Frequently asked questions about safeguarding adults

safeguarding adult

All adults deserve to be treated with respect, and not experience abuse or neglect during their daily lives. However, some adults have care needs that prevent them from being able to look after themselves and protect themselves from experiencing abuse.

For this reason, it is important that everyone who works in certain settings, such as care homes and hospitals, understands how to safeguard vulnerable adults, and what they need to do to prevent these people from coming to harm.

In this article, we will explore safeguarding vulnerable adults and answer ten frequently asked questions about the process.

What is safeguarding?
What are the safeguarding principles?
Who is a vulnerable adult?
What is abuse?
Who is at risk of abuse?
What is mental capacity?
What are the forms of abuse?
How do you spot abuse?
How do you spot financial abuse?
How do you spot modern slavery?

What is safeguarding?

Everyone has the right to live a happy life that is free from harm. While many adults can achieve this independently, some require help from others to do so. Safeguarding is the act of ‘protecting an adult’s right to live in safety, free from abuse and neglect’ and refers to any actions taken to achieve this. This includes taking steps to:

Protect their health, safety and quality of life.
Make sure they are treated with dignity and respect.
Ensure they have choice and control over their lives.

What are the safeguarding principles?

The Care Act 2014 is the main piece of legislation that sets out the requirements for adult safeguarding. It places a duty on organisations to prevent, detect and report the abuse and neglect of vulnerable adults in their care.

It details six principles that should be followed during all adult safeguarding work:

Empowerment: The support an adult receives should be personal to them and implemented with their consent.
Prevention: Action should be taken before harm occurs.
Proportionality: The least intrusive response to the risk presented should be taken.
Protection: Those with the greatest need should receive support and representation.
Partnership: Local community services should work together to protect vulnerable adults.
Accountability: Safeguarding should be delivered with accountability and transparency.

Who is a vulnerable adult?

The Care Act guidance states that a vulnerable adult is anyone 18 or over who:

Has needs for care and support.
Is experiencing, or at risk of, abuse or neglect.
Is unable to protect themselves from the risk or experience of abuse or neglect as a result of their care and support needs.

Be aware that some adults are more vulnerable than others due to factors that make them more dependent on care and support systems, such as age, illness, disability and mental capacity.

What is abuse?

Abuse can be broadly defined as any act, or lack thereof, that causes a vulnerable person harm or distress. This could be one single act or a series of repeated acts, and can be done willfully or unintentionally.

Adults who are at risk can be abused by anyone who has contact with them at any time. This includes:

Family members.
Professional staff and volunteers.
Other at risk adults.
Other service users.
Neighbours.
Friends and associates.

Abusers are often people in a position of power or trust, who take advantage of their position to target vulnerable adults. Be aware that abuse is not always malicious, and can take place because carers are unable to cope with the support demands placed on them.

Abuse can take place in any setting, including anywhere the vulnerable adult lives, works, socialises or receives care. It can also take place online or by phone, where increased anonymity makes it easier for abusers to develop fake identities and protect themselves from being discovered. For more information on digital safeguarding, consider reading the Online Digital Safeguarding article.

Who is at risk of abuse?

All vulnerable adults are at risk of experiencing abuse, but some factors increase the risk of this occurring. These include:

Isolation from others, including friends, family, and local community groups.
A power imbalance in a relationship.
Suffering from mental health issues.
Having difficulty communicating.
Having memory problems.
Lacking the mental capacity to make decisions.
Misuse of alcohol and/or drugs by the adult or their carer.

Certain situations can also increase the risk of someone being abused. For example, if a person is isolated at home and does not regularly see any other people, it can be easy for an abuser to hide their actions.

What is mental capacity?

Some people lack the mental capacity to be able to make informed decisions about their own welfare and safety. Specifically, they may lack the ability to:

Understand the risks they face.
Take action to protect themselves from harm.
Participate fully in making decisions about their lives.

This may be the case if someone has dementia, a severe learning disability, a brain injury or is unconscious. The Mental Capacity Act 2005 is designed to protect these people and ensure that they are able to receive the care they require in spite of their mental capacity. It states that:

A person must be assumed to have capacity unless it is established that they lack capacity.
A decision made on behalf of a person who lacks capacity must be made in their best interests.
Any decision made must be the least restrictive of the person’s rights and freedom of action.
A person is not to be treated as unable to make a decision unless all practicable steps to help them to do so have been taken without success.
A person is not to be treated as unable to make a decision merely because they make an unwise decision (often known as the right to make unwise decisions).

