Adult Safeguarding Guidance and Procedures

The Safeguarding of Vulnerable Adults (SoVA)
Guidance and Procedure for organisations with paid staff and/or
regular contact with vulnerable adults
Contents of this document
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2.
3.
4.
Why this document is necessary
Adult Safeguarding Guidance
Expected headings and contents
Template including; Flowcharts, and links to localised Adult Safeguarding
Guidance and Procedures
1. Why this document is necessary
The aim of all agencies and individuals working in social and health care should be to safeguard
vulnerable people from abuse and to ensure that people who have been abused receive
support and protection from further abuse.
The adult safeguarding policy guidance and procedures set out the steps to be taken when
abuse is disclosed, identified, suspected or alleged. The accompanying practice guidance
provides valuable help in:
• defining abuse
• recognising and understanding how abuse can occur; reducing the risk of abuse
happening
The Cambridgeshire Adult Safeguarding Policies guidance and Procedures have been
produced to strengthen our existing arrangements and meet the requirements of ‘No Secrets –
Guidance on Developing and Implementing Multi-Agency Policies and Procedures to Protect
Vulnerable Adults from Abuse’ (Department of Health 2000) which:
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is a guidance document issued under Section 7 of the Local Authority Social Services
Act 1970
applies to all statutory agencies
is a guidance with which every agency has to comply unless local circumstances
indicate exceptional reasons that justify a variation
identifies the local authority as the lead agency
requires that a senior manager should be identified in each agency to take the lead
role
2. Adult Safeguarding Guidance
The Adult Safeguarding Policy Template (Part 4) is a starting point for any Adult Social Care
Service with paid staff and/or regular contact with vulnerable adults.
We would strongly advise incorporating many of the recommendations given below that apply to
your service. You should also refer to our Adult Safeguarding Policies guidance and
Procedures.
http://www.cambridgeshire.gov.uk/social/adultprot/
As this is a large document it would be beneficial to offer guidance on the key areas of our local
Adult Safeguarding Policies guidance and Procedures.
The policy should be reviewed on a regular basis to ensure they reflect any changes to
Cambridgeshire County Council guidance, and that all staff read this on at least a yearly basis.
Please be advised this is not an exhaustive list and can be used in conjunction with your
national Safeguarding Guidance.
From Part 1 of the Guidance
Partner agencies
Legal Reference
Further legal guidance
Guidance
From Part 2 of the Guidance
Practice Guidance 3
Advocacy
Practice Guidance 8
Domestic Abuse and Violence
Practice Guidance 9
Emergency Duty Team
Practice Guidance 10
Four Levels of Response
Practice Guidance 11
Good Practice Examples
Practice Guidance 17
National Standards for Good Practice (ADASS)
Practice Guidance 18
Partner agencies - Roles and Responsibilities
Practice Guidance 20
Preserving Evidence
Practice Guidance 22
Risk Assessment
Practice Guidance 23
Safer Recruitment Guidance - Resignations and Compromise Agreements
Practice Guidance 24
Sharing of Information
Practice Guidance 27
Training for Staff and Volunteers
Practice Guidance 28
Forced Marriage and Honour Based Violence - Guidance for staff working with Vulnerable
Adults
Practice Guidance 29
Photographic Evidence
Appendix 3
Safeguarding of Vulnerable Adults Referral Form
Appendix 4
Adult Safeguarding Process Checklist
Appendix 6
Adult Safeguarding Flow Chart
Appendix 7
Actions to be taken after becoming aware of a safeguarding concern
Revisions made to these procedures in April 2012 page 167
Note: The flow chart (Appendix 1 in this document) will need to be tailored to your service, and
highlight who is responsible for dealing with a safeguarding concern, for example a line
manager.
A Whistleblowing policy that includes: the Public Interest Disclosure Act and the contact details
for public concern at work should be included in the policy and supported by your own internal
Whistleblowing policy.
Any further information can be discussed in your management responsibilities training.
