The Lewisham Adult Safeguarding Pathway

1. Prevention and Early Help	2. Professional Curiosity	3. Statutory Adult Safeguarding Procedures	4. Adult Safeguarding Pathway Resources
Non-Statutory Safeguarding	Identifying Abuse and Neglect	Stage 1: Concern Stage 2: Enquiry Stage 3: Devising and Implementing the Safeguarding Plan  Closing the Safeguarding Procedures	Leaflets Posters  Videos Workbooks Policy Templates   Training Tools

The Adult Safeguarding Pathway provides comprehensive guidance for anyone working with, supporting, caring for, or providing services to adults in Lewisham. 

We must always start from the perspective that we can all help to prevent the risk of abuse and neglect and as such the pathway provides guidance on what can be done outside of the scope of the statutory duty and criteria (see below) for safeguarding 'Adults at Risk'.  

Section 42 of the Care Act 2014 [statutory duty] states:
s.42(1) - where a local authority has reasonable cause to suspect that an adult in its area (whether or not ordinarily resident there) (a)has needs for care and support (whether or not the authority is meeting any of those needs), (b)is experiencing, or is at risk of, abuse or neglect, and (c)as a result of those needs is unable to protect himself or herself against the abuse or neglect or the risk of it.

As individuals we must have the professional curiosity to identify the experience or risk of abuse and neglect, and organisations must provide the right cultures and systems to allow this to thrive. The pathway provides an outline of this and free training is provided on this subject: Lewisham Safeguarding Adults Board >LSAB Learning Zone

We must know when and how to submit a Safeguarding Concern to the local authority in line with the above criteria. This pathway provides the necessary and detailed information to make that distinction.

The local authority is the lead organisation in the borough in relation to the Statutory Adult Safeguarding Procedures and as such will follow the guidance outlined in this local pathway which has been written in conjunction with the London Multi-Agency Adult Safeguarding Policy, Practice Guidance and Procedures November 2025

The Lewisham pathway therefore encapsulates the best evidence available for effective adult safeguarding. Accordingly, I encourage every agency in Lewisham to use the pathway and the associated documentation, and link in with the work and training delivered by the Lewisham Safeguarding Adults Board. 

Ben Mant                                                                                                                 

Independent Chair                                                                                                                                                  

Lewisham Safeguarding Adults Board 

Prevention and Early Help: Non-Statutory Safeguarding

Prevention and Early Help is crucial in relation to adult safeguarding and goes hand in hand with Empowerment: the first two of the six Safeguarding Principles. See page 8: London Multi-Agency Adult Safeguarding Policy, Practice Guidance and Procedures November 2025

All professionals must work to maximise their efforts in conjunction with their clients and service users, to help prevent the experience or risk of abuse and neglect. This is non-statutory safeguarding work which can be done without the need to involve the local authority.

We can all help to prevent adult abuse and neglect by supporting the delivery of these key objectives:

1. Improve Public Awareness.

This can be achieved by helping to support awareness building campaigns and by signposting adults to appropriate sources of information (this website is an excellent place to start).

2. Identify Adults who May be at Increased Risk.

There are many factors which might increase the risks of adult abuse and neglect including:

• Age - older adults aged 65+ are much more likely to be the subject of a Safeguarding Concern, but we must not forget younger adults too, including those who are care experienced.
• Those living with a disability.
• Cognitive illness or brain injury.
• Serious Mental ill-Health. 
• Addiction.
• Loneliness and isolation. 
• Those who rely on others for daily health and social care support.
• Unpaid carers. 
• Homelessness.
• Missing adults. 

There are lots of cross-overs (intersectionality) and this links to the adult’s needs for care and support. This list is not exhaustive.

3. Identifying & Responding Effectively to Abuse.

Organisations and individuals working to improve their understanding and early identification of the different types of adult abuse, so that an effective response can be achieved in conjunction with the adults views and wishes. This might involve a single agency response, or work alongside other partners when the legal duty or criteria for safeguarding adults at risk has not been met. 

4. Consistent & Widespread Application of Policies & Procedures.

It is important for organisations delivering services to adults to have appropriate policies and procedures which are developed in line with guidance from the Lewisham Safeguarding Adults Board, and embedded into the practice of all professionals.

LSAB Policies and Procedures Library

5. Focus on Equality & Narrowing Inequality.

Adults from financially deprived backgrounds are more likely to become an ‘identified’ victim of adult abuse and neglect, and it may be less likely that an adult from some of the ethnically diverse communities will be engaged with statutory services in Lewisham. All professionals can help to improve reporting and equal access to protective services.

This Government Guidance provides some excellent information and resources to help reduce inequality: Inclusion Health: Applying All Our Health (May 2021)

6. Help Adults to Protect Themselves.

Every organisation delivering services to adults can identify ways in which they can help to inform, and support adults in protecting themselves from abuse and neglect.

7. Provide Information, Advice & Advocacy.

Individual organisations will know the communication needs of their client groups, and as such are best placed to provide bespoke adult safeguarding information in the most appropriate formats, methods and languages. Pathway Resources

More information on the Statutory Advocacy Provider in Lewisham can be found here: https://www.pohwer.net/lewisham

8. Provide Access to Training & Education.

Organisations have a responsibility to provide access to up to date and relevant adult safeguarding training for their staff and volunteers, and additional support for the person (s) responsible for leading on this subject within that agency. 

9. Support Broader Wellbeing Strategies.

There is a clearly established link between the prevention of adult abuse and broader health and wellbeing strategies, including the reduction of social isolation and loneliness. Organisations can help to engage adults in these type of strategies, which will also indirectly help to prevent adult abuse.

Preventing abuse and neglect of adults with care and support needs - SCIE

This video Safeguarding Adults - Helping People To Protect Themselves From Crime which has been produced by the Social Care Institute for Excellence, shows what care workers and others who are in contact with adults at risk can do to help them protect themselves from crime.

This video Safeguarding Adults - Looking Out For Each Other To Prevent Abuse which has been produced by the Social Care Institute for Excellence, can be helpful to highlight what the local community can do to protect themselves and those they care about.

Feeling lonely or isolated? - Age UK Silver Line.

As we get older, we may find we spend more time on our own. This can sometimes feel lonely, boring or make us miss friends or family.

If you or someone you know is missing the joy of regular conversation,

The Silver Line Helpline run by Age UK is a free, 24-hour telephone service for older people across the UK.

We offer friendship, conversation, and support for people aged 55 or over, especially those who may be experiencing feelings of loneliness and isolation.

Find out more about the Silver Line

London Fire Brigade -  Home Fire Safety Checker.

Get started with the Home Fire Safety Checker

Metropolitan Police- Lewisham - Personal safety: how to stay safe.

Independent Age - Advice and support for older age.

Independent Age have some great advice on what can cause falls, what you can do if you do fall and where to find out further information.

Falls and How to Avoid Them

Lewisham Community Falls Service

Lewisham and Greenwich NHS Trust offer a Community Falls Service which you can refer yourself to, or you can also access the service via referral from your GP.

Age UK Lewisham and Southwark.

Age UK Lewisham and Southwark exists to improve the lives of older people in the London Boroughs of Lewisham and Southwark, working towards a future in which older people are valued, safe and empowered to make choices about their lives.

Age UK Lewisham and Southwark aims to empower and enable older people to lead fulfilled lives by:

• Providing services and support that address poverty and isolation
• Protecting the human rights of local older people
• Promoting health and wellbeing
• Connecting older people with their communities
• Working positively with partners across all sectors
• Community Connections Lewisham – Bringing Lewisham to you
• Support in Lewisham ~ Factsheets – Community Connections Lewisham
• Food Projects and Community Meals (over 60 services)
• Community Connections Lewisham - Breaking social isolation - YouTube

Protect yourself from fraud and cyber crime with Report Fraud.