Be aware that adults can have the capacity to make some decisions but not others. For example, a person may be able to decide on what clothes to wear, but not how to deal with a complex family matter.

What are the forms of abuse?

Abuse and neglect can take a significant number of forms, the most prominent of which being:

Physical abuse
Psychological abuse
Sexual abuse
Neglect and acts of omission
Self-neglect
Financial or material abuse
Discriminatory abuse
Organisational abuse
Modern slavery
Domestic abuse

Physical abuse

Physical abuse includes assault, hitting, kicking, slapping, punching, pushing, misuse of medication, restraint and inappropriate physical sanctions.

Psychological abuse

Psychological abuse includes emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, bullying, isolation, unreasonable and unjustified withdrawal of services or support networks, and withdrawing or limiting access to medication or assistive equipment.

Sexual abuse

Sexual abuse includes rape, sexual assault, sexual harassment and sexual activities to which the adult has not consented or was pressured into consenting to. This includes non-contact sexual acts such as indecent exposure, online abuse and pornographic activities.

Neglect and acts of omission

Neglect and acts of omission include:

Wilfully ignoring medical or physical care needs.
Failing to provide access to appropriate health and social care (such as not supporting a person to access clinical appointments and support).
Withholding the necessities of life (such as medication, adequate nutrition and heating).
Depriving someone of stimulation or company, adaptations, equipment or aids to communication.

Self-neglect

Self-neglect covers a wide range of behaviour that shows a failure of someone to care for their personal hygiene, health or surroundings. Human rights legislation limits what support services can do to affect the way someone lives their own life, but cases of self-neglect should still be reported because these services can provide constructive help and further support if permitted.

Financial or material abuse

Financial or material abuse includes theft, fraud and exploitation, pressuring someone about their financial arrangements (such as wills, property, inheritance and financial transactions) and the misuse or stealing of property, possessions or benefits.

Discriminatory abuse

Discriminatory abuse includes unequal treatment, harassment or any other abuse perpetrated due to a person’s ‘protected characteristics’ as defined by the Equality Act 2010. These characteristics are age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation.

Organisational abuse

Organisational abuse includes neglect and poor care within an institution or care setting, including that which takes place in a person’s own home. This can be a one-off incident or ongoing ill-treatment and usually occurs as a result of the structure, policies, processes and practices of an organisation.

Modern slavery

Modern slavery includes slavery, human trafficking, forced labour and domestic servitude. Traffickers and slave masters make use of whatever they can to coerce, deceive and force individuals into a life of abuse and inhumane treatment.

Trafficking specifically is the movement of people by means such as force, fraud, coercion or deception with the aim of exploiting them. This exploitation can include forced prostitution, labour, begging, criminality, marriage and organ removal. This is different from smuggling because, unlike trafficking, individuals who have been smuggled are free once they reach their destination country.

Domestic abuse

Domestic abuse is defined by the Government as ‘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.’ This definition encompasses all types of abuse, including all those mentioned previously, honour-based violence, female genital mutilation and forced marriage.

When working with service users who may have been a victim of some form of domestic abuse or domestic violence, the issue must be approached appropriately and with respect. This includes not commenting on a relationship or encouraging someone to leave their partner.

How do you spot abuse?

There are several signs of abuse that someone working with vulnerable adults should look out for. These include:

Becoming quiet or withdrawn.
Being aggressive or angry for no apparent reason.
Looking unkempt, dirty or thinner than usual.
Sudden changes in character.
Physical signs such as bruises, wounds or fractures.
The same or similar injuries happening frequently.
Not wanting to be left alone or with certain people.
Being unusually lighthearted.
Their home being unusually dirty, untidy or bare.

How do you spot financial abuse?

Financial abuse is very common, making it important to understand the specific signs that indicate financial abuse is taking place. These include:

A change in living conditions.
Selling possessions.
Having an unexplained lack of money.
Having money taken out of an account without a reason.
Financial documents getting lost without a reason.
Being cut off from family, friends or their social network.
A carer having more money to spend on items such as clothes, travel and accommodation.
Sudden changes to a bank account or how it is used.
New authorised signatories on a card.
Money being taken from the adult without permission using their ATM card.
A change in how their ATM card is being used.
Sudden changes to their will or other financial documents.

How do you spot modern slavery?

Modern slavery shares many of its signs with other forms of abuse. However, there are some specific signs that may indicate that a person is being trafficked or used as a slave. These include:

Having no access to their passport or identity documents (or using false documents)
Having few personal belongings and items of clothing
Fearing authorities such as the police.

Do you want to learn more about modern slavery? Consider taking our Modern Slavery Awareness Training Course.