Multi-Agency Protocol and Guidance and Local Processes
Supporting Adults who Self-Neglect
This interagency protocol has been developed and co-produced by partners across Slough Safeguarding Partnership.
Self Neglect Protocol and Practice Guidance
The aim of the protocol is to serve as a guide and toolkit for professionals and agencies to be more consistent in the way in which we jointly identify, assess and coordinate support and reduce risks that arise for adults who self-neglect.
This guidance should be read in conjunction with the Slough Hoarding Protocol and the Slough framework for multi-agency working with those who do not access services.
This guidance has also been developed in line with the Berkshire Safeguarding Adults Policies and Procedures
www.berkshiresafeguardingadults.co.uk/
The section on self-neglect can be found at Slough Procedures and Appendixes (berkshiresafeguardingadults.co.uk)
A friends and family leaflet
Slough Safeguarding Partnership has worked with SBC Co-Production network to produce a simplified leaflet for friends and family members to help people who may be self neglecting. The leaflet can be found here.
This leaflet aims to help friends and family members to identify if someone they care about may be self neglecting, and to know what to do to help them. It also contains details of helpful organisations and a contact for Slough Adult Care Services.
This leaflet is based on the Self Neglect Protocol.
Making Safeguarding personal
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Safeguarding Adult Reviews (SARs) and Guidance
SARs including new guidance
The partnership has a legal duty to carry out a Safeguarding Adults Review (SAR) when there is reasonable cause for concern about how agencies worked together to safeguard an adult who has died, and abuse or neglect is suspected to be a factor in their death, or if the adult is still alive and the SAB knows or suspects that the adult experienced serious abuse or neglect.
The aim of a SAR is for all agencies to learn lessons about the way they safeguard adults at risk and prevent such tragedies happening in the future. They will make sure that partners get the full picture of what needs to improve and also what went well, so that all organisations involved can learn.
All agencies represented on the Safeguarding Adult Review Panel have a responsibility to disseminate learning in their organisation to ensure practice improvement.
the SARP reviews the impact of learning from very Safeguarding Adult Review 6 months and one year following completion.
All learning informs the multi-agency learning and development programme and also priority setting for the safeguarding partnership strategic plan.
Safeguarding Adults Reviews and Briefing Notes produced by Slough Safeguarding Partners and by neighbouring authorities are published below:
2023
2022
2020
DHR
See the Safer Slough Partnership web pages for Domestic Homicide Reviews.
Briefing/Practice Notes
Briefing Notes for cases that did not meet the threshold for a SAR but highlighted good practice and/or additional learning
Mr C Briefing note. Complex case involving substance misuse
Practice Note: Learning from reviews
Efficient information sharing does not always result in effective communication. See the briefing note below to find out more about why.
Efficient Information Sharing is not the same as effective communication
SARs from Neighbouring Authorities in Berkshire
National SARs
Contact us if you have any comments or queries.
The documents below will be reviewed in January 2025
SARP TOR September 2023
GUIDANCE ON SAFEGUARDING REVIEWS
Very often, Safeguarding Adult Reviews are conducting at the same time as other processes, such as criminal investigations and the Coroner's inquest.
Click on this link for the National guidance on the SAR and Coronial processes October 24
USE THIS FORM if you feel a case should be considered by the group. Always consult with your representative on the group before doing so.
Scoping report template is used when providing information to the group about a case, for consideration for review.
Guidance on scoping reports: provides information on how to complete the template above.
Decision making template used for meetings to decide on whether a case meets the criteria for a formal Safeguarding Adult Review.
Contact the safeguarding partnership team if you have any queries.
Learning from Reviews
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Multi-Agency Risk Tool for Adults
Recent SAR’s have highlighted the need to address concerns for adults, including 17 - 25 year olds transitioning from support from Slough Children First who do not access services for a number of reasons, including lack of perceived appropriate services, personal choice, lack of awareness.
A Multi agency risk tool (MART) has been developed to assist in support for these individuals and is available to download here
The Multi agency Risk Framework has been reviewed and can be found on this link Multi Agency Risk Framework
MART training is available as a 2 hour virtual seminar via Microsoft Teams. The Training can be accessed via the events section of the website, it is recommended to attend the training before using the tool.
I would recommend that this is viewed and then discussed in a team meeting or at least with a line manager to embed the learning and to discuss the best use of the tool for your clients/patients. You will also find Case studies below to help with the learning as mentioned in the video.
