Stage 1: Concern - Advice for Submitting an Adult Safeguarding Concern

1. Talk to the adult (unless it is not safe to do so).

Think about how you ask questions and how you can improve your understanding of a person's life circumstances: Lewisham Safeguarding Adults Board - Professional Curiosity

2. If the adult does not wish to report the abuse: Are they in immediate danger or risk of serious harm?

Has a crime been committed? If so, and the adult is in immediate danger or risk of serious harm, then this should be reported to the Police immediately. Help to keep the adult safe until the Police respond. The adult does not need to give their consent under these circumstances due to an 'urgent or emergency situation' (Data Protection Act 2018). 

Is the adult experiencing a mental health crisis? If so then see this webpage for further advice on how to respond and Get Help with Mental Health

How to Report Your Concerns About an Adult

Are others, including children in immediate danger or risk of serious harm? If so, then this should be reported to Police immediately, and consideration also give to reporting this to Children’s Services. Help to keep the child safe until the Police respond. The adult(s) does not need to give their consent under these circumstances due to an 'urgent or emergency situation' (Data Protection Act 2018). 

How to Report Your Concerns About a Child

Safeguarding and promoting the welfare of children and adults most at risk of abuse and neglect is a shared responsibility. The ‘Think Family’ approach should be used by all practitioners who should consider the needs of the whole family, including young carers, taking into account family circumstances and responsibilities. Existing professional relationships should be viewed as a chance to identify risk, refer to colleagues in other services, and to use targeted support to help prevent problems from escalating and therefore potentially limiting harm.

Refer to the: The Think Family page where you will find the Lewisham Think Family Practice Guidance and resources.

3. Consider if this matter meets the Section 42 (1) criteria within the Care Act 2014 as a Safeguarding Concern: 

a. do I have reasonable cause to suspect that the adult has needs for care and support; and

b.do I have reasonable cause to suspect that the adult is experiencing abuse or neglect, or the risk of it. 

It must be noted that the third criteria (c) under the legal duty for a Section 42 Enquiry (1) is not relevant 'for the referrer' at the Concern Stage. This is for the local authority to determine, but referrers should pass on any evidence to help support decision making. 

c. as a result of those needs is unable to protect himself or herself against the abuse or neglect or the risk of it. 

LGA/ADASS Guidance on What Constitutes a Safeguarding Concern - Sept 2020

Local Government Association - What Constitutes a Safeguarding Concern: FAQ's

If this is not a crime and these criteria appear to have been met, then speak to the adult to get their views on the Safeguarding Concern or the incident. It is always best to support the adult in reporting abuse themselves. Find out what they want to happen next. 

If a decision is made not to refer to the Local Authority the individual agency must make a record of the concern and any action taken. Concerns should be recorded in such a way that repeated, low level harm incidents are easily identified and subsequently referred. 

Not referring under safeguarding adults’ procedures does not negate the need to report internally or to regulators/commissioners as required, and if care providers are using this guidance, it is important to note that all Safeguarding Concerns must be notified to the Local Authority. 

If this criteria does not appear to have been met, but you are unsure, then you must seek further advice including from the Local Authority. How to Report Your Concerns About an Adult

If you are certain that this criteria has not been met, then consider what other pathways, options or services could be used to help support this adult, including providing relevant information? Record your decision-making in relation to this subject in an appropriate manner.

4. Seek the adult’s consent to submit a Safeguarding Concern to the Local Authority.

Seek the adult’s consent to submit the Safeguarding Concern and explain this may mean that several agencies may gain access to their personal details:     

• Read The Caldicott Principles. These are relevant if you work in health and social care. 
• Also see Information Sharing page which is full of advice, guidance and the local Information Sharing Agreement. 
• Does the adult have the mental capacity to consent to the Safeguarding Concern being submitted now?
• Is there a need to provide statutory advocacy: Advocacy 7 Minute Briefing March 2023
• Is there any possibility that the adult has/ is suffering from any type of coercion, control, threat, duress or pressure from another person(s) which may mean they refuse consent?
• Does mental capacity (including executive capacity) need to be assessed or reviewed? For more information read: Decision Making and Mental Capacity (NICE Guidelines), Supported decision-making toolkit for people with communication difficulties, Practicable steps for people with communication difficulties and Oldham SAB's Executive Functioning Guidance
• Give due regard to the adult’s views and wishes, including their desired outcomes, even if Best Interest Decisions have been made linked to the Mental Capacity Act. For more information read: Local Government Association - Making Safeguarding Personal Toolkit including on the six Safeguarding Principles and Alcohol Change UK Cognitive Impairment Guide and Alcohol Change UK How to use legal powers to safeguard highly vulnerable dependent drinkers guide.
• If the adult does have the mental capacity to consent to the Safeguarding Concern being submitted, but refuses, professionals must be careful that they consider how to keep the adult safe. This may be particularly relevant in domestic abuse cases if they continue to submit the concern. The adult must be informed that a Safeguarding Concern has been submitted, unless it is unsafe or impractical to do so.
• A Safeguarding Concern can still be submitted without the adult’s consent if it is an 'urgent or emergency situation' (Data Protection Act 2018).  For more information read: LGA/ADASS Guidance on What Constitutes a Safeguarding Concern - Sept 2020
• If the adult meets the safeguarding duty criteria, and is at risk of significant harm, and it is deemed they do have the mental capacity to refuse consent and to not engage with any Safeguarding Enquiry, then the local authority should consider seeking legal advice and the use of the Court of Protection, and or Inherent Jurisdiction: 39 Essex Chambers: Guidance on Use of Inherent Jurisdiction 

5. Gather as much information as possible.

Having spoken to the adult (as above) and determined their views, wishes and desired outcomes. Also gather as much information as possible from other relevant sources and documentation:

• Does anyone else need to be informed or involved, including the nominated safeguarding lead in your agency, before progressing to submitting a Safeguarding Concern?
• Are there any other internal policy or procedural requirements within your agency?
• If you unhappy about how your organisation is dealing with a Safeguarding Concern do you know how to escalate this, which could include the use of a Whistleblowing Policy?

Help to keep the adult safe until the Local Authority respond.

Professionals should read the London Multi-Agency Safeguarding Policy and Procedures (pages 60-66) for further information on this subject, using the checklists and good practice guidance that is provided.

6. Submit the Adult Safeguarding Concern.

• Ensure all of the relevant fields in the Safeguarding Concern Form are fully completed with as much detail as possible, and submitted correctly using the contact details outlined in the link below. The Safeguarding Concern Form is also included on the weblink below.
• You should receive receipt of this and be kept informed of progress.
• If you do not receive any feedback on progress you should follow this up with the Local Authority involving your organisational lead if required.
• If the Safeguarding Concern does not progress and you feel the appropriate steps have not been taken to reduce or remove the risk to the adult, then you might consider challenging this decision. Read the Inter-Agency Escalation Policy July 2023 for further information. 

This links to the subject of Professional Curiosity as it is good practice to respectfully challenge safeguarding decisions that you believe are not appropriate read more on Professional Curiosity. 

Allegations against People in Positions of Trust (PiPOT).

The Local Authority’s 'relevant partners' (outlined in the Care Act), and those providing universal care and support services, should have clear policies for dealing with allegations against people who work, in either a paid or unpaid capacity, with adults with care and support needs. See here for more information: Lewisham Safeguarding Adults Board - People in Positions of Trust

The Adult Safeguarding Procedures: