What does vulnerable adult mean?
A vulnerable adult is someone aged 18 or above who may need community care services for reasons like mental health issues, disability, age or illness.
They may not be able to take care of themselves or protect themselves from harm or exploitation.
What does abuse mean?
- An abuse is a violation of an individual’s human and civil rights by any other person or group of people.
- Abuse or neglect can happen anywhere - at home or in public, in hospitals, day centres, schools, colleges or care homes.
- Often the person causing the harm is someone you know, in a position of trust and power. This could be a health, education or care professional, or a friend, relative or neighbour.
Types of abuse and neglect
- unauthorised restraint
- denial of food or water
- not being helped to go to the toilet when needed
- misuse of medication.
- indecent exposure
- sexual harassment
- unwanted looking or touching
- sexual teasing and inappropriate jokes
- being shown pornography when unwanted
- sharing naked photos of someone online that they didn’t want shared
- witnessing sexual acts
- unwanted or unconsented sexual acts.
- threats of being physically hurt, left alone or abandoned
- stopping someone see other people
- verbal abuse
- unreasonably or unjustifiably taking away or stopping someone receiving support or services
This is usually abuse by someone in the home - like a family member, partner, house mate or carer. Domestic abuse includes:
- threatening physical violence
This is abuse because of someone’s disability, race, gender, age, sexual orientation, or religion. Discriminatory abuse includes harassment, name-calling and unfair treatment.
- spending someone else’s money inappropriately when appointed to look after it on their behalf
- forcing someone to spend their money on things they don’t want
- Internet, email, phone, postal and doorstep scams.
Another example of financial abuse is when someone makes “friends” with a vulnerable adult and then persuades them to give or lend them their benefits money. This kind of abuse can be hard to spot if the vulnerable adult believes they’re just helping a friend.
- not giving someone enough food or the right food
- not washing someone or supporting them to wash
- not changing someone’s dirty or wet clothes
- not getting a doctor when someone needs medical attention
- not making sure someone has the right medicines.
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Where to get help
If you feel you are being abused or neglected, here are some things you can do now:
- Tell someone you trust: friends, care workers, family, or colleagues. Speak to someone who might understanding the situation and act fast to help you improve the situation.
- Talk to a professional: speak to a doctor, nurse, teacher, therapist, counsellor or support worker about your concerns. You can also speak to your local council's Safeguarding Adults team.
- Talk to the police: if you think a crime has been committed or you are at risk of harm, call the police or ask someone you trust to help you speak to the police.
Know the signs of abuse and neglect
Sometimes people with a learning disability can find it hard to let others know they are being harmed.
This could be because they might not:
- understand that what’s happening to them is wrong.
- be able to tell other people what's happening.
- know how to raise it.
It’s good to know about abuse and neglect so you can help someone if you spot the signs. You might become worried about someone if you notice they:
- have become quieter or depressed
- have lost weight
- seem to be struggling with money
- have cuts or bruises that can’t be explained
- have changed behaviour
- seem malnourished.
It's always better to do something about your concerns than try to ignore them. You won't be making a fuss - just checking that someone is ok and making sure they are safe.
If you're worried about someone
Do you have concerns about someone else’s safety? Start by talking to the person in private if you can.
- Tell them gently that you’ve noticed a change and ask them if they are ok.
- Listen. They might really need someone to talk to. Let them talk as much as they want and be calm, even if what you hear upsets you.
- Be patient. They may not want to talk at all. Many people who are abused are scared to talk in case it makes things worse.
- Try not to promise you won't tell anyone what you've heard, because if an adult is being abused or neglected, it's vital to find help for them as soon as possible.
- Make it clear they have a right to feel safe, and that what’s happening to them is wrong.
If you think that there are still safeguarding concerns after your conversation, you should report them.
Report your safeguarding concerns
To find out who to report your concerns to, select from the list below what kind of care and support the adult is receiving.
The adult doesn't have any formal care or support
If the person is not receiving any support and you are worried for their safety, here are your options:
- Talk to their GP: you can talk in confidence to their GP about your concerns. GP’s have safeguarding policies to follow when safeguarding concerns are reported. Use the words ‘safeguarding concern’ to show that your worries are serious and that their safeguarding policy should be followed.
- Get a copy of the GP’s safeguarding policy: if it’s not on the website you can get a copy from reception. The safeguarding policy will typically involve the GP working with the local adult social care safeguarding team. Knowing their policy helps you follow their progress and ensure the appropriate action is being taken.