3. Suggested headings and contents of your SoVA policy
1. A Named Safeguarding Champion
2. Staff Responsibilities
3. Definitions
4. Categories
5. Abuse Indicators
6. Assessment of Risk
7. Whistleblowing
8. Consent and Confidentiality
9. Reporting and Recording Procedure (including Flowchart)
10. Reporting to CQC
11. Links to Local Authority, Health Services, Police, Regulatory Authorities and other
relevant partner agencies
4. Template including; Flowcharts, and links to the Cambridgeshire Adult
Safeguarding Policies guidance and Procedures.
The person responsible for this Guidance and Procedure is (insert name,
position)
The above person will:
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Ensure that the welfare of vulnerable adults is given the highest priority by our
organisation, its management and staff/volunteers
Act as the main contact for sharing information around Adult Safeguarding concerns
Ensure that the concerns of Vulnerable Adults are heard and acted upon
Be responsible for ensuring concerns are reported to appropriate authorities
Ensure training is provided for all staff/volunteers, and remain up to date with current
practice and legislation
Ensure all staff/volunteers service users and families have access to further
appropriate information
Mission Statement Example
…………. (Name of organisation) provides services to a wide range of individuals and we
recognise that some of the people we support may be Vulnerable Adults. A key aim of our
service is to safeguard vulnerable people from abuse and to ensure that people who have been
abused receive support and protection from further harm.
Definitions
A vulnerable adult is defined in ‘No Secrets’ as:
‘a person aged 18 years or over, who is in receipt of or may be in need of community care
services by reason of ‘mental or other disability, age or illness and who is or may be unable to
take care of him or herself, or unable to protect him or herself against significant harm or
exploitation’.
For the purpose of this guidance “community care services” will be taken to include all care
services provided in any setting or context.
Abuse is defined in ‘No Secrets’ as:
‘The violation of an individual’s human or civil rights by any other person or persons’.
Abuse may consist of a single act or repeated acts. It may be physical, verbal or psychological,
an act of neglect or an omission to act, or it may occur when a vulnerable person is persuaded
to enter into a financial or sexual transaction to which he or she has not consented, or cannot
consent. It may also occur through deliberate targeting or grooming of vulnerable people and
may be carried out by individuals or groups of individuals.
Abuse can occur in any relationship and may result in significant harm to, or exploitation of, the
person subjected to it.
Types of Abuse
Physical abuse
Definition - Non accidental harm to the body caused by the use of force, which results in pain,
injury or a change in the person’s natural physical state.
Some examples are: hitting, slapping, pushing, kicking, misuse of medication, restraint,
inappropriate sanctions, rough handling, pinching, punching, shaking, burning, and forced
feeding.
Sexual abuse
Definition - Sexual abuse is the involvement of a vulnerable adult in sexual activities or
relationships, which are for the gratification of the other person and which: they have not
consented to, or they cannot understand and are not able to consent to, or which violates the
individual’s expressed cultural or religious preferences, sexual taboos, or family custom and
practice.
Some examples are: rape and sexual assault or sexual acts to which the vulnerable adult has
not consented, or could not consent or was pressured into consenting. Inappropriate touching
and fondling, indecent exposure, penetration (or attempted penetration) of vagina, anus or
mouth by penis, fingers, or other objects.
Psychological abuse
Definition - Psychological or Emotional abuse is behaviour that has a harmful effect on a
vulnerable adult’s emotional health and development.
Some examples are: emotional abuse, threats of harm or abandonment, deprivation of contact,
humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, isolation or
withdrawal from services or supportive networks, withholding affection, shouting, depriving the
person of the right to choice, information and privacy. Behaviour that has a harmful effect on the
vulnerable adult’s emotional health and development.
Financial or material abuse
Definition - Financial or material abuse involves the use of a vulnerable adult’s property, assets
or income without their informed consent or making financial transactions that they do not
understand to the advantage of another person.
