Checked: 01-05-2024 by
Vicky Ryan Next Review: 30-04-2026
Safeguarding Adults procedures
The following guidelines were last updated by the Adult safeguarding team in April 2024
Reporting concerns
If you have concerns about an adult at risk of harm, please refer to the appropriate local authority in which the adult lives using the links below:
Out of Hours
Call emergency duty team on 01454 615165 for all BNSSG.
Connecting Care
GPs can access information about families and identify whether Social Care is involved through Connecting Care. If adults have opted out of this service, then please liaise directly with the local authority.
Connecting Care - login page
Police welfare checks
The police have advised that requests for 'welfare checks' will not be carried out unless:
- There is an identifiable and immediate risk to life or property.
- The vulnerable person or child is suffering, or is at risk of suffering, immediate and significant harm.
- It is reasonably believed that a crime has been committed, is being committed or is about to be committed.
- Attendance of a police officer is necessary to prevent a breach of the peace.
Please see the attached letter which explains these changes which came into use from 4th November 2019.
Safeguarding Adults Multi-Agency Policy
Agreed by Safeguarding Adults Boards in BANES, Bristol City, North Somerset, South Gloucestershire, and Somerset.
Joint Safeguarding Adults Policy (June 2019)
Practice Safeguarding policies
Safeguarding Adults Policy
Each practice should have a Safeguarding Adults Protocol. The RCGP toolkit is generally considered the best available guide for GPs. It is a comprehensive document which can be made available on practice intranet and contains guidance on how to set up a practice specific protocol and how to undertake a practice based self-assessment. Practices can use this toolkit to produce a concise practice specific safeguarding protocol.
Link / Lead GPs
Unlike for Children’s Safeguarding, not every practice in BNSSG has a Safeguarding Link GP. However, more GPs across BNSSG are considering taking dual roles in safeguarding adults and children. The role of the lead GP is to ensure that members of the practice team have relevant training and resources, to disseminate newsletters and information and to ensure that the practices have an up-to-date safeguarding protocol. Link GPs attend meetings organised by the ICB safeguarding team at which current topics and issues in safeguarding are discussed.
Please let us know when there is a change to your Link GP so we can update our records by emailing: bnssg.safeguardingadmin@nhs.net
BNSSG Self Assessment Audit Tool
The new BNSSG-wide Safeguarding Self-Assessment Audit Tool
The BNSSG Safeguarding Self-Assessment Audit Tool for Primary Care is designed to support Primary Care in evaluating and enhancing practices related to the safeguarding and protection of vulnerable individuals, particularly children, young people, and adults at risk
This audit tool provides a structured approach for Practices to assess existing safeguarding policies, procedures and practices, identify areas for improvement, and ensure compliance with current safeguarding regulations and best practices. By completing the self-assessment, you can gauge the effectiveness of your safeguarding activities, identify gaps in training or resources and reinforce your commitment to protecting those who are most vulnerable.
The tool covers a range of topics, including:
- Governance and leadership in safeguarding
- Staff training and development
- Risk assessments and reporting mechanisms
- Collaboration with other safeguarding agencies and professionals
- Support systems for patients at risk
You do not have to share the Audit with the ICB Primary Care Safeguarding Team but they are happy to work with you if you need any support.
Training requirements for Primary Care staff
Training requirements for primary care staff
All GPs and primary care staff need to ensure that they have adequate training in safeguarding adults which is appropriate to the role. This is quite a complex area which often causes some confusion.
The joint colleges produced an intercollegiate document on the roles and competencies for health care staff which gives definitive guidance: Intercollegiate Document: Adult Safeguarding - Roles and Competencies for Health Care Staff
The RCGP also produced a summary and guidance document for primary care: RCGP primary care safeguarding training requirements
BNSSG ICB All Age Safeguarding Team
The BNSSG safeguarding team provide support and training for primary care colleagues. They arrange regular meetings with link GPs, provide training updates, host Q+A drop-in sessions and participate in a variety of policy groups and committees.
They are happy to give advice on safeguarding matters to clinicians. Contact details are below. Please remember that they cannot offer urgent advice but are happy to talk through complex issues. Any advice given, is provided to assist you in your decision making and you may still wish to liaise with your indemnifying organisation, or seek further advice from, for example, your data protection officer.
