Lambeth Safeguarding Adults Board

What is safeguarding adults?

Safeguarding means protecting someone’s right to live in safety, free from abuse and neglect.

An adult at risk of abuse or neglect is someone who has care and support needs and is therefore unable to protect themselves from either the risk of, or the experience of, abuse or neglect.

Adult abuse or neglect is not acceptable. If you or someone you know is at risk of being abused or neglected, or experiencing abuse or neglect, tell someone.

Don’t ignore it.

Don’t assume that someone else is doing something about the situation. Tell us about it so that we can help.

How we help:

We aim to stop abuse or neglect wherever possible, prevent harm and reduce the risk of abuse or neglect to adults who need care and support.

To help us decide what to do, we'll always contact the adult at risk or experiencing abuse or neglect. What they want to happen is very important. We'll try to talk to them first, even if it is difficult for them to communicate what has happened.

If the person has substantial difficulty with being involved, then we may ask for an independent advocate to help them understand what is happening and to help them express their views.

The person telling us about the possible abuse or neglect can remain anonymous.

Please report safeguarding concerns here - Report neglect or abuse of an adult | Lambeth Council

What is abuse?

Physical abuse - includes hitting, kicking, misuse of medication, inappropriate sanctions or unlawful / inappropriate restraint.
The following list may be indicators of physical abuse:

Unexplained bruising - in well protected areas or soft parts of the body
Bruising in different stages of healing
Unexplained burns - unusual location / type
Unexplained fractures to any part of the body
Unexplained lacerations or abrasions
Slap, kick, punch or finger marks
Injury shape similar to an object
Untreated medical problems
Weight loss due to malnutrition or dehydration

Sexual abuse - includes rape and sexual assault or sexual acts to which the adult at risk has not consented, or could not consent or was pressured into consenting.
The following list may be indicators of sexual abuse:

Sudden change in behaviour
Sudden onset of confusion
Incontinence
Withdrawal
Overt sexual behaviour / language by the adult
Self-inflicted injury
Disturbed sleep pattern / poor concentration
Difficulty in walking
Torn, stained underwear
Love bites
Pain or itching, bruising or bleeding in the genital area
Frequent infection
Sexually transmitted disease / urinary tract / vaginal infection
Bruising to upper thighs and arms
Severe upset or agitation when being bathed etc.
Pregnancy in a person unable to consent

Domestic violence and abuse includes any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been, intimate partners or family members regardless of gender or sexuality. It also includes so called 'honour’ -based violence, female genital mutilation and forced marriage.
Coercive or controlling behaviour is a core part of domestic violence and can include:

acts of assault, threats, humiliation and intimidation
harming, punishing, or frightening the person
isolating the person from sources of support
exploitation of resources or money
preventing the person from escaping abuse
regulating everyday behaviour.

The following list is possible indicators of domestic abuse:

Low self-esteem
Feeling that the abuse is their fault when it is not
Physical evidence of violence such as bruising, cuts, broken bones
Verbal abuse and humiliation in front of others
Fear of outside intervention
Damage to home or property
Isolation – not seeing friends and family
Limited access to money

Financial abuse - includes theft, fraud, exploitation, pressure in connection with financial matters, or the misuse of someone else's finances.
The following list is possible indicators of financial abuse:

Sudden inability to pay bills
Sudden withdrawal of money from an account
Person lacks belongings that they can clearly afford
Lack of receptivity by the persons relatives to necessary expenditure
Power of attorney obtained when the person is unable to understand what they are signing
Extraordinary interest by family members in the vulnerable adults assets
Recent change of deeds to the house
Carers main interest is financial with little regard for the health and welfare of the vulnerable adult
The person managing the finances is evasive and uncooperative
Reluctance to accept care services
Purchase of items that the individual does not require or use
Personal items going missing
Unreasonable or inappropriate gifts

Psychological abuse (also sometimes referred to as emotional abuse) includes threats of harm or abandonment, humiliation, blaming, controlling, coercion, harassment, verbal abuse.
The following may be indicators of psychological abuse:

Ambivalence about carer
Fearfulness, avoiding eye contact, flinching on approach
Deference
Insomnia or need for excessive sleep
Change in appetite
Unusual weight loss / gain
Tearfulness
Unexplained paranoia
Low self esteem
Confusion, agitation
Coercion
Possible violation of human and civil rights
Distress caused by being locked in a home or car etc.
Isolation - no visitors or phone calls allowed
Inappropriate clothing
Sensory deprivation
Restricted access to hygiene facilities
Lack of personal respect
Lack of recognition of individuals rights
Carer does not offer personal hygiene, medical care, regular food/drinks
Use of furniture to restrict movement

Neglect or acts of omission - - includes ignoring medical or physical care needs, and the withholding of necessities, such as medication and adequate nutrition.
The following may be indicators of neglect:

Poor environmental conditions
Inadequate heating and lighting
Poor physical condition of the vulnerable adult
Persons clothing is ill fitting, unclean and in poor condition
Malnutrition
Failure to give prescribed medication properly
Failure to provide appropriate privacy and dignity
Inconsistent or reluctant contact with health and social care agencies
Isolation - denying access to callers or visitors

Discriminatory abuse includes abuse such as harassment, slurs or hate crime based on a person's race, sex, disability, faith, sexual orientation, or age.

