Lewisham Safeguarding Adults Board

What is Safeguarding

Safeguarding Adults

Every adult has the right to be treated with dignity, respect and live a life free of fear.

We call this process safeguarding adults.

Every adult has a right to make their own decisions and take risks, however, some adults are at greater risk of being abused because they rely on another person to manage day to day living.

We use the term "adult at risk" to describe people that need this support. Not all adults who need care and support are considered at risk, we assess each person according to their own abilities. Many adults with care and support needs manage their lives very well.

If you suspect that you or an adult you care about may be at risk of abuse or neglect please complete the Adult Safeguarding Concern form and return to the Lewisham Adult Gateway as instructed in the form. Alternatively if you have concerns about the immediate safety of an adult at risk then please contact the Police on 999.

Social Care and Health have produced a video on Safeguarding Adults in British Sign Language.

 

 

Forms and Signs of Abuse

Forms and Signs of Abuse

People with care and support needs, such as older people or people living with a disability, are more likely to be abused or neglected. They may be seen as an easy target and may be less likely to identify abuse themselves or to report it. People with communication difficulties can be particularly at risk because they may not be able to alert others. Sometimes people may not even be aware that they are being abused, and this is especially likely if they have a cognitive impairment. Abusers may try to prevent access to the person they abuse.

Whilst these particular adults are the specific focus of ‘Safeguarding Adults’ policy and procedures, this does not negate the public duty of those carrying out this work to protect the human rights of all citizens, including those who are the subject of concern but are not covered by these procedures, or those who are not the subject of the initial concern.

Such work is the responsibility of all agencies and cannot exist in isolation. It must be effectively linked to other initiatives, as part of a network of measures aimed at enabling all citizens to live lives that are free from violence, harassment, humiliation and degradation.

Signs of abuse

Signs of abuse can often be difficult to detect. The information below aims to help people who come into contact with people with care and support needs to identify abuse and recognise possible indicators. Many types of abuse are also criminal offences and should be treated as such.

Evidence of any one indicator from the following lists should not be taken on its own as proof that abuse is occurring. However, it should alert professionals to make further assessments and to consider other associated factors. The lists of possible indicators and examples of behaviour are not exhaustive and people may be subject to a number of abuse types at the same time.

Types of abuse:

Discriminatory abuse +

Types of discriminatory abuse

  • Unequal treatment based on age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex or sexual orientation (known as protected characteristics’ under the Equality Act 2010)
  • Verbal abuse, derogatory remarks or inappropriate use of language related to a protected characteristic
  • Denying access to communication aids, not allowing access to an interpreter, signer or lip-reader
  • Harassment or deliberate exclusion on the grounds of a protected characteristic
  • Denying basic rights to healthcare, education, employment and criminal justice relating to a protected characteristic
  • Substandard service provision relating to a protected characteristic

Possible indicators of discriminatory abuse

  • The person appears withdrawn and isolated
  • Expressions of anger, frustration, fear or anxiety
  • The support on offer does not take account of the person’s individual needs in terms of a protected characteristic

Hate Crime +

Hate crime is the targeting of individuals, groups and communities because of who they are.

It is any incident which is a criminal offence and which is thought, by you or someone else, to be motivated by a hostility or prejudice based on race, ethnicity, religious beliefs, gender, gender identity, disability, age, sexual orientation or any other actual or seeming difference.

This can include:

  • Threats, bullying or intimidation
  • Threatening or offensive mail, texts or emails
  • Verbal abuse
  • Damage to property
  • Physical assaults

It is important to report all hate incidents, even if you think nothing can be done as it helps the police and other agencies identify areas of concern, patterns of behaviour and what is happening in our communities. Hate crimes are not only crimes against the targeted victim, but also against a particular group as a whole. Firm action will be taken against people who commit any acts of hatred.

We know that some victims may not wish to be identified, so we encourage victims to report crime anonymously to a third party reporting site to ensure that the police can do all they can to tackle hate crime in the community.

The police and the council will:

  • Investigate all reported incidents of hate crime
  • Take legal action if there is sufficient evidence to enable us to do this
  • Keep in contact with you and let you know of our progress
  • Support you during this process

Some organisations can offer support to help you decide if you want to make an official report or complaint. If you do, this will be forwarded to the police and the council to note or take action and for monitoring the numbers of incidents reported.

Below is a list of groups and local venues where you can make an anonymous report of hate crime.

Afghanistan and Central Asian Association

Room 68b, the Albany, Deptford SE8 4AG

admin@afghanistan-central-asian.org.uk

020 8469 0723

African Advocacy Foundation

76 Elmer Rd, London SE6 2ER

020 8698 4473

shani@africadvocacy.org

Catford and Bromley Synagogue

6 Crantock Road, London, SE6 2QT

admin@catfordsynagogue.org.uk

020 8698 9496

Citizens Advice Lewisham

Leemore Community Information Hub

Bonfield Road, Lewisham SE13 5EU

0800 231 5453

Goldsmiths Students’ Union

Dixon Rd, London SE14 6NW

020 7717 2511

welcome@goldsmithssu.org

Goldsmiths, University of London

8 Lewisham Way, New Cross, London SE14 6NW

020 7919 7050

studentcentre@gold.ac.uk

Lewisham Council

9 Holbeach Road, Catford, SE6 4TW

020 8314 7237

cer@lewisham.gov.uk

Lewisham Irish Community Centre

2A Davenport Road, Catford SE6 2AZ

020 8695 6264 manager@lewishamirish.org.uk

Lewisham Islamic Centre

363–365 Lewisham High Street, Lewisham SE13 6NZ

020 8690 5090

info@lewishamislamiccentre.com

Lewisham Library

199-201 Lewisham High St, London SE13 6LG

020 8314 8430

Juan.Rey-Torre@lewisham.gov.uk

Lewisham Refugee and Migrant Network

341 Evelyn Street, SE8 5QX

020 8694 0323

info@lrmn.org.uk

Lewisham and Southwark College

Lewisham Way, London SE4 1UT

020 3757 3340

Steven.Curran@lscollege.ac.uk

Lewisham Speaking Up

Deptford Albany, Douglas Way, SE8 4AG

020 8692 1862

info@lsup.org.uk

METRO

1st Floor Equitable House, 7 General, Gordon Square, Woolwich SE18 6FH

020 8305 5000

info@metrocentreonline.org

Second Wave Youth Arts

1 Creek Rd, London SE8 3BT

020 8694 2444

info@secondwave.org.uk

More information on Hate Crime can be found on the Lewisham Council Website

Domestic abuse +

Types of domestic abuse

Domestic abuse can be characterised by any of the indicators of abuse relating to:>

  • Psychological
  • Physical
  • Sexual
  • Financial or economic
  • Emotional

Domestic abuse includes any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been, intimate partners or family members regardless of gender or sexuality. It also includes so called 'honour’ based violence, female genital mutilation and forced marriage. (This definition will change once the Domestic Abuse Act 2021 comes into force).

Possible indicators of domestic abuse

  • Low self-esteem
  • Feeling that the abuse is their fault when it is not
  • Physical evidence of violence such as bruising, cuts, broken bones
  • Verbal abuse and humiliation in front of others
  • Fear of outside intervention
  • Damage to home or property
  • Isolation – not seeing friends and family
  • Limited access to money

Coercive or controlling behaviour is a core part of domestic violence +

A pattern of controlling or coercive behaviour can be well established before a single incident is ever reported to support services. In many cases the conduct of the perpetrator might seem innocent - especially if considered in isolation of other incidents - and the victim may not be aware of, or be ready to acknowledge, abusive behaviour. 

"In many relationships, there are occasions when one person makes a decision on behalf of another, or when one partner takes control of a situation and the other has to compromise. The difference in an abusive relationship is that decisions by a dominant partner can become rules that, when broken, lead to consequences for the victim."

Building on examples provided within the Statutory Guidance, relevant behaviours to be aware of can include:

  • Isolating a person from their friends and family
  • Depriving them of their basic needs
  • Monitoring their time
  • Monitoring a person via online communication tools or using spyware
  • Taking control over aspects of their everyday life, such as where they can go, who they can see, what to wear and when they can sleep
  • Depriving them access to support services, such as specialist support or medical services
  • Repeatedly putting them down such as telling them they are worthless
  • Enforcing rules and activity which humiliate, degrade or dehumanise the victim
  • Forcing the victim to take part in criminal activity such as shoplifting, neglect or abuse of children to encourage self-blame and prevent disclosure to authorities
  • Financial abuse including control of finances, such as only allowing a person a punitive allowance
  • Control ability to go to school or place of study
  • Taking wages, benefits or allowances
  • Threats to hurt or kill
  • Threats to harm a child
  • Threats to reveal or publish private information (e.g. threatening to 'out' someone)
  • Threats to hurt or physically harming a family pet
  • Assault
  • Criminal damage (such as destruction of household goods)
  • Preventing a person from having access to transport or from working
  • Preventing a person from being able to attend school, college or University
  • Family 'dishonour'
  • Reputational damage
  • Disclosure of sexual orientation
  • Disclosure of HIV status or other medical condition without consent
  • Limiting access to family, friends and finances

This is not an exhaustive list and you should be aware that a perpetrator will often tailor the conduct to the victim, and that this conduct can vary to a high degree from one person to the next.

See our Adult Safeguarding Pathway for Coercive Control Resources

Economic Abuse +

Economic abuse involves behaviours that interfere with an individual’s ability to acquire, use and maintain economic resources such as money, transportation and utilities. It can be controlling or coercive. It can make the individual economically dependent on the abuser, thereby limiting their ability to escape and access safety.

Examples of economic abuse

Examples of economic abuse include:

  • Having sole control of the family income
  • Preventing a victim from claiming welfare benefits
  • Interfering with a victim’s education, training, or employment
  • Not allowing or controlling a victim’s access to mobile phone/transport/utilities/food
  • damage to a victim’s property

Indicators of Economic Abuse

There are some common warning signs to look out for in victims of economic abuse.

These include:

  • A person often not having enough money
  • There being a conflict with joint finances, such as one person controlling a couple’s money;
  • Shopping habits including always using cash or not being able to buy something without a partner’s permission.
  • Changes in someone’s working life, such as leaving a job they enjoyed
  • If they suddenly stop socialising and seeing friends
  • Their appearance changes, or they become overly anxious

Financial or material abuse +

Types of financial or material abuse

  • Theft of money or possessions
  • Fraud, scamming Age UK Avoiding Scams Guide
  • Preventing a person from accessing their own money, benefits or assets
  • Employees taking a loan from a person using the service
  • Undue pressure, duress, threat or undue influence put on the person in connection with loans, wills, property, inheritance or financial transactions
  • Arranging less care than is needed to save money to maximise inheritance
  • Denying assistance to manage/monitor financial affairs
  • Denying assistance to access benefits
  • Misuse of personal allowance in a care home
  • Misuse of benefits or direct payments  in a family home
  • Someone moving into a person’s home and living rent free without agreement or under duress
  • False representation, using another person's bank account, cards or documents
  • Exploitation of a person’s money or assets, e.g. unauthorised use of a car
  • Misuse of a power of attorney, deputy, appointeeship or other legal authority
  • Rogue trading – eg. unnecessary or overpriced property repairs and failure to carry out agreed repairs or poor workmanship

Possible indicators of financial or material abuse

  • Missing personal possessions
  • Unexplained lack of money or inability to maintain lifestyle
  • Unexplained withdrawal of funds from accounts
  • Power of attorney or lasting power of attorney (LPA) being obtained after the person has ceased to have mental capacity
  • Failure to register an LPA after the person has ceased to have mental capacity to manage their finances, so that it appears that they are continuing to do so
  • The person allocated to manage financial affairs is evasive or uncooperative
  • The family or others show unusual interest in the assets of the person
  • Signs of financial hardship in cases where the person’s financial affairs are being managed by a court appointed deputy, attorney or LPA
  • Recent changes in deeds or title to property
  • Rent arrears and eviction notices
  • A lack of clear financial accounts held by a care home or service
  • Failure to provide receipts for shopping or other financial transactions carried out on behalf of the person
  • Disparity between the person’s living conditions and their financial resources, e.g. insufficient food in the house
  • Unnecessary property repairs

Modern slavery +

Types of modern slavery

  • Human trafficking
  • Forced labour
  • Domestic servitude
  • Sexual exploitation, such as escort work, prostitution and pornography
  • Debt bondage – being forced to work to pay off debts that realistically they never will be able to

Possible indicators of modern slavery

  • Signs of physical or emotional abuse
  • Appearing to be malnourished, unkempt or withdrawn
  • Isolation from the community, seeming under the control or influence of others
  • Living in dirty, cramped or overcrowded accommodation and or living and working at the same address
  • Lack of personal effects or identification documents
  • Always wearing the same clothes
  • Avoidance of eye contact, appearing frightened or hesitant to talk to strangers
  • Fear of law enforcers

A new local guidance document on Modern Slavery and Human Trafficking will be published in 2022, but professionals should also refer to the Lewisham Modern Slavery Victim Care Pathway.

Further Home Office information on identifying and reporting modern slavery

London Directory of Services
The Human Trafficking Foundation has created a Directory of Survivor Support Services in London, which is constantly updated.

Neglect and Acts of Omission

Types of neglect and acts of omission

  • Failure to provide or allow access to food, shelter, clothing, heating, stimulation and activity, personal or medical care
  • Providing care in a way that the person dislikes
  • Failure to administer medication as prescribed
  • Refusal of access to visitors
  • Not taking account of individuals’ cultural, religious or ethnic needs
  • Not taking account of educational, social and recreational needs
  • Ignoring or isolating the person
  • Preventing the person from making their own decisions
  • Preventing access to glasses, hearing aids, dentures, etc.
  • Failure to ensure privacy and dignity

Possible indicators of neglect and acts of omission

  • Poor environment – dirty or unhygienic
  • Poor physical condition and/or personal hygiene
  • Pressure sores or ulcers
  • Malnutrition or unexplained weight loss
  • Untreated injuries and medical problems
  • Inconsistent or reluctant contact with medical and social care organisations
  • Accumulation of untaken medication
  • Uncharacteristic failure to engage in social interaction
  • Inappropriate or inadequate clothing

Organisational or institutional abuse +

Types of organisational or institutional abuse

  • Discouraging visits or the involvement of relatives or friends
  • Run-down or overcrowded establishment
  • Authoritarian management or rigid regimes
  • Lack of leadership and supervision
  • Insufficient staff or high turnover resulting in poor quality care
  • Abusive and disrespectful attitudes towards people using the service
  • Inappropriate use of restraints
  • Lack of respect for dignity and privacy
  • Failure to manage residents with abusive behaviour
  • Not providing adequate food and drink, or assistance with eating
  • Not offering choice or promoting independence
  • Misuse of medication
  • Failure to provide care with dentures, spectacles or hearing aids
  • Not taking account of individuals’ cultural, religious or ethnic needs
  • Failure to respond to abuse appropriately
  • Interference with personal correspondence or communication
  • Failure to respond to complaints

Possible indicators of organisational or institutional abuse

  • Lack of flexibility and choice for people using the service
  • Inadequate staffing levels
  • People being hungry or dehydrated
  • Poor standards of care
  • Lack of personal clothing and possessions and communal use of personal items
  • Lack of adequate procedures
  • Poor record-keeping and missing documents
  • Absence of visitors
  • Few social, recreational and educational activities
  • Public discussion of personal matters
  • Unnecessary exposure during bathing or using the toilet
  • Absence of individual care plans
  • Lack of management overview and support

Physical abuse +

Types of physical abuse

  • Assault, hitting, slapping, punching, kicking, hair-pulling, biting, pushing
  • Rough handling
  • Scalding and burning
  • Physical punishments
  • Inappropriate or unlawful use of restraint
  • Making someone purposefully uncomfortable (e.g. opening a window and removing blankets)
  • Involuntary isolation or confinement
  • Misuse of medication (e.g. over-sedation)
  • Forcible feeding or withholding food
  • Unauthorised restraint, restricting movement (e.g. tying someone to a chair)

Possible indicators of physical abuse

  • No explanation for injuries or inconsistency with the account of what happened
  • Injuries are inconsistent with the person’s lifestyle
  • Bruising, cuts, welts, burns and/or marks on the body or loss of hair in clumps
  • Frequent injuries
  • Unexplained falls
  • Subdued or changed behaviour in the presence of a particular person
  • Signs of malnutrition
  • Failure to seek medical treatment or frequent changes of GP

Psychological or emotional abuse +

Types of psychological or emotional abuse

  • Enforced social isolation – preventing someone accessing services, educational and social opportunities and seeing friends
  • Removing mobility or communication aids or intentionally leaving someone unattended when they need assistance
  • Preventing someone from meeting their religious and cultural needs
  • Preventing the expression of choice and opinion
  • Failure to respect privacy
  • Preventing stimulation, meaningful occupation or activities
  • Intimidation, coercion, harassment, use of threats, humiliation, bullying, swearing or verbal abuse
  • Addressing a person in a patronising or infantilising way
  • Threats of harm or abandonment
  • Cyber bullying

Possible indicators of psychological or emotional abuse

  • An air of silence when a particular person is present
  • Withdrawal or change in the psychological state of the person
  • Insomnia
  • Low self-esteem
  • Uncooperative and aggressive behaviour
  • A change of appetite, weight loss/gain
  • Signs of distress: tearfulness, anger
  • Apparent false claims, by someone involved with the person, to attract unnecessary treatment

Self-neglect +

Types of self-neglect

  • Lack of self-care to an extent that it threatens personal health and safety
  • Neglecting to care for one’s personal hygiene, health or surroundings
  • Inability to avoid self-harm
  • Failure to seek help or access services to meet health and social care needs
  • Inability or unwillingness to manage one’s personal affairs

Indicators of self-neglect

  • Very poor personal hygiene
  • Unkempt appearance
  • Lack of essential food, clothing or shelter
  • Malnutrition and/or dehydration
  • Living in squalid or unsanitary conditions
  • Neglecting household maintenance
  • Hoarding
  • Collecting a large number of animals in inappropriate conditions
  • Non-compliance with health or care services
  • Inability or unwillingness to take medication or treat illness or injury

7 Minute Briefing - Self-Neglect and Alcohol and Substance Misuse - Teeswide Safeguarding Adults Board

Sexual abuse +

Types of sexual abuse

  • Rape, attempted rape or sexual assault
  • Inappropriate touch anywhere
  • Non- consensual masturbation of either or both persons
  • Non- consensual sexual penetration or attempted penetration of the vagina, anus or mouth
  • Any sexual activity that the person lacks the capacity to consent to
  • Inappropriate looking, sexual teasing or innuendo or sexual harassment
  • Sexual photography or forced use of pornography or witnessing of sexual acts
  • Indecent exposure

Possible indicators of sexual abuse

  • Bruising, particularly to the thighs, buttocks and upper arms and marks on the neck
  • Torn, stained or bloody underclothing
  • Bleeding, pain or itching in the genital area
  • Unusual difficulty in walking or sitting
  • Foreign bodies in genital or rectal openings
  • Infections, unexplained genital discharge, or sexually transmitted diseases
  • Pregnancy in a woman who is unable to consent to sexual intercourse
  • The uncharacteristic use of explicit sexual language or significant changes in sexual behaviour or attitude
  • Incontinence not related to any medical diagnosis
  • Self-harming
  • Poor concentration, withdrawal, sleep disturbance
  • Excessive fear/apprehension of, or withdrawal from, relationships
  • Fear of receiving help with personal care
  • Reluctance to be alone with a particular person

National Rape Crisis Helpline logo image Safeline Helpline for men image of logo

Sexual violence

Sexual violence includes any form of sexual activity (involving physical contact, words, or photographs) that takes place without the other person's full and informed consent. Rape and sexual assault are mostly carried out by someone known to the victim: a husband, boyfriend, friend, colleague or other family member.

Sexual violence can happen to anyone regardless of age, gender, race, sexual orientation, religion, class, or background.

Research shows that the majority of sexual violence is experienced by women and girls, but men and boys can also be victims. If you are a man who has experienced sexual violence, Lewisham Council and Refuge provide help and information and links to further resources to Support Men.

Sexual violence can include:

  • Pressuring or forcing someone to do something sexual
  • Touching someone sexually without their permission
  • Unwanted sexting — sending sexually explicit texts and images to someone without their consent
  • Unwanted sexual attention — for example 'wolf-whistling' and making sexualised comments about women's bodies
  • Watching a sexual act take place without permission
  • Engaging in sexual acts with someone who is too drunk, or too intoxicated, to give consent
  • Engaging in a sexual act with someone who is asleep or unconscious
  • Having sex with someone who cannot legally consent — for example, a boy or girl under the age of 16, or someone with a disability who does not have the capacity to understand the situation
  • Making someone watch or appear in pornography against their will
  • Preventing someone from using contraception

Understanding consent

When you're having sex, or doing something intimate with another person, it's important to be sure that they want to be doing it too — that they have consented. Even if you're in a relationship with someone it's important to make sure your partner agrees to any sexual act every time.

  • Consent is showing or verbally communicating a clear 'yes' to your partner. If you're not sure if someone is consenting, ask
  • To be able to consent, a person must have both the capacity to say yes and must understand what is happening and what they are agreeing to do
  • The absence of "no" doesn't mean yes. Someone might have been pressured or frightened into doing something they don't want to — this means they haven't consented. If you are not sure if your partner is consenting, ask
  • Everyone has the right to say no to any kind of sexual activity, or to change their mind at any time before or during sex
  • It's also important to remember that there are some groups of people who cannot consent under law. If someone is not physically or mentally capable of making a decision to have sex — or they can't understand what they're agreeing to — they cannot give consent. For example, if someone is very drunk or intoxicated when they agree to sex, the law recognises that they don't have the capacity to give `true' consent
  • The age of consent in the UK is 16

If you have been sexually assaulted or raped

If you have just been raped or sexually assaulted, try to remember that you are not alone and you are not to blame for what has happened. Here are some simple steps you can take to help ensure your safety:

  • Find somewhere you feel safe
  • You might be in shock, so wrap up warm
  • Consider telling someone you trust about what happened. If you don't feel comfortable telling anyone yet, you can call the 24 hour National Domestic Abuse Helpline for support on 0808 2000 247
  • Call 999 if you require urgent medical attention

You might want to consider contacting a Sexual Assault Referral Centre (SARC). SARCs provide support to victims of rape or sexual assault — including providing a confidential space for interviews, examinations and collecting evidence. Some may also offer counselling services. These services are available regardless of whether you feel you want to report to the police.

If you are considering reporting what happened, or simply want more information about your options, see Support Services in London.

Find out about the specialist services Refuge Athena Lewisham provides to victims of sexual violence.

Information for Professionals

Space for Self: The therapeutic model of the Rape and Sexual Abuse Support Centre (RASASC). The report evaluates the outcomes of using the RASASC therapeutic empowerment model for children and young people aged up to 25.

Who is an adult at risk?

An “Adult at Risk” is defined as any person aged 18 years and over who is or may be in need of community care services by reason of mental health issues, learning or physical disability, sensory impairment, age or illness and who is or may be unable to take care of him/herself or unable to protect him/herself against significant harm or serious exploitation.

Since the publication of ADASS Best Practice Document: ‘Safeguarding Adults’ (2005), the range of people considered to be vulnerable has been widened to include, people encountering domestic abuse, substance misusers and asylum seekers.

When a young person reaches the age of 18 the responsibility for their well being may transfer to adult service providers.

Perpetrators of Abuse

The person alleged to have caused harm

Abuse can occur anywhere and be perpetrated by anyone. Adults at risk are sometimes abused by strangers, but more often, they are abused by someone known to them or in a position of trust. This may include:

  • A partner, relative, friend or child
  • A neighbour or someone from the community network
  • A paid carer or volunteer
  • A health, social care worker or other professional
  • Another vulnerable adult
  • A non-carer or stranger

Abuse can occur in any relationship. It often occurs where the person who is abusing is in a more powerful position than the person who is being abused.

Abuse occurs when the abuser misuses such power either intentionally, or unintentionally or for their own benefit or gain.

The person who is abusing may have more power because they are more able than the person they are abusing.

They may also have more power because the adult at risk may be dependent on them in some way.

In some instances the abuser themselves may also be an adult at risk, for example another service user, or an adult with learning disabilities caring for a frail older parent.

In any formal caring situation, the person providing the care is held in a position of trust.

