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Social work is a regulated profession in which social workers are uniquely educated and qualified to support individuals and families in meeting some of life’s biggest challenges. Social workers who work with adults are responsible for ensuring that people who use their service can live free from harm, abuse and neglect; this is fundamental to high-quality care and support. As a social worker, you need to understand your responsibilities around adult safeguarding and the standards that you need to follow.
What is safeguarding?
Safeguarding is an area of social work activity concerned with the care and protection of adults who have care and support needs and who may be at risk of abuse or neglect. This is a major concern for social workers who have prime responsibility for ensuring as far as possible that the vulnerable clients they work with are protected.
Safeguarding means protecting people from harm including physical, emotional, sexual and financial harm and neglect. Social workers working with adults have a duty to recognise the signs and symptoms of abuse and to act on any concerns. Duties to safeguard are required by professional regulators and service regulators and are supported by law.
Safeguarding adults at risk means protecting their right to live in safety and free from abuse and neglect.
Adults at risk means anyone aged 18 or over who:
- Has needs for care and support.
- Is experiencing, or is at risk of, abuse or neglect.
- 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.
Safeguarding also means that individuals are adequately supported to access care and support where this is needed, so that they are able to stay well and maintain a high quality of life. This is achieved by different organisations working effectively together to prevent and stop both the risks and experience of abuse or neglect. Safeguarding aims to balance the right to be safe with the right of the individual to make informed choices and to have their wellbeing promoted at all times.
Safeguarding adults is shaped by six principles:
- Principle 1 – Empowerment – presumption of person-led decisions and consent
- Principle 2 – Protection – support and representation for those in greatest need
- Principle 3 – Prevention – prevention of harm and abuse is a primary objective
- Principle 4 – Proportionality – proportionality and least intrusive response appropriate to the risk presented
- Principle 5 – Partnerships – local solutions through services working with communities
- Principle 6 – Accountability – accountability and transparency in delivering safeguarding
What risk factors make someone more likely to experience abuse?
Abuse and neglect can occur anywhere to anyone; however, there are risk factors that can make a person more vulnerable to abuse.
An adult at risk of abuse may:
- Have an illness affecting their mental or physical health
- Be physically dependent on others
- Have a sensory impairment
- Have a learning disability
- Suffer from drug or alcohol problems
- Have low self-esteem
- Be unable to make their own decisions
- Have a previous history of abuse
- Have negative experiences of disclosing abuse
- Be of increasing age
- Be frail
- Have experienced a lack of access to health and social services or high-quality information
- Financial hardship, tenancy/home security risk
- History of a chaotic lifestyle
This list is not exhaustive, and other people might also be considered to be adults at risk.
The types of abuse adults can encounter
There are ten types of abuse listed in the Care Act (2014).
These are:
- Physical abuse – this may involve physical violence, misuse of medication, inappropriate restraint or sanctions.
- Sexual abuse – this can include verbal sexual abuse, non-consensual touching, fondling, physical restraint, cornering, tickling, kissing, excessive cleaning of genitals, enemas, intercourse, sodomy, oral sex, invasion of privacy and stalking.
- Psychological abuse – this includes emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, harassment and verbal abuse.
- Financial or material abuse – including theft, fraud, exploitation, pressure in connection with wills, property, inheritance or financial transactions, and misuse or misappropriation of property, possessions or benefits.
- Neglect and acts of omission – including ignoring medical or physical care needs, failure to provide access to appropriate health, social care or educational services, or withholding medication, adequate nutrition and heating.
- Discriminatory abuse – including racist, sexist or abuse based on a person’s disability.
- Domestic abuse – including psychological, physical, sexual, financial and emotional abuse, and so-called honour-based violence.
- Modern slavery – includes slavery, human trafficking, and forced labour and domestic servitude.
- Organisational abuse – including neglect and poor care practice within an institution or specific care setting such as a hospital or care home.
