Contacts and Practice Resources

Glossary

National Contacts

Using this Procedures Site

Amendments

https://trixcms.trixonline.co.uk/api/content/wynyy-kirklees

Emerging Learning.pdf

emerging learning from safeguarding adult reviews emerging themes from recent safeguarding adult reviews (sars) continue to highlight systemic weaknesses in how legal literacy is understood and applied in practice. while professionals are generally aware of key legislation, there is inconsistency in how statutory duties—such as those set out in the care act, mental capacity act, and safeguarding guidance—are translated into timely and proportionate action. this can result in uncertainty around thresholds, roles, and escalation, and ultimately delays in protecting adults at risk.  emerging learning from all statutory reviews including domestic homicide reviews, child practice reviews and sars information sharing also remains fragmented. reviews show that agencies often hold important pieces of the wider safeguarding picture, but these are not consistently brought together to inform a shared understanding of risk. this can lead to missed opportunities to intervene earlier, particularly where risks are cumulative, complex, or evolving. eﬀective safeguarding relies on professionals being conﬁdent to share relevant information lawfully and proactively, recognising that no single agency sees the full picture.   there is also evidence of insuﬃciently eﬀective multi-agency working. in some cases, partners are working hard within their own roles, but responses remain siloed, with limited coordination or collective ownership of risk. reviews reinforce the importance of coming together—formally and informally—to analyse risk, agree clear plans, and understand who is responsible for what and by when. strong multi-agency working enables a more holistic understanding of the adult’s needs and supports more eﬀective risk assessment and defensible decision-making.   what this means for frontline practice  for practitioners, these themes emphasise the importance of:  applying legal literacy in practice not just knowing the law, but using it to guide decisions—e.g. understanding when section 42 duties apply, how the mental capacity act informs decision-making, and when to escalate concerns.  professional curiosity and critical thinking looking beyond single incidents to understand patterns, history, and context, particularly where there may be self-neglect, coercion, or hidden harm.  proactive information sharing sharing relevant information early and clearly, in line with legal frameworks, to support a fuller understanding of risk across agencies.  clear roles and coordinated action being explicit about who is leading safeguarding activity, what actions are required, and how agencies are working together to reduce risk.  focus on the adult’s lived experience 
ensuring safeguarding activity is person-centred, capturing the voice of the adult, and considering how risks are aﬀecting their day-to-day life and wellbeing.  timely escalation and challenge where risks are not reducing, or plans are not eﬀective, practitioners should feel conﬁdent to escalate concerns, challenge drift, and seek multi-agency review.  collectively, these areas are critical to improving how we identify, support ,assess, and manage risk. strengthening practice in these areas will support earlier, more coordinated, and more eﬀective safeguarding interventions, and ultimately improve outcomes for adults at risk.  further learning, alongside your own available organisation learning oﬀer can be sourced from the kirklees safeguarding adults board online procedures:  welcome and introduction – this is where you can ﬁnd the joint multiagency safeguarding adults policy and procedure. contacts and practice resources – various resources, local multiagency policy and procedures including self-neglect and hoarding.  here you can access short ﬁlms on domestic abuse and financial abuse and various other areas.  section 17 on the contacts and practice resources – holds a wealth of information, learning and resources speciﬁcally around domestic abuse. ksab multiagency learning oﬀer – various training and further learning available.    home - kscp - this site primarily provides safeguarding information for professionals and volunteers in kirklees resources - kscp - the safeguarding children procedures are to be used at all times when there is concern that a child is at risk of harm. procedures must be followed to ensure prompt and eﬀective help to children and their families  you can also speak to your manager.   eﬀective supervision and regular case discussion are critical in strengthening safeguarding practice and addressing the themes identiﬁed in safeguarding adult reviews. supervision provides a structured space for reﬂection, professional curiosity, and critical analysis of risk, enabling practitioners to test their thinking, explore uncertainty, and ensure that legal duties are being applied appropriately. where situations are complex or risks are escalating, early discussion with a manager supports clearer decision-making management oversight and timely escalation, with shared accountability. it also helps to guard against drift, over-optimism, or reliance on single-agency perspectives. practitioners are encouraged to actively bring cases to supervision, seek advice at the earliest opportunity, and use these discussions to challenge, reﬂect, and strengthen multi-agency responses. strong supervision underpins conﬁdent practice, reinforces legal literacy, and supports more eﬀective and proportionate safeguarding interventions.  


