Stage 1: Reporting a Concern

The Care Act sets out 10 categories of abuse and neglect. For information about these categories, and examples of how the accompanying abuse or neglect may be experienced, see: The Care Act 2014, Categories of Abuse and Neglect.

Concerns about abuse and neglect may arise from any of the following:

• An active disclosure by the adult at risk, where the adult at risk tells a member of staff that they are experiencing abuse and/or neglect;
• A passive disclosure of abuse where someone has noticed signs of abuse or neglect, for example clinical staff who notice unexplained injuries;
• An allegation of abuse by a third party, for example, a family member, friend or neighbour who has observed abuse or neglect or has been told of it by the adult at risk;
• A complaint or concern raised by an adult at risk or a third party who doesn't perceive that it is abuse or neglect. Complaints Officers should consider whether there are safeguarding matters;
• A concern raised by staff or volunteers, others using the service, a carer or a member of the public;
• An observation of the behaviour of the adult at risk;
• An observation of the behaviour of another;
• Patterns of concerns or risks that emerge through reviews, audits and complaints or regulatory inspections or monitoring visits.

Records of concerns should be made, and stored securely with any supporting documentation in line with the requirements of the relevant organisation.

A disclosure happens when the adult at risk communicates that they have been (or are worried they may be) abused or neglected.

A disclosure can be verbal, but can also be written (for example a text, email or letter).

A disclosure can relate to abuse that is happening now, may happen in the future or has happened in the past (historical).

Disclosing can be very traumatic for the adult at risk, and often they will have spent some time thinking about whether or not to tell someone what has happened, is happening or what they are worried about.

One of the barriers to disclosing can be the fear that nothing will happen, that they will not be believed or that the abuse will get worse because they have told someone.

It is important that all of these potential fears are recognised and allayed by the response to a disclosure.

The lists below set out some good practice dos and don'ts when responding to a disclosure by the adult at risk:

Do:

• Take the disclosure seriously;
• Accept what they are saying;
• Listen carefully;
• Don't interrupt them;
• Try to remember the words used by the adult at risk, and anything they want to happen next;
• Stay calm and avoid reactions such as shock, disbelief or anger;
• Ask questions to establish basic facts;
• Establish if the adult at risk feels safe now, to identify if immediate action may be required;
• Establish any emotional support they may need after you leave;
• Talk about the safeguarding adults process and seek consent to make a referral;
• Explain what will happen next and when they can expect to hear from someone;
• Reassure them that they will be involved in any decisions;
• When talking about what will happen next, think about any specific communication needs they may have and how to make sure information is accessible.

Don't:

• Question their motives for disclosing;
• Interview them;
• Ask them to repeat the disclosure to someone else;
• Make promises about keeping the information confidential: explain how the information will be shared, who with and why;
• Speculate about the outcome of the safeguarding process.

A written record of the disclosure must be made as a matter of urgency, as soon as possible after it is made.

Records should be made in line with the local recording requirements of the organisation or professional to whom the disclosure was made.

Where relevant, all records should contain the following information:

1. The date, time and location that the disclosure was made;
2. Who made the disclosure;
3. The facts that have been provided;
4. The evidence that has been seen (including any injuries or witnesses);
5. The views and wishes of the adult at risk (or representative acting on their behalf).

If anyone else has additional information about the disclosure, or the abuse or neglect that may have taken place they should make their own record.

All records should be legible and signed and dated by the author.

The record of disclosure, and any supporting documentation should be stored securely in line with the requirements of the relevant agency.

The Safeguarding Concerns Manager/Lead is the nominated individual in provider organisations (including private, public and voluntary organisations) with responsibility for:

• Deciding whether to report a safeguarding concern to the local authority;
• Taking (or instructing others to take) immediate actions, wherever possible, to ensure the adult at risk is safe from abuse or neglect.

It is essential that following a disclosure, or in any other circumstances where there are safeguarding concerns, the Safeguarding Concerns Manager/Lead is notified without delay.

The Safeguarding Concerns Manager/Lead is then responsible for ensuring the remaining steps in this procedure are carried out.

If the Safeguarding Concerns Manager/Lead is not available, or the circumstances are urgent or serious, any member of staff (or volunteer) may need to undertake these steps.

This also applies if it is deemed the Safeguarding Concerns Manager/Lead is not taking appropriate steps to ensure the adult is safe, or the concerns relate to the Safeguarding Concerns Manager/Lead themselves.

