This chapter provides information for multi-agency practitioners about carers of adults with care and support needs in relation to adult safeguarding. Specifically, it outlines their role in preventing and detecting abuse or neglect of those for whom they care, but it also discusses potential harm that may be caused by carers. Multi-agency practitioners need to be aware of such possible risks to adults with care and support needs.
A carer, in this context, is usually a family member or a friend.
Carers can play a significant role in preventing and detecting abuse and neglect for the people they care for. The vast majority of carers strive to act in the best interests of the person they support. There are times, however, when carers themselves experience abuse from the person to whom they are offering care and support or from the local community in which they live.
Risk of harm to the supported person may also arise because of carer stress, tiredness, or lack of information, skills or support (see Carers: Preventing, Delaying or Reducing Needs). Also, there are times where harm is intended.
Circumstances in which a carer could be involved in a situation that may require a safeguarding response from agencies include:
- a carer may witness or speak up about abuse or neglect in relation to the adult they care for, or another person;
- a carer may experience intentional or unintentional harm from the adult they are trying to support, or from professionals and organisations they are in contact with;
- a carer may harm or neglect the adult they support on their own or with others. This may, or may not, be deliberate.
All staff and professionals should support a rights based approach to issues of abuse and neglect and to the recognition and support of carers.
Assessment of both the carer and the adult they care for must include considering the wellbeing of both people. The Care Act includes protection from abuse and neglect as part of the definition of wellbeing (see Promoting Wellbeing). As such, a needs assessment for the adult or a carer’s assessment is an important opportunity to explore the individuals’ circumstances and consider whether it would be possible to provide information or support that prevents abuse or neglect from occurring. This may be for example, by providing training to the carer about the condition that the adult they care for has, or to support them to care more safely. Where that is necessary the local authority should make arrangements for providing such interventions.
3. Safeguarding Enquiries
If a carer raises any issues about abuse or neglect, it is essential that they are listened to and that, where appropriate, a safeguarding enquiry is undertaken and other agencies are involved as required.
If a carer experiences intentional or unintentional harm from the adult they are supporting, or if a carer unintentionally or intentionally harms or neglects the adult they support, consideration should be given to:
- removing or reducing risk – whether, as part of the assessment and support planning process for the carer and / or the adult they care for, support can be provided that removes or reduces the risk of abuse. This may include, for example, the provision of training, information or other support that minimises the stress experienced by the carer. In some circumstances the carer may need to have independent representation or advocacy (see Independent Advocacy); in others, a carer may benefit from having such support if they are under great stress;
- involving other agencies – whether other agencies should be involved: in some circumstances where it is possible a criminal offence has been committed this will include alerting the police, or in others the primary healthcare services may need to be involved in monitoring the situation.
Other key considerations for carers should include:
- involving carers in safeguarding enquiries relating to the adult they care for, as appropriate;
- whether or not a joint assessment of the adult and the is appropriate in each individual circumstance;
- the risk factors that may increase the likelihood of abuse or neglect occurring;
- whether a change in circumstance changes the risk of abuse or neglect occurring.
A change in circumstance should also trigger the review of the care and support plan and, or, support plan (see Care and Support Planning). Further information about these considerations can be found in Carers and Safeguarding: Working Together to Improve Outcomes (ADASS, 2011).