How much do you really know about fraud and cyber crime? Report Fraud has lots of helpful information and advice on how to keep you safe. If you’ve been affected by any kind of cyber crime or fraud and live in England, Wales or Northern Ireland – Report Fraud are the people you need to speak to. They will help you report to the police, learn about how to prevent it, and get the support you need.

You can read more about scams, fraud and cyber crime on our Scams Information and Advice webpage.

Professional Curiosity: Identifying Abuse and Neglect

Step One: Professional Curiosity.

It is now universally accepted that we must understand and work to remove the 'barriers' and improve the 'enablers' to effective professional curiosity, as a crucial factor in being able to identify Safeguarding Concerns.    

Barriers to Professional Curiosity:

Rule of Optimism: Risk enablement is about a strengths-based approach, but this does not mean that new or increasing risks should not be treated seriously. This is a well-known dynamic in which professionals can tend to rationalise away risks despite clear evidence to the contrary. 

Accumulating Risk: Reviews repeatedly demonstrate that professionals tend to respond to each situation or new risk discreetly, rather than assessing the new information within the context of the whole person or looking at the cumulative effect of a series of incidents and information.

Normalisation: This refers to social processes through which ideas and actions become taken for granted or ‘natural’ in everyday life. Because they are seen like this they cease to be questioned and are therefore not recognised as potential risks or assessed as such.

Professional Deference: Workers who have most contact with the individual are in a good position to recognise when the risks to the person are escalating. However, there can be a tendency to give more regard to the opinion of a ‘higher status’ professional, who has less contact with the person, but who views the risks differently.

Confirmation Bias: This is when we look for evidence that supports or reinforces our pre-held view and ignores contrary information that refutes them. It occurs when we filter out potentially useful facts and opinions that don’t coincide with our preconceived ideas.

Knowing but not Knowing: This is about having a sense that something is not right but not understanding exactly what, so it is difficult to grasp the problem and take-action.

Confidence in Managing Tension: Disagreement, disruption and aggression from families or others, can divert meetings away from topics the practitioner wants to explore and back to the family’s own agenda. 

Dealing with Uncertainty: Contested accounts, vague or retracted disclosures, deception and inconclusive medical evidence are common in safeguarding practice. Practitioners are often presented with concerns which are impossible to substantiate. In such situations, there is a temptation to discount concerns that cannot be ‘proved’.

Disguised Compliance: This involves carers giving the appearance of co-operation with agencies to avoid raising suspicions and allay concerns. There is a continuum of behaviours from carers on a sliding scale with full co-operation at one end and planned and effective resistance at the other. Showing your best side or ‘saving face’ may be viewed as normal behaviour and therefore we can expect a degree of this in all families; but at its worst it may be used to conceal deliberate abuse.

Professional Challenge: Having different opinions within safeguarding practice is a sign of healthy and well-functioning inter-agency partnerships. These differences are usually resolved by discussion and negotiation between the practitioners concerned, but it is essential that they do not adversely affect outcomes for adults.

Cultural Competence or Capability: This type of safeguarding practice is essential in achieving the right outcomes, and for improving the well-being of adults from the ethnically diverse range of communities in our borough. A lack of this among practitioners can impact on their ability to effectively work with and support adults at risk and therefore deal with abuse and neglect appropriately. Lewisham Safeguarding Adults Board - Cultural Capability

“Adults involved in safeguarding enquiries may feel embarrassed, ashamed, hurt or traumatised. Being curious by asking sensitive and respectful questions will allow information to be discovered and enable appropriate support to be provided”. (Local Government Association, 2017).

Linked to this is the need to adopt Trauma Informed Approaches which will further enhance our ability to engage adults at risk and better understand their personal circumstances. 

Trauma Informed Approach.

1.Safety - The physical, psychological, and emotional safety of service users and staff is prioritised.

2.Trustworthiness – Transparency exists in policies and procedures, with the objective of building trust among staff, service users and wider communities.

3.Choice – Service users are supported in shared decision-making, choice and goal setting to determine the plan of action they need to heal and move forward.

4.Collaboration – The value of staff and service user experience is recognised in overcoming challenges and improving the system as a whole.

5.Empowerment – Efforts are made to share power and give service users and staff a strong voice in decision-making.

6.Cultural Consideration – Move past cultural stereotypes and biases based on gender, sexual orientation, age, religion, disability, geography, race or ethnicity.

Working definition of trauma-informed practice - GOV.UK

For more information on this subject please see here:

Lewisham Safeguarding Adults Board > Professional Curiosity

LSAB Learning Zone

Step Two: You need to recognise if what you are seeing or hearing is potential abuse or neglect.

There are many forms and ways that adult abuse and neglect can occur, so we should not be constrained by definitions and terminologies. Adult abuse is also often complex involving more than one type of abuse occurring at any one time.

However, the most common forms of abuse are:   

Physical Abuse +

Domestic Violence or Abuse +

Sexual Abuse and Exploitation +

Psychological or Emotional Abuse +

Financial or Material Abuse +

Modern Slavery +

Discriminatory Abuse +

Organisation or Institutional Abuse +

Neglect and Acts of Omission +

Self-Neglect +

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

Safeguarding Principle - Protection What does this means for the professionals: Adults are offered ways to protect themselves, and there is a co-ordinated response to adult safeguarding. What does this means for the adult: "I am provided with help and support to report abuse. I am supported to take part in the safeguarding process to the extent to which I want and which I am able".

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 at risk, or, experiencing abuse or neglect. 

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. 

Safeguarding Principle - Empowerment What does this mean for the professionals: Adults are encouraged to make their own decisions and are provided with information and support. What does this mean for the adult: "I am consulted about the outcomes I want from the safeguarding process and these directly inform what happens".

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: 

Stage:	Description	Target Timescale
1. Concern	1. Immediate Action: by the person raising the concern in cases of emergency. Ensure the safety and wellbeing of the adult. 2. Determine: if the s.42(1) criteria are met. Is there reasonable cause to suspect: The adult has needs for care and support; and The adult is experiencing or at risk of abuse and neglect; and As a result of those needs is unable to protect themselves from the abuse or neglect, or risk of it. [This is for the local authority to determine].  3. Respond to Partner Organisations: Provide feedback.	Same day

Stage 1: Concern - Guidance for Decision Makers

The purpose of this guidance is to help with the consistency of decision making used to cause a Safeguarding Enquiry to be conducted. It is primarily for use by lead professionals working in the Local Authority at the point of receiving an adult Safeguarding Concern; although others may also find it helpful to refer to this guidance when responding to a concern of abuse or neglect, and deciding if this should be referred to, the Local Authority. If care providers are using this guidance, it is important to note that all Safeguarding Concerns must be notified to the Local Authority.

The guidance is not intended to replace, but support professional judgement, and links to the section in the London Multi-Agency Adult Safeguarding Policy, Practice Guidance and Procedures November 2025 which provides the procedural detail in relation to Safeguarding Enquiries (pages 67-76).

1. Legal definitions.

The Care Act 2014 Care and Support Statutory Guidance and Section 42 (1) criteria states that the Local Authority must make enquiries, or cause others to do so, if they reasonably have cause to suspect an adult:

a. Has needs for care and support (whether or not the local authority is meeting any of those needs) and;

b. Is experiencing, or at risk of, abuse and neglect; and

c. 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.