Discriminatory abuse can be:

derogatory comments
harassment
being made to move to a different resource/ service based on age
being denied medical treatment on grounds of age or mental health
not providing access
The following list may be indicators of discriminatory abuse:
The person appears withdrawn and isolated
Expressions of anger, frustration, fear or anxiety
The support on offer does not take account of the person’s individual needs in terms of a protected characteristic

Organisational abuse- includes neglect and poor care practice within an institution or specific care setting such as a hospital or care home, for example, or in relation to care provided in one’s own home. This may range from one off incidents to on-going ill-treatment.

It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation.

The following list may be indicators of organisational abuse:

No flexibility in bed time routine and/or deliberate waking
People left on the commode or toilet for long periods of time
Inappropriate care of possessions, clothing and living area
Lack of personal clothes and belongings
Un-homely or stark living environments
Deprived environmental conditions and lack of stimulation
Inappropriate use of medical procedures e.g. enemas, catheterisation
'Batch care' - lack of individual care programmes
Illegal confinement or restrictions
Inappropriate use of power or control
People referred to, or spoken to with disrespect
Inflexible services based, on convenience of the provider rather than the person receiving services
Inappropriate physical intervention
Service user removed from the home or establishment, without discussion with other appropriate people or agencies, because staff are unable to manage the behaviours

Modern Slavery - includes human trafficking, forced labour and domestic servitude.
The following list may be indicators of modern slavery:

Physical appearance: signs of physical or psychological abuse, look malnourished or unkempt, or appear withdrawn
Isolation: person rarely allowed to travel on their own, seem under the control, influence of others, rarely interact or appear unfamiliar with their neighbourhood or where they work
Poor living conditions: person may be living in dirty, cramped or overcrowded accommodation, and / or living and working at the same address
Few or no personal affects: Person may have no identification documents, have few personal possessions and always wear the same clothes day in day out. What clothes they do wear may not be suitable for their work.
Restricted freedom of movement: Person have little opportunity to move freely and may have had their travel documents retained, e.g. passports
Unusual travel times: Person may be dropped off / collected for work on a regular basis either very early or late at night.
Reluctant to seek help: Person may avoid eye contact, appear frightened or hesitant to talk to strangers and fear law enforcers for many reasons, such as not knowing who to trust or where to get help, fear of deportation, fear of violence to them or their family.

Self-neglect - includes situations where a person is declining support with their care needs, hygiene, health or their environment, and this is having a significant impact on their overall wellbeing.
The following list may be indicators of Indicators of self-neglect:

Very poor personal hygiene
Unkempt appearance
Lack of essential food, clothing or shelter
Malnutrition and/or dehydration
Living in squalid or unsanitary conditions
Neglecting household maintenance
Hoarding
Collecting a large number of animals in inappropriate conditions
Non-compliance with health or care services
Inability or unwillingness to take medication or treat illness or injury

How to report a concern

In an emergency you should always call the Police on 999. Alternatively if it is not an emergency you can call Police on 101.

If you think an adult is at risk of being neglected, abused or someone is neglecting or abusing you, please contact Lambeth’s Adult Social Care.

Do it online

Please use our Safeguarding Adults online form (quickest and most secure way to raise concerns).

Do it by phone

Tel: 020 7926 5555
(9am to 5pm. Monday to Friday)

Outside office hours (This includes public holidays)
Tel: 020 7926 5555

Report elsewhere

If you would prefer to contact someone other than Lambeth Council, there are charities that can offer advice and support:

Hourglass can be contacted on their Helpline on 080 8808 8141 or by email at enquires@wearehourglass.org
Respond can be contacted on their Helpline on 0808 808 0700 or by email at admin@respond.org.uk

You can also talk to other professionals, such as your GP or nurse, a police officer or your key worker. They will help you to report your concerns.

Who can you talk to if you have concerns?

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What happens after a concern is reported

After talking with the person at risk of, or experiencing abuse or neglect, we'll then make enquiries about the circumstances of the abuse or neglect.

We may talk to other people, such as family members, staff, GPs, friends and possibly the police. If the police tell us that a crime has been committed, then they may investigate what has happened.

We will support the adult at risk to help them decide what they want to happen and then concentrate on improving the situation for that person, and address what has caused the abuse or neglect.

If we think that you or anyone you have told us about is at immediate risk of harm we will act very quickly to protect you or the adult at risk of abuse or neglect.

To find out more about what happens after a concern is reported, check out our brief guide on what to expect.

What to expect when you raise a safeguarding concern

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What if you're not happy?

Central to Safeguarding Adults, is the person’s wishes. If you feel that the adult at risk is not being held at the centre of the enquiry or you are unhappy with the way the enquiry is being managed, you should in the first instance speak with the Safeguarding Adults Manager for the case.

If at any point of the Safeguarding Adults process, you would like to discuss your experience or give feedback, there is a local independent organisation called Healthwatch. They work to ensure that the adult safeguarding process is a positive experience for you.

They can also signpost you to other resources and support in the community dependent on your needs.

If you would like to talk to someone from Healthwatch Lambeth, please call: 0207 095 5762

Give us feedback

Lambeth Adult Social Care

If you would like to give us feedback on your experiences of the Safeguarding Adults process, please feel free to email: safeguardingadults@lambeth.gov.uk

Lambeth Healthwatch

If you would like to discuss your safeguarding experience or give feedback to a local independent organisation, you can call Healthwatch on: 0207 095 5762 or email: info@healthwatchlambeth.org.uk

Or you can complete their feedback form via the 'Speak Up' section of Lambeth Healthwatch's website.