Multi Agency Risk Tool Case Studies can be viewed here
Case Study 1
Case Study 2
Exploitation of Adults / Modern Slavery
Modern slavery is a serious crime. It encompasses slavery, servitude, and forced or compulsory labour and human trafficking. Modern slavery victims can often face more than one type of abuse and slavery, for example if they are sold to another trafficker and then forced into another form of exploitation. A person is trafficked if they are brought to (or moved around) a country by others who threaten, frighten, hurt and force them to do work or other things they don’t want to do. Victims of this type of abuse can be exploited in their own home. A summary of exploitation in the home (Cuckooing) can be found here
Specified public authorities have a duty to notify the Home Office about any potential victims of modern slavery they encounter in England and Wales.
Tea Time Training Slides
The following tea time slides are aimed to take no more than 10 -15 mins!! So grab yourself a cuppa and catch up on all the latest Modern Slavery information and resources below:
The University of Nottingham have published research about Exploitation of Adults with Cognitive Impairment in England. looking at the impact of cognitive impairment on its impact on verbality to exploitation.
National Referral Mechanism(NRM) Changes April 2025
Changes to the National Referral Mechanism can into force at the end of April 2025, and the Home office have issued the following guidance:
First Responder guide for England and Wales, provides first responders with details of the NRM process.
First Responder Offline prompt sheet provides the questions that first responders will be guided to ask during an interview.
The Home Office has produced two high level e-learning modules for use by all first responders.
The First Responder e-learning training covers: 20-056 - Home Office - Modern slavery
- indicators of modern slavery
- what to do when you encounter a potential victim of modern slavery
The Child Victims of Modern Slavery e-learning covers: Modern Slavery: Child Focus
- child-specific indicators of modern slavery
- forms of exploitation that are particularly prevalent.
- safeguarding and NRM referral processes
- specific knowledge required to respond to child cases of modern slavery.
Useful links:
Modern slavery information for workers in Health, Housing and Education.
Summary of support available in Slough
Modern Slavery Helpline. Call 08000 121 700 to get help, report a suspicion or get advice.
How to report modern slavery
Guidance for Practitioners to Support Adults, Children or Young People at Risk of Suicide Ideation
We are aware that mental health concerns have risen since the pandemic which has led to an increase in suicide ideation in the adult population. Many different practitioners may come into contact with clients who are considering or threatening to take their own life which is a very difficult situation for a practitioner who does not normally deal with severe mental health concerns.
This area of concern was also highlighted last year when a case was considered by the Safeguarding Adults Review Panel (SARP) which involved a carer faced with a client who was stating that she planned to end her life. The SARP considered that it was important for practitioners to have some guidance regarding this extremely difficult situation.
Slough Safeguarding Partnership has worked with Public Health Colleagues and Mental Health Practitioners to develop guidance which includes support for practitioners working with adults and children and young people who are at risk of suicide ideation. Click on the link below to access the guidance.
Guidance for Practitioners to support adults, children or young people at risk of suicide ideation
5-Minute Facts
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5-minute facts Further
National Practice Guidance
Access to adults suspected to be at risk or abuse or neglect
This guide aims to clarify the different types of legal powers that can be called upon when access to an adult who is suspected to be at risk of neglect or abuse is required but, for whatever reason, is being denied or restricted.
Berkshire Safeguarding Adults Policy and Procedures
The purpose of the Berkshire Safeguarding Adults Policy and Procedures is to support staff to respond appropriately to all concerns of abuse or neglect they may encounter, providing a consistent response across the county. They are updated regularly and practitioners are encouraged to refer to the online version rather than download and retain a copy.
Domestic abuse
A considerable proportion of safeguarding adults work relates to the abuse or neglect of people with care and support needs who are living in their own homes. Domestic abuse can take many other forms and be perpetrated by a range of people. Adult Safeguarding and Domestic Abuse This guide sets out the overlaps between safeguarding and domestic abuse and the approaches and legal frameworks for domestic abuse that can be used in the safeguarding context.
Female Genital Mutilation
FGM is illegal in the UK. It is also illegal to take a British national or permanent resident abroad for FGM or to help someone trying to do this. The Berkshire Child Protection Procedures includes a clear pathway on what to do if you suspect FGM.
