Publications
Adult Safeguarding Leaflets and Posters
Adult Safeguarding Posters - See it, Report it!
Adult Safeguarding Leaflet:
Infographic - It all Points to Prevention
Annual Reports
The Care Act 2014 requires each Safeguarding Adults Board (SAB) to publish an annual report.
The Care Act (Schedule 2.4 (1) a–g) defines the minimum content of an annual report.
As soon as is feasible after the end of each financial year, a SAB must publish a report on:
- What it has done during that year to achieve its objective,
- What it has done during that year to implement its strategy,
- What each member has done during that year to implement the strategy,
- The findings of the reviews arranged by it under section 44 (safeguarding adults reviews) which have concluded in that year (whether or not they began in that year),
- The reviews arranged by it under that section which are ongoing at the end of that year (whether or not they began in that year),
- What it has done during that year to implement the findings of reviews arranged by it under that section, and
- Where it decides during that year not to implement a finding of a review arranged by it under that section, the reasons for its decision.
- The performance of member agencies and how effectively, or otherwise, they are working together should be included in the report.
The annual report must be sent to:
- The Chief Executive and leader of the local authority which established the SAB,
- Any local policing body that is required to sit on the SAB,
- The local Health watch organisation,
- The chair of the local health and wellbeing board.
Annual reports should form the basis for the consultation on the strategic plan for the coming year.
A SAB should seek assurance from its members that the annual report has been considered within their internal governance processes.
LSAB Annual Report 2022-2023
Message from the Independent Chair
“One particular area of concern locally is the resourcing of mental health services, both for people with severe forms of mental distress requiring an inpatient bed, and for those living in the community, but in need of wrap-around mental health support”.
It is my pleasure to introduce this annual report which describes the work that has been done and the progress that has been made in keeping adults safe from abuse and neglect. We are slowly emerging from the worst of the Covid-19 pandemic but it continues to have an impact emotionally and practically for everyone. Services are having to readjust their ways of working, and for citizens the health, emotional and social impacts of the pandemic continue to be felt.
We are also experiencing a significant cost of living crisis, with a seemingly endless rise in the use of food banks and in poverty. We are only beginning to capture the data about the impact of this crisis on adult safeguarding, and I expect that next year’s annual report will reflect on what health, housing and social care services have witnessed. The Board has sought assurance from the local authority and its partners about the measures put in place to support citizens affected by the cost of living crisis.
We have continued to see the impact of financial austerity on public services. One particular area of concern locally is the resourcing of mental health services, both for people with severe forms of mental distress requiring an inpatient bed, and for those living in the community, but in need of wrap-around mental health support. We will continue to engage with mental health service providers and focus on improving the quality of practice.
The management of Safeguarding Adults Reviews continues to be a major focus of the Board’s work. It is reassuring that partner agencies are referring cases for consideration where an adult has died or experienced significant harm as a result of abuse and neglect. The Board has also kept a focus on how practice has improved and services developed, through webinars and assurance reporting, following the implementation of recommendations from completed reviews.
The Board has refreshed its Strategic Business Plan, a statutory requirement, to ensure that there is a clear focus on priority areas for assurance reporting and targeted task and finish work.
The Board has continued its work on developing its collation and reporting on performance data, and is actively supporting the local authority in its preparation for a forthcoming inspection by the Care Quality Commission. We have engaged directly with people with lived experience of adult safeguarding, but there is more that we must do in order to learn from those who have experienced abuse and neglect. This is one of my personal priorities.
I would like to thank Martin Crow and Vicki Williams who have supported me and taken forward much of the Board’s work. The Board’s web pages are a particular excellent example of the work they have put in. I also thank all of the Board’s partners for their contribution to adult safeguarding in Lewisham.
Professor Michael Preston-Shoot
Summary of Delivery in 2022-23
The Board continued to oversee the delivery of its strategic aims and objectives. Key areas of work included: Safeguarding Adults Reviews (SARs)
The Board continues to be busy in this area of work which reflects the willingness of local professionals to seek transparency in relation to their practice.
Learning and Development
The Board continues to invest heavily in this subject providing free to access courses in a range of subject areas. The Board supported the National Safeguarding Awareness Week in November 2022 by helping to provide a very extensive learning programme in London and nationally.
Community Engagement
The Board routinely communicates and engages with around 200 local organisations in Lewisham, and continues to expand on this
outreach. A first of its kind Citizen’s Assembly was delivered by the Board in October 2022, which was co-produced and delivered by over a dozen local Voluntary and Community Sector Organisations.
Seeking Assurance
An audit of safeguarding practice and delivery was completed by selected partners, and the trends used to develop the Board’s strategic priorities. The Housing Related Safeguarding Audit was finalised with a ‘Summit’ in December 2022 attended by a wide range of agencies. The Lewisham Adult Safeguarding Pathway was also reviewed in November 2022 based on feedback from local practitioners.
Partners Work
Metropolitan Police Service
PC Chesca Rogers won a well-deserved national safeguarding award in 2022, as well as being recognised within the Metropolitan Police Service, for her outstanding work on the Domestic Abuse and Violence Disclosure Scheme (Clare’s Law).
Chesca has helped an incredible number of people in the last 2-3 years, as well as recommending changes to this national scheme to ensure this was more accessible during the Covid-19 pandemic period.
“Clare’s Law is the most empowering thing I have ever worked on giving people the ability to safeguard themselves and their children. I would encourage anyone to use it as it is completely confidential and the person being enquired about will never know about this. You would check reviews about products before you buy online, so why not do the same about a potential partner”.
