Safeguarding Adults: Recognition, Response & Support
Article by: Seamus Doherty
Safeguarding Adults: Recognition, Response & Support
Comprehensive guide aligned with the Care Act 2014
What is Safeguarding Under the Care Act 2014?
Under the Care Act 2014, Safeguarding means protecting an adult's right to live in safety, free from abuse and neglect. Local authorities have a duty to make enquiries if they believe an adult is experiencing or at risk of abuse or neglect and is unable to protect themselves because of their care needs.
- Has needs for care and support (whether or not the authority is meeting any of those needs)
- Is experiencing, or is at risk of, abuse or neglect
- As a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect
Safeguarding Adults duties apply where a local authority has reasonable cause to suspect that an adult in its area:
Key Definitions:
- Adult at risk: A person aged 18 or over who has care and support needs and is experiencing or at risk of abuse or neglect
- Care and support needs: May be due to age, illness, disability, physical or mental impairment, or substance misuse
- Abuse: Includes physical, sexual, psychological, financial, discriminatory, organisational, neglect, and self-neglect
- Wellbeing: Central principle including personal dignity, physical and mental health, protection from abuse, and participation in society
The Six Key Principles of Safeguarding Adults
🎯 Empowerment
People being supported and encouraged to make their own decisions and give 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
The 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 people, communities, and each other. "I am confident that professionals will work together and with me to get the best result for me".
📋 Accountability
Accountability and transparency in Safeguarding practice. "I understand the role of everyone involved in my life and so do they."
📊 Understanding Abuse Cycles and Patterns
How Abuse Often Develops and Escalates
Adult abuse rarely happens in isolation. Understanding common patterns helps identify and respond to abuse more effectively:
Trust Building
Perpetrator establishes trust and dependency. May involve isolating the person from family and friends, or becoming indispensable to them.
Grooming & Control
Gradual boundary crossing, testing responses. Small acts of abuse or control that increase over time as the person becomes more vulnerable.
Escalation
Abuse becomes more serious and frequent. The person may become more isolated, dependent, or fearful of reporting the abuse.
Normalisation
Abuse becomes routine and accepted. The person may believe they deserve it, or that this is normal treatment for someone like them.
👥 Who Are Adults at Risk?
The Care Act 2014 recognises that any adult can become at risk in certain circumstances. Vulnerability is not fixed - it can change based on situation, environment, and life circumstances:
👴 Older Adults
May face age-related vulnerability due to frailty, cognitive changes, social isolation, or increased dependency on others for care and support.
🧠 Learning Disabilities
May have difficulty understanding complex situations, recognising abuse, or communicating concerns. Often face discrimination and social exclusion.
🏥 Mental Health Conditions
May experience periods of crisis, reduced capacity, or difficulty accessing services. Stigma can increase vulnerability and reduce support networks.
♿ Physical Disabilities
May require assistance with personal care, mobility, or daily activities. Dependency on carers can increase vulnerability to various forms of abuse.
👁️ Sensory Impairments
People with sight or hearing loss may have difficulty detecting abuse, accessing help, or communicating their needs and concerns.
🍷 Substance Misuse
May impair judgment, increase risk-taking behaviour, or create dependency relationships that can be exploited by others.
🏠 Social Isolation
People who are isolated from family, friends, or community may lack support networks and be more vulnerable to exploitation and abuse.
🤝 Carers (formal and Informal)
May be at risk of abuse, harm, neglect, exploitation, stress, isolation, and dependence on the person they care for.
🚪🔒 Adults Experiencing Domestic Abuse
Victims may be isolated, controlled, and fearful of seeking help. Abuse can be physical, emotional, financial, or coercive.
🏚️ Homelessness
People experiencing homelessness face multiple vulnerabilities including exposure to crime, exploitation, and difficulty accessing services.
⛓️ Victims of Modern Slavery
Adults trafficked or exploited for labour, sexual exploitation, or other forms of modern slavery. Often controlled through debt, threats, or violence.
🌍 Asylum Seekers & Migrants
May face language barriers, unfamiliarity with systems, insecure immigration status, and cultural isolation that increases vulnerability.
⚠️ Types of Abuse and Neglect
Physical Abuse
Hitting, slapping, pushing, kicking, misuse of medication, restraint, or inappropriate physical sanctions. Includes withholding physical care.