Some examples are: theft, fraud, exploitation, and pressure in connection with wills, property or
inheritance or financial transactions, or the misuse or misappropriation of property, possessions
or benefits.
Neglect and acts of omission
Definition - Neglect is behaviour that results in the vulnerable adult’s basic needs not being met.
Some examples are: ignoring medical or physical care needs, persons physical
condition/appearance is poor e.g. ulcers, pressure ulcers, soiled or wet clothing, failure to
provide access to appropriate health, social care or educational services, the withholding of the
necessities of life, such as medication, adequate nutrition and heating and undermining
personal beliefs.
Professional abuse
Definition - Is the misuse of power and abuse of trust by professionals, the failure of
professionals to act on suspected abuse/crimes, poor care practice or neglect in services,
resource shortfalls or service pressures that lead to service failure and culpability as a result of
poor management systems/structures.
Abuse by Organisations – Institutional Abuse
Definition - Involves the collective failure of an organisation to provide an appropriate and
professional service to vulnerable people. It can be seen or detected in processes, attitudes and
behaviour that amount to discrimination through unwitting prejudice, ignorance, thoughtlessness
and stereotyping. It includes a failure to ensure the necessary safeguards are in place to protect
vulnerable adults and maintain good standards of care in accordance with individual needs,
including training of staff, supervision and management, record keeping, unable or unwilling to
implement professional or clinical guidelines and liaising with other providers of care.
Abusive behaviour may be part of the accepted custom and culture within an organisation or an
individual member of staff, or particular group of staff may carry it out. The key risk factors for
institutional abuse are:
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it is widespread within the setting
it is repeated
it is generally accepted by the staff and not seen as being poor practice
it is sanctioned, it is encouraged or condoned by line managers
it takes place in a setting where there is poor monitoring by senior management
there are environmental factors (e.g. unsuitable buildings, lack of equipment, many
temporary staff) that adversely affect the quality of care
™ it is systemic e.g. factors such as a lack of training, poor operational procedures, poor
supervision and management all encourage the development of institutionally abusive
practice
Domestic abuse and violence
Definition - Domestic abuse and violence is best described as the use of physical and/or
emotional abuse or violence, including undermining of self-confidence, sexual violence or the
threat of violence, by a person who is or has been in a close relationship.
Domestic abuse can go beyond actual physical violence and involve emotional abuse, the
destruction of a spouse's or partner's property, their isolation from friends, family or other
potential sources of support, threats to others including children, control over access to money,
personal items, food, transportation, telephone, and stalking.
It can include violence perpetrated by a son, daughter or any other person who has a close or
blood relationship with the victim. It can also include violence inflicted on, or witnessed by
children. The wide adverse effects of living with domestic violence for children must be
recognised as a child protection issue. It may link to poor educational achievement, social
exclusion and to juvenile crime, substance abuse, mental health problems and homelessness
from running away.
Domestic violence is not a 'one-off' occurrence but is frequent and persistent aimed at instilling
fear into and compliance from, the victim.
Reference: Department of Constitutional Affairs Domestic Violence Guide to Civil Remedies &
Criminal Sanctions.
Any incident of threatening behaviour, violence or abuse, psychological, physical, sexual,
financial or emotional between adults who are, or have been intimate partners or family
members, regardless of gender or sexuality’. (Source Home Office Definition 2004)
Domestic violence takes place within an intimate or family-type relationship and that forms a
pattern of coercive and controlling behaviour. This can include forced marriage and so-called
‘honour crimes‘. Domestic violence may include a range of abusive behaviours. (Source:
Women‘s Aid)
Discriminatory abuse
Definition - Discriminatory abuse is behaviour that makes or sees a distinction between people
as a basis for prejudice or unfair treatment.
Some examples are: racism, sexism, religious and ageism, based on a person’s disability, and
other forms of harassment, slurs or similar treatment.