See here for more information on Clare's Law
Lewisham and Greenwich NHS Trust
The following case example helps to illustrate Clare’s Law in action:
A woman attended the Emergency Department (ED) at the University Hospital of Lewisham with injuries that suggested an assault. She reported that she was intoxicated but had no memory of an assault. The ED team made a safeguarding referral to the trust safeguarding team and she was admitted to a ward. The safeguarding advisor gained consent for a referral to the Independent Domestic Violence Advisor (IDVA) and suggested that the medical photography team record the injuries.
A police report was discussed with the woman but she declined this. The IDVA then worked with the woman and discovered that she had just moved in with a new partner, and she had a history of experiencing domestic abuse in past relationships.
The IDVA supported the woman to make a Clare’s Law application to the Metropolitan Police, and the disclosure came back with some very concerning information about the history of the new partner. The woman decided to end the relationship and with the support of the IDVA she then made a report to the police, who requested the photographs. The IDVA offered a refuge referral, and the woman declined initially, but after further housing enquiries, this offer was remade and accepted. The IDVA also provided the woman with a voucher for food.
“Thank you for everything. I felt really looked after”.
Lewisham Council - Adult Social Care
It has been 18 months since the Adult Multi-Agency Safeguarding Hub (MaSH) Team was established, which now addresses all of the Safeguarding Concerns that come into the local authority via Adult Social Care. During this time significant progress has been achieved and the team has been expanded, including the recent recruitment of a specialist domestic abuse Officer who will help to strengthen links with partners.
Relationships with health colleagues have continued to improve and the time taken to effectively deal with pressure ulcer cases has significantly reduced. The link with adult mental health services has also been strengthened and there is now a dedicated mental health liaison social worker within the MaSH team, who will help to take forward the plan for further integration with South London and Maudsley NHS Foundation Trust (SLaM).
The amount of work that the MaSH Team has completed in the past year has also continued to grow, with around 500 referrals a month being managed, along with the 500 Police Merlin reports that are also triaged each month. Work is in progress to help make this system more efficient, and the MaSH Team will continue to develop their wider practice to help keep those most at risk of abuse and neglect in Lewisham safe from harm.
Learning, Training and Development
Amanda and Eileen Dean SAR Learning Event 22 February 2023
A record 1,248 people attended 35 learning and development events delivered by the Board during the last 12 months, which is significantly higher than any previous year. This was bolstered by over 400 people attending the online and joint learning event for the Amanda and Eileen Dean SARs which is the single largest activity ever held by the Board, that attracted attention from across London and the wider U.K.
This event was recorded and can be viewed here: Safeguarding Adults Reviews
We recommend you take the time to watch this video linked to these very high profile cases.
The success of the Board’s learning events are carefully analysed and are routinely scored as having a ‘significant impact’.
Lewisham Adult Safeguarding Pathway
Another record 97,128 hits were achieved on the Board’s website (25% increase on the previous year), many of which were on the Lewisham Adult Safeguarding Pathway pages.
The Pathway was first published in April 2021 and has been constantly updated since then whenever the legal framework has changed, national guidance has been produced, or local policies created or updated. The ambition is to ensure every organisation (around 500 in Lewisham) and professional delivering services to, or working with adults at risk, are regularly accessing the Pathway.
Please ensure you use the Lewisham Adult Safeguarding Pathway
Communication and Engagement
Citizen’s Assembly - Corbett Community Library: 7 October 2022
This Assembly, which was the first of its kind for the Board, was planned in a lot of detail, and delivered in conjunction with a wide range of Voluntary and Community Sector Agencies, and attended by 25 residents (plus carers) from Lewisham.
In total there were 250+ pieces of evidence and feedback was captured which has been collated, shared, and used to help shape the delivery of services locally.
The most prevalent type of abuse disclosed by those attending was Domestic Abuse with people sharing their stories about the ways this was being experienced:
Financial in nature, including the misuse or withholding of the adult’s benefits.
Familial abuse with younger adults abusing their parents or other family carers.
Female Genital Mutilation (FGM). This was highlighted as a significant issue with (east) African communities and unlikely to reach the attention of statutory services.
There may also be some inter-connectedness with ‘neglect’ by family members with caring responsibilities.
Safeguarding Information 2022-23
Table 2: Police MERLIN and Crime Report Investigation System (CRIS)
The MERLIN system is the way in which police share intelligence about adults where there are wider ‘vulnerability’ concerns, although this does not match the Care Act 2014 criteria in relation to ‘adults at risk’. Local police attended an average of 68 incidents per month in relation to adults with a “mental health crisis” (London average = 52), which in 8/9 of the months reported was in the top 10 in London.
The Domestic Abuse and Violence Against Women & Girls (VAWG) Strategy was published in December 2021. In the shorter term the aim was to continue improving awareness which would result in increased reporting, including within Adult Social Care, which should then reduce as interventions and prevention measures develop.
Safeguarding Adults Reviews (SARs)
‘Amanda’. This review was published on 2 November 2022.
Amanda was a white woman who was born and grew up in southeast London. She died in May 2019 at age 57. At a young age, doctors had diagnosed Amanda with paranoid schizophrenia. Amanda developed a dependence on drugs and alcohol and used different substances at different times in her adult life.
The Care Home where Amanda lived provided her with 24-hour care and support. In 2018-2019 some of Amanda’s social life revolved around street drinking. When she was intoxicated Amanda was susceptible to falling and sustaining injuries.
On 15 May 2019 Amanda did not return to The Care Home. Amanda did sometimes go missing for short periods of time. On this occasion, when she did not return quickly, family members began their own enquiries. The police responded by searching an unused garage in the borough. The garage was derelict and along with adjacent garages was due to be demolished as part of a redevelopment programme. It had been used as a rough sleeping site. To stop this activity, the entrance to the garage was boarded up in May 2019. On 5 July 2019 the police found Amanda’s body in the back of the garage. She had been missing for just under two months.