There can often be a power imbalance between a member of staff, paid carer or a volunteer and an adult at risk.

It must be noted that some abusers deliberately seek out adults who appear to be vulnerable, with the intention of abusing, harming, exploiting or manipulating that person.

How to report your concerns

If you suspect that you or an adult you care about may be at risk of abuse or neglect please complete the Adult Safeguarding Concern form and return to the Lewisham Adult Gateway as instructed in the form. Alternatively if you have concerns about the immediate safety of an adult at risk then please contact the Police on 999. 

If you are a member of the public we recommend you make contact with the Lewisham Adult Gateway via telephone.

There are a number of other ways you can contact the Lewisham Adult Gateway

The team can be contacted Monday - Friday 9am - 5pm

Tel: 020 8314 7777 (select option 1) Tel: 020 8314 7766 (outside of office hours)

Fax: 020 8314 3014

Email Lewisham Adult Gateway

Contact details for the deaf / impaired hearing community

Minicom: 020 8314 3309

Text Message: 07730 637 194

Glide: LEWISHAM Adult Social Care / 07730 637 194

Please note – Glide is a free app which allows video messaging (for sign language).

It can be downloaded free of charge from the following sources:

Apple itunes

Google play

Microsoft app store

More information on the Lewisham Adult Gateway 

If you believe that a criminal offence may have been committed and you would prefer to report your concerns anonymously please report them to Crimestoppers UK

What happens after you report your concerns

Once a report of suspected adult abuse or neglect is made, the organisation you reported your concerns to will take steps to ensure the immediate safety of the person and anyone else who may be affected. You can be assured that all reports of suspected abuse or neglect are taken seriously and are confidential.

Collecting information

When a report of suspected adult abuse is received further information will be gathered. If the adult at risk is unable to speak for themselves they can choose someone to act on their behalf such as a friend or family member. If this isn’t possible Adult Social Care can arrange for an independent person to do this, they are known as an Advocate.

They will talk to the person, or a suitable representative on their behalf, to find out what is happening and then work together to plan what can be done to help keep them safe and as independent as possible.

People involved

Where necessary Adult Social Care will investigate allegations of abuse with partner organisations and take appropriate action.

Meetings

Sometimes a meeting is needed. The individual, or the person who acts on their behalf, may be invited to a meeting called a safeguarding planning meeting. During this meeting concerns will be discussed and the Chairperson will ensure that everybody has their say.

The Chairperson will ensure that everything that was agreed to be done is being done, and decide if any further action is needed. A safeguarding plan may be agreed to continue to keep the person safe.

Sometimes they will need to arrange further meetings to review the safeguarding plan and make changes if necessary to ensure the person continues to remain safe.

What if you don’t want anything to happen?

If the abuse is happening to you, you have a right to say what you want to be done about it. You will always be asked what you want and who you want to be involved.

Sometimes there are other people who may also be in danger and the abuse is too serious for people to do nothing. Professionals have a duty of care to you and other people and may have to act against your wishes. If this has to happen you will always be told why.

What if you’re not happy?

If you’re not happy about the safeguarding adults process Lewisham Adult Social Care would like to know why. You can speak to the Chairperson who was involved in your meetings, or you can contact the Lewisham Safeguarding Adults Manager.

Positive Outcomes

This video Safeguarding Adults- An Independent Life After Abuse produced by the Social Care Institute for Excellence shows the positive outcomes the safeguarding process can have on a person who has been abused.

Six Safeguarding Principles

There are six safeguarding principles that underpin all safeguarding work:

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Mental Capacity, DoLS and Advocacy

Mental Capacity Act Deprivation of Liberty Safeguards

The Mental Capacity Act (MCA) 2005 came into force during 2007. A number of government departments sponsored its implementation. The MCA is designed to protect and restore power to those vulnerable people who lack capacity. The MCA also supports those, over the age of 18, who have capacity and choose to plan for their future. It applies to everyone working in health and social care who is involved in the care, treatment and support of people aged 16.

At the heart of the MCA in terms of concepts and values are the five ‘statutory principles’. Consider the five principles as the benchmark. They should be used to underpin all acts done and decisions taken in relation to those who lack capacity.

Using the Mental Capacity Act

This new film below from Social Care Institute for Excellence explains the MCA and how it can protect the right to make choices. It's an introduction to the Act for people who need it, staff, carers and others.

SCIE free online Mental Capacity Act e-learning

This course explores the Mental Capacity Act 2005, including best interests decision-making, and how to support people to make their own decisions.

The course is for everyone who looks after or cares for someone, for example, doctors, nurses, care assistants, social workers, and family members.

Deprivation of Liberty Safeguards

The Deprivation of Liberty Safeguards (DoLS) provide additional protection for the most vulnerable people living in residential homes, nursing homes, hospital environments and supported housing through the use of a rigorous, standardised assessment and authorisation process. They aim to protect those who lack capacity to consent to arrangements made in relation to their care and/or treatment, but who need to be deprived of their liberty in their own best interest to protect them from harm. They also offer the person concerned the rights:

  • To challenge the decision to deprive them of their liberty;
  • For a representative to act for them and protect their interests; and
  • The right to have their status reviewed and monitored on a regular basis.

DoLS help ensure that an institution only restricts liberty safely and correctly and only when all other less restrictive options have been explored. The Local Authority manages this process and reports to the local Safeguarding Adults Board. In March 2014 the Supreme Court judgement in the case of “P v Cheshire West and Chester Council and another and “P and Q v Surrey County Council” lowered the threshold for a deprivation and significantly widened the scope of the Mental Capacity Act Deprivation of Liberty Safeguards themselves.

Lewisham Council's Adult Social Care has a dedicated Deprivation of Liberty Safeguards web page that provides general information, links to other sources of information and contact details for the Deprivation of Liberty Safeguards Team.

Independent advocacy under the Care Act 2014

Advocacy and the duty to involve

Local authorities must involve people in decisions made about them and their care and support. No matter how complex a person’s needs, local authorities are required to help people express their wishes and feelings, support them in weighing up their options, and assist them in making their own decisions.

When does the advocacy duty apply?

The advocacy duty will apply from the point of first contact with the local authority and at any subsequent stage of the assessment, planning, care review, safeguarding enquiry or safeguarding adult review. If it appears to the authority that a person has care and support needs, then a judgement must be made as to whether that person has substantial difficulty in being involved and if there is an appropriate individual to support them. An independent advocate must be appointed to support and represent the person for the purpose of assisting their involvement if these two conditions are met and if the individual is required to take part in one or more of the following processes described in the Care Act:

  • A needs assessment
  • A carer’s assessment
  • The preparation of a care and support or support plan
  • A review of a care and support or support plan
  • A child’s needs assessment
  • A child’s carer’s assessment
  • A young carer’s assessment
  • A safeguarding enquiry
  • A safeguarding adult review
  • An appeal against a local authority decision under Part 1 of the Care Act (subject to further consultation)

Judging ‘substantial difficulty’

Local authorities must consider, for each person, whether they are likely to have substantial difficulty in engaging with the care and support process. The Care Act defines four areas where people may experience substantial difficulty. These are:

  • Understanding relevant information
  • Retaining information
  • Using or weighing information
  • Communicating views, wishes and feelings

Supported decision-making toolkit for people with communication difficulties

Practicable steps for people with communication difficulties

LSAB 7 Advocacy Minute Briefing Advocacy

Who is an ‘appropriate individual’ to assist a person’s involvement?

If the person being supported doesn’t want that person to support them, that’s not an appropriate adult. You can’t force an advocate on someone.

Co-production workshop participant

Local authorities must consider whether there is an appropriate individual who can facilitate a person’s involvement in the assessment, planning or review process, and this includes four specific considerations. The appropriate individual cannot be:

  • Already providing care or treatment to the person in a professional capacity or on a paid basis
  • Someone the person does not want to support them
  • Someone who is unlikely to be able to, or available to, adequately support the person’s involvement
  • Someone implicated in an enquiry into abuse or neglect or who has been judged by a safeguarding adult review to have failed to prevent abuse or neglect

The role of an ‘appropriate individual’ under the Care Act is potentially fuller and more demanding than that of an individual with whom it is ‘appropriate to consult’ under the Mental Capacity Act (MCA). Under the Care Act the appropriate individual’s role is to facilitate the person’s involvement, not merely to consult them and make decisions on their behalf.

Information and advice

The Care Act places a duty on local authorities to ensure that all adults in their area have access to information and advice on care and support, and to keep them safe from abuse and neglect. Prior to making contact with the local authority, there may be some people who require independent advocacy to access information and advice.

Continuing health care

The advocacy duty in the Care Act applies equally to those people whose needs are being jointly accessed by the NHS and the local authority, or where a package of support is planned, commissioned or funded by both a local authority and a clinical commissioning group (CCG), known as a ‘joint package’ of care.

Independence

The independence of the service is an important consideration for all commissioners.  For services to be meaningful and acceptable to those they are designed to support they must have the confidence of individuals, carers and the public.

Prisoners

From April 2015 local authorities will also be responsible for assessing and meeting the social care needs of adult prisoners (not just on discharge from prison but also while in custody). All prisoners will be treated as if they are resident in that area for the purposes of the Care Act and for as long as they reside in that prison. Prisoners will be entitled to the support of an independent advocate in the same circumstances as people in the community.

Social Care and Health have produced this video in British Sign Language on the provision of Independent Advocacy under the Care Act 2014.

Prevention

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 a vulnerable adult 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

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London Fire Brigade -  Home Fire Safety Checker

You can get tailored advice for your home, or the home of someone you care for direct from the London Fire Brigade.
Our tool allows you to carry out a thorough check of the home in only a few minutes. It’s simple and practical – giving specific advice tailored to your circumstances and your home.

Get started with the Home Fire Safety Checker

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

Tips and advice on keeping yourself protected from crime: from pickpocketing and personal robbery to harassment and dealing with violent situations.

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.

Staying steady on your feet

Lewisham and Greenwich NHS Trust offer a falls rehabilitation service which you can access 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

Find out how Age UK Lewisham can help you. 

Protect yourself from fraud and cyber crime with Action Fraud

How much do you really know about fraud and cyber crime? Action Fraud has lots of helpful information and advice on how to keep you safe.

About Us

About Us and How To Contact Us

The overarching purpose of the Lewisham Safeguarding Adults Board (LSAB) is to help and safeguard adults with care and support needs by:

  • Assuring itself that local safeguarding arrangements are in place as defined by the Care Act 2014 and statutory guidance;
  • Assuring itself that safeguarding practice is person-centred and outcome-focused;
  • Working collaboratively to prevent abuse and neglect where possible;
  • Ensuring agencies and individuals give timely and proportionate responses when abuse or neglect have occurred; and
  • Assuring itself that safeguarding practice is continuously improving and enhancing the quality of life of adults in its area.

The Board meets four times a year and has an Independent Chair.

In Lewisham the Board believes that "Safeguarding is Everyone's Business". Its pledge to the people in Lewisham is that by working together and in partnership the risk of abuse or harm can be reduced by raising awareness of safeguarding of adults. As intelligence is gathered from across the partnership activity trends can be analysed and areas of concern identified so that preventative measures can be applied to keep people safe.

**Do not contact the Independent Safeguarding Adults Board to report Safeguarding Concerns. You need to contact Adult Social Care Gateway at Lewisham Council. Please see "How to Report a Safeguarding Adult Concern" section below. Please also consider the transmission of personal information when making a referral to the Council. **

There are two ways that you can get in contact with us, by email or letter. 

Email Us

Postal Address: Lewisham Safeguarding Adults Board, C/o London Borough of Lewisham, 3rd Floor, Laurence House, Catford, London, SE6 4RU.

How to Report a Safeguarding Adult Concern

If you suspect that you or an adult you care about may be at risk of abuse or neglect call Lewisham Adult Gateway on 020 8314 7777 alternatively if you have concerns about the immediate safety of an adult at risk then please contact the Police on 999.

There are a number of ways you can contact Gateway

The Gateway can be contacted Monday - Friday 9am - 5pm

Tel: 020 8314 7777 (select option 1)

Fax: 020 8314 3014

Email Gateway

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You can also follow us on Twitter @lewisham_sab

Safeguarding Adults Reviews & How to Make a Referral

Lewisham Safeguarding Adults Board (LSAB) will arrange a Safeguarding Adults Review (SAR) when an adult in Lewisham dies as a result of abuse or neglect, whether known or suspected, and there is concern that partner agencies could have worked more effectively to protect the adult.

We will also arrange a SAR if an adult in Lewisham has not died, but the LSAB knows or suspects that the adult has experienced serious abuse or neglect.

We are also free to arrange for a SAR in any other situations involving an adult in Lewisham with needs for care and support.

The Department of Health's Safeguarding Care and Support Statutory Guidance guides the reviews we carry out.

Should the LSAB carry out a review we have a LSAB SAR Policy & Procedures October 2023 that we work to, which explains in detail what you can expect us to undertake for the Lewisham Community.

Read our published Safeguarding Adult Reviews.

Make a referral to the Board for a Safeguarding Adults Review

If you would like to refer a case to us for the boards consideration for a Safeguarding Adult sReview to be commissioned please use our dedicated notification form.

LSAB Structure and Members

The current membership of the LSAB:

Governance and operational structure

The LSAB is a self-governing independent body with a set of legal responsibilities and duties which came into force on the 1st April 2015. The Board’s work is supported through the activities of four sub-groups which focus on key work streams to enhance the effectiveness of the Board. The membership of these sub-groups includes representatives from local organisations as well as the organisations represented on the LSAB itself.

The governance of the Board and sub-groups is supported by Chief Officers from the following organisations: Lewisham Council, Metropolitan Police Service, NHS Lewisham Clinical Commissioning Group, South London and Maudsley NHS Foundation Trust, Lewisham & Greenwich NHS Trust, Joint Commissioning for Lewisham, Public Health for Lewisham and the Chair of the Board.

The LSAB currently provides the Annual Report to the Healthier Communities Select Committee of the Council in order to provide assurance of how well safeguarding adults is progressing in Lewisham and to identify any areas of concern or challenge. In addition, the Annual Report is shared with the Lewisham Health and Wellbeing Board, which is a multi-agency group with statutory responsibilities.

Lewisham Safeguarding Adults Board Structure

 LSAB Structure June 2023

The LSAB Compact and Strategic Business Plan 2023-2024 describes how these organisations and their representatives on the Lewisham Safeguarding Adults Board (LSAB) will work together in partnership to safeguard the residents of Lewisham in 2023-24. It is based on the statutory functions of Safeguarding Adults Boards as set out in the Care and Support Statutory Guidance, issued and updated from time to time by the Department of Health and Social Care.

Publications

Adult Safeguarding Leaflets and Posters

Adult Safeguarding Posters - See it, Report it!

Adult Safeguarding Leaflet:

Infographic - It all Points to Prevention 

Annual Reports

LSAB Annual Report 2022-23 front cover image

The Care Act 2014 requires each Safeguarding Adults Board (SAB) to publish an annual report. 

The Care Act (Schedule 2.4 (1) a–g) defines the minimum content of an annual report.

As soon as is feasible after the end of each financial year, a SAB must publish a report on:

  • What it has done during that year to achieve its objective,
  • What it has done during that year to implement its strategy,
  • What each member has done during that year to implement the strategy,
  • The findings of the reviews arranged by it under section 44 (safeguarding adults reviews) which have concluded in that year (whether or not they began in that year),
  • The reviews arranged by it under that section which are ongoing at the end of that year (whether or not they began in that year),
  • What it has done during that year to implement the findings of reviews arranged by it under that section, and
  • Where it decides during that year not to implement a finding of a review arranged by it under that section, the reasons for its decision.
  • The performance of member agencies and how effectively, or otherwise, they are working together should be included in the report.

The annual report must be sent to:

  • The Chief Executive and leader of the local authority which established the SAB,
  • Any local policing body that is required to sit on the SAB,
  • The local Health watch organisation,
  • The chair of the local health and wellbeing board.

Annual reports should form the basis for the consultation on the strategic plan for the coming year.

A SAB should seek assurance from its members that the annual report has been considered within their internal governance processes.

LSAB Annual Report 2022-2023

Photo of Professor Michael Preston-Shoot - Independent Chair - Lewisham Safeguarding Adults Board

Message from the Independent Chair

“One particular area of concern locally is the resourcing of mental health services, both for people with severe forms of mental distress requiring an inpatient bed, and for those living in the community, but in need of wrap-around mental health support”.

It is my pleasure to introduce this annual report which describes the work that has been done and the progress that has been made in keeping adults safe from abuse and neglect. We are slowly emerging from the worst of the Covid-19 pandemic but it continues to have an impact emotionally and practically for everyone. Services are having to readjust their ways of working, and for citizens the health, emotional and social impacts of the pandemic continue to be felt.

We are also experiencing a significant cost of living crisis, with a seemingly endless rise in the use of food banks and in poverty. We are only beginning to capture the data about the impact of this crisis on adult safeguarding, and I expect that next year’s annual report will reflect on what health, housing and social care services have witnessed. The Board has sought assurance from the local authority and its partners about the measures put in place to support citizens affected by the cost of living crisis.

We have continued to see the impact of financial austerity on public services. One particular area of concern locally is the resourcing of mental health services, both for people with severe forms of mental distress requiring an inpatient bed, and for those living in the community, but in need of wrap-around mental health support. We will continue to engage with mental health service providers and focus on improving the quality of practice.

The management of Safeguarding Adults Reviews continues to be a major focus of the Board’s work. It is reassuring that partner agencies are referring cases for consideration where an adult has died or experienced significant harm as a result of abuse and neglect. The Board has also kept a focus on how practice has improved and services developed, through webinars and assurance reporting, following the implementation of recommendations from completed reviews.

The Board has refreshed its Strategic Business Plan, a statutory requirement, to ensure that there is a clear focus on priority areas for assurance reporting and targeted task and finish work.

The Board has continued its work on developing its collation and reporting on performance data, and is actively supporting the local authority in its preparation for a forthcoming inspection by the Care Quality Commission. We have engaged directly with people with lived experience of adult safeguarding, but there is more that we must do in order to learn from those who have experienced abuse and neglect. This is one of my personal priorities.

I would like to thank Martin Crow and Vicki Williams who have supported me and taken forward much of the Board’s work. The Board’s web pages are a particular excellent example of the work they have put in. I also thank all of the Board’s partners for their contribution to adult safeguarding in Lewisham.

Professor Michael Preston-Shoot

Summary of Delivery in 2022-23

The Board continued to oversee the delivery of its strategic aims and objectives. Key areas of work included: Safeguarding Adults Reviews (SARs)

The Board continues to be busy in this area of work which reflects the willingness of local professionals to seek transparency in relation to their practice. 

Learning and Development

The Board continues to invest heavily in this subject providing free to access courses in a range of subject areas. The Board supported the National Safeguarding Awareness Week in November 2022 by helping to provide a very extensive learning programme in London and nationally. 

Community Engagement

The Board routinely communicates and engages with around 200 local organisations in Lewisham, and continues to expand on this
outreach. A first of its kind Citizen’s Assembly was delivered by the Board in October 2022, which was co-produced and delivered by over a dozen local Voluntary and Community Sector Organisations. 

Seeking Assurance

An audit of safeguarding practice and delivery was completed by selected partners, and the trends used to develop the Board’s strategic priorities. The Housing Related Safeguarding Audit was finalised with a ‘Summit’ in December 2022 attended by a wide range of agencies. The Lewisham Adult Safeguarding Pathway was also reviewed in November 2022 based on feedback from local practitioners.

Lewisham Demographics

Partners Work

Metropolitan Police Service  

PC Chesca Rogers won a well-deserved national safeguarding award in 2022, as well as being recognised within the Metropolitan Police Service, for her outstanding work on the Domestic Abuse and Violence Disclosure Scheme (Clare’s Law).

Chesca has helped an incredible number of people in the last 2-3 years, as well as recommending changes to this national scheme to ensure this was more accessible during the Covid-19 pandemic period.

Clare’s Law is the most empowering thing I have ever worked on giving people the ability to safeguard themselves and their children. I would encourage anyone to use it as it is completely confidential and the person being enquired about will never know about this. You would check reviews about products before you buy online, so why not do the same about a potential partner”.

See here for more information on Clare's Law

Lewisham and Greenwich NHS Trust

The following case example helps to illustrate Clare’s Law in action:

A woman attended the Emergency Department (ED) at the University Hospital of Lewisham with injuries that suggested an assault. She reported that she was intoxicated but had no memory of an assault. The ED team made a safeguarding referral to the trust safeguarding team and she was admitted to a ward. The safeguarding advisor gained consent for a referral to the Independent Domestic Violence Advisor (IDVA) and suggested that the medical photography team record the injuries. 

A police report was discussed with the woman but she declined this. The IDVA then worked with the woman and discovered that she had just moved in with a new partner, and she had a history of experiencing domestic abuse in past relationships.

The IDVA supported the woman to make a Clare’s Law application to the Metropolitan Police, and the disclosure came back with some very concerning information about the history of the new partner. The woman decided to end the relationship and with the support of the IDVA she then made a report to the police, who requested the photographs. The IDVA offered a refuge referral, and the woman declined initially, but after further housing enquiries, this offer was remade and accepted. The IDVA also provided the woman with a voucher for food.

 “Thank you for everything. I felt really looked after”.

Lewisham Council - Adult Social Care

It has been 18 months since the Adult Multi-Agency Safeguarding Hub (MaSH) Team was established, which now addresses all of the Safeguarding Concerns that come into the local authority via Adult Social Care. During this time significant progress has been achieved and the team has been expanded, including the recent recruitment of a specialist domestic abuse Officer who will help to strengthen links with partners. 

Relationships with health colleagues have continued to improve and the time taken to effectively deal with pressure ulcer cases has significantly reduced. The link with adult mental health services has also been strengthened and there is now a dedicated mental health liaison social worker within the MaSH team, who will help to take forward the plan for further integration with South London and Maudsley NHS Foundation Trust (SLaM).

The amount of work that the MaSH Team has completed in the past year has also continued to grow, with around 500 referrals a month being managed, along with the 500 Police Merlin reports that are also triaged each month. Work is in progress to help make this system more efficient, and the MaSH Team will continue to develop their wider practice to help keep those most at risk of abuse and neglect in Lewisham safe from harm.

Learning, Training and Development

Amanda and Eileen Dean SAR Learning Event 22 February 2023

A record 1,248 people attended 35 learning and development events delivered by the Board during the last 12 months, which is significantly higher than any previous year.‚Äč This was bolstered by over 400 people attending the online and joint learning event for the Amanda and Eileen Dean SARs which is the single largest activity ever held by the Board, that attracted attention from across London and the wider U.K.

This event was recorded and can be viewed here: Safeguarding Adults Reviews

We recommend you take the time to watch this video linked to these very high profile cases.

The success of the Board’s learning events are carefully analysed and are routinely scored as having a ‘significant impact’. 

Lewisham Adult Safeguarding Pathway

Another record 97,128 hits were achieved on the Board’s website (25% increase on the previous year), many of which were on the Lewisham Adult Safeguarding Pathway pages.

The Pathway was first published in April 2021 and has been constantly updated since then whenever the legal framework has changed, national guidance has been produced, or local policies created or updated. The ambition is to ensure every organisation (around 500 in Lewisham) and professional delivering services to, or working with adults at risk, are regularly accessing the Pathway.

 Please ensure you use the Lewisham Adult Safeguarding Pathway

Communication and Engagement

Citizen’s Assembly - Corbett Community Library: 7 October 2022

This Assembly, which was the first of its kind for the Board, was planned in a lot of detail, and delivered in conjunction with a wide range of Voluntary and Community Sector Agencies, and attended by 25 residents (plus carers) from Lewisham. 

 

 In total there were 250+ pieces of evidence and feedback was captured which has been collated, shared, and used to help shape the delivery of services locally. 

The most prevalent type of abuse disclosed by those attending was Domestic Abuse with people sharing their stories about the ways this was being experienced: 

Financial in nature, including the misuse or withholding of the adult’s benefits.

Familial abuse with younger adults abusing their parents or other family carers.

Female Genital Mutilation (FGM). This was highlighted as a significant issue with (east) African communities and unlikely to reach the attention of statutory services.

There may also be some inter-connectedness with ‘neglect’ by family members with caring responsibilities.

