RCGP Safeguarding toolkit

Central to adult safeguarding legislation and policy across the UK is the concept of whether an adult is ‘an adult at risk of harm/adult in need of protection’ (in some legislation and policy, ‘adult at risk’ is used instead).

The first step in determining whether an adult is ‘an adult at risk of harm/adult in need of protection’ is understanding whether the adult is at risk of, or is currently, experiencing abuse.

The second step is understanding whether the adult has additional needs/care and support needs. These are personal or life circumstances which may be permanent, transitional or fluctuate over time. ‘Care and support’ and other similar terms are used to describe the help some adults need to live as well as possible with any illness or disability they may have The help needed can be practical, financial or emotional or can be a mixture of all three.

Examples of care and support needs are:

• physical disability
• learning disability
• mental health needs
• physical health needs
• long or short term illness
• alcohol or substances misuse/dependence
• elderly frail.

The third step is to understand whether the adult with care and support needs is able to protect themselves from abuse, due to their care and support needs. This includes being able to protect their own wellbeing, property, assets, rights or other interests.

Only adults at risk of harm/adults in need of protection are eligible for consideration of adult safeguarding referrals following local multi-agency processes.

Of course there can be adults who are experiencing abuse who are not adults at risk of harm/adults in need of protection. An example of this is an adult with no care and support needs who is experiencing domestic abuse in their relationship. In this situation, and any situation where an adult is experiencing abuse but is not an ‘adult at risk of harm’, there is still a lot of help and support that can be given even though an adult safeguarding referral is not indicated. Examples of support that can be given include:

• consideration of what help and support the adult currently needs and wishes
• signposting to local support agencies such as domestic abuse agencies
• provision of general practice care, or appropriate secondary care referrals, for any physical or mental health difficulties
• consideration given to any others who might be at risk in this situation such as children or ‘adults at risk of harm’. Safeguarding referrals may be necessary to protect others
• consideration given to other agency involvement such as referral to MARAC (if there are concerns about high risk domestic abuse (see section on domestic abuse for further information)
• continue to monitor the situation as risk can change over time, as can the adult’s ability to protect themselves.

It is important to understand, however, that just because an individual is not eligible for a safeguarding response under safeguarding legislation, there are always ways to support people.