Head of Safeguarding (All Age): Faye Kamara
Named GP for Safeguarding (All Age): Dr Vicky Donkin (Tues & Weds)
Named GP for Safeguarding (All Age): Dr Marie McVeigh (Weds + Fri)
Designated Professional for Safeguarding Adults: Alex Morgan
Designated Nurse for Safeguarding Children: Toyah Carty-Moore
Designated Nurse for Safeguarding Children in Care and Care Leavers: Nicki Ayres
Deputy Designated Nurse for Safeguarding Children in Care and Care Leavers: Gemma Shannon
Deputy Designated Nurses for Safeguarding (All Age):
Harjit McLean (Bristol)
Lucy Austin (North Somerset)
Louise Field (South Gloucestershire)
Named Professionals for Primary Care:
Kirsten Bowes
Louise Ledgerwood-Care
Designated Doctor for Safeguarding Children Bristol and South Gloucestershire: Dr Emma Bradley
Designated Doctor for Safeguarding Children in Care and Care Leavers: Dr Saraswati Hosdurga
Designated Doctor for Safeguarding Children North Somerset: Dr Richard Williams
Please email bnssg.safeguardingadmin@nhs.net to get in touch with us
BNSSG ICB Primary Care Safeguarding Training Programme:
For further information about safeguarding training please see our ICB webpage: Safeguarding information - NHS BNSSG ICB
GMC guidance for doctors
The GMC has produced guidance for practitioners outlining their responsibilities in protecting adults at risk: GMC ethical hub: adult safeguarding
Allegations of abuse
Allegations against people who work with adults at risk
Allegations of abuse of adults at risk, by adults who work with them are becoming increasingly common especially following recent high-profile cases. These may include allegations against patients who are carers, and other professionals and volunteers. It may also involve allegations against NHS staff including practice staff. These are investigated by the Local Authority.
Safeguarding Adults Boards within each local authority have their own Persons in a Position of Trust (PiPoT) policy:
Keeping Bristol Safe Partnership
North Somerset Safeguarding Adults Board
South Gloucestershire Safeguarding Adults Board
Please discuss complex cases with the safeguarding team.
RCGP Toolkit and Identification of Risk
The RCGP has issued coding guidance in the Adult safeguarding toolkit
Processing and storing of safeguarding information in primary care
The coding and documentation of safeguarding information on a patient’s record is as important as the coding and documentation of any other significant medical issue such as cancer, diabetes, depression or learning disability for example. Safeguarding information needs to be immediately obvious on a patient’s notes to all health practitioners who may access those medical notes for the purposes of direct patient care. Suffering abuse or neglect is as threatening to the health and well-being of a patient as other major medical conditions are and therefore should be treated in the same manner. By coding and documenting this in the same way as we do other medical conditions, we highlight patients who are vulnerable and who are at risk which enables us to offer appropriate support.”
RCGP safeguarding coding guidance (2017)
RCGP domestic violence coding guidance (2021)
Safeguarding Adults Reviews (SARs)
A Safeguarding Adults Review (SAR) is a multi-agency review process which seeks to determine what agencies could have done differently to have prevented harm or a death from taking place. The purpose of a SAR is to promote effective learning and improvement, not to apportion blame. The chair of the local safeguarding board launches a review in cases that meet nationally agreed criteria.
All agencies are requested to provide information detailing their involvement with the adult to which the SAR pertains. A request for a Chronology will be sent directly from the local safeguarding board or via the Designated Professional for Safeguarding Adults to the person’s GP practice. The GP practice must complete the Chronology in order for the Named GP for Safeguarding to write an Individual Management Review (IMR).
Information and summaries of local SARs can be found on the safeguarding board websites:
Bristol: Bristol SAR
NS: North Somerset SAR
South Glos: South Gloucestershire SAR
Following Serious Adult Reviews, one of the tasks of the ICB safeguarding team is to disseminate learning and action plans. We do this through our regular training events and GP link meetings.
Domestic Homicide Reviews (DHRs)
A Domestic Homicide Review (DHR) is a multi-agency review of the circumstances in which the death of a person aged 16 or over has, or appears to have, resulted from violence, abuse, or neglect by a person to whom they were related or with whom they were, or had been, in an intimate personal relationship, or a member of the same household, or from suicide. Since 13 April 2011 there has been a statutory requirement for local authorities to conduct a DHR following a domestic homicide that meets the criteria.
All agencies are requested to provide information detailing their involvement with the adult to which the DHR pertains. A request for a chronology will be sent directly from the local safeguarding board, or via the Designated Professional for Safeguarding Adults, to the person's GP practice. The GP practice must complete the Chronology in order for the Named GP for Safeguarding to write an Individual Management Review (IMR).
Bristol DHR
North Somerset DHR
South Gloucestershire DHR
Following a Domestic Homicide Review one of the tasks of the safeguarding team is to disseminate the learning identified and to consider how this can be used to deliver improvements to practice to safeguard victims and prevent domestic homicide.