Learning from SAR/DHR

Learning Briefing Adult O.pdf

safeguarding adults review led by independent sar reviewer lorna warriner‘adult o’learning from sarbackgroundthe safeguarding adults review (sar) subgroup received a referral for adult o, a female in her 20’s who sadly passed away. adult o had been living at her family home and was cared for primarily by her mother.  adult o had complex health needs from birth, including cerebral palsy , scoliosis , blindness, epilepsy , quadriplegia  and she also had a profound learning disability. the sar subgroup reviewed records from the organisations who had worked with adult o and found that it met the criteria for a review to be conducted.safeguarding concerns•no transitional process from children services to adult services •awareness by some agencies mum had phobia of health professionals / hospital settings /dentists however no action was taken to support.•numerous missed appointments with dentist / hospital paediatric consultants / dietetics/ epilepsy clinic / home visits including gastrostomy tube  and nutritional feeds follow up•concerns around loss of weight when not attending school and poor personal care •epilepsy medication not collected - gp did not identify this for 12 months•adult o not registered to have annual learning disability health checks from the age of 14•occurring pressure sores with no evidence of support / advice to reduce risk provided to mum•mum requesting but then declining day care due costs with no further exploration of this •no safeguarding advice or concerns raised for suspected neglect / acts of omission •no mental capacity assessment or best interest decision completed •lack of multiagency information sharing and working together increased the risk of adult o’s health and social care needs not being metkey learningpartner agencies and local organisations are required to do the following: •review transitional policies and update and amend if required. •make reasonable adjustments to care pathways to ensure people with learning disabilities, autism or both, along with their carers can access highly personalised care and achieve equality of outcomes. •have an up to date and fit for purpose organisational ‘was not brought policy’.•increase their application and understanding around legal literacy to include raising  safeguarding adult concerns and deprivation of liberty safeguards.  •assess mental capacity regarding important life decisions and future care at the age of 16.  at 18 parental responsibility ceases therefore formal legal authority should be considered i.e. court appointed deputy or lasting power of attorney along with a mca and best interest meeting should take place, to make health and welfare decisions. 
good practice•as a child, adult o attended a special education school, which promoted reasonable access to health services and provided an easily accessible environment for them to be seen. •the consultant paediatrician made many attempts to engage professionals in the transition process in 2016 (when adult o was aged eighteen years old).•in august 2018, the gp followed up concerns that mum was not recognising signs of sepsis -  a face-to-face appointment with adult o and her mum was completed providing advice regarding catching and treating infection early, in the event that adult o became unwell. •dietician identified that there was an emerging theme of not being able to see adult o at home and contacted the gp to determine if they had any concerns.•a hospital learning disability matron visited her on the ward and made contact with several agencies to see who adult o was known to. the matron also referred to the community learning disability team •raising a section 42 safeguarding adult concern has been noted as a missed opportunity / learning point – we  would like to acknowledge that a section 42 was raised by a hospital trust due to concerns about her presenting physical condition on admission, sadly she passed a few days later.  kirklees safeguarding adult board response•the ksab commissioned an independent author to carry out the review •all agencies involved with adult o were required to submit a scoping document and chronology that encouraged early individual reflective learning. the chronologies and learning were then combined, and the author, chair and sar panel identified further areas that needed to be explored by all agencies involved.•a practitioner learning event was held which provided an opportunity for the practitioners who were involved with adult o and her family, to collaboratively reflect and identify learning in a safe and transparent space.  •this review was overseen by the kirklees safeguarding adults board (ksab) subgroup.•a combined multiagency action plan was put in place to address all concerns identified*glossary of terms usedwas not brought policy has a safeguarding focus and relates to patients who rely on others to take them to an appointment. safeguarding concern sometime referred to as a section 42 under the care act is the process to refer allegations of abuse and neglect of an adult at risk (someone with care and support needs)the act of neglect and acts of omission can be intentional or unintentional and relates to when a person at risk is reliant on another person to provide care. neglect and acts of omission can include ignoring a person’s medical needs, failure to provide care and support and withholding the necessities of life, such as medicationif you need to raise a safeguarding concern, contact kirklees community health and social care hub – call 0300 304 5555if any agency who was involved wishes to see copy of the report they are requested to contact ksab@kirklees.gov.uk 