Significant harm
A key concept in adult safeguarding work is ‘significant harm’, which helps to determine how
serious or extensive abuse must be to justify intervention. This has been defined as follows:
“harm” should be taken to include not only ill treatment (including sexual abuse and forms of ill
treatment that are not physical), but also the impairment of, or an avoidable deterioration in,
physical or mental health and the impairment of physical, emotional, social or behavioural
development.
Specific Indicators of Abuse
Although abuse often comes to light through disclosure by the person, who sensing they are
safe, confides in a trusted person, there are situations or events that might indicate that all is not
well.
The following list highlights situations or events that may require closer attention.
They are merely indicators, the presence of one or more does not confirm abuse and they are
no substitute for a thorough assessment.
However, a cluster of several indicators may indicate a potential for abuse and a need for
assessment.
For ease of use the indicators have been grouped under a number of headings.
Typically an abusive situation may well involve indicators from a number of groups in
combination.
General Indicators of Abuse
The denial (often forthright) that anything is amiss, with an accompanying emphasis that things
‘have never been better’.
Resignation, stoicism, and, sometimes, an acceptance of incidents as being part of being
old/vulnerable:
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inconsistency of information
seeking (attention/protection), often from numerous sources
the vulnerable adult appears to be withdrawn or agitated and anxious
they may be isolated in one room of the house or confined to living in a small space
mobility is restricted due to absence of suitable mobility aids
they may be excluded from outside social contacts
they are overly subservient or anxious to please
professional and other visitors may have difficultly gaining access to the vulnerable adult
or may find confidential interaction inhibited
lack of eye contact – looking at the floor during discussions or looking to others to answer
questions even when directed to the individual
dramatic changes in behaviour or personality; depression or confusion, for which no
medical explanation can be offered
refusal to allow person into respite/permanent care
poor conditions, lack of clothing, lack of access to own money
reluctance to return home or to service placement
Indicators of Physical Abuse
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multiple bruising that is not consistent with the explanation e.g. a fall
cowering and flinching
bruised eyes, marks resulting from a slap and/or kick, other unexplained bruises
abrasions, especially around the neck, wrists and/or ankles
unexplained burns, especially on the back of the hands
scalds, especially with a well-defined edge from immersion in water
hair loss in one area – scalp sore to touch
frequent minor accidents without seeking medical help
unusually sleepy or docile, tendency to flounder or slip over
unexplained fractures
malnutrition, ulcers, pressure sores and sores due to lack of care for incontinence
frequent ‘hopping’ from one GP, hospital or care agency to another
need for health or social care services ignored or obstructed
misuse of medication
Indicators of Sexual Abuse
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changes i.e. the person starts to seek or avoid attention where previously they did not, by
expressing over sexualised behaviour, or becoming fixated on sexual matters
complaints of soreness in genital/anal area, no medical cause known
recurring conditions such as thrush or cystitis
pregnancy or diagnosis of a sexually transmitted disease when the person is not known
to be sexually active
bruising on the inner thighs or shoulders, breasts and/or genital area
objects to being washed in genital areas, which is a change in behaviour
Indicators of Financial or Material Abuse
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unexplained or sudden inability to pay bills
gifting and transferring of assets and property
unexplained or sudden withdrawal of money from accounts
contrast between known income or capital and unnecessarily poor living conditions
especially where this has developed recently
personal possessions of value go missing from the home without satisfactory explanation
contrast with their previous lifestyle and standards
someone has taken responsibility for paying rent, bills, buying food etc - but is clearly not
doing so
unusual interest taken by relative, friend, neighbour or other in financial assets especially
if little real concern is shown in other matters
next of kin refuse to follow advice regarding control of property via Court of Protection or
through securing Enduring Power of Attorney/Lasting Power of Attorney, but insist upon
informal arrangements
care services including residential care are refused by family or other potential inheritors
unusual purchases unrelated to the known interests of the vulnerable adult e.g.