Referring agencies need to use their professional judgement, consider the views of the adult at risk, and where appropriate seek consent for sharing information on a multi-agency basis.

2. Consent and engagement with the adult in relation to a Safeguarding Enquiry. 

This can often been seen as crucial factors in determining if a Safeguarding Enquiry can progress, and may lead to decisions not to proceed that leave the adult still exposed to a risk of significant harm.       

• Read The Caldicott Principles. 
• Also see LSAB Information Sharing Agreement March 2026
• Does the adult have the mental capacity to consent to the Safeguarding Enquiry?
• Is there a need to provide statutory advocacy: LSAB 7 Minute Briefing: Statutory Advocacy Jan 2026
  
• 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 Enquiry, but refuses, professionals must be careful that they consider how to keep the adult safe. This may be particularly relevant in domestic abuse cases. 
• A Safeguarding Enquiry can still proceed without the adult’s consent if this is an 'urgent or emergency situation' [Safeguarding Adults at Risk fits within this definition]. (Data Protection Act 2018). 
• 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 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. 
• See and use the Guidance on Improving our Approach to Adult Engagement March 2026 which includes an overview of Trauma Informed Practice. 
• See and use the LSAB Self-Neglect Policy, Practice Guidance and Procedures April 2025
• Professionals must consider escalating decision making where necessary in more complex cases, and respectfully challenge decision making if necessary and appropriate Inter-Agency Escalation Policy July 2023 
• This links to the subject of Professional Curiosity as it is good practice to respectfully challenge safeguarding decisions that you believe are not appropriate. 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. 

3. Concerns Checklist.

• Safety of adult and others made.
• Initial conversation held with the adult. 
• Emergency services contacted and recorded (if necessary).
• Medical treatment sought (if necessary).
• Informed consent sought. 
• Mental capacity considered if there are doubts if informed consent cannot be given.
• Best Interests decisions made and recorded. 
• Vital and public interest considerations recorded.
• Police report made (if necessary).
• Evidence preserved. 
• Referral to specialist agencies (if necessary).
• Referral to children's services, including safeguarding (if necessary). 
• Action taken to reduce or remove risk where possible and recorded. 
• Record rationales for any decision making. 
• Referral to the local authority and recorded (if applicable).

4. Managing the different levels of harm.

In order to manage the large volume of adult Safeguarding Concerns which come under safeguarding adults’ policy and procedures, there is a need to differentiate between those concerns relating to low level harm/risk, and those that are more serious. Whilst it is likely that concerns relating to low level harm/risk will not progress beyond an Initial Enquiry Stage, the concern will be recorded by the Local Authority and proportionate action taken to manage the risks that have been identified. This may include: provision of information or advice; referral to another agency or professional; assessment of care and support needs.

The sharing of low level concerns helps the Local Authority to understand any emerging patterns or trends that may need to be taken into consideration when deciding whether safeguarding adults procedures need to continue.

Local Government Association - Making Safeguarding Personal Toolkit

LGA/ADASS Making Decisions on the Duty to Carry out a Safeguarding Enquiry

5. Using this guidance.

The guidance is not designed in a way in which further actions are determined by achieving a score, it is there to provide guidance and key considerations for practitioners who are assessing the context, circumstances, seriousness and impact of the abuse that is occurring, as well as the risk of it recurring.

6. Other Safeguarding Enquiry.

Local authorities may choose to undertake safeguarding enquiries for people where there is not a section 42 enquiry duty, if the local authority believes it is proportionate to do so, and will enable the local authority to promote the person’s wellbeing and support a preventative agenda (Care Act 2014 Care and Support Statutory Guidance 14.44). 

Safeguarding Principle - Proportionality What does this mean for the professionals: A proportionate and least intrusive response is made balanced with the level of risk. What does this for the Adult: "I am confident the professionals will work in my interest and only get involved as much as needed".

7. The interface between Section 42 Enquiries and Safeguarding Adults Reviews (SAR).

As a matter of law an enquiry under Section 42 cannot be initiated in relation to an adult who is deceased. However, if the circumstances of the death mean that there are reasons to be concerned about risks to other adults, Section 42 Enquiries may need to be made to decide whether action needs to be taken to protect them. For example, this will often be necessary following a death in an organisational setting where other adults are continuing to receive a service.

Where a Section 42 Enquiry has already commenced and the adult subsequently passes away, then as outlined above, the enquiry may need to be concluded if there are potential ongoing risk to other adults. Otherwise a multi-agency decision involving “interested others”, which could include family members, should be made regarding the enquiry potentially being suspended.

Where a death is suspected to be the result of abuse or neglect and the other SAR criteria are met, a SAR notification should be submitted to enable the Lewisham Safeguarding Adults Board (LSAB) to consider this under Section 44 of the Care Act.

How to make a SAR Referral to the Lewisham Safeguarding Adults Board

SAR Notifications must be submitted as soon as possible after the adult’s death. It should be noted that a brief investigation may be necessary to assemble the required information for the LSAB's Case Review Sub-Group to make a recommendation as to whether a SAR should take place. This investigation should aim only to gather sufficient information for that purpose, and should not aim to reach firm conclusions about what happened. This investigation should be recorded as an Other Enquiry.

The Care Act statutory guidance also gives examples of serious abuse or neglect cases where an adult “would have been likely to have died but for an intervention, or has suffered permanent harm or has reduced capacity or quality of life (whether because of physical or psychological effects) as a result of the abuse or neglect”. Under these circumstances, Section 42 Enquiries into what happened to that adult will still need to take place in parallel, to ensure the adult’s immediate safety and the safety of any others who may be at risk, but should be limited to those purposes rather than duplicating more thorough investigations into the history which may take place through a SAR.

The Local Authority (or delegated agency) may need to make initial enquiries to consider whether the conditions for a SAR are met, but should not describe these as Section 42 Enquiries. In these circumstances the meeting should be a Safeguarding Information Sharing Meeting and logged onto the case management system as an Other Enquiry. Where the suspected abuse or neglect has taken place in an organisational setting, and there may be potential risks to others, the meeting should be an 'Organisational Safeguarding Meeting' and consideration should be given to invoking the Provider Concerns Process.

8. Factors to be considered.

8.1 Contextual Factors.

The following table should be used to consider the context of the Safeguarding Concern alongside the broader issues such as: mental capacity; mental health; physical disability; learning disability; communication issues; possible coercive control and the relationship between the victim and any alleged perpetrator; where the victim lives; who do they rely upon for their care; what is the extent of their circle or network of supportive relationships.