Safeguarding Information 2022-23

 

Table 2: Police MERLIN and Crime Report Investigation System (CRIS)

The MERLIN system is the way in which police share intelligence about adults where there are wider ‘vulnerability’ concerns, although this does not match the Care Act 2014 criteria in relation to ‘adults at risk’. Local police attended an average of 68 incidents per month in relation to adults with a “mental health crisis” (London average = 52), which in 8/9 of the months reported was in the top 10 in London.

 

 

 

The Domestic Abuse and Violence Against Women & Girls (VAWG) Strategy was published in December 2021. In the shorter term the aim was to continue improving awareness which would result in increased reporting, including within Adult Social Care, which should then reduce as interventions and prevention measures develop. 

Safeguarding Adults Reviews (SARs)

Amanda’. This review was published on 2 November 2022. 

 Amanda was a white woman who was born and grew up in southeast London. She died in May 2019 at age 57. At a young age, doctors had diagnosed Amanda with paranoid schizophrenia. Amanda developed a dependence on drugs and alcohol and used different substances at different times in her adult life.

The Care Home where Amanda lived provided her with 24-hour care and support. In 2018-2019 some of Amanda’s social life revolved around street drinking. When she was intoxicated Amanda was susceptible to falling and sustaining injuries. 

On 15 May 2019 Amanda did not return to The Care Home. Amanda did sometimes go missing for short periods of time. On this occasion, when she did not return quickly, family members began their own enquiries. The police responded by searching an unused garage in the borough. The garage was derelict and along with adjacent garages was due to be demolished as part of a redevelopment programme. It had been used as a rough sleeping site. To stop this activity, the entrance to the garage was boarded up in May 2019. On 5 July 2019 the police found Amanda’s body in the back of the garage. She had been missing for just under two months.

Read the 7 Minute Briefing for professionals to see the key learning points.  

Eileen Dean’. This review was published on 11 November 2022.

Eileen Dean was a 93-year-old white British woman who had moved into a care home in Lewisham in June 2020.  Although her capabilities were reduced by dementia, Eileen remained happy and contented.

"The Adult" is a white British man who was 62 years old when he physically assaulted Eileen. He had initially been admitted to a general medical ward at the University Hospital Lewisham (UHL) operated by Lewisham and Greenwich NHS Trust in July 2020 following alcohol withdrawal seizures.

 The Adult was detained under Section 2 of the Mental Health Act 1983 (MHA) on 3 Sept 2020, and eventually transferred to the inpatient psychiatric unit at UHL, and later discharged to the same care home as Eileen in December 2020.

The Adult was diagnosed with Wernicke-Korsakoff Syndrome, which has an established link in academic literature with aggressive behaviour. Between 5 August 2020 to 4 September 2020, there were at least 34 recorded incidents of The Adult’s violence or threats to patients or staff, including The Adult threatening to use a bread knife, scissors and dinner trays as weapons.

At 12.30am on 4 January 2021 Eileen Dean was assaulted whilst lying in bed by The Adult. Eileen sustained significant injuries and died in hospital later that day.

Read the 7 Minute Briefing for professionals to see the key learning points.

SAR Notifications between April 2018 and March 2023

 

During this period there were 21 SAR Notifications:

14 Female                       7 Male

The age range for the subjects of SAR Notifications is much lower than for Safeguarding Enquiries.

From these Notifications 9 SARs have been completed between April 2015 and 31 March 2023 and all have been published in the public domain. 

The dominant subject area that is prevalent in the Notifications is mental ill-health, which is a feature in 66% of the published SARs and 3 further ongoing reviews.  

In comparison mental ill-health was the Primary Support Reason in only 5% of the concluded s.42 Enquiries conducted in Lewisham in 2020-21 and 2022-23 (16% in  England).

 Adults from Black British, Black African and Black Caribbean backgrounds were  disproportionally more likely to be the subjects of a SAR Notification linked to mental ill-health.

Work of the Sub-Groups

Case Review Sub-Group                       

The Sub-Group oversees Safeguarding Adults Review (SAR) processes locally, and is led by the Board’s Independent Chair Professor Michael Preston-Shoot.

The group met 6 times during 2022-23 and considered or monitored 9 cases throughout the year, including 4 new SAR  Notifications.

A new joint protocol has been developed over the last year between the two safeguarding partnerships in the Borough, and the Safer Lewisham Partnership Board, which more clearly defines which statutory review process will take precedence when a case meets the criteria for more than one.

The board also contributed to the National SAR Library which holds all of the reviews which have been published in Lewisham since April 2015.

Lewisham Modern Slavery and Human Trafficking (MSHT) Network

The Board continues to administrate and support the delivery of this multi-agency group which meets on a quarterly basis.

Colleagues from the Human Trafficking Foundation also underpin this work, and in July 2022 they gave a presentation to the Board updating them on the local, regional and national picture. 

 In the last year the Borough has also been successful in joining other local authority areas in conducting National Referral Mechanism (NRM) decisions locally (rather than by the Home Office) for under 18’s. This is helping to speed up decision making dramatically and ensure victims of MSHT are receiving the care and support they require. 

Performance, Audit and Quality Sub-Group

This group continued to meet quarterly throughout the year to analyse and monitor the Board’s performance indicators and other relevant safeguarding information. This activity also plays a significant part in informing the ongoing development of the Board’s strategic objectives. The group provided the necessary governance for the LSAB Safeguarding Audit that was conducted during 2022-23. The findings from this were reviewed by partners at the Board’s Development Session in March 2023, which included a chance to constructively challenge each organisations individual self-assessment.

 The Housing Related Safeguarding Audit has led to a further review of local Self-Neglect Policy and Procedures and the creation of a

working group to take this forward. This group are considering the most suitable options for escalating risks in relation to this subject. This will lead to a follow-up and Second ‘Summit’ in December 2023.

The group also commissioned a Hospital Discharge audit which will be reported on in next years’ Annual Report.

Liberty Protection Safeguards (LPS) Task and Finish Group

This group met periodically again throughout the year but has now been stood down as the Government have announced that

the Mental Capacity (Amendment) Act 2019 will not now be implemented in this current period of parliament, and as such the current Deprivation of Liberty Safeguard (DoLS) regime will prevail. There will be a review of DoLS procedures locally during 2023-24.  

Strategic Business Plan 2023-24

 

In line with the five priority areas there are a total of 22 Actions that are planned for 2023-24. This is the most ambitious work programme the Board has had since it became a statutory body in 2015.  

Full details can be read here:

LSAB Partnership Compact and Strategic Business Plan 2023-24

 

Download a copy of the LSAB Annual Report 2022-2023

Download a copy of the LSAB Annual Report 2021-2022

Download a copy of the LSAB Annual Report 2020-2021

Download a copy of the LSAB Annual Report 2019-2020

Download a copy of the LSAB Annual Report 2018-2019

Safeguarding Adults Reviews

Read and download all of the published Safeguarding Adult Reviews Commissioned by Lewisham Safeguarding Adults Board.

Safeguarding Adults Review - Arthur - 10 November 2023

Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review Arthur.

Accompanying this report is a statement from the family of Arthur

The Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing - Arthur - for Professionals.

Safeguarding Adults Review Joshua 7 June 2023 

Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review Joshua.

The Lewisham Safeguarding Adults Board has also published a statement in relation to this review.

The Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing - Joshua - for Professionals.


Safeguarding Adults Review (SAR) Learning Event Amanda and Eileen Dean 

Lewisham Safeguarding Adults Board held this important online event on Wednesday 22 February 2023 2pm - 4pm.

The event was hosted by our Independent Chair, Professor Michael Preston-Shoot and included presentations from the independent reviewers involved in these cases (Susan Harrison and Patrick Hopkinson) as well information on wider SAR themes, including a Q&A session. This high-profile and heavily subscribed event provided a significant learning experience for those who attended.

Recordings, Q&A and presentations from the event are available below. 

Amanda

Eileen Dean

Questions and Answers from the Amanda and Eileen Dean SAR Learning Event

Questions and Answers from the Amanda and Eileen Dean SAR Learning Event 22-02-23

Safeguarding Adults Review for Eileen Dean 11 November 2022

Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review for Eileen Dean.

Accompanying this report is a statement from Eileen's family.

The Lewisham Safeguarding Adults Board has also published a statement in relation to this review.

The Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing - Eileen Dean - for Professionals.


Safeguarding Adults Review for Amanda 2 November 2022

Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review for Amanda.

Accompanying this report is a statement from the family of Amanda.

Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing - Amanda - for Professionals.


Safeguarding Adults Review for Mia 29 September 2021

Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review for Mia.

Lewisham Safeguarding Adults Board has also produced a LSAB 7 Minute Briefing - Mia - for Professionals.


19 July 2021 Safeguarding Adults Review – Adult Z

Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review for Adult Z.

Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing - Adult Z - for Professionals.

The key learning points from this Safeguarding Adults Review were mental ill health, the complexities of mental capacity assessment and providing emergency care in the community for adults with complex needs.


Friday 26 June 2020 - Safeguarding Adults Review – Mrs A & Miss G

Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review for Mrs A & Miss G.

Lewisham Safeguarding Adults Board has also produced a LSAB 7 Minute Briefing - Mrs A & Miss G - for Professionals.


Friday 12 June 2020 - Safeguarding Adults Review – Mr Tyrone Goodyear

Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review for Mr Tyrone Goodyear.

Accompanying this report is a statement from the family of Tyrone.

Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing - Tyrone Goodyear - for Professionals.

Zero Suicide Alliance provide a range of awareness training options, which provide a better understanding of the signs to look out for and the skills required to approach someone who is struggling, whether that be through social isolation or suicidal thoughts. 


Friday 5 June 2020 - Safeguarding Adults Review - Executive Summary - Lee

Lewisham Safeguarding Adults Board has today published the Safeguarding Adults Review Executive Summary - Lee.

Lewisham Safeguarding Adults Board has also produced a 7 Minute Briefing – Lee - for Professionals.


During 2018 Lewisham Safeguarding Adults Board published two safeguarding adult reviews. The full reports and accompanying documents are available to read and download below.

Mr Michael Thompson - Safeguarding Adults Review - Full Report

Statement of the board in relation to the Safeguarding Adults Review - Mr Michael Thompson

Safeguarding Adult Review, Reflection and Development Briefing - Personalising Care and Improving Outcomes


Mr CS - Safeguarding Adults Review - Full Report (Includes board statement)

Mr CS - Safeguarding Adults Review - Practice Briefing

Guidelines On Risk Assessment for Smoking in Care Homes

Find out more about Safeguarding Adult Reviews and How to Make a Referral to the LSAB.

Watch the Carers Guide to Home Fire Safety 


National SAR Analysis – 7 minute briefings

The LGA have produced a series of 7 minute briefings for different audiences regarding the findings of the national SAR analysis:


National Network for Chairs of Adult Safeguarding Boards

You can find all of the Safeguarding Adults Reviews published nationally in the National Network for Chairs of Adult Safeguarding Boards - SAR Library.

Partnership Compact and Strategic Business Plan 2023-2024

Introduction
This document describes how organisations and their representatives on the Lewisham Safeguarding Adults Board (LSAB) will work together in partnership to safeguard the residents of Lewisham in 2023-24. It is based on the statutory functions of Safeguarding Adults Boards as set out in the Care Act 2014, Care and Support Statutory Guidance.

Safeguarding means protecting an adult’s right to live in safety, free from abuse and neglect. It is about people and organisations working together to prevent and stop both the risks and experience of abuse or neglect, while at the same time making sure that the adult’s wellbeing is promoted including, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action.

1.1 The aims of adult safeguarding:
• stop abuse or neglect wherever possible;
• prevent harm and reduce the risk of abuse or neglect to adults with care and support needs;
• safeguard adults in a way that supports them in making choices and having control about how they want to live;
• promote an approach that concentrates on improving life for the adults concerned;
• raise public awareness so that communities as a whole, alongside professionals, play their part in preventing, identifying and responding to abuse and neglect;
• provide information and support in accessible ways to help people understand the different types of abuse, how to stay safe and what to do to raise a concern about the safety or well-being of an adult; and
• then address what has caused the abuse or neglect.

1.2 Six key principles underpin all adult safeguarding work:
• Empowerment – people being supported and encouraged to make their own decisions and informed consent.
• Prevention – it is better to take action before harm occurs.
• Proportionality – the least intrusive response appropriate to the risk presented.
• Protection – support and representation for those in greatest need.
• Partnership – local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse.
• Accountability – accountability and transparency in delivering safeguarding.

1.3 Safeguarding duty: (this applies to an adult who)
• has needs for care and support (whether or not the local authority is meeting any of those needs) and;
• is experiencing, or at risk of, abuse or neglect; and
• as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect.

2. What is abuse and / or neglect?
The criteria set out in section 1.3 above need to be met before the issue is considered as a concern under the statutory safeguarding duty. Exploitation is a common theme in the following list of the types of abuse and neglect.

• Physical abuse: including assault, hitting, slapping, pushing, misuse of medication, restraint, or inappropriate physical sanctions.
• Domestic abuse: including psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence. A new definition is outlined in the Domestic Abuse Act 2021  including a description of ‘personally connected’.
• Sexual abuse: including rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography or witnessing sexual acts, indecent exposure and sexual assault or sexual acts to which the adult has not consented or was pressured into consenting.
• Sexual exploitation: This is when a sexual act takes place in exchange for things like food, shelter, protection, or to pay bills, and the victim may have been coerced or manipulated into this sexual act.
• Psychological abuse: including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyber bullying, isolation or unreasonable and unjustified withdrawal of services or supportive networks.
• Financial or material abuse: including theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.
• Modern slavery: encompasses slavery, human trafficking, forced labour and domestic servitude. Traffickers and slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment.
• Discriminatory abuse: including forms of harassment, slurs or similar treatment; because of race, gender and gender identity, age, disability, sexual orientation or religion (including Hate Crimes).
• Organisational abuse: including neglect and poor care practice within an institution or specific care setting such as a hospital or care home, for example, or in relation to care provided in one’s own home. This may range from one off incidents to on-going ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation.
• Neglect and acts of omission: including ignoring medical, emotional or physical care needs, failure to provide access to appropriate health, care and support or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating.
• Self-neglect: this covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding.

3. The statutory functions of Safeguarding Adults Boards
As set out in Care and Support Statutory Guidance, each Safeguarding Adults Board should:

• identify the role, responsibility, authority, and accountability with regard to the action each agency and professional group should take to ensure the protection of adults;
• establish ways of analysing and interrogating data on safeguarding notifications that increase the SAB’s understanding of prevalence of abuse and neglect locally that builds up a picture over time;
• establish how it will hold partners to account and gain assurance of the effectiveness of its arrangements;
• determine its arrangements for peer review and self-audit;
• establish mechanisms for developing policies and strategies for protecting adults which should be formulated, not only in collaboration and consultation with all relevant agencies but also take account of the views of adults who have needs for care and support, their families, advocates and carer representatives;
• develop preventative strategies that aim to reduce instances of abuse and neglect in its area;
• identify types of circumstances giving grounds for concern and when they should be considered as a referral to the local authority as an enquiry;
• formulate guidance about the arrangements for managing adult safeguarding, and dealing with complaints, grievances and professional and administrative malpractice in relation to safeguarding adults (which includes whistleblowing: see 5.4.3 to 5.4.7 of the London Multi-Agency Adult Safeguarding Policy and Procedures);
• develop strategies to deal with the impact of issues of race, ethnicity, religion, gender and gender orientation, sexual orientation, age, disadvantage and disability on abuse and neglect;
• balance the requirements of confidentiality with the consideration that, to protect adults, it may be necessary to share information on a ‘need-to-know basis’;
• identify mechanisms for monitoring and reviewing the implementation and impact of policy and training;
• carry out Safeguarding Adults Reviews;
• produce a Strategic Plan and an Annual Report;
• evidence how SAB members have challenged one another and held other boards to account; and,
• promote multi-agency training and consider any specialist training that may be required; including considering any scope to jointly commission some training with other partnerships, such as the Lewisham Safeguarding Children’s Partnership Board.

The Strategic Business Plan for 2023-24 (page 11) sets out how the LSAB partner agencies will collectively prioritise and deliver these functions over the next 12 months.

4. Lewisham Safeguarding Adults Board (LSAB) Terms of Reference
The LSAB works to prevent harm or neglect and to help those harmed by leading on and facilitating the following safeguarding adult activities for the borough:
• Strategic planning: activities such as consultation, setting goals and objectives, action planning and prioritisation, securing resources, tracking and review of implementation and goal achievement for safeguarding strategy. In addition, the LSAB will influence and link to strategic planning and commissioning across the partnership to advise and scrutinise in relation to safeguarding adults.
• Setting standards and guidance: activities such as setting standards to be achieved, developing policies and procedural guidance to guide practice towards those standards. Monitoring and auditing the implementation of these policies and procedures.
• Quality assurance: lead and ensure activities such as monitoring, audit and review of practice, review of serious cases, incorporation of research and national guidance are undertaken as required. Conducting audits to ensure the effectiveness of what is done by agencies individually and collectively to safeguard and promote the welfare of adults at risk. Commissioning Safeguarding Adults Reviews and / or other reviews of incidents or organisations when an adult dies or is seriously harmed and abuse or neglect is suspected or proven.
• Promoting participation: by people who use services and carers in safeguarding practice. Promoting awareness and action in the wider community.
• Awareness raising & publicity: activities such as public awareness campaigns, targeted publicity and educational strategies, raising awareness within services.
• Capacity building and training: activities such as training and workforce development.
• Relationship management: activities such as the negotiation and clarification of interagency roles and contributions, member agency compliance, troubleshooting and resolution of difficulties, liaison with wider partnerships and related areas of practice. In addition, undertake work as appropriate with the Lewisham Safeguarding Children’s Partnership Board, Safer Lewisham Partnership and Lewisham Health and Wellbeing Board to ensure that policy and procedures, training and all other activities are co-ordinated and coherent.

4.1 Care and Support Statutory Guidance
Members of a SAB are expected to consider what assistance they can provide in supporting the Board in its work. This might be through payment to the local authority or to a joint fund established by the local authority to provide, for example, secretariat functions for the Board.

Members might also support the work of the SAB by providing administrative help, premises for meetings or holding training sessions. It is in all core partners’ interests to have an effective SAB that is resourced adequately to carry out its functions.
Members who attend in a professional and managerial capacity should be:
• able to present issues clearly in writing and in person;
• experienced in the work of their organisation;
• knowledgeable about the local area and population;
• have a thorough understanding of abuse and neglect and its impact;
• understand the pressures facing front line practitioners;
• able to explain their organisation’s priorities;
• able to promote the aims of the SAB; and,
• able to commit their organisation to agreed actions*.

While board members representing their organisations are expected to have the authority to commit their organisation to agreed actions, those board members representing Sub-Groups or non-service provider organisations may not have the relevant authority. In their case their role is to liaise between the Board and the Sub-Group and take back to their own organisations any proposals or recommendations for action.

Each member of SAB must co-operate and contribute to the carrying out of a Safeguarding Adults Review (SAR) with a view to:
a) identifying lessons to be learnt from the adult’s case, and
b) applying those lessons to future cases.

4.2 The responsibilities of members of the LSAB
The Lewisham Safeguarding Adults Board has an Independent Chair and Deputy Chair from one of the Board’s partner agencies.

The LSAB expects board members to:
• develop and maintain effective working arrangements based on trust and mutual understanding;
• be an active partner in safeguarding and promoting the welfare of adults at risk of harm or neglect;
• contribute to the LSAB financially or by providing staff for particular tasks;
• collate and provide management information as required by the LSAB and contribute to quality assurance arrangements;
• share information to safeguard adults in line with agreed information sharing arrangements;
• commit to the work of the Board by undertaking allocated tasks or sourcing the appropriate support from within their agency to undertake the work and contributing to discussions;
• identify and support staff to participate in the interagency activities of the LSAB through their active membership of the Sub-Groups and / or Task & Finish Groups, and to progress of the work of the Board between meetings;
• ensure that the policies, procedures, guidance, tools and resources in the Lewisham Adult Safeguarding Pathway are disseminated and acted upon in an effective way within their own organisations;
• ensure that communications are cascaded through organisations, services and to front-line staff as appropriate;
• represent the LSAB and its activities within their own organisation and within any groups they represent on the Board;
• report difficulties with own organisation and between organisations to the LSAB and work with partners to find effective solutions.

4.3 Organisations represented on the LSAB
1. Age UK Lewisham and Southwark
2. Bromley, Lewisham and Greenwich MIND
3. Department for Work and Pensions – South London District
4. Healthwatch Lewisham
5. Lewisham & Greenwich NHS Trust
6. Lewisham Adult Social Care
7. Lewisham Children & Young People’s services
8. Lewisham Refugee and Migrant Network (LRMN)
9. Lewisham Safeguarding Children Partnership (LSCP)
10. Lewisham Homes
11. Lewisham Joint Commissioning Group
12. Lewisham Public Health
13. Lewisham Public Protection and Safety
14. Lewisham Strategic Housing Services
15. London Ambulance Service
16. London Fire Brigade
17. Metropolitan Police, Lewisham (South East BCU)
18. National Probation Service, Lewisham and Bromley
19. NHS South East London Integrated Care Service and Board
20. South London & Maudsley NHS Foundation trust

There will also be representatives from partner agencies on Sub-Groups.

4.4 Governance and accountability
• The LSAB is responsible for ensuring organisations are meeting their safeguarding obligations effectively and will hold them to account if they are not.

• As individuals, Board members are accountable to their own agencies but the Board as a whole will be accountable to the Department of Health and Social Care, and provides reports locally to the Health and Wellbeing Board and the Healthier Communities Select Committee. Its work may be scrutinised periodically by the Overview and Scrutiny Committee and is liable to be inspected at any time by the Care Quality Commission (CQC).
• The Board, through the independent chair, is accountable to the Chief Executive of the Local Authority, the Chief Executive of the NHS Integrated Care Board (ICB) and the Borough Commander of Police.
• These Executive Group of agencies may periodically meet to discuss the strategic direction of the Board, and additionally invite the London Fire Brigade Borough Commander, Chief Executive of Lewisham & Greenwich NHS Trust, and Chief Executive of the South London & Maudsley NHS Foundation Trust to join this group.

4.5 Equality and fairness
• The LSAB operates and supports the principles that actively value the benefits of
diversity, fair treatment, and equal access to, and outcomes from local service delivery.
• The LSAB will seek, so far as it is practicable, to ensure equality of representation and participation in the local democratic process of which it is a part.
• The LSAB will, through its composition and ways of working, seek to inform, support, involve and give a voice to all sections of the local communities it serves, with particular emphasis on the inclusion of black, Asian and minority ethnic groups, faith communities and those living with a disability. It will seek to ensure an appropriate gender balance in its membership, so far as this is practicable.

4.6 Dispute resolution between LSAB Members – escalation policy
In order for practitioners and agencies to work together effectively to safeguard adults at risk, ‘professional challenge’ should be seen as part of a healthy working relationship.
Successful partnership working is reliant upon resolving professional disagreements in a timely manner in order to avoid any potential risks to the adult(s) in question.
• As far as possible any inter-agency disputes should be resolved by negotiation and discussion between the practitioners directly involved.
• If this does not bring the matter to a satisfactory conclusion this should be escalated through the hierarchies of the agencies up to senior management level if needed.
• If this still does not lead to a constructive and positive outcome the issue should be referred to the Executive Group in writing via the Chair of the LSAB. The group will consider whether it is necessary to establish a panel consisting of no less than three members from constituent organisations, who have no direct involvement in the matter. Appropriate representation from LSAB member(s) of the agencies involved in the dispute will then be invited to attend a resolution meeting. A formal agreement to resolve the dispute will be recorded and sent to the organisations involved for reference.

4.7 Conflicts of interest
Whenever a representative has a conflict of interest in a matter to be decided upon, the representative concerned shall declare such interest at or before discussions begin on the matter. The Chair shall record the interest in the minutes of the meeting and that representative shall take no part in the decision-making process.

5. The operational structure of the Lewisham Safeguarding Adults Board


5.1 The frequency of LSAB meetings
The Board meets four times a year. Board meeting dates will be set as far in advance as possible (normally 12 months) to ensure availability of all board members.

5.2 LSAB Sub-Groups
LSAB work activities are designed to achieve results in the most effective and efficient ways. This may include formal Sub-Groups meeting on a planned regular basis or through smaller specific Task and Finish Groups, workshops, or other consultative events.

