LISA Safeguarding Policy

London Inclusion Sports Academy

Safeguarding Policy

June 2022

Safeguarding Lead

Thomas Coughlan

Policy Summary 

1 Scope 

1.1  This policy applies to all staff, volunteers, trustees and anyone working on our behalf. 

1.2 It outlines the LISA approach to preventing and responding to concerns of abuse, harm or neglect of adults. 

2 Policy Statement 

2.1 This policy and procedure aims to ensure that our staff are able to respond to any concerns in a consistent manner, and is therefore in line with the following: 

• The Care Act 2014. 

• Care and Support Statutory Guidance 2014 (Care Act 2014). 

• Social Care Institute for Excellence SCIE Report 2011. 

• Making Safeguarding Personal 2014, LGA. 

• Local authority Procedures, including London Multi-Agency Safeguarding Policy and Procedures 2019 

• Human Rights Act 1998 

2. This policy defines Safeguarding as set out in the Care Act 2014 as ‘protecting an adult’s right to live in safety, free from abuse and neglect.’ 

3. Safeguarding applies to all adults who have care and support needs and are experiencing, or are at risk of, abuse or neglect. A safeguarding concern may arise from a range of sources. 

4. An adult with care and support needs is a person aged 18 years or over “who is or may be in need of community care services by reason of mental or other disability, age or illness; and who is or may be unable to care for him or herself, or unable to protect him or herself against significant harm or exploitation” (Dept. Health guidance, 2000). 

Whilst many LISA members will meet the definitions of the Care Act, some customers will not meet the local authority threshold of having “care and support needs”.

2.6 There are many different types and patterns of abuse and neglect, and there is a full list of the most common types in Appendix Three. This is not an exhaustive list and should not limit staff views of what constitutes abuse or neglect: 

3 The London Inclusion Sport Academy Approach

3.1 The Care Act sets out six key principles which apply to all sectors. These principles should inform the ways in which professionals and other staff work with adults and include how the principle is perceived from the customer perspective. 

Empowerment 

People being supported, provided with information and encouraged to make their own decisions and informed consent. 

“I am asked what I want as the outcomes from the 

safeguarding process and these directly inform what happens.” 

Prevention 

It is better to take action before harm occurs. 

“I receive clear and simple information about what abuse is, how to recognise the signs and what I can do to seek help.” 

Proportionality 

A proportionate and least intrusive response appropriate to the risk presented. 

“I am sure that the professionals will work in my interest, as I see them and they will only get involved as much as needed.” 

Protection 

Support and representation for those in greatest need. “I get help and support to report abuse and neglect. I get help so that I am able to take part in the safeguarding process to the extent to which I want.” 

Partnership 

Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse. 

“I know that staff treat any personal and sensitive information in confidence, only sharing what is helpful and necessary. I am confident that professionals will work together and with me to get the best result for me.” 

Accountability 

Accountability and transparency in delivering safeguarding. “I understand the role of everyone involved in my life and so do they.” 

4 Preventing abuse and being prepared 

4.1 Each league, programme, network or club must ensure that it is has appropriate measures to minimise the likelihood of safeguarding incidents, whilst also being ready to respond appropriately and effectively when they do. Prevention measures are divided into four areas: 

Prevention A: Staff who understand safeguarding 

4.2 We will ensure that all staff can identify and report all safeguarding concerns and comply with all statutory responsibilities, following the procedures set out by the relevant local authority. 

Prevention B: Members who understand safeguarding 

4.3 Where members may have poor understanding of safeguarding and/or do not have capacity to make decisions around their own safeguarding, we will refer them to appropriate advocacy services who can help them make decisions in their best interest, when incidents occur, or as needed.

4.4 We will talk to any customers who are subject to a safeguarding concern at every stage to determine what they want the outcome to be and what action they want taken. 

Prevention D: See Think Act implemented 

4.5   See Think Act is an approach which was developed with the Royal College of Psychiatry for staff to identify any potential risks or concerns before they may escalate into a formal safeguarding. 

4.6 Where risks or concerns are identified through using See Think Act, staff, volunteers and/or stakeholders should inform the safeguarding lead.

5 Diversity and inclusion 

5.1 Services provided should be appropriate to the adult with care and support needs and not discriminate because of disability, age, gender, sexual orientation, race, religion, culture or lifestyle.  