Indicators of Abuse
Some adults at risk may reveal abuse themselves by talking about or drawing attention to physical signs, or – where verbal communication is limited or absent – displaying certain actions or gestures. Practitioners and carers need to be aware of these signs and understand what they may mean. This Good practice guide by SCIE lists possible indicators and examples of behaviour to help practitioners identify abuse.
Making Safeguarding Personal
Adult safeguarding arrangements are there to protect individuals. Making safeguarding personal means it should be person-led and outcome-focused. It engages the person in a conversation about how best to respond to their safeguarding situation in a way that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety. The Making Safeguarding Personal Toolkit sets out models, theories and approaches that safeguarding practitioners need to be aware of. It can be used as a practitioner guide for pointers on how to respond to individual cases, or as a starting point resource for service development. It has been designed as a resource that will develop over time and allow updates and amendments to be made as development takes place or innovative and effective practice comes to light.
Mental Capacity Act
The Mental Capacity Act (MCA) is designed to protect and empower individuals who may lack the mental capacity to make their own decisions about their care and treatment. It is a law that applies to individuals aged 16 and over. There is a Mental Capacity Act Code of Practice 2005.
See also Deprivation of Liberty Safeguards.
Modern slavery and human trafficking
Modern slavery is a serious crime. It encompasses slavery, servitude, and forced or compulsory labour and human trafficking. Modern slavery victims can often face more than one type of abuse and slavery, for example if they are sold to another trafficker and then forced into another form of exploitation. A person is trafficked if they are brought to (or moved around) a country by others who threaten, frighten, hurt and force them to do work or other things they don’t want to do. Specified public authorities have a duty to notify the Home Office about any potential victims of modern slavery they encounter in England and Wales.
Useful links:
Modern Slavery Helpline. Call 08000 121 700 to get help, report a suspicion or get advice.
How to report modern slavery
Useful Links
If you are worried about an adult at risk of abuse or neglect
Call 01753 475111 or email safeguarding.adults@slough.gov.uk.
Safeguarding Training video
The Safeguarding Partnership has produced a video about Safeguarding basics during COVID-19. Click on this Link to access.
National helplines
Samaritans: 116 123
Domestic Violence Hotline: 0808 2000 247
Mind: 0300 123 3393
Age UK: 0800 169 6565
Thinking of volunteering? Click on this link: https://sloughcvs.org/
Video for those volunteering in Slough on THIS LINK
Video for those volunteering and new to safeguarding on THIS LINK
Good Safeguarding Practice
Access to adults suspected to be at risk or abuse or neglect
This guide aims to clarify the different types of legal powers that can be called upon when access to an adult who is suspected to be at risk of neglect or abuse is required but, for whatever reason, is being denied or restricted.
Berkshire Safeguarding Adults Policy and Procedures
The purpose of the Berkshire Safeguarding Adults Policy and Procedures is to support staff to respond appropriately to all concerns of abuse or neglect they may encounter, providing a consistent response across the county. They are updated regularly and practitioners are encouraged to refer to the online version rather than download and retain a copy.
Domestic abuse
A considerable proportion of safeguarding adults work relates to the abuse or neglect of people with care and support needs who are living in their own homes. Domestic abuse can take many other forms and be perpetrated by a range of people. Adult Safeguarding and Domestic Abuse This guide sets out the overlaps between safeguarding and domestic abuse and the approaches and legal frameworks for domestic abuse that can be used in the safeguarding context.
Female Genital Mutilation
FGM is illegal in the UK. It is also illegal to take a British national or permanent resident abroad for FGM or to help someone trying to do this. The Berkshire Child Protection Procedures includes a clear pathway on what to do if you suspect FGM.
Indicators of Abuse
Some adults at risk may reveal abuse themselves by talking about or drawing attention to physical signs, or – where verbal communication is limited or absent – displaying certain actions or gestures. Practitioners and carers need to be aware of these signs and understand what they may mean. This Good practice guide by SCIE lists possible indicators and examples of behaviour to help practitioners identify abuse.
Making Safeguarding Personal
Adult safeguarding arrangements are there to protect individuals. Making safeguarding personal means it should be person-led and outcome-focused. It engages the person in a conversation about how best to respond to their safeguarding situation in a way that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety. The Making Safeguarding Personal Toolkit sets out models, theories and approaches that safeguarding practitioners need to be aware of. It can be used as a practitioner guide for pointers on how to respond to individual cases, or as a starting point resource for service development. It has been designed as a resource that will develop over time and allow updates and amendments to be made as development takes place or innovative and effective practice comes to light.