Each Sub-Group have their own Terms of Reference (Appendices 3-4), are responsible for delivering specific LSAB Strategic Objectives, and may commission Task and Finish Groups to deliver specific pieces of work linked to these objectives. Members of these groups must understand the remit of the LSAB; that they are assisting the LSAB to meet its objectives; and have the capacity to undertake work for the Board.

Membership of these groups will reflect a range of agencies across Lewisham. They may also include individuals with specialist knowledge or the ability to add value to achieving and implementing planned objectives.
Members are expected to attend meetings; contribute to discussions and activities of the Sub-Group. They may be required to undertake agreed specific tasks, delivering these in a timely way, alerting the Sub-Group Chair or other identified lead officer in advance of any deadlines being missed.

Strategic Learning will be shared along with the Lewisham Safeguarding Children Partnership (LSCP) and Safer Lewisham Partnership (SLP) to share the learning from Safeguarding Adults Reviews, Child Safeguarding Practice Reviews and Domestic Homicide Reviews, enabling higher level strategic objectives to be developed and shared.

5.3 Attendance
Individuals identified as Board, Sub-Group and / or Task and Finish Group members are expected to regularly attend meetings. Where there is unavoidable absence, all organisations should ensure that there is a suitable substitute representative from their agency.

5.4 Administrative arrangements for the LSAB
The agenda and associated papers for each Board meeting are issued no later than five working days before the meeting by the LSAB Administrator.

Minutes of LSAB Board meetings are taken by the LSAB Administrator and circulated within 15 working days of the meeting.

6. Review
These terms of reference will be reviewed as required in response to significant change in guidance, legislation, or member organisations.

Strategic Business Plan 2023-24

strategic business plan on page 23/24

LSAB Strategic Business Plan 2023 - 2024

Board Meeting Minutes

On this page you can find minutes of the Lewisham Safeguarding Adults Board meetings.

Policy and Procedures

The introduction of the Care Act 2014 put adult safeguarding on a statutory footing for the first time, embracing the principle that the ‘person knows best’. It laid the foundation for change in the way that care and support is provided to adults, encouraging greater self-determination, so people maintain independence and have real choice.

There is an emphasis on working with adults at risk of abuse and neglect to have greater control in their lives to both prevent abuse and neglect from happening, and to give meaningful options for dealing with it should it occur.

For professionals who work in Care & Support settings the Care Act provides clearer guidance, and supports pathways to working in an integrated way, breaking down barriers between organisations.

The Association of Directors of Adult Social Services (ADASS), NHS London, the Metropolitan Police, and the London Clinical Commissioning Council have produced London Multi-Agency Adult Safeguarding Policy & Procedures Lewisham Safeguarding Adults Board follows these procedures.

LSAB Adult Safeguarding Single Agency Policy and Procedure Template

This good practice template can be used and modified by any agency. The template outlines the sections that need to be inserted by the agency to include their individual procedures, details and arrangements.

Download Single Agency Policy and Procedures Template (for use by any agency) January 2023

Self-Neglect and Hoarding Multi-Agency Policy, Practice Guidance and Toolkit from the LSAB

Read our policy and practice guidance on self-neglect and hoarding.

Lewisham Modern Slavery Partnership and Victim Care Pathway

Lewisham Modern Slavery Victim Care Pathway

Lewisham Modern Slavery Partnership Strategy (Oct 2022)

Modern Slavery and Human Trafficking 7 Minute Briefing 

Modern Slavery and Human Trafficking 7 Minute Briefing

LSAB Guidance for Reporting Medication Incidents as Adult Safeguarding Concerns Jan 2022

LSAB Guidance for Reporting Medication Incidents as Adult Safeguarding Concerns Jan 2022

Guidance for Falls Events as Adult Safeguarding Concerns -

Guidance for Falls Events as Adult Safeguarding Concerns (Jan 2023)

Inter-Agency Escalation Policy - 

Inter-Agency Escalation Policy (July 2023)

LSAB Guidance on Improving our Approach to Adult and Family Engagement

This guidance provides information on Adopting a Trauma Informed Approach, Understanding the Barriers to Seeking Help, Engagement Principles and Methods that can be Used for Engagement.

Information Sharing

Adult Safeguarding: Sharing Information

Sharing the right information, at the right time, with the right people, is fundamental to good practice in safeguarding adults.

Frontline professionals and volunteers should always report safeguarding concerns in line with their organisation’s policy. Policies should be clear about how confidential information should be shared between departments in the same organisation.

For Safeguarding purposes sensitive or personal information sometimes needs to be shared between the Local Authority and its safeguarding partners (including GP’s, health, the police, service providers, housing, regulators and the Office of the Public Guardian). This may include information about individuals who are at risk, service providers or those who may pose a risk to others. It aims to enable partners to share information appropriately and lawfully in order to improve the speed and quality of safeguarding responses.

The Care Act emphasises the need to empower people, to balance choice and control for individuals against preventing harm and reducing risk, and to respond proportionately to safeguarding concerns. The Act deals with the role of the safeguarding adults board’s (SAB’s) in sharing strategic information to improve local safeguarding practice. Section 45 ‘the supply of information’ covers the responsibilities of others to comply with requests for information from the safeguarding adults board.

Sharing information between organisations as part of day-to-day safeguarding practice is already covered in the common law duty of confidentiality, The EU General Data Protection Regulation (GDPR) the Data Protection Act, the Human Rights Act and the Crime and Disorder Act. The Mental Capacity Act is also relevant as all those coming into contact with adults with care and support needs should be able to assess whether someone has the mental capacity to make a decision concerning risk, safety or sharing information.

LSAB Information Sharing Agreement Jan 2024

Lewisham Safeguarding Adults Board (LSAB) has an information sharing agreement that includes the whole partnership.

LSAB Information Sharing Agreement Jan 2024

Appendix A: Template ‘information sharing request’ form

Appendix B: Template ‘information sharing decision and update’ form

It remains the responsibility of organisations and the professionals they employ to ensure that they have a basis for processing that meets common law requirements and the requirements of the GDPR; and for public bodies that they are acting within their powers.

    Why do we need to share adult safeguarding information?

    Organisations need to share safeguarding information with the right people at the right time to:

    • Prevent death or serious harm,
    • Co-ordinate effective and efficient responses,
    • Enable early interventions to prevent the escalation of risk,
    • Prevent abuse and harm that may increase the need for care and support,
    • Maintain and improve good practice in safeguarding adults,
    • Reveal patterns of abuse that were previously undetected and that could identify others at risk of abuse,
    • Identify low-level concerns that may reveal people at risk of abuse,
    • Help people to access the right kind of support to reduce risk and promote wellbeing,
    • Help identify people who may pose a risk to others and, where possible, work to reduce offending behaviour,
    • Reduce organisational risk and protect reputation.

    False perceptions about needing consent to share safeguarding information

    Some frontline professionals and their managers can be over-cautious about sharing personal information, particularly if it is against the wishes of the individual concerned. They may also be mistaken about needing consent to share safeguarding information. The risk of sharing information is often perceived as higher than it actually is. It is important that professionals consider the risks of not sharing safeguarding information when making decisions and that these decisions are recorded.

    How to address false perceptions

    • Raise awareness about responsibilities to share information (profession or work role-specific guidance may help),
    • Encourage consideration of the risks of not sharing information,
    • Brief staff and volunteers on the basic principles of confidentiality the EU General Data Protection Regulation and data protection,
    • Improve understanding of the Mental Capacity Act,
    • Provide a contact number for staff and volunteers to raise concerns,
    • Be clear in procedures about when to raise a safeguarding concern,
    • Assure staff and volunteers that they do not necessarily need to have evidence to raise a concern.

    Complex networks between safeguarding partner agencies

    The local authority has the lead responsibility for safeguarding adults with care and support needs, and the police and the NHS also have clear safeguarding duties under the Care Act 2014. Clinical commissioning groups and the police will often have different geographical boundaries and different IT systems. Housing and social care providers will also provide services across boundaries.

    The Care Act 2014 (Section 6 [7]) places duties on the local authority and its partners to cooperate in the exercise of their functions relevant to care and support including those to protect adults. The safeguarding adults board should ensure that it ‘has the involvement of all partners necessary to effectively carry out its duties’.

    Below is a simple flowchart of the key principles for information sharing. You can also download this flowchart.

      Sharing information to prevent abuse and neglect

      Sharing information between organisations about known or suspected risks may help to prevent abuse taking place. The safeguarding adults board has a key role to play in sharing information and intelligence on both local and national threats and risks. The board’s annual report must provide information about any safeguarding adults reviews. This can include learning to inform future prevention strategies. Designated adult safeguarding managers ‘should also have a role in highlighting the extent to which their own organisation prevents abuse and neglect taking place’.

      What if a person does not want you to share their information?

      Frontline workers and volunteers should always share safeguarding concerns in line with their organisation’s policy, usually with their line manager or safeguarding lead in the first instance, except in emergency situations. As long as it does not increase the risk to the individual, the member of staff should explain to them that it is their duty to share their concern with their manager. The safeguarding principle of proportionality should underpin decisions about sharing information without consent, and decisions should be on a case-by-case basis.

      Individuals may not give their consent to the sharing of safeguarding information for a number of reasons. For example, they may be frightened of reprisals, they may fear losing control, they may not trust social services or other partners or they may fear that their relationship with the abuser will be damaged.

      If a person refuses intervention to support them with a safeguarding concern, or requests that information about them is not shared with other safeguarding partners, their wishes should be respected. However, there are a number of circumstances where the practitioner can reasonably override such a decision, including:

      • You have a lawful basis for sharing without consent under the GDPR & Data Protection Act 2018,
      • The individual lacks the mental capacity to make that decision – this must be properly explored and recorded in line with the Mental Capacity Act,
      • Other people are, or may be, at risk, including children sharing the information could prevent a crime,
      • The alleged abuser has care and support needs and may also be at risk,
      • A serious crime has been committed staff are implicated,
      • The person has the mental capacity to make that decision but they may be under duress or being coerced,
      • The risk is unreasonably high and meets the criteria for a multi-agency risk assessment conference referral,
      • You have a legal obligation.

      If none of the above apply and the decision is not to share safeguarding information with other safeguarding partners, or not to intervene to safeguard the person:

      • Support the person to weigh up the risks and benefits of different options,
      • Ensure they are aware of the level of risk and possible outcomes,
      • Agree on and record the level of risk the person is taking,
      • Offer to arrange for them to have an advocate or peer supporter,
      • Offer support for them to build confidence and self-esteem if necessary,
      • Record the reasons for not intervening or sharing information,
      • Regularly review the situation,
      • Try to build trust and use gentle persuasion to enable the person to better protect themselves.

      If it is necessary to share information outside the organisation:

      • Explore the reasons for the person’s objections – what are they worried about?
      • Explain the concern and why you think it is important to share the information,
      • Tell the person who you would like to share the information with and why,
      • Explain the benefits, to them or others, of sharing information – could they access better help and support?
      • Discuss the consequences of not sharing the information – could someone come to harm?
      • Reassure them that the information will not be shared with anyone who does not need to know,
      • Reassure them that they are not alone and that support is available to them.

      If the person cannot be persuaded to give their consent then, unless it is considered dangerous to do so, it should be explained to them that the information will be shared without consent. The reasons should be given and recorded.

      It is very important that the risk of sharing information is also considered. In some cases, such as domestic violence or hate crime, it is possible that sharing information could increase the risk to the individual. Safeguarding partners need to work jointly to provide advice, support and protection to the individual in order to minimise the possibility of worsening the relationship or triggering retribution from the abuser.

      What if a safeguarding partner is reluctant to share information?

      There are only a limited number of circumstances where it would be acceptable not to share information pertinent to safeguarding with relevant safeguarding partners. Safeguarding adults boards set clear policies for dealing with conflict on information sharing. If there is continued reluctance from one partner to share information on a safeguarding concern the matter would be referred to the board. It can then consider whether the concern warrants a request, under Clause 45 of the Care Act, for the ‘supply of information. Then the reluctant party would only have grounds for refusal if it would be ‘incompatible with their own duties or have an adverse effect on the exercise of their functions’.

      Useful Links

      On this page we have listed links to organisations that we think you will find helpful

      Age UK Lewisham & Southwark

      British Medical Association

      Care Act Factsheets from GOV.UK

      Care Quality Commission Safeguarding People

      Carers Trust

      Community Connections

      Crimestoppers UK

      Department of Health and Social Care

      Disclosure and Barring Service

      Gangmasters and Labour Abuse Authority

      General Medical Council

      Get Safe Online

      Health & Care Professions Council

      Hourglass - Safer Ageing

      IAPT (Improving Access to Psychological Therapies) - NHS

      Independent Age - Advice and support for older age

      Iranian and Kurdish Women’s Rights Organisation

      Jargon Buster

      Lewisham Council - Adult Social Care

      Lewisham Council Policing and Public Safety

      Lewisham Wellbeing Map

      Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS) Safeguarding Network

      Mayors Office for Policing and Crime

      Metropolitan Police Lewisham

      Ministry of Justice

      Modern Slavery and Exploitation Helpline

      Neighbourhood and Home Watch Network

      NHS England

      No Recourse to Public Funds Network

      Office of the Public Guardian

      Patient - Safeguarding Information

      Rape Crisis South London

      Refuge - Lewisham Athena Service

      Revenge p*rn helpline

      Safety Net

      Skills for Care

      Social Care Institute for Excellence - Safeguarding

      Survivors UK - Male Rape & Sexual Abuse

      Victims Choice

      Victim Support

      The LGA and the Association of Directors of Adult Social Services (ADASS) Safeguarding Network have worked with key partners to bring together a consolidated list of key safeguarding resources for council, care provider and wider partners' staff.

      LSAB Learning Zone

      LSAB Learning Zone

      All of our Safeguarding Adults Courses are available to Private, Voluntary and Independent organisations and commissioned care providers in Lewisham.

      Subscribe to our E-Bulletin to be among the first to find out about the Adult Safeguarding Training we offer. 

      Please note:

      All the learning events that the Lewisham Safeguarding Adults Board provide are free of charge to the delegate. However, a lot of time, resource, and public expense is used in planning and delivering these activities, so if you register, please make a full commitment to attending. If you do not, you may prevent someone else from being able to participate.

      Please cancel your booking if your circumstances change or contact us by email as soon as possible so that a replacement can be considered.

      Repeat non-attenders may be barred from registering for our events in the future.

      Safeguarding Adults Training+

      Online Adult Safeguarding Foundation Level Training Sessions

      The aim of these online sessions is to provide an introduction to adult safeguarding by outlining the legal framework, definitions and principles that are used, and by explaining the content of the Lewisham Adult Safeguarding Pathway which includes key local and national resources.

      This is for new staff or volunteers, or for those needing a refresher on this subject. The training is led by Martin Crow, LSAB Business Manager.

      Our online training is held on the Microsoft Teams platform.

      Our in person training is held at Civic Suite, Catford Road, Catford

      Wednesday 20 March 2024 13:00pm to 16.30pm Online Book Here

      Wednesday 15 May 2024 13:00pm to 16.30pm Online Book Here

      Wednesday 10 July 2024 13:00pm to 16.30pm Online Book Here

      Wednesday 4 September 2024 13:00pm to 16.30pm Online Book Here

      Wednesday 6 November 2024 13:00pm to 16.30pm Online Book Here

      Wednesday 8 January 2025 13:00pm to 16.30pm Online Book Here

      Training for Adult Safeguarding Leads or Managers (non-statutory sector)

      These sessions are for those who have leadership or managerial responsibility (including supervisors/ first line managers) for adult safeguarding within their organisation, but is not for Council, NHS or Police staff who are involved in delivering statutory safeguarding enquiries.  

      These sessions will focus on the Adult Safeguarding Principles, Legal Literacy (including information sharing and mental capacity), Safeguarding Literacy, Professional Curiosity, and the Lewisham Adult Safeguarding Pathway in a leadership context; whilst also examining supervision, documentation and record keeping. Delegates will also consider how they can improve their organisational policies, procedures and overall approach to this subject. This is led by Martin Crow (LSAB Business Manager). 

      Wednesday 17 April 2024 10:00am to 15.30pm Online Book Here

      Modern Slavery - Awareness Raising

      These online sessions are at Foundation Level and are suitable for any professional (including local businesses) who are new to the subject or who needs to refresh their knowledge. The objectives are:

      1. To gain an understanding of the definitions of modern slavery.
      2. To develop your ability to identify potential victims of modern slavery using common indicators of exploitation.
      3. To improve your understanding of victim-centred referral mechanisms for potential victims.

      This is led by Martin Crow (LSAB Business Manager) supported by local practitioners.

      Monday 29 April 2024 10am - 12.30pm Book your ticket

      Monday 22 July 2024 10am - 12.30pm Book your ticket

      Monday 14 October 2024 10am - 12.30pm Book your ticket

      Tuesday 14 January 2025 10am - 12.30pm Book your ticket

      Adult Safeguarding Awareness Training for Community Groups

      A shorter and simpler version of our adult safeguarding awareness training aimed at smaller grass root community organisations. Delivered in an evening to make this more accessible for those that may not be able to attend training during office hours. This is also suitable for members of the public, and particularly for those who may employ personal assistants for their home care. This is led by Martin Crow LSAB Business Manager.

      Tuesday 27 February 2024 18:00 - 20:00pm Book your ticket

      Tuesday 18 June 2024 18:00 - 20:00pm Book your ticket

      Tuesday 8 October 2024 18:00 - 20:00pm Book your ticket

      Tuesday 28 January 2025 18:00 - 20:00pm Book your ticket

      Mental Capacity Act – Update and Refresher: Lunch & Learn Session

      This will be led by Steve Chamberlain who is a leading expert nationally in all things related to the Mental Capacity Act (MCA).

      Steve conducted a multi-agency MCA Audit in October 2023 in Lewisham and will give feedback on his findings, key learning points and otherwise give an update on best practice.

      The session will be recorded for those that cannot attend.

      Monday 26 February 2024 12:00 - 13:00pm Online Book Here

      Familial Domestic Abuse

      Target Group - Any professional working with children and young people in the Borough of Lewisham
      Training provided by Athena Service, Refuge on Microsoft Teams

      Aims and Objectives
      • Definition of domestic abuse
      • Spotlight on defining abuse within a family context
      • Impact of abuse on victims
      • Identifying and addressing risk
      • Lessons learnt from national and local DHRs
      • Your role as a professional to safeguard victims: Recognise, Record and Refer!
      • Local referral pathway for victims to access support (Athena, run by Refuge)

      Delegates are responsible for ensuring they have management / budget holder approval prior to booking onto courses. This is in the event of your non-attendance or late cancellation where a fee of £75 will be applied. Also, you need to register with LSCP in order to book the event.

      LSCP Event Management System User Guide

      LSCP Learning Partnership Learning Terms & Conditions

      Thursday 14 March 2024 12:00 - 14:00pm Online Book Here

      Drumbeat School and ASD Service 

      Understanding and Supporting a Neurodivergent Profile

      Following their recent successful training event, Drumbeat School and ASD Service has made their Understanding and Supporting a Neurodivergent Profile resource booklet available to everyone. 

      Read and download the Understanding and Supporting a Neurodivergent Profile resource booklet.

      Adult Safeguarding Workbooks+

      We are pleased to bring you the first two workbooks in our series on adult safeguarding.

      1. Introduction to Adult Safeguarding Workbook - March 2023
      2. 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.  

      e-Learning+

      There are lots of benefits to e-learning including personalised learning and you are not bound by geography or time.

      Alcohol Change UK Webinar's

      National Trading Standards

      This resource has been designed to assist professionals and practitioners who will be interacting with victims of scams, this includes but is not limited to; social workers, community nurses, volunteers and befrienders. The e-Learning will give you an understanding of the scale of the problem of scams, an insight into the behaviour of the criminals behind scams, an understanding of the legislation that can be used to support scam victims and to prosecute criminals behind scams, and practical advice on how best to support a victim of scams.

      Practitioner E-Learning Course

      Zero Suicide Alliance

      Zero Suicide Alliance provide a range of awareness training options, which provide a better understanding of the signs to look out for and the skills required to approach someone who is struggling, whether that be through social isolation or suicidal thoughts. 

      Home Office PREVENT e-learning

      The Home Office have produced introductory e-learning training on PREVENT.

      The training offers an introduction to the Prevent duty, and explains how it aims to safeguard people from being radicalised to supporting terrorism or becoming terrorists themselves.

      The training provides an important foundation on which to develop further knowledge around the risks of radicalisation and the role that you can play in supporting those at risk.

      This training addresses all forms of terrorism and non-violent extremism, including far right wing and Islamist extremism threatening the UK.

      This learning package uses an interactive mix of video, paper, and screen based exercises.

      Who Cares UK

      Everyone who commissions or provides regulated health and social care services that are publicly arranged and/or funded is legally bound to comply with the Human Rights Act 1998. This means that these organisations must act in ways which respect and protect the human rights of service users, such as the right to life or the right to private and family life.
       
      Video-based training modules have been developed by Who Cares UK with funding from the Equality and Human Rights Commission to create a better understanding among those working in health and social care of the human rights of people with various disabilities.
       
      The modules are aimed at frontline health and social care staff but may also benefit anyone working with disabled people in a paid or unpaid capacity. 

      Self-Neglect and Hoarding Resources+

      Learning from Human Stories about Self-neglect - Webinar - Friday 8 December 2023

      Here you can find the slides and handout from the Learning from Human Stories about Self-neglect webinar held by Professor Michael Preston-Shoot.

      Here you will find the resources from all of the Self-neglect and Hoarding Training held by the LSAB

      Read the LSAB Self-neglect and Hoarding Policy and Procedures.

      SCAMS Information and Advice+

      image of a Scammer

      New! 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

      What is Fraud

      Fraud is when a person lies to you, or ‘scams’ you, to gain an advantage, such as taking your money or learning private information about you.

      This could be by email, text, phone or in person, either on the street or on your doorstep.

      Criminals are turning to more sophisticated ways to take your money, whether through online offers, emails or telephone calls.

      Scams affect the lives of millions of people across the UK. People who are scammed often experience shame and social isolation as a result.

      With a little knowledge you can protect yourself from fraudsters.

      Watch out for Scams like these

      • Banking Fraud
      • Cash Machine Fraud
      • Cheque Scam
      • Holiday Fraud
      • Identity Theft
      • Online shopping Fraud

      Watch this video from the Metropolitan Police Service on online shopping fraud

      • Impersonation Fraud

      Watch this video from the Metropolitan Police Service on Impersonation Fraud

      • Investment Fraud

      Investing in stocks and shares or any other commodity can be a successful way of making money. However, it can also lead to people losing their entire life savings. Fraudsters will persuade you to invest in all kinds of products. They will offer you high rates of return, particularly over longer periods of time, which often do not exist.

      Common products that will be offered include binary options, virtual currency, carbon credits, wine, rare metals, gemstones, land and alternative energy. Often, initial investments will yield small returns as an incentive to invest further funds. However, larger investments or cashing out will be met with excuses or a penalty charge. Eventually contact with the fraudster will be impossible and all funds and bogus returns lost.

      Fraudsters are organised and they may have details of previous investments you have made or shares you have purchased. Knowing this information does not mean they are genuine.

      Criminals may direct you to well-presented websites or send you glossy marketing material. These resources do not prove they are a genuine company. Many fraudulent companies have a polished customer image to cover their illegal activities.

      It is relatively easy to register a company with Companies House. This does not confirm or endorse that they can provide genuine investments. Indeed, emerging investment markets may be unregulated, making these open to abuse.

      • Invoice and Mandate Fraud
      • Payment in Advance Fraud
      • Purchase Scam

      Companies may be registered at prestigious addresses, for example Canary Wharf or Mayfair. This does not mean they operate from there. It is an accepted business practice to rent such a virtual office to enhance a business’s status. However, fraudsters are also aware of this and exploit it. The fraudster may put pressure on you by offering a ‘once in a lifetime opportunity’ or claim the deal has to be done quickly to maximise profit.

      In addition - be wary of companies that offer to ‘recover’ any funds you have lost to any sort of investment scam. They may be linked to the company who initially defrauded you in the first place and may be targeting you again. This is known as ‘Recovery Fraud’.

      How to protect yourself

      • There are no get rich quick schemes. If it sounds too good to be true, it probably is.
        Genuine investment companies will not cold call you. Be extremely wary of anyone who does.
      • Research both what you have been offered, and the investment company. Speak to Trading Standards if you have concerns.
        Before investing, check the Financial Conduct Authority register to see if the firm or individual you are dealing with is authorised (https://register.fca.org.uk/)
      • Check the FCA Warning List of firms to avoid.