Procedure  

6 Procedure statement 

6.1 This procedure sets out the process for following up on any safeguarding concerns and sets out the responsibilities and roles for everyone involved. 

7 Identifying a safeguarding concern 

7.1 All staff must take any safeguarding concerns seriously, without exception. Proof is not required to report something as a safeguarding concern; all that is required is that there are reasonable grounds to suspect abuse has taken place. 

7.2 The Care Act identifies a number of different types of abuse and neglect which are listed in Appendix Three. Whilst these are the most common they should not be seen as exhaustive and each case needs to be reviewed on its own merits. 

8 Responding to a safeguarding concern 

8.1 All staff have a duty to respond if they are concerned that an adult with care and support needs: 

• Has been harmed, abused or neglected; or  Is being harmed, abused or neglected; or 

• Is at risk of being harmed, abused or neglected. 

8.2 This concern can arise from number of sources including (but not limited to): 

• The member themselves may inform a staff member 

• A staff member identifies the potential signs of abuse 

• A third party such as a family member, others using the service, a carer or a member of the public 

• A safeguarding concern can also be made directly to the local authority by a third party, or staff member, NHS, policy or any other appropriate multi-disciplinary team

8.3 The concern may well be reported as something else such as a complaint or antisocial behaviour and the staff member needs to assess whether it is a safeguarding issue. 

9 Step by step safeguarding process 

9.1 This is a summary step by step guide of what to actions staff should take when responding to a safeguarding concern.  It should be reviewed alongside the more detailed information that follows. 

• Any staff aware of a safeguarding concern should lead the immediate management, making the situation as safe as possible. Contact emergency services if necessary

• Inform your safeguarding lead as soon as possible. If they are not working, inform the nearest/most easy to contact manager

• Record the incident

• Safeguarding lead to check the details on the Safeguarding report and once approved it should be submitted to the local authority within 24 hours. Keep notes of when it is submitted and any communication received. 

• Safeguarding lead will decide on who else should be informed. This mayinclude (but is not restricted to) police family members or carers and the Care Quality Commission (CQC).

• All staff to carry out any tasks as directed by the Safeguarding Until formally team.

Step 8 

Step 1: Making the immediate situation safe 

9.2 The member of staff who receives the information will: 

• Make an immediate evaluation of the risk and take steps to ensure that no one is in immediate danger, particularly considering the safety and wellbeing of any alleged victim. 

• Where appropriate dial 999 if the emergency services are needed. 

• Contact the local authority’s Child Protection Team (or Emergency Duty Team if out of hours) if a child is also at risk. 

• Make sure that other members are not at risk. 

9.3 Where a disclosure has been made, staff need to be as sensitive and accommodating of this as they can, avoiding quick judgements and always taking the views and wishes of the alleged victim into account. 

• Assure them that you are taking them seriously. 

• Listen carefully to what they are telling you, stay calm, get as clear a picture as you can, but avoid asking too many questions at this stage. 

• Do not give promises of complete confidentiality. 

• Explain that you have a duty to tell your Manager or other designated person, and that their concerns may be shared with others who could have a part to play in protecting them. 

• Reassure them that they will be involved in any decisions made. 

• Explain you will take steps to protect them from further abuse or neglect. 

9.4 If police inform staff that they will attend the scene, staff must ensure that evidence is not contaminated or lost. Therefore where relevant: 

• Do not disturb or move articles that could be used in evidence, and secure the scene, for example by locking the door to a room. 

• Keep the customer’s file in a secure place. Documents may be required as evidence so it must not be tampered with. 

Step 2: Informing a Manager 

9.5 Once staff have made sure the person is safe and there is no immediate risk, they must inform the safeguarding lead that an incident has occurred or that a concern has been reported. 

9.6 If an allegation has been made against a member of staff the Safeguarding lead must be informed 

9.7 Staff should not discuss the concern with the person alleged to have caused harm at this stage, unless the immediate welfare of the vulnerable adult makes this unavoidable. 

9.8 Where staff do not have confidence in how the concern will be managed by the Safeguarding lead then they can report the concern through the Whistleblowing Policy and Procedure. 

Step 3: Recording the concern 

9.9 On the same day as becoming aware of the concern, the staff member needs to make a record of what has happened. Staff should complete the Local Service Safeguarding Form supplied by the local safeguarding authority.

