Engaging the adult at risk and their family

Effective person-centred practice should involve working together with the adult at risk and where appropriate their carers/family.

When undertaking s.126 Social Services and Well-being Act (Wales) 2014 enquiries, the following should be considered:

• the possibility that the adult thought to be at risk is not making decisions freely;
• the need to involve an advocate ;
• the need to carry out the enquiry sensitively and with the minimum distress to the person and others (for example, carers and family members);
• whether the alleged abuser is providing care or support for another adult at risk or child who may be at risk;
• the mental capacity of the adult at risk to make specific decisions at a particular time.

Pointers for Practice: Promoting Participation Amongst Adults at Risk with and Without Mental Capacity

Making immediate contact with the adult at risk

The adult at risk should be seen the same day if the individual:

• is reported to have sustained a physical injury;
• has disclosed sexual abuse and is to be returned to a situation that might place her/ him at risk;
• is already subject to a protection plan;
• is suffering from severe neglect or other severe health risk;
• is abandoned.

For example, a young woman with physical and mild learning difficulties has begun a relationship with an individual. Her parents are concerned by the expensive gifts she receives from this man and suspect she is being sexually exploited. The Report-taker believes, based on the information provided that the woman may be an adult at risk. They check with the police and police records indicate this man has previous criminal convictions for sexual exploitation and grooming of young women and police become involved to ascertain whether a crime has been committed. The on-going enquiries are therefore undertaken by both social services and the police, and a joint visit is made by police and woman’s social worker.

To avoid undermining any subsequent criminal case, in any contact with an adult at risk prior to a strategy discussion , practitioners should:

• listen to the adult at risk and ask open-ended questions;
• allow the adult at risk to describe any events that are significant to them;
• note the discussion including timing, setting, presence of others as well as what was said.

Pointers for Practice: Contact with An Adult at risk Prior To Police Involvement

If the adult at risk does not want any action taken

Adults with care and support needs may be able to protect themselves from abuse, neglect and [exploitation] by others. Frailty, age or disability, for example, does not automatically preclude an individual from protecting themselves and mental capacity assessments are always situation specific.

Practitioners should always seek to respect the personal wishes and autonomy of the adult. Practitioners should ensure that the person is aware of any risks and the potential impact on their safety and well-being and encourage them to develop strategies to protect themselves. However, a professional judgement is required about the ability of an adult to make an informed choice. Practitioners should consider:

• Does the adult at risk have the mental capacity to make informed decisions about their own safety bearing in mind the particular situation?
• Are they aware of their options?
• Are they making the decision free from pressure or duress from a third party?
• Are there any public interest considerations?
• Have they refused a care and support plan because of pressure or coercion from a third party?

For example, an adult has multiple sclerosis and is dependent on their daily care needs being met by their partner. A duty to report is received from a health professional that the partner is emotionally abusing the adult with multiple sclerosis, who is deemed to be an adult at risk. The adult at risk indicates they want no further action taken against their partner. They explain that they can and do go to their daughter’s when things get ‘bad’.

In this situation, it is important, for practitioners to make an assessment and judgement as to whether the partner is threatening or coercing the adult at risk into requesting no further action. In addition, it is important to establish whether the daughter can protect her parent if necessary. Enquiries indicate that there was no coercion and the daughter is confident she can continue to protect her mother, so no further action is taken.

A record should be kept by practitioners that includes:

• why no action is being taken;
• the findings of any initial screening;
• the protection arrangements offered;
• the work undertaken to understand the reasons for not accepting support.

It is important that the record of the enquiry is accessible and attached to any care and support plan .

In some circumstances, the wishes of the adult at risk may be overridden. The following are examples:

• there is high risk to the health and/or safety of the individual;
• others, including children or other adults, may be at risk;
• a crime is suspected or may have been committed against the adult;
• concerns relate to a failure in care, breach of regulation or professional code of conduct;
• adult social services, health services or another agency is supporting or working with an adult who is directly or indirectly affected by an issue or incident that has caused harm;
• an adult at risk is thought to be the perpetrator of abuse or neglect towards another adult or child at risk;
• coercion.

Pointers for Practice: Working with Resistance from The Adult at risk and Their Carers

Pointers for Practice: Practitioner Responses to Resistance and Aggression

Pointers for Practice: Managing Family Disagreements