According to recent figures, safeguarding concerns for adults have risen annually, highlighting the growing need for public awareness and understanding. This authoritative guide answers the critical question: Who needs safeguarding as an adult? and empowers you to recognize and respond to potential abuse and neglect.
Understanding the Foundation of Adult Safeguarding
Adult safeguarding is the process of protecting an adult's right to live in safety, free from abuse and neglect. This is not just a reactive measure but a proactive approach involving individuals, organizations, and the community to prevent harm and promote well-being. The principles of adult safeguarding, such as empowerment, prevention, and accountability, guide all actions, ensuring the adult's wishes are central to the process.
The framework is defined by specific legal criteria. For instance, in England, Section 42 of the Care Act 2014 specifies that local authorities must make inquiries if there is a reasonable cause to suspect that an adult has care and support needs, is experiencing or is at risk of abuse or neglect, and is unable to protect themselves because of those needs. This shifts the focus from simply being a 'vulnerable adult' to considering specific circumstances and support requirements.
The Criteria for Needing Safeguarding
An adult may need safeguarding if they meet three key conditions:
- They have care and support needs: This is a broad category, encompassing physical, mental, or cognitive conditions that require some level of assistance. This can include anything from help with personal hygiene to managing finances. An adult does not need to be currently receiving these services to be considered to have needs.
- They are experiencing or are at risk of abuse or neglect: The harm can be occurring now or there is a strong possibility it will in the future. This includes various forms of mistreatment, from financial exploitation to self-neglect.
- They are unable to protect themselves: This is the critical third leg of the criteria. As a result of their care and support needs, the person lacks the capacity or ability to defend themselves against the abuse or neglect, or the risk of it.
Identifying Adults with Care and Support Needs
Many different groups of adults may have care and support needs that put them at risk. These can include:
- Elderly and frail individuals: Those with ill-health, physical disability, or cognitive impairment, such as dementia.
- People with learning disabilities: Individuals who may have difficulty communicating or understanding complex situations.
- Individuals with physical or sensory impairments: This includes people who are deaf, blind, or have mobility issues.
- People with mental health needs: This includes those with conditions like schizophrenia, severe anxiety, or personality disorders.
- Long-term illness or chronic condition sufferers: Those with illnesses like cancer, diabetes, or motor neurone disease.
- Substance or alcohol misusers: Individuals whose dependency on substances may impair their ability to protect themselves.
- Carers: In some cases, a person who is a carer themselves may be subject to abuse.
- Individuals with fluctuating or diminished mental capacity: The Mental Capacity Act 2005 provides a framework for assessing whether someone can make a specific decision for themselves at a particular time. A person is assumed to have capacity unless proven otherwise.
Recognizing the Signs of Abuse and Neglect
Being able to spot the warning signs is a crucial first step in safeguarding. Abuse and neglect can manifest in various ways and often do not present a single, obvious indicator. Some signs are physical, while others are behavioural or financial.
- Physical Abuse: Unexplained bruises, welts, broken bones, or burn marks. Signs of restraint, inappropriate use of medication, or frequent injuries.
- Financial Abuse: Sudden and unexplained changes in bank accounts, disappearance of valuable possessions, or unpaid bills despite adequate funds. Forged signatures on financial documents or control exerted over the adult's finances.
- Psychological/Emotional Abuse: Verbal threats, intimidation, humiliation, or treating the person like a child. The adult may appear withdrawn, agitated, or emotionally distressed. They might exhibit unusual behaviours like rocking or biting.
- Neglect (by others): Poor personal hygiene, soiled clothing or bedding, or pressure sores. The person may show signs of malnutrition, dehydration, or have untreated medical problems. Living conditions may be unsafe or unsanitary.
- Self-Neglect: When an adult neglects their own needs, including personal hygiene, health, or living conditions. This can manifest as hoarding, extreme filth, or a refusal to take life-saving medication.
- Sexual Abuse: Unexplained venereal disease, bruising around genitals or breasts, torn undergarments, or a sudden change in demeanor around a particular person.
- Modern Slavery: Isolation, malnutrition, signs of physical abuse, or being under the control of another person.
Comparing Institutional vs. Domestic Abuse
| Feature | Domestic Abuse | Institutional Abuse |
|---|---|---|
| Location | The adult's own home, or the home of a family member or caregiver. | A hospital, nursing home, assisted-living facility, or residential care setting. |
| Perpetrator | Often a family member, spouse, partner, or close friend. | A member of staff, such as a care worker, nurse, or manager. |
| Type of Abuse | Any form, but may be more hidden and isolated, often involving a single perpetrator or family dynamic. | Can range from one-off incidents to systemic issues, such as poor care practice, inadequate staffing, or a lack of individualised care. |
| Reporting | May be challenging due to emotional bonds or fear of retaliation. The adult may be isolated from external contact. | More complex, as it can involve official policies or poor practices within an organisation. Whistleblowing policies should be in place. |
How to Respond to a Safeguarding Concern
When you suspect abuse, it is crucial to take appropriate action. Your role is not to investigate but to report your concerns to the correct authorities. Remember these key steps:
- Report to the right place: Depending on the severity and context, this could be Adult Protective Services (APS), the local council's social services, or the police if it is an emergency or a crime has been committed. In the UK, it is advisable to contact the local authority's safeguarding adults team.
- Provide clear, factual information: Note down what you observed, including dates, times, and specific details. Be prepared to provide contact information for the adult at risk and the alleged abuser, if known. Describe the harm, the risk of harm, and the adult's needs.
- Do not confront the abuser: This could put you or the adult at further risk. Leave the investigation to the trained professionals.
- Listen to the adult: If possible, listen to the person's wishes. While their capacity to make decisions will be assessed, their views should be considered and respected as much as possible.
- Confidentiality: Most reports can be made anonymously, but giving your name allows authorities to contact you for further information if needed. Information is only shared on a 'need-to-know' basis to protect the adult at risk.
Conclusion: Everyone's Role in Protection
Safeguarding is everyone's responsibility, not just professionals. From recognizing the early signs of self-neglect to reporting suspicions of financial exploitation, public awareness and decisive action are essential. Adults with care and support needs have the right to live safely, and by understanding who needs safeguarding as an adult, we can all contribute to a safer, more respectful community. For further reading on the legal aspects, a good resource is the full text of the Care Act 2014 in the UK, which sets the legal framework for adult safeguarding.
Working together—from individuals to agencies—creates a safety net that protects those who need it most. Never hesitate to report a concern; your intervention could be life-changing.