9.10 The following information will need to be included: 

• Date and time of the incident 

• Include the exact words made by anyone who has made a disclosure, and exact details of why this concern is being reported 

• Appearance and behaviour of the adults at the centre of the concern 

• Any injuries observed 

• Name and signature of the person making the record 

11. All records should be factual. However, if the record does contain your opinion or an assessment, it should be clearly stated as such and be backed up by factual evidence. Information from another person should be clearly attributed to them. 

Step 4: Reporting the concern to the local authority 

9.13 The Safeguarding Lead must review all the reported information and determine whether to make a safeguarding referral to the relevant statutory authority. If the grounds are met for referral, this must be made to the local authority (or any other locally agreed referral point, for example a Multi Agency Safeguarding Hub (MASH). 

9.14 This should be done immediately by the Manager or an appointed staff member. The initial contact should be by phone and followed up by sending a copy of the local authority’s Safeguarding Concern form. 

. 

Step 5: Reporting the concern to other stakeholders 

9.16   If staff witness a crime committed against any LISA Member they have a duty to report the incident to the police. If we are informed of a crime that has been committed against a member but didn’t witness it ourselves, staff should support the customer to report the crime to police. See Section 11 for more details. 

9.17   If the customer has a social worker and/or care coordinator, they must be informed. The Safeguarding Leah may also need to contact other key stakeholders such as the Commissioners of the service. 

9.18   The Safeguarding Lead must decide when/whether to inform families and carers. Staff must not inform families and carers of safeguarding concerns where they are themselves implicated. 

9.19   Where a customer lacks capacity and has a court appointed person who can act on their behalf, they should be informed of any safeguarding concerns raised. 

Step 6: Responding to local authority 

9.20  The local authority Safeguarding Adults team will decide whether the concern raised meets grounds for further action under their procedures. If it does then they will take overall responsibility for the progress of the case. 

9.22   Where this happens, the local authority will gather information about the case, in all likelihood liaising with our staff. Staff must always cooperate with any local authority investigations or reviews which are being carried out, providing information where required. 

9.23 If the concern is not accepted as a safeguarding case by the local authority, the 

Safeguarding Leah must decide whether further investigation is required. 

Step 7: When we disagree with the local authority 

9.24 If a decision is made to formally challenge the local authority then the Safeguarding Leah will write to the appropriate senior lead in the local/health authority (e.g. the Chair of the Safeguarding Adults Board or the Director of Adult Social Services) setting out the reasons why we believe the case has not been correctly managed.. 

Step 8: Closing the case 

9.28 Once the Safeguarding Lead has decided that all steps have been taken to safeguard any adults at risk, and that no further investigation is required, they can close the incident.

10 Communication with staff and customers 

Customers who are subject to the safeguarding concern 

10.1 If the safeguarding concern is about one of our members, we will listen to the customer at every stage, always maintaining their dignity and privacy, and will seek to understand what they want the outcome to be and what action they want taken. Where possible staff should ensure these views are reflected in the actions taken, and keep members informed of developments. 

10.2 Where a member may lack capacity to make decisions about their situation, then staff should complete a Mental Capacity Assessment to determine whether they have capacity or not. Where they do not have capacity then the LISA should involve the relevant appointed person, who may be a family member, friend, appointed advocate, solicitor or someone else the court has appointed. 

10.3 Where a member has substantial difficulty in understanding or retaining information, or communicating their views, the service should ensure an appropriate adult is available to support them through the process. This can be a staff member, but they may be unable to independently fulfil this role and the service should seek an advocate (such as an Independent Mental Capacity Advocate (IMCA) or a Care Act advocate) who the local authority have a duty to provide. 

10.4 Staff must keep information regarding any safeguarding concern confidential as set out in the Data Protection and Confidentiality Policy and Procedure. 

Members who are alleged to have caused harm 

10.5 If the person causing harm is another customer, action taken could include removing them from contact with particular customers. In this situation, arrangements must be put in place to ensure that the needs of the person alleged to be causing harm are also met. 

Staff who are alleged to have caused harm 

10.6 If allegations are raised against staff member(s) (including volunteers and external Personal Support Workers) a decision will need to be immediately taken by the Safeguarding Lead about whether they pose a risk to members or other staff members (e.g. whistle-blowers) and what action needs to be taken. The local authority Safeguarding team should also be consulted within 24 hours. 