Learning briefing Adult O.pdf

safeguarding adults review led by independent sar reviewer lorna warriner‘adult o’learning from sarbackgroundthe safeguarding adults review (sar) subgroup received a referral for adult o, a female in her 20’s who sadly passed away. adult o had been living at her family home and was cared for primarily by her mother.  adult o had complex health needs from birth, including cerebral palsy , scoliosis , blindness, epilepsy , quadriplegia  and she also had a profound learning disability. the sar subgroup reviewed records from the organisations who had worked with adult o and found that it met the criteria for a review to be conducted.safeguarding concerns•no transitional process from children services to adult services •awareness by some agencies mum had phobia of health professionals / hospital settings /dentists however no action was taken to support.•numerous missed appointments with dentist / hospital paediatric consultants / dietetics/ epilepsy clinic / home visits including gastrostomy tube  and nutritional feeds follow up•concerns around loss of weight when not attending school and poor personal care •epilepsy medication not collected - gp did not identify this for 12 months•adult o not registered to have annual learning disability health checks from the age of 14•occurring pressure sores with no evidence of support / advice to reduce risk provided to mum•mum requesting but then declining day care due costs with no further exploration of this •no safeguarding advice or concerns raised for suspected neglect / acts of omission •no mental capacity assessment or best interest decision completed •lack of multiagency information sharing and working together increased the risk of adult o’s health and social care needs not being metkey learning•adult o did not go through a formal transition process from children to adult services, which she should have had in accordance with the national institute for health and care excellence (nice) guideline [ng43] for ‘transition from children’s to adults’ services for young people using health or social care services’ (2016)•both child and adult services, all agencies involved did not have an effective ‘was not brought’ organisational policy, or they were still working under an organisational ‘did not attend policy.’•when adult o turned sixteen this would have been a time for agencies to assess her mental capacity regarding important life decisions and future care.  when adult o turned eighteen, her mum no longer had parental responsibility nor did she have a formal legal authority in the way of being a court appointed deputy  or lasting power of attorney, to make health and welfare decisions – a mca and best interest meeting should have taken place. •no consideration by the agencies that she may have been deprived of her liberty and required a court of protection, deprivation of liberty (copdol11) authorisation.
good practice•as a child, adult o attended a special education school, which promoted reasonable access to health services and provided an easily accessible environment for her to be seen. •the consultant paediatrician made many attempts to engage professionals in the transition process in 2016 (when adult o was aged eighteen years old).•in august 2018, the gp followed up concerns that mum was not recognising signs of sepsis -  a face-to-face appointment with adult o and her mum was completed providing advice regarding catching and treating infection early, in the event that adult o became unwell. •dietician identified that there was an emerging theme of not being able to see adult o at home and contacted the gp to determine if they had any concerns.•mum offered but declined carers assessment – no information provided where to seek support if required •a hospital learning disability matron visited her on the ward and made contact with several agencies to see who adult o was known to. the matron also referred to the community learning disability team •a section 42 safeguarding adult concern raised by hospital trust due to concerns about physical condition kirklees safeguarding adult board response•the ksab commissioned an independent author to carry out the review •all agencies involved with adult o were required to submit a scoping document and chronology that encouraged early individual reflective learning. the chronologies and learning were then combined, and the author, chair and sar panel identified further areas that needed to be explored by all agencies involved.•this review was overseen by the kirklees safeguarding adults board (ksab) subgroup.•a practitioner learning event was held which provided an opportunity for the practitioners who were involved with adult o and her family, to collaboratively reflect and identify learning in a safe and transparent space.  *glossary of terms usedwas not brought policy has a safeguarding focus and relates to patients who rely on others to take them to an appointment. please see further was not brought guidancesafeguarding concern sometime referred to as a section 42 under the care act is the process to refer allegations of abuse and neglect of an adult at risk (someone with care and support needs)the act of neglect and acts of omission can be intentional or unintentional and relates to when a person at risk is reliant on another person to provide care. neglect and acts of omission can include ignoring a person’s medical needs, failure to provide care and support and withholding the necessities of life, such as medicationif you need to raise a safeguarding concern contact kirklees community health and social care hub – call 0300 304 5555 or email gatewaytocare@kirklees.gov.uk if any agency who was involved wishes to see copy of the report they are requested to contact ksab@kirklees.gov.uk 


Video and Online Learning Resources.pdf

video and online learning resources  resource and area duration source mate crime     have we learned the lessons from steven hoskin's murder? 12.27 scie gemma: murdered by friends 29.59 bbc coercive control     walking on eggshells 16.55 womens aid/surrey police self-neglect and hoarding     keith's story: a personal and touching film about hoarding 13.34 birmingham safeguarding adults board self-neglect guidance 10.15 teeswide safeguarding adults board female genital mutilation     fgm: the uk's hidden crime 7.09 euronews modern slavery     break the chain: a short film about modern slavery in the uk 5.15 break the chain forced marriage     awareness of forced marriage-free online course   forced marriage unit nazir afzal part 1: forced marriage and honour killings 16.00 honour based violence awareness network radicalisation     prevent programme training-free online course   home office  