Table 1: Contextual Factors
1. The Abusive Act	Less Serious                                           More Serious			Less serious concerns are likely to be dealt with at initial enquiry stage only, whilst the more serious concerns will progress to further stages in the safeguarding adults’ procedures.
2. Seriousness of Abuse	Less Serious                                           More Serious			Refer to table 2. Look at the relevant categories of abuse and use your knowledge of the case and your professional judgement to gauge the seriousness of the concern.
3. Pattern of Abuse	Isolated incident	Recent abuse in an ongoing relationship	Repeated abuse	The volume of incidents or  Safeguarding Concerns about an individual adult, provider or locality should be carefully considered as part of the wider context of potential abuse, but no benchmark number set to automatically trigger an enquiry.
4. Impact of Abuse on Victims	No impact	Some impact but not long-lasting	Serious long-lasting impact	Impact of abuse does not necessarily correspond to the extent of the abuse – different people will be affected in different ways. Views of the adult at risk will be important in determining the impact of abuse. Protected Characteristics such as disability should be considered as well as disproportionality.
5. Impact on Others	No one else affected	Others indirectly affected	Others directly affected	Other people may be affected by the abuse of another adult. Are relatives, children or other adults distressed or affected by the abuse? Are other people intimidated and/or their environment affected?
6. Intent of Alleged Perpetrator(s)	Unintended/ill-informed	Opportunistic	Deliberate/targeted	Is the act/omission a violent/serious unprofessional response to difficulties in providing care? Is the act/omission planned and deliberately malicious? Is the act a breach of a professional code of conduct?
7. Illegality of Actions	Bad practice/Not illegal	Criminal act	Serious criminal act	Seek advice from the Police if you are unsure if a crime has been committed. Is the act/omission poor or bad practice (but not illegal) or is it clearly a crime? (* See below)
8. Risk of Repeated Abuse on the Victim	Unlikely to recur	Possible to recur	Likely to recur	Is the abuse less likely to recur with significant changes e.g. training, supervision, respite, support or very likely even if changes are made and/or more support provided?
9. Risk of Repeated Abuse on Others	Others not at risk	Possibly at risk	Others at serious risk	Are others (adults and/or children) at risk of being abused: Very unlikely? Less likely if significant changes are made? This perpetrator/setting represents a risk/threat to other adults or children?

*See: London Multi-Agency Safeguarding Policy and Procedures (pages 66-68)

8.2 Types and Level of Abuse.

The second table should also be used in conjunction with Table 1. The issues described within the ‘Less Serious’ sections may be notified to the Local Authority, but these are likely to be managed at the Initial Enquiry Stage only, and may not progress to a Safeguarding Enquiry.

Concerns of a more serious nature should be referred to the Local Authority.

These concerns will receive additional scrutiny and progress further under Safeguarding Adults’ procedures. Where a criminal offence is thought or alleged to have been committed the Police will be contacted. Other emergency services should be contacted as required.

Table 2: Types and Level of Abuse
	Less Serious	More Serious
Discriminatory Abuse	Isolated incident of teasing motivated by prejudicial attitudes. Isolated incident of care planning that fails to address an adult’s specific diversity/equality associated needs for a short period.	Inequitable access to service provision as a result of a diversity or equality issue. The Protected Characteristics are: 1.      Age 2.      Disability (inc. learning disability) 3.      Gender Reassignment 4.      Marriage and Civil Partnership 5.      Pregnancy and Maternity 6.      Race 7.      Religion or Belief 8.      Sex 9.      Sexual Orientation Recurring failure to meet specific care/support needs associated with diversity or equality. Being refused access to essential services. Denial of civil liberties e.g. voting, making a complaint. Humiliation or threats on a regular basis, recurring taunts. Hate crime which may result in injury/emergency medical treatment/fear for life/attempted murder/honour-based violence.
Domestic Abuse	Isolated incident of abusive nature. Occasional taunts or verbal outbursts	Inexplicable marking or lesions, cuts or grip marks on a number of occasions. Alleged perpetrator exhibits controlling or coercive behaviour. Limited access to medical and dental care. Accumulations of minor incidents. Frequent verbal/physical outbursts. No access/control over finances. Stalking. Relationship characterised by imbalance of power. Threats to kill, attempts to strangle choke or suffocate. Also see: Financial Abuse.  AGE UK Avoiding Scams Guide Physical Abuse. Psychological Abuse.  Sexual Abuse. The ‘SafeLives’ Domestic Abuse, Stalking and Honour Based Violence (DASH) Risk Identification Checklist should be used to determine the level of risk in domestic abuse cases and a referral made into MARAC where appropriate. SafeLives Risk Identification Checklist Domestic Abuse Statutory Guidance July 2022 LSAB Adult Safeguarding and Domestic Abuse 7 minute briefing
Financial or Material Abuse If any of these elements occur within the context of a family or intimate relationship, then this should be dealt with as Domestic Abuse.	Staff personally benefit from the adult’s funds e.g. accrue ‘reward’ points on their own store loyalty cards when shopping. Money not recorded safely and properly. Adult not routinely involved in decisions about how their money is spent or kept safe – capacity in this respect is not properly considered. Non-payment of care fees not impacting on care.	Adult’s monies kept in a joint bank account – unclear arrangements for equitable sharing of interest. Adult denied access to his/her own funds or possessions. Misuse/misappropriation of property or possessions of benefits by a person in a position of trust or control. Personal finance removed from the adult’s control. Ongoing non-payment of care fees putting an adult’s care at risk. Fraud/exploitation relating to benefits, income, property or will. Theft (this may include household items such as food).
Modern Slavery	All Safeguarding Concerns about Modern Slavery are deemed to be more serious.    A new local guidance document on Modern Slavery and Human Trafficking will be published later in 2022, but professionals should also refer to the Lewisham Modern Slavery Victim Care Pathway	Limited freedom of movement. Being forced to work for little or no payment. Limited or no access to medical and dental care. Forced marriage. Limited access to food or shelter. Be regularly moved (trafficked) to avoid detection or linked to drug dealing - ‘County Lines’. Removal of passport or ID documents. Sexual exploitation. Starvation. Organ harvesting. No control over movement/imprisonment. No access to appropriate benefits. Modern Slavery and Human Trafficking - 7 Minute Briefing London Directory of Services The Human Trafficking Foundation has created a Directory of Survivor Support Services in London which is constantly updated.
Neglect & Acts Of Omission	Isolated missed home care visit where no harm occurs. Adult is not assisted with a meal/drink on one occasion and no harm occurs. Adult not bathed as often as would like – possible complaint. Not having access to aids to independence. Inadequacies in care provision that lead to discomfort or inconvenience- no harm occurs e.g. being left wet occasionally.   Recurring missed medication or administration errors that cause no harm. Adult does not receive prescribed medication (missed/wrong dose) on one occasion – no harm occurs.	Recurrent missed home care visits where risk of harm escalates, or one missed visit where harm occurs. Hospital discharge without adequate planning and harm occurs. Ongoing lack of care to the extent that health and wellbeing deteriorate significantly e.g. pressure wounds, dehydration, malnutrition, loss of independence/confidence. Failure to arrange access to lifesaving services or medical care. Failure to intervene in dangerous situations where the adult lacks the capacity to assess risk. Safeguarding adults protocol: pressure ulcers and raising a safeguarding concern - GOV.UK Stop the Pressure 2025: Society of Tissue Viability Pressure Ulcer Panel Process - University Hospital Lewisham Dec 2020 Pressure Ulcer Panel Process - In the Community Sept 2022 LSAB Guidance for Reporting Medication Incidents as Adult Safeguarding Concerns Jan 2022 Guidance for Reporting Falls Events as Adult Safeguarding Concerns May 2024
Organisational Abuse	Lack of stimulation/ opportunities for adults to engage in social and leisure activities. Adults not given sufficient voice or involvement in the running of the service. Denial of individuality and opportunities for adults to make informed choice and take responsible risks. Care-planning documentation not person-centred.	Rigid/inflexible routines. Adult’s dignity is undermined e.g. lack of privacy during support with intimate care needs, sharing under-clothing. Inadequate risk assessment resulting in multiple adult on adult incidents within a care setting. See SCIE (Social Care Institute of Excellence): Resident-to-resident harm in care homes and residential settings Bad/poor practice not being reported and going unchecked. Unsafe and unhygienic living environments. Missed medication round resulting in more than one person not receiving their prescribed medication. Staff misusing their position of power over adults in their care (see DBS Briefing and Harmful behaviour and making referrals to DBS). Over-medication and/or inappropriate restraint used to manage behaviour. Widespread consistent ill-treatment. NICE Guidelines: Safeguarding in Care Homes Guidance for Reporting Falls Events as Adult Safeguarding Concerns May 2024 Disclosure and Barring Service (DBS) Briefing Harmful behaviour and making referrals to DBS Also see this briefing from the Somerset Safeguarding Adults Board: Mendip House Practice Briefing
Physical Abuse If any of these elements occur within the context of a family or intimate relationship, then this should be dealt with as Domestic Abuse.	Staff error causing little or no harm e.g. friction mark on skin due to ill-fitting hoist sling. Minor events that still meet criteria for ‘incident reporting’ accidents. Single incident - adult on adult in care setting causing little or no harm. Inexplicable marking found on one occasion. Minor event where adult lacks capacity in keeping themselves safe	Recurring missed medication or errors that affect more than one adult and/or result in harm. Incident involving adult on adult in care setting where injury occurs. Deliberate maladministration of medications. Covert administration without proper medical authorisation. Inappropriate restraint. Withholding of food, drinks or aids to independence. Inexplicable fractures/injuries. Multiple (more than 2) adult on adult incidents involving the same adult/s in care setting. Accumulations of minor incidents. Inexplicable marking or lesions, cuts or grip marks on a number of occasions. Assault. Grievous bodily harm/assault with a weapon leading to irreversible damage or death. Pattern of recurring medication errors or an incident of deliberate maladministration that results in ill-health or death. LSAB Guidance for Reporting Medication Incidents as Adult Safeguarding Concerns Jan 2022 Guidance for Reporting Falls Events as Adult Safeguarding Concerns May 2024
Psychological Abuse If any of these elements occur within the context of a family or intimate relationship, then this should be dealt with as Domestic Abuse.	Isolated incident where adult is spoken to in a rude or inappropriate way – respect is undermined but no/little distress caused. Occasional taunts or verbal outburst. Withholding of information to disempower.	Treatment or behaviour that undermines dignity and esteem. Denying or failing to recognise adult’s choice or opinion. Coercive or controlling behaviour. Humiliation. Emotional blackmail e.g. threats or abandonment/harm. Frequent and frightening verbal outbursts or harassment. Basic human rights/civil liberties, over-riding advance directive. Prolonged intimidation. Vicious/personalised verbal attacks.
Self-Neglect	Hoarding behaviour which doesn’t impact on the health and well-being of the adult or others. Isolated/occasional reports about unkempt personal appearance or property which is out of character or unusual for the adult. Incontinence leading to health concerns.	Multiple reports of concerns from multiple agencies. Ongoing lack of care or behaviour to the extent that health and wellbeing deteriorate significantly e.g. pressure sores, wounds, dehydration, malnutrition. Behaviour which poses a fire risk to the adult and others. Poor management of finances leading to risks to health, wellbeing or property. Hoarding behaviour impacting on the health and well-being of the individual and/or others. Life in danger if intervention is not made in order to protect the adult. Failure to seek lifesaving services or medical care where required. Multi-Agency Self Neglect Policy, Practice Guidance and Procedures Self-Neglect High Risk Panel - Risk Assessment & Action Plan Template Guidance for Reporting Falls Events as Adult Safeguarding Concerns May 2024 Read our Homelessness and Safeguarding Information page for guidance, tools and advice.
Sexual Abuse (and sexual exploitation) If any of these elements occur within the context of a family or intimate relationship, then this should be dealt with as Domestic Abuse.	Isolated incident of teasing or low-level unwanted sexualised attention (verbal) directed at one adult by another whether or not capacity exists.	Any sexualised touching or isolated or recurring masturbation without consent. Voyeurism without consent. Being subject to indecent exposure. Grooming including via the internet and social media. Attempted penetration by any means (whether or not it occurs within a relationship) without consent. Being made to look at pornographic material against will/where consent cannot be given. Female Genital mutilation. Sex in a relationship characterised by authority inequality or exploitation e.g. receiving something in return for carrying out a sexual act. Sex without consent (rape).