10.7 The programme or event may decide to immediately suspend the employee or end the worker’s assignment where they are suspected of abusing an adult or adults at risk. Advice must always be sought from the Safeguarding Lead and any actions should not be initiated until this has been done. Being suspended at the start of a safeguarding investigation must be “without prejudice” pending the findings of the investigation, and should not be recorded as a disciplinary unless the findings suggest it will need to be subject to the disciplinary procedure. 

10.8 Where a disciplinary investigation has been completed into an employee and they have been found to have been responsible for the abuse of an adult at risk, the Head of HR will decide with a senior Manager whether a referral should be made to the Disclosure and Barring Service (DBS).  This referral should be made within two days of the formal process being concluded (including any appeal process). 

10.9 When staff members are the subject of safeguarding investigations, they need to be able to access support and have a single point of contact for any enquiries that they have. 

11 Police Engagement 

11.1 All safeguarding concerns must be reported to the local authority. Staff also have a duty to report a crime to the police if they have witnessed it themselves. 

11.2 Where the crime has been reported to staff by a third party (including the customer themselves), then they should support the customer to report it to the police as soon as possible, or offer to report it on their behalf. 

11.3 Where a member does not consent to reporting a crime (not witnessed by staff) to police then staff must discuss this with the Safeguarding Lead for a final decision. Whilst the views of the member must always be respected as much as possible staff may have to inform police depending on the proportionality and impact of the crime. In some cases it may be best to have an informal discussion with the police to help decide whether a police response is necessary. 

11.4 If staff believe that someone may be at immediate risk of harm then they have a duty to contact the police as it is in the public interest whether or not the member consents. 

11.5 If a member has been the victim of sexual assault or rape, and does not want to disclose this to police, they must always be referred to the local sexual assault referral centre who can take evidence which can be used later on if the customer changes their mind. Staff should respect the customer views not to inform the police in these instances, unless staff have specific knowledge of someone being at immediate risk of harm or where there is any reason to believe the alleged perpetrator may be someone holding a position of trust. All cases where the police are not informed must be escalated to the Safeguarding Lead.

13 Support for staff, volunteers, trustees and stakeholders

13.1 Dealing with safeguarding and risk management is complex and can feel overwhelming for staff, volunteers, stakeholders and trustees. For some staff it will trigger memories (for example adverse childhood experiences) and/or affect current personal relationships. The organisation has clear support systems in place including regular supervision; professional development and we can refer to  counselling services. 

Appendix 1: Types of Abuse: Quick Glance Table 

Types of abuse 

Brief Description 

Discriminatory 

Harassment, slurs or similar treatment because of race, gender, gender identity, age, disability, sexual orientation, religion 

Domestic 

Psychological, Physical, Sexual, Financial and/or Emotional 

Female Genital Mutilation (FGM) 

Procedures that intentionally alter or injure female genital organs for non-medical reasons 

Financial or Material 

Theft, fraud, internet scamming, coercion in relation to financial affairs, misuse of property or possessions 

Forced Marriage 

Adult at risk married against their will or without their consent 

Hate Crime 

Any incident that is perceived by the victim, or any other person, to be racist, homophobic, transphobic or due to a person’s religion, belief, gender identity or disability 

Honour Based Violence 

Violence committed when families feel that dishonour has been brought to them 

Human 

Trafficking 

Supply of people and services by way of exploiting the social, cultural or financial vulnerability of the victim. 

Mate Crime 

People are befriended by members of the community who go on to exploit and take advantage of them 

Modern Slavery 

Slavery, forced labour 

Neglect and acts of omission 

Ignoring medical, emotional or physical care needs, failure to provide appropriate health, care and support services, withholding the necessities of life, such as medication, nutrition, heating 

Organisational 

Neglect, poor care practice in a care or support setting 

Physical 

Assault, Hitting, Slapping, Pushing, Misuse of Medication, Inappropriate Physical Sanctions 

Psychological 

Emotional abuse, threats of harm, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal, cyber bullying, isolation, withdrawal of supportive networks 