Sexual Abuse
Rape, sexual assault, sexual acts without consent, sexual harassment, or involvement in pornography. Includes any sexual activity the person lacks capacity to consent to.
Psychological/Emotional
Threats, humiliation, bullying, intimidation, coercion, isolation, verbal abuse, cyber bullying, or controlling behaviour that causes emotional distress.
Financial/Material
Theft, fraud, internet scamming, coercion regarding financial affairs, misuse of benefits, or pressure around wills, property, or possessions.
Domestic Abuse
Controlling, coercive, threatening behaviour, violence or abuse between family members or intimate partners. Can affect adults of all ages.
Modern Slavery
Human trafficking, forced labour, debt bondage, sexual exploitation, or domestic servitude. Control through violence, threats, debt, or immigration status.
Discriminatory
Harassment, slurs, or similar treatment based on race, gender, age, disability, sexual orientation, religion, or other protected characteristics.
Organisational
Neglect and poor care practice within institutions. Includes rigid routines, inadequate staffing, poor management, or institutional cultures that harm residents.
Neglect & Acts of Omission
Ignoring medical, emotional, or physical care needs. Failure to provide access to healthcare, medication, food, heating, or other essentials for wellbeing.
Self-Neglect
Neglecting personal hygiene, health, surroundings, or safety. May result from mental health conditions, cognitive impairment, or social isolation.
Online / Cyber / Digital Abuse
Exploitation, harassment, scams, or grooming carried out online or through technology. These include "romance" or "investment" scams or identity fraud / theft.
Peer-to-Peer Abuse
Harm caused by other adults at risk in shared settings (e.g., residential care, supported living), which may include bullying, intimidation, exploitation, or violence
🚨 Warning Signs and Risk Indicators
Recognising the Signs of Adult Abuse and Neglect
Physical Signs
- Unexplained injuries, bruises, burns, or marks
- Frequent injuries with vague explanations
- Poor hygiene, inadequate clothing, or unkempt appearance
- Unexplained weight loss or malnutrition
- Pressure sores, dehydration, or untreated medical conditions
- Over-sedation or under-medication
- Signs of restraint marks or inappropriate use of restraints
Behavioural & Emotional Signs
- Withdrawal from activities or social interaction
- Changes in mood, behaviour, or personality
- Fear of specific people or reluctance to be alone with them
- Anxiety, depression, or signs of trauma
- Regression in behaviour or capabilities
- Sleep disturbances or changes in eating patterns
- Low self-esteem or expressions of worthlessness
Financial Concerns
- Unexplained financial transactions or money missing
- Sudden changes in financial circumstances
- Missing personal belongings or valuables
- Unusual interest from new 'friends' or strangers
- Changes to wills, power of attorney, or bank accounts
- Bills unpaid when money should be available
- Person lacks access to their own money
Environmental Signs
- Poor living conditions or unsafe environment
- Lack of heating, food, or other essentials
- Dirty or inappropriate clothing
- Home security concerns or restricted access
- Isolation from family, friends, or services
- Overcrowding or unsuitable living arrangements
- Evidence of neglect in the home environment
- Signs of substance misuse in the environment
Care Provider / Relationship Signs
- Carer showing lack of knowledge about person's needs
- Carer appearing stressed, burnt out, or struggling to cope
- Person showing fear or anxiety around specific people
- Controlling behaviour from family, friends, or care providers
- Isolation imposed by others or restricted social contact
- Decisions being made without involving the person
- Care providers showing signs of substance misuse
Service / System Signs
- High staff turnover in care settings
- High use of agency or temporary staff
- Lack of person-centered care plans
- Rigid routines that don't meet individual needs
- Volume and frequency of medication errors
- Poor record keeping or incident reporting
- Inadequate staffing levels or training
- Complaints not taken seriously or investigated
- Poor management oversight or supervision
- Inadequate Safeguarding policies or procedures
📋 Professional Response Framework
8-Step Professional Response Process
Recognise & Ensure Safety
Notice warning signs and trust your professional instincts. If immediate danger exists, call 999. Ensure the person's immediate safety.
Respond & Listen
Create a safe, private space to discuss concerns. Use open questions, listen without judgment, and validate their experiences.