- Self-neglect – includes a wide range of behaviour neglecting to care for personal hygiene, health or surroundings and includes behaviour such as hoarding.
What adult safeguarding issues do social workers need to be aware of?
Abuse and neglect can take many forms ranging from exploitation and disrespectful treatment to physical harm. It can be at a low level, and take place over a long time, or it can take place over a short time and be more extreme. It is all abuse.
Organisations and individuals should not be constrained in their view of what constitutes abuse, neglect or harm and should always consider the circumstances on a person-centred basis. Adults safeguarding concerns vary according to the nature of harm, the circumstances it arose and the people concerned.
Adult social work is a collaborative profession, working alongside other professionals, and there is some crossover between the vulnerable adults safeguarded by social workers and those safeguarded by doctors, nurses and care workers, but there are some different groups that social workers must work with as well. As a general rule, doctors, nurses and care workers look after those with physical and mental illnesses, and social workers aid people with mental illnesses as well, but also people in situational difficulties.
Adult safeguarding duties apply in whatever setting people live. People’s ability to keep themselves safe is partly determined by their individual circumstances, and this may change at different stages in their life, so it is important that safeguarding is always considered in relation to the wishes of the person concerned. Preventing abuse and neglect should occur in the context of person-centred support and personalisation, empowering individuals to make choices and supporting them to manage risks. Enabling people to have choice and control over their own lives can bring lots of benefits, in fact restricting people’s independence is a form of abuse.
Alcohol and other drug issues are a central part of much of social work practice, and if key issues in this area are missed, interventions linked to other behaviours or problems will not be so effective. Alcohol and other drug issues can lead to other safeguarding concerns such as, but not limited to, homelessness, sexual exploitation, cuckooing and violence.
The roles and responsibilities of a social worker in regard to adult safeguarding
Safeguarding is a huge part of the social workers’ role, because they are working with some of the most vulnerable people in the country. They have a lead role in safeguarding people who may be socially excluded, at risk of abuse or neglect, or who become vulnerable for other reasons. They balance support and protection/safeguarding roles carefully and in keeping with the specific needs and circumstances of the person or family, taking protective action as needed and within the context of legal roles and frameworks. In adult social care they endorse and act in accordance with the principles of personalisation, ensuring that care and support are person-centred and as far as possible put the people with whom they work in control of their lives.
A social worker’s role in adult safeguarding is to:
- Work in a way that prevents and protects those they support
- Be aware of the signs of abuse or neglect
- Identify and respond to concerns
- Identify with people, or their representatives or Best Interest Assessors if they lack capacity, to achieve the outcomes they want
- Build managing safeguarding risks and benefits into care planning with people
- Review care plans
- Lead and support enquiries into abuse or neglect
The adult safeguarding issues social workers may come across
Understanding what abuse and neglect might look like and how to recognise warning signs is an important aspect of adult safeguarding. Some examples social workers might encounter may include, but are not limited to:
Self-neglect – this can be a complex and challenging issue for social workers to address, because of the need to find the right balance between respecting a person’s autonomy and fulfilling their duty to protect the adult’s health and wellbeing. It is important to recognise that self-neglect may present itself in many ways and it is unlikely to have a “typical” case.
Indicators associated with self-neglect include, but are not limited to:
- Living in very unclean, sometimes verminous or harmful conditions
- Neglecting household maintenance, and therefore creating hazards within and surrounding the property
- Portraying eccentric behaviour/lifestyles
- Obsessive hoarding
- Poor diet and nutrition, for example, evidenced by little or no fresh food in the fridge, or what is there, being unfit for consumption
- Declining or refusing prescribed medication and/or other community healthcare support
- Refusing to allow access to health and/or social care staff in relation to personal hygiene and care
- Refusing to allow access to other organisations with an interest in the property, for example, staff working for utility companies such as water, gas, electricity
- Repeated episodes of anti-social behaviour – either as a victim or perpetrator
- Being unwilling to attend external appointments with professional staff whether social care, health or other organisations such as housing
- Poor personal hygiene, poor healing/sores, long toenails
- Isolation
A considerable amount of adult safeguarding work in people’s homes relates to the domestic abuse of people with care and support needs. There is a good deal of overlap between safeguarding and domestic abuse procedures. Domestic abuse is typically an incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse by someone who is, or who has been, an intimate partner or family member.