Mental Capacity Act
The Mental Capacity Act (MCA) is designed to protect and empower individuals who may lack the mental capacity to make their own decisions about their care and treatment. It is a law that applies to individuals aged 16 and over. There is a Mental Capacity Act Code of Practice 2005.
See also Deprivation of Liberty Safeguards.
Modern slavery and human trafficking
Modern slavery is a serious crime. It encompasses slavery, servitude, and forced or compulsory labour and human trafficking. Modern slavery victims can often face more than one type of abuse and slavery, for example if they are sold to another trafficker and then forced into another form of exploitation. A person is trafficked if they are brought to (or moved around) a country by others who threaten, frighten, hurt and force them to do work or other things they don’t want to do. Specified public authorities have a duty to notify the Home Office about any potential victims of modern slavery they encounter in England and Wales.
Useful links:
Modern Slavery Helpline. Call 08000 121 700 to get help, report a suspicion or get advice.
How to report modern slavery
Deprivation of Liberty Standards (DoLS)
The Deprivation of Liberty Safeguards (DOLS) in conjunction with the Mental Capacity Act 2005 were introduced in 2009 to provide legal protection for vulnerable people who are or may become deprived of their liberty in their best interests.
The safeguards apply to people aged 18 or over in hospitals and care homes throughout England and Wales who have a mental disorder and lack capacity to consent to care or treatment. Deprivation of Liberty Safeguards does not apply to people who are detained under the Mental Health Act 1983.
There is no set definition for what constitutes a deprivation of liberty. In each case, the following factors would need to be considered:
- Was restraint (including sedation) used to admit the person to an institution?
- What level of control do staff exercise over the care and movement of a person?
- What level of support does the person need from staff?
- Has a decision been made to not allow the person into the care of others or to live elsewhere?
- Have carers / next of kin requested for the person to be discharged into their care and this request has been rejected?
- Is the person able to have access to their friends / family / carers?
- Is the person under continuous supervision from staff?
Hospitals and care homes have a duty to identify anyone who could be at risk of a deprivation of liberty.
How to apply for a deprivation of liberty authorisation:
Slough Borough Council has one single point of entry for receiving all requests for a deprivation of liberty authorisation. The safeguarding team will co-ordinate all requests.
Once the managing authority (care home or hospital) has determined if an urgent or standard authorisation is required, they must complete the relevant form and contact the DoLS administrator:
Useful guides:
Useful Links
Access to adults suspected to be at risk or abuse or neglect
Age UK
Association of Directors of Adult Social Services (ADASS) policy network on safeguarding adults
Care Act 2014 Fact Sheets and Care and Support Statutory Guidance
Care Quality Commission.
Deprivation of Liberty Safeguards (DoLS)
Disclosure and Barring Service
Domestic Abuse
Female Genital Mutilation
Forced Marriage
Healthwatch Slough
Making Safeguarding Personal
MCA and unwise decisions https://www.communitycare.co.uk/2019/06/28/misinterpretation-unwise-decisions-principle-illustrates-value-legal-
literacy-social-workers/
Mental Capacity Act 2005
Modern Slavery Helpline.
How to report modern slavery
Office of the Public Guardian
Police and Crime Commissioner
Prevent Duty Guidance (Gov.uk)
Skills for Care
Social Care Institute for Excellence (SCIE)
Women's Aid
Human Stories Self Neglect
Briefing Note SAR Lead Reviewers July 2024
Cuckooing SAR Katie
Interface between SAR and Coronial Processes
National SAR Analysis 25.06.2024
NHS inquiries PQ Ryan
Executive Mental Capacity
What is Executive mental Capacity?
In the context of the Mental Capacity Act, Executive Mental Capacity can be linked to the person’s ability “to understand the relevant information” at the time it is required, and the ability to “use” the relevant information to make the decision at the time it is required.
You may be concerned about someone’s Executive Mental Capacity if they:
- repeatedly makes unwise decisions that put them at significant risk of harm or exploitation
- make a particular unwise decision that is obviously irrational or out of character
Following a number of Safeguarding Adult Reviews in Slough, the Safeguarding Partners have collaborated to develop this Resource Pack to help practitioners in all agencies to consider Executive Functioning within Mental Capacity when working with clients/patients with challenging situations and risky behaviour.