- Speak to the duty social care team: if you don’t know who their GP is, or the situation is urgent and the adult does not have a social worker, the duty social care team should be informed. You can do this by contacting the local council. You can check their council area by using the postcode search on the gov.uk website.
- Contact the local Safeguarding Adults Board: Local authorities are responsible for the safeguarding of vulnerable adults and children in their area. If your concerns are not being taken seriously, contact the local Safeguarding Adults Board directly. The safeguarding team will review the situation and decide whether to investigate or take action right away. You’ll be able to ask the GP or social worker whether any action has been taken, but won’t have the right to know about the specifics.
- Contact the police: if you believe the adult is at immediate risk, call the police.
The adult receives support and has a social worker
All local authorities have a lead safeguarding officer, and social workers trained to alert the right person when a safeguarding concern is raised.
If you’re worried about an adult who is already receiving support and has a social worker, you can get in touch with their social worker. They’ll listen to your concerns and get advice from the local authority safeguarding team.
If you feel that the social worker doesn’t take your concerns seriously, contact the local Safeguarding Adults Board (SAB) directly through the local council website.
The adult has health care support in the community
- You can speak to the manager of the care provider.
- If you feel this isn’t appropriate - because you think they are causing the harm, for example - go straight to the local authority Safeguarding Adults Board. You’ll find their contact details on the local council website.
- Although health care packages are funded by the NHS and regulated by the Care Quality Commission, local authorities have overall responsibility for safeguarding all vulnerable adults in their community.
- If you have any problems contacting the local authority, or they don’t respond appropriately, you can call the Care Quality Commission: 03000 616161.
The adult is in hospital
- You can raise the concern with the hospital’s Safeguarding Co-Ordinator. Most hospitals have at least one designated Co-ordinator for safeguarding matters and the ward manager will know who this is.
- The Safeguarding Co-Ordinator can get advice from the central safeguarding team at NHS England or, for out of hours reports, they can contact the emergency social services safeguarding team in the local authority.
- If you’re still not sure who to contact after speaking to the ward or department manager, try contacting the Patient Advice and Liaison Service (PALS). For the adult’s nearest PALS, use this postcode search.
- NHS Trusts have someone responsible for overseeing safeguarding concerns who you can ask to speak to.
- If you feel that the hospital is not taking your safeguarding concerns seriously, you can report it to the local authority, which has overall responsibility for safeguarding people in their area.
After a safeguarding concern is reported
What happens after you report a safeguarding concern?
- The safeguarding person or team will decide whether the person is at immediate risk of harm. If they are, the authority will take action. This could mean removing the person from the harmful situation, or removing the person causing the harm.
- There are many different courses of action and the best interests of the vulnerable adult will be kept at the centre of any response.
- The safeguarding person or team will decide whether they need to investigate the issues any further.
Further investigations may involve:
- discussing the issues with other professionals in the adult’s care, and with the adult themselves
- building up a more detailed picture of what is happening and make further investigations
- considering measures that can be put in place to prevent the vulnerable adult from being abused and neglected
- drawing lessons from the case that can used to improve the effectiveness of safeguarding procedures across the board.
Support through safeguarding enquiries, investigations or reviews
If the vulnerable adult needs to take part in safeguarding adult reviews or safeguarding enquiries (under the Care Act 2014), and the local authority deems the person to have care and support needs, then they will make a judgement on two things:
- Does the person have substantial difficulty in being involved?
- Do they lack an appropriate individual to support them?
If the answer to both of these is ‘yes’, an independent advocate must be appointed to support and represent the person.
What does ‘substantial difficulty’ mean?
The Care Act defines four areas where people may experience substantial difficulty:
- Understanding relevant information.
- Retaining information.
- Using or weighing information.
- Communicating views, wishes and feelings.
This is not the same as lacking mental capacity and is an entirely different concept. Somebody with full mental capacity may still have substantial difficulty being involved in a safeguarding review or enquiry.
What does an ‘appropriate individual’ mean?
The local authority will consider whether there is an appropriate individual to support the adult, instead of appointing an independent advocate. There are four specific considerations. Individuals are considered inappropriate if they are:
- 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 failed to prevent abuse or neglect as judged by a safeguarding adult review.
If there is no appropriate individual available, the local authority must appoint a trained professional known as an independent advocate to support and represent the adult through the safeguarding process, regardless of the level of care the person gets.
If you have any questions about safeguarding or are worried about someone but are unsure what to do, you can call the Learning Disability Helpline on 0808 808 1111.