Respect Choice & Capacity
Respect the person's right to make decisions. Assess mental capacity if there are concerns. Support informed decision-making.
Record & Document
Document concerns accurately using the person's own words. Include dates, times, and objective observations. Follow your organisation's procedures.
Report & Refer
Report to your local authority Safeguarding Team within 24 hours. Make appropriate referrals with consent where possible.
Risk Assessment
Contribute to risk assessment processes. Consider immediate and ongoing risks to the person and others.
Participate & Coordinate
Participate in Safeguarding enquiries and multi-agency planning. Share relevant information appropriately.
Review & Learn
Review outcomes and learn from the experience. Seek supervision and support. Consider what could be improved for future cases.
👥 This Applies to ALL Professionals
The Care Act 2014 creates responsibilities across all sectors. Everyone has a role in Safeguarding adults based on their position, role, responsibility, remit and contact with adults at-risk.
⚖️ Legal Framework and Key Processes
Key Legal Protections and Processes Under the Care Act 2014:
- Section 42 - Safeguarding Duty: Local authorities must make enquiries when they believe an adult at risk is experiencing or at risk of abuse or neglect
- Section 43 - Safeguarding Adults Boards (SABs): Multi-agency partnerships to coordinate local Safeguarding work and ensure effectiveness
- Section 44 - Safeguarding Adults Reviews (SARs): Multi-agency reviews when an adult dies or has been seriously harmed and there are concerns about how agencies worked together
- Mental Capacity Act 2005: Framework for making decisions on behalf of adults who lack capacity, including Deprivation of Liberty Safeguards (DoLS)
- Making Safeguarding Personal: Person-centered, outcome-focussed approaches, ensuring the individual's voice is central to Safeguarding responses - linked to the 6 key principles of Safeguarding above
- Information Sharing: Legal framework allowing appropriate sharing of information to protect adults at risk
- Criminal Law: Most forms of abuse are also criminal offenses. Police should be involved where crimes may have been committed
- Human Rights Act 1998: Right to life (Article 1), Prohibition of torture, inhuman or degrading treatment (Article 3), Respect for private and family life, home and correspondence (Article 8)
📞 Essential Contacts & Support Services
24/7 Support Services and Key Contacts
Local Authority Adult Social Care
Your first point of contact for Safeguarding concerns. Most have 24/7 emergency duty teams.
Contact: Your local council's adult social services or emergency duty team
Age UK
Support, advice and services for older people including Safeguarding concerns.
Phone: 0800 678 1602
Website: www.ageuk.org.uk
Hourglass (Elder Abuse)
Specialist helpline focused on the abuse, neglect and mistreatment of older people.
Phone: 0808 808 8141
Email: www.wearehourglass.org
Care Quality Commission (CQC)
For concerns about care services, care homes, or healthcare providers.
Phone: 03000 616161
Website: www.cqc.org.uk
Modern Slavery Helpline
24/7 confidential helpline for reporting modern slavery and human trafficking.
Phone: 08000 121 700
Website: www.modernslaveryhelpline.org
National Domestic Abuse Helpline
24/7 support for domestic abuse affecting adults of all ages.
Phone: 0808 2000 247
Website: www.nationaldahelpline.org.uk
Mencap Learning Disability Helpline
Support and advice for people with learning disabilities and their families.
Phone: 0808 808 1111
Website: www.mencap.org.uk
Mind Mental Health Support
Information and support for mental health concerns and Safeguarding issues.
Phone: 0300 123 3393
Website: www.mind.org.uk
Victim Support
Free and confidential support for anyone affected by crime, including vulnerable adults.
Phone: 0808 168 9111
Website: www.victimsupport.org.uk
Disability Rights UK
Advocacy and advice for disabled adults, including issues around Safeguarding.
Phone: 0330 995 0400
Website: www.disabilityrightsuk.org
Samaritans
24/7 emotional support for anyone in distress, including those experiencing abuse.
Phone: 116 123 (free)
Website: www.samaritans.org
Citizens Advice
Free advice on legal, financial, and practical issues that may relate to abuse situations.
Phone: 0808 223 1133
Website: www.citizensadvice.org.uk
Emergency - Immediate Danger
Police, Fire, Ambulance
Silent Solution: Call 999, press 55 when prompted if you cannot speak
Text: Text 'POLICE' to 60066 for non-emergency police contact