Stage 2: Enquiry - Advice for Conducting an Adult Safeguarding Enquiry

Role of the local authority.

The local authority should decide very early on in the process who is the best person/organisation to lead on the enquiry. The local authority retains the responsibility for ensuring that the enquiry is referred to the right place and is acted upon.

If the local authority has caused someone else to make enquiries, it is able to challenge the organisation/individual making the enquiry if it considers that the process and/or outcome is unsatisfactory. In exceptional cases, the local authority may undertake an additional enquiry, for example, if the original fails to address significant issues. The local authority therefore retains oversight and should be able to seek assurance that those enquiries 'caused to be made' are satisfactory.

Causing S.42 Enquiries Letter Template (Word)

Decisions need to consider all relevant information through a multi-agency planning group wherever possible, including the views of the adult taking into consideration mental capacity and consent.

The degree of involvement of the local authority will vary from case-to-case, but at a minimum must involve decision making about how the enquiry will be carried out, oversight of the enquiry, decision making at the conclusion of the enquiry about what actions are required, ensuring data collection is carried out, and quality assurance of the enquiry has been undertaken. 

S42 Enquiry Report Template (Pdf)    S42 Enquiry Report Template (Word Version)

Criminal investigations.

Although the local authority has the lead role in making enquiries or requesting others to do so, where criminal activity is suspected, early involvement of the police is essential. Police investigations should be coordinated with the local authority who may support other actions but should always be police led.

Conversations with the adult - including appropriate support.

In most cases, unless it is unsafe to do so, each safeguarding enquiry will start with a conversation with the adult at risk. The adult and/or their representative should not have to repeat their story. In many cases staff/organisations who already know the adult well maybe best placed to lead on the enquiry. They may be a housing support worker, a GP, or other health worker such as a community nurse or a social worker. While many enquiries will require significant input from a social care practitioner, there will be aspects that should and can be undertaken by other professionals. 

 Points to consider:

• The pace of the conversations. 
• Whether the presenting issues identifies the risk to the adult's safety, or whether there are additional risks to be considered. 
• Wider understanding and assessment of the adult's overall wellbeing. 

The adult should be aware at the end of the conversation what action will be taken and provided with contact details for key people. 

 Objectives:

• Ascertain the adult's views and wishes and preferred outcomes. 
• Assess the needs of the adult in terms of their protection, support and redress, and how these things might be met.
• Protect the person from the abuse and neglect, in accordance with the wishes of the adult where possible. 
• Enable the adult to achieve resolution where possible. 
• Wider potential risk to other adults to be considered. 

Desired outcomes identified by the adult: 

The desired outcome(s) by the adult at risk should be clarified and confirmed at the end of the conversation(s), to:

• Ensure that the outcome(s) are achievable.
• Manage any expectations that the adult at risk may have had. 
• Gove focus to the enquiry. 

Staff should support adults at risk to think in terms of realistic outcomes but should not restrict or unduly influence the outcome that the adult would like. Outcomes should make a difference to risk, and at the same time satisfy the persons’ desire for justice and enhance their wellbeing.

For example: “I want to be safer”; “I want this to stop”; “I want to be in control”; “I want an apology”; “I want justice”; “I want the other person to change what they are doing”; “I want to change what I am doing”; “I want to live somewhere else”; “I want new friends”; “I want to know this won’t happen to anyone else”; “I don’t want anything to change”.

The adult’s views, wishes, and desired outcomes may change throughout the course of the enquiry process. There should be an on-going dialogue and conversation with the adult to ensure their views and wishes are gained as the process continues, and enquiries re-planned should the adult change their views.