Financial abuse – this could be someone stealing money or other valuables from a vulnerable person, or it might be that someone appointed to look after their money on their behalf is using it inappropriately or coercing them to spend it in a way that they are not happy with. Internet scams and doorstep crime are also common forms of financial abuse that may be perpetrated against vulnerable adults.
Where should social workers go with an adult safeguarding concern?
If you encounter a safeguarding incident at any point, whether that is while providing care or when interacting with a vulnerable individual, you will need to take responsibility for the situation and provide immediate action to ensure the person in question is properly protected.
Some concerns may be minor in nature but provide an opportunity for early intervention, for example advice to prevent a problem from escalating. Other safeguarding concerns may be more serious and need a response through multi-agency procedures and possible statutory intervention through regulators, the criminal justice system or civil courts.
Immediate concerns about abuse or neglect should be dealt with under local safeguarding procedures first. The person who raises a safeguarding concern within their own organisation should follow their organisation’s policy and procedures. This concern may result from something that you have seen, been told or heard.
In following local procedures for reporting incidents/risks you may be required to report the concern to the Safeguarding Adults Board (SAB). This is a multi-agency partnership comprising statutory, independent and charitable organisations. The board’s objective is to protect and promote individual human rights and independence and improve wellbeing, so that adults at risk stay safe and are protected at all times from abuse, neglect, discrimination, or poor treatment.
In all cases you should make a written statement of the individual’s account, using their words, your observations and any actions taken. It is vital that abuse is reported, as it can stop further abuse and ensure that those involved receive support. Overall, it is your professional responsibility.
You don’t need to have all the facts to prove your concern, but you must have a reasonable belief that wrongdoing is either happening now, took place in the past, or is likely to happen in the future.
What legislation do social workers have to follow in regard to adult safeguarding?
The Care Act 2014 sets out statutory responsibility for the integration of care and support between health and local authorities. NHS England and Clinical Commissioning Groups are working in partnership with local and neighbouring social care services. Local authorities have statutory responsibility for safeguarding, and in partnership with health they have a duty to promote wellbeing within local communities.
Safeguarding Vulnerable Groups Act 2006 and the Protection of Freedoms Bill – this Act was passed to help avoid harm, or risk of harm, by preventing people who are deemed unsuitable to work with children and vulnerable adults from gaining access to them through their work. Organisations with responsibility for providing services or personnel to vulnerable groups have a legal obligation to refer relevant information to the Disclosure and Barring Service (DBS).
The Equality Act 2010 – this Act aims to protect people or groups of people who have one or more “protected characteristics”. These protected characteristics are features of people’s lives upon which discrimination, in the UK, is now illegal.
The protected characteristics listed in the Act are:
- Age
- Disability
- Sexual orientation
- Sex
- Gender reassignment
- Marriage and civil partnership
- Pregnancy and maternity
- Race
- Religion and belief
Under the Act:
- Every individual has the right to be treated equally and fairly and not be discriminated against regardless of any “protected characteristics”.
- Every individual has the right to be treated with respect and dignity.
- Health services have a duty to ensure that services are fair and meet the needs of everyone, regardless of their background or current circumstances.
Sexual Offences Act 2003 – this Act modernised the law by prohibiting any sexual activity between a care worker and a person with a mental disorder while the relationship of care continues. A relationship of care exists where one person has a mental disorder and another person provides care.