Learning briefing Domestic Abuse.pdf

‘domestic abuse’learning from sar/dhrwhat is domestic abuseunder section 9(4) of the domestic violence, crime and victims act 2004, a domestic homicide review (dhr) is a review of the circumstances in which the death of a person aged 16 or over has, or appears to have, resulted from domestic abuse.the domestic abuse act 2021 defines domestic abuse as behaviour between two people that are personally connected that consists of physical or sexual abuse; violent or threatening behaviour; controlling or coercive behaviour; economic abuse; psychological, emotional or other abuse.  it does not matter whether the behaviour consists of a single incident or a course of conduct. we define people who are ‘personally connected’ as: intimate partners, ex-partners, family members including siblings or individuals who share parental responsibility for a child. there is no requirement for the victim and perpetrator to live in the same household.professional curiosity •professional curiosity is the capacity and communication skill to explore and understand what is happening within a family rather than making assumptions or accepting things at face value.•professional curiosity can require practitioners to think ‘outside the box’, beyond their usual professional role, and consider families’ circumstances holistically.  curious professionals engage with individuals and families through visits, conversations, observations and asking relevant questions to gather historical and current information. •it is important to understand the context of language, if someone advises that a partner/ family member is becoming more aggressive – what do they mean by this, is this physical abuse/ verbal or emotional abuse.  all of which are definitions of domestic abuse, and any interventions need to have this risk in mind and respond appropriately to it.  domestic abuse and dementia / cognitive declineeven in previously healthy relationships, a person living with dementia can begin to use abusive behaviour.  in situations where the perpetrator has dementia, the risk of harm can significantly increase, particularly if the victim-survivor is their primary carer. providing intimate care means close physical contact, making it harder for victim-survivors to keep themselves safe. sometimes signs of domestic abuse are either overlooked, or seen as a one-off incident, rather than a pattern of coercive behaviour. there is also a tendency to treat the abuse as unintentional harm or neglect, thanks to a general assumption that families and partners always act with compassion towards the older person. yet the reality is often far from the idealised picture we have of care and support in later life. when an individual is experiencing cognitive decline there is a risk that domestic abuse may not be suspected because of the vulnerability of the perpetrator. whilst it may feel uncomfortable referring people diagnosed with dementia to agencies stating they are a perpetrator of domestic abuse; it is important to share this information to reduce risks.  multiagency working is key and sharing information to all parties involved is critical in keeping victims safe, this includes domiciliary care providers.  
responding to domestic abuse•domestic abuse is a crime if you're a victim of domestic abuse, or know someone who is, and there's an emergency that's ongoing or life is in danger, call 999 now.•consideration of section 42 duty – if the victim has care and support needs as defined in the care act 2014 and domestic abuse is suspected then a referral should be made to adult social care to raise a safeguarding concern.  a safeguarding response may then be initiated, and a multiagency meeting may be convened where risks should be shared and responded to, it is imperative risks are shared with care providers.  professionals can raise a safeguarding concern to adult social care - report abuse or neglect of an adult at risk | kirklees council•all safeguarding concerns will be considered in line with making safeguarding personal in reaching effective outcomes in line with the person's own wishes.  •unpaid carers require a carers assessment – when working with people consideration should be made as to who is caring for who, and a carers assessment offered.  it may be that both victim and perpetrator care for each other so both should be offered a carers assessment.  •referral to specialist services – the pennine domestic abuse partnership is a registered charity that provides high quality specialist support, advice, information and safe accommodation to anyone effected by or experiencing domestic abuse.•multiagency working is the most effective way to approach the issue at both an operational and strategic level – anyone can call a multi-agency meeting to share concerns about a family.kirklees community partnership board responsewhen someone dies as a result of domestic abuse, a domestic homicide review should be carried out to:•establish what lessons are to be learned from the domestic homicide regarding the way in which local professionals and organisations work individually and together to safeguard victims.•identify clearly what those lessons are both within and between agencies, how and within what timescales they will be acted on, and what is expected to change as a result.•apply these lessons to service responses including changes to policies and procedures as appropriate.•prevent domestic violence homicide and improve service responses for all domestic violence victims and their children through improved intra and inter-agency working.central to a dhr is improving our understanding of domestic abuse and how our services respond to victims and children.  understanding how disclosures and/or other evidence of domestic abuse were recognised and responded to will support us to improve our co-ordinated multi-agency approach so domestic abuse can be identified and responded to effectively at the earliest opportunity.further resourceskirklees council - domestic abusewelcome to pennine domestic abuse partnership – pdapkirklees domestic abuse strategyadvice about domestic abuse | police.uk (www.police.uk)contacts and practice resources (trixonline.co.uk) – section 7hidden harms - domestic abuse in older people – youtubeprofessional curiosity film