Initial Action and Decision Making under Section 42 

Action	Establish that the adult is safe. Establish the need for advocacy. Establish consent and capacity to make relevant decisions by understanding the management of risk, what an adult safeguarding enquiry is, how they might protect themselves. Is the adult aware of the safeguarding concern and do they perceive it as a concern and want action/support. Is there suspicion that a crime may have been committed and a report to the police needed. Ensure that the adult at risk, or their representative, has been asked what outcomes they want. Establish whether the desired outcomes can be reasonably and safely done? Provide feedback to the person making the referral. Record all actions and conversations.	Enquiry lead within the local authority or another if the local authority causes others to do so (also known as delegated enquiries).
Decisions	Who is best placed to speak with the adult at risk. Are there any reasons to delay speaking with the adult at risk. What the adult safeguarding enquiry might consist of. Whether to proceed without consent. What follow-up action may be needed. Whether actions so far have completed the enquiry. Is there a need for s9 Care Act assessment, s27(1) review of a care and support plan, or 27(4) Care Act reassessment of care and support needs.	Decisions made by the Safeguarding Adults Manager

Professionals should also read the London Multi-Agency Adult Safeguarding Policy, Practice Guidance and Procedures November 2025 (pages 67-76) for further information on conducting Adult Safeguarding Enquiries, using the checklists and detailed good practice guidance.  

Making Safeguarding Personal during a Safeguarding Enquiry.

Making Safeguarding Personal (MSP) is an initiative which aims to develop a person centred and outcomes focus to safeguarding work in supporting people to improve or resolve their circumstances.

 What MSP Seeks to achieve: 

1. A personalised approach enabling safeguarding to be done with and not to people, using practical methods defined by the adults individual needs rather than those of the organisation.
2. The outcomes an adult wants, by determining these at the beginning of working with them, and ascertaining if those outcomes were realised at the end.
3. Improvement to people’s circumstances rather than on ‘investigation and conclusion’.
4. Utilisation of person-centred practice rather than ‘putting people through a process’.
5. Good outcomes for people by working with them in a timely way, rather than one constrained by timescales.
6. Improved practice by supporting a range of methods for staff learning and development.
7. Learning through sharing good practice.
8. Further development of recording systems in order to understand what works well.
9. Broader cultural change and commitment within organisations, to enable practitioners, families, teams and the Lewisham Safeguarding Adults Board to know what difference has been made. 

Supporting people living with Dementia to be involved in adult Safeguarding Enquiries (March 2021)

Making Safeguarding Personal | Local Government Association

Local Government Association - Making Safeguarding Personal Toolkit 

Safeguarding Principle - Empowerment What does this mean for the professionals: Adults are encouraged to make their own decisions and are provided with support and information. What does this mean for the adult: "I am consulted about the outcomes I want from the safeguarding process and these directly inform what happens".

The Adult Safeguarding Procedures 

Stage:	Description	Target Timescale
2. Enquiry	Initial Conversation: with the adult at risk or their representative to establish the facts and if any action is required. Ensure the safety and wellbeing of the adult. Plan the Enquiry: assess the needs of the adult and actions to support and redress how these might be met. Complete the Enquiry: and make decisions about further actions required. Respond to Partner Organisations: Provide feedback.	Same day   5 working days from above   20 working days from above 5 working days from above

Stage 3: Devising and Implementing the Safeguarding Plan

On completion of an adult safeguarding enquiry, s42(2) Care Act 2014 requires the local authority to decide whether any actions should be taken and, if so, what they are, and who should take those actions. These actions form the basis of the Safeguarding Plan.

An adult Safeguarding Plan is not a care and support plan, and it will focus on care provision only in relation to the aspects that safeguard against abuse or neglect, or which offer a therapeutic or recovery-based resolution. In many cases the provision of care and support may be important in addressing the risk of abuse or neglect, but where this is the intention, the adult Safeguarding Plan must be specific as to how this intervention will achieve this outcome. 

See pages 76-78: London Multi-Agency Adult Safeguarding Policy, Practice Guidance and Procedures November 2025

The Safeguarding Plan should set out:

• Steps to be taken to assure the future safety of the adult at risk.
• The provision of any support, treatment or therapy, including on-going advocacy.
• Any modifications needed in the way services are provided (e.g. same gender care or placement; appointment of an OPG deputy).
• How best to support the adult through any action they may want to take to seek justice or redress.
• What will be done to meet needs of the adult for protection, support and redress, in line with their wishes is any on-going risk management strategy appropriate?
• What will be done to protect them from the abuse and neglect, in accordance with their wishes.
• What follow-up action should be taken regarding the person or organisation responsible for the abuse or neglect.
• What will be done to enable the adult to achieve resolution and recovery.

The plan should outline the roles and responsibilities of all individuals and agencies involved and should identify the lead professional who will monitor and review the plan, and when this will happen. Plans should be person-centred, and outcome focused.

Safeguarding Plans should be made with the full participation of the adult and/or their representative.

In some circumstances it may be appropriate for Safeguarding Plans to be monitored through ongoing processes for one or more organisations. These will usually be “business as usual” processes for one or more of the organisations involved, such as ongoing care management, or provision of health or social care services, or support from a voluntary sector service.

Some actions might be for the adult and their family, friends or other support network to take forward. i.e. health or social care provisions; support from the voluntary sector; what the adult needs, their family, friends or support network will do.  

What is the purpose of a Multi-Agency Adult Safeguarding Planning Meeting?

The overarching purpose of a Multi-Agency Adult Safeguarding Planning Meeting is to bring together all of the relevant stakeholders, so that information and intelligence can be shared to determine what the appropriate actions should be to “sufficiently reduce, or remove the risk to the adult” (although it may also be appropriate for this to 'remain' in some circumstances).

Old terminology such as 'substantiate' should not be used which can become combative between professionals and agencies, detracting from the efforts to improve the adult's wellbeing and safety.  

Multi-Agency Adult Safeguarding Planning Meeting Form (Word) 

Multi-Agency Adult Safeguarding Planning Meeting Form Word Template

When might a Multi-Agency Adult Safeguarding Planning Meeting be needed?

A Planning Meeting may not always be necessary in relation to all Section 42 Safeguarding Enquiries, but the following points should be used to help determine if one is required:

1. Where the health and safety of the adult is, or maybe compromised, and a detailed (or initial) safeguarding plan is required.
2. Where there have been previous Safeguarding Concerns and the issues have been repeated, and or, the risks are more acute than previously thought.
3. Where multiple agencies (including providers) are needed in providing support and or protection, and there is a need to co-ordinate actions.
4. In organisational or institutional cases where other adults are at risk of abuse or neglect. This may include where issues have affected residents of other Local Authorities.
5. Where the abuse involved a member of staff/volunteer (position of trust), and this brings into question the safety of other adults, and or the service.
6. Where there is the potential for parallel or overlapping criminal investigations by Police. In some instances a Planning Meeting may be required at short notice (1 day) following on from the initial Safeguarding Enquiries, if the issues identified place the adult at significant risk of harm, otherwise this should be arranged within 5 working days of a decision being made that one is necessary. With this in mind the following points made under each of the six Safeguarding Principles should be followed to ensure that Planning Meetings are utilised effectively and consistently.