Remember: Safeguarding is everyone’s responsibility.

Following a disclosure, or in any other circumstance where concerns are present, there should always be an immediate evaluation of risk to identify any urgent steps required to ensure the adult at risk is in no pressing danger.

This may involve an element of gathering information; checking relevant records, ascertaining concerns from colleagues, gathering background information, etc. However, at this stage limit information gathering to that which is necessary to decide about whether to report a safeguarding concern and any actions needed to keep the adult at risk safe.

Unless it might prejudice a safeguarding enquiry or a Police investigation, the Safeguarding Concerns Manager (or other individual acting) should speak to the adult at risk to get their views about any immediate action required.

Unless there is a risk to life, the adult at risk lacks capacity to make decisions of this nature, or there is a risk to others any immediate actions should take place in line with the views and wishes of the adult at risk (or representative acting on their behalf) about how best to protect them from harm.

Examples of immediate action could include:

1. Calling 999 if a crime is in progress;
2. Notifying the police if a crime has been committed but is no longer in progress (for example, using 101);
3. Calling 999 in a medical emergency;
4. Calling NHS 111 for medical advice;
5. Taking the adult at risk to their GP or other health professional;
6. Supporting the adult at risk to get home safely;
7. Arranging for someone to be with the adult at risk so they are not alone;
8. Steps to manage the risk to others.

Where the adult at risk has capacity, an immediate action could also be to support them to contact the police or local authority to report the concern themselves.

Further guidance on police engagement

Contact with the Police will fall mainly into four main areas:

• Reporting a crime – if an individual witnesses a crime, they have a duty to report it to the Police;
• Third party reporting of a crime – if an individual is made aware of a crime, they should support the adult at risk to report to the Police, or make a best interest decision to do so. In domestic abuse situations practitioners should be aware of the principles of safe enquiry;
• Consultation with the Police – seeking advice;
• Sharing intelligence and managing risk.

Regulated services

Regulated services include:

• Residential homes;
• Nursing homes;
• Domiciliary care providers (including those based in supported living and extra care schemes, and those provided in-house by the local authority or NHS Trust);
• Mental health hospitals;
• NHS Trust and independent hospitals;
• Hospices.

As soon as the Regulated Service is aware of the concerns, they are under a duty to take corrective action and protect the adult from harm as soon as possible. As such, they should not wait until they have raised a concern before making their own initial enquiries in line with their internal procedures for this purpose.

After taking any necessary immediate action, the regulated service should raise a concern to the local authority (as below), and notify them of the initial enquiry actions undertaken to protect the adult at risk from further harm. They should also notify the Care Quality Commission.

Note: If the concern relates solely to a pressure ulcer, the service provider should request a clinical assessment is carried out by a clinician with experience in wound management (usually a nurse) to help determine whether a safeguarding concern should be raised. This is in line with Department of Health and Social Care guidance Pressure ulcers: how to safeguard adults.

Where it appears a criminal offence has taken place the regulated service should notify the police as well as raise the concern.

The commissioning body regarding the service should also be notified, for example the Local Authority, Mental Health Trust or Integrated Care Board.

Allegations against members of staff

In all services (regulated or otherwise) the provider may decide that it is appropriate to take immediate action by way of redistributing or even suspending the staff member in question.

At this stage all action against a staff member should be done on a 'without prejudice' basis, and in line with the HR procedures of the employer. 

It is important that forensic and other evidence is preserved when:

1. A crime may have been committed; or
2. The adult at risk wishes to report any alleged abuse or neglect to the police.

The Police may need to attend the ‘scene’, and agencies and individuals can play an essential part in ensuring that evidence is not contaminated or lost.

Do not make assumptions about what evidence to preserve and how to preserve it. The police are the experts and have responsibility for determining this. As such, they should be contacted for guidance.

In all circumstances, try not to disturb the scene, clothing or victim if at all possible.

Depending on the nature of the concerns raised, the preservation of physical evidence could involve:

1. Not cleaning surfaces, carpets, door handles etc.
2. Not washing clothing or bedding;
3. Not throwing anything away (e.g., containers, documents);
4. Limiting physical contact with the adult at risk;
5. Discouraging the adult at risk from washing/bathing;
6. Securing the area where the incident took place (not allowing anyone in).

Safeguarding is everyone's responsibility. This means that anybody can report a concern.

This means that the adult experiencing abuse or neglect can raise their concerns themselves, but so can their friends, family members, unpaid carers, other members of the public, paid carers, professionals and partner organisations.