Read the 7 Minute Briefing for professionals to see the key learning points.
‘Eileen Dean’. This review was published on 11 November 2022.
Eileen Dean was a 93-year-old white British woman who had moved into a care home in Lewisham in June 2020. Although her capabilities were reduced by dementia, Eileen remained happy and contented.
"The Adult" is a white British man who was 62 years old when he physically assaulted Eileen. He had initially been admitted to a general medical ward at the University Hospital Lewisham (UHL) operated by Lewisham and Greenwich NHS Trust in July 2020 following alcohol withdrawal seizures.
The Adult was detained under Section 2 of the Mental Health Act 1983 (MHA) on 3 Sept 2020, and eventually transferred to the inpatient psychiatric unit at UHL, and later discharged to the same care home as Eileen in December 2020.
The Adult was diagnosed with Wernicke-Korsakoff Syndrome, which has an established link in academic literature with aggressive behaviour. Between 5 August 2020 to 4 September 2020, there were at least 34 recorded incidents of The Adult’s violence or threats to patients or staff, including The Adult threatening to use a bread knife, scissors and dinner trays as weapons.
At 12.30am on 4 January 2021 Eileen Dean was assaulted whilst lying in bed by The Adult. Eileen sustained significant injuries and died in hospital later that day.
Read the 7 Minute Briefing for professionals to see the key learning points.
SAR Notifications between April 2018 and March 2023
During this period there were 21 SAR Notifications:
14 Female 7 Male
The age range for the subjects of SAR Notifications is much lower than for Safeguarding Enquiries.
From these Notifications 9 SARs have been completed between April 2015 and 31 March 2023 and all have been published in the public domain.
The dominant subject area that is prevalent in the Notifications is mental ill-health, which is a feature in 66% of the published SARs and 3 further ongoing reviews.
In comparison mental ill-health was the Primary Support Reason in only 5% of the concluded s.42 Enquiries conducted in Lewisham in 2020-21 and 2022-23 (16% in England).
Adults from Black British, Black African and Black Caribbean backgrounds were disproportionally more likely to be the subjects of a SAR Notification linked to mental ill-health.
Work of the Sub-Groups
Case Review Sub-Group
The Sub-Group oversees Safeguarding Adults Review (SAR) processes locally, and is led by the Board’s Independent Chair Professor Michael Preston-Shoot.
The group met 6 times during 2022-23 and considered or monitored 9 cases throughout the year, including 4 new SAR Notifications.
A new joint protocol has been developed over the last year between the two safeguarding partnerships in the Borough, and the Safer Lewisham Partnership Board, which more clearly defines which statutory review process will take precedence when a case meets the criteria for more than one.
The board also contributed to the National SAR Library which holds all of the reviews which have been published in Lewisham since April 2015.
Lewisham Modern Slavery and Human Trafficking (MSHT) Network
The Board continues to administrate and support the delivery of this multi-agency group which meets on a quarterly basis.
Colleagues from the Human Trafficking Foundation also underpin this work, and in July 2022 they gave a presentation to the Board updating them on the local, regional and national picture.
In the last year the Borough has also been successful in joining other local authority areas in conducting National Referral Mechanism (NRM) decisions locally (rather than by the Home Office) for under 18’s. This is helping to speed up decision making dramatically and ensure victims of MSHT are receiving the care and support they require.
Performance, Audit and Quality Sub-Group
This group continued to meet quarterly throughout the year to analyse and monitor the Board’s performance indicators and other relevant safeguarding information. This activity also plays a significant part in informing the ongoing development of the Board’s strategic objectives. The group provided the necessary governance for the LSAB Safeguarding Audit that was conducted during 2022-23. The findings from this were reviewed by partners at the Board’s Development Session in March 2023, which included a chance to constructively challenge each organisations individual self-assessment.
The Housing Related Safeguarding Audit has led to a further review of local Self-Neglect Policy and Procedures and the creation of a
working group to take this forward. This group are considering the most suitable options for escalating risks in relation to this subject. This will lead to a follow-up and Second ‘Summit’ in December 2023.
The group also commissioned a Hospital Discharge audit which will be reported on in next years’ Annual Report.
Liberty Protection Safeguards (LPS) Task and Finish Group
This group met periodically again throughout the year but has now been stood down as the Government have announced that
the Mental Capacity (Amendment) Act 2019 will not now be implemented in this current period of parliament, and as such the current Deprivation of Liberty Safeguard (DoLS) regime will prevail. There will be a review of DoLS procedures locally during 2023-24.
Strategic Business Plan 2023-24
In line with the five priority areas there are a total of 22 Actions that are planned for 2023-24. This is the most ambitious work programme the Board has had since it became a statutory body in 2015.
Full details can be read here:
LSAB Partnership Compact and Strategic Business Plan 2023-24
Download a copy of the LSAB Annual Report 2022-2023
Download a copy of the LSAB Annual Report 2021-2022
Download a copy of the LSAB Annual Report 2020-2021
Download a copy of the LSAB Annual Report 2019-2020
Download a copy of the LSAB Annual Report 2018-2019
Safeguarding Adults Reviews
Read and download all of the published Safeguarding Adult Reviews Commissioned by Lewisham Safeguarding Adults Board.
Safeguarding Adults Review - Arthur - 10 November 2023
Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review Arthur.
Accompanying this report is a statement from the family of Arthur.
The Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing - Arthur - for Professionals.
Safeguarding Adults Review Joshua 7 June 2023
Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review Joshua.
The Lewisham Safeguarding Adults Board has also published a statement in relation to this review.
The Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing - Joshua - for Professionals.
Safeguarding Adults Review (SAR) Learning Event Amanda and Eileen Dean
Lewisham Safeguarding Adults Board held this important online event on Wednesday 22 February 2023 2pm - 4pm.
The event was hosted by our Independent Chair, Professor Michael Preston-Shoot and included presentations from the independent reviewers involved in these cases (Susan Harrison and Patrick Hopkinson) as well information on wider SAR themes, including a Q&A session. This high-profile and heavily subscribed event provided a significant learning experience for those who attended.
Recordings, Q&A and presentations from the event are available below.
Amanda
Eileen Dean
Questions and Answers from the Amanda and Eileen Dean SAR Learning Event
Questions and Answers from the Amanda and Eileen Dean SAR Learning Event 22-02-23
Safeguarding Adults Review for Eileen Dean 11 November 2022
Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review for Eileen Dean.
Accompanying this report is a statement from Eileen's family.
The Lewisham Safeguarding Adults Board has also published a statement in relation to this review.
The Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing - Eileen Dean - for Professionals.
Safeguarding Adults Review for Amanda 2 November 2022
Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review for Amanda.
Accompanying this report is a statement from the family of Amanda.
Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing - Amanda - for Professionals.
Safeguarding Adults Review for Mia 29 September 2021
Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review for Mia.
Lewisham Safeguarding Adults Board has also produced a LSAB 7 Minute Briefing - Mia - for Professionals.
19 July 2021 Safeguarding Adults Review – Adult Z
Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review for Adult Z.
Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing - Adult Z - for Professionals.
The key learning points from this Safeguarding Adults Review were mental ill health, the complexities of mental capacity assessment and providing emergency care in the community for adults with complex needs.
Friday 26 June 2020 - Safeguarding Adults Review – Mrs A & Miss G
Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review for Mrs A & Miss G.
Lewisham Safeguarding Adults Board has also produced a LSAB 7 Minute Briefing - Mrs A & Miss G - for Professionals.
Friday 12 June 2020 - Safeguarding Adults Review – Mr Tyrone Goodyear
Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review for Mr Tyrone Goodyear.
Accompanying this report is a statement from the family of Tyrone.
Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing - Tyrone Goodyear - for Professionals.
Zero Suicide Alliance provide a range of awareness training options, which provide a better understanding of the signs to look out for and the skills required to approach someone who is struggling, whether that be through social isolation or suicidal thoughts.
Friday 5 June 2020 - Safeguarding Adults Review - Executive Summary - Lee
Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review Executive Summary - Lee.
Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing – Lee - for Professionals.
During 2018 Lewisham Safeguarding Adults Board published two safeguarding adult reviews. The full reports and accompanying documents are available to read and download below.
Mr Michael Thompson - Safeguarding Adults Review - Full Report
Statement of the board in relation to the Safeguarding Adults Review - Mr Michael Thompson
Safeguarding Adult Review, Reflection and Development Briefing - Personalising Care and Improving Outcomes
Mr CS - Safeguarding Adults Review - Full Report (Includes board statement)
Mr CS - Safeguarding Adults Review - Practice Briefing
Guidelines On Risk Assessment for Smoking in Care Homes
Find out more about Safeguarding Adult Reviews and How to Make a Referral to the LSAB.
Watch the Carers Guide to Home Fire Safety
National SAR Analysis – 7 minute briefings
The LGA have produced a series of 7 minute briefings for different audiences regarding the findings of the national SAR analysis:
National Network for Chairs of Adult Safeguarding Boards
You can find all of the Safeguarding Adults Reviews published nationally in the National Network for Chairs of Adult Safeguarding Boards - SAR Library.
Partnership Compact and Strategic Business Plan 2023-2024
Introduction
This document describes how organisations and their representatives on the Lewisham Safeguarding Adults Board (LSAB) will work together in partnership to safeguard the residents of Lewisham in 2023-24. It is based on the statutory functions of Safeguarding Adults Boards as set out in the Care Act 2014, Care and Support Statutory Guidance.
Safeguarding means protecting an adult’s right to live in safety, 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 that the adult’s wellbeing is promoted including, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action.
1.1 The aims of adult safeguarding:
• stop abuse or neglect wherever possible;
• prevent harm and reduce the risk of abuse or neglect to adults with care and support needs;
• 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;
• raise public awareness so that communities as a whole, alongside professionals, play their part in preventing, identifying and responding to abuse and 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 well-being of an adult; and
• then address what has caused the abuse or neglect.
1.2 Six key principles underpin all adult safeguarding work:
• Empowerment – people being supported and encouraged to make their own decisions and informed consent.
• Prevention – it is better to take action before harm occurs.
• Proportionality – the least intrusive response appropriate to the risk presented.
• Protection – support and representation for those in greatest need.
• Partnership – local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse.
• Accountability – accountability and transparency in delivering safeguarding.
1.3 Safeguarding duty: (this applies to an adult who)
• has needs for care and support (whether or not the local authority is meeting any of those needs) and;
• is experiencing, or at risk of, abuse or neglect; and
• as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect.
2. What is abuse and / or neglect?
The criteria set out in section 1.3 above need to be met before the issue is considered as a concern under the statutory safeguarding duty. Exploitation is a common theme in the following list of the types of abuse and neglect.
• Physical abuse: including assault, hitting, slapping, pushing, misuse of medication, restraint, or inappropriate physical sanctions.
• Domestic abuse: including psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence. A new definition is outlined in the Domestic Abuse Act 2021 including a description of ‘personally connected’.
• 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.
• Sexual exploitation: This is when a sexual act takes place in exchange for things like food, shelter, protection, or to pay bills, and the victim may have been coerced or manipulated into this sexual act.
• 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 or 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 (including Hate Crimes).
