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Adult safeguarding 

Find out more about adult safeguarding, including what to do if you are worried about someone you care about.

The Care Act 2014 defines safeguarding as 'protecting an adult’s right to live in safety, free from abuse and neglect'.

Cambridgeshire and Peterborough ICB’s role in safeguarding adults:

NHS Cambridgeshire and Peterborough Integrated Care Board (ICB) works with health service providers and a range of other local partner organisations in the county to ensure that all adults are protected. We are responsible for ensuring all the services we commission are safe and effective. We ensure that safeguarding is everyone’s business by working closely with many different people and organisations across Cambridgeshire and Peterborough.

Adult safeguarding duties apply to an adult who:

  • Has needs for care and support (whether or not the local authority is meeting any of those needs)
  • Is experiencing, or at risk of abuse and/or neglect.
  • As a result of their care and support needs, is unable to protect themselves from the risk or experience of abuse and/or neglect.

What to do if you are concerned about an adult

If you have a concern about an adult and wish to make a safeguarding referral, you will need to use the relevant online safeguarding referral form.

Click here if you are a member of the public wishing to make a safeguarding referral.

Click here if you are a professional wishing to make a safeguarding referral. 

If you think a child or an adult with care and support needs is in immediate danger, phone 999.

There are six key principles of adult safeguarding work:

  1. Empowerment – People being supported and encouraged to make their own decisions and informed consent.
  2. Prevention – It is better to take action before harm occurs.
  3. Proportionality – The least intrusive response appropriate to the risk presented.
  4. Protection – Support and representation for those in greatest need.
  5. Partnership – Local solutions through services working with their communities. Communities have apart to play in preventing, detecting, and reporting neglect and abuse.
  6. Accountability – Accountability and transparency in delivering safeguarding.

Emotional/psychological abuse

Emotional abuse, also referred to as psychological abuse, is the attempt to scare, control or isolate an individual by intimidation or fear.

It may involve:

  • deliberately telling an individual that they are worthless.
  • not giving someone the opportunity to express their views, deliberately silencing them or ‘making fun’ of what they say.
  • bullying, coercive and controlling behaviour or blackmail.

Just because there is no physical mark that does not mean the abuse is not real. Emotional abuse can have short-term and long-lasting effects that are just as serious as the effects of physical abuse.

Financial/material abuse

Financial abuse can involve theft, fraud, scamming and exploitation. It can also be when a person is coerced into certain financial affairs or arrangements, including pressure in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions, or benefits. Blackmail is a type of abuse that can be used for financial gain and may involve using threats of physical, mental, or emotional harm, or of criminal prosecution, against a victim or someone close to them. You, or someone you know, may be being financially abused if you spot any of these indicators:

  • Substantial increase in account activity, particularly when a joint bank account has recently been established or someone is now assisting the individual with their finances.
  • Person with a disability is accompanied by family, staff or others who appear to coax, or otherwise pressure, the individual into making transactions.
  • Individual is confused about missing funds in accounts.
  • Rent arrears and eviction notices.
  • A lack of clear financial accounts held by a care home or service.
  • Failure to provide receipts for shopping or other financial transactions conducted on behalf of the person.
  • Disparity between the person’s living conditions and their financial resources, e.g. insufficient food in the house.
  • Unnecessary property repairs


This is the main form of abuse reported to the Office of the Public Guardian – there is more information available on this website.

Modern slavery and human trafficking

  • Human trafficking
  • Forced labour.
  • Domestic servitude
  • Sexual exploitation, such as escort work, prostitution, and pornography
  • Debt bondage – being forced to work to pay off debts that realistically they never will be able to

GOV.UK has more information on identifying and reporting modern slavery


Human Trafficking

Human trafficking is a form of modern slavery. It is a criminal act that involves the movement of persons with the intent to exploit them. Trafficking can occur within the same street, within the UK, across county boarders, and also internationally. People are victims of human trafficking if they have been moved for the purposes of exploitation, even if this exploitation is yet to take place.

People can be trafficked for many different forms of exploitation such as forced prostitution, forced labour, forced begging, forced criminality, forced marriage, domestic servitude and forced organ removal.

Traffickers and ‘slave masters’ use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment.

Common signs that someone is being exploited include those listed below. Please note that this is not an exhaustive list and that warning signs will show themselves differently in each person. It is important to explore all concerns over someone’s behaviour and personal circumstances and to consider whether these could be signs of exploitation.

  • lacking personal items and identity documents – these may be in the possession of another person
  • fearful or withdrawn behaviour, or efforts made to disguise this
  • having their communication controlled by another person – may act as though they are instructed by or dependent on someone else
  • tattoos or other marks indicating ownership
  • physical or psychological abuse, ill health, exhaustion or injury – may look unkempt and malnourished.
  • working and living in the same location or building
  • dirty, cramped, unhygienic or overcrowded accommodation, including shared houses, caravans, sheds, tents and outbuildings
  • working in a job different to that specified at the time of recruitment.
  • reluctance or inability to provide details about their personal circumstances – such as work or accommodation addresses

Discriminatory abuse

  • Unequal treatment based on age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex or sexual orientation (known as ‘protected characteristics’ under the Equality Act 2010 )
  • Verbal abuse, derogatory remarks or inappropriate use of language related to a protected characteristic.
  • Denying access to communication aids, not allowing access to an interpreter, signer, or lip-reader
  • Harassment or deliberate exclusion on the grounds of a protected characteristic
  • Denying basic rights to healthcare, education, employment, and criminal justice relating to a protected characteristic
  • Substandard service provision relating to a protected characteristic.