Radicalisation 

Adult at risk involved in extremist activities or terrorism 

Restraint 

Unlawful or inappropriate use of restraint or physical interventions 

Self neglect 

Neglecting to care for one’s hygiene, health or surroundings, hoarding 

Sexual Abuse 

Rape, Sexual Assault, Indecent exposure, Sexual harassment, Inappropriate looking or touching, Sexual teasing or innuendo, Subject to pornography or witnessing sexual acts, Non-consensual sexual acts 

Sexual 

Adult at risk receives something (e.g. food, drugs, money) for performing sexual activities 

Exploitation 

where those exploiting the adult have power over them in some way (eg. age, physical, intellect) 

Appendix 2: Types of abuse: detailed description 

Discriminatory abuse 

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

This is always the least often reported type of abuse, as it often involves one of the other types of abuse targeted on adults due to discriminatory beliefs of the person alleged to have caused the harm. 

This can be seen as a safeguarding equivalent to a hate crime, which is a crime (such as an assault etc.) but the motivation for the criminal act was racial hatred for example. Therefore discriminatory abuse often can involve unequal treatment, verbal abuse or derogatory remarks referring to the adult’s identity (sexual orientation, ethnicity, religion, disability etc.). 

Indicators could include harassment, or deliberate and unwarranted exclusion from services, or a lack of respect shown to an individual who may be withdrawn and isolated, or denial of access to communication e.g. suitable interpreter, signer or lip reader. 

Domestic abuse 

Domestic abuse can include psychological, physical, sexual, financial and/or emotional abuse. It isn’t restricted to just intimate partners but can include all family members regardless of their age, gender or sexuality. 

There can be overlap between safeguarding and domestic abuse procedures, and Managers will have to ensure that the correct approach is taken for each individual scenario. A formal safeguarding response will apply where it meets the criteria of the Care Act 2014, but Managers need to understand how safeguarding teams locally work with the Multi-Agency Risk Assessment Conferences (MARAC) which are convened to plan responses to domestic abuse. 

Female Genital Mutilation (FGM) 

FGM is an illegal procedure that intentionally alters or injures genital organs for nonmedical reasons. The Female Genital Mutilation Act (2004) makes it illegal to practise FGM in the UK or take girls/women who are British nationals or permanent residents in the UK abroad for FGM regardless of whether it is lawful in the other country. 

Financial or material abuse 

This includes 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. 

It is the use of a person’s property, assets, income, funds or any resources without their informed consent or authorisation. It includes: 

• Theft 

• Fraud 

• Exploitation 

• Undue pressure in connection with wills, property, inheritance or financial transactions 

• The misuse or misappropriation of property, possessions or benefits 

• The misuse of an enduring power of attorney or a lasting power of attorney, or appointeeship 

Signs may include disparity between apparent income and impoverished circumstances of customers. Unexplained or sudden inability to pay bills or withdrawal of money from accounts can also be an indicator of financial abuse. 

The issue of customers borrowing money, or valuables, within a service is often a concern raised by staff. This will be a safeguarding matter where there is concern that the impact on the adult with care and support needs is one of a significant amount of distress, or harm. 

Forced marriage 

This is used to describe a marriage where one or both of the parties are married without their consent or against their will. A forced marriage is different from an arranged marriage. It is a criminal offence to force someone to marry under the Anti-Social Behaviour, Crime and Policing Act 2014. 

Hate crime 

The Metropolitan Police Service defines hate crime as “any incident that is perceived by the victim, or any other person, to be racist, homophobic, transphobic or due to a person’s religion, belief, gender identity or disability.” This definition is based on the perception of the victim or anyone else and is not reliant on evidence. In addition it includes incidents that do not constitute a criminal offence. 

The police monitor five strands of hate crime: 

• Disability 

• Race 

• Religion 

• Sexual orientation 

• Transgender 

Honour-based violence 

This is committed primarily by family members against women (but not exclusively). This is usually committed when families feel that dishonour has been brought on them by the individual. Safeguarding concerns which may point towards honour based violence include domestic violence, concerns about forced marriage, enforced house arrest and missing person’s reports. 

Mate crime 

Mate crime is when vulnerable people are befriended by members of the community who go on to exploit and take advantage of them. This may not necessarily be an illegal act but still has a negative effect on the person. 

Mate crime can be difficult for the police to investigate, due to its sometimes ambiguous nature. This should always be reported to the police, where there are concerns, which will make a decision whether a crime has been committed. Mate crime often happens in private and there have been a number of cases of people with a learning disability who were murdered or seriously harmed by people claiming to be their friend. 