Safeguarding Principle - Empowerment What does this mean for the professionals: Adults are encouraged to make their own decisions and are provided with support and information. What does this mean for the adult: "I am consulted about the outcomes I want from the safeguarding process and these directly inform what happens"

Safeguarding Principle - Prevention  What does this mean for the professionals: Strategies are developed to prevent abuse and neglect that promotes resilience and self-determination. What does this mean for the adult: "I am provided with easily understood information about what abuse is, how to recognise the signs and what I can do to seek help".

Safeguarding Principle - Proportionality What does this mean for the professionals: A proportionate and least intrusive response is made balanced with the level of risk. What does this mean for the adult: "I am confident professionals will work in my interest and only get involved as much as needed".

Safeguarding Principle - Protection  What does this mean for the professionals: Adults are offered ways to protect themselves, and there is a co-ordinated response to safeguarding. What does this mean for the adult: "I am provided with help and support to report abuse. I am supported to take part to the extent to which I want and to which I am able".

Safeguarding Principle - Partnerships  What does this mean for the professionals: Local solutions through services working together within their communities. What does this mean for the adult: "I am confident that information will be appropriately shared in a way that takes into account its personal and sensitive nature. I am confident that agencies will work together to find the most effective responses for my own situation".

Safeguarding Principle - Accountability What does this mean for the professionals: Accountability and transparency in delivering a safeguarding response. What does this mean for the adult: "I am clear about the roles and responsibilities of all those involved in the solution to the problem".

 Who should attend a Multi-Agency Adult Safeguarding Planning Meeting?

There are a wide range of people who may be required to attend a Planning Meeting, including, but not limited to:

1. The adult and or their representative.
2. The Safeguarding Adults Manager or their equivalent.
3. The Safeguarding Enquiry Officer.
4. The person who raised the Safeguarding Concern (if they are a professional).
5. Police manager.
6. Other criminal justice agencies.
7. NHS Trust manager and or relevant specialist.
8. GP
9. Care Quality Commission.
10. Care Provider agency manager.
11. Relevant LBL and or South East London (SEL) Integrated Care Board (ICB) Commissioner.
12. Quality Assurance or Contracts Officer from LBL and or SEL ICB.
13. The person/agency alleged to have caused the harm should have been given the opportunity to submit their representations. If this an agency, then a manager not directly involved in providing care in the case may be invited to attend.
14. Any other relevant agency/service representative as deemed appropriate by the person chairing the meeting.

Whoever attends a Planning Meeting should be of sufficient seniority to make decisions within the meeting concerning the organisation’s role and the resources they may contribute to the agreed Safeguarding Plan.

Planning Meetings should be formally recorded and minutes taken, which should be shared with those attending. This should be completed within 5 working days of the Meeting.

The practitioner who is setting up and chairing a Planning Meeting must ensure that the adult’s views, wishes and opinions are effectively represented, and conduct the meeting in an appropriate manner, using appropriate adaptations if required, allowing for the full participation of the adult and or their representative(s).    

If the adult does wish to attend the following points must be born in mind:

• The adult can bring someone to support them at the meeting. This might be a family member, friend or an Advocate and or a legal representative.
• The meeting is about the adult and their views and wishes. The Chair of the meeting must ensure these are heard and listened to by everyone else.
• The meeting may need to decide what actions need to be taken, and by who, to make the adult safer and improve their wellbeing. This will be a group decision and the adult’s views will form part of this decision.
• A Safeguarding Plan may be agreed - this is about how the adult wants to be supported to be safe. Decisions about the adult’s welfare or care will need to be agreed with them.
• If the adult has been assessed as not having mental capacity to make a particular decision at that time, then it will need to be made in their ‘best interests’, and their views, wishes, feelings and beliefs must still be taken into account.

 If the adult does not wish to attend they may:

• Give their views in writing, or
• Ask someone to attend on their behalf, for example an advocate, friend or family member, or
• Ask the Safeguarding worker or Safeguarding Adults Manager to pass on their views.

 Local Government Association - Making Safeguarding Personal Toolkit

Practical arrangements. 

Whilst there is a need to formally record the minutes from Planning Meetings, these should be set up as informally and flexibly as possible to meet the requirements of the adult and or their representative(s), whilst also helping ensure that professionals can contribute when these meetings are being set up at relatively short-notice. 

It may be suitable and appropriate to set these meetings up online using video methods, or via telephone, or by being flexible in utilising meeting rooms that are accessible for those involved. Otherwise the chair of the Planning Meeting should consider:   

1. How to create a comfortable and welcoming environment.
2. Whether the adult wishes to have a representative(s) with them and whether they will or should have an active or silent role (legal representative). This should be agreed with the adult, their legal representative and the chair ahead of the Planning Meeting.
3. Any communication requirements or other accessibility issues.
4. Location of facilities such as refreshments and toilets.
5. How breaks will be agreed, if needed.
6. Arrangements should the adult require a break or wish to clarify any points covered in the meeting.
7. The adult and their representative(s) should not be required to join a room where other attendees have previously gathered, and where possible they should be in the room before other attendees join, having met and had a chance to talk with the chair ahead of the meeting.
8. Meetings can also be in multiple parts to make them less intimidating (smaller groups) and more manageable for the adult, and include a separate and wider ‘professionals’ meeting.
9. Where the venue is the adult’s own home, consideration should be given to how their home will be treated with respect, and how to maintain confidentiality if others not attending the meeting may also be present in the home.

Multi-Agency Adult Safeguarding Planning Meeting Form (Word) 

Multi-Agency Adult Safeguarding Planning Meeting Form Word Template

Stage:	Description	Target Timescales
3. Devising and Implementing the Safeguarding Plan	Adult Safeguarding Plan: decide how to ensure the future safety of the adult and how best to support the adult through any actions agreed. Follow up Actions: who will be responsible for these; how these will be achieved; and by when linked to the risks. This should be agreed locally to reflect the level of risk and the individual circumstances. Respond to Partner Organisations: Provide feedback. Review of the Safeguarding Plan: This is optional and should be decided locally based on the circumstances.	5 working days from enquiry report completion   No more than 3 months from above Within 5 working days of conclusion To be decided locally

Closing the Adult Safeguarding Procedures

Decision Making on Closure and Feedback.

At any stage of the Statutory Safeguarding Procedures a decision could be made not to continue with them.

This can be for many reasons, but the Safeguarding Adults Manager (SAM) must have oversight of this decision making and the rationale for decisions should be clearly set out and recorded.

All adult Safeguarding Concerns referred to the local authority should be assessed to decide if the criteria for adult safeguarding are met. Keeping the person who raised the concern informed is an essential requirement under these procedures. Feedback provides assurance that action has been taken whether under adult safeguarding or not.

The following closure actions must be considered at any stage of the procedures:

1. Outcomes are reviewed: these have been discussed and confirmed with the adult and/or their representative.
2. The adult and/or their representative is made aware that the Section 9 duty continues: or they are provided with advice, information and signposting.
3. Partner organisations and workers are made aware of this decision: including the referrer.
4. Learning is identified and is shared with all relevant stakeholders.
5. Decisions are recorded including the rationale.

Organisations raising concerns may want to challenge or discuss closure decisions and need to be updated on what action has been taken. It is more likely that the public will continue to raise concerns, where there is an acknowledgement that their concern has reached the right agency and is being taken seriously. Feedback to the wider community needs to take account of confidentiality and requirements of data protection legislation.

If the matter is subject to police involvement, the police should always be consulted so criminal investigations are not compromised. The Home - Local Government and Social Care Ombudsman and Welcome to the Parliamentary and Health Service Ombudsman | Parliamentary and Health Service Ombudsman (PHSO) are both useful sources to explore case examples.