• 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 services, the withholding of the necessities of life, such as medication, adequate nutrition and heating.
• Self-neglect: this covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding.
3. The statutory functions of Safeguarding Adults Boards
As set out in Care and Support Statutory Guidance, each Safeguarding Adults Board should:
• identify the role, responsibility, authority, and accountability with regard to the action each agency and professional group should take to ensure the protection of adults;
• establish ways of analysing and interrogating data on safeguarding notifications that increase the SAB’s understanding of prevalence of abuse and neglect locally that builds up a picture over time;
• establish how it will hold partners to account and gain assurance of the effectiveness of its arrangements;
• determine its arrangements for peer review and self-audit;
• establish mechanisms for developing policies and strategies for protecting adults which should be formulated, not only in collaboration and consultation with all relevant agencies but also take account of the views of adults who have needs for care and support, their families, advocates and carer representatives;
• develop preventative strategies that aim to reduce instances of abuse and neglect in its area;
• identify types of circumstances giving grounds for concern and when they should be considered as a referral to the local authority as an enquiry;
• formulate guidance about the arrangements for managing adult safeguarding, and dealing with complaints, grievances and professional and administrative malpractice in relation to safeguarding adults (which includes whistleblowing: see 5.4.3 to 5.4.7 of the London Multi-Agency Adult Safeguarding Policy and Procedures);
• develop strategies to deal with the impact of issues of race, ethnicity, religion, gender and gender orientation, sexual orientation, age, disadvantage and disability on abuse and neglect;
• balance the requirements of confidentiality with the consideration that, to protect adults, it may be necessary to share information on a ‘need-to-know basis’;
• identify mechanisms for monitoring and reviewing the implementation and impact of policy and training;
• carry out Safeguarding Adults Reviews;
• produce a Strategic Plan and an Annual Report;
• evidence how SAB members have challenged one another and held other boards to account; and,
• promote multi-agency training and consider any specialist training that may be required; including considering any scope to jointly commission some training with other partnerships, such as the Lewisham Safeguarding Children’s Partnership Board.
The Strategic Business Plan for 2023-24 (page 11) sets out how the LSAB partner agencies will collectively prioritise and deliver these functions over the next 12 months.
4. Lewisham Safeguarding Adults Board (LSAB) Terms of Reference
The LSAB works to prevent harm or neglect and to help those harmed by leading on and facilitating the following safeguarding adult activities for the borough:
• Strategic planning: activities such as consultation, setting goals and objectives, action planning and prioritisation, securing resources, tracking and review of implementation and goal achievement for safeguarding strategy. In addition, the LSAB will influence and link to strategic planning and commissioning across the partnership to advise and scrutinise in relation to safeguarding adults.
• Setting standards and guidance: activities such as setting standards to be achieved, developing policies and procedural guidance to guide practice towards those standards. Monitoring and auditing the implementation of these policies and procedures.
• Quality assurance: lead and ensure activities such as monitoring, audit and review of practice, review of serious cases, incorporation of research and national guidance are undertaken as required. Conducting audits to ensure the effectiveness of what is done by agencies individually and collectively to safeguard and promote the welfare of adults at risk. Commissioning Safeguarding Adults Reviews and / or other reviews of incidents or organisations when an adult dies or is seriously harmed and abuse or neglect is suspected or proven.
• Promoting participation: by people who use services and carers in safeguarding practice. Promoting awareness and action in the wider community.
• Awareness raising & publicity: activities such as public awareness campaigns, targeted publicity and educational strategies, raising awareness within services.
• Capacity building and training: activities such as training and workforce development.
• Relationship management: activities such as the negotiation and clarification of interagency roles and contributions, member agency compliance, troubleshooting and resolution of difficulties, liaison with wider partnerships and related areas of practice. In addition, undertake work as appropriate with the Lewisham Safeguarding Children’s Partnership Board, Safer Lewisham Partnership and Lewisham Health and Wellbeing Board to ensure that policy and procedures, training and all other activities are co-ordinated and coherent.
4.1 Care and Support Statutory Guidance
Members of a SAB are expected to consider what assistance they can provide in supporting the Board in its work. This might be through payment to the local authority or to a joint fund established by the local authority to provide, for example, secretariat functions for the Board.
Members might also support the work of the SAB by providing administrative help, premises for meetings or holding training sessions. It is in all core partners’ interests to have an effective SAB that is resourced adequately to carry out its functions.
Members who attend in a professional and managerial capacity should be:
• able to present issues clearly in writing and in person;
• experienced in the work of their organisation;
• knowledgeable about the local area and population;
• have a thorough understanding of abuse and neglect and its impact;
• understand the pressures facing front line practitioners;
• able to explain their organisation’s priorities;
• able to promote the aims of the SAB; and,
• able to commit their organisation to agreed actions*.
While board members representing their organisations are expected to have the authority to commit their organisation to agreed actions, those board members representing Sub-Groups or non-service provider organisations may not have the relevant authority. In their case their role is to liaise between the Board and the Sub-Group and take back to their own organisations any proposals or recommendations for action.
Each member of SAB must co-operate and contribute to the carrying out of a Safeguarding Adults Review (SAR) with a view to:
a) identifying lessons to be learnt from the adult’s case, and
b) applying those lessons to future cases.
4.2 The responsibilities of members of the LSAB
The Lewisham Safeguarding Adults Board has an Independent Chair and Deputy Chair from one of the Board’s partner agencies.