      REMEMBER - Don’t be pressured into making a quick decision.

      CAUTION - Seek independent financial advice before committing to any investment.

      THINK - Why would a legitimate investment company call me out of the blue?

      • Rental Fraud

      Sometimes, criminals advertise properties to rent when these properties don’t belong to them, or even don’t exist! Victims are then tricked into paying an upfront fee to rent the property.

      In reality, the property does not exist, has already been rented out, or has been rented to multiple victims at the same time. The victim loses the upfront fee they have paid and is not able to rent the property they thought they had secured with the payment. Rental fraudsters often target students looking for university accommodation.

      How to Protect Yourself

      • Do not send money to anyone advertising rental properties online until you are certain the advertiser is genuine.
      • If you need to secure accommodation in the UK from overseas, seek the help of the employer or university you are coming to, or get a friend, contact or relative to check the property exists and is available.
      • Do not pay any money until you or a reliable contact has visited the property with an agent or the landlord.
      • Ask for copies of tenancy agreements and any safety certificates such as Gas Electricity or HMO Licence.
      • Do not be pressurised into transferring large sums of money. Transfer funds to a bank account having obtained the details by contacting the landlord or agent directly after the above steps have been followed. Be sceptical if you’re asked to transfer any money via a money transfer service like Western Union.
      • Romance and Dating FraudRomance Fraud Image

      Dating online is now one of the most popular ways for new couples to meet, with millions of people finding new relationships, romance and love this way. Unfortunately, amongst the genuine profiles are fake profiles set up by fraudsters. They are after your money, not your love. They are masters of manipulation, playing on your good nature and emotions to ultimately steal your money.

      Criminals will build a relationship with online members, quickly asking to move communication off the dating website. This is so they can continue their contact with you, even if their profile is later identified by the site as fraudulent and subsequently deleted.

      Fraudsters are often very flattering, appearing really interested in you within a short space of time. However, they will use a range of excuses as to why they can’t meet in person, such as they are stuck overseas, have a family emergency or have an issue with their business. They then start asking for money to help with their problems, assuring you they will pay it back as soon as they can. The fraudster may claim to be desperate to meet you as soon as this obstacle is overcome. This is all a scam and their true intention is to take as much money from you as they can.

      How to Protect Yourself

      • Stay on site.
      • Keep all communication on the dating website you are using. Don’t be convinced by profile pictures, they may have been taken from somewhere else on the internet. You can check photos using a reverse image search on the internet through websites like https://www.tineye.com or https://reverse.photos
      • Do your own research on the person – are they members of any other social networking sites? Can you confirm what they are telling you about themselves, such as where they work or where they live?
      • Never send money to someone you have not met in person and be extremely wary of giving money to someone you have recently started a relationship with.
      • Be wary of anyone asking you to receive money on their behalf and transfer it on. They may be using you to launder money.
      • Talk to family and friends for advice, even if the other party is asking you to keep the relationship secret.
      • Watch Metropolitan Police's video on Romance Fraud

      REMEMBER - Stay on site! Never send money to someone you have not met in person, or receive/ transfer money on their behalf.

      CAUTION - Be wary of continuing the relationship away from the dating website you initially made contact on.

      THINK - Why are they so quick to declare their love for me? How do I know they are telling me the truth?

      • Doorstep Crime and Scams

      Stop and think

      Remember:

      Your bank, the police, or tax office will never ask you to attend your bank, withdraw, transfer or pay money over the   phone or send couriers to collect your card or cash. Nor would they ask you to buy goods or vouchers.

      This is a scam.

      Hang up (Never give details or money following a cold call)

      Take 5 (Seek a second opinion, tell someone what has happened)

      Verify (if concerned, contact the company via a pre-confirmed method)

      Friends Against Scams is a National Trading Standards (NTS) Scams Team initiative, which aims to protect and prevent people from becoming victims of scams by empowering communities to "Take a Stand Against Scams".

      Friends Against Scams has been created to tackle the lack of scams awareness by providing information about scams and those who fall victim to them. This information enables communities and organisations to understand scams, talk about scams and cascade messages throughout communities about scams prevention and protection.

      Friends Against Scams encourages communities and organisations to take the knowledge learnt and turn it into action.

      Friends Against Scams Easy Read Resources Webpage

      https://www.friendsagainstscams.org.uk/easyread

      Anybody can join Friends Against Scams and make a difference in their own way.

      Become a friend

      If you would like to be a Friend Against Scams you can attend a short awareness session in person or complete the online training.

      After this session you will be asked to start taking action to "Take a Stand Against Scams". 

      Click here for more information.

      Take Five Campaign

      Beware if you receive a text message purporting to be from a trusted organisation such as your bank – can you be sure it’s genuine?

      It is a good idea to follow the advice from Take Five

      STOP

      Taking a moment to stop and think before parting with your money or information could keep you safe.

      CHALLENGE

      Could it be fake? It’s ok to reject, refuse or ignore any requests. Only criminals will try to rush or panic you.

      PROTECT

      Contact your bank immediately if you think you’ve fallen for a scam and report it to Action Fraud.

      Ten golden rules to prevent fraud

      Remember these ten golden rules to help you prevent fraud and beat the scammers.

      1. Be suspicious of all ‘too good to be true’ offers and deals. There are no guaranteed get-rich-quick schemes.
      2. Don’t agree to offers or deals immediately. Insist on time to get independent or legal advice before making a decision.
      3. Don’t hand over money or sign anything until you’ve checked someone’s credentials and their company’s.
      4. Never send money to anyone you don’t know or trust, whether in the UK or abroad, or use methods of payment you’re not comfortable with.
      5. Never give banking or personal details to anyone you don’t know or trust. This information is valuable so make sure you protect it.
      6. Always log on to a website directly rather than clicking on links in an email.
      7. Don’t just rely on glowing testimonials. Find solid, independent evidence of a company’s success.
      8. Always get independent or legal advice if an offer involves money, time or commitment.
      9. If you spot a scam or have been scammed, report it and get help.
      10. Don’t be embarrassed about reporting a scam. Because the scammers are cunning and clever there’s no shame in being deceived. By reporting it, you'll make it more difficult for them to deceive others.

      Get help or report a scam

      If you think you’ve uncovered a scam, been targeted by a scam or fallen victim to fraudsters, contact Action Fraud on 0300 123 2040 or at Action Fraud.

      Call the Police on 101 if you know the suspect or they’re still in the area.

      Reporting crime, including fraud, is important. If you don’t tell the authorities, how do they know it’s happened and how can they do anything about it?

      Remember that if you’re a victim of a scam or an attempted scam, however minor, there may be hundreds or thousands of others in a similar position. Your information may form part of one big jigsaw and be vital to completing the picture.

      lewisham council logo

      Scams Prevention Advice and Support From Lewisham Council

      The Neighbourhood Watch and Scams Prevention Officer can provide support if you have been the victim of a scam. They can also give advice and talks on how to prevent scams, and discuss any concerns you have about scams.

      Other useful Information

      Age UK Avoiding Scams Guide

      Crimestoppers Romance Fraud e-Booklet

      Change People.org Keeping-Safe-Online-Easy-Read-Guide

      Scam Marshals - play a role in helping National Trading Standards (NTS) Scams Team to stop scam mail (friendsagainstscams.org.uk)

      Social Housing Providers+

      Social housing and safeguarding

      All social housing providers must have appropriate safeguarding arrangements in place for tenants who have care and support needs. The Care Act 2014 requires you to support and train your staff.

      See our Adult Safeguarding Training section above for information on free e-learning, courses available in Lewisham and other learning opportunities.

      Housing Related Safeguarding Summit December 2023

      The second annual Housing Related Safeguarding Summit was held 14 December 2023. The Summit was very well attended with representation from all Lewisham Social Housing Providers and local health and social care services. For those who were unable to make it on the day, a recording of the Summit is below. 

      The presentations from the Summit are available for you to read and download.

      New analysis: How your home affects your health. Moving to healthy homes

      Housing Related Safeguarding Audit July 2022

      The aim of this Audit was to examine cases where an adult was living in uninhabitable conditions that may have posed a risk to their health or wellbeing, and to ascertain what the adult safeguarding response was, or could have been, in these instances.

      The key objective of the audit was to draw out learning to inform the development of best practice in Lewisham, between the council, housing providers and other relevant agencies. The auditor was also asked to identify and draw learning from any potentially discriminatory practice.

      Read the full report to find out more.

      Housing Related Safeguarding Audit July 2022

      Adult Safeguarding for Housing Staff

      SCIE has produced an introductory video on Adult Safeguarding for housing staff.

      A guide for staff on promoting sexuality, relationships and consent in housing with care services

      Written by Dr Adi Cooper – City & Hackney Safeguarding Adults Board

      This guide focuses on older people, sexuality, intimacy and relationships in housing with care. It looks at non-sexual and sexual relationships and individual sexual behaviour. This is not an easy subject and each case is unique, but this guide aims to steer you through how to respond and think about situations of this nature. Just because a person is old, it does not diminish their desire for companionship, intimacy and love and yet often this basic right may be denied, ignored or stigmatised. Older people in housing with care who wish to and are capable of expressing choice, should be supported to develop or maintain any relationship of their choosing. 

      Guide to Common Safeguarding Words and Phrases+

      Safeguarding is a large and complex topic. Sometimes the language used regarding safeguarding can be confusing and difficult to understand. Here we have given you simple explanations to common safeguarding words and phrases.

      A

      Abuse - Abuse is the breaching of someone’s human and civil rights by another person or people. It may be a repeated or single act; it can be unintentional or deliberate and can take place in any relationship or setting. It includes: physical harm, sexual abuse, emotional and psychological harm, neglect, financial or material abuse, and harm caused by poor care or practice or both in institutions such as care homes. It may result in significant harm to, or exploitation of, the person being abused.

      Adult at risk - Anyone aged 18 years or over who may be unable to take care of themselves due to age-related frailty, visual or hearing impairment, severe physical disability, learning disability, mental health problem, substance misuse or because they are providing care for someone else and therefore may be at risk of harm and serious exploitation.

      Alleged perpetrator(s) or Person/ organisation alleged to have caused harm or risk - Anyone who has been accused of abusing or neglecting an adult at risk, where this has not yet been proved.

      Alleged victim(s) - Adult at risk, who may have been abused, harmed or neglected by someone else, where it has not yet been proved that they are a victim.

      Assessment – An assessment is conducted in the workplace or care environment to ensure that the needs of adults are met competently.

      Advocacy – Advocacy refers to speaking or acting on someone else’s behalf, in their best interests. For instance, an adult with learning difficulties may rely on an advocate to help them to put across their wishes or feelings on a certain subject.

      ADASS – Association of Directors of Adult Social Services. ADASS was set up to help, advise, and advocate for adults that require social services support.

      B 

      Barred List – The barred list is a register of people’s names and details who are banned from working in contact with adults at risk or children. The barred list is held and maintained by the DBS and is revealed when an Enhanced with barred list DBS check is carried out.

      Basic DBS check – The lowest level of DBS check, which searches an individual’s criminal record and returns details of unspent convictions only. Any individual can request a basic DBS check for themselves, without going through a business or organisation. 

      Best Interests Decision – The result of a process of deciding whether an action is in the best interests of an individual that lacks the mental capability to decide for themselves, according to the criteria set out in the Care Act 2014. The best interest decision considers present or past wishes of the individual, lasting power of attorney, or input from relatives, carers, or other advocates.

      C

      Carer – Refers to a person who looks after an adult. The role of a carer is either a paid position, an official voluntary role, or undertaken by a relative or friend.

      Child Abuse – A term used to describe violent, abusive, or threatening behaviour or neglect towards any person under the age of 16. 

      Care Act 2014 – The Care Act aims to ensure the wellbeing of people in need of care and support services. It also aims to bring about the personalisation of care services, putting the person at the centre of the process.

      Community Safety – A term used to describe all of the available services in a local community that help to improve health and safety. Some of the main focuses of community safety is to reduce anti-social behaviour and domestic abuse.

      Clinical Governance – An NHS framework designed to make sure that high standards of care are delivered across the board.

      Commissioners - People who purchase services, often from voluntary and independent sector organisations, to provide health and care services.

      Care Quality Commission (CQC) - Independent regulator of health and care services in England. CQC inspects providers such as hospitals, dentists and care homes to ensure the care they provide meets government quality and safety standards.

      D

      Deprivation of Liberty Safeguards (DoLS) - Rules that ensure special protection is given to people who cannot make a decision (‘lack capacity’) to consent to care or treatment (or both) that will be given in a care home or hospital and stops them doing what they want to do (‘deprives them of their liberty’). The hospital or care home has to get special permission to give the care or treatment and must make decisions that are in the person’s ‘best interests’.

      DBS – Disclosure and Barring Service. Set up in 2012 to replace the CRB (criminal records bureau), the DBS is in charge of overseeing and processing applications to search individual’s criminal records. The result of a DBS check helps employers and organisations to decide whether people are fit for the role in question, especially if it involves working in contact with groups of people who may be more at risk. A DBS check can be applied for online through this website.

      Domestic Abuse – A term used to describe violent, abusive, or threatening acts or behaviour towards any person over the age of 16. 

      E

      Enhanced DBS check – The highest level of DBS check, which can be requested alone or with details of the DBS barred list too. An enhanced DBS check reveals spent and unspent conviction, cautions, warnings, reprimands, and any relevant police notes that are kept on file. The type of jobs that require enhanced DBS checks are teachers, doctors, nurses, and care workers.

      G

      GDPR – General Data Protection Regulation. GDPR is an EU and EEA law that protects individuals from intrusive data collection or use by organisations. It is relevant to safeguarding as sensitive data may be kept on people at risk and is managed in accordance with GDPR guidance.

      H

      Health and Wellbeing Board - Forums that bring together key health and social care leaders to work in a more joined-up way to reduce health inequality and improve local wellbeing. They will listen to local community needs, agree priorities and encourage health and social care commissioners to work better together to meet local needs.

      Healthwatch - Is the independent consumer champion created to gather and represent the views of the public. Healthwatch plays a role at both national and local level and makes sure that the views of the public and people who use services are taken into account.

      Harm – Harm refers to any situation or action that can potentially damage or compromise an individual’s physical, emotional, social, or intellectual security or development.

      I

      ICS - Integrated care systems (ICSs) are partnerships that bring together NHS organisations, local authorities and others to take collective responsibility for planning services, improving health and reducing inequalities across geographical areas.

      M

      Mental Capacity Act (MCA 2005) - A law that supports and protects people who may be unable to make some decisions for themselves (people who ‘lack capacity’) because of a physical or mental disability or ill-health. It includes a test professionals can perform to tell whether someone can make decisions or not. It covers how to act and make decisions on behalf of people who ‘lack capacity’. It is often used for decisions about health care, where to live and what to do with money.

      N

      NHS – National Health Service. The NHS provides healthcare to residents of the United Kingdom and accessible to all and free at the point of entry.

      P

      Partner Agencies - Organisations that are members of the Safeguarding Adults Board.

      Public Interest – A term used to describe whether an action is justified as being beneficial for the public to find out about it or to experience it. In other words whether the action can be considered to have been taken in the “public interest”. The news media follows guidelines that decide whether releasing sensitive information is in the public interest.

      R

      Radicalisation – Describes the process of an individual being drawn into a radical and extreme belief system that condones violent or threatening behaviour to achieve a group’s stated cause. For example, a radicalising influence may try to recruit people from at risk groups to a hate-fuelled ideology that encourages acts of terrorism. To prevent radicalisation the UK government introduced the PREVENT strategy in 2007 which sets out to stop people being recruited to become a terrorist or support terrorism. 

      S

      Safeguarding – A term that covers all and any activities related to protecting an individual’s right to safety and security.

      Safeguarding Adults - All work that enables adults at risk to retain independence, wellbeing, choice and to stay safe from abuse and neglect.

      Safeguarding Adults Review - An SAB must arrange a Safeguarding Adults Review (SAR) when an adult in its area dies as a result of abuse or neglect, whether known or suspected, and there is concern that partner agencies could have worked more effectively to protect the adult. SABs must also arrange an SAR if an adult has not died but the SAB knows or suspects that the adult has experienced serious abuse or neglect.

      Safeguarding Concern (Adult) - A Safeguarding Concern is when the local authority is first told that an adult at risk may have been abused, is being abused, or might become a victim of abuse. Anyone can raise a Concern: professionals, family members, adults at risk and members of the public. Often a Concern is raised because of a feeling of anxiety or worry for an adult at risk. This feeling can arise because the adult at risk has told you what they are experiencing, you have seen abuse or something risky happening, or you have seen other signs and symptoms such as bruises.

      Safeguarding Enquiry – Also known as a “section 42 enquiry” after section 42 of the Care Act 2014. An enquiry is the action taken or instigated by the local authority in response to a concern that abuse or neglect may be taking place.

      Service providers - Organisations that deliver health and/or social care services.

      Service user - A person who is a customer or user of a service particularly used in relation to those using social care services.

      Standard DBS Check – A mid-level DBS check that provides details on spent and unspent conviction, warnings, reprimands and cautions. A standard DBS check must be requested on behalf of an individual by an organisation and can be applied for online.

      U

      Unpaid Carer - Family, friends or neighbours who provide unpaid support and care to another person. This does not include those providing care and support as a paid member of staff or as a volunteer.

      V

      Vital Interests – A term to describe the sharing and dissemination of private data and information when it is imperative to protect an individual or group from serious harm, distress, or threat to their lives.

      Terminology and Acronyms

      Find out more about the common terminology and acronyms used in safeguarding adults.

      Common Acronyms

      ACE – Adverse Childhood Experiences

      ADASS – Association of Directors of Adult Social Services

      ASC – Autistic spectrum conditions

      CQC – Care Quality Commission

      CSE – Child Sexual Exploitation

      CSP – Community Safety Partnership

      DA – Domestic abuse

      DBS – Disclosure and Barring Service

      DHR – Domestic homicide review

      DoLS – Deprivation of Liberty Safeguards

      DSP – Designated senior person

      DV - Domestic violence

      EI – Early intervention

      FGM – Female Genital Mutilation

      FMU – Forced Marriage Unit

      IDVA - Independent Domestic Violence Advisor

      IMCA – Independent Mental Capacity Advocate

      IMHA – Independent Mental Health Advocate

      LA – Local Authority

      LAC – Looked-after child

      LPA – Lasting Power of Attorney

      LSAB - Lewisham Safeguarding Adults Board

      MAPPA – Multi Agency Public Protection Arrangements

      MARAC - multi-agency risk assessment conference

      MASH – Multi Agency Safeguarding Hubs

      MCA – Mental Capacity Act 2005

      MSP – Making Safeguarding Personal

      OPG – Office of the Public Guardian

      PALS – Patient Advice and Liaison Service

      PIPOT – People in positions of trust

      PoT – Position of Trust

      SAB – Safeguarding Adults Board

      S42 Enquiry  – An enquiry is the action taken or instigated by the local authority in response to a concern that abuse or neglect may be taking place.

      SAR – Safeguarding Adults Review

      SI – Serious Incident

      TAF – Team around the family

      Professionals

      Information for Professionals

      Information for Professionals

      The information in this section is for all staff engaged in safeguarding adults at risk. It gives practical pointers to help people assess the risk of abuse, recognise it when it does occur and respond to it appropriately. It will also help put front line safeguarding in a context of multi-agency, cross-borough work to prevent and investigate abuse across London.

      While there are similarities between practice with children and adults at risk, there are significant differences and, to a large extent this is reflected in the definition of adults at risk which contributes to that complexity.

      Services have a duty to safeguard all of their service users but provide additional measures for service users who are less able to protect themselves from harm or abuse.

      ‘Safeguarding adults’ covers a spectrum of activity from prevention through to multi agency responses where harm and abuse occurs.

      Safeguarding Resources

      The Lewisham Adult Safeguarding Pathway has lots of helpful adult safeguarding resources built into it and gives you a step by step guide. 

      The Lewisham Safeguarding Adults Board produces leaflets and posters on adult safeguarding which you can download for free.

      Skills for Care have collated practical and useful safeguarding resources for the Private Voluntary and Independent Sector. The information available includes recommendations, standards, guides and links to a whole host of related resources.

      Jargon Buster

      Think Local Act Personal have a useful Jargon Buster that can help professionals from fields other than social work understand the language that is commonly used in care and support work.

      Disclosure and Barring Service

      The Disclosure and Barring Service have produced guidance on 'Making Recruitment Easier'. 

      Learning from Safeguarding Adults Reviews for Care Providers

      The Institue of Public Care and the Oxford Brookes University has produced a discussion paper on How Can Care Providers Learn From Safeguarding Adult Reviews? which looks at mechanisms to identify and share relevant learning from SARs with care providers.

      Safeguarding in Care Homes Guidelines and Tools

      NICE guideline on Safeguarding adults in care homes

      The final guideline has now been published on the NICE website. You can also find the supporting evidence, tools and resources as well as all the stakeholder comments that were received during consultation and the responses to these comments. The comments were invaluable in helping NICE to develop and refine the guideline. They have also produced an equality impact assessment to support the guideline.

      The recommendations from this guideline have been included in the NICE Pathway on safeguarding adults in care homes, which brings together everything which was said on safeguarding adults in care homes in an interactive flowchart. There is brief information about the guideline for people using services, carers and the public at Information for the public’.

      If you have any further queries, please contact SafeguardingAdults@nice  

      Health and Safety Executive Guidance - Violence and aggression at work

      The Health and Safety Executive has refreshed their guidance for employers on Violence and aggression at work. The guidance includes information on topics including:

      • What violence in the workplace is and how to prevent it
      • Health and safety laws which are relevant to violence at work
      • How to assess the risks of violent incidents at work
      • Put the right controls in place to protect your workers from violence
      • What incidents to report and how to learn from them
      • Typical examples of how employers have reduced the risk of violence

      and includes Advice for workers:

      • How your employer and you can prevent violence

      Modern Slavery and Human Trafficking

      Lewisham Modern Slavery and Human Trafficking Conference 23 January 2024

      The Lewisham Modern Slavery and Human Trafficking Conference was held 23 January 2024.

      The conference was very well attended with representation from all local health and social care services. For those who were unable to make it on the day, the presentations from the Conference are available for you to read and download.

      Modern Slavery in Supply Chains - London Borough of Lewisham

      Responding to Modern Slavery and Human Trafficking in Lewisham - Human Trafficking Foundation

      Modern Slavery and Human Trafficking Lewisham - Metropolitan Police Service

      Operation Makesafe has been developed in partnership with London’s boroughs to raise awareness of child exploitation in the business community, such as hotels, licensed premises, taxi companies, shops, and care homes. The purpose of Operation Makesafe is to empower businesses and organisations to tackle child exploitation through increased awareness and training.

      Links to further learning, advice and organisations that were shared at the Conference.

      Modern Slavery: Duty to notify

      Do you know that you have a duty to notify the Home Office of potential victims of modern slavery?

      The Modern Slavery Fact-sheet can tell you more on your duty to notify.

      The Home Office has published new modern slavery it's closer than you think campaign resources which brings together documents and promotional material related to the awareness campaign on modern slavery which you can use in your local campaigns.

      Identification of victims

      The Home Office has produced Modern Slavery Victims - Guidance, Referral and Assessment Forms which gives information on how to identify and refer potential victims of modern slavery/human trafficking to the national referral mechanism.

      Lewisham Modern Slavery Victim Care Pathway

      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

      What is the National Referral Mechanism?

      The national referral mechanism (NRM) is a victim identification and support process. The NRM is designed to make it easier for all agencies that could be involved in a trafficking case (eg the police, UK Visas and Immigration, local authorities, non-governmental organisations) to share information about potential victims and facilitate their access to advice, accommodation and support.

      The guidance document gives information including:

      • What the NRM is
      • The referral process
      • How to complete the referral forms

      Slavery and human trafficking in supply chains: guidance for businesses

      The Home Office provides Statutory guidance for organisations on how to ensure that slavery and human trafficking is not taking place in their business or supply chains.

      Links to further information and resources

      Lewisham Modern Slavery and Human Trafficking 7 Minute Briefing

      Hope for Justice exist to bring an end to modern slavery by rescuing victims, restoring lives, and reforming society.

