Q:    What happens when I have a safeguarding concern about an adult and I ring 0344 800 8020??

A:     This telephone number puts you through to Norfolk County Council’s (NCC) Customer Services. Tell the call handler you wish to raise a ‘safeguarding adults concern’.

If the person you are concerned about has an active social care worker, the call hander will put you straight through to them, or their duty team. In all other cases you will be put through to the Social Care Community Engagement (SCCE) team. 

The relevant team member will record the details of your concern, but at this stage it is not necessarily ‘a referral’. Please use the 'raising a concern checklist' to make sure you give as much information as possible.

The worker will discuss your concern with their manager, or a Safeguarding Adult Practice Consultant (SAPC) to determine if it meets the criteria for a safeguarding enquiry (Section 42). SAPCs will always be consulted within working hours if it appears that abuse / harm has occurred. 

Some safeguarding concerns are really about risk in a situation, which may not be abusive, but rather a result of choices made by individuals, or complicated relationships. Other concerns may be about the quality of a service being provided. 

If your concern meets the criteria for a s42 enquiry NCC will inform you as soon as possible. 

Please note: depending on your relationship to the situation / individual, you may not get direct feedback on the outcome of the safeguarding enquiry.

Q: When I call this number, if my concern is not urgent I am being asked to raise it through the online portal - why is this?

A: Each year the number of safeguarding calls to NCC increases, and many of these will not progress to a safeguarding enquiry, for example because the concern may relate to general safety, risk or quality issues. Using the online portal helps NCC triage and manage the volume more effectively to get the information where it needs to be more quickly.

Where the concern needs immediate action (outside of emergency services) or if you need to update / share more on a concern already raised you can still ask to speak to someone.

Always call 999 if there is immediate threat of harm or to life.

Q:    Who can raise a concern?

A:     Anyone can raise a concern about an adult at risk of abuse or harm, whether you are a professional or member of the public.

Q:    When I ring 0344 800 8020 to report a safeguarding adult concern am I speaking to the Multi Agency Safeguarding Hub (MASH)?

 A:     No. When you call 0344 800 8020 this is the main number for Norfolk County Council (NCC) and the call will be answered by a Customer Service agent first. They will find out what your call is about. TIP: tell the call handler you wish to raise a ‘safeguarding adults concern’ – use these words.

Q:    Can I remain anonymous?

A:     Anyone bringing a concern to Adult Social Care (ASC) at Norfolk County Council (NCC) can ask for their details to be kept confidential or choose not to share those details with NCC in the first place. However, anonymity can sometimes make it difficult for the safeguarding team to progress the enquiry, particularly if your information is quite generalised. 

If the concern that you share is serious, NCC will need to explore it with the individual or service involved. It is possible that you may be identified as the source as a result. Also if you haven’t given your name a worker from ASC will not be able to give you feedback because they have no means of contacting you.

Q:    I am worried about raising a safeguarding concern about my service, will it reflect badly on the care we provide? 

A:     On the contrary, by ringing in a safeguarding concern within your service you are demonstrating good and transparent practice and protecting those who use your service. It is more harmful to your service’s reputation not to report.

Q:    What do I do next? 

A:     Once you have confirmation that a safeguarding enquiry (section 42 enquiry) has been raised, there may be a slight delay if Adult Social Care need to discuss your enquiry with police colleagues. If the police decide to investigate this should happen before anyone else does any other enquiry. In the meantime, make sure the person you are concerned about, or anyone else at risk, is as safe as possible. The Adult Social Care worker will inform you of the next steps, where appropriate.

Q:    What can I do if my concern isn’t accepted as I am still worried about the person? 

A:     If the situation continues to cause you concern, the risk remains or increases, please call again and ask for the concern to be reviewed. It is helpful if you can provide as much detail and additional information as possible. Remember that safeguarding is only one avenue of support, so even if it is not a safeguarding enquiry, agencies can often help in other ways.

Q:    Will I find out what has happened once I have raised my concern? Will I get feedback? 

A:     If the concern that you bring to NCC’s attention is raised as a safeguarding enquiry, then the worker should inform you that this is happening – but please be aware that, depending on your relationship to the situation / individual, you may not get direct feedback on the outcome of the safeguarding enquiry.

For example, if the person you have called about has mental capacity (i.e. the ability to make decisions for themselves), they may not want the outcome shared with you.

If the concern you raised is not going to be a safeguarding enquiry, the worker should inform you. This does not necessarily mean that no action at all will be taken (although sometimes this might be the case) and they should advise you about what will happen next. 

If you haven’t received feedback on a concern you have raised, do call back to check, but please be aware that NCC’s information sharing policy may limit what you can be told.

If you are a health professional (for example a nurse or therapist working in an area where there are numerous professionals responding to calls and queries), please check with colleagues or make local arrangements for sharing feedback you have received on safeguarding concerns. Feedback may be recorded, for example, in ward notes. NCC relies on the person who receives the feedback to share it with those colleagues who need to know the outcome.

Q:    I think someone is not looking after themselves properly – is this safeguarding?

