongoing to ensure similar arrangements are made for those placed out of area in residential and nursing care homes. ADASS Eastern Region has also issued guidance on safeguarding people in secure settings. As the regulator, the Care Quality Commission must be able to take steps immediately to highlight improvement actions which need to be taken, which protect individuals and improve the quality of care and they will also contribute to Safeguarding Adult Reviews.

Commissioners and regulators have a key role to play in the development, design, and approval of services – so that lessons about what makes such environments more likely to develop are learnt and prevented in the future.

These may include:

• previous risk concerns
• high staff and resident turnover
• isolated from friends or family by distance/attitudes
• fragmented care, information and governance
• lack of candour and openness to other people and organisations
• limited external contact with shops, and services like GPs and hairdressers
• weak communication with external partners
• limited contact overall with people.

People with learning disabilities and/or, autism and safeguarding

National concerns about the higher number of early deaths of people with learning disabilities caused the NHS to set up the programme known as Learning Disability Mortality Reviews (often known as LeDeR). These reviews consider lessons learned with the aim of improving practice and actions from these reports and are shared with Safeguarding Adults Boards so that they can also add governance to actions to be delivered locally. 

What to do if you are concerned people may be living in a ‘closed environment’? Start with the safeguarding lead for the organisation providing the care – explain your concerns to them. If you don’t see changes, or if you feel things are too urgent to wait, do the following: contact the local authority safeguarding team for the area where the hospital or home is based; contact the commissioners who pay for the placement; contact the Care Quality Commission and explain your concerns to them; if someone is at immediate risk of serious harm, call the police.

Allegations about people in positions of trust – PiPoT

When allegations are made against staff or those who work in an unpaid capacity, the Care Act 2014 states that local authorities and their partners providing services should have clear policies, in line with Safeguarding Adults Board policies, for dealing with them. These policies are referred to as People in Positions of Trust’ or ‘PiPoT policies and should explicitly consider when information from the DBS should be used.

Local authorities and NHS organisations should have such policies in place. Other organisations(especially those providing care and support) should consider also having such policies.

Safeguarding Adult Reviews

Safeguarding Adult Boards also have responsibility for organising independent Safeguarding Adults Reviews (SARs), for example, where there is evidence of gaps in multi-disciplinary agency coordination that might have prevented abuse. They are then responsible for ensuring that the learning from such reviews is developed locally and all partners take the learning into their own organisations or sectors. The LGA/ADASS commissioned a review of all SARs in 2020 which provides significant learning on a national and local basis for individual agencies and multiagency safeguarding partnerships, from information sharing to understanding the complexities of how to assess mental capacity in the context of safeguarding. There is now an online library of all available SARs, which can be assessed through the National Network of Safeguarding Adults Board website.

The National SAR analysis

The National Analysis of SARs has demonstrated where we still need to improve, especially where someone has capacity and may decline services – we cannot walk away. Common themes around professional curiosity, legal literacy, trauma informed practice and robust decision making are still very important as well as an outcome focussed approach, especially with complex safeguarding issues involving exploitation, substance misuse and self-neglect. There has been growing understanding about the connection between self-neglect and hoarding and guides from the Fire Service have been issued which show how to identify the severity and impact. Also there was identification of under-identification of abuses such as organisational abuse, domestic abuse and discriminatory abuse.

Transitional safeguarding and working with people who are criminally exploited

The term transitional safeguarding describes ‘an approach to safeguarding adolescents and young adults fluidly across developmental stages which builds on the best available evidence, learns from both children’s and adult safeguarding practice and which prepares young people for their adult lives’.

It focuses on safeguarding young people, from adolescence into adulthood, recognising this period of transition will be experienced differently by young people at different times. Increasing recognition is given to the transitions of young people from children to adult care services beyond 18 years, with local safeguarding strategies developed as a result of a collaboration between the Chief Social Worker for Adults, Association of Directors of Adult Social Services (ADASS), British Association of Social Work (BASW), Local Government Association (LGA) and Research in Practice (RiP) being published in the guide ‘Bridging the Gap.’

Emerging themes concern exploitation of people who are young and adults at risk, with particular concerns about modern slavery and human trafficking and the impact on individuals. Multi-agency partnerships work best in this area, especially strong working practices with local police. Nationally, in recent years we have seen an increase in the exploitation of adults at risk by organised crime groups (OCGs). A vulnerable adult may become involved in 'county lines'- a term used for trafficking drugs into rural or smaller towns from major cities - adults at risk are often recruited to pay off a debt or in exchange for drugs.

Cuckooing and other scams

Cuckooing is the criminal exploitation of adults at risk, involving the use of their homes for criminal activities through intimidation or in exchange for drugs. The premises could be used to facilitate the movement of illegal drugs, to hold or move money (money mule / money laundering), to store stolen items or weapons including firearms.

Increasing financial abuse and scams involving use of the internet and texts to mobile phones are of concern and local trading standards in local authorities regularly raise alerts for local residents.

In addition, due to some suspects having care and support needs there could be a need to conduct joint investigations with partners to gather best evidence to maximise the prospects for bringing the offender to justice. To achieve, with partners, the best protection and support for the person suffering abuse or neglect, a trauma informed approach needs to be used when dealing with victims, witnesses and suspected offenders.

If a professional thinks that a vulnerable adult is being exploited by an OCG they should report this matter to the police via 101.

Immigration and abuse of migrants

Many people have opened their homes to support people displaced by war and conflict – such as those coming from Afghanistan in 2021, and Ukraine in 2022. Not all those volunteering do so with the right motivation, and care has been taken with the Home for Ukraine scheme in particular to check on both hosts and families, to ensure they are safe and well supported, especially for adults with care and support needs. The need to understand the particular vulnerabilities of migrants (for example, how their lack of access to money and employment may make them particularly suspectable to exploitation) is important, and a safeguarding approach should be considered when concerns are raised if the person has care and support needs. Homelessness and concerns about lack of suitable, secure accommodation can be a particular challenge, and an area where the local authority does have a role in providing advice and support to all.

Safeguarding is everyone’s business – but different professionals within local and national systems have specific roles and tasks in relation to safeguarding adults at risk of harm. This document aims to summaries these and make them accessible to people. As systems and processes develop, so too will this guidance.