See here for local information: LSAB Information Sharing Agreement March 2026

The Information Commissioner's Office (ICO) also provides advice on information sharing. 

Closure Summary Record (if stages 2 & 3 of the Safeguarding Procedures have been completed).

At the end of an enquiry the SAM is responsible for ensuring that a clear summary of all actions taken and any ongoing risk management plan. The following should be recorded:

• All the views of the adult or their representative about the adult safeguarding work needs to be noted. This should include any agreements/disagreements about decisions. Whether their desired outcomes have been achieved and if not/why not.
• Any further referrals for assessment and support and who to.
• Any advice and information provided.
• All organisations involved in the enquiry to be updated and informed.
• Feedback has been provided to the referrer.
• Any action(s) taken with the person alleged to have caused harm.
• Any action(s) taken to support other people.
• Referral to children and young people made (if necessary).
• Whether to refer to a SAB for consideration for a s44 Care Act Safeguarding Adults Review.
• Any lessons to be learnt.
• Agreement on how matters will be followed up with the adult if there are further concerns.
• Recording key data in an anonymised way that can be used to inform practice, provide aggregated outcomes information for Safeguarding Adults Boards and enable the statutory Safeguarding Adults Collection (SAC) NHSE Digital return to be completed.
• There may be circumstances when the enquiry has closed but ongoing monitoring is required to manage risks and/or establish if the agreed actions are appropriate. In these circumstances, in addition to the actions outlined in the closure summary report outlined above consideration should be given to referring to a multi-agency panel to share the management of people at high risk of abuse.
• Professional/concerned curiosity should be maintained throughout.
• Agreement on the monitoring arrangements and by whom should be agreed and recorded in the closure summary record).
• It is good practice where a care management assessment or review, Care Programme Approach (CPA), health review, placement review or any other pre-booked review is due to take place following the safeguarding enquiry, for a standard check to be made that there has been no reoccurrence of adult safeguarding concerns.

End of the adult safeguarding work:

There may be some situations where the risks cannot be reduced or mitigated adequately, and ongoing support or case management is required. Multi-agency high risk panels may assist workers to escalate risks, share information, hold risk collectively and explore creative solutions for particularly complex situations. In these circumstances whilst a specific enquiry may be completed, ongoing monitoring and review may be required.

Processes that continue after the safeguarding adult procedures close or are concluded:

The adult safeguarding procedure may be closed but other processes may continue, for example, a disciplinary or professional body investigation.

Where there are outstanding criminal investigations and pending court actions, the adult safeguarding process can also be closed providing that the adult is safeguarded.

These processes may take some time, and consideration should be given to:

• The impact of these on the adult, the risk management plan.
• How this will be monitored and by who? (This should include changes to care plans which may have changed as a direct result of safeguarding recommendations
• How often.
• How will concerns be escalated.
• This should all be recorded in the adult safeguarding enquiry report.

See pages 55-57 & 77: London Multi-Agency Adult Safeguarding Policy, Practice Guidance and Procedures November 2025

Adult Safeguarding Pathway Resources

Adult Safeguarding Posters - See it, Report it!

• LSAB Adult Safeguarding Poster Version 1

Adult Safeguarding Leaflet:

• Easy Read Version
• LSAB Adult Safeguarding Leaflet (2024) Links to above poster
• Translated Bengali Version
• Translated Hindi Version
• Translated Urdu Version

Learning and Development Workbooks

The Introduction to Adult Safeguarding & Modern Slavery Awareness are the first two workbooks in our series on adult safeguarding.

1. Introduction to Adult Safeguarding Workbook - October 2025
2. Training Case Studies
3. Modern Slavery Awareness Foundation Level Workbook October 2023

The roll-out of further Workbooks in this series will be linked to specific strands of adult abuse and neglect, and other adult safeguarding related subjects.  

Adult Safeguarding Policy and Procedures Template

LSAB Adult Safeguarding Single Agency Policy and Procedures Template (for use by any agency updated January 2025).

LSAB Single Agency Policy Template For Small Community Organisations (January 2025).

Adult Safeguarding Pathway Forms and Templates

• Multi-Agency Adult Safeguarding Concern Form (Pdf)
• Multi-Agency Adult Safeguarding Concern Form (Word)
• Causing-S42-Enquiries-Letter-Template (Word)
• S42 Enquiries Report Template (Pdf)
• S42 Enquiries Report Template (Word)
• Multi-Agency Adult Safeguarding Planning Meeting Form (Word) 
• Multi-Agency Adult Safeguarding Planning Meeting Form Word Template

New! LSAB Human Stories: Learning Through Lived Experience

This collection of fictionalised stories is inspired by real experiences of people in Lewisham who have faced abuse, neglect, and isolation.

Each story highlights the importance of trauma-informed practice, safeguarding, and supporting unpaid carers, while addressing issues such as financial and domestic abuse.

These narratives are designed to raise awareness, encourage professional curiosity, and promote collaborative action to keep adults and families safe.

Use the LSAB Human Stories in training and briefings to strengthen understanding and improve practice across our community.

LSAB Human Stories Print Version

Scams Easy Read Booklet

This booklet was made by Lewisham Speaking Up on behalf of the Lewisham Safeguarding Adults Board.

Read and download the Scams Easy Read Booklet

Think Family: Working with Fathers and Male Carer's Toolkit

A toolkit for professionals working with fathers and male carers.

Working with Fathers and Male Carer's Toolkit Checklist

A checklist that focusses professionals work when working with fathers and male carer's.

Working with Fathers and Male Carer's Toolkit Resources

A collection of resources for professionals working with fathers and male carer's in Lewisham.

Use of Statutory Advocacy

Advocacy 7 Minute Briefing March 2023

Tricky Friends

Good friends can make life really great. But friendships can be tricky. Watch our Tricky Friends video which will give you helpful advice on friendship.

Coercive Control

Raise awareness of the signs of Coercive Control by displaying - Lewisham's - Can you see the signs of coercive control? - Poster

Watch these two short clips for brilliant examples of "Gaslighting" a common form of abuse seen in Domestic Abuse.

Gaslight - You Think I'm Insane: After becoming hysterical at a friend's house Paula (Ingrid Bergman), Gregory (Charles Boyer) shares his frustrations with her.

Gaslight (1944) - You Think I'm Insane Scene (5/8) | Movieclips – Youtube

Gaslight - You're Being Driven Insane: With Brian's (Joseph Cotten) help, Paula (Ingrid Bergman) discovers the horrifying truth about her husband.

Gaslight (1944) - You're Being Driven Insane Scene (6/8) | Movieclips - Youtube

London Fire Brigade: Help for Hoarders - Fire Safety Tips

• London Fire Brigade: Help for Hoarders - Fire Safety Tips

Stop Hate UK: Hate Crime Posters for Lewisham 

• Lewisham Stop Hate UK Poster - See it, Report it, Sort it
• Lewisham Stop Hate UK Poster - Online Hate
• Lewisham Stop Hate UK Poster - What ever they call you, call us

West Midlands Modern Slavery Victim Support Booklet

• English Version
• Albanian Version
• Bulgarian Version
• Chinese Version
• Latvian Version
• Lithuanian Version
• Polish Version
• Roma Version
• Romanian Version
• Slovak Version
• Vietnamese Version

The Government has also produced a Support for Victims of Modern Slavery leaflet in 11 languages.

Migrant Help Sexual Assault and Sexual Abuse Information

• English Version.pdf
• Arabic Version.pdf
• Albanian Version.pdf
• Farsi Version.pdf
• Kurdish Version.pdf
• Pashto Version.pdf