Incidents between adults in a service

Incidents between adults in a service can include any interaction involving two or more adults in any setting, involving physical, psychological/emotional, sexual, financial, or discriminatory abuse or behaviour, which results in the risk of abuse or neglect, or actual abuse or neglect.

Not all incidents between adults in a service will require a safeguarding concern to be raised. Agencies must use their own internal incident policy and processes and ensure that all incidents are reported using the appropriate procedures. What is important is for each incident to be considered according to the individual circumstances of the situation, and a professional judgement reached.

A degree of conflict on occasions is to be expected in all relationships. This applies equally to environments where people with care and support needs live together or spend long periods of time together. There may be times when the actions of one adult in a service towards another goes beyond usual conflict and their behaviour is abusive, causing an impact.

Preventing incidents between adults in a service from occurring wherever possible is always the preferred approach. Those in receipt of services should expect to be supported or cared for in a safe environment. Abuse by other adults in the service who also have care and support needs themselves is just as impactful as any other form of abuse. Provider services should ensure that interventions and support arrangements are in place to minimise the risk of abuse between adults using their service.

Where there are systemic failings in a provider’s management processes which lead to repeated incidents between adults in that service, consideration should be given as to whether a safeguarding enquiry into organisational abuse is warranted. There is an obligation on all services involved to identify such failings and ensure that safeguarding concerns are raised where necessary, and that issues are addressed.

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Having robust and comprehensive pre-admission assessment arrangements to establish an individual’s previous and current needs. This should include consideration to building and maintaining relationships with others, vulnerability, and any behaviour which may challenge, including bullying.
Considering the potential impact, where appropriate, on existing adults in the service prior to the placement or person starting to use the service and keeping the compatibility of all adults in that service under review.
The inclusion of anti-bullying, issues of inappropriate interactions between adults in the service and between staff and adults, being included in relevant policies and procedures.
Promoting a positive culture of mutual respect where individual rights and responsibilities are discussed with adults in the service, and the Mental Capacity Act principles of least restrictive practice are followed and confirmed in the service’s documentation.
Understanding how to support adults who are involved in incidents through the assessment of needs and risk, and mitigating the risks to both, and linking them in with appropriate support services.
Care and support plans directing staff on how to promote the safety of adults in their service.
Having measures in place to positively support those with known behavioural difficulties.
Ensuring that staff have appropriate training and know who to identify, record and review incidents involving adults in the service.
Ensuring that staff numbers are sufficient to meet the needs of the adults in the service.
Following the agency’s notification procedures including, where appropriate, informing the adults’ families or nominated representatives.
Ensuring that measures are in place to secure the safety of people within or visiting the service.

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When an incident occurs between adults in a service, the details should be recorded to identify any potential patterns. The information as a minimum should record the incident date and time, the adults involved, members of staff on duty, and the circumstances immediately prior to the incident and any other relevant information.
Reviews of risk assessments and care plans should always be undertaken following each incident.
Senior managers should review post incident information on a regular basis to determine whether certain adults are regularly involved, either as the victim or the person who is the cause of risk, and the staff on duty at the time. Reviews should consider lessons learnt, whether the incident could have been prevented, and the need for changes to avoid similar incidents recurring. The post incident findings may also trigger the need for further review and updating of risk assessments and/or a safeguarding concern being raised.

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Non-reportable concerns

Lower-level concern where the criteria for a safeguarding enquiry is unlikely to be met. However, an internal written record of what happened and what action was taken should be kept. Where there are several low-level concerns, consideration should be given as to whether the criteria may be met for a safeguarding enquiry due to increased risk.

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

Review of relevant policies and procedures.
Internal relevant training provided.
Review of existing care plans or creation of new care plans/risk assessments.
Complaints or disciplinary processes.

Examples of non-reportable concerns include:

Incidents between people using a service where there is no apparent impact, and actions are undertaken to minimise the risk of reoccurrence.
More than one incident where there is no apparent impact, and:
- A care plan and/or risk assessment is in place and is being adhered to.
- Action is taken to minimise further risk.
- Other relevant professionals have been notified.
- There has been full discussion with the person, their next-of-kin, or their representative.
- No other indicators of abuse or neglect.

Concerns requiring consultation

Incidents at this level should be recorded, and internal policies and procedures followed. Consultation should be undertaken internally as well as through the Sussex Safeguarding Adults Policy and Procedures. Action should be taken to reduce risk and consultation with the local authority Adult Social Care department considered. Following this you may be requested to formally raise a safeguarding concern.

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

Share information with the ICB Quality Team and/or the CQC.
Discussion with Health/Social Care Commissioners.
DATIX, Serious Incident or alternative review or investigative process.

Examples of concerns requiring consultation include:

Any incident between people using a service in which medical attention or attendance at hospital is required.
Multiple incidents where the person lacks capacity and is unable to take action to protect themselves.
There have been other similar incidents involving the same perpetrator.
Concerns over escalation of behaviours between identified individuals.
The care plan has not been implemented.
It is not clear that professional advice or support has been sought at the appropriate time.
There have been other similar incidents involving the perpetrator or areas of concern.
Repeat use of discriminatory language between people using a service.

Reportable concerns

Incidents at this level should 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. Ensure 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.

Examples of reportable concerns include:

Any incident resulting in intentional or intended harm or risk of harm to the person, including hate crimes.
Any incident where a weapon or other object is used with the intention to cause injury.
Repeated incidents where the person lacks capacity and is unable to protect themselves.
The victim is, or appears, fearful in the presence of the other person or is adapting their behaviour to pacify or avoid the other person.

Last updated: 01 July 2026

Incidents between adults in a service

Non-reportable concerns

Concerns requiring consultation

Reportable concerns

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