Physical abuse

The act of causing physical injury to someone else. Incidents relating to falls, pressure damage and medication concerns, and incidents between adults in a service are addressed separately within this guidance document.

Non-reportable concerns

Examples of isolated incidents where no other similar concerns have been identified and that do not need to be reported as a safeguarding concern include:

• Error by staff causing no or minor injury (e.g., an ill-fitting hoist is used).
• Light marking or bruising found which can be explained and where the person is not distressed.
• Appropriate moving and handling procedures not followed on a single occasion and with minimal or no impact caused.

Concerns requiring consultation

More serious incidents will require internal consultation, through relevant organisational policies and procedures and senior leadership as well as potentially through the Sussex Safeguarding Adults Policy and Procedures and other organisations being made aware.

Actions that should be considered to reduce risk include:

• Share information with the ICB Quality Team and/or the CQC.
• Referral to local authority Adult Social Care department for a social care assessment, carers assessment, or review of existing arrangements.
• Review staffing arrangements.
• Complete internal reporting system to ensure the details of the incident is recorded appropriately.

Examples that require external consultation with the relevant Adult Social Care department, and may lead to a safeguarding referral needing to be submitted, include:

Examples of concerns requiring consultation include:

• Unexplained marking, bruising, lesions, minor cuts, or grip marks on several occasions or on several people cared for by the same team or carer.
• Repeated incidents/patterns of similar physical injuries.
• Carer unable to continue in caring role and at risk of breakdown.
• Rough or inappropriate handling or restraint that causes marks to be left but no external medical treatment/consultation required.
• Risk cannot be managed appropriately with current professional oversight.
• Intentional or non-intentional injury or deprivation of liberty by formal or informal carers.

Reportable concerns

Serious incidents need to be formally raised as a safeguarding concern with the local authority Adult Social Care department. Consideration should also be given as to whether the police or other emergency services need to be contacted. Professional curiosity is important and a Think Family approach if children or other adults may be impacted.

In these cases, it is important that you consider additional actions to contacting the local authority. These include:

• RAISE SAFEGUARDING CONCERN
• If there is an indication a criminal act has occurred, the police must be consulted.
• Immediate safety plans must be implemented.
• Initiate agency policies in managing staff if the person is a Person in a Position of Trust.

Examples of reportable concerns include:

• Physical assaults or actions that result in significant injury or ongoing emotional distress caused to the person.
• Intended injury towards a person.
• Deliberate withholding of food, drinks, or aids to independence.
• Deliberate force-feeding food or drinks.
• Unexplained fractures/serious injuries.
• Assault by another person requiring medical treatment, including hate or mate crime.
• Rough or inappropriate handling that causes marks to be left and the person appears fearful or distressed; this can include inappropriate use of manual handling equipment.
• Inappropriate restraint techniques that result in injury; this can include deprivation of liberty with no evidence of lawful process.
• Unexplained significant injuries such as fractures.
• Any concerns about a Person in a Position of Trust.