It applies to people working both on a paid and an unpaid basis and includes:
- Social workers
- Doctors
- Nurses
- Care workers in homes
- Workers providing services in clinics or hospitals
- Volunteers
The Mental Capacity Act 2005 – in order to protect those who lack capacity and to enable them to take part as much as possible in decisions that affect them, the following statutory principles apply:
- You must always assume a person has capacity unless it is proved otherwise.
- You must take all practicable steps to enable people to make their own decisions.
- You must not assume incapacity simply because someone makes an unwise decision.
- Always act, or decide, for a person without capacity in their best interests.
- Carefully consider actions to ensure the least restrictive option is taken.
The Deprivation of Liberty Safeguards 2009 (DoLS), an amendment to the Mental Capacity Act 2005, provide a legal framework to protect those who lack the capacity to consent to the arrangements for their treatment or care, for example by reason of their dementia, learning disability or brain injury and where levels of restriction or restraint used in delivering that care for the purpose of protection from risk/harm are so extensive as to potentially be depriving the person of their liberty.
The Public Interest Disclosure Act 1998 – this Act, often referred to as the Whistleblowers Act, encourages staff to report suspected wrongdoing and protects those that do against being dismissed or suffering a detriment by their employers. It also gives protection to employees against suffering a detriment or retaliation from another employee for reporting suspected wrongdoing.
Voyeurism (Offences) Act 2019 – this Act criminalises the act of “upskirting”. The Criminal Prosecution Service (CPS) defines “upskirting” as a colloquial term referring to the action of placing equipment, such as a camera or mobile phone, beneath a person’s clothing to take a voyeuristic photograph without their permission.
The General Data Protection Regulations (GDPR) and the Data Protection Act 2018 introduced new elements to the data protection regime, superseding the Data Protection Act 1998. Practitioners must have due regard to the relevant data protection principles which allow them to share personal information. However, the GDPR and Data Protection Act 2018 do not prevent, or limit, the sharing of information for the purposes of keeping vulnerable adults safe.
PREVENT, section 26 of the Counter-Terrorism and Security Act 2015 – this is part of the Government’s counter-terrorism strategy. Its aim is to stop people from becoming terrorists or supporting terrorism. The strategy promotes collaboration and co-operation among public service organisations. Healthcare professionals have a key role in Prevent. Prevent focuses on working with vulnerable individuals who may be at risk of being exploited by radicalisers and subsequently drawn into terrorist-related activity. Prevent does not require you to do anything in addition to your normal duties. What is important is that if you are concerned that a vulnerable individual is being exploited in this way, you can raise these concerns in accordance with your organisation’s policies and procedures, as you would do with any safeguarding issue.
Why is safeguarding training important?
It is important that we all understand safeguarding, and know what to do should safeguarding concerns arise.
Safeguarding induction and training is essential for all staff appropriate to their role, including:
- Information on types of harm, abuse and neglect
- How to spot abuse
- How to respond to concerns
- Who to report concerns to
Training should be directly applicable to the responsibilities and daily practices of the person being trained, and to the care and support needs of the adults that they are working with. An example of appropriate safeguarding training includes Safeguarding Vulnerable Adults (SOVA) Level 2, designed for people who are working with vulnerable adults and teaches the skills needed to safeguard people who are at higher risk of abuse.
Managers should evaluate changes in understanding and confidence before and after training, assessing this:
- Immediately after the training
- In regular long-term evaluations, for example as part of supervision sessions
- Annually, for example as part of the performance management/appraisal process
Line managers should provide feedback through supervision and appraisals, acknowledging how social worker staff have learned from their experience of identifying, reporting and managing safeguarding concerns.
How often should social workers renew their safeguarding training?
Managers should assess social worker staff safeguarding knowledge annually, and run refresher training if needed. To help social workers increase their confidence in managing safeguarding concerns, they should at a minimum refresh their safeguarding training at least every two years and participate in continuing professional development (CPD).