Safeguarding concerns must be reported as soon as possible to ensure that the local authority is able to provide a timely and appropriate response.

Never assume that another person or organisation will report the concern, even if they tell you they will.

There is an expectation in West Yorkshire, North Yorkshire, and City of York that safeguarding adult concern(s) are reported to the local authority within 24 hours of identification.

Safeguarding concerns should be reported whenever there is a reasonable belief that first 2 criteria of the safeguarding duty apply:

1. The adult has need for care and support (regardless of whether these have been assessed or are being met by the local authority); and
2. They are experiencing, or at risk of experiencing abuse or neglect.

This is in accordance with guidance included within Understanding what constitutes a safeguarding concern and how to support effective outcomes (Local Government Association).

An adult is anyone aged 18 or above.

Before reporting the concern, consider the following checklist (not all will be possible / appropriate):

• Have you discussed your concerns with the adult at risk (or representative acting on their behalf)?
• Have you sought consent from the adult at risk to report a safeguarding concern?
• Have you discussed possible outcomes with the adult at risk (or representative acting on their behalf)? Have you asked them what they would like to happen?
• Does the adult at risk have the capacity to understand that a safeguarding concern will be raised – and what this process means?
• Have you thought about who you need to share the concern with immediately?

Unless it might prejudice a safeguarding enquiry or a Police investigation, the Safeguarding Concerns Manager (or other individual acting) should speak to the adult at risk to get their views about:

• What has happened;
• What they want to happen now;
• The desired outcomes that the adult at risk wants.

Desired outcomes are those changes that the adult at risk wants to achieve from the support they receive, such as feeling safe at home, access to community facilities, restricted or no contact with certain individuals or pursuing the matter through the criminal justice system.

Adults

Consent of the adult at risk should always be sought before reporting the concern, unless:

1. Seeking consent will increase the level of risk posed to them (or a child or other adult at risk); or
2. Consent cannot practically be sought (for example, the referrer is being denied access to the adult at risk or the adult at risk cannot be located in a timely way); or
3. The adult at risk lacks capacity to consent, and a decision has been made that reporting a concern is in their best interests.

Note: A mental capacity assessment must be completed before reaching the conclusion that the adult at risk lacks capacity to consent.

For guidance about assessing capacity see: The Mental Capacity Act 2005 Resource and Practice Toolkit.

Where consent has not been sought the reasons should be clearly recorded in line with recording requirements of the relevant agency.

Note: If consent has not been sought because it was not possible to locate the adult at risk in a timely way, the adult at risk should be notified that a concern has been reported as soon as possible so that their views and wishes can be considered in any subsequent decision making, ensuring an appropriate and proportionate response.

Children

Consent does not need to be sought before reporting a safeguarding concern about a child.

For information about how to raise a concern about a child, see Section 6.7, How to report a concern (Children).

If an adult at risk has not given their consent further questions should be asked as necessary to determine whether or not their wishes should be overridden and a concern reported.

It is only appropriate to report a concern without consent if:

1. It is in the public interest e.g., there is also a risk to others, a member of staff or volunteer is involved, or the abuse has occurred on property owned or managed by an organisation with a responsibility to provide care;
2. The adult at risk lacks mental capacity to consent and it is in their best interests;
3. The adult at risk is subject to coercion or undue influence, to the extent that they are unable to give consent;
4. It is in the adult at risk’s vital interests (to prevent serious harm or distress or life-threatening situations).

Where a decision has been made to report a concern without the adult at risk's consent the reason for doing so should be clearly recorded.

If an adult at risk declines safeguarding support that is not the end of the matter. Consideration should be given to ways in which the risk could be managed or mitigated, taking into account the impact of abuse or neglect on the adult at risk’s wellbeing, including their 'vital interests' and the impact on others in the situation. This is recommendation four of Understanding what constitutes a safeguarding concern and how to support effective outcomes (Local Government Association).

If an adult is subject to coercion and control or undue influence by another person this may impair their judgement and could impact on their ability to make decisions about their safety. If this is the case, Mental Capacity Policy and Procedures may not cover the particular situation. Professionals from a range of disciplines will need to work with the person, to explore options that may be available to keep them safe. Supporting people who are subject to coercion is often complex and challenging work. If the situation cannot be resolved in other ways, you may need to seek legal advice regarding whether to apply to the High Court for inherent jurisdiction.