Modern slavery and human trafficking 

Modern slavery includes slavery, servitude, forced benefit fraud, forced marriage and forced and compulsory labour. It may also involve coercing people into committing crime for others. Victims may be transported a few miles within a town or across continents to be forced into jobs they do not want. Victims can include adults and children and come from all walks of life and backgrounds including British nationals. A quarter of all victims are children. 

Trafficking is the movement of people by means such as force, fraud or deception with the aim of exploiting them. Trafficking in adults includes the transportation, transfer, harbouring or receipt of people. This is often carried out through the threat or use of force or other forms of coercion such as abduction, fraud, deception or the giving or receiving of payments or benefits to achieve control over another person.  

Trafficking people is a criminal offence. The fact that the adult consents to the intended exploitation is irrelevant. Victims of modern slavery and exploitation may be unwilling to come forward to law enforcement or public protection agencies, not seeing themselves as victims, or fearing further reprisals or death from their abusers against themselves or family members. 

The Modern Slavery Act 2015 places a duty on specified public authorities (including local authorities) to report details of suspected cases of modern slavery to the National Crime Agency. 

Neglect and acts of omission 

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

Neglect is the failure of any person who has responsibility for the charge, care or custody of an adult with care and support needs to provide the amount and type of care that a reasonable person would be expected to provide. 

Behaviour that can lead to neglect includes ignoring medical or physical needs, failing to allow access to appropriate health, social care and educational services and withholding the necessities of life such as medication, adequate nutrition, hydration or heating. 

Neglect can be intentional or unintentional. Intentional neglect would result from: 

• Willfully failing to provide care. 

• Willfully preventing the adult with care and support needs from getting the care they needed. 

• Being reckless about the consequences of the person not getting the care they need. 

If the individual committing the neglect is aware of the consequences and the potential for harm to result due to the lack of action(s) then the neglect is intentional in nature. Unintentional neglect could result from a carer failing to meet the needs of the adult with care and support needs because they do not understand the needs of the adult with care and support needs, may not know about services that are available or because their own needs prevent them from being able to give the care the person needs. It may also occur if the individuals are unaware of or do not understand the possible effect of the lack of action on the adult with care and support needs. 

Signs of neglect include but are not limited to: 

• Customers who are unkempt, unclean in body or clothing 

• Weight loss, dehydration, pressure ulcers 

• Not meeting basic medical, physical or psychological needs 

• An impoverished environment 

• Passive, non-communicative and highly dependent adults are at most risk of neglect 

A key factor in demonstrating that the duty of care is met towards “service refusers” will be how the customer’s decisions to refuse care and support have been recorded, dealt with and escalated, both within LISA and to specialist referrals (e.g. psychiatric, occupational therapy). 

The following questions will need to be explored where there is an allegation of neglect: 

1. Whether the person who is alleged to be neglectful can reasonably be expected to have done the act (that they are accused of not doing) 

2. Whether the person who is alleged to be neglectful can also reasonably be expected to have known the consequences of not doing the act (that they are accused of not doing) 

3. Did the person not do the act (that they are accused of not doing)? 

4. Did this result in the adult suffering, or being put at a real risk of suffering from significant harm? 

If the answer to all four questions is yes then neglect can be said to have occurred. 

Organisational abuse 

This includes neglect and poor care practice within a 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 ongoing ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation. 

This is defined as abusive practices and behaviours (of the other kinds listed above) that occur on a widespread basis within an institution and are considered “Acceptable” within the culture of that service. This is different from random instances of abuse committed by an individual within an institution, which would be condemned by other staff members. 

Examples include: 

• Uniform mistreatment of all service users 

• Mass apathy of staff and general failure to meet assessed customer needs 

• Lack of choices given to customers, who are treated not as individuals, but as objects where the bare minimum standards of care are met 

• Possessions and clothes being used by anyone in the service 

• Service users forced to follow routines that benefit the service not the service users eg bed times are the same for all customers 

• Regular overuse of PRN medication to keep customers quiet and over sedated 

Signs of Physical Abuse 

This includes but is not limited to: 

• Hitting, pushing, pinching, slapping and shaking 

• Overuse/misuse of medication that can cause physical harm 

• Excessive and inappropriate restraint (This is also a breach of Regulation 11 for registered care services) 

• An adult showing signs of fear of carers, generalised anxiety or inability to speak up in presence of another, may indicate that they have been abused 

Psychological abuse 

This includes emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyberbullying, isolation or unreasonable and unjustified withdrawal of services or supportive networks. 