purchases of fashionable clothes, expensive make-up, food and holidays
reluctance to accept financial assessment or engagement from department
Indicators of Organisational/Institutional Abuse
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poor staff morale, high turnover or high sickness rate amongst staff; excessive hours are
worked and there is frequent use of agency staff
general lack of consideration of privacy e.g. staff walk casually into bedrooms; washing and
personal care tasks (going to the toilet) lack appropriate privacy and dignity; there is no
telephone that can be used privately
residents/service users appear unusually subdued, especially when compared to their
previous behaviour; they retreat into their own room or other areas out of the way of staff
lack of care when dealing with personal clothing, e.g. loss of clothes, being dressed in other
people’s clothes, dirty or unkempt, spectacles not clean, wearing other people’s spectacles,
hearing aid or false teeth
poor hygiene e.g. strong smell of urine, dirty clothing or bed linen, only changed when staff
consider it necessary
inappropriate and thoughtless use of equipment e.g. restraint and buzzers out of reach
lack of internal procedures, including poorly written and/or outdated policies
lack of clear lines of responsibility and consistency of management
lack of staff training, supervision, appraisals and assessment of competencies
lack of appropriate skill mix and assessment of staff competencies and training and
development plan
inadequate care/support plans and risk assessment
inappropriate use of medical or nursing procedures e.g. enemas, catheterisation, over
reliance on medication
lack of appropriate relevant information sharing between staff about service users
lack of open transparent communication from staff to relatives
reliance on rigid routines
staff feel powerless to influence good practice; they may be discouraged from participating in
discussions with outside agencies
Indicators of Professional Abuse
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entering into a sexual relationship with a service user
failure to refer disclosure of abuse, poor, ill-informed or outmoded care practice
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failure to support vulnerable adult to access health care/treatment, denying vulnerable adults
access to professional support and services such as advocacy
service design where groups of users living together are incompatible, punitive
responses to challenging behaviours, failure to whistle-blow on issues when internal
procedures to highlight issues are exhausted
Indicators of Domestic Abuse and Violence
It must be remembered that all categories of abuse may be found within a domestic environment,
i.e. close family relationships.
Reactions to Abuse
The consequences of abuse can have profound effects on all the parties involved.
These may include:
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denial that abuse has occurred may be strongly stated, even in the face of compelling
evidence to the contrary, there may be an attempt to persuade others that an abusive
relationship is normal
withdrawal from social activity can occur, ranging from withdrawal from normal activities to
total lack of communication
increased agitation and anxiety may also present itself in a variety of forms from attentionseeking behaviour to overly subservient behaviour
parties involved can experience depression
parties involved can experience confusion, this can be characterised by the marked
deterioration in a previously confident person, someone who may appear to be confused
might be trying to communicate his or her distress about an abusive event
a dramatic change in behaviour or personality can occur suddenly and unexpectedly and can
be associated with fear following an incident of abuse
physical or verbally aggressive behaviour can occur and an individual may seem unusually
hostile or be prone to over-reaction
self-neglect can also occur including the loss of self-esteem, deterioration in appearance,
weight loss or erosion of personal confidence
Respect
When abuse has been disclosed, reported or observed, it is important that the person be treated
with dignity and respect and is involved as an equal in the investigation, and kept fully informed on a
regular basis.
They have the right:
™ to be believed when they report abuse of themselves and/or others, unless there is direct
and unequivocal evidence to the contrary
™ to appropriate education/information in order to identify behaviour which constitutes
abuse and the rights to informed decision-making and consequent risk
™ to have the investigation processed where possible through a timescale with which they
can be comfortable
™ to privacy and confidentiality in the conduct of the investigation (see practice guidance
24, sharing of information)
™ to be assisted by an interpreter, advocate, relative or carer in giving information, or
evidence, unless the evidence which is to be given is subject to separate rules, e.g.
police procedures
™ where a person’s capacity is compromised to have decisions made in their best interest
™ to expect arrangements to be made to promote safety and welfare in both the short and
long term
™ to expect that the issues of power, coercion and intent on the part of the alleged abuser to
the alleged victim are given particular attention
™ not to have to undergo repeated presentations of information/evidence, except as required in
criminal proceedings
™ to be involved in decisions made as a result of the investigation
™ to not participate in the investigation
™ to have access to the police action for justice procedures where appropriate
Reporting and Recording Procedure
Anyone who suspects that a vulnerable adult may be at risk of abuse or is being abused must
report their concern immediately. People have the right to expect that information shared with a
member of staff should be treated as confidential. However, it should be made clear that where
the staff member has a reason to be concerned for the welfare of a vulnerable person they
must share the information with someone who is in a position to take action or responsibility.
Abuse of vulnerable adults can take many forms including physical, emotional, sexual and
financial. It is not the responsibility of anyone working within (insert organisation name) in a
paid or unpaid capacity to decide whether or not abuse has taken place. It is therefore vital that
staff raise all cases of suspected or alleged abuse in line with the procedures identified in this
policy. It is important to do this, as there may already have been concerns expressed by other
members of staff and failure to report concerns may put a vulnerable person at risk.
Any disclosure or suspicion of abuse should be reported to the staff member’s / volunteer’s line
manager as soon as possible. Where the perpetrator is a member of staff, proprietor or service
manager the agency will invoke their disciplinary and Whistleblowing codes alongside this
procedure.
The person in charge responsible for overseeing the safeguarding concerns will ensure that
Adult Safeguarding process is followed (Refer to appendix 1).
If a disclosure of abuse is made by a service user, care should be taken to explain to them the
procedure that will be followed and they should be told that it may not be possible for (insert
organisation name) to maintain confidentiality.
If a service user of (insert organisation name) makes an allegation about another organisation
this should be reported to your Manager who will take appropriate action.
All relevant information about the allegation should be recorded as simply and clearly as
possible and stored securely.
Consent and the Sharing of Information:
Consent:
Many of the Data Protection issues surrounding the disclosure of information can be avoided if the
informed consent of the individual has been sought and obtained. Consent must be freely given
after the alternatives and consequences are made clear to the person from whom permission is
being sought.
If the data is classified as sensitive data, the consent must be explicit. In this case, the specific detail
of the processing should be explained, the particular types of data to be processed, the purposes of
the processing and any specific aspects of the processing which may affect the individual
disclosures.
Where an overriding public interest exists:
If informed consent has not been sought or sought and withheld, the agency must consider if there
is an overriding public interest of justification for the disclosure being made to a third party.
In making this decision and compliant with the Human Rights Act, the following questions may be
considered:
™ Is the disclosure necessary for the prevention or detection of crime, to protect public
safety or to protect the rights and freedoms of others?
™ Is the disclosure necessary for the protection of young or vulnerable people?
™ What risk to others is posed by this individual (alleged offender)?
™ What will be the impact of the disclosure on the offender?
™ Is the disclosure proportionate to the intended aim?
™ Is there an equally effective but less intrusive alternative means of achieving that aim?
Having due regard to the seriousness of the abuse and the potential risk to others, disclosure in
such circumstances would be justified. It is important that it is made clear to the alleged victim and
their relatives (if appropriate) that in these cases there is a necessity for the police and/or agency to
investigate due to the possible risk to other vulnerable persons.
Confidentiality
Whether or not planning a response to an adult safeguarding concern is through informal
consultations or a formal meeting you are likely to be sharing information that would normally be
considered confidential.
Each agency holds information, which in the normal course of events, is regarded as confidential
and will have their own safeguards and procedures for sharing this with other related agencies.
Some information will be subject to the Data Protection Act 1998.
An adult safeguarding concern provides sufficient grounds to warrant sharing information on a “need
to know” basis and/or “in the public interest” and unnecessary delays in sharing that information
should be avoided. Whenever possible the vulnerable adult must be consulted about information
being shared on their behalf. Often consent has been given through the usual assessment process.