The LSAB expects board members to:
• develop and maintain effective working arrangements based on trust and mutual understanding;
• be an active partner in safeguarding and promoting the welfare of adults at risk of harm or neglect;
• contribute to the LSAB financially or by providing staff for particular tasks;
• collate and provide management information as required by the LSAB and contribute to quality assurance arrangements;
• share information to safeguard adults in line with agreed information sharing arrangements;
• commit to the work of the Board by undertaking allocated tasks or sourcing the appropriate support from within their agency to undertake the work and contributing to discussions;
• identify and support staff to participate in the interagency activities of the LSAB through their active membership of the Sub-Groups and / or Task & Finish Groups, and to progress of the work of the Board between meetings;
• ensure that the policies, procedures, guidance, tools and resources in the Lewisham Adult Safeguarding Pathway are disseminated and acted upon in an effective way within their own organisations;
• ensure that communications are cascaded through organisations, services and to front-line staff as appropriate;
• represent the LSAB and its activities within their own organisation and within any groups they represent on the Board;
• report difficulties with own organisation and between organisations to the LSAB and work with partners to find effective solutions.
4.3 Organisations represented on the LSAB
1. Age UK Lewisham and Southwark
2. Bromley, Lewisham and Greenwich MIND
3. Department for Work and Pensions – South London District
4. Healthwatch Lewisham
5. Lewisham & Greenwich NHS Trust
6. Lewisham Adult Social Care
7. Lewisham Children & Young People’s services
8. Lewisham Refugee and Migrant Network (LRMN)
9. Lewisham Safeguarding Children Partnership (LSCP)
10. Lewisham Homes
11. Lewisham Joint Commissioning Group
12. Lewisham Public Health
13. Lewisham Public Protection and Safety
14. Lewisham Strategic Housing Services
15. London Ambulance Service
16. London Fire Brigade
17. Metropolitan Police, Lewisham (South East BCU)
18. National Probation Service, Lewisham and Bromley
19. NHS South East London Integrated Care Service and Board
20. South London & Maudsley NHS Foundation trust
There will also be representatives from partner agencies on Sub-Groups.
4.4 Governance and accountability
• The LSAB is responsible for ensuring organisations are meeting their safeguarding obligations effectively and will hold them to account if they are not.
• As individuals, Board members are accountable to their own agencies but the Board as a whole will be accountable to the Department of Health and Social Care, and provides reports locally to the Health and Wellbeing Board and the Healthier Communities Select Committee. Its work may be scrutinised periodically by the Overview and Scrutiny Committee and is liable to be inspected at any time by the Care Quality Commission (CQC).
• The Board, through the independent chair, is accountable to the Chief Executive of the Local Authority, the Chief Executive of the NHS Integrated Care Board (ICB) and the Borough Commander of Police.
• These Executive Group of agencies may periodically meet to discuss the strategic direction of the Board, and additionally invite the London Fire Brigade Borough Commander, Chief Executive of Lewisham & Greenwich NHS Trust, and Chief Executive of the South London & Maudsley NHS Foundation Trust to join this group.
4.5 Equality and fairness
• The LSAB operates and supports the principles that actively value the benefits of
diversity, fair treatment, and equal access to, and outcomes from local service delivery.
• The LSAB will seek, so far as it is practicable, to ensure equality of representation and participation in the local democratic process of which it is a part.
• The LSAB will, through its composition and ways of working, seek to inform, support, involve and give a voice to all sections of the local communities it serves, with particular emphasis on the inclusion of black, Asian and minority ethnic groups, faith communities and those living with a disability. It will seek to ensure an appropriate gender balance in its membership, so far as this is practicable.
4.6 Dispute resolution between LSAB Members – escalation policy
In order for practitioners and agencies to work together effectively to safeguard adults at risk, ‘professional challenge’ should be seen as part of a healthy working relationship.
Successful partnership working is reliant upon resolving professional disagreements in a timely manner in order to avoid any potential risks to the adult(s) in question.
• As far as possible any inter-agency disputes should be resolved by negotiation and discussion between the practitioners directly involved.
• If this does not bring the matter to a satisfactory conclusion this should be escalated through the hierarchies of the agencies up to senior management level if needed.
• If this still does not lead to a constructive and positive outcome the issue should be referred to the Executive Group in writing via the Chair of the LSAB. The group will consider whether it is necessary to establish a panel consisting of no less than three members from constituent organisations, who have no direct involvement in the matter. Appropriate representation from LSAB member(s) of the agencies involved in the dispute will then be invited to attend a resolution meeting. A formal agreement to resolve the dispute will be recorded and sent to the organisations involved for reference.
4.7 Conflicts of interest
Whenever a representative has a conflict of interest in a matter to be decided upon, the representative concerned shall declare such interest at or before discussions begin on the matter. The Chair shall record the interest in the minutes of the meeting and that representative shall take no part in the decision-making process.
5. The operational structure of the Lewisham Safeguarding Adults Board
5.1 The frequency of LSAB meetings
The Board meets four times a year. Board meeting dates will be set as far in advance as possible (normally 12 months) to ensure availability of all board members.
5.2 LSAB Sub-Groups
LSAB work activities are designed to achieve results in the most effective and efficient ways. This may include formal Sub-Groups meeting on a planned regular basis or through smaller specific Task and Finish Groups, workshops, or other consultative events.
Each Sub-Group have their own Terms of Reference (Appendices 3-4), are responsible for delivering specific LSAB Strategic Objectives, and may commission Task and Finish Groups to deliver specific pieces of work linked to these objectives. Members of these groups must understand the remit of the LSAB; that they are assisting the LSAB to meet its objectives; and have the capacity to undertake work for the Board.
Membership of these groups will reflect a range of agencies across Lewisham. They may also include individuals with specialist knowledge or the ability to add value to achieving and implementing planned objectives.