      Hope for Justice also have comprehensive briefing documents that define human trafficking, outline the UK and global markets for the exploitation of human beings and analyse the current mechanisms for addressing this complex crime.

      Human Trafficking Foundation (HTF) is a UK-based charity which grew out of the work of the All Party Parliamentary Group on Human Trafficking. HTF was created in order to support and add value to the work of the many charities and agencies operating to combat human trafficking in the UK.

      London Directory of Services
      The Human Trafficking Foundation has created a Directory of Survivor Support Services in London, which is constantly updated.

      Gangmasters and Labour Abuse Authority (GLAA)

      Hoarding & Self-neglect

      What is Hoarding?

      • The acquisition of, and failure to discard, a large number of possessions that appear to be useless or of limited value. (Frost and Gross, 1993)

      And/or

      • Living spaces are cluttered enough that they can't be used for the activities for which they were designed.  (Frost and Hartl, 1996)

      And

      • Where significant distress or impairment in functioning is caused by the hoarding.

      Hoarding has been recognised as a metal health issue since Community Care published ‘Hoarding and self-neglect – what social workers need to know

      Learning from London Safeguarding Adult Reviews

      London SAR Task and Finish Group recently commissioned an analysis of the nature and content of 27 Safeguarding Adults reviews commissioned and completed by London Safeguarding Adults Boards since the implementation of the Care Act 2014 on 1st April 2015 up to 30th April 2017. 17 reviews were submitted to the project for analysis.

      The purpose of the project was to consider the establishment of a repository of London SAR's. The is would allow for the development of quality markers, disseminate relevant lessons and methods to measure the impact of learning from SAR's. The repository would also hold information on reviewers and methodologies.

      Read the report to see the results of the analysis project.

      Hoarding and Self-Neglect Briefing from the LSAB

      Read our briefing on hoarding and self-neglect.

      LSAB Self-Neglect Learning Seminar

      Thanks to all those that attended our learning seminar. As promised to you at the event here is the presentation for you. 

      Here are links to some good background documents & briefings on hoarding and self-neglect.

      In particular:

      SCIE Self Neglect Managers Briefing March 2015 by Suzy Braye, David Orr and Michael Preston-Shoot

      British Psychological Society Hoarding - A Psychological Perspective on Hoarding

      The clutter image rating clearly illustrates the wide range of clutter in different rooms from clear to extreme.

      Self- Help to De-Hoard Your Home

      If you feel you are hoarding in your home and would like to help yourself de-hoard below are links to advice, information and top tips on how you can achieve this.

      http://www.helpforhoarders.co.uk/

      New Training Resource from Safeguarding Adults in Gloucestershire

      “Am I YOUR Job?” is a brand new trainer resource (training session plan and video) on Self-Neglect from Safeguarding Adults in Gloucestershire.

       

      Criminal Exploitation of vulnerable adults: County Lines & Cuckooing

      What is cuckooing?

      Criminal gangs target the homes of vulnerable people to be used for drug dealing – a process known as “cuckooing” after the “Cuckoo” bird that invades other bird’s nests. Victims are often left with little choice but to co-operate.

      Drug dealers will often approach the vulnerable person offering money or free drugs to use their home for dealing. In some instances after providing free drugs, the dealers will then force the person to sell drugs for them in order to ‘re-pay’ their drug debts.

      These criminals are selective about who they target, a lot of the time victims are lonely, isolated, frequently drug users themselves and can already be known to the police.

      “Cuckooing” means the drug dealers can operate from a property rather than the street, which is out of sight from the police making it a very attractive option. They can then use the premises to deal drugs from, which is difficult for the police to monitor.  

      What to do if you suspect a property is being ‘cuckooed’?

      Call Metropolitan Police Service on 101 or 999 in an emergency to report drug-related information.

      If you don’t want to speak to the police directly, you can call Crimestoppers anonymously on 0800 555 111.

      Criminal Exploitation of children and vulnerable adults: Updated County Lines Guidance

      The government has published refreshed County Lines Guidance. The guidance is primarily aimed at frontline staff who work with children, young people and potentially vulnerable adults.

      If you’re a professional working in social care, education, health, housing, benefits, law enforcement (police) and related partner organisations this guidance is for you.

      Criminal exploitation of children and vulnerable adults is a geographically widespread form of harm that is a typical feature of county lines activity. It is a harm which is relatively little known about or recognised by those best placed to spot its potential victims.

      The guidance is intended to explain the nature of this harm to enable you, the professional, to recognise its signs and respond appropriately so that potential victims get the support and help they need.

      Like other forms of abuse and exploitation, county lines exploitation:

      • Can affect any vulnerable adult over the age of 18 years;
      • Can still be exploitation even if the activity appears consensual;
      • Can involve force and/or enticement-based methods of compliance and is often accompanied by violence or threats of violence;
      • Can be perpetrated by individuals or groups, males or females, and young people or adults; and
      • Is typified by some form of power imbalance in favour of those perpetrating the exploitation. Whilst age may be the most obvious, this power imbalance can also be due to a range of other factors including gender, cognitive ability, physical strength, status, and access to economic or other resources.

      As so little is known about this type of abuse the national picture on county lines continues to develop but there are recorded cases of:

      • Both males and females being exploited;
      • White British children and young people being targeted because gangs perceive they are more likely to evade police detection but a person of any ethnicity or nationality may be exploited;
      • The use of social media to make initial contact with children and young people;
      • Class A drug users being targeted so that gangs can takeover their homes (known as ‘cuckooing’).

        What to do if you are a professional who is concerned

        Any practitioner working with a vulnerable person who they think may be at risk of county lines exploitation should follow their local safeguarding guidance and share this information with Lewisham Council’s social care services. If you believe a person is in immediate risk of harm, you should contact the police.

        Guidance

        Canterbury City and Kent County Council's and their partnership have produced multi-agency guidance on tackling Cuckooing which can be applied locally.

        Tackling Cuckooing Multi-Agency Guidance.

        Read the full Guidance for more detailed information on County Lines exploitation.

        Promotional and digital resources to support your work on addressing County Lines in Lewisham.

        For additional information on cuckooing, please see the 'Introduction to Cuckooing' presentation

        CONTEST and the Prevent Strategy

        What is CONTEST and the Prevent Strategy?

        The Prevent Strategy is one of the key elements of CONTEST, the Government's counter- terrorism strategy and it aims to stop people from being drawn into terrorist-related activity. Prevent has strong links to safeguarding because vulnerable adults and children can be susceptible to radicalisation and recruitment into violent extremist and terrorist organisations.

        CONTEST has four strands:

        • Protect: Strengthen our protection against terrorist attack.
        • Prepare: Mitigate the impact of an attack.
        • Pursue: Stop a terrorist attack.
        • Prevent: Stop people from becoming terrorists or supporting terrorism by:
          • responding to the ideological challenge of terrorism and the threat we face from those who promote it,
          • preventing people from being drawn into terrorism and ensuring that they are given appropriate advice and support,
          • working with sectors and institutions where there are risks of radicalisation that we need to address.

        What does the Prevent Duty mean for Statutory Organisations in Lewisham?

        Since 2015, statutory agencies have a duty under the Counter Terrorism & Security Act "to have due regard to the need to prevent people from being drawn into terrorism". This means that local authorities should:

        • Establish strategic and operational links with other specified authorities,
        • Facilitate the assessment of risk for specified authorities, including providing advice and sharing threat assessments based on the Counter Terrorism Local Profiles (CTLP),
        • Provide a range of training products (including but not limited to Workshops to Raise Awareness of Prevent - WRAP) to all specified authorities,
        • Understand the full range of bodies affected by the new duties, and ensure they understand their responsibilities,
        • Embed Prevent into commissioning, procurement, and grant funding processes,
        • Embed Prevent into Safeguarding Policies and ensure all providers are signed up to local Safeguarding arrangements. In Lewisham, work has been taking place to ensure that all relevant agencies are complying with their obligations under the 2015 Counter Terrorism & Security Act. This includes delivering briefings, training and advice.

        Image of London Brough of Lewisham logo

        Lewisham Prevent Service

        London Borough of Lewisham Prevent are available to assist agencies in complying with their Counter Terrorism Act duties. The support offer includes: 

        • Prevent in Lewisham operates a Strategic Board
        • Prevent Delivery Group 
        • Multi-Agency Safeguarding Panel – Channel

        Compliance in Lewisham

        • The provision of Workshops to Raise Awareness of Prevent (WRAP training for frontline staff),
        • Management briefings regarding Prevent Duty compliance,
        • Coordination of strategic and operational groups,
        • The provision of Prevent-related resources and dissemination of relevant information.

        Safeguarding vulnerable people against radicalisation and extremism

        There have been several cases where extremist groups have attempted to radicalise vulnerable adults. This can include justifying political, religious, sexist, or racist violence, or to steer individuals towards an ideology of extremism and intolerance. A vulnerable adult might be groomed and radicalised into carrying out acts of violence and cause significant harm to others.

        There are several ways in which vulnerable adults can be at risk of radicalisation.

        • They can be groomed either online or in person by people seeking to draw them into extremist activity.
        • Vulnerable adults can be radicalised online via networks or online chat platforms.
        • Grooming can also be carried out by those who hold harmful, extremist beliefs, including peer or family members who have an influence over the person's life.
        • People can be exposed to violent, anti-social, extremist imagery and narratives which can lead to normalising intolerance of others and extremist ideology.

        All agencies play a vital role in ensuring vulnerable adults and our communities are safe from the threat of radicalisation, extremist ideologies and terrorism.

        If you are concerned that a vulnerable adult or other family members may hold extremist views or are at risk of being radicalised, it is important to ensure that they receive support to protect them from being drawn into terrorism.

        Making a Referral

        If you are are a professional or work in the voluntary sector and are worried about a vulnerable person you should follow your own organisation’s safeguarding procedures.

        If you are a member of the public your concerns should be reported to:

        London Borough of Lewisham Gateway
        020 8314 7777 (Lines are open Monday to Friday from 9am to 5pm)
        Email

        In an emergency always dial 999.

        If you have any questions regarding Prevent in Lewisham contact the Prevent Manager by email

        Channel Awareness

        This training package is for anyone who may be asked to contribute to, sit on, or even run a Channel Panel. It is aimed at all levels, from a professional required to input and attend a Channel Panel meeting for the first time, to a member of staff new to their role and organising a panel meeting. It covers an introduction to what Channel is, how it operates in the local area, and how to organise a Channel Panel for the first time. It also covers information sharing, including how, when and with whom to share information of a Channel case.

        Public Advice

        • If you see or hear anything that could be terrorist-related, trust your instincts and call the Anti-Terrorist Hotline on 0800 789 321.
        • If you think you have seen a person acting suspiciously, or if you see a vehicle, unattended package or bag which might be an immediate threat, move away and call 999.
        • If you are involved in an incident follow police advice to: 'RUN, HIDE AND TELL 
        • Download the citizenAID App , which provides safety and medical advice from Google Play, Apple App or the Windows Store, for free.  

        Prevent Support and Advice

        You can contact the Prevent team directly and we will be more than happy to provide training, advice and support. However all referrals this should be done in addition to your usual safeguarding referral pathway.

        Contact the Lewisham Prevent Team for support and information on fulfilling the duty.  

        Lewisham Prevent Service Training

        Prevent Referrals

        Workshop to Raise Awareness of Prevent (WRAP)

        Target Group:  All professionals working with vulnerable adults in the Borough of Lewisham.

        The session is intended to:

        • Develop an understanding of the Prevent Strategy & roles within it.
        • Develop existing expertise and professional judgement in relation to extremism and radicalisation or recruitment to extremist groups.
        • Increase awareness of the national / international picture of extremism and terrorism.
        • Raise awareness of the links between online risks and radicalisation.
        • Improve confidence to raise concerns.
        • Raise awareness of the Channel interventions, safeguarding the individual.
        • Increase the whole organisations capacity to prevent extremism and safeguard vulnerable people.

        The webinars will include a presentation and Q&A session.

        Hosted by Lewisham Prevent Team

        The training is for anyone who has been through the Prevent awareness eLearning or a Workshop to Raise Awareness of Prevent (WRAP), and so already understands Prevent and of their role in safeguarding vulnerable people. 

        The package shares best practice on how to articulate concerns about an individual and ensure that they are robust and considered.

        It is aimed at anyone who may be able to notice signs of vulnerability to radicalisation and seeks to give them confidence in referring on for help if appropriate. It is also designed for those (for example line managers) who may receive referrals and need to consider how to respond, whether that be establishing more context, or reaching out to partner agencies for support.

        The Lewisham Prevent Service offer bespoke training packages designed to meet the needs of the audience. Contact the Lewisham Prevent Service to find out more and book your training event.

        E-Learning

        Prevent Home Office awareness eLearning.

        The Prevent awareness eLearning has recently been refreshed. This includes updates to reflect the recommendations from the Parsons Green review, updated information following the change in threat and recent attacks, and new case studies. A link to the training is below. 

        http://www.elearning.prevent.homeoffice.gov.uk

        Prevent Referrals E-Learning

        https://www.elearning.prevent.homeoffice.gov.uk/preventreferrals

        Guidance and Further Reading

        The Prevent Duty guidance for partners and Local Authorities

        Information on Channel

        Home Office guide for schools about social media and radicalisation

        How people become radicalised

        Homelessness and Safeguarding

        image of Homeless word in dictionary

        On this page you can find practice briefings, policies, toolkits and training opportunities on Homelessness and Safeguarding. We have also included a 7 minute briefing from a Lewisham Safeguarding Adults Review (SAR) where the adult was homeless and links to SAR reports from other areas where the adult was homeless.

        If you’re a professional who is concerned that a Homeless person may be experiencing neglect (including self-neglect) and abuse and are unable to protect themselves. You can find advice for Submitting an Adult Safeguarding Concern in the Lewisham Adult Safeguarding Pathway.

        Online learning

        Homeless Link - Bitesize learning: Supporting adults and young people through safeguarding.

        Homeless Link have created six bitesize (30-minute) sessions to give frontline staff working in homelessness services the knowledge and skills to better support people who are facing multiple disadvantage (also known as multiple and/or complex needs) and are at risk of or are experiencing homelessness.

        The sessions are delivered by Fiona Bateman, Safeguarding Consultant from Safeguarding Circle and Bruno Ornelas, Head of Homelessness at Concrete and Safeguarding Consultant.

        All sessions are free to watch, thanks to funding from The Department of Levelling Up, Housing and Communities, as part of the Capacity Building programme.

        Rough Sleeper Mental Health Awareness

        Backed by the Mayor of London's Rough Sleeping Innovation Fund, Westminster City Council and London Borough of Lambeth, this free course supports cross-sector professionals in recognising and working with the Mental Health needs of people who sleep rough and the unstably housed.

        Fifteen leading experts (incl. service users, Sir Michael Marmot, Deputy Mayor James Murray, A. Prof Nick Maguire, Jane Cook DoH MHCLG amongst others) will discuss the context and complexity of need, approaches to engagement and support, recognising and working with risk and key mental health and substance use problems.

        The course will also explore the use of legislation such as the Mental Health Act, navigating the NHS and helping those with ‘no recourse to public funds’.

        Length: Four modules, duration: 30 - 45 mins of study per module.

        Homeless Link - How homeless services can support LGBTQI+ women

        This webinar from Homeless Link, delivered in 2023, provides an introduction to issues of sexuality and gender and the relationship to homelessness.

        LSAB logo

        Online Adult Safeguarding Foundation Level Training and Workbooks

        The Lewisham Safeguarding Adults Board runs regular Online Adult Safeguarding Foundation Level Training Sessions, and we also have a series of adult safeguarding workbooks.

        All of our Safeguarding Adults Courses are available to Private, Voluntary and Independent organisations and commissioned care providers in Lewisham.

        Find out more in our learning zone.

        Practice Briefings and Guidance

        lsab logo

        LSAB Self-Neglect and Hoarding Multi-Agency Policy, Practice Guidance and Hoarding Toolkit

        This guidance is aimed at a wide range of professionals involved in working with people who may self-neglect and sets out the response that professionals should take to this complex issue.

        LSAB Guidance on Improving our Approach to Adult and Family Engagement

        This guidance provides information on Adopting a Trauma Informed Approach, Understanding the Barriers to Seeking Help, Engagement Principles and Methods that can be Used for Engagement.

        Alcohol Change UK - How to use legal powers to safeguard highly vulnerable dependent drinkers in England and Wales

        This guide provides an accessible introduction to three pieces of legislation that can be applied to chronic, highly vulnerable, dependent drinkers so as to improve outcomes for them, their families and their communities. The guide also outlines the limits of these legal frameworks and when they should not be used.

        The Kings Fund - Delivering health and care for people who sleep rough - Going above and beyond

        This report aims to help local systems improve health outcomes among people who sleep rough and to support the ambition to end rough sleeping.

        Homeless Link - Taking action following the death of someone sleeping rough - Briefing for Homelessness Services

        This guidance details the steps that agencies can take should there be a death of a rough sleeper in their area.

        Homeless Link - Autism and Homelessness Briefing for frontline staff

        This briefing aims to provide frontline staff with information to better support people experiencing homelessness who are known or suspected to have autism. It includes suggestions of how to overcome challenges and case examples of two individuals with autism who were successfully supported to address their housing needs.

        Homeless Link - Supporting LGBTIQ+ people in homelessness services - An introduction for frontline staff

        This guidance, updated in June 2020 by The Outside Project, is written for staff who are new to LGBTIQ+ issues, or those seeking to make their service more inclusive, welcoming, and safe. It includes links to specialist agencies and resources to help you develop service provision tailored to individuals' needs.

        7 minute Briefing Supporting staff to have conversations about health

        Having conversations about health can be difficult for frontline workers. This briefing jointly produced by Groundswell, Homeless Link and Pathway outlines the key ways in which organisations can ensure their staff have the resources and support they need to feel more confident when having health-related conversations.

        Accessing social care assessments using the Care Act – Homelessness - Guidance for frontline staff

        This guidance sets out the basic principles of referral and assessment under the Care Act 2014 and the steps that support workers should take to ensure service users are fairly assessed under the Act.

        Toolkits

        VOICES Care Act Toolkit: Homelessness

        A tool to assist with the collection and submission of information to social services. This is intended to help people experiencing multiple needs articulate their circumstances in the context of the Care Act. For this purpose, multiple needs is defined as combinations of homelessness, mental ill-health, addiction, and offending. These needs may be fluctuating.

        Learning-Disabilities and Homelessness Toolkit

        This toolkit is for services who support people experiencing homelessness who may also have learning disabilities.

        Safeguarding Multiple Exclusion Homelessness Toolkit 2023

        The focus of this tool is to improve multi-agency support for individuals who have an appearance of need for care and support and are experiencing multiple exclusion homelessness (MEH).

        Research in Practice - Radical Safeguarding Toolkit for Homelessness (Coming Soon!)

        Radical Safeguarding Toolkit for Homelessness - Online | Research in Practice

        The co-produced toolkit will offer a new approach to safeguarding adults experiencing homelessness and multiple disadvantages, rooted in the work of social justice movements.

        The toolkit will explore principles of power, autonomy, solidarity and accountability in safeguarding, supporting practitioners to consider intersectional and anti-oppressive approaches to work in this area.

        Safeguarding Adults Reviews (SAR’s)

        LSAB logo

        Analysis of SAR’s

        National SAR Analysis - Briefing for practitioners - Analysis of Safeguarding Adults Reviews

        This briefing summarises key findings from the landmark study ‘Analysis of Safeguarding Adult Reviews (SARs) April 2017 – March 2019’, with particular reference to professional practice in direct work with the individual at risk of abuse and/or neglect. It is therefore of particular relevance to the work of practitioners and others who have frontline contact with individuals. It aims to support practitioners to apply best practice in their direct work and thus achieve positive outcomes in adult safeguarding.

        Adult Safeguarding and Homelessness: Learning from Safeguarding Adult Reviews

        This briefing identifies the number of Safeguarding Adult Reviews (SARs) completed in England where homelessness has been a central feature. The learning from these SARs about good practice and practice shortfalls has enabled an evidence-base for positive practice to be developed. This evidence-base can be used by practitioners working with people experiencing homelessness to advocate for best practice.

        Adult safeguarding and homelessness: A briefing on positive practice

        This briefing is to assist senior leaders, such as members of Safeguarding Adults Boards (SABs), as well as commissioners, practitioners and operational managers who are working across relevant sectors and agencies in this field, to support people who are homeless and at risk of or experiencing abuse or neglect.

        Safeguarding, homelessness and rough sleeping: An analysis of Safeguarding Adults Reviews

        This report from Kings College London presents findings from an analysis of 14 Safeguarding Adults Reviews (SARs) where homelessness was a factor, and the results of a review of the literature relating to third sector and local authority policy and guidance on adult safeguarding and homelessness.

        Policies

        Appendix 7 - London Multi-Agency Safeguarding Policy and Procedures

        Legislation

        Strategies

        DLUHC Ending Rough Sleeping For Good – September 2022

        This strategy sets out how the whole of government is taking action to meet their ambition to end rough sleeping.

        Lewisham’s Homelessness & Rough Sleeping Strategy 2023-26

        This strategy builds on the hard work that already goes on a daily basis to prevent homelessness and reduce rough sleeping in Lewisham and will help support our teams in their mission to ensure everybody has a safe, secure place to call home.

        Guidance

        Duty to Refer

        This guidance provides an overview of the duty to refer, which will help public authorities understand how to administer the duty.

        Discharging people at risk of or experiencing homelessness

        Guidance for staff involved in planning to discharge patients at risk of or experiencing homelessness, or who have no recourse to public funds.

        Information Sharing

        LSAB Information Sharing Agreement (Coming Soon!)

        Find out more on Information Sharing

        Local Services Resources

        Community directory to support health and wellbeing

        A community directory to support health and wellbeing includes local organisations, voluntary and community groups and local businesses.

        999 Club

        The Gateway Centre in Deptford for people who are experiencing homeless, or at risk of experiencing homelessness. The centre is open from 9am to 4pm on weekdays. The centre provide showers, food, phone charging, use of a phone or computer and wifi, laundry and postal address. The centre offer support with ID, claiming benefits, finding work, searching for housing, social integration and referrals to specialist agencies. They also have a women-only space called “The Sanctuary”.

        South East London Mind 

        South East London Mind provides a range of high quality mental health support services for adult residents in the borough of Lewisham. This includes specialised support for people from Black, Asian, Minority Ethnic and Refugee communities, for new mums, and for anyone needing help with benefits.

        Change Grow Live - New Direction

        Free and confidential community drug and alcohol service. If you're a professional and you'd like to refer someone to the service, use the link above to visit their website. 

        Thames Reach - Deptford Reach

        Deptford Reach community outreach service provides advice and support within communities across Lewisham and Southwark. They aim to target people at risk of homelessness and provide casework and support to prevent this from occurring.

        Lewisham Housing Options

        If you need housing advice call 020 8314 7007. The service will refer anyone homeless or at risk of homelessness to a housing solutions officer who will assess you by phone.

        Telephone 0808 178 0939

        Find more adult safeguarding information in our Adult Safeguarding Pathway

        Carers

        Safeguarding Information for Carers

        Spotting signs of abuse: Information for carers

        It's not always easy to spot the symptoms of abuse. Someone being abused may make excuses for why they're bruised, they don't want to go out or talk to people, or they're short of money.

        It's important to know the signs of abuse and, where they are identified, gently share your concerns with the person being abused. If you wait, hoping the person will tell you what's been happening to them, you could delay matters and allow the abuse to continue. 

        The lists of possible indicators and examples of behaviour are not exhaustive and people may be subject to a number of abuse types at the same time.

        Physical abuse +

        Types of physical abuse

        • Assault, hitting, slapping, punching, kicking, hair-pulling, biting, pushing
        • Rough handling
        • Scalding and burning
        • Physical punishments
        • Inappropriate or unlawful use of restraint
        • Making someone purposefully uncomfortable (e.g. opening a window and removing blankets)
        • Involuntary isolation or confinement
        • Misuse of medication (e.g. over-sedation)
        • Forcible feeding or withholding food
        • Unauthorised restraint, restricting movement (e.g. tying someone to a chair)

        Possible indicators of physical abuse

        • No explanation for injuries or inconsistency with the account of what happened
        • Injuries are inconsistent with the person’s lifestyle
        • Bruising, cuts, welts, burns and/or marks on the body or loss of hair in clumps
        • Frequent injuries
        • Unexplained falls
        • Subdued or changed behaviour in the presence of a particular person
        • Signs of malnutrition
        • Failure to seek medical treatment or frequent changes of GP

        Domestic violence or abuse +

        Types of domestic violence or abuse

        Domestic violence or abuse can be characterised by any of the indicators of abuse outlined relating to:

        • Psychological
        • Physical
        • Sexual
        • Financial
        • Emotional.

