Consider discussing a potential referral with a trusted colleague, safeguarding lead or member of the local Clinical Commissioning Group (CCG) safeguarding adults team. Before making a safeguarding referral ensure the patient fits the statutory criteria for an adult at risk (as defined in the introduction) and assess their mental capacity to consent to the referral5 (Box 2). If a patient lacks capacity to make a decision about a safeguarding referral, it is acceptable to refer them in their ‘best interests’.
Box 2. Defining and assessing mental capacity, as described in The Mental Capacity Act 20055
‘… a person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain.’
‘A person is unable to make a decision if they cannot:
understand information about the decision to be made
retain that information in their mind
use or weigh that information as part of the decision-making process, or
communicate their decision (by talking, using sign language or any other means).’
Once a decision is made to make a safeguarding adults referral, make as comprehensive a referral as possible, as per local referral procedure (Figure 1). Carefully outline the alleged abuse. Include details about friends, family, or advocacy (who may be able to assist the adult) and any communication difficulties the adult may have. Indicate any concerns about the adult’s capacity to understand the safeguarding process.
