Safeguarding adults

Safeguarding means protecting an adults’ life to live in safety and free from abuse and neglect. It is about people and organisations working together to prevent and stop both the risks and experience of abuse or neglect, while at the same time making sure the adults wellbeing is promoted, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action (The Care Act 2014)

Safeguarding at risk adults is the responsibility of all staff (employed, contracted and who volunteer) who during the course of their job come directly or indirectly into contact with at risk adults.

The NHS Cheshire and Merseyside safeguarding team encompasses the six safeguarding principles as part of the multi-agency approach to safeguarding: prevention, protection, empowerment, proportionate responses, partnership and accountability.

Our guidance and procedures are based on the principle that people should be enabled and supported to make their own decisions about their lives and should be made aware of any choices and options available to help them make decisions.

The six principles and the Care Act (2014) highlight the concept of promoting the individual’s wellbeing and ensuring that Safeguarding is person-led and outcome-focused. The statutory guidance advocates those local authorities in conjunction with their partner agencies make safeguarding a personalised experience, aiming to achieve the outcomes identified by adults at risk of harm and abuse:

  • NHS Cheshire and Merseyside will support people to be in control of decisions about their own lives.
  • NHS Cheshire and Merseyside will support services and staff to recognise abuse, know how to seek advice and report concerns. Making safeguarding personal involves supporting those at risk to identify, assess and make informed decisions about situations of risk.
  • NHS Cheshire and Merseyside will support carers to understand their rights, ensure their needs are recognised and are supported in fulfilling their role.
  • Those patients funded by NHS Cheshire and Merseyside for continuing healthcare or funded nursing care will be involved wherever possible in discussions about safeguarding referrals, and any strategy meetings or case conferences about them.

Who is an adult at risk?

An adult at risk is a person aged 18 or over, who is or may be unable to protect themselves against significant harm due to age, illness or disability (e.g., physical impairment, learning disability, mental health condition).

An adult with care and support needs may be for example:

  • An older person
  • A person with a physical disability, a learning difficulty or a sensory impairment
  • Someone with mental health needs, including dementia or a personality disorder
  • A person with a long-term health condition
  • Someone who misuses substances or alcohol to the extent that it affects their ability to manage day-to-day living.
  • Someone who may be isolated, feel victimised, coerced, and unable to prevent potential abuse or neglect because of such factors.

It is important to remember that a person's disability or age does not in itself make the adult at risk. Most adults who could be considered as 'at risk' will never experience abuse and with the right support in place can safeguard themselves.

An adult's ability to protect themselves and safeguard their wellbeing will be affected by:

  • Personal circumstance AND
  • Risks arising from their environment COUNTERED BY
  • Resilience factors

It's important to see the person and not just the disability or illness as safeguarding is about working with people to help keep them safe.

Everyone is different and will have different needs so speak to them and their carers/families about how we can help them.

Types of abuse

Physical abuse

Including assault, hitting, slapping, pushing, misuse of medication, restraint or inappropriate physical sanctions.

Domestic abuse

Including psychological- coercion and control, physical, sexual, financial, emotional abuse; so, called ‘honour’ based violence and abuse, forced marriage and Female Genital Mutilation.

Sexual abuse

Including rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography or witnessing sexual acts, indecent exposure and sexual assault or sexual acts to which the adult has not consented or was pressured into consenting.

Psychological abuse

Including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyber bullying, isolation or unreasonable and unjustified withdrawal of services or supportive networks.

Financial / material abuse

Including theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.

Modern slavery

Encompasses slavery, human trafficking, forced labour and domestic servitude. Traffickers and 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.

Discriminatory abuse

Including forms of harassment, slurs or similar treatment; because of race, gender and gender identity, age, disability, sexual orientation or religion.

Organisational abuse

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 on-going ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation.

Neglect and acts of omission

Including ignoring medical, emotional or physical care needs, failure to provide access to appropriate health, care and support or educational.

Self neglect

Self-neglect is defined as covering a wide range of behaviours – failure to meet own personal hygiene, health or surroundings and includes behaviour such as hoarding.

Examples of self-neglect include:

  • Lack of or unable to self-care – examples: neglect of personal hygiene, nutrition, hydration, health, thereby endangering safety and well-being,
  • Lack of or unable to care of one’s environment – examples: squalor and hoarding,
  • Refusal of services that may lessen the risk of potential harm.