Section 42 - Statutory Safeguarding Enquiry
The Care Act 2014 (Section 42) requires that each local authority must make enquiries, or cause others to do so, if it believes an adult at risk of harm is experiencing, or is at risk of, abuse or neglect. An enquiry should establish whether any action needs to be taken to prevent or stop abuse or neglect, and if so, by whom.
While many enquiries will need a lot of input from a social care practitioner there will be aspects that should be carried out by other professionals with the necessary skills and knowledge. For example, it may be a health professional who has the closest relationship with the individual and is best placed to explore a particular concern with them in the first instance.
Non-statutory enquires:
Safeguarding enquiries carried out on behalf of adults who do not fit the criteria outlined in Section 42 of the Care Act 2014. Local authorities are not required by law to carry out enquiries for these individual, but may do so at their discretion. These enquiries would relate to an adult who is believed to be experiencing, or is at risk of, abuse or neglect, and does not have care and support needs (but might have just support needs).
Self-neglect and hoarding
This is a complex issue and covers a wide range of behaviours, such as neglecting to care for one’s personal hygiene, health, or surroundings such as can be seen with hoarding.
Avon Fire & Rescue Service - Clutter Image Rating Scale
Bristol Self-neglect
North Somerset Self-neglect
South Gloucestershire Self-neglect
Modern Slavery
Modern slavery means being forced to work illegally against your will. Here are some examples of modern slavery: forced to work in prostitution, domestic servitude, nail bars, car washes or care homes with little or no pay. A growing form of modern slavery is in recruiting children and adults into crime “County Lines” drug trafficking or drug production.
Helen Bamber Foundation - Quick guide to Modern Slavery and Human Trafficking.
Give us information about a suspected vulnerable or exploited person | Avon and Somerset Police
Bristol Modern Slavery
North Somerset Modern Slavery
South Gloucestershire Modern Slavery
Independent Mental Capacity Advocate (IMCA)
IMCAs are a safeguard for people who lack capacity to make some important decisions. These are advocates when the patient has been assessed as having no capacity and they have no-one else apart from paid carers to speak on their behalf.
The IMCA role is to support and represent the person in the decision-making process. Essentially, they make sure that the Mental Capacity Act is being followed.
Who should get an IMCA? An Independent Mental Capacity Advocate (IMCA) must be instructed for people in the following circumstances:
- The person is aged 16 or over;
- A decision needs to be made about either a long-term change in accommodation or serious medical treatment;
- The person lacks capacity to make that decision; and
- There is no-one independent of services, such as a family member or friend, who is “appropriate to consult”.
An IMCA may also be provided to people for other decisions concerning:
- Care Reviews; or
- Adult Protection Cases
In adult protection cases an IMCA may be instructed even where family members or others are available to be consulted.
Details of IMCA Services in the BNSSG area
Bristol: POhWER
The new provider from 1st Nov 2024, for ALL types of advocacy (statutory and non-statutory) will be an organisation called POhWER
Email: pohwer@pohwer.net
Tel: 0300 456 2370
North Somerset: The Advocacy People
Email: info@theadvocacypeople.org.uk
Tel: 0330 440 9000
PO Box 375, Hastings, East Sussex, TN34 9HU
North Somerset (theadvocacypeople.org.uk)
South Gloucestershire: VoiceAbility
Email: helpline@voiceability.org
Tel: 0300 303 1600
VoiceAbility, c/o Sayer Vincent, Invicta House, 108-114 Golden Lane, London, EC1Y 0TL
https://find-information-for-adults-children-families.southglos.gov.uk/kb5/southglos/directory/advice.page?id=OBPEzFM_hfU
Information for people living in or being supported in Bristol needing Care Act Advocacy Your Say Advocacy
Email: admin@yoursay-advocacy.com
Tel: 01291 417 933 / 07778 496707
Address: Unit 36 BasePoint, Beaufort Park, Chepstow, NP16 5UH
Multi-Agency Public Protection Arrangements
MAPPA stands for Multi-Agency Public Protection Arrangements. They are the set of arrangements through which the Police, Probation and Prison Services work together with other agencies to manage the risks posed by those convicted of violent, sexual and terrorism offences who are living in the community, in order to protect the public.
MAPPA are not a statutory body in themselves but are a mechanism through which agencies can better discharge their statutory responsibilities and protect the public in a co-ordinated manner. Agencies at all times retain their full statutory responsibilities and obligations.
This site provides professionals and the public with information on how those convicted of violent, sexual and terrorism offences are managed in the community. The public should be reassured that agencies involved in MAPPA are working closely together to ensure that resources are best directed to protect the public and to reduce reoffending.
https://mappa.justice.gov.uk/MAPPA/groupHome
Resource
https://www.anncrafttrust.org/professional-curiosity-safeguarding-adults-an-essential-introduction/
Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.
Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.