        Domestic violence and abuse includes any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been, intimate partners or family members regardless of gender or sexuality. It also includes so called 'honour’ -based violence, female genital mutilation and forced marriage.

        Coercive or controlling behaviour is a core part of domestic violence. Coercive behaviour can include:

        • Acts of assault, threats, humiliation and intimidation
        • Harming, punishing, or frightening the person
        • Isolating the person from sources of support
        • Exploitation of resources or money
        • Preventing the person from escaping abuse
        • Regulating everyday behaviour

        Possible indicators of domestic violence or abuse

        • Low self-esteem
        • Feeling that the abuse is their fault when it is not
        • Physical evidence of violence such as bruising, cuts, broken bones
        • Verbal abuse and humiliation in front of others
        • Fear of outside intervention
        • Damage to home or property
        • Isolation – not seeing friends and family
        • Limited access to money

        Sexual abuse +

        Types of sexual abuse

        • Rape, attempted rape or sexual assault
        • Inappropriate touch anywhere
        • Non- consensual masturbation of either or both persons
        • Non- consensual sexual penetration or attempted penetration of the vagina, anus or mouth
        • Any sexual activity that the person lacks the capacity to consent to
        • Inappropriate looking, sexual teasing or innuendo or sexual harassment
        • Sexual photography or forced use of pornography or witnessing of sexual acts
        • Indecent exposure

        Possible indicators of sexual abuse

        • Bruising, particularly to the thighs, buttocks and upper arms and marks on the neck
        • Torn, stained or bloody underclothing
        • Bleeding, pain or itching in the genital area
        • Unusual difficulty in walking or sitting
        • Foreign bodies in genital or rectal openings
        • Infections, unexplained genital discharge, or sexually transmitted diseases
        • Pregnancy in a woman who is unable to consent to sexual intercourse
        • The uncharacteristic use of explicit sexual language or significant changes in sexual behaviour or attitude
        • Incontinence not related to any medical diagnosis
        • Self-harming
        • Poor concentration, withdrawal, sleep disturbance
        • Excessive fear/apprehension of, or withdrawal from, relationships
        • Fear of receiving help with personal care
        • Reluctance to be alone with a particular person

        Psychological or emotional abuse +

        Types of psychological or emotional abuse

        • Enforced social isolation – preventing someone accessing services, educational and social opportunities and seeing friends
        • Removing mobility or communication aids or intentionally leaving someone unattended when they need assistance
        • Preventing someone from meeting their religious and cultural needs
        • Preventing the expression of choice and opinion
        • Failure to respect privacy
        • Preventing stimulation, meaningful occupation or activities
        • Intimidation, coercion, harassment, use of threats, humiliation, bullying, swearing or verbal abuse
        • Addressing a person in a patronising or infantilising way
        • Threats of harm or abandonment
        • Cyber bullying

        Possible indicators of psychological or emotional abuse

        • An air of silence when a particular person is present
        • Withdrawal or change in the psychological state of the person
        • Insomnia
        • Low self-esteem
        • Uncooperative and aggressive behaviour
        • A change of appetite, weight loss/gain
        • Signs of distress: tearfulness, anger
        • Apparent false claims, by someone involved with the person, to attract unnecessary treatment

        Financial or material abuse +

        Types of financial or material abuse

        • Theft of money or possessions
        • Fraud, scamming
        • Preventing a person from accessing their own money, benefits or assets
        • Employees taking a loan from a person using the service
        • Undue pressure, duress, threat or undue influence put on the person in connection with loans, wills, property, inheritance or financial transactions
        • Arranging less care than is needed to save money to maximise inheritance
        • Denying assistance to manage/monitor financial affairs
        • Denying assistance to access benefits
        • Misuse of personal allowance in a care home
        • Misuse of benefits or direct payments  in a family home
        • Someone moving into a person’s home and living rent free without agreement or under duress
        • False representation, using another person's bank account, cards or documents
        • Exploitation of a person’s money or assets, e.g. unauthorised use of a car
        • Misuse of a power of attorney, deputy, appointeeship or other legal authority
        • Rogue trading – eg. unnecessary or overpriced property repairs and failure to carry out agreed repairs or poor workmanship

        Possible indicators of financial or material abuse

        • Missing personal possessions
        • Unexplained lack of money or inability to maintain lifestyle
        • Unexplained withdrawal of funds from accounts
        • Power of attorney or lasting power of attorney (LPA) being obtained after the person has ceased to have mental capacity
        • Failure to register an LPA after the person has ceased to have mental capacity to manage their finances, so that it appears that they are continuing to do so
        • The person allocated to manage financial affairs is evasive or uncooperative
        • The family or others show unusual interest in the assets of the person
        • Signs of financial hardship in cases where the person’s financial affairs are being managed by a court appointed deputy, attorney or LPA
        • Recent changes in deeds or title to property
        • Rent arrears and eviction notices
        • A lack of clear financial accounts held by a care home or service
        • Failure to provide receipts for shopping or other financial transactions carried out on behalf of the person
        • Disparity between the person’s living conditions and their financial resources, e.g. insufficient food in the house
        • Unnecessary property repairs

        Modern slavery +

        Types of modern slavery

        • Human trafficking
        • Forced labour
        • Domestic servitude
        • Sexual exploitation, such as escort work, prostitution and pornography
        • Debt bondage – being forced to work to pay off debts that realistically they never will be able to

        Possible indicators of modern slavery

        • Signs of physical or emotional abuse
        • Appearing to be malnourished, unkempt or withdrawn
        • Isolation from the community, seeming under the control or influence of others
        • Living in dirty, cramped or overcrowded accommodation and or living and working at the same address
        • Lack of personal effects or identification documents
        • Always wearing the same clothes
        • Avoidance of eye contact, appearing frightened or hesitant to talk to strangers
        • Fear of law enforcers

        Further Home Office information on identifying and reporting modern slavery

        Discriminatory abuse +

        Types of discriminatory abuse

        Unequal treatment based on age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex or sexual orientation (known as protected characteristics’ under the Equality Act 2010)

        • Verbal abuse, derogatory remarks or inappropriate use of language related to a protected characteristic
        • Denying access to communication aids, not allowing access to an interpreter, signer or lip-reader
        • Harassment or deliberate exclusion on the grounds of a protected characteristic
        • Denying basic rights to healthcare, education, employment and criminal justice relating to a protected characteristic
        • Substandard service provision relating to a protected characteristic

        Possible indicators of discriminatory abuse

        • The person appears withdrawn and isolated
        • Expressions of anger, frustration, fear or anxiety
        • The support on offer does not take account of the person’s individual needs in terms of a protected characteristic

        Organisation or institutional abuse +

        Types of organisational or institutional abuse

        • Discouraging visits or the involvement of relatives or friends
        • Run-down or overcrowded establishment
        • Authoritarian management or rigid regimes
        • Lack of leadership and supervision
        • Insufficient staff or high turnover resulting in poor quality care
        • Abusive and disrespectful attitudes towards people using the service
        • Inappropriate use of restraints
        • Lack of respect for dignity and privacy
        • Failure to manage residents with abusive behaviour
        • Not providing adequate food and drink, or assistance with eating
        • Not offering choice or promoting independence
        • Misuse of medication
        • Failure to provide care with dentures, spectacles or hearing aids
        • Not taking account of individuals’ cultural, religious or ethnic needs
        • Failure to respond to abuse appropriately
        • Interference with personal correspondence or communication
        • Failure to respond to complaints

        Possible indicators of organisational or institutional abuse

        • Lack of flexibility and choice for people using the service
        • Inadequate staffing levels
        • People being hungry or dehydrated
        • Poor standards of care
        • Lack of personal clothing and possessions and communal use of personal items
        • Lack of adequate procedures
        • Poor record-keeping and missing documents
        • Absence of visitors
        • Few social, recreational and educational activities
        • Public discussion of personal matters
        • Unnecessary exposure during bathing or using the toilet
        • Absence of individual care plans
        • Lack of management overview and support

        Neglect and acts of omission +

        Types of neglect and acts of omission

        • Failure to provide or allow access to food, shelter, clothing, heating, stimulation and activity, personal or medical care
        • Providing care in a way that the person dislikes
        • Failure to administer medication as prescribed
        • Refusal of access to visitors
        • Not taking account of individuals’ cultural, religious or ethnic needs
        • Not taking account of educational, social and recreational needs
        • Ignoring or isolating the person
        • Preventing the person from making their own decisions
        • Preventing access to glasses, hearing aids, dentures, etc.
        • Failure to ensure privacy and dignity

        Possible indicators of neglect and acts of omission

        • Poor environment – dirty or unhygienic
        • Poor physical condition and/or personal hygiene
        • Pressure sores or ulcers
        • Malnutrition or unexplained weight loss
        • Untreated injuries and medical problems
        • Inconsistent or reluctant contact with medical and social care organisations
        • Accumulation of untaken medication
        • Uncharacteristic failure to engage in social interaction
        • Inappropriate or inadequate clothing

        Self-neglect +

        Types of self-neglect

        • Lack of self-care to an extent that it threatens personal health and safety
        • Neglecting to care for one’s personal hygiene, health or surroundings
        • Inability to avoid self-harm
        • Failure to seek help or access services to meet health and social care needs
        • Inability or unwillingness to manage one’s personal affairs

        Indicators of self-neglect

        • Very poor personal hygiene
        • Unkempt appearance
        • Lack of essential food, clothing or shelter
        • Malnutrition and/or dehydration
        • Living in squalid or unsanitary conditions
        • Neglecting household maintenance
        • Hoarding
        • Collecting a large number of animals in inappropriate conditions
        • Non-compliance with health or care services
        • Inability or unwillingness to take medication or treat illness or injury

        Please don't ignore your concerns, that could allow any abuse to carry on or escalate.

        Carers who are at risk of harm/or who harm

        The Care Act defines a carer as someone who ‘provides or intends to provide care for another adult’ (but not as a volunteer or contracted worker).

        There are three main considerations in relation to safeguarding, domestic abuse and carers.

        Carers may cause harm, through abuse or neglect of the person they care for, they may be caused harm by the person they care for, or they may be important observers and reporters of harm by others. Some people with care and support needs are intentionally abusive to their carers. However, others may not have capacity to choose not to be abusive; their disability may cause abusive behaviour, as in some cases involving people with dementia, support to address domestic abuse should be offered if abuse is causing a carer’s physical or mental health to deteriorate, or preventing them from caring for another adult. The carer may feel unable to leave or seek help for themselves due to fear of leaving the person they care for with the perpetrator, or fear of being unable to care for them on their own. The Local Authority has a duty to assess a carers needs for support to maintain their well-being – including protection from abuse.

        If you are a Carer and live in Lewisham and think that you need an assessment of your needs please contact the Adult Social Care Gateway

        Tel: 020 8314 7777

        Email: Gateway@lewisham.gov.uk

        Opening hours:

        Monday - Friday 9am - 5pm

        Carers - Information and Support

        If you help another person who needs support to live in their home then you may be a Carer. The person you care for could be mentally or physically disabled, ill or elderly and frail. They could be your parent, child, partner, relative or friend

        Other Useful Links for Carers

        Contacts

        Tel: 020 8314 7777

        Email: Gateway@lewisham.gov.uk

        Opening hours: Monday - Friday 9am - 5pm

        Tel: 020 8699 8686

        Email: info@carerslewisham.org.uk

        Professionals using too much jargon?

        If you're finding it difficult to navigate the mind field of jargon that can often be used by professionals in the care and support occupations Think Local Act Personal have a useful Jargon Buster that can help carers understand the language that is commonly used in care and support work.

        Help and Advice for Carers

        More information can be found on the Carers UK website: Help and Advice

        Lewisham Adult Safeguarding Pathway

        Lewisham Adult Safeguarding Pathway

        Lewisham Adult Safeguarding Pathway

        Arrow Image

        I welcome wholeheartedly the introduction of the Adult Safeguarding Pathway in Lewisham.

        Safeguarding Adults Reviews in Lewisham and nationally regularly highlight missed opportunities to refer adult Safeguarding Concerns and to conduct adult Safeguarding Enquiries. The Pathway provides comprehensive guidance for all those working in and around adult safeguarding. It offers a framework for the prevention of abuse and neglect, including self-neglect, and for protecting individuals who have experienced and or are at risk of abuse and neglect.

        The Pathway has been informed by, and indeed references good practice guidance that has been published by the Local Government Association in partnership with the Association of Directors of Social Services. The Lewisham Pathway therefore encapsulates the best evidence available for effective adult safeguarding. Accordingly, I hope that every agency in Lewisham will use the Pathway and the associated documentation, and link in with the work and training delivered by the Lewisham Safeguarding Adults Board. 

        I would like to thank everyone who has contributed to the development of the Pathway. It forms such an important component of the jigsaw of policies, procedures, practice and services that are designed to keep people safe.

        Professor Michael Preston-Shoot                                                                                                                   

        Independent Chair                                                                                                                                                  

        Lewisham Safeguarding Adults Board 

        ………………………………………………………………………………………………………………………………………………

        In this section of the website you will find all the local guidance, tools and forms you need to raise an Adult Safeguarding Concern, and for relevant practitioners to conduct an Adult Safeguarding Enquiry.

        This supports each of the four stages outlined in the London Multi-Agency Adult Safeguarding Policy and Procedures.

        If you also have any feedback on the Pathway, or want to generally share good practice including anonymised case examples of how you have helped to support adults in achieving positive outcomes, then please let us know and we will share and promote this via our regular e-Bulletins and training: LSAB@lewisham.gov.uk

        Concerns Stage 1: Advice for Submitting an Adult Safeguarding Concern 

        1. 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

        – including assault, hitting, slapping, pushing, misuse of medication, restraint or inappropriate physical sanctions.

        Domestic Abuse

        – including psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence (see the full definition for Domestic Abuse in the Domestic Abuse Act 2021 - Statutory Guidance).

        Domestic Abuse Act 2021 - Statutory Guidance July 2022

        Domestic Abuse and Older People – Information from Safe Lives

        Free online training for Female Genital Mutilation and Forced Marriage: Virtual College

        Read the Lewisham: Domestic Abuse and Violence Against Women and Girls Strategy 2021-26

        Raise awareness of the signs of Coercive Control by sharing and 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

        Sexual Abuse

        – including rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography.

        Psychological Abuse

        – including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation or blaming.

        Financial or Material Abuse

        – including theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements.

        Modern Slavery

        – encompasses slavery, human trafficking, forced labour and domestic servitude. 

        Lewisham Modern Slavery and Human Trafficking Network - Partnership Strategy Oct 2022

        Lewisham Modern Slavery Victim Care Pathway

        Discriminatory Abuse

        Including forms of harassment, slurs or similar treatment because of race, gender and gender identity, age, disability, sexual orientation or religion. 

        For more information, please refer to:

        Discriminatory Abuse Webinar

        Discriminatory Abuse Self- Assessment (September 2023)

        https://lewisham.gov.uk/inmyarea/publicsafety/hate-crime

        www.stophateuk.org

        https://www.met.police.uk/hatecrime

        https://metrocharity.org.uk/community/lgbt-hate-crime-greenwich-and-lewisham

        https://lsup.org.uk/?s=hate+crime

        Organisational Abuse

        – including neglect and poor care practice within and institution or specific care setting such as a hospital or care home, for example, or in relation to care provided in one’s own home.

        NICE Guidelines: Safeguarding in Care Homes

        Guidance for reporting Falls Events as Adult Safeguarding Concerns - Oct 2022

        If there any concerns about the behaviour and conduct of a professional working with an adult at risk of abuse and neglect, then this should be reported as a Safeguarding Concern under the 'Public Interest Duty', and if this work is a regulated activity, then a referral to the Disclosure and Barring Service (DBS) should also be considered: DBS Briefing

        Neglect and Acts of Omission

        – including ignoring medical, emotional or physical care needs, failure to provide access to appropriate health, care and support or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating.

        Pressure Ulcers: Safeguarding Adults Protocol

        Stop the Pressure: NHS Improvement

        Pressure Ulcer Panel Process - University Hospital Lewisham Dec 2020

        Pressure Ulcer Panel Process - In the Community Sep 2022

        Guidance for reporting Falls Events as Adult Safeguarding Concerns - Oct 2022

        Self-Neglect

        – this covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding.

        LSAB Self-Neglect and Hoarding Multi-Agency Policy, Practice Guidance and Hoarding Toolkit April 2021

        Please see the London Fire Brigade: Help for Hoarders - Fire Safety Tips

        Guidance for reporting Falls Events as Adult Safeguarding Concerns - Oct 2022

        Read our Homelessness and Safeguarding Information page for guidance, tools and advice

        More detailed information on this subject can be found here: Forms and Signs of Abuse

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

        ………………………………………………………………………………………………………………………………………............

        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".

        …………………………………………………………………………………………………………………………...............................

        2.1 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 ‘vital interest’ considerations (immediate danger or risk of serious harm).

        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 ‘public interest’ considerations (others, including children are in immediate danger or risk of serious harm). 

        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: Lewisham Think Family Protocol

        2.2 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 at the Concern stage: 

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

        SCIE: Assessment and Eligibility Outcomes (Care & Support Needs)

        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.

        3. 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:     

        4. 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 61-66) for further information on this subject, using the checklists and good practice guidance that is provided.

        5. 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, and in exceptional circumstances this can also be escalated to the Lewisham Safeguarding Adults Board to consider.

        How to Report Your Concerns About an Adult

        6. 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. 

        Where such concerns are raised about someone who works with adults with care and support needs, it will be necessary for the employer (or student body or voluntary organisation) to assess any potential risk to adults with care and support needs who use their services, and, if necessary, to take action to safeguard those adults.

        If the allegation and the circumstances of it matches the criteria outlined above, then the guidance for submitting a Safeguarding Concern to the Local Authority should be followed. The guidance for the Local Authority in conducting Safeguarding Enquiries (on the following pathway pages) outline the possible outcomes that may be relevant in such cases. 

        Whilst the focus of safeguarding adults work is to safeguard one or more identified adults with care and support needs (adult at risk), there are occasions when incidents are reported that do not involve an adult at risk, but indicate, nevertheless, that a risk may be posed to adults at risk by a person in a position of trust.

        Examples of such concerns could include allegations that relate to a person who works with adults with care and support needs who has:

            • Behaved in a way that has harmed, or may have harmed an adult or child (this could include their own family members).
            • Possibly committed a criminal offence against, or related to, an adult or child.
            • Behaved towards an adult or child in a way that indicates they may pose a risk of harm to adults with care and support needs.

        When a person’s conduct towards an adult may impact on their suitability to work with or continue to work with children, this must be referred to the Local Authority’s Designated Officer (LADO). 

        Employers, student bodies and voluntary organisations should have clear procedures in place setting out the process, including timescales, for investigation and what support and advice will be available to individuals against whom allegations have been made. Any allegation against people who work with adults should be reported immediately to a senior manager within the organisation. Employers, student bodies and voluntary organisations should have their own sources of advice (including legal advice) in place for dealing with such concerns.

        If an organisation removes an individual (paid worker or unpaid volunteer) from work with an adult with care and support needs (or would have, had the person not left first) because the person poses a risk of harm to adults, the organisation must make a referral to the Disclosure and Barring Service. It is an offence to fail to make a referral without good reason.

        Disclosure and Barring Service (DBS) Briefing

        In some instances a relevant agency may come across information about a person in a position of trust who does not work or volunteer for them, and feel it is appropriate to notify the local authority outside of the formal adult safeguarding procedures. 

        Decisions on sharing information must be justifiable and proportionate, based on the potential or actual harm to adults or children at risk and the rationale for decision-making should always be recorded.

        Care Act 2014 - Care and Support Statutory Guidance: 14.120 to 14.132

        Principals to Inform PiPOT - National Safeguarding Adults Network

        ADASS - Top Tips for Dealing with Allegations for PiPOT


        Concerns Stage 1: Guidance for Making Decisions on Adult Safeguarding Enquiries

        1. Purpose of this guidance

        This guidance has been developed to assist practitioners in assessing the context, seriousness and level of risk associated with an adult Safeguarding Concern, and in doing so, 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 Safeguarding Policy and Procedures which provides the procedural detail in relation to Safeguarding Enquiries (pages 66-78).

        2. Legal definitions

        The Care Act 2014 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.

        Advice for Submitting an Adult Safeguarding Concern.

        3. 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 Guidance on What Constitutes a Safeguarding Concern - Sept 2020

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

        4. 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.

        5. Other Safeguarding Enquiry

        Other Safeguarding Enquiries can be used when all of the Section 42 (1) criteria have not been met (see section 2), but the Local Authority still considers it "necessary and proportionate" to conduct a safeguarding enquiry. This could be linked to promoting an individual’s well-being as outlined in Section 1 of the Care Act, or for carers who do not qualify under Section 42. More detail on this subject is provided here (Page 7): ADASS Advice Note   

        …………………………………………………………………………………………………………………………...........................

        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".

        ……………………………………………………………………………………………………………………….......................

        6. 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.

        7. Factors to be considered

        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, Safeguarding Concerns and or Quality Alerts 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 67-68)>

        7.2 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.

        Advice for Submitting an Adult Safeguarding Concern

        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

        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.

        Pressure Ulcers: Safeguarding Adults Protocol

        Stop the Pressure: NHS Improvement

        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 Jan 2023

        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).
        • 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 Jan 2023

        Disclosure and Barring Service (DBS) Briefing

        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 Jan 2023

        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.

        LSAB Self-Neglect and Hoarding Multi-Agency Policy, Practice Guidance and Hoarding Toolkit (April 2021)

        Guidance for Reporting Falls Events as Adult Safeguarding Concerns Jan 2023

        Read our Homelessness and Safeguarding Information page for guidance, tools and advice.

        Sexual Abuse (including 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).

        Enquiry Stage 2: Advice for Conducting an Adult Safeguarding Enquiry

        1. The decision-making process

        The Multi-Agency Adult Safeguarding Concern Form has been designed to provide all of the detailed and necessary information to allow colleagues in the Local Authority to effectively make a decision on if a Safeguarding Concern needs to progress to a Section 42 (or Other Enquiry) under the Local Authorities duty to do so within the Care Act 2014.

        Please also refer to: Guidance for Making Decisions on Adult Safeguarding Enquiries

        All of this Safeguarding data will be collated within the Local Authorities case management system (as the lead agency in the Borough) so that there is a central source of information and intelligence, which will allow this to be carefully monitored and assessed.

        Also carefully consider if statutory advocacy is required: Advocacy 7 Minute Briefing March 2023        

        2. Enquiry routes

        Once a decision is made that a Safeguarding Enquiry must be conducted under the Section 42 duty, the relevant team within the Local Authority will decide who is best placed to conduct this, directing it through one of the four strands (2.1 to 2.4) outlined below. When this is delegated outside of the Local Authority they will still retain the overall responsibility to co-ordinate the enquiry as the lead agency, and as such they will provide the quality assurance and oversight in relation to all Safeguarding Enquiries.

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

        Professionals should also read the London Multi-Agency Safeguarding Policy and Procedures (pages 66-78) for further information on conducting Adult Safeguarding Enquiries, using the checklists and detailed good practice guidance (target timescales are the bottom of this page). 

        2.1 Police investigation

        If a Safeguarding Concern has been submitted to the Local Authority and it is identified that an element, or all of this Concern may be linked to criminal activity, then the early involvement of police is essential. Police investigations should be coordinated by the local police MaSH team who may also support other parallel actions or enquiry options, but this should always be police led.   

        See pages 67-68 of the London Multi-Agency Safeguarding Policy and Procedures for more information.

        2.2 Standard delegation within the London Borough of Lewisham (LBL) Council

        All social work staff within LBL can have Safeguarding Enquiries delegated to them, normally through one of the following four main strands:

        1. Neighbourhood Teams 1-4 (London Borough of Lewisham).
        2. Placements Team (London Borough of Lewisham). 
        3. Hospital Social Work Team (University Hospital Lewisham).
        4. Mental Health Social Work Team within South London and Maudsley (SLaM) NHS Foundation Trust.

