Please visit our dedicated family, friends, and carers webpage if you are concerned about the safety or wellbeing of an adult with care and support needs, or if you would just like to know more about adult safeguarding and the work of the Safeguarding Adults Board.
Version: 1
Published: November 2025
Review due: November 2028
Our sector learning briefing series has been produced to share learning from our reviews, including learning reviews and Safeguarding Adults Reviews.
Each sector learning briefing is aimed at a different area of the adult safeguarding sector and draws out particularly relevant learning from our published reviews. This is not to say that there isn’t wider learning to be taken from our reviews, but that the learning contained in these briefings is particularly pertinent to the sector.
These sector learning briefings are intended to be a concise exploration of key themes identified in our reviews. They will be updated with any new identified learning or themes, as needed.
This briefing includes learning from reviews published since 2021 and is intended for use by local authority staff.
It draws primarily on learning from the following published West Sussex reviews:
All staff working with adults with care and support needs should be aware of, and regularly referring to, the Sussex Safeguarding Adults Thresholds.
These thresholds are designed to support staff, partners, and providers to decide on whether to report a safeguarding concern for an adult with care and support needs. They are intended to support professional judgement, and to provide examples of when incidents may be ‘non-reportable’, ‘require consultation’, or are ‘reportable’.
We know from our reviews of the importance of timely and accurate reporting of safeguarding concerns, to support staff to provide the help you need, when you need it.
Make sure you’re up-to-date with your safeguarding thresholds knowledge. If, after referring to the safeguarding thresholds you are still unsure of whether a safeguarding referral is appropriate, please call 03302 228400 to speak with a social care practitioner in the Safeguarding Adults Hub.
When working with adults with care and support needs, and particularly those with multiple and compound needs, it is essential that you engage in multi-agency working.
This means working closely and well together with staff from the involved agencies. This will ensure that everybody involved in an adult’s care is aware of, and understands, each other’s work and views so that the adult has the best experience of a co-ordinated approach.
We have learned from our reviews that multi-agency working is important for effective risk assessment, capacity assessments, and care planning.
To support multi-agency working you should consider:
Self-neglect can describe a wide range of situations or behaviours experienced by a person. Each circumstance is unique.
It could be someone whose personal care or health is deteriorating due to a lack of attention, or where they are not maintaining their home environment for so long that it becomes unsafe to their health or the wellbeing of others.
We know from our reviews that staff do not always recognise self-neglect as a potential safeguarding issue, and so do not seek the appropriate support to manage it.
There are a range of explanations and contributing factors which may lead to a person self-neglecting, including:
In Sussex we have a five-step process to working with adults who are self-neglecting. These steps are set out in the Sussex Safeguarding Adults Policy and Procedures but are also relevant for self-neglect which sits outside of safeguarding processes.
The steps are:
The term professional or concerned curiosity, sometimes called respectful nosiness, is used to describe an in-depth interest in the adults you are working with by exploring and understanding what is happening, rather than making assumptions or accepting things at face value.
It requires skills of looking, listening, asking direct questions, and being able to hold difficult conversations. Nurturing concerned curiosity and challenge are a fundamental aspect of working together to keep adults safe from harm.
We’ve learned that staff need to be more professionally curious, and to ensure that they are making time to speak with adults alone, and away from the influence of family, friends, or carers.
Concerned curiosity is vital in helping to identify abuse and neglect in cases where it may be less obvious. This could be in a care home, where abuse practices may be hidden from visiting staff. It could also be in an adult’s own home, where they are not able to tell you about the abuse they are experiencing, as a result of domestic abuse or when a person is being coerced or controlled.
It is important that you make time and space to have a private conversation with the adult. This will provide them with a space where they are more likely to feel able to disclose abuse or neglect without repercussions from the perpetrators.
When conducted appropriately, information sharing is an essential mechanism to support the safeguarding of adults with care and support needs.
Sharing information within an agreed framework and in accordance with legislation helps to:
Our reviews have told us that improved information sharing between agencies is likely to lead to better outcomes for adults we work with.
The statutory guidance to the Care Act emphasises the need to share information about safeguarding concerns at an early stage. This is key in providing an effective response where there are emerging concerns about abuse or neglect. See our information sharing resources for more information.
Risk assessment is the process of working with an adult to maximise safety and to reduce future risk. Risk assessment should support positive risk management and promote empowerment and control.
It is an integral part of safeguarding, and staff need to adopt a flexible solution-focused approach to mitigating risk. To do this, measures should be reviewed regularly in response to the level and nature of the risk.
We know from our reviews that joint risk assessment and management plans can prompt earlier intervention by specialist services, such as pest control or deep cleaning services, and therefore better outcomes for the adult.
Cases involving significant risks often require a multi-agency approach, underpinned by clear and timely information-sharing and shared risk-assessing resulting in multi-agency risk management plans. These should be proportionate and focused on preventing, reducing, or eliminating the future risk of harm. Where risks specifically relate to self-neglect, you should refer to our learning resources about self-neglect, including the Sussex Self-Neglect Procedure.
In some cases, the support required by an adult with care and support needs may fall outside of the remit or experience of those commissioning the services.
In these cases, it’s important that commissioning staff seek the direct involvement of relevant specialist professionals when making decisions.
Our reviews have told us that, when specialist services are being commissioned, there needs to be direct involvement in the process from relevant specialist clinicians.
This is likely to involve liaising with health services, such as Speech and Language, Occupational Therapy, or Tissue Viability teams, for example.
When care and support is arranged and managed by the local authority or a provider such as Continuing Healthcare, there are processes in place for the oversight of that care.
When adults with care and support needs receive funding to arrange their own care and support, though, there can be limited oversight of the quality and safety of that care.
We’ve learned from our reviews that there is a risk involved in the limited oversight associated with self-directed support, such as care provided by Personal Assistants through direct payments.
It’s therefore important for local authorities to consider how they will retain a level of oversight of care and support provided to people in receipt of direct payments. This should include seeking assurance that the adults in receipt of care understand how, and have the opportunity, to report quality issues, abuse, and neglect. It’s critical that these opportunities include the opportunity to speak with adults alone to help mitigate against disguised compliance, coercion, and control.
The Mental Capacity Act 2005 Code of Practice provides guidance to anyone who is working with adults who may lack capacity to make decisions, and particularly decisions about their care and treatment.
Mental capacity is defined as the ability to make a specific decision, at the time that the decision needs to be made. This can include ‘daily life’ decisions, such as what to wear, or daily routines, or more ‘complex’ decisions which have more significant consequences. This could include decisions around medical treatments, move to a care home placement, or planning a will.
We know from our reviews that staff across the partnership require a better understanding of the Mental Capacity Act and its implementation in their practice.
If you are not already confident in your understanding of the Mental Capacity Act, and how it is relevant to your practice, you should take steps to address this. Visit our Mental Capacity Act learning resources.
If you have concerns about an adult safeguarding decision made by another practitioner or agency, it is your responsibility to ensure that you escalate your concerns to reach a resolution.
You should:
We know from our reviews that our Escalation and Resolution Policy is underused, which could potentially lead to unnecessary delays in accessing support for the adults we work with.
It is key that all staff should feel able to respectfully challenge decision-making and to see this as their right and responsibility in promoting best practice. The Sussex Safeguarding Adults Escalation and Resolution Protocol provides staff with the means to raise concerns that they may have about decisions made by other staff or agencies.
If you would like to explore any of these themes in more depth, you can refer to our learning resources:
