Adults Policies & Guidance

This guidance seeks to provide front line professionals with a framework to facilitate effective working with adults who are at risk of significant harm due to their complex needs, and the risks cannot effectively be managed via other processes or interventions, such as section 9 care and support assessment or section 42, safeguarding enquiry (Care Act). The CARM guidance is used when the adult declines to engage with services and yet the risk is significant and an individual agency procedures have not been able to resolve the problem(s).

Complex Adult Risk Management (Full Policy)

The Deprivation of Liberty Safeguards (DoLS), which apply only in England and Wales, are an amendment to the Mental Capacity Act 2005. The DoLS under the MCA allows restraint and restrictions that amount to a deprivation of liberty to be used in hospitals and care homes – but only if they are in a person’s best interests. To deprive a person of their liberty, care homes and hospitals must request standard authorisation from a local authority.

Additional resources are available on the Adult Safeguarding Information pages

HSAB Think Fire Risk

This guidance supports good practice in information sharing by offering clarity on when and how information can be shared legally and professionally, in order to achieve improved outcomes. This guidance will be especially useful to support early intervention and prevention work where decision about information sharing may be less clear then in safeguarding situations

The legal framework provided by the Mental Capacity Act 2005 is supported by this Code of Practice (the code), which provides guidance and information about how the Act works in practice.  The Code has statutory force, which means that certain categories of people have a legal duty to have a regard to it when working with or caring for adults who may lack capacity to make decision for themselves

Additional resources are available on the Adult Safeguarding Information pages

Herefordshire Safeguarding Adult Boards protocol for responding to allegations and concerns against people working with adults with care and support needs.

Positions of Trust Toolkit 

Professional Curiosity Learning Briefing - February 2023.

Reviews have routinely highlighted the importance of professionals challenging decisions to ensure the best outcomes for the adults they are working with. In some cases, professionals may believe that they have challenged a decision; but the process of the review has evidenced that the challenge was not clear or not perceived as such.

The purpose of this policy is to explain what to do when a professional has a concern or a professional difference with another agency decision or action and how to respond to that challenge

For guidance and forms on Safeguarding Adult Reviews, see the Safeguarding Adult Reviews pages

HSAB’s Multi-agency Self Neglect and Hoarding Policy and Practice Guidance provides guidance for practitioners whose role may bring them into contact with individuals, who persistently self-neglect or engage in hoarding behaviours that place them at risk of significant harm.

Self Neglect and Hoarding Policy and Practice Guidance

Self-Neglect and Hoarding - HSAB Learning Briefing

Presentation slides on Self-Neglect, delivered at the Practitioner Forum in March 2023 – HSAB Self-Neglect Presentation_March 2023

A recording of the presentation above (28 minutes) can be viewed here

Self-neglect can be a complex and challenging issue for practitioners to address, not least because of difficulties in striking a balance between respecting a person’s right to autonomy and fulfilling the statutory duty of care to protect their health and wellbeing.

Self-neglect typically features a triad of behaviours –

1. Lack of self-care to an extent that it threatens their personal health and safety.
2. Failure to attend to their living environment to the extent that it becomes hazardous to self or others e.g. fire risk, infestation, lack of sanitation.
3. Failure to seek help or access services to meet their critical health and social care needs.

The person may present with a compulsion to accumulate belongings or animals. The term hoarding should be used sensitively as the person may place a high emotional value on these items.

You may also be interested in: SCIE self-neglect at a glance

Trauma-Informed Practice and ACES Briefing

To learn more, check www.herefordshirecpd.co.uk for training opportunities, or check out these resources:

E-learning: ACEs (acesonlinelearning.com)

Adverse Childhood Experiences (ACEs) – YouTube

An Introduction to Adverse Childhood Experiences (ACEs) and Trauma-Informed Practice – West Midlands Violence Reduction Partnership (westmidlands-vrp.org)

Working definition of trauma-informed practice – GOV.UK (www.gov.uk)

Learning resources & events on trauma | Research in Practice

Introduction – Trauma-informed practice: toolkit – gov.scot (www.gov.scot)

Brené Brown on Empathy – YouTube

All the key partners of Herefordshire Safeguarding Adults Board (HSAB) have agreed that the West Midlands regional policy for safeguarding adults should govern all safeguarding work with adults at risk in Herefordshire. The policy, therefore, applies to all professionals and agencies working with adults at risk in the county.

It is important that all staff members and volunteers are vigilant in order to keep children as well as adults who access support safe. We must be alert to the potential for abuse and neglect and speak up.