        There is a need for supervision and co-ordination of enquiries by Safeguarding Adults Managers (SAMs). 

        See pages 57-58 of the London Multi-Agency Safeguarding Policy and Procedures for more information.

        2.3 External delegation

        Safeguarding Enquiries or elements of them may also be routinely delegated outside of LBL to the following partners:

        1. Lewisham and Greenwich NHS Trust (LGT) Safeguarding Team, who may then sub-delegate across their internal divisions, including to the District Nursing Service.
        2. South London and Maudsley NHS Foundation Trust (SLaM).
        3. South East London (SEL) Integrated Care Board (ICB). 
        4. Care and Nursing Homes.
        5. Home Care Providers.
        6. GP Practices.
        7. Other Service Providers.

        Causing S.42 Enquiries Letter Template (Word)

        SAMs will also need to supervise and co-ordination these enquiries.

        2.4 Referrals to Pressure Ulcer Panels (PUPs)

        Potential Safeguarding Concerns linked to pressure ulcers can be challenging as it needs to be determined if this has been caused by poor quality care or evidence of neglect or omissions in care provision. This can occur due to other associated factors and may require input from a professional for clinical judgements to be considered:

         The person’s physical and mental health.

        • Multiple co-morbidities.
        • State of overall skin condition of the person.
        • Indicators of neglect of care provision in relation to hygiene and/or repositioning.
        • Evidence of ineffective continence management.
        • Evidence of ineffective nutritional and fluid management.
        • Ineffective Pain management.
        • Evidence of completed and accurate proactive risk and wound assessments and subsequent care planning.
        • Accurate monitoring and recording in all documentation.
        • The views of the service user, family and friends on treatment and care are recorded.
        • Capacity and level of engagement of service users and others.
        • Evidence of appropriate and timely referrals to members of multidisciplinary team
        • Views of others including professionals.

        Pressure Ulcer Panel Process - University Hospital Lewisham Dec 2020

        Pressure Ulcer Panel Process - In the Community Sept 2022

        While Pressure Ulcers are a risk for people who are frail and not able to move easily, with good management and care these can be prevented. If an adult at risk has a pressure ulcer this should not been as a reason to automatically suspect abuse or neglect, although this should be carefully considered, and a Safeguarding Concern must always be submitted for a stage 3, 4, Unstageable, Deep Tissue Injury and Medical Device pressure ulcers.

        If a Safeguarding Concern has been submitted for a pressure ulcer related matter the Local Authority will pass this case onto the relevant Pressure Ulcer Panel (PUP) to oversee the initial investigation:

        • The Community PUP - overseen by the South East London, Integrated Care Board. (Care Home Only)
        • The Acute Trust’s PUP - overseen by Lewisham and Greenwich NHS Trust. (Trust Acute and Community Service)

        Health professionals will then inform the safeguarding process by conducting a Pressure Ulcer Synopsis and Root Cause Analysis (RCA) and submit the relevant reports to the appropriate PUP. The Lewisham Multi-Agency Safeguarding Hub (MaSH) will provide the initial support and oversight of pressure ulcer related cases until the RCA has been completed. 

        If the pressure ulcer amounts to the wilful neglect of an individual who lacks mental capacity, a crime under section 44 of the Mental Capacity Act 2005 may have occurred, and in these instances the police will be informed.

        SAM’s should engage with the PUP’s to gain understanding of process and decision making of PUP professionals, alongside assisting to co-ordinate any other elements of the safeguarding enquiry if there is another aspect to this.

        The PUP’s will attempt to conclude their investigation within 28 days, but this may not always be possible. Once the PUP’s have decided no further investigation by panel is required, the enquiry is closed to the panel and an action plan process is implemented. The SAM should then co-ordinate any further actions up to the point of the enquiry being closed overall.

        3. Professional Curiosity and Critical Evaluation

        Professional Curiosity is the capacity and communication skill to explore and understand what is happening within a family (or an organisational setting) rather than making assumptions, accepting things at face value, or allowing your personal values or possible unconscious bias to influence the way that that you see and interpret risk. 

        This has been described as the need for practitioners to practice ‘respectful uncertainty’ in applying Critical Evaluation to any information they receive, or ‘thinking the unthinkable’.

        Watch this YouTube Video: The journey from reflection towards reflexivity (relevant for all practitioners)

        The following factors highlight the need to improve professional curiosity:

        • The views and feelings of some adults can be very difficult to ascertain.
        • Practitioners do not always listen to adults who try to speak on behalf of another adult and who may have important information to contribute.
        • Carers can prevent practitioners from seeing and listening to an adult.
        • Practitioners can be misinformed with stories they want to believe are true.
        • Effective multi-agency work needs to be coordinated.
        • Challenging carers and other professionals requires expertise, confidence, time and a considerable amount of emotional energy.

         The key to effective safeguarding practice is to ask the right questions, including: 

        1. Would I live here, and if not, why not?
        2. Would I be happy with this standard of care for a member of my family?
        3. What does good look like?
        4. Is there anything else going on in this person’s life which might be causing harm, or the potential for adult abuse or neglect?

        3.1 Barriers to professional curiosity

        It is important to note that when a lack of professional curiosity is cited as a factor in any safeguarding enquiry or review that this does not automatically mean that blame should be apportioned. It is widely recognised that there are many barriers to being professionally curious, some of which are set out below:

        The ‘rule of optimism’.
        Risk enablement is about a strengths-based approach, but this does not mean that new or escalating risks should not be treated seriously. The ‘rule of optimism’ is a well-known dynamic in which professionals can tend to rationalise away new or escalating risks despite clear evidence to the contrary.

        Accumulating risk – seeing the whole picture.
        Reviews repeatedly demonstrate that professionals tend to respond to each situation or new risk discretely, 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 come to be seen as 'normal' and become taken-for-granted or 'natural' in everyday life. Because they are seen as ‘normal’ 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 defer to the opinion of a ‘higher status’ professional who has limited contact with the person but who views the risk as less significant. Be confident in your own judgement and always outline your observations and concerns to other professionals, be courageous and challenge their opinion of risk if it varies from your own. Escalate ongoing concerns through your manager and by using more formal procedures if necessary.

        Confirmation bias.
        This is when we look for evidence that supports or confirms 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 knowing 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 undermine confidence and 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’. A person-centred approach requires practitioners to remain mindful of the original concern and be professionally curious:

        • ‘Unsubstantiated’ concerns and inconclusive medical evidence should not lead to case closure without further assessment.
        • Retracted allegations still need to be investigated wherever possible.
        • The use of risk assessment tools can reduce uncertainty, but they are not a substitute for professional judgement, and results need to be collated with observations and other sources of information.
        • Social care practitioners are responsible for triangulating information such as, seeking independent confirmation of information, and weighing up information from a range of practitioners, particularly when there are differing accounts, and considering different theories/ research to understand the situation.

        Other barriers to professional curiosity.
        Poor supervision, complexity and pressure of work, changes of case worker leading to repeatedly ‘starting again’ in casework, closing cases too quickly, fixed thinking/preconceived ideas and values, and a lack of openness to new knowledge are also barriers to a professionally curious approach.

        3.2 Disguised Compliance

        Disguised Compliance involves carers giving the appearance of co-operating 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 of the scale, 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 Disguised Compliance in all families; but at its worst superficial cooperation may be to conceal deliberate abuse, and professionals can sometimes delay or avoid interventions due to Disguised Compliance.

        The following principles will help front line practitioner’s deal with Disguised Compliance more effectively:

        • Focus on the needs, voice and lived experience of the adult.
        • Avoid being encouraged to focus too extensively on the needs and presentation of the carers, whether aggressive, argumentative or apparently compliant.
        • Think carefully about the engagement of the carers and the impact of this behaviour on the practitioner’s view of risk.
        • Focus on change in the family dynamic and the impact this will have on the life and well-being of the adult. This is a more reliable measure than the agreement of carers in the professionals plan.
        • There is some evidence that an empathetic approach by professionals may result in an increased level of trust and a more open family response leading to greater disclosure by adults.
        • Practitioners need to build close partnership style relationships with families whilst being constantly aware of the adult’s needs and the degree to which they are met.
        • There is no magic way of spotting Disguised Compliance other than the discrepancy between a carer’s account and observations of the needs and account of the adult. The latter must always take precedent.
        • Practitioners should aim to ‘triangulate’ and cross-reference the information they have received to confirm or refute the facts that have been presented.

        3.3 Professional Challenge - having different perspectives

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

        If you have a difference of opinion with another practitioner, remember:

        • Professional differences and disagreements can help find better ways to improve outcomes for adults and families.
        • All professionals are responsible for their own actions in relation to case work.
        • Differences and disagreements should be resolved as simply and quickly as possible, in the first instance by individual practitioners and /or their line managers.
        • All practitioners should respect the views of others whatever the level of experience – remember that challenging more senior or experienced practitioners can be hard.
        • Expect to be challenged; working together effectively depends on an open approach and honest relationships between agencies and professionals.
        • Differences are reduced by clarity about roles and responsibilities, the ability to discuss and share problems, and by effectively networking.

        Also see this briefing from the Somerset Safeguarding Adults Board: Mendip House Practice Briefing

        3.4 Cultural Competence

        Culturally competent safeguarding practice is essential in achieving the right outcomes, and for improving the well-being of adults from Black, Asian and Minority Ethnic (BAME) communities.

        Lack of cultural awareness among practitioners can impact on their ability to effectively work with and support adults, and therefore deal with abuse and neglect appropriately. This can also result in poor practice or interventions, which in turn can reduce trust in statutory agencies and create barriers for engagement with and from minority ethnic communities.   

        It is important therefore that practitioners are sensitive to differing family patterns and lifestyles that vary across different racial, ethnic and cultural groups. At the same time they must be clear that abuse or neglect cannot be condoned for religious or cultural reasons.

        All practitioners working with adults at risk and their carers whose faith, culture, nationality and recent history differs significantly from that of the majority culture, must be professionally curious and take personal responsibility for informing their work with sufficient knowledge (or seeking advice) on the particular culture and/or faith by which the adult and their family or carers live their daily lives.

        Practitioners should be curious about situations or information arising in the course of their work, allowing the family to give their account as well as researching such things by discussion with other practitioners, or by researching the evidence base. Examples of this might be around attitudes towards, and acceptance of, services e.g. health and dietary choices.

        In some instances reluctance to access support stems from a desire to keep family life private. In many communities there is a prevalent fear that social work practitioners will negatively interfere, and there may be a poor view of support services arising from initial contact through the immigration system, and, for some communities – particularly those with insecure immigration status – an instinctive distrust of the state arising from experiences in their country of origin.

        Practitioners must take personal responsibility for utilising specialist services. Knowing about and using services available locally to provide relevant cultural and faith-related input to prevention, support and rehabilitation services for adults (and their family) will help support practice.

        This includes:

        • Knowing which agencies are available to access locally (and nationally).
        • Having contact details to hand.
        • Timing requests for expert support and information appropriately to ensure that assessments, care planning and review are sound and holistic.

        Often for BAME communities, accessing appropriate services is a consistent barrier to them fully participating in society, increasing their exclusion and potential for victimisation.

        Social Graces

        The term ‘Social Graces’ is a mnemonic to help us remember some of the key features that influence personal and social identity. This helps to prompt a professional to have discussions with an adult in a more inclusive way, which in turn may help to improve their understanding of that person's life circumstances and risks they may be facing:

        G Gender and Geography

        R Race and Religion

        A Age, Accent, Appearance and Ability 

        C Class and Culture

        E Ethnicity, Education and Employment 

        S Sexual Orientation and Spirituality

        Read here for more information: Social Graces: A practical tool to address inequality www.basw.co.uk

        4. The Challenge of Engagement and Self-Neglect

        Only 5% of Section 42 Enquiries are related to Self-Neglect in Lewisham, but professionals must understand the significance of these complex cases as almost half of all Safeguarding Adults Reviews, and therefore some of the most serious cases of abuse nationally, are related to this subject.

        When an adult is self-neglecting, relationship based work becomes crucial and having one worker as a single point of contact may be beneficial.

        Using the label “hard to engage” is damaging and may result in other professionals believing there is little point in attempting to do so, and therefore should be avoided (“seldom heard” may be a more appropriate term).

        Practitioners should work together if one is struggling to achieve meaningful engagement with the adult, as another may still be able to take the lead on behalf of an Enquiry Officer in managing and monitoring risk.

        Practitioners should also consider the following in helping to improve engagement with adults:

        1. Creative, flexible and imaginative ways to communicate with adults, including working with faith, community leaders and non-safeguarding practitioners to achieve the best outcomes.
        2. Producing information in a number of ways to meet individual needs.
        3. Involving family members appropriately to help support adults.
        4. The use of advocacy to engage with adults.
        5. Training staff to enable and improve engagement with adults.

        LSAB Self-Neglect and Hoarding Multi-Agency Policy, Practice Guidance and Hoarding Toolkit

        5. 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)

        ……………………………………………………………………………………………………………………………………………

        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". ……………………………………………………………………………………………………………………………………………

        Local Government Association - Making Safeguarding Personal Toolkit

        Plan & Review Stage 3: Multi-Agency Adult Safeguarding Planning Meeting Guidance

        1. 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).

        This is a shift in terminology and emphasis away from trying to 'substantiate' reports of abuse, which can become combative between professionals and agencies, detracting from the efforts to improve the adult's wellbeing and safety.  

        See: Multi-Agency Adult Safeguarding Planning Meeting Form (Word)   Multi-Agency Adult Safeguarding Planning Meeting Form (Pdf)

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

        A Planning Meeting may not 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. The objectives of a Safeguarding Enquiry are laid out on page 70 of the London Multi-Agency Safeguarding Policy and Procedures. 

        ……………………………………………………………………………………………………………………………………………

        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 practitioner who is setting up and chairing a Planning Meeting (see section 3) 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).    

        2.1 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 (see section 3.2 of the London Multi-Agency Safeguarding Policy and Procedures), 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. Such decisions must be made in line with the Mental Capacity Act 2005 (Mental capacity should be carefully considered during every safeguarding enquiry- see section 3.1 of the London Multi-Agency Safeguarding Policy and Procedures).

         2.2 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  ………………………………………………………………………………………………………………………………………….

        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". ……………………………………………………………………………………………………………………………………………

        2.3 The Planning Meeting should consider:

        • The longer-term ongoing support the adult will need.
        • What learning can be shared across agencies to help prevent further re-occurrences. This is also linked to Section 44 of the Care Act 2014 - if the criteria for a Safeguarding Adults Review (SAR) is met.
        • If a referral to the Provider Concerns Process should be made (see sections 5.7 & 5.8 of the London Multi-Agency Safeguarding Policy and Procedures)
        • What training or education is needed to help prevent further re-occurrences of abuse.
        • How information should be recorded and shared in line with the data protection legislation to help prevent further instances of abuse (see section 2.39 of the London Multi-Agency Safeguarding Policy and Procedures.

        ……………………………………………………………………………………………………………………………………………

        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".

        ……………………………………………………………………………………………………………………………………………

        • If the abuse or neglect is unintentional and has arisen because an informal carer is struggling to care for another person. An assessment of both the carer and the adult must be considered in relation to wellbeing principles and duties. 

        ...................................................................................................................................................................…………………..

        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". ……………………………………………………………………………………………………………………………………………

        • The details of the Safeguarding Concern and how this places the adult at risk of abuse or neglect.
        • That there is clarity about the type of abuse that has occurred and that this is recorded effectively, considering types of abuse that are particularly under-recorded:
          • Organisational Abuse
          • Discriminatory Abuse
          • Modern Slavery
          • Domestic Abuse.
        • If an enquiry does take place, that an appropriate risk assessment of the available information is conducted that informs decisions regarding how the investigation will be undertaken, by whom, and by when.
        • How a Safeguarding Plan will be delivered to reduce or remove the risk of harm to the adult, and or others.
        • Any potential risks to children and young people (or other adults at risk) and agreement on who will arrange a Child Protection referral, where necessary. Refer to the: Lewisham Think Family Protocol
        • The link with other key processes and procedures e.g. personnel issues (including referrals to the Disclosure and Barring Service or a professional or regulatory body); Police investigations; other regulatory processes such as a NHS Serious Incident, and the link to Pressure Ulcer Panels (see section 6).

        ...................................................................................................................................................................………………..

        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".

        ……………………………………………………………………………………………………………………...……………………

        • How everyone involved in the enquiry will deliver the actions that are agreed as a result of the investigation in a manner consistent with Making Safeguarding Personal principles (MSP) and that the adult’s views and wishes are achieved as agreed. 

        Local Government Association - Making Safeguarding Personal Toolkit

        ……………………………………………………………………………………………………………………………………………

        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".

        ………………………………………………………………………………………………………………………………………………….

        • That arrangements are in place to give feedback to the person raising the Safeguarding Concern if they are not in attendance at the Planning Meeting.
        • How partners are going to monitor and measure the delivery of the agreed actions with MSP in mind.
        • Issues relating to inequalities and or potential discrimination are identified and taken account of.

        3. Who can convene a Multi-Agency Adult Safeguarding Planning Meeting?

        An Enquiry Officer or a Safeguarding Adults Manager from the London Borough of Lewisham (LBL) can convene a Multi-Agency Adult Safeguarding Planning Meeting.   

        4. 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 (see 2.1).
        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.

        5. 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.

        See: Multi-Agency Adult Safeguarding Planning Meeting Form (Word)   Multi-Agency Adult Safeguarding Planning Meeting Form (Pdf)

        6. How do Planning Meetings link to Pressure Ulcer Panels and the Provider Concerns process?

        6.1 Pressure Ulcer Panels 

        Any Section 42 Safeguarding Enquiry which has commenced as a result of a pressure ulcer related issue will normally be conducted via one of the two Pressure Ulcer Panels in the Borough of Lewisham, which are both overseen by a senior social work practitioner from within LBL. 

        If these are routine cases, then a separate Planning Meeting will not be required, unless one or more of the issues listed in section 2 of this guidance are also present in the case. 

        If a Planning Meeting is deemed to be necessary in relation to a pressure ulcer related case, then one should be convened within 5 working days of a decision being made that one is necessary, even if the case has not been brought to a conclusion by the relevant Pressure Ulcer Panel. 

        6.2 Provider Concerns 

        As described in section 2.3, one outcome from a Planning Meeting might be to make a referral to the Provider Concerns process if the criteria for this has been reached. The Planning Meeting may help to identify signs linked to provider concerns, allowing for early supportive actions to be taken by commissioning authorities in supporting social care providers. A referral for the Provider Concerns Process should be made through the applicable Contracts Officer from LBL/ SEL ICB, or through the Head of Safeguarding and Gateway at LBL.

        Provider Concern Process Flowchart Oct 2022

        Quality, Safeguarding and Provider Concerns Procedure Oct 2022

        Provider Concerns Policy and Procedures - Oct 2022

        7. Monitoring and review of Planning Meetings 

        The Operational Lead from LBL will provide operational oversight and monitor all activity linked to the Section 42 Enquiry process, including Planning Meetings, in conjunction with the Service Manager with overall responsibility for adult safeguarding within LBL.

        The Service Manager within LBL will provide oversight of Planning Meetings, providing quality assurance to the Lewisham Safeguarding Adults Board through ongoing audit and reporting processes.

        Stage 4: Closing the Enquiry

        A Safeguarding Concern/Enquiry can be closed at any of the previous three stages of the procedure.

        However, the following points should be used as a checklist to ensure the procedure has been closed effectively and appropriately:

        • Anyone involved in the Safeguarding Concern/Enquiry should be advised on how and who to contact if there are further concerns about the adult at risk.
        • There should be agreement on how any further concerns will be followed up.
        • It is good practice where a care management assessment, Care Programme Approach (CPA), reassessment of care and support, 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 concerns.
        • Closure records should note the reason for this decision and the views of the adult at risk to the proposed closure. The SAM responsible should ensure that all actions have been taken, building in any personalised actions:
          • Agreements with the adult at risk to closure.
          • Referral for assessment and support.
          • Advice and information provided.
          • All organisations involved in the enquiry updated and informed.
          • Feedback has been provided to the referrer (this is very important).
          • Action taken with the person alleged to have caused harm.
          • Action taken to support other service users.
          • Referral to children and young people made (if necessary).
          • Outcomes noted and evaluated by adult at risk.
          • Consideration for a Safeguarding Adults Review (SAR).
          • Any lessons to be learnt.

        The SAM may decide to convene a multi-agency meeting at the closure stage so that the Safeguarding Enquiry process can be reviewed, to ensure that the "risk to the adult has been sufficiently reduced, or removed" (although it may also be appropriate for this to 'remain' in some circumstances), before being closed.

        This will not always be required, but may be useful in the following circumstances: 

        1. To ensure that in the most complex cases the risk management arrangements that have been put in place are being effective.
        2. Where multiple agencies (including providers) have been involved in offering support and or protection, and ongoing co-ordination is required.
        3. In organisational or institutional cases where other adults may also have also been at risk of abuse or neglect. This may include where issues have affected residents of other Local Authorities.
        4. Where the abuse involved a member of staff/volunteer (position of trust), and this brought into question the safety of other adults, and or the service.
        5. Where there may have been multiple ongoing enquiries by different organisations or other processes, including by Police and the Pressure Ulcer Panels.
        6. To consider if other legal or statutory actions or redress are needed. This may include a referral for a Safeguarding Adults Review (SAR - s.44 Care Act 2014).             

        Provider Concerns 

        One further outcome from a multi-agency meeting might be to make a referral to the Provider Concerns process if the criteria for this has been reached. This meeting may help to identify signs linked to provider concerns, allowing for early supportive actions to be taken by commissioning authorities in supporting social care providers. A referral for the Provider Concerns Process should be made through the applicable Contracts Officer from LBL/ SEL ICB, or through the Head of Safeguarding and Gateway at LBL.

        Provider Concern Process Flowchart Oct 2022

        Quality, Safeguarding and Provider Concerns Procedure Oct 2022

        Provider Concerns Policy and Procedures - Oct 2022

        The adult safeguarding process may be closed but other processes may continue, for example, a disciplinary or professional body investigation. These processes may take some time. Consideration may need to be given to the impact of these on the adult and how this will be monitored. Where there are outstanding criminal investigations and pending court actions, the adult safeguarding process can also be closed providing that the adult is safeguarded.

        All closures no matter at what stage are subject to an evaluation of outcomes by the adult at risk. If the adult at risk disagrees with the decision to close safeguarding down their reasons should be fully explored and alternatives offered.

        At the close of each enquiry there should be evidence of:

        1. Enhanced safeguarding practice ensuring that people have an opportunity to discuss the outcomes they wanted at the start of safeguarding activity.
        2. Follow-up discussions with adults at risk at the end of safeguarding activity to see to what extent their desired outcomes have been met.
        3. Recording the results by fully completing all of the data recording requirements within the LBL Case Management System (LAS) so this can be used to inform practice, and provide the necessary performance monitoring information for the Lewisham Safeguarding Adults Board.

        Adult Safeguarding Pathway Resources

        Adult Safeguarding Posters - See it, Report it!

        Adult Safeguarding Leaflet:

        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 - March 2023
        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 2023).

        Single Agency Policy Template For Small Community Organisations (September 2023)

        Adult Safeguarding Pathway Forms and Templates

        Use of Statutory Advocacy

        Advocacy 7 Minute Briefing March 2023

        LSAB Tricky Friends Still 2

        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.

        LBL Can you see the signs of coercive control image of poster

        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

        Stop Hate UK: Hate Crime Posters for Lewisham 

        West Midlands Modern Slavery Victim Support Booklet

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

        Prevention

        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. One easy way to do this is by following @lewisham_sab on Twitter and supporting the campaigns we deliver.

        2. Identify Adults who May be at Increased Risk

        There are many factors which might increase the risks of adult abuse and neglect including: older age; physical, mental, sensory, learning or cognitive illness or disability; and having to rely on others for health and social care support.

        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.

        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. See: Pathway Resources

        5. Focus on Equality & Narrowing Inequality

        Adults from financially deprived backgrounds are more likely to become an identifiedvictim of adult abuse and neglect, and it is less likely that an adult from some ethnic minority 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 at risk of abuse and neglect can identify ways in which they can help to inform, and support adults in protecting themselves from abuse.

        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. See: 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.

        Please let us know if you have any thoughts or ideas in relation to prevention.