Any behaviour which causes an adult to suffer from emotional harm to a significant extent can be considered to be psychological abuse. This often accompanies other forms of abuse and may be where abusive relationships are first noticed. It is the willful infliction of mental suffering by a person who is in a position of trust and power to an adult with care and support needs. 

This includes but is not limited to: 

• Use of disparaging and negative language 

• Refusal to allow an adult an opinion of his or her own 

• Strain within a relationship, denial of privacy, or freedom of choice and a lack of dignity in how customers are addressed 

• Threats of harm or abandonment, being deprived of social or any other sort of contact, humiliation, blaming, controlling, intimidation, coercion and bullying 

It undermines the adult’s self-esteem and results in them being less able to protect themselves and exercise choice. 

Behaviour that can be deliberately linked to causing serious psychological and emotional harm may constitute a criminal offence. Specialist advice from the police should be sought. 

Radicalisation and extremism 

The UK Government defines extremism as vocal or active opposition to fundamental British values, including democracy, the rule of law, individual liberty and mutual respect and tolerance of different faiths and beliefs. Extremism also includes calls for death of members of the armed forces. 

Radicalisation refers to the process by which a person comes to support terrorism and extremist ideologies associated with terrorist groups. 

Restraint 

Unlawful or inappropriate use of restraint or physical interventions and/or deprivation of liberty are forms of physical abuse. Restraint covers a wide range of actions including the use of active or passive means, e.g. use of key pads to prevent people going in to part of a building. In some circumstances restraint may constitute a criminal offence. 

Self-neglect 

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

Self-neglect is defined as the inability or unwillingness to provide for oneself or having the goods and services needed to live safely and independently. It can show itself in a range of ways; these include but are not limited to: 

• Hygiene including: poor personal hygiene, domestic squalor and/or hoarding behaviour 

• Life threatening behaviour including: refusal to eat, drink, take prescribed medications and/or comply with an understood medical regime 

• Financial including: the mismanagement of financial affairs 

Staff must establish whether the customer has capacity to make decisions about their own wellbeing, and whether or not they are able or willing to care for themselves. Staff must recognise and respect the customer’s right to choose how they live their life. However as a support provider staff have a duty of care to do everything they can to enable customers to live in a safe, clean and personalised environment and this may require staff to make interventions, provide additional support and to escalate the concern internally and externally as a safeguarding concern. 

Where staff identify concerns with the living environment of any customer, they must refer to the Living Standards Policy and Procedure which provides detail and guidance on the actions that must be taken. This also sets out some minimum standards to help staff understand when they will need to take further action. 

Sexual Abuse 

This includes both contact and non-contact sexual relationships and can involve such things as rape, indecent exposure, serious teasing, and use of innuendo regarding sexual matters, subjection to pornography or witnessing sexual acts or sexual acts which the adult had not consented to or was pressured in to consenting to. 

The key issue is whether there was consent between the adults involved and whether this was freely given by both parties in alleged sexual act. This can be complicated by issues such as mental capacity and one party being subject to duress or coercion by another person. Indicators include both physical signs of injury (also including bleeding, discharge, STDs, pregnancy), and emotional changes to an adult, or possibly to both adults. 

Sexual abuse allegations will always require urgent action involving the police and possibly the collection of forensic evidence to secure a conviction, where the police decide to seek a prosecution. 

Rape and other sexual assaults are among the most serious offences investigated by the police. The trauma that victims suffer presents unique challenges to any investigation. All staff should be aware of their individual roles and responsibilities to maximise all evidential opportunities to assist any investigation of a sexual nature and the minimum standards required regarding immediate response, recording and reporting. 