The following flowcharts are available to support Safeguarding Concern Managers and anyone else deciding whether to report a safeguarding concern:

• Flowchart A: Deciding if you need to raise a safeguarding concern to the local authority / Multi-Agency Safeguarding Hub (MASH);
• Flowchart B: Managing Safeguarding Concerns Flowchart;
• Flowchart C: Key questions when deciding whether to report a safeguarding concern.

See: Flowcharts to Support Stage 1: Reporting a Concern.

If you are concerned that an adult is in imminent danger from abuse or neglect, or that a criminal act has taken place you should contact the police by dialing 999 before raising a concern to the local authority.

Bradford

To report a safeguarding concern:

Tel: 01274 431077
Online: Report a safeguarding adults concern

For information and advice:

Tel: 01274 431 077 (office hours)
Tel: 01274 431010 (outside office hours)
Email:  safeguarding.adults@bradford.gov.uk

For additional information, visit: Safeguarding Adults

Calderdale

To report a safeguarding concern:

Tel: 01422 393 000 (office hours)
Email (office hours): Gatewaytocare@calderdale.gov.uk
Online: Reporting concerns

Tel: 01422 288 000 (outside office hours)
Email (outside office hours): EDT@calderdale.gov.uk

For information and advice:

Tel: 01422 393 804 (office hours)
For additional information, visit: Safeguarding Adults

City of York

To report a safeguarding concern:
Tel: 01904 555 111 (office hours)
Text (for individuals who are hearing impaired): 0753 443 7804
Fax: 01904 554 017
Email: adult.socialsupport@york.gov.uk
Online: Report adult abuse in York

Tel: 0845 0349 417 (outside office hours)
Email: edt@northyorks.gov.uk

Kirklees

To report a safeguarding concern or seek advice:
Tel: 01484 414 933 (24 hours)
Email: gatewaytocare@kirklees.gov.uk
Online: Report abuse or neglect of an adult at risk

For additional information, visit: Safeguarding Adults

North Yorkshire

To report a safeguarding concern, see: Safeguarding vulnerable adults

For information and advice:

Tel: 0300 131 2 131 (24 hours)
For additional information, visit: Safeguarding Adults

Wakefield

To report a safeguarding concern or seek advice:

Tel: 0345 8 503 503
Fax: 01924 303455
Minicom: 01924 303450
Email: social_care_direct@wakefield.gov.uk
Online: Reporting abuse (adults)

For additional information, visit: Safeguarding

If you are concerned that a child is in imminent danger from abuse or neglect, or that a criminal act has taken place you should contact the police by dialing 999 before raising a concern to the local authority.

Bradford

See: Get in touch with Children's Services Contact Centre

Calderdale

See: Reporting concerns

City of York

See: Concerned about a child or young person

Kirklees

See: Worried about a child?

North Yorkshire

See: Worried About a Child? Make a Referral

Wakefield

See: How to report child abuse

In all cases, the following information should be provided, where relevant:

1. The nature of the concerns;
2. What has happened, or what might happen;
3. The evidence upon which concerns are based (including injuries);
4. Details of any disclosure made;
5. The views and wishes of the adult at risk (or representative acting on their behalf);
6. The names of any other witnesses;
7. Any immediate actions taken to reduce the risk of harm;
8. Any physical evidence that has been preserved;
9. Any previous incidents of concern;
10. Any risk of harm to other adults or to children;
11. Where the concern relates solely to a pressure ulcer, a copy of the clinical assessment and adult safeguarding decision guide;
12. Any other information deemed relevant by the referrer or the local authority.

A copy of any disclosure report or supporting documentary evidence should be sent securely to the local authority.

The Safeguarding Concerns Manager/Lead reporting the safeguarding concern should make a record of the concern(s) they have reported, and any advice given by the local authority, about next steps.

Where the police have been contacted, a similar record should also be made. This should include any crime numbers or other reference or contact numbers given.

A record should also be made within the organisation of all actions taken and decisions made (including the rationale behind them). Records may be required as part of a Police investigation or Enquiry. Records should be as clear and accurate as possible and also include details of:

• The nature of the safeguarding concern/allegation;
• The wishes and desired outcomes of the adult at risk;
• The support and information provided to enable the adult at risk to make an informed decision;
• Assessments of mental capacity, where indicated;
• The decision of the organisation to raise a safeguarding concern (or not).

All recording should be made in line with the recording requirements of the relevant organisation.