Members are expected to attend meetings; contribute to discussions and activities of the Sub-Group. They may be required to undertake agreed specific tasks, delivering these in a timely way, alerting the Sub-Group Chair or other identified lead officer in advance of any deadlines being missed.
Strategic Learning will be shared along with the Lewisham Safeguarding Children Partnership (LSCP) and Safer Lewisham Partnership (SLP) to share the learning from Safeguarding Adults Reviews, Child Safeguarding Practice Reviews and Domestic Homicide Reviews, enabling higher level strategic objectives to be developed and shared.
5.3 Attendance
Individuals identified as Board, Sub-Group and / or Task and Finish Group members are expected to regularly attend meetings. Where there is unavoidable absence, all organisations should ensure that there is a suitable substitute representative from their agency.
5.4 Administrative arrangements for the LSAB
The agenda and associated papers for each Board meeting are issued no later than five working days before the meeting by the LSAB Administrator.
Minutes of LSAB Board meetings are taken by the LSAB Administrator and circulated within 15 working days of the meeting.
6. Review
These terms of reference will be reviewed as required in response to significant change in guidance, legislation, or member organisations.
Strategic Business Plan 2023-24
LSAB Strategic Business Plan 2023 - 2024
Board Meeting Minutes
On this page you can find minutes of the Lewisham Safeguarding Adults Board meetings.
Policy and Procedures
The introduction of the Care Act 2014 put adult safeguarding on a statutory footing for the first time, embracing the principle that the ‘person knows best’. It laid the foundation for change in the way that care and support is provided to adults, encouraging greater self-determination, so people maintain independence and have real choice.
There is an emphasis on working with adults at risk of abuse and neglect to have greater control in their lives to both prevent abuse and neglect from happening, and to give meaningful options for dealing with it should it occur.
For professionals who work in Care & Support settings the Care Act provides clearer guidance, and supports pathways to working in an integrated way, breaking down barriers between organisations.
The Association of Directors of Adult Social Services (ADASS), NHS London, the Metropolitan Police, and the London Clinical Commissioning Council have produced London Multi-Agency Adult Safeguarding Policy & Procedures Lewisham Safeguarding Adults Board follows these procedures.
LSAB Adult Safeguarding Single Agency Policy and Procedure Template
This good practice template can be used and modified by any agency. The template outlines the sections that need to be inserted by the agency to include their individual procedures, details and arrangements.
Download Single Agency Policy and Procedures Template (for use by any agency) January 2023
Self-Neglect and Hoarding Multi-Agency Policy, Practice Guidance and Toolkit from the LSAB
Read our policy and practice guidance on self-neglect and hoarding.
Lewisham Modern Slavery Partnership and Victim Care Pathway
Lewisham Modern Slavery Partnership Strategy (Oct 2022)
Modern Slavery and Human Trafficking 7 Minute Briefing
Modern Slavery and Human Trafficking 7 Minute Briefing
LSAB Guidance for Reporting Medication Incidents as Adult Safeguarding Concerns Jan 2022
Guidance for Falls Events as Adult Safeguarding Concerns -
Guidance for Falls Events as Adult Safeguarding Concerns (Jan 2023)
Inter-Agency Escalation Policy -
Inter-Agency Escalation Policy (July 2023)
LSAB Guidance on Improving our Approach to Adult and Family Engagement
This guidance provides information on Adopting a Trauma Informed Approach, Understanding the Barriers to Seeking Help, Engagement Principles and Methods that can be Used for Engagement.
Information Sharing
Adult Safeguarding: Sharing Information
Sharing the right information, at the right time, with the right people, is fundamental to good practice in safeguarding adults.
Frontline professionals and volunteers should always report safeguarding concerns in line with their organisation’s policy. Policies should be clear about how confidential information should be shared between departments in the same organisation.
For Safeguarding purposes sensitive or personal information sometimes needs to be shared between the Local Authority and its safeguarding partners (including GP’s, health, the police, service providers, housing, regulators and the Office of the Public Guardian). This may include information about individuals who are at risk, service providers or those who may pose a risk to others. It aims to enable partners to share information appropriately and lawfully in order to improve the speed and quality of safeguarding responses.
The Care Act emphasises the need to empower people, to balance choice and control for individuals against preventing harm and reducing risk, and to respond proportionately to safeguarding concerns. The Act deals with the role of the safeguarding adults board’s (SAB’s) in sharing strategic information to improve local safeguarding practice. Section 45 ‘the supply of information’ covers the responsibilities of others to comply with requests for information from the safeguarding adults board.
Sharing information between organisations as part of day-to-day safeguarding practice is already covered in the common law duty of confidentiality, The EU General Data Protection Regulation (GDPR) the Data Protection Act, the Human Rights Act and the Crime and Disorder Act. The Mental Capacity Act is also relevant as all those coming into contact with adults with care and support needs should be able to assess whether someone has the mental capacity to make a decision concerning risk, safety or sharing information.
LSAB Information Sharing Agreement Jan 2024
Lewisham Safeguarding Adults Board (LSAB) has an information sharing agreement that includes the whole partnership.
LSAB Information Sharing Agreement Jan 2024
Appendix A: Template ‘information sharing request’ form
Appendix B: Template ‘information sharing decision and update’ form
It remains the responsibility of organisations and the professionals they employ to ensure that they have a basis for processing that meets common law requirements and the requirements of the GDPR; and for public bodies that they are acting within their powers.
Why do we need to share adult safeguarding information?
Organisations need to share safeguarding information with the right people at the right time to:
- Prevent death or serious harm,
- Co-ordinate effective and efficient responses,
- Enable early interventions to prevent the escalation of risk,
- Prevent abuse and harm that may increase the need for care and support,
- Maintain and improve good practice in safeguarding adults,
- Reveal patterns of abuse that were previously undetected and that could identify others at risk of abuse,
- Identify low-level concerns that may reveal people at risk of abuse,
- Help people to access the right kind of support to reduce risk and promote wellbeing,
- Help identify people who may pose a risk to others and, where possible, work to reduce offending behaviour,
- Reduce organisational risk and protect reputation.