Institutional/organisational abuse

Organisational abuse is the inability to provide a good level of care to an individual or group of people in a care setting such as a hospital or care home, or in a person’s own home if they receive care assistance there. It may be a one-off incident, repeated incidents, or on-going ill-treatment. It could be due to neglect or poor care because of the arrangements, processes, and practices in an organisation. This could include:

  • a lack of dignity or respect in a care setting
  • rigid routines or processes organised to meet staff needs rather than the individuals.
  • disrespectful attitudes towards individuals receiving care.
  • a culture of abusive behaviour or tolerance of abusive behaviour
  • repeated failure to prevent abuse, or neglect within a service, including incorrect use of restraint, isolation, or unauthorised deprivations of liberty.


These may include:

  • treating adults like children
  • strict, regimented, or inflexible routines or schedules for daily activities such as mealtimes, bed / awakening times, bathing / washing, going to the toilet.
  • withholding or refusing necessary medication
  • Quality of Care


Safeguarding is not a substitute for:

  • provider’s responsibilities to provide safe and high-quality care and support.
  • commissioners regularly assuring themselves of the safety and effectiveness of commissioned services.
  • the Care Quality Commission (CQC) ensuring that regulated providers comply with the fundamental standards of care or by taking enforcement action.
  • the core duties of the police to prevent and detect crime and protect life and property.

Neglect and acts of omission

Neglect is the ongoing failure to meet an individual’s basic and essential needs, either deliberately, or by failing to understand these.

It includes ignoring a person’s needs, or withholding essentials to meet needs, such as medication, food, water, shelter, and warmth. This can include acts like not getting enough to eat or ignoring an individual’s medical or physical care needs.

Everyone has the right to access the necessities of life, such as food, shelter, clothing, heating, stimulation, and activity.

Possible indicators of neglect:

  • poor environment – dirty or unhygienic
  • poor physical condition and/or personal hygiene
  • pressure sores or ulcers (Department of Health pressure ulcer guidance for professionals)
  • malnutrition or unexplained weight loss
  • untreated injuries and medical problems
  • inconsistent or reluctant contact with medical and social care organisations
  • accumulation of untaken medication
  • uncharacteristic failure to engage in social interaction.
  • inappropriate or inadequate clothing

Self neglect/hoarding

  • lack of self-care to an extent that it threatens personal health and safety.
  • neglecting to care for one’s personal hygiene, health, or surroundings.
  • inability to avoid harm as a result of self-neglect.
  • failure to seek help or access services to meet health and social care needs.
  • inability or unwillingness to manage one’s personal affairs.


Chronic self-neglect and/or hoarding is likely to have developed over many years, and it may be considered a safeguarding concern at the point:

  • where the person with care and support needs can no longer control their behaviour, so they cannot protect themselves.
  • where there is a defined high risk of harm to the individual.
  • or the physical / environmental risk to others is significant.


More information can be found at: Self-neglect: At a glance | SCIE

Honour based abuse/violence

Honour Based Abuse is a term used by many cultures for justification of abuse and violence. In most honour-based abuse cases there are multiple perpetrators from the immediate family, sometimes the extended family and occasionally the community at large. It is a crime or incident committed in order to protect or defend the family or community ‘honour’.

Honour based abuse will often go hand in hand with forced marriages, although this is not always the case. Honour crimes and forced marriages are already covered by the law, and can involved a range of criminal offences.

Honour Based Abuse is often the collective term used to include Female genital Mutilation and Forced Marriage.

Forced Marriage

A forced marriage is one that is carried out without the consent of both people. This is very different to an arranged marriage, which both people will have agreed to. There is no religion that says it is right to force you into a marriage and you are not betraying your faith by refusing such a marriage​

The legal age of marriage and civil partnerships has been raised to 18 years​ in England & Wales.  ​

Forced marriage is illegal in England and Wales since 2014. ​

This includes:​

  • Taking someone overseas to force them to marry (whether or not the  ​

      forced marriage takes place).​

  • Marrying someone who lacks the mental capacity to consent to the marriage​

     (whether they are pressured to or not).​

Female Genital Mutilation

  • FGM is recognised internationally as a violation of the human rights of girls and women.​
  • FGM involves the partial or total removal of external female genitalia or other injury to the genitalia for non-medical reasons.​
  • The practice has no health benefits and is illegal. 
  • FGM can cause severe bleeding, problems urinating, infection, cysts, complications in childbirth, emotional trauma, and increased risk of Newborn deaths.​
  • More than 2000 million girls and women alive today have been subjected to FGM in 30 countries.​
  • FGM is usually carried out on children from infancy to the age of 15 years.    

Contact NHS Cambridgeshire and Peterborough safeguarding team

Single point of contact:

Emails of a confidential nature, or those containing patient information should be sent from a secure account such as Please note that the ICB do not accept or process safeguarding referrals. If a referral is required for an adult safeguarding concern, the referral should be made to the local authority for the area in which the abuse occurred.