The following principles should be applied in the case of sexual abuse: 

• The most important priority is to ensure that the urgent medical and welfare requirements of the adult with care and support needs are met 

• Preserve any potential forensic opportunities, and record verbatim the disclosure made by the adult with care and support needs 

• Any sexual activity that is not freely consented to is criminal and must be reported immediately to the police via 999, before any internal investigation or interview 

• Sexual relationships or inappropriate sexual behaviour between a member of staff and a service user are always abusive and will lead to disciplinary proceedings. This is additional to any criminal action that has been taken 

• A sexual relationship between the service user and a care worker is a criminal offence under Sections 38–42 of the Sexual Offences Act 2003 

• Rape and serious sexual assaults are investigated by specially trained officers who will be responsible for arranging a forensic examination. This will normally be conducted at a sexual assault referral centre (In London this is run by The Havens, see www.thehavens.co.uk) 

• There may be Safeguarding Adults referrals that involve sexual innuendo or remarks that will not result in a criminal investigation; however, all 

Safeguarding Adults referrals that indicate any form of sexual abuse require a risk assessment, intelligence gathering and appropriate information sharing with relevant partners 

In a small number of cases customers may report to staff that this has happened but not want the police to be involved. If staff believe that someone may be at immediate risk of harm then they have a duty to contact the police as it is in the public interest whether or not the customer consents. 

However if this doesn’t apply and the customer is alleged to have been the victim of sexual assault or rape, and does not want to disclose this to police, they should always be referred to the local sexual assault referral centre who can take evidence which can be used later on if the customer changes their mind. If the customer meets the definition of the Care Act 2014 then this will have to be reported to the Local authority in all cases. These cases should be escalated to the Safeguarding lead or Senior Manager for a final decision. 

Sexual exploitation 

This covers exploitative situations, contexts and relationships where adults at risk (or a third person or persons) receive ‘something’ (e.g. food, accommodation, drugs, alcohol, cigarettes, affection, gifts, money) as a result of them performing, and/or another or others performing on them, sexual activities. People who are sexually exploited do not always perceive themselves as being exploited. 

Appendix 5: Guidance related to Young People in Specific Circumstances 

Young people and Care Leaver Services 

1. Young people in these services may be vulnerable to abuse or exploitation whether from ongoing contact with their families or from outside of their families. LISA staff, volunteers and trustees have a key role to play to mitigate against these risks as they may be the only trusted adult for the customer, even where the young person has an allocated social worker or Personal Adviser. Information sharing must be robust with clear lines of reporting within the professional network. 

2. Our prevention work with these young people includes developing trusted relationships with them; developing links with education and health services, challenging behaviours that will increase their vulnerability such as alcohol or substance misuse, promoting e safety and increasing their life skills. 

3. The transition period to adulthood and growing independence and risk taking between the ages of 16-18 can present increased vulnerability and safeguarding risks. As well as the change from children’s and familiar support networks to adult services. Local services should work with in partnership with the young person, care and mental health professionals to ensure there is a personalised transition plan in place. The service should also consider the customer age mix and put in place measures to mitigate associated risks 

4. Extra-familial threats can arise in an educational establishment, from within their peer groups, in the accommodation, or more widely from within the community or online. These threats can take a variety of forms and can include exploitation by criminal gangs and organised crime groups such as county lines; trafficking; online abuse; modern slavery; sexual exploitation and the influences of extremism leading to radicalisation. Extremist groups make use of the internet to radicalise and recruit and to promote extremist materials creating a risk of customers being drawn into terrorism. Prevent is the Government initiative that protects children from the risk of radicalisation and should be seen as part of our wider safeguarding duties, and is similar in nature to protecting children from other harms (e.g. drugs, gangs, neglect, sexual exploitation), whether these come from within their family or are the product of outside influences 

5. Risk management plans need to take account of these risks including the customer use of technology. Staff need to be vigilant and aware of the dynamics within the peer group and the impact on individuals. 

6. Local inter-agency arrangements will have robust systems in place for information sharing including the contact details for referral to the Channel Panel and the CSE risk assessment tool. 

7. Going missing is a significant risk indicator for young people and warrants a robust response and staff should refer to the separate policy for Children who go Missing. It is important to maintain professional curiosity and not make assumptions that young people are safe e.g. because they state that they are spending time with a family member. 

Staff must always reference any local inter-agency procedures. Risk management plans should be updated after every missing episode. 

Author

Thomas Coughlan

Safeguarding Lead

June 2022

Thanks to Look Ahead Care and Support and Camden and Islington NHS FT for supporting with the writing of this policy.