False perceptions about needing consent to share safeguarding information
Some frontline professionals and their managers can be over-cautious about sharing personal information, particularly if it is against the wishes of the individual concerned. They may also be mistaken about needing consent to share safeguarding information. The risk of sharing information is often perceived as higher than it actually is. It is important that professionals consider the risks of not sharing safeguarding information when making decisions and that these decisions are recorded.
How to address false perceptions
- Raise awareness about responsibilities to share information (profession or work role-specific guidance may help),
- Encourage consideration of the risks of not sharing information,
- Brief staff and volunteers on the basic principles of confidentiality the EU General Data Protection Regulation and data protection,
- Improve understanding of the Mental Capacity Act,
- Provide a contact number for staff and volunteers to raise concerns,
- Be clear in procedures about when to raise a safeguarding concern,
- Assure staff and volunteers that they do not necessarily need to have evidence to raise a concern.
Complex networks between safeguarding partner agencies
The local authority has the lead responsibility for safeguarding adults with care and support needs, and the police and the NHS also have clear safeguarding duties under the Care Act 2014. Clinical commissioning groups and the police will often have different geographical boundaries and different IT systems. Housing and social care providers will also provide services across boundaries.
The Care Act 2014 (Section 6 [7]) places duties on the local authority and its partners to cooperate in the exercise of their functions relevant to care and support including those to protect adults. The safeguarding adults board should ensure that it ‘has the involvement of all partners necessary to effectively carry out its duties’.
Below is a simple flowchart of the key principles for information sharing. You can also download this flowchart.
Sharing information to prevent abuse and neglect
Sharing information between organisations about known or suspected risks may help to prevent abuse taking place. The safeguarding adults board has a key role to play in sharing information and intelligence on both local and national threats and risks. The board’s annual report must provide information about any safeguarding adults reviews. This can include learning to inform future prevention strategies. Designated adult safeguarding managers ‘should also have a role in highlighting the extent to which their own organisation prevents abuse and neglect taking place’.
What if a person does not want you to share their information?
Frontline workers and volunteers should always share safeguarding concerns in line with their organisation’s policy, usually with their line manager or safeguarding lead in the first instance, except in emergency situations. As long as it does not increase the risk to the individual, the member of staff should explain to them that it is their duty to share their concern with their manager. The safeguarding principle of proportionality should underpin decisions about sharing information without consent, and decisions should be on a case-by-case basis.
Individuals may not give their consent to the sharing of safeguarding information for a number of reasons. For example, they may be frightened of reprisals, they may fear losing control, they may not trust social services or other partners or they may fear that their relationship with the abuser will be damaged.
If a person refuses intervention to support them with a safeguarding concern, or requests that information about them is not shared with other safeguarding partners, their wishes should be respected. However, there are a number of circumstances where the practitioner can reasonably override such a decision, including:
- You have a lawful basis for sharing without consent under the GDPR & Data Protection Act 2018,
- The individual lacks the mental capacity to make that decision – this must be properly explored and recorded in line with the Mental Capacity Act,
- Other people are, or may be, at risk, including children sharing the information could prevent a crime,
- The alleged abuser has care and support needs and may also be at risk,
- A serious crime has been committed staff are implicated,
- The person has the mental capacity to make that decision but they may be under duress or being coerced,
- The risk is unreasonably high and meets the criteria for a multi-agency risk assessment conference referral,
- You have a legal obligation.
If none of the above apply and the decision is not to share safeguarding information with other safeguarding partners, or not to intervene to safeguard the person:
- Support the person to weigh up the risks and benefits of different options,
- Ensure they are aware of the level of risk and possible outcomes,
- Agree on and record the level of risk the person is taking,
- Offer to arrange for them to have an advocate or peer supporter,
- Offer support for them to build confidence and self-esteem if necessary,
- Record the reasons for not intervening or sharing information,
- Regularly review the situation,
- Try to build trust and use gentle persuasion to enable the person to better protect themselves.
If it is necessary to share information outside the organisation:
- Explore the reasons for the person’s objections – what are they worried about?
- Explain the concern and why you think it is important to share the information,
- Tell the person who you would like to share the information with and why,
- Explain the benefits, to them or others, of sharing information – could they access better help and support?
- Discuss the consequences of not sharing the information – could someone come to harm?
- Reassure them that the information will not be shared with anyone who does not need to know,
- Reassure them that they are not alone and that support is available to them.
If the person cannot be persuaded to give their consent then, unless it is considered dangerous to do so, it should be explained to them that the information will be shared without consent. The reasons should be given and recorded.
It is very important that the risk of sharing information is also considered. In some cases, such as domestic violence or hate crime, it is possible that sharing information could increase the risk to the individual. Safeguarding partners need to work jointly to provide advice, support and protection to the individual in order to minimise the possibility of worsening the relationship or triggering retribution from the abuser.
What if a safeguarding partner is reluctant to share information?
There are only a limited number of circumstances where it would be acceptable not to share information pertinent to safeguarding with relevant safeguarding partners. Safeguarding adults boards set clear policies for dealing with conflict on information sharing. If there is continued reluctance from one partner to share information on a safeguarding concern the matter would be referred to the board. It can then consider whether the concern warrants a request, under Clause 45 of the Care Act, for the ‘supply of information’. Then the reluctant party would only have grounds for refusal if it would be ‘incompatible with their own duties or have an adverse effect on the exercise of their functions’.