Incidents between adults in a service

Incidents between adults in a service can include any interaction involving two or more adults in any setting, involving physical, psychological/emotional, sexual, financial, or discriminatory abuse or behaviour, which results in the risk of abuse or neglect, or actual abuse or neglect.

Not all incidents between adults in a service will require a safeguarding concern to be raised. Agencies must use their own internal incident policy and processes and ensure that all incidents are reported using the appropriate procedures. What is important is for each incident to be considered according to the individual circumstances of the situation, and a professional judgement reached.

A degree of conflict on occasions is to be expected in all relationships. This applies equally to environments where people with care and support needs live together or spend long periods of time together. There may be times when the actions of one adult in a service towards another goes beyond usual conflict and their behaviour is abusive, causing an impact.

Non-reportable concerns

Lower-level concern where the criteria for a safeguarding enquiry is unlikely to be met. However, an internal written record of what happened and what action was taken should be kept. Where there are several low-level concerns, consideration should be given as to whether the criteria may be met for a safeguarding enquiry due to increased risk.

In these cases, it is important that you consider alternative actions to contacting the local authority. These include:

• Review of relevant policies and procedures.
• Internal relevant training provided.
• Review of existing care plans or creation of new care plans/risk assessments.
• Complaints or disciplinary processes.

Examples of non-reportable concerns include:

• Incidents between people using a service where there is no apparent impact, and actions are undertaken to minimise the risk of reoccurrence.
• More than one incident where there is no apparent impact, and:
  • A care plan and/or risk assessment is in place and is being adhered to.
  • Action is taken to minimise further risk.
  • Other relevant professionals have been notified.
  • There has been full discussion with the person, their next-of-kin, or their representative.
  • No other indicators of abuse or neglect.

Concerns requiring consultation

Incidents at this level should be recorded, and internal policies and procedures followed. Consultation should be undertaken internally as well as through the Sussex Safeguarding Adults Policy and Procedures. Action should be taken to reduce risk and consultation with the local authority Adult Social Care department considered. Following this you may be requested to formally raise a safeguarding concern.

In these cases, it is important that you consider alternative or additional actions to contacting the local authority. These include:

• Share information with the ICB Quality Team and/or the CQC.
• Discussion with Health/Social Care Commissioners.
• DATIX, Serious Incident or alternative review or investigative process.

Examples of concerns requiring consultation include:

• Any incident between people using a service in which medical attention or attendance at hospital is required.
• Multiple incidents where the person lacks capacity and is unable to take action to protect themselves.
• There have been other similar incidents involving the same perpetrator.
• Concerns over escalation of behaviours between identified individuals.
• The care plan has not been implemented.
• It is not clear that professional advice or support has been sought at the appropriate time.
• There have been other similar incidents involving the perpetrator or areas of concern.
• Repeat use of discriminatory language between people using a service.

Reportable concerns

Incidents at this level should be formally raised as a safeguarding concern with the local authority Adult Social Care department. Consideration should also be given as to whether the police or other emergency services need to be contacted. Ensure Think Family approach if children or other adults may be impacted.

In these cases, it is important that you consider additional actions to contacting the local authority. These include:

• RAISE SAFEGUARDING CONCERN
• If there is an indication a criminal act has occurred, the police must be consulted.
• Immediate safety plans must be implemented.

Examples of reportable concerns include:

• Any incident resulting in intentional or intended harm or risk of harm to the person, including hate crimes.
• Any incident where a weapon or other object is used with the intention to cause injury.
• Repeated incidents where the person lacks capacity and is unable to protect themselves.
• The victim is, or appears, fearful in the presence of the other person or is adapting their behaviour to pacify or avoid the other person.