A:     Self-neglect is a category of abuse in the Care Act guidance, but it will rarely require an enquiry under s42. However, NSAB promote a multi-agency approach to be taken by all those working with people where there are concerns of this type. Partners need to consider any risks to the individual, and what support to be given. NSAB have a self-neglect and hoarding strategy and more information can be found on the website here Self-neglect and Hoarding | Norfolk Safeguarding Adults Board.

Self-neglect is a subjective term and can occur in a range of situations. People may be acutely unwell or have experienced specific difficulties or losses; things that are usual to them may not be usual to someone else, but that may not make it wrong. Where there are environmental or concerns about the person’s health / wellbeing, we would not necessarily consider this a safeguarding issue – we would expect that all possible steps are taken to work with that person to properly identify what risks there may be, how the person feels about those risks, and what support may be available. This should involve all appropriate agencies (social care, health, housing, fire service, local community etc).

In situations where, despite a multi-agency / long-term approach, the risks to the person remain and indicate a high risk of harm, concerns may be raised to NCC and a s42 enquiry started. NB: this does not give any additional powers to the agencies involved but provides a further forum in which to review the risks and take actions if necessary.

Q:    As a professional do I need to inform the Care Quality Commission (CQC) that I have raised a safeguarding concern (providers)?

 A:     CQC will expect you as a service provider to tell them when you raised a concern with NCC, once we have confirmed that it will be raised as a s42 enquiry. 

For more information on what may or may not constitute a safeguarding concern in relation to falls, medication errors, incidents between adults and pressure care, please refer to our NSAB concise concerns framework and / or the longer guidance on our 'guidance' page. 

Make sure you check with the person you are in contact with at NCC so you are clear if the issue will be taken forward under the safeguarding process. This should include the Integrated Quality Team.

Q:    What if the person who is being abused will not consent to a concern being raised? 

A:     Individuals may refuse consent to the sharing of safeguarding information for several reasons. For example, they may be frightened of reprisals, they may fear losing control, they might not trust social services or other partners, or they may fear that their relationship with the abuser will be damaged. 

Reassurance and appropriate support along with gentle persuasion can help to change their view on whether it is best to share information.

If a person refuses help or requests that information about them is not shared with other safeguarding partners, you should respect their wishes. However, there are a number of circumstances where you can reasonably override their wishes:

• Where the person lacks the mental capacity to make that decision – this must be properly explored and recorded in line with the Mental Capacity Act
• Where other people are, or may be, at risk, including children
• Where sharing the information could prevent a crime
• Where the alleged abuser has care and support needs and may also be at risk
• If a serious crime has been committed
• If staff are implicated
• Where the person has the mental capacity to make that decision, but they may be under duress or being coerced
• Where the risk is unreasonably high and meets the criteria for a Multi-agency Risk Assessment Conference (MARAC) referral
• If a court order or other legal authority has requested the information.

If none of the above apply and the decision is not to share safeguarding information with other safeguarding partners, or not to intervene to safeguard the person you must still work to:

• support the person to weigh up the risks and benefits of different options
• ensure they are aware of the level of risk and possible outcomes
• offer to arrange an advocate or peer supporter
• offer support for them to build confidence and self-esteem if necessary
• agree on and record the level of risk the person is taking
• record the reasons for not intervening or sharing information
• regularly review the situation
• try to build trust and use gentle persuasion to enable the person to better protect themselves.

As long as it does not increase the risk to the individual, always tell the person of your concerns. Explain why you are worried and that there are services to support them in stopping the abuse and harm from happening. If they still do not want their information to be shared, explain that it is your responsibility to share safeguarding concerns in line with your organisation’s policy, usually with your line manager or safeguarding lead in the first instance, except in emergency situations. 

If you have a safeguarding concern about someone who is using your service, you should always tell your line manager. Your manager will decide whether to share this information with external agencies, including the police and local authority. 

If it is necessary to share information outside the organisation:

• explore the reasons for the person’s objections – what are they worried about?
• explain the concern and why you think it is important to share the information
• tell the person who you would like to share the information with and why
• explain the benefits, to them or others, of sharing information – could they access better help and support?
• discuss the consequences of not sharing the information – could someone come to harm?
• reassure them that the information will not be shared with anyone who does not need to know
• reassure them that they are not alone, and that support is available to them.

If you cannot persuade the person to give their consent, then, unless you consider it dangerous to do so, explain to them that the information will be shared without their consent and your reasons and record them. The safeguarding principle of proportionality should underpin decisions about sharing information without consent, and decisions should be made on a case-by-case basis.

If it is not clear that information should be shared outside the organisation, discuss it with safeguarding partners in the police or local authority without disclosing the identity of the person in the first instance. They can then advise on whether full disclosure is necessary without the consent of the person concerned.

It is very important that you consider the risk of sharing information. In some cases, such as domestic violence or hate crime, it is possible that sharing information could increase the risk to the individual. Safeguarding partners need to work jointly to provide advice, support and protection to the individual in order to minimise the risk of worsening the relationship or triggering retribution from the abuser.