There will be a need to share information with other agencies for example Health, Advocacy and the
Police, and generally permission would be asked before doing so.
However in exceptional circumstances e.g. if it is considered someone is at serious risk of abuse
then information may be disclosed without consent.
Where they have capacity and they are not being pressured or intimidated their agreement should
be sought and their refusal respected.
If other adults are at risk the “public interest” principle may override their decision.
The principles governing the sharing of information include:
™ confidentiality must not be confused with secrecy
™ information will only be shared on a ‘need to know basis’ when it is in the best interests of
the service user(s)
™ informed consent should be obtained but if it is not possible and other adults are at risk, it
may be necessary to override the requirement
™ it is inappropriate for agencies to give assurances of absolute confidentiality in cases where
there are concerns about abuse, particularly in those situations when other vulnerable
people may be at risk
Whistleblowing
All staff/volunteers and others with serious concerns about any aspect of their work are encouraged
to come forward and voice those concerns. The Whistleblowing Policy has been designed to assist,
encourage and enable employees to make serious concerns known within the within the
organisation.
Furthermore, in respect of issues concerning adult abuse if any employee suspects fraud, corruption
or other malpractice then they must report their concerns to …………….. If it would be inappropriate
to report to ……………., or the employee is nervous or worried about doing so, then they should
contact ……………………..
Whistleblowers should know how to access support and to protect their own interests. Even if they
decide that they wish to make an anonymous report, the information they provide will be taken into
account and treated seriously. Further support can be found at Public Concern at Work – on their
website or call for confidential whistleblowing advice - 020 7404 6609. For staff working within
the NHS or Social Care Sector, call 08000 724 725.
All requests for anonymity by the referrer will be fully respected. It cannot however be guaranteed,
especially if the referrer’s information becomes an essential element in any subsequent legal
proceedings.
In addition, the Data Protection Act 1998 removes the blanket confidentiality of third party
information.
Staff who do not report concerns about the possible abuse of a vulnerable adult in accordance with
the multi-agency practice guidance and procedures, could be disciplined for not doing so, or for
colluding with the abuse.
For the purposes of the practice guidance and procedures “staff” includes volunteers as well as
employees of agencies.
Refer to our own internal Whistleblowing Procedures for further information.
Whistleblowers should know how to access support and to protect their own interests. Even if they
decide that they wish to make an anonymous report, the information they provide will be taken into
account and treated seriously.
Reporting to CQC
The Adult Safeguarding Lead Person will follow outcome 20 of the CQC Essential Standards.
The Adult Safeguarding Lead Person will complete an Outcome 20 notification to the care
quality commission where the Outcome 20 criteria are met.
Ratified on .....................................
Signed: .........................................
To be reviewed: ……………………….. or as legislation changes.
Appendix 1
(Appendix 7 of Adult Safeguarding Guidance and Procedure)
Actions to be taken after becoming aware of an adult safeguarding concern
Flowchart for all agencies
Abuse discovered
or suspected
IMMEDIATELY
IF SERIOUS
Is the vulnerable adult in immediate danger
or in need of emergency medical
treatment?
And/or has a crime been committed?
And/or is there a need to protect forensic
evidence?
Consult with manager
whether an adult
safeguarding referral
is appropriate
Adult safeguarding
concern confirmed
Contact Emergency
Services e.g. police,
Ambulance, GP
No further action under Adult
Safeguarding Policy
Guidance and Procedures.
Record accurately details of
the incident and outcome of
discussion with manager.
WITHIN
24 HOURS
Consider other options. Is
another adult or child at risk?
Is there evidence a
crime has been
committed?
Contact police and Adult
Safeguarding Lead via
Cambridgeshire Direct with
adult safeguarding concern
Record all information
and pass to manager
and relevant Adult
Safeguarding Lead
If allegation involves
agency staff, appropriate
contact is made with the
agency
Contact
Cambridgeshire
Direct with